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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]

A novel approach for paper drying using airborne ultrasound technology is presented. A unique experimental setup is developed, and a systematic study is conducted using 23 factorial design of experiments and Analysis of Variance. Three controlling factors are considered in the experiments including the initial moisture content, basis weight and refining condition. The outcome of the experiments is compared to a previous work on direct-contact ultrasonic drying of paper. The results confirm that similar to direct-contact, for airborne ultrasonic drying, the basis weight/thickness of the sample is the most important factor in ultrasonic drying and it is followed by the effect of initial moisture content. Using linear regression model, a correlation for predicting the total time of ultrasonic drying is provided. Quality of the dried samples is evaluated, and the permeability measurements confirmed the effect of pore characteristics on ultrasonic drying. The analysis for energy consumption reveals that airborne ultrasonic drying is more efficient at higher moisture contents. [ABSTRACT FROM AUTHOR]

This study contributes to the diversity literature by probing whether diversity papers are cited as frequently as nondiversity papers in management and industrial/organizational (I/O) psychology journals. Based on the stigma‐by‐association theory, I argue that as a result of their association with minority groups, diversity papers may be devalued and thus "othered" by scholars. Using a citation analysis of 46,930 papers published in 29 peer‐reviewed management and I/O psychology journals, I present empirical evidence in Study 1 that diversity papers were cited significantly less frequently than nondiversity papers. The authors' gender and institutional prestige, journal tier and domain, and year of publication were not moderators. In Study 2, I used a scenario experiment to demonstrate the stigma‐by‐association effect. The authors' gender demonstrated a significant moderating effect in this experiment. [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]

A systematic-study is conducted using an innovative technology for paper drying by applying ultrasound mechanism. The advantages include greater energy efficiency, lower drying time and temperature, improvement of the product quality, and it is considered a green technology. The effects of initial moisture content, thickness, and refining condition are studied for different types of pulps (hardwood and softwood) using 23 factorial design of experiments. Analysis of Variance show that in the range of the studied parameters, thickness has the maximum effect on ultrasonic drying time followed by the initial moisture content. In addition, using a linear regression model, a relationships for the total time of drying is provided. The results confirmed that ultrasonic drying is more efficient at higher moisture content and higher thickness of the sample. These results are related to the structural characteristic of the samples such as porosity, pore distribution, and surface roughness. [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]

This paper outlines an initial analysis of 20 years of data held on an electronic bridge management database for approximately 3500 arch bridges across Northern Ireland (NI) by the Department for Infrastructure. Arch bridges represent the largest group of bridge types, making up nearly 56% of the total bridge stock in NI. This initial analysis aims to identify trends that might help inform maintenance decisions in the future. Consideration of the Bridge Condition Indicator (BCI) average value for the overall arch bridge stock indicates the potential for regional variations in the overall condition and the potential for human bias in inspections. The paper presents the most prevalent structural elements and associated defects recorded in the inspections of arch bridges. This indicated a link to scour and undermining for the worst-conditioned arch bridges. An Analysis of Variance (ANOVA) analysis identified function, number of spans, and deck width as significant factors during the various deterioration stages in a bridge's lifecycle. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to optimize the key parameters (mesh count, paper type and ink type) in screen printing, which are affecting the printed ink volume. The objective of the optimization was to maximize the color reliability by decreasing the color difference (ΔE value) of the prints while minimizing the ink consumption. Screen printing is still dominating the printing industry to make cost-effective production when high volumes are needed. Design/methodology/approach: The experiment was designed using the Taguchi method, and the samples were prepared with screen-printing by using the standard squeegee angle and pressure. The effect of mesh count, ink type and paper type on ink consumption was evaluated with using analysis of variances and main effects plots of S/N ratio and standard deviation. Findings: The factors ink type, paper type and mesh count were found significant for ink consumption due to their Probability (P) values which were lower than 0.05. It was determined that the mesh count was the most critical variable with the analysis of variance. The analysis showed that the selection of an optimum mesh count was the key to controlling the amount of the deposited ink. Although mesh counts were inversely proportional with the ink consumptions, they did not affect the color differences as expected. Originality/value: The optimization of process parameters, that are most effective on the print quality, is necessary to minimize the ink usage and lower the costs and environmental impact without exceeding the desired ΔE value limits. [ABSTRACT FROM AUTHOR]

Evidently, paper-based microfluidic devices, including fuel cells, have been proven to power low-power integrated miniaturized devices. However, the harvested energy depends on various design parameters, positioning and other ancillary factors. Herein, design of experiment is used to make a boisterous study of the data used in paper-based microfluidic fuel cell and to make various optimizations and studies of the raw data used in the microbial fuel cell paper. The paper-based microfluidic fuel cell was analysed for two different positioning, horizontal and vertical, and the maximum power outputs were noted. A statistical technique based on full factorial design was used to study the performance of paper-based microfluidic fuel cell. In the microbial fuel cell, a rigorous study was conducted pertaining to the electrode separation, channel variation and absorbent pad stability. In both these cases, the analysis of mean, analysis of variance, signal-to-noise ratio and desirability study were performed. For the paper-based microfluidic fuel cell, the best desirability values for the horizontal and vertical arrangements were measured to be 0.8842 and 0.92768, respectively. For the microbial fuel cell, in the case of 2 mm electrode separation, the present analysis of variance model came out to be significant. Inclusively, this work provides a pathway to realize optimum paper-based microfluidic fuel cell, and such study can be extrapolated to develop other microfluidic devices. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To develop an automated algorithm to detect, quantify, and differentiate between tremor using pen-on-paper spirals. METHODS: Patients with essential tremor (n = 25), dystonic tremor (n = 25), Parkinson’s disease (n = 25), and healthy volunteers (HV, n = 25) drew free-hand spirals. The algorithm derived the mean deviation (MD) and tremor variability from scanned images. MD and tremor variability were compared with 1) the Bain and Findley scale, 2) the Fahn–Tolosa–Marin tremor rating scale (FTM–TRS), and 3) the peak power and total power of the accelerometer spectra. Inter and intra loop widths were computed to differentiate between the tremor. RESULTS: MD was higher in the tremor group (48.9±26.3) than in HV (26.4±5.3; p < 0.001). The cut-off value of 30.3 had 80.9% sensitivity and 76.0% specificity for the detection of the tremor [area under the curve: 0.83; 95% confidence index (CI): 0.75, 0.91, p < 0.001]. MD correlated with the Bain and Findley ratings (rho = 0.491, p = 0 < 0.001), FTM–TRS part B (rho = 0.260, p = 0.032) and accelerometric measures of postural tremor (total power, rho = 0.366, p < 0.001; peak power, rho = 0.402, p < 0.001). Minimum Detectable Change was 19.9%. Inter loop width distinguished Parkinson’s disease spirals from dystonic tremor (p < 0.001, 95% CI: 54.6, 211.1), essential tremor (p = 0.003, 95% CI: 28.5, 184.9), or HV (p = 0.036, 95% CI: -160.4, -3.9). CONCLUSION: The automated analysis of pen-on-paper spirals generated robust variables to quantify the tremor and putative variables to distinguish them from each other. SIGNIFICANCE: This technique maybe useful for epidemiological surveys and follow-up studies on tremor. [ABSTRACT FROM AUTHOR]

Objective: This paper addresses the Graeco-Latin square design (GLSD) under neutrosophic statistics. In this work, we propose a novel approach for analyzing Graeco-Latin square designs using uncertain observations. Method: This approach involves the determination of a neutrosophic ANOVA and the determination of the neutrosophic hypotheses and decision rule. Results: The performance of the proposed design is evaluated using the numerical examples and simulation study. Conclusion: Based on the results observed, it can be concluded that the GLSD under neutrosophic statistics performs better than the GLSD under classical statistics in the presence of uncertainty. [ABSTRACT FROM AUTHOR]

