Search Results (3,527)

Background/Objective: The global increase in life expectancy has led to a higher prevalence of multimorbidity among older patients, often requiring frequent and complex healthcare. Enhancing self-care skills during hospitalization is a key priority in promoting patient autonomy and improving outcomes. The objective of the study was to analyze the effect of the primary nursing model on the therapeutic self-care of older patients with multimorbidity during hospitalization. Methods: It was a quasi-experimental study conducted in two comparable medical-surgical units of a private hospital in Portugal. The intervention unit adopted the primary nursing model, while the control unit maintained standard nursing care. A convenience sample of older patients with multimorbidity was recruited (n = 206; intervention group = 106, control group = 100). Therapeutic self-care was measured using the Portuguese version of the Therapeutic Self-Care Scale at admission, discharge, and follow-up. Statistical analyses included independent samples t-tests to assess between-group differences. Results: At baseline, the intervention group had significantly lower self-care scores than the control group (t_(191.045) = −2.24; p = 0.026). However, between admission and follow-up, the intervention group showed significantly greater improvements in self-care scores compared with the control group (t_(187.55) = 2.68; p = 0.008). Conclusions: The primary nursing care model contributed to enhanced therapeutic self-care skills in older patients with multimorbidity during and after hospitalization. Nurse managers and clinical teams can consider the primary nursing model as an effective care organization strategy to foster self-care, promote patient-centered outcomes, and improve care continuity for older patients with complex needs. Trial Registration: ClinicalTrials.gov Identifier: NCT06702150 (Registered 12 November 2024). Full article

This study addresses autonomous underwater vehicle (UUV) recovery onto dynamic docking stations by proposing a fork-column recovery control system with a segmented docking strategy (long-distance approach + guided descent). To enhance model fidelity, transmission lag of actuators is captured by a specified transfer function, and nonlinear dynamics are characterized as an improved quasi-linear parameter-varying (QLPV) model. An adaptive variable–prediction–step mechanism was designed to accommodate different phases of acoustic–optical guided recovery. A model predictive controller (MPC) was developed based on an improved dynamic model to effectively handle complex constraints during the recovery process. Simulation and physical experiments demonstrated that the proposed system significantly reduces errors, among which the control accuracy (tracking error under disturbance < 0.3 m) and docking success rate (>95%) are notably superior to traditional methods, providing a reliable solution for the dynamic recovery of unmanned underwater vehicles (UUVs). Full article

This study focuses on the analysis of the simultaneous impact of inclined magnetohydrodynamic Carreau hybrid nanofluid flow over a stretching sheet, including microorganisms with the effects of chemical reactions in the presence and absence of slip conditions for dilatant $(n>1.0)$ and quasi-elastic hybrid nanofluid $(n<1.0)$ limitations. Meanwhile, the transfer of energy is strengthened through the employment of heat sources and bioconvection. The analysis incorporates nonlinear thermal radiation, chemical reactions, and Arrhenius activation energy effects on different profiles. Numerical simulations are conducted using the efficient Bvp5c solver. Motile concentration profiles decrease as the density slip parameter of the motile microbe and Lb increase. The Weissenberg number exhibits a distinct nature depending on the hybrid nanofluid; the velocity profile, skin friction, and Nusselt number fall when $(n>1.0)$ and increase when $(n<1.0)$. For small values of inclination, the 3D surface plot is far the surface, while it is close to the surface for higher values of inclination but has the opposite behavior for the 3D plot of the Nusselt number. A detailed numerical investigation on the effects of important parameters on the thermal, concentration, and motile profiles and the Nusselt number reveals a symmetric pattern of boundary layers at various angles $\left(\alpha \right)$. Results are presented through tables, graphs, contour plots, and streamline and surface plots, covering both shear-thinning cases $(n<1.0)$ and shear-thickening cases $(n>1.0)$. Full article