The growing demand for Location-based Augmented Reality (LAR) experiences has driven the integration of Visual Simultaneous Localization And Mapping (VSLAM) with Google Street View (GSV) to enhance the accuracy. However, the impact of the ambient light intensity on the accuracy and reliability is underexplored, posing significant challenges in outdoor LAR implementations. This paper investigates the impact of light conditions on the accuracy and reliability of the VSLAM/GSV integration approach in outdoor LAR implementations. This study fills a gap in the current literature and offers valuable insights into vision-based approach implementation under different light conditions. Extensive experiments were conducted at five Point of Interest (POI) locations under various light conditions with a total of 100 datasets. Descriptive statistic methods were employed to analyze the data and assess the performance variation. Additionally, the Analysis of Variance (ANOVA) analysis was utilized to assess the impact of different light conditions on the accuracy metric and horizontal tracking time, determining whether there are significant differences in performance across varying levels of light intensity. The experimental results revealed that a significant correlation (p < 0.05 ) exists between the ambient light intensity and the accuracy of the VSLAM/GSV integration approach. Through the confidence interval estimation, the minimum illuminance 434   lx is needed to provide a feasible and consistent accuracy. Variations in visual references, such as wet surfaces in the rainy season, also impact the horizontal tracking time and accuracy. [ABSTRACT FROM AUTHOR]

Background: In recent years, the integration of large language models (LLMs) into healthcare has emerged as a revolutionary approach to enhancing doctor–patient communication, particularly in the management of diseases such as prostate cancer. Methods: Our paper evaluated the effectiveness of three prominent LLMs—ChatGPT (3.5), Gemini (Pro), and Co-Pilot (the free version)—against the official Romanian Patient's Guide on prostate cancer. Employing a randomized and blinded method, our study engaged eight medical professionals to assess the responses of these models based on accuracy, timeliness, comprehensiveness, and user-friendliness. Results: The primary objective was to explore whether LLMs, when operating in Romanian, offer comparable or superior performance to the Patient's Guide, considering their potential to personalize communication and enhance the informational accessibility for patients. Results indicated that LLMs, particularly ChatGPT, generally provided more accurate and user-friendly information compared to the Guide. Conclusions: The findings suggest a significant potential for LLMs to enhance healthcare communication by providing accurate and accessible information. However, variability in performance across different models underscores the need for tailored implementation strategies. We highlight the importance of integrating LLMs with a nuanced understanding of their capabilities and limitations to optimize their use in clinical settings. [ABSTRACT FROM AUTHOR]

Introduction: Digitalization in medicine is steadily increasing. Complex treatments, scarce personnel resources and a high level of documentation are a constant burden on healthcare systems. The balancing between correct manual documentation in the digital records and limited staff resources is rarely successful. The aim of this study is to evaluate the adherence between documentation and lack of documentation in the treatment of critical care patients. Material and Methods: For the evaluation, data from the hospital information system (HIS) of several intensive care units (ICU) were examined in conjunction with data collected from a checklist. All boluses of sedatives, analgesics and catecholamines were documented paper based across all shifts and all weekdays and compared with corresponding digital data from the HIS (2019–2022) of previous years. Results: 939 complete digital patient records revealed a massive under-documentation of the medication administration compared to that applied according to the checklist. Only 12% of all administered catecholamines, 11% of α2-agonists, 33% of propofol, 92% of midazolam and 46% of opioids were found in the digital recordings. In comparison, the effect was more pronounced on weekdays compared to weekends. In addition, the highest documentation gap was found in the comparison of early shifts. Comparing neurosurgical vs. internal vs. anesthesiologic ICUs there was a highly significant difference between anesthesiologic ICUs compared with other disciplines (p < 0.0001). Discussion: Our data shows that there is a remarkable documentation gap and incongruence in the area of applied boli. Automated documentation by connecting syringe pumps that enter data directly into the HIS can not only reduce the workload, but also lead to comprehensive and legally required documentation of all administered medication. [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: Mindfulness practices enhance executive function skills and academic achievement, spurring interest in integrating mindfulness interventions into education. Embedding mindfulness practice into a digital math game may provide a low‐cost, scalable way to induce mindfulness and boost game‐based learning, yet this approach remains unexplored. Objectives: We investigated the learning benefits of integrating mindfulness exercises in a digital math learning game and examined how students' trait mindfulness might moderate the outcomes. Methods: Two classroom studies were conducted with 404 5th and 6th grade students from six public schools in the U.S. (nStudy 1 = 227, nStudy 2 = 177). The two randomized controlled experiments assigned students to one of the three conditions: passive control (playing the digital learning game Decimal Point), story‐enriched active control, or mindfulness‐enriched condition. Trait mindfulness, learning gains, and in‐game problem‐solving (including problem‐solving duration, error count and correctness after reminder) were assessed. Study 2 included a manipulation check to better understand the effects of the mindfulness intervention. Results: Findings showed no significant differences in learning gains, problem‐solving duration or error count among the conditions. Students' trait mindfulness did not moderate these outcomes. Mindfulness reminders in the mindfulness‐enriched game led to more correct answers after errors than jokes in the story‐enriched game. Study 2 revealed that we failed to induce higher state mindfulness through the mindfulness inductions. Conclusions: Mindfulness prompts could be especially beneficial for students experiencing frustration during gameplay, warranting more exploration for digital game‐based instruction. We highlight barriers and future directions for fostering mindfulness through computer‐based instruction in classrooms. Lay Description: What is currently known about this topic?: Researchers focus on digital games as productive learning environments for math, with potential for higher learning gains compared with traditional methods. However, results are mixed, and not all games lead to improved math outcomes.Executive function (EF) skills are crucial for math learning, and mindfulness‐based interventions show promise in enhancing EF skills in school‐aged students.Embedding mindfulness practice into a digital math game may provide a low‐cost, scalable way to induce mindfulness and, in turn, boost EF skills and game‐based learning, yet this approach remains unexplored What does this paper add?: This paper presents the results of two randomized control trials investigating the feasibility and benefits of incorporating mindfulness exercises into a digital math game designed for middle school students. Benefits are compared to those of a story‐enriched and regular version of the same digital math learning game.The paper also explores variations in the effects of the mindfulness‐enriched game based on students' initial trait mindfulness levels.We observe that listening to mindfulness inductions at the beginning of game sessions do not induce mindfulness, and therefore does not benefit math learning.We find that mindfulness prompts received after recurrent errors can be beneficial for students' problem solving. Implications of study findings for practitioners: Our study provides important information on how digital learning game designers should attempt to induce mindfulness in a digital game to promote learning.Digital learning game designers should consider incorporating mindfulness exercises into their games strategically. Presenting mindfulness inductions in audio format at the beginning of game sessions may not induce mindfulness or benefit math learning. Instead, designers should focus on integrating mindfulness prompts at moments when students encounter frustration within the learning game.Beyond embedding audio mindfulness exercises in the game, learning designers should also consider alternative technological and game features to induce mindfulness within a learning game. [ABSTRACT FROM AUTHOR]

Background: Behavioural intention (BI) has been predicted using other variables by adopting the technology acceptance model (TAM). However, few studies have examined whether BI can predict learning performance. Objectives: The present study used an extended TAM to investigate whether students' BI is a predictor of their listening learning performance (LLP) through vocabulary learning performance (VLP) in the context of mobile vocabulary‐assisted listening learning by using two mobile learning tools. Methods: A total of 129 college students with a pre‐intermediate level of English were recruited as participants, and a 10‐week mobile vocabulary‐assisted, listening‐learning course was conducted in 2022. In each task of this course, the students had to learn target words from a listening passage on Quizlet and then engage in listening activities on Randall's ESL Cyber Listening Lab. Quantitative responses obtained through an online questionnaire were analysed through partial‐least‐squares structural equation modelling. Results: The analysis results indicated that BI significantly predicted LLP through VLP. Perceived ease of use (PEU) and perceived usefulness (PU) were significant antecedents of BI. However, PEU did not significantly predict PU because of the difficulty of navigating between the two technological tools used in this study. The extended model demonstrated its effectiveness in explaining listening learning performance, as evidenced by an explained variance (R2) of 69%. Conclusion: The extended model validates the influence of BI on learning performance and it can also draw teachers' focus toward the significance of enhancing students' BI to improve their listening learning performance. Pedagogical implications based on the results are provided in this paper. Lay Description: What is already known about this topic?: TAM was used to study learners' acceptance of mobile‐assisted language learning.TAM incorporates latent variables to explore mobile‐assisted language learning.Investigating factors influencing BI is a primary research focus in extended TAM literature.Mobile tools could improve listening learning and vocabulary retention. What this paper adds to that: Learning performance was considered as a dependent variable in an extended TAM.BI might predict students' learning performance in vocabulary and listening in an extended TAM.Teachers used two mobile tools to design mobile vocabulary‐assisted listening tasks.Pre‐learning the target words facilitate students' listening learning performance. Implications for practice and/or policy: We show the importance of BI on predicting listening learning performance.The impact of BI on other factors became another focus of TAM research.Results highlight pre‐learning target words' importance for better listening performance.Existing mobile tools improve listening performance, avoiding new system development. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to examine and evaluate the existing clinical practice guidelines and consensus statements regarding tracheostomy care for non‐mechanically ventilated patients. Methods: A systematic search of databases, and professional organisations was conducted from inception to 19 March 2023. Two appraisers evaluated each guideline using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Text and Opinion Papers. Results: No specific clinical guidelines exist on airway management in non‐mechanically ventilated patients. Of 6318 articles identified, we included 12 clinical practice guidelines, and 9 consensus statements, which were from China, the US, the UK, South Korea, Australia, France and Belgium. The AGREE II scores in six domains are (1) the scope and purpose, 70.30%; (2) stakeholder involvement, 37.61%; (3) rigor of development, 33.97%; (4) clarity of presentation, 68.16%; (5) applicability, 44.23% and (6) editorial independence, 40.06%. The overall quality of evidence was level B. The summarised recommendations for clinical practice encompass the following six areas: airway humidification, management of the trach cuff, management of inner cannula, tracheostoma care, tracheostomy suctioning and management and prevention of common post‐operative complications. Conclusions: The overall quality of the clinical guidelines on non‐ventilated tracheostomy care was moderate, and further improvements are needed in domains of stakeholder involvement, applicability, clarity of presentation and editorial independence. Recommendations on non‐ventilated tracheostomy care are often embedded in the guidelines on ventilated tracheostomy. Specific clinical guidelines are needed to provide a standardised approach to tracheostomy care for non‐ventilated patients. Relevance to clinical practice: Patients with non‐ventilated tracheostomy need specialised airway management. Improving patient outcomes requires standardised protocols, patient involvement, quality evaluation, and interdisciplinary approaches. No patient or public contribution: The study reviewed clinical practice guidelines and consensus statements, therefore patient or public input was not needed. [ABSTRACT FROM AUTHOR]

The sleeping stage classification plays an important role in the medical science because it helps the diagnosis of the mental health diseases. The conventional approach for performing the sleeping stage classification is based on the electroencephalograms (EEGs). However, it is worth noting that the EEGs reflect the brain activities. Nevertheless, the brain activities are very complicated even though the subjects are sleeping. Hence, performing the sleeping stage classification via the EEGs may yield the low classification accuracy. On the other hand, the electrooculograms (EOGs) are the voltages between the front eyes and the back eyes which are related to the eye ball movement. As it can directly reflect the various sleeping stages, it can achieve a higher classification accuracy. Therefore, this paper employs the two channel EOGs for performing the sleeping stage classification. The major contribution of this paper is to 1) employ the singular spectrum analysis (SSA) to exploit the latent intrinsic high dimensional dynamics of the one dimensional EOGs for performing the sleeping stage classification, 2) employ the approximate entropy as the features for performing the sleeping stage classification, and 3) assign the same features of different SSA components of different channels of the epochs of the EOGs into the same group and perform the principal component analysis (PCA) on each group of the feature vectors so that the properties of each type of the features are preserved. The results show that our proposed method yields the five sleeping stage classification accuracy at 93.73% and the sensitivity of the stage one non-rapid eye movement (S1) at 78.44%, which achieves the significant improvements compared to the existing methods. Therefore, our proposed method could be used to reduce the workload of the medical officers. [ABSTRACT FROM AUTHOR]

From the moment the SARS-CoV-2 virus was identified in December 2019, the COVID-19 disease spread around the world, causing an increase in hospitalisations and deaths. From the beginning of the pandemic, scientists tried to determine the major cause that led to patient deaths. In this paper, the background to creating a research model was diagnostic problems related to early assessment of the degree of damage to the lungs in patients with COVID-19. The study group comprised patients hospitalised in one of the temporary COVID hospitals. Patients admitted to the hospital had confirmed infection with SARS-CoV-2. At the moment of admittance, arterial blood was taken and the relevant parameters noted. The results of physical examinations, the use of oxygen therapy and later test results were compared with the condition of the patients in later computed tomography images and descriptions. The point of reference for determining the severity of the patient's condition in the computer imagery was set for a mild condition as consisting of a percentage of total lung parenchyma surface area affected no greater than 30%, an average condition of between 30% and 70%, and a severe condition as greater than 70% of the lung parenchyma surface area affected. Patients in a mild clinical condition most frequently had mild lung damage on the CT image, similarly to patients in an average clinical condition. Patients in a serious clinical condition most often had average levels of damage on the CT image. On the basis of the collected data, it can be said that at the moment of admittance, BNP, PE and HCO3− levels, selected due to the form of lung damage, on computed tomography differed from one another in a statistically significant manner (p < 0.05). Patients can qualify for an appropriate group according to the severity of COVID-19 on the basis of a physical examination and applied oxygen therapy. Patients can qualify for an appropriate group according to the severity of COVID-19 on the basis of BNP, HCO3 and BE parameters obtained from arterial blood. [ABSTRACT FROM AUTHOR]

Stabilization using industrial by-products is presently gaining importance in the construction sector for improving the geotechnical characteristics of soft soils. The optimum dosage of stabilisers has become of great interest to experimenters in terms of improved strength, time, and economy for construction projects. This work presents the utilization of biomedical waste ash for improving the strength of soft soil. In this paper, response surface methodology (RSM) was adopted to determine the optimum combination curing period (C) and biomedical waste ash (BA) quantity for attaining the maximum unconfined compressive strength (UCS) of soft soil and to reduce the number of trial tests required. The response factors C and BA were varied from 0 to 14 days and 4% to 20%, respectively, and the experiments were conducted according to the experimental plan provided by the RSM design. Based on a Face-centred Central Composite Design (FCCCD), a mathematical equation was created for the experimental results. Analysis of variance (ANOVA) was used to determine the generated model's significance, and the results indicated a statically significant model (p ≤ 0.05). The results revealed that the curing period imparts more influence towards strength improvement, and the optimum dosage was 19.912% BA, with curing of 14 days to yield a maximum UCS of 203.008 kPa. This optimization technique may be suggested to obtain a preliminary estimation of strength prior to stabilization. [ABSTRACT FROM AUTHOR]

Background: This study examines the effect of a Theory of Mind (ToM) intervention on ToM abilities and social–emotional functioning in adolescents with developmental language disorder (DLD) or who are deaf/hard of hearing (D/HH). It emphasizes the importance of self‐reflection and measurement for personal growth. The research design incorporates both subjective and objective measures to evaluate the intervention's efficacy. Aims: To investigate the impact of the ToM intervention on ToM abilities and social–emotional functioning in adolescents with DLD or who are D/HH. It hypothesizes that participants in the intervention groups will show improved ToM and social–emotional functioning compared with those in the control groups. Methods & Procedures: Adolescents with DLD or who are D/HH were recruited through collaboration with educational institutions. The study utilized a pre‐/post‐test design, assigning participants to either the intervention or the control group. The ToM intervention involved targeted activities to enhance ToM abilities. ToM abilities and social–emotional functioning were assessed using standardized tests and self‐report questionnaires. Statistical analyses compared outcomes between the intervention and no intervention groups. Outcomes & Results: The findings reveal subjective improvements in social–emotional functioning among the D/HH intervention group. However, no significant effects on objective ToM measures were observed. These results highlight the need for further investigation and refinement of interventions in these areas. Future research should focus on improving intervention strategies and exploring additional objective measures to gain a comprehensive understanding of the intervention's impact on ToM and social–emotional functioning in this population. Conclusions & Implications: The ToM intervention shows subjective benefits in improving social–emotional functioning among D/HH adolescents. However, it does not yield significant effects on objective ToM measures. These findings emphasize the ongoing need to refine interventions targeting ToM abilities and social–emotional functioning in this population. Future studies should explore alternative strategies and incorporate additional objective measures to enhance understanding and outcomes. WHAT THIS PAPER ADDS: What is already known on this subject: Before this study, it was known that ToM interventions have the potential to enhance ToM abilities. However, the specific effects of such interventions on subjective and objective measures for ToM and social–emotional functioning in adolescents with DLD or who are D/HH remained unclear, necessitating further research. What this paper adds to the existing knowledge: This study adds to the existing knowledge by demonstrating subjective improvements in social–emotional functioning among adolescents who are D/HH and underwent a ToM intervention. However, no significant effects on objective ToM measures were observed. These findings highlight the need for refining interventions and exploring additional measures to better understand the intervention's impact. What are the potential or actual clinical implications of this work?: The subjective improvements in social–emotional functioning observed in this study have important clinical implications. They suggest that ToM interventions can positively impact the social well‐being of adolescents who are D/HH. However, the lack of significant effects on objective ToM measures emphasizes the need for further research and intervention refinement to address specific areas of improvement in this population. [ABSTRACT FROM AUTHOR]