Background/Objectives: Novice nurses often struggle to assertively voice patient safety concerns due to limited clinical experience and hierarchical healthcare environments. Immersive virtual reality simulation (IVRS) may provide opportunities to practice assertive communication skills essential for interprofessional collaboration in a psychologically safe environment. This study aimed to evaluate the short- and long-term effectiveness of an IVRS speak-up training program in enhancing communication clarity and collaborative attitudes, as well as reducing experiences of nursing malpractice among novice nurses. Methods: A quasi-experimental study was conducted with 36 novice nurses (18 participants each in control and experimental groups). The experimental group received a 200 min IVRS speak-up training program incorporating TeamSTEPPS communication strategies through four virtual reality scenarios. The control group received a 110 min conventional group lectures and discussions on communication training covering the same TeamSTEPPS strategies. Communication clarity and collaborative attitudes were measured at baseline, immediately post-intervention, and 6 weeks post-intervention. Nursing malpractice experiences were assessed at 6 weeks post-intervention. Results: Communication clarity showed no significant interaction effect between groups and time points (F = 0.84, p = 0.437), though both groups demonstrated immediate post-intervention improvements. Collaborative attitudes showed a significant interaction effect (F = 4.23, p = 0.020), with the experimental group exhibiting significantly greater and sustained improvements at immediate and 6-week follow-up compared with the control group. No significant difference in nursing malpractice experiences was observed between groups (Z = 0.16, p = 0.872). Conclusions: The IVRS speak-up training program effectively enhanced novice nurses’ assertive communication skills in immersive, interactive environments tailored for realistic practice compared to conventional group discussion-based training. This program improved communication clarity in the short term and enhanced collaborative attitudes up to 6 weeks. Integrating or boosting IVRS training into novice nurses’ communication education may foster interprofessional collaboration and advance patient safety in clinical practice. Full article

The swift advancement of the digital economy presents new pathways toward achieving common prosperity in China. Based on microdata derived from the China Family Panel Studies (2010–2022), this study employs the “Broadband China” pilot policy as a quasi-natural experiment to explore how digital economy development influences multidimensional relative poverty. We develop a multidimensional relative poverty index encompassing economic, health, education, and living condition aspects utilizing the Alkire–Foster dual cutoff method and employ a staggered Difference-in-Differences design for empirical analysis. Results show that the policy leads to an average decrease of 1.8 percentage points in the probability of multidimensional relative poverty across households. The effect is more pronounced in central and western regions, rural households, and those with a high proportion of non-labor force, particularly in the dimensions of economic, health, and living conditions dimensions. Mechanism analysis via interaction term regression indicates that increased population mobility and improved informal employment are key channels. These findings suggest that enhancing digital infrastructure and tailoring mobility and employment policies to fit regional and urban–rural contexts can effectively alleviate multidimensional relative poverty. This study contributes empirical evidence connecting the advancement of the digital economy to poverty alleviation and aligns with the United Nations Sustainable Development Goal 1 (No Poverty). Full article

The sensory glove (also known as data or instrumented glove) plays a key role in measuring and tracking hand dexterity. It has been adopted in a variety of different domains, including medical, robotics, virtual reality, and human–computer interaction, to assess hand motor skills and to improve control accuracy. However, no particular technology has been established as the most suitable for all domains, so that different sensory gloves have been developed, adopting different sensors mainly based on optic, electric, magnetic, or mechanical properties. This work investigates the performances of the MANUS Quantum sensory glove that sources an electromagnetic field and measures its changing value at the fingertips during fingers’ flexion. Its performance is determined in terms of measurement repeatability, reproducibility, and reliability during both quasi-static and dynamic hand motor tests. Full article

Coal seams, as critical components of open-pit mine slopes, are subjected to both quasi-static and dynamic loading disturbances during mining operations, with their mechanical properties directly influencing the slope stability. Consequently, to clarify the mechanical properties and failure mechanisms of coal seams affected by the strain rate under the static–dynamic loading conditions, the mineral composition and meso-structural characteristics of lignite were analyzed in this study, and uniaxial compression tests with different quasi-static loading rates and dynamic compression tests with different impact velocities were conducted. The results indicate that there is an obvious horizontal bedding structure in lignite, which leads to differences in mechanical response and failure mechanism at different strain rates. Under the quasi-static loading, lignite exhibits significantly lower strain-rate sensitivity than compared to dynamic impact conditions. The Poisson’s ratio difference between the bedding matrix and the lignite will produce interfacial friction, which gradually decreases with the increase in the distance from the interface, thus promoting the transformation of lignite from multi-crack tensile shear mixed fracture to single-crack splitting failure. Under the dynamic impact conditions, low-impact velocities induce stress wave reflection at bedding interfaces due to wave impedance disparity between the matrix and lignite, generating tensile strains that result in bedding-plane delamination failure; at higher velocities, incomplete energy absorption by the rock specimen leads to fragmentation failure of lignite. These findings are of great significance for the stability analysis of open-pit slopes. Full article