Background: Pictures drawn by people with aphasia (PWA) are often more challenging to understand than those drawn by healthy people. There are two types of objects: those that tend to be drawn symbolically (symbolically drawn objects—SOs) and those that are likely to be drawn realistically (realistically drawn objects—ROs). Aims: To compare the identification rate and number of misunderstanding types between SOs and ROs drawn by PWA and healthy controls (HCs). To reveal trends in the misunderstandings of drawings by PWA, and to identify the language or cognitive abilities related to the identification rate of pictures drawn by PWA. Methods & Procedures: We designed a drawing task involving SOs and ROs. A total of 18 PWA and 30 HCs completed the task, and respondents identified the drawings. The identification rate and number of misunderstandings were analysed with two‐way analysis of variance (ANOVA) including group (PWA and HCs) and object type (SOs and ROs). The misunderstandings were divided into four categories varying in semantic and morphological similarity; these ratios were examined with a chi‐square test. The relationships of language and cognitive abilities with the identification rate were investigated with multiple regression analyses. Outcomes & Results: There was a significant effect of the interaction between group and object type on the identification rate (F(1.1387) = 3.90, Mean Squared Error (MSE) = 4139.67, p = 0.04): the identification rates for ROs were lower in the PWA than in the HCs. For the number of misunderstanding types, an interaction was observed between group and object type (F(1.56) = 8.26, MSE = 26.93, p < 0.01): the number of misunderstanding types for ROs in the PWA was greater than that in the HCs. The misunderstanding patterns differed between ROs and SOs (χ2(3) = 694.30, p < 0.001, V = 0.37). ROs were semantically related, whereas SOs were morphologically related. The identification rates of ROs and SOs were correlated only with Kanji writing scores (ROs: β = 3.66, p = 0.01; SOs: β = 6.57, p < 0.01). Conclusions & Implications: In drawings by the PWA, SOs had a higher identification rate, while ROs had a lower identification rate and a greater variety of misunderstandings. SOs may increase drawing motivation. Interventions to improve the identifiability of SOs and ROs should reflect each character. Identification rates were correlated only with Kanji writing scores. The PWA, whose native language was Japanese and had preserved Kanji writing abilities, and their communication abilities may be increased through drawing. WHAT THIS PAPER ADDS: What is already known on the subject: PWA often have impaired drawing abilities and draw pictures that third parties misinterpret. Some objects tend to be drawn symbolically, and some are drawn realistically. However, it is not clear whether there is a difference between these types of drawings depicted by PWA in identifiability and the tendency to be misunderstood by ordinary people. In addition, the relationships between language or cognitive abilities and the identification rate of drawn pictures are not clear. What this paper adds to the existing knowledge: The identification rate differed between SOs and ROs. In drawings by PWA, SOs had a higher identification rate, while ROs had a lower identification rate and the greatest variety of misunderstandings. Approximately half of the misunderstandings were related to the target object. SOs tended to be confused with morphologically related objects, while ROs tended to be confused with semantically related objects. Identification rates were correlated only with Kanji writing scores. What are the potential or actual clinical implications of this work?: To motivate PWA's drawing, it is suitable to begin with SOs. Examining drawing ability from the perspective of SOs and ROs increases the chance of identifying drawing ability. PWA whose native language is Japanese and have preserved Kanji writing abilities may be able to increase their communication abilities through drawing. [ABSTRACT FROM AUTHOR]

Background: Training parents to implement language and communication intervention strategies is an effective approach to promote language development for children with language delay. Aims: This study introduces an online parent training program conducted in Hubei province, China, which was designed to help parents of language‐delayed children with a diagnosis of autism spectrum disorder (ASD), developmental language disorder (DLD) or global developmental delay (GDD) apply language intervention strategies into daily interactions and promote their children's language development at home. Methods & Procedures: The Bethel Hearing and Speaking Training Center Family Training for Early Communication & Language Development (Bethel Family Training Program, BFT) (Bethel HSTC, 2020) was designed to improve the language and communication skills for children with language delay in a naturalistic way. The caregivers (including parents, grandparents and other main caregivers) participated in an 8‐h online program, including lectures on milestones in child language development, common misunderstandings of child language development, and three basic family language intervention strategies ('Looking together, playing together, and talking together') incorporating active learning through video analysis and discussion. Tongji Hospital in Hubei then continued with 3 months of online home intervention monitoring to all the caregivers via weekly online Q&As led by BFT certified speech therapists' team. The Gesell Developmental Schedules (GDS) was carried out before the online parent training program and after the 3‐month online home intervention monitoring. Outcomes & Results: 146 families whose children aged 12–68 months with language delay participated in the online training program. The results of the GDS assessments conducted before and after the program showed that not only did the developmental quotient (DQ) of language improve, but so did the DQ of social behaviour and adaptive behaviour (p < 0.001). There is no between‐group difference in the application of three strategies between the ASD group and the DLD or GDD group (p > 0.05). Furthermore, both caregivers' ability to apply 'looking together, playing together, talking together' strategies and the effective interaction time played important roles in improving the child's language abilities. Conclusion & Implications: The online parent training focusing on improving daily interaction with children through speech–language stimulation strategies promoted the development of language skills. It is an economic and practical approach for children with language delay who have limited access to local language intervention programs. WHAT THIS PAPER ADDS: What is already known on the subject: Parent‐implemented language intervention is an effective approach at improving children's language development. Telepractice is an appropriate model of service delivery for audiologists and speech–language therapists and may be the primary mode of service delivery or may supplement in‐person services. What this paper adds to the existing knowledge: This paper explores the effectiveness of an online parent training program and provides new evidence that online training on language support strategies (looking together, playing together, talking together) followed by home intervention monitoring works for Mandarin‐speaking children and it is equally effective for children with ASD and non‐ASD diagnosis. What are the potential or actual clinical implications of this work?: Developmental behavioural paediatricians and speech–language therapists in countries and areas that lack sufficient training resource for every child will have the option to deliver parent training and home intervention monitoring online, which will save time and cost considerably while offering convenience. [ABSTRACT FROM AUTHOR]

Background: Ancient classic prescription play a crucial role in the preservation and advancement of traditional Chinese medicine (TCM) theories. They represent a significant milestone in the ongoing development and transmission of TCM knowledge and practices and are considered one of the breakthroughs in the development of TCM inheritance. In the process of developing ancient classic prescriptions, many problems may still arise in ensuring quality consistency between traditional methods and modern production processes, among which the extraction process poses major challenges. This paper introduces a practical approach extracting an ancient classic prescription using a modern extraction process. The technique is demonstrated through the study of the extraction process of Shenshou Taiyi powder (STP). Methods: This study focuses on optimising the STP extraction process to ensure consistency in the quality of the product obtained through ancient and modern processes using the standard relation and fuzzy analytic hierarchical process (FAHP) and criteria importance through intercriteria correlation (CRITIC) method integrated weights combined with the Box-Behnken response surface test. Using the contents of rosmarinic acid, isoimperatorin, puerarin, as well as the extract yield and fingerprint similarity as evaluation indexes of STP, the Box-Behnken response surface method was employed to examine the varying extraction parameters, including water addition ratio, extraction duration, and number of extractions. The weighted coefficients for each parameter were calculated by combining the benchmark correlation and FAHP-CRITIC method, deriving a comprehensive score. Results: The optimal extraction process for STP consisted of a two extractions, each using at a tenfold quantity of water, performed for one hour. Process verification across three separate batches yielded a comprehensive score of 94.7, with a relative standard deviation of 0.76%. Conclusions: The application of the Box-Behnken response surface method combined with standard relation and FAHP-CRITIC approach proved to be stable and feasible for optimising the extraction process of STP. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment associated with schizophrenia (CIAS) represents a distinct, persistent, and core group of schizophrenia symptoms. Cognitive symptoms have been shown to have an impact on quality of life. There are several published CIAS measures, but none based on direct patient self-report. It is important to capture the patient's perspective to supplement performancebased outcome measures of cognition to provide a complete picture of the patient's experience. This paper describes additional validation work on the Patient-Reported Experience of Cognitive Impairment in Schizophrenia (PRECIS) instrument. Methods: Data from two large, international, pharmaceutical clinical trials in medically and psychiatrically stable English-speaking patients with schizophrenia and 88 healthy controls were analyzed. An exploratory factor analysis (EFA) was conducted in one trial (n = 215), using the original 35-item PRECIS. The factor structure suggested by EFA was further evaluated using item response theory (IRT; Samejima's graded response model), and tested using confirmatory factor analysis (CFA). Both EFA and CFA results were tested in a second trial with similar inclusion/exclusion characteristics (n = 410). Additional statistical properties were evaluated in healthy controls. Results: EFA suggested that the best solution after item reduction suggested a factor structure of 6 factors based on 26 items (memory, communication, self-control, executive function, attention, sharpness of thought), supporting a total score, with an additional 2-item bother score (28 items in all). IRT analysis indicated the items were well-ordered within each domain. The CFA demonstrated excellent model fit, accounting for 69% of the variance. The statistical properties of the 28-item version of the PRECIS were confirmed in the second trial. Evidence for internal consistency and test-retest reliability was robust. Known-groups validity was supported by comparison of healthy controls with patients with schizophrenia. Correlations indicated moderate associations between PRECIS and functioning instruments like the Schizophrenia Cognition Rating Scale (SCoRS), but weak correlations with performance-based outcomes like MATRICS Consensus Cognitive Battery (MCCB). Discussion: Using two clinical trial samples, we identified a robust factor structure for the PRECIS and were able to replicate it in the second sample. Evaluation of the meaningful score difference (MSD) should be repeated in future studies, as these samples did not show enough change for it to be evaluated. Conclusions: This analysis provides strong evidence for the reliability and validity of the PRECIS, a 28-item, patient-reported instrument to assess cognitive impairment associated with schizophrenia. The correlation with functioning and the weak correlation with performance on cognitive tasks suggests that patient reports of cognitive impairment measure a unique aspect of patient experience. [ABSTRACT FROM AUTHOR]

Introduction: Globally, healthcare organizations have transitioned from paper-based documentation to electronic health records (EHR), including in Saudi Arabia. However, the adoption of EHR at the national level in Saudi Arabia needs more attention. Thus, this study aimed to determine the workflow integration of EHR and associated factors. Objectives: The specific aims were to examine the level of EHR use and workflow integration among nurses, to determine the differences in EHR use and workflow integration based on nurses' demographic characteristics, and to determine the association between the predictive factors and EHR workflow integration. Methods: This is a cross-sectional, correlational descriptive study. The data were collected from 293 nurses using the convenience sampling method. The participating nurses completed a questionnaire that included two measures: the Information System Use Survey and the Workflow Integration Survey (WIS). The data were analyzed using descriptive and multivariate statistics with SPSS software. Results: The nurses had a positive perception of EHR use and workflow. The EHR use scores differed based on workplace (P <.01), education level (P <.05), and area of practice (P <.001). Similarly, the EHR workflow integration scores varied according to workplace (P <.05), education level (P <.05), and area of practice (P <.001). Education level and workplace significantly predicted information system use. Furthermore, education level and information system use significantly predicted the EHR integration into nurses' workflow. Conclusion: The nurses expressed a greater perceived use of EHR regarding the integrated health information system, which was a predictor of EHR integration into nurses' workflow. [ABSTRACT FROM AUTHOR]

This paper is inspired by medical studies in which the same patients with multiple sclerosis are examined at several successive visits (doctor's appointments) and described by fractional anisotropy tract profiles, which can be represented as f unctions. Since the observations for each patient are dependent random processes, they follow a repeated measures design for functional data. To compare the results for different visits, we thus consider functional repeated measures analysis of variance. For this purpose, a pointwise test statistic is constructed by adapting the classical test statistic for one-way repeated measures analysis of variance to the functional data framework. By integrating and taking the supremum of the pointwise test statistic, we create two global test statistics. In addition to verifying the general null hypothesis of the equality of mean functions corresponding to different objects, we also propose a simple method for post hoc analysis. We illustrate the finite sample properties of permutation and bootstrap testing procedures in an extensive simulation study. Finally, we analyze a real data example in detail. All methods are implemented in the R package rmfanova, available on CRAN. [ABSTRACT FROM AUTHOR]

Background: Virtual reality (VR) offers much potential for learning, but it challenges learners' orientation. Objectives: This paper investigates whether it is possible to use light or movement cues to facilitate orientation in a search task in a desktop‐VR environment so that participants can better attend to the learning content presented simultaneously. Methods: In two pre‐registered online experiments, we investigated the effects of cueing (light and movement) on search time, learning, and several evaluation variables. Participants were asked to find tools in a virtual workshop, while information about the respective tool was narrated. Experiment 1 (N = 60) used a within‐subject design, that is, the objects were alternately highlighted by light, movement or not. For Experiment 2 (N = 159) the narration was substantially shortened, and a between‐subject design was used. Cognitive load and presence were measured additionally. Results and conclusions: In Experiment 1, only the movement cue decreased search time, indicating automatic guidance of learners' attention. There was no effect of cueing on learning, which may be due to the average search time being substantially shorter than the narration, leaving sufficient time to attend to the narration exclusively. In Experiment 2 search times were significantly faster for both cueing methods, but only the light cue resulted in better learning outcomes, which could be explained by the slightly lower presence in the movement cue condition. Implications: Results imply that it is important to develop cues that automatically guide attention without reducing presence. Lay Description: What is already known about this topic: Virtual reality (VR) offers a lot of opportunities for the integration of educational scenarios.VR is challenging for learners with regard to orientation in a 360° environment.Regarding learning outcomes, research on the effects of cues to highlight important content in a 360° environment is still rare.Presence, defined as the feeling of being there in a VR environment, is an important prerequisite for learning in VR. What this paper adds: The influence of light and movement cues on search times and learning outcomes in a desktop‐VR environment was tested.Movement cues can reliably reduce search times (indicating successful orientation), whereas light cues only reduced search times in predictable scenarios.In a predictable scenario, light cues enhanced learning outcomes compared with movement cues.Movement cues reduced presence, which is one potential reason why movement cues did not improve learning. Implications for practice and/or policy: Using light cues might assist orientation and enhance overall performance in predictable scenarios (i.e., when learners know what kind of cue to expect).In an unpredictable setting with variable cues, light cues did not facilitate orientation, whereas movement cues did.However, movement cues reduced presence, which may have negatively affected learning outcomes. It is important to develop cueing methods that also work in more unpredictable settings, but that do not reduce presence. [ABSTRACT FROM AUTHOR]