In the present investigation, stress–strain curves and strain hardening rates on samples rolled at ambient temperature with thickness reductions of 0%, 10%, 30%, and 50% were studied. On the processed samples, static tensile tests at ambient temperature were performed. Transformation of the engineering stress–strain curves to true stress–strain curves and their numerical processing by first derivation (θ = dσ/dε) was carried out. Dependencies θ = f(ε_T) characterizing the strain hardening rates were derived. From the curves and the true stress–strain and strain hardening rates, the three stages describing different rates of strain hardening were identified. A rapid increase in true stress and a rapid decrease in the strain hardening rate in Stage I were observed. Quasi-linear dependencies with an increase in true stress but with a slow, gradual decline in the strain hardening rate in Stage II were obtained. Slowly increasing true strains, accompanied by a decrease in strain hardening rates and their transition to softening, led to the formation of plastic instability and necking in Stage III. The endpoints of the strain hardening rate depending on the cold rolling deformations lie in the following intervals: θ_{Stage I} ∈ <1904;3032> MPa, θ_{Stage II} ∈ <906;−873> MPa, θ_{Stage III} ∈ <−144;−11,979> MPa. While in Stage I and Stage II, the plastic deformation mechanism is predominantly dislocation slip, in Stage III, the plastic deformation mechanism is twinning accompanied by dislocation slip. Full article

This study aims to investigate the effects of selenium (Se) fortification on growth performance and the Se content in kale using Se fertilizer, and it determines the influences of Se fortification on the metabolic profile of kale using quasi-targeted metabolomics. The results showed that Se fortification increased the plant height and leaf weight of kale, up-regulated the total Se content and decreased the chlorophyll and total phenolic contents in kale leaf. Se fortification elevated selenate (Se(IV)), selenite (Se(VI)), selenocystine (SeCys₂), Se-methylselenocysteine (Se-MeSeCys) and selenomethionine (SeMet) contents, as well as total contents of Se in different forms in kale leaf. Se fortification also changed the metabolic profile of kale leaf, via six particular types of compounds (amino acid and its derivatives; organic acid and its derivatives; carbohydrates and its derivatives; lipids; flavonoids; organoheterocyclic compounds) and eight metabolic pathways (alanine, aspartate and glutamate metabolism; amino sugar and nucleotide sugar metabolism; sulfur metabolism; starch and sucrose metabolism; taurine and hypotaurine metabolism; glycolysis/gluconeogenesis; fructose and mannose metabolism; nitrogen metabolism). Moreover, 24 metabolic biomarkers were screened for kale leaf affected by Se fortification. Furthermore, correlations were observed between metabolic biomarkers and Se contents as well as speciation. These results indicate that Se fortification has a significant influence on the growth performance and nutritional compounds of kale, providing references for the future study on the production and bioactivity of Se-enriched kale. Full article

This study presents a non-invasive three-dimensional cell manipulation technique based on acoustic microfluidic chips, which generates acoustic flow fields through the vibration of micropillars induced by bulk acoustic waves to achieve precise multi-dimensional rotational manipulation of cells. Moreover, the characteristics of the acoustic flow field under linear, quasi-circular, elliptical, and higher-order vibration modes were intensively studied, and the rotational manipulation performance of polystyrene microbeads and cancer cells was optimized by adjusting the frequency and voltage. The results showed that the rotational speed and direction of the particles varied significantly in different vibration modes, with the particles and cells achieving the highest rotational speed in the elliptical vibration mode (frequency: 44.9 kHz, and voltage: 60 Vpp). In addition, the technique successfully achieved in-plane and out-of-plane rotation of cancer cells, and cell viability tests showed that 94% of the cells remained active after manipulation, demonstrating the low damage and biocompatibility of the method. This study provides a new, efficient, precise and gentle approach to three-dimensional manipulation of cells, which holds significant potential in biomedical research and clinical applications. Full article