Background: A practical test that measures the information and communication technology (ICT) skills students need for effectively using ICT in primary education has yet to be developed (Oh et al., 2021). This paper reports on the development, validation, and reliability of a test measuring primary school students' ICT skills required for effectively using ICT (the ECC‐ICT test). Objectives: Based on existing literature, three ICT use domains were identified for effectively using ICT: Effective, collaborative, and creativeuse of ICT. For these three domains, 24 corresponding teaching objectives were identified from a widely used digital literacy framework. Thirty‐four test items cover these teaching objectives in an online test. Methods: A mixed‐method approach was used for the ECC‐ICT test. Four pilot rounds (n=25) implemented qualitative interviews for cognitive validity and refining the test items, followed by a qualitative usability study(n=6). Confirmatory factor analysis and ANOVA provided quantitative insight into the large‐scale test administration(n=575). Results and Conclusions: Composite reliability of our conceptual 3‐factor confirmatory model showed that the test reliably measured primary school effective use of ICT (ω = 0.82), collaborative use of ICT (ω = 0.80) and creative use of ICT (ω = 0.64). Convergent validity (ranging from 0.41 to 0.46) was acceptable. Internal consistency (ranging from 0.84 to 0.91) and discriminant validity (HTMT values below 0.90) are good. ANOVA results show that mean test scores are higher for students in higher grade levels (p < 0.001). The post hoc Bonferroni results show that most grade‐by‐grade comparisons are significant (p < 0.001). Lay Description: What is already known about this topic: Information and communication technology (ICT) skills are finding their way into national curriculums as teachers implement more digital learning environments.Teachers currently do not have a measurement instrument for the ICT skills primary education students need to learn in a personalised way. What this paper adds: This paper gives teachers a test that reliably measures the effective, collaborative, and creative ICT skills required for primary school students to learn using ICT.To our knowledge, this test is the first of its kind.Al materials to reproduce the test are available digitally for teachers. The implications of study findings for practitioners: For policy, this test can be used to check if a student is ready to use ICT in a self‐regulated setting.With this test, teachers can assess and support students' growth on the effective, collaborative, and creative ICT skills required for primary school students using ICT. [ABSTRACT FROM AUTHOR]

Step pools are micro-geomorphology hosted in gullies which are closely related to the channel erosion rate and hydraulic characteristics of runoff. These features are widely developed in the Yuanmou dry-hot Valley area of the Central Yunnan Plateau, China. In this paper, the morphological characteristics of different types of step pools in the Yuanmou dry-hot Valley were analyzed using analysis of variance and cluster analyses. The results show that: (1) step pools can be divided into differential, bedrock, barrier, and sub-erosion step pools based on the environment of development; the bedrock and differential step pools develop on a large scale, while barrier and sub-erosion step pools develop on a small scale; (2) the width and depth of the step, the height of the step, the width of the pool, and the depth of the step of the differential type, bedrock type, and sub-erosion type step pools exhibited a significant positive correlation (P < 0.01); the height of the step and the depth of the pool of the barrier type step pools were significantly negatively correlated with the height of the step and the concave hole depth of the sub-erosion type (P < 0.01); (3) the differential type and undercurrent type step pools were seriously eroded. The study of the types and morphologies of gully step pools in the Yuanmou dry-hot Valley helps understand the formation and evolution mechanisms of erosion gullies and provides a scientific basis for monitoring and controlling soil erosion. [ABSTRACT FROM AUTHOR]

This paper presents a comparative analysis of the laser operating power (P1 and P2) and synthetic leather thickness to achieve the optimal quality of components in the airbag area, produced through micro-perforation laser processing. Within the study, various laser power settings and material thicknesses were investigated to determine the combinations that ensure the best component performance. The experimental results indicate that setting the laser to 25% of its total power (P1, P2) of two kilowatts (kW) represents the optimal parameter setup to achieve parts of superior quality. This configuration is not significantly influenced by the material thickness, suggesting important versatility in practical applications. The overall results indicate the significant influence of the laser power level on micro-perforation processing. The normal analysis of means (ANOM) and factorial design (DOE) provide significant evidence for an interaction, highlighting that the effects of one laser power factor depend on the level of the other laser power factor. These findings are essential in improving production processes, as they allow for the manufacture of airbag components with high precision and consistency, minimizing the risks of material deformation or damage. Thus, not only is compliance with safety standards ensured, but the economic efficiency of the production process is also enhanced. [ABSTRACT FROM AUTHOR]

This study concerns the optimization of an industrial recycling line; in other terms, this paper aims to find the optimal processing parameters that allow for a decrease in the loss of stress crack resistance (SCR) using a notched crack ligament stress (NCLS) test and an increase in the gain of the elongation at break, flexural modulus, and Izod impact strength of a polyethylene (PE) blend before and after recycling. The recycling line is composed mainly of a mono- and twin-screw extruder and a filtration system. Hence, the research question is as follows: How can we optimize the recycling process, without compromising the mechanical properties of recycled polyethylene (PE) blends? To answer the research question, Taguchi's design of experiment and grey relational analysis (GRA) for multiobjective optimization was applied. Experiments were performed according to L 16 standard orthogonal array based on five process parameters: mono-screw design, screw speed of the mono- and twin-screw extruder, melt pump pressure, and filter mesh size. Based on grey relational analysis (GRA), the optimal setting of process parameters was identified, and a barrier screw and a higher screw speed for both extruders were allowed to have optimal mechanical properties. Furthermore, the analysis of variance (ANOVA) indicated that the mono-screw design and screw speed of the mono- and twin-screw extruder significantly impact the mechanical properties of recycled polyethylene (PE) blends. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to determine the demand category and level of government and investors in public–private partnership (PPP) projects. It emphasizes the importance of meeting the demands of stakeholders and controlling the unreasonable demands. This study aims to improve the demand management of stakeholders in the PPP project and lay a foundation for the research on behavior based on the motivation theory. Design/methodology/approach: This paper opted for a questionnaire survey to collect data based on indicators identified through literature. The participants come from the government and private sector (investors, contractors, operators, etc.) in China PPP Lecture Hall. The reliability, validity and variance analyses are used to test the reliability of data. Factor analysis and entropy method are used to determine demand categories and weights. Findings: The government's 14 demands are divided into four groups: satisfy public activities, self-interest, responsibility and relief financial pressure; 6 investor's demands are divided into development ability and satisfy social activities. The self-interest of government is higher than that of the publicity in PPP projects; investor's social reputation is most important, it is a foundation for obtaining external resources and achieving enterprise development. Research limitations/implications: Because of the chosen research approach, the demand indexes cannot be exhausted. Therefore, researchers are encouraged to enrich relevant contents further. Practical implications: This paper includes implications for a targeted demand control mechanism and for managing the unreasonable demand. Originality/value: This paper comprehensively identifies the demand hierarchy of the government and investors, and provides the theoretical basis for the target management of stakeholders. [ABSTRACT FROM AUTHOR]

With the progressive development of new energy technologies, high-power lithium batteries have been widely used in ship power systems due to their high-power density and low environmental pollution, and they have gradually become one of their main propulsion energy sources. However, the large-scale deployment of lithium batteries has also brought a series of safety problems to ship operations, especially the battery internal short circuit (ISC). Battery ISC faults are very hidden and unpredictable at the initial stage and often fail to be detected in time, ultimately leading to overheating, fire or even an explosion of the ship's power system. Based on this, this paper proposes a fast and accurate method for early-stage ISC fault location and detection of lithium batteries. Initially, voltage variations across the lithium battery packs are quantified using curvilinear Manhattan distances to pinpoint faulty battery units. Subsequently, the localized characteristics of voltage variance among adjacent batteries are leveraged to detect an early-stage ISC fault. Simulation results indicate that the proposed method can quickly and accurately locate the position of 5 Ω, 10 Ω and 15 Ω ISC faulty batteries within the battery pack, as well as detect the abnormal batteries in a timely manner with considerable sensitivity and reliability. [ABSTRACT FROM AUTHOR]

In the ever-evolving landscape of digital marketing, the role of social media in shaping effective communication strategies is paramount. This research paper delves into the world of data-driven insights to examine how social media channels contribute to the success of digital communication efforts. This paper focuses on exploring the multifaceted aspects of social media's impact on brand visibility, engagement, and customer interaction. The data was analyzed quantitatively using descriptive statistics while Analysis of Variance was used to establish associations between variables. The study revealed that major factors influencing the social media's effectiveness in digital communication are Content, Customer Interaction and Social Media metrics. As a result of comprehensive analysis, this research paper not only provides valuable insights into the current state of social media's effective-ness in digital communication but also offers practical recommendations for businesses looking to optimize their social media strategies. In an era where data reigns supreme, this research findings serve as a guide for harnessing the power of social media as a dynamic and influential tool in the digital communication arsenal. [ABSTRACT FROM AUTHOR]

Aim: This study examined the preliminary effects of a nurse‐led self‐management education and support programme on the self‐management behaviours and quality of life among people with type 2 diabetes in Western Ethiopia. Methods: A pilot randomized controlled trial was conducted between January and August 2021. Participants were recruited in the hospital and randomly assigned to the control arm to continue usual care (n = 38) or the intervention arm to receive usual care and the diabetes self‐management education and support programme (n = 38) in the community. Self‐management behaviours and quality of life were assessed using a 10‐item summary of diabetes self‐care activity (expanded) scale and a 34‐item diabetes quality of life measure, respectively, at baseline and 2 months after follow‐up. Generalized estimating equation models were used to examine the preliminary effects of the programme on the outcomes. Results: Preliminary results indicated that the programme outperformed usual care in self‐management practise, with large effect sizes immediately postintervention and at 2 months after the intervention, and quality of life at 2 months after the intervention. Conclusion: A nurse‐led diabetes self‐management education and support intervention, including the families of people with diabetes, may be an option to boost the self‐management practise and quality of life of patients with diabetes. Summary statement: What is already known about this topic? Family‐supported diabetes self‐management education intervention produced inconclusive effects on self‐management behaviour and quality of life. What this paper adds? A social‐cognitive theory‐guided, culture‐tailored, and community‐based diabetes self‐management education and support programme resulted in a preliminary effect on improving self‐management behaviour and quality of life.A nurse‐led diabetes self‐management education and support programme intervention, including the families of patients, may be an option to boost the self‐management practise and quality of life of people with diabetes. The implications of this paper: Culturally tailored diabetes self‐management education and support programme could be an option to improve self‐management behaviour and enhance quality of life.Community‐based nurse‐delivered diabetes self‐management education and support can improve self‐management behaviours and enhance quality of life in 2 months duration. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to conceptualise a research study to examine leadership as a relational concept between leaders and followers. The context is within surgical practice examining how motivated consultant surgeons are to lead junior doctors and which type of leadership style they use. From a follower perspective, the motivation of junior doctors will be explored, and their leadership preferences will be correlated with those of the actual style of consultant surgeons. Design/methodology/approach: In this paper, the authors provide a detailed description of the methods for an international quantitative research study, exploring sequentially how motivated consultant surgeons are to lead and how leadership styles impact on the motivation of junior doctors. The objectives, method and data collection of this study are explained, and the justification for each method is described. Findings: The findings for this outline study illustrate how critical it is to redefine leadership as a relational concept of leader and follower to ensure adequate support is provided to the next generation of consultant surgeons. Without consideration of the relational model of leadership, attrition will continue to be a critical issue in the medical workforce. Research limitations/implications: The research limitations are that this is a proposed quantitative study due to the need to collect a large sample of data from surgeons across the UK, Egypt and Germany. This research will have immense implications in developing new knowledge of leadership as a relational concept in medicine and healthcare. This study additionally will impact on how leadership is conceptualised in the curriculum for specialist surgical practice. Practical implications: The practical implications are that relational leadership is supportive of generating a supportive leadership culture in the workplace and generating more effective teamwork. Originality/value: To the best of the authors' knowledge, this is the first study of its kind to look at a relational model of leadership in surgical practice between consultant surgeons and surgical trainees. This study will also identify any specific country differences between the UK, Germany and Egypt. [ABSTRACT FROM AUTHOR]

This paper introduces a novel type of floating machine gun that can be simplified as a self-balancing two-degree-of-freedom mechanical system with distinct vibration characteristics. The model accounts for intricate motion patterns and encompasses numerous potential influencing factors. Multifactor combination optimization of the system represents a pressing engineering challenge. After establishing a simulation model for the machine gun and validating it experimentally, seven factors were chosen as optimization variables. The maximum recoil displacement of the inner receiver (MRD) and the firing rate were chosen to be indicators. Orthogonal combinations and variance analyses were used, and the effects of multiple factors were analyzed using SPSS software; these processes led to a determination of the optimal combination. The results indicated that the piston cylinder pressure, the bi-directional buffer spring energy storage, and the inner receiver mass significantly affected the MRD. Furthermore, the automaton mass and the reset spring energy storage were found to substantially affect the firing rate. Careful analysis of the variance results facilitated the determination of the optimal combination of parameter values. Remarkably, the optimal combination chosen resulted in an MRD reduction of approximately 20.2% and a firing rate increase of approximately 26.6%. [ABSTRACT FROM AUTHOR]

Tensor product smoothers are frequently used to include interaction effects in multiple nonparametric regression models. Current implementations of tensor product smoothers either require using approximate penalties, such as those typically used in generalized additive models, or costly parameterizations, such as those used in smoothing spline analysis of variance models. In this paper, I propose a computationally efficient and theoretically precise approach for tensor product smoothing. Specifically, I propose a spectral representation of a univariate smoothing spline basis, and I develop an efficient approach for building tensor product smooths from marginal spectral spline representations. The developed theory suggests that current tensor product smoothing methods could be improved by incorporating the proposed tensor product spectral smoothers. Simulation results demonstrate that the proposed approach can outperform popular tensor product smoothing implementations, which supports the theoretical results developed in the paper. [ABSTRACT FROM AUTHOR]

The aim of this study is to employ a response surface methodology (RSM) to optimize experimental parameters in microfluidic paper-based analytical devices (µ-PADs). The independent parameters include concentrations and volumes of acetylcholinesterase, acetylthiocholine iodide, and 5,5-dithiobis-(2-nitrobenzoic acid). Their effect on mean color intensity was tested and optimized. From the analysis of variance, high regression and fitting values were obtained between the experimental and RSM predicted mean color intensity. Under optimum conditions, satisfactory linearity (R2 > 0.9990) in the range of 0.25–16 mg/L was obtained for the studied pesticides. The limit of detection (LOD) varies from 0.13 to 0.27 mg/L; high precision (RSD of 3.8–8.0%), reproducibility (RSD of 7.2–11.0%), and recovery (78–97%) were achieved. The RSM approach has been demonstrated to be more efficient than the traditional approach. It resulted in a µ-PAD system with less amount of reagent usage and better LOD compared with a univariate approach. [ABSTRACT FROM AUTHOR]

While previous studies found that origami, when used for cognitive training and education, can improve spatial ability, the underlying mechanisms of this change, presumably associated with the origami folding process, remain unclear. In the present study, we focused on origami imagery in which participants imagined the process of folding paper to create a work of art; and we examined the cognitive factors involved in the imagery process and their association with mental transformations and the extent to which visual imagery was vivid. We identified four specific relevant cognitive factors in origami imagery: (a) controllability of origami transformations, (b) visual imagery of shapes, (c) hand sensations, and (d) visual imagery of colors. We associated the first two of these with non-rigid transformations: the controllability of origami transformations and the visual imagery of shapes. Moreover, vividness of visual imagery was related to all four cognitive factors. We propose this cognitive model of origami as one that considers the key relationships between origami imagery, mental transformations, and vividness of visual imagery. [ABSTRACT FROM AUTHOR]

With the rapid development of pure electric vehicles, how to improve the range has become the focus of research. Due to the large shell mass of the battery pack shell (BPE), it is necessary to optimize its structure in turn. In this paper, the BPE model was reconstructed by improving the upper shell material and adding reinforcements following the direction of the leaf vein fibers of the Magnolia Grandiflora. A quasi-Monte Carlo method based on Sobol sequences and a Latin hypercube design with variance sensitivity analysis was used to determine the seven design variables. The 122 data sets were trained and predicted using the basic gradient descent algorithm combined with the conjugate direction method, and the predictions were compared with static mechanical simulations for sharp cornering conditions on bumpy roads. The results showed that the BPE weight reduction ratio was 19.5%, and the maximum stress reduction ratio was 27.49%, and the displacement reduction ratio was 29.29% respectively, which satisfied the material requirements. It had a 20.88% increase in first-order mode frequency, which effectively prevented resonance. [ABSTRACT FROM AUTHOR]

The new generation of pavement technology with the goal of longevity is an important supporting technology that can promote the achievement of sustainable development of high-speed roadways. To further investigate the evolution trend of long-life pavement performance, this paper paved experimental sections to explore the correlations between pavement structure combinations and pavement performances. This paper presented four experimental sections with different pavement structures, asphalt concrete layer thicknesses, and pavement materials. Then, this paper analyzed the effects of the seasonal factors, pavement structure, and lanes on the deflection value and rut depth from three dimensions by the Pearson correlation coefficient (PCC). Finally, this paper used the analysis of variance (ANOVA) to analyze the relationships between the layer thickness of various materials in the pavement structure and the pavement performances, including the deflection value, international roughness index (IRI), texture depth (TD), British Pendulum Number (BPN), sideway force coefficient (SFC), rut depth, and disease area. The results showed that the seasonal factors significantly affected the deflection values of pavement structures with PCCs of 0.61, 0.72, 0.53, and 0.78. The high temperatures increased the average deflection values by 22.85%, 72.88%, 77.61%, and 88.13%, respectively. Under the influence of high temperature in summer and traffic loads, the increased ranges of average rut depth were -0.2%, 4.89%, 9.56%, and 7.31%, respectively. The results of ANOVA showed that the pavement structure type and thickness of each structural layer significantly affected the deflection value, and there also was a strong correlation between the pavement structure type, thickness, BPN, and SFC with p-values less than 0.05. Increasing the thickness of the asphalt surface was beneficial for reducing the area of defects, while laying the semi-rigid base layer was beneficial for maintaining the deflection value and rut depth at a lower level. [ABSTRACT FROM AUTHOR]

Two quantitative, environment-friendly and easily monitored assays for Ni (II) and Co (III) ions analysis in different lipstick samples collected from 500-Iraqi dinars stores located in Baghdad were introduced. The study was based on the reaction of nickel (II) ions with dimethylglyoxime (DMG) reagent and the reaction of cobalt (III) ions with 1-nitroso-2-naphthol (NN) reagent to produce colored products. The color change was measured by spectrophotometric method at 565 nm and 430 nm for Ni and Co, respectively, with linear calibration graphs in the concentration range 0.25-100 mg L-1 (Ni) and 0.5-100 mg L -1 (Co) and LOD and LOQ of 0.11 mg L-1 and 0.36 mg L-1 (Ni), and 0.15 mg L-1 and 0.49 mg L-1 (Co). The UV/VIS data was compared to the results obtained by a novel microfluidic paper-based analytical device (µPAD) platform offering in-situ and cost-effect assay with a similar calibration graph with LOD and LOQ of 0.21 mg L-1 and 0.70 mg L-1 (Ni), and 0.22 mg L-1 and 0.75 mg L-1 (Co). The analysis of variance (ANOVA) indicated no significant difference between the UV/VIS, µPAD, and standard atomic absorption spectrometry (AAS) assay Ftab= 3.46 is much higher than FStat = 0.13 (Ni) and Ftab= 3.46 is much higher than FStat = 0.02 (Co). Also, a good correlation between results via the three methods was found. Thus, the µPAD platform offers a solid base for providing valuable information outside centralized laboratories. [ABSTRACT FROM AUTHOR]

Appropriate paper-based technology (APT) is used to provide postural support for children with cerebral palsy (CP) in low-resourced settings. This pilot study aimed to evaluate the impact of APT on the children's and families' lives. A convenience sample of children with CP and their families participated. Inclusion was based on the Gross Motor Function Classification System levels IV and V. APT seating or standing frames were provided for six months. A mixed methods impact of APT devices on the children and families included the Family Impact Assistive Technology Scale for Adaptive Seating (FIATS-AS); the Child Engagement in Daily Life (CEDL) questionnaire; and a qualitative assessment from diary/log and semi-structured interviews. Ten children (median 3 years, range 9 months to 7 years). Baseline to follow-up median (IQR) FIATS-AS were: 22.7 (9.3) and 30.3 (10.2), respectively (p=.002). Similarly mean (SD) CEDL scores for "frequency" changed from 30.5 (13.2) to 42.08 (5.96) (p=.021) and children's enjoyment scores from 2.23 (0.93) to 2.91 (0.79) (p=.019). CEDL questionnaire for self-care was not discriminatory; seven families scored zero at both baseline and 6 months. Qualitative interviews revealed three key findings; that APT improved functional ability, involvement/interaction in daily-life situations, and a reduced family burden of care. APT devices used in Kenyan children with non-ambulant CP had a meaningful positive effect on both the children's and their families' lives. Assistive devices are often unobtainable for children with cerebral palsy (CP) in low-income countries. APT is a low cost and sustainable solution to make seating and standing devices for disabled children in Kenya. The regular use of a postural support device enhanced the children's motor skills, ability to function and participate in everyday activities, reduced the burden of care for the families and promoted the children's social interaction. The postural support devices were highly valued and utilised by the children and families in this study. [ABSTRACT FROM AUTHOR]

Background: Cough is one of the most common presenting problems for patients in primary care and is largely managed in primary care clinical settings. Family physicians' familiarity with chronic cough guidelines and the extent to which these guidelines translate into everyday practice have not been well described. The objective of this study was to characterize current diagnosis, treatment, and referral practices among family physicians and to identify potentially impactful strategies to optimize chronic cough management in primary care. Methods: We conducted a cross-sectional survey of 5,000 family physicians to explore diagnosis, treatment, and referral practices related to chronic cough management in adults in primary care. Respondents completed the survey via paper or online. The outcome measures were self-reported numeric ratings and responses related to the survey elements. Results: 588 surveys were completed (11.8% response rate). About half (49.6%) of respondents defined chronic cough in a manner consistent with the American College of Chest Physicians (ACCP) chronic cough guidelines, with the rest differing in opinion primarily regarding duration of symptom presentation. Respondents reported trying to rule out most common causes of chronic cough themselves before referring (mean 3.41 on a 4-point scale where 4 is "describes me completely") and indicated a desire for more resources to help them manage and treat chronic cough. Years in practice and rural/urban setting influenced diagnosis and referral practices. Conclusions: Family physicians see chronic cough as a complicated condition that can be and is often diagnosed and treated entirely in a primary care setting. They also value the ability to refer in complex cases. Our results support that family physicians provide evidence-based management of chronic cough. [ABSTRACT FROM AUTHOR]

Nomex Honeycomb core is the foundational building block for manufacturing aerospace composite components. Its usage requires machining honeycomb in complex aerodynamic profiles where the quality of the core is governed by accuracy and precision of cut profiles. The assessment of accuracy and precision is directly related to forces induced in the cutting tool and cutting efficiency. These two parameters form the basis of a multi‐objective function that this paper aims to optimize for the milling operation. The parameter of depth of cut considered in this paper has not been analyzed in a multi‐objective optimization study of the Nomex Honeycomb core previously. A Taguchi‐based array of Design of Experiments followed by Analysis of Variance and correlation analysis is utilised. The results indicate that the most significant factor is the feed rate, with a percentage contribution of 72% for the cutting forces and depth of cut, with a percentage contribution of 85% in the case of cutting efficiency. The two parameters are optimized using Desirability Function Analysis and Grey Relational Analysis. The results are validated through experimental runs with an error within 5% of the statistical predictions, with the percentage improvement in cutting forces for optimum runs as compared to the worst experimental run at 47.8%. The percentage improvement in cutting efficiency likewise is 11%. [ABSTRACT FROM AUTHOR]

Based on the survey data of hydropower immigrants in Yantan, Guangxi, the combination empowerment method and Topsis model are used to quantify the sustainable livelihoods composed of three abilities, and variance analysis is used to explore the impact of follow-up supports and their specific measures on the sustainable livelihoods for the overall and three types of immigrant households in order to evaluate the effectiveness. The results show that the overall sustainable livelihood level of immigrant households is lower than the medium level, and the sustainable livelihood level of non-poor households, general poverty alleviation households and low-income poverty alleviation households decreases successively. Comprehensive assistance has significantly improved the sustainable livelihoods of overall immigrant households. The involvement of specific measures has different effects on the sustainable livelihoods for different immigrant households, among which education and training have significant effects on the improvement of the sustainable livelihoods of three types of immigrant households. The number of measures involved has a significant impact on the sustainable livelihoods of non-poor households and low-income poverty-stricken households, but has no meaningful impact on ordinary poverty-stricken households. This paper expands the research methods in the field of of evaluating the effectiveness of follow-up support for immigrants, which can provide a basis for accurately and efficiently promoting immigrants support. [ABSTRACT FROM AUTHOR]