PM_2.5 poses a serious threat to public health, and stronger intellectual property (IP) protection can help reduce PM_2.5 concentrations. This study treats the rollout of National Intellectual Property Model Cities (NIPMC) as a quasi-natural experiment in IP protection, using an unbalanced panel of 2074 counties from 2005 to 2021. We employ a multi-period difference-in-differences (DID) design to examine how NIPMC affects both average PM_2.5 levels and their variability. Three main findings emerge. First, NIPMC significantly lowers PM_2.5 levels and their dispersion in pilot counties, a result that remains robust across a battery of checks. Second, NIPMC reduces PM_2.5 by strengthening local innovation capacity and by accelerating industrial restructuring and upgrading. Third, the reduction in average PM_2.5 is especially pronounced in areas with weaker IP protection, general (non-core) cities, and in western regions; meanwhile, the reduction in PM_2.5 variability is particularly notable in weak-IP areas, general cities, and central regions. Together, these results provide new evidence on the environmental benefits of IP protection and offer actionable policy guidance for developing countries pursuing cleaner air. Full article

This study aims to address the challenges junior high school students often encounter when learning abstract spatial vector concepts. By developing and implementing a virtual robotic system, this research intends to improve students’ spatial reasoning, deepen their conceptual understanding, and increase engagement through an interactive, visual, and experiential learning environment that remedies the shortcomings of traditional teaching methods. The system was developed with the Unity Game Engine to deliver 3D visualization, interactive manipulation, and real-time feedback, thereby enhancing conceptual learning. In addition, the instructional design employed the ADDIE model (Analysis, Design, Development, Implementation, Evaluation) to enhance students’ understanding of spatial vector concepts. A quasi-experimental design was conducted involving 60 eighth-grade students divided evenly into experimental and control groups. Pre- and post-tests—including achievement assessments, learning attitude questionnaires, and cognitive load scales—were administered to evaluate learning outcomes. The main findings are as follows: (1) The experimental group demonstrated significantly higher learning achievement compared to the control group. (2) Both groups showed improvements in mathematics learning attitudes, with the experimental group exhibiting greater gains in practicality and confidence. (3) Although the experimental group experienced a slightly higher cognitive load, this difference was not statistically significant. (4) The experimental group reported high satisfaction with the system, especially in perceived usefulness. This study demonstrates that integrating virtual reality with the ADDIE model can substantially enhance learners’ conceptual understanding and motivation. Full article

Innovation can balance environmental objectives while enhancing economic efficiency. However, its policy dimension has largely been overlooked. Leveraging financial instruments to promote technological innovation has become a primary policy tool. This study treats China’s pilot policies on technology finance integration as a quasi-natural experiment and constructs a multi-period difference-in-differences model with 5434 panel datapoints from 286 cities between 2005 and 2023. Within the environmental Kuznets curve theoretical framework, we examine the impact of technology finance policies on urban carbon emissions. The findings reveal that these policies significantly curb urban carbon emissions. Heterogeneity analysis shows stronger effects in large, non-resource-dependent eastern cities than in others. Mechanism tests indicate that these policies primarily generate green value through technological innovation and industrial structure upgrading, with the latter demonstrating a significantly stronger effect than the former. Our findings regarding the outstanding role of industrial structure upgrading may challenge and reorient the literature’s general focus on green technologies. This study employs economic principles to offer new insights into innovation’s effective balancing of economic growth and sustainability, broadening discussions about the green value of financial policy tools. Full article

The aim of this study was to investigate the changes in students’ attitudes towards design and technology in different Information and Communication Technology (ICT)-based learning environments for technical and engineering subjects. Students’ positive attitudes towards the subject can promote deeper knowledge transfer and reduce anxiety about technology. Teachers who have a positive attitude towards the subject tend to promote a high-quality learning process. A total of 44 students participated in this study, with the experimental group and the control group each consisting of 22 students. For this study, we used a quasi-experimental research design with pre- and post-tests and a control variable for ICT engagement. The results suggest that the technology-enhanced systems thinking approach has significant effects on perceptions of the difficulty of technology and engineering differences in students’ attitudes towards design and technology, while perceived autonomy in ICT use can increase motivation and engagement. Feeling competent in ICT use may increase perceived interest, awareness, and aspirations for design and technology and reduce tediousness and gender differences in technology and engineering. Full article

Environmental pollution and waste caused by traditional citrus farming has become more serious. As the direct subject of agricultural production, we should pay more attention to the green production behavior of farmers. Numerous studies have fully proven that technology training is the important driving factor of farmers’ production behavior, but the question of which main body or organization should carry out the training is the question that still has no definite conclusion, in order to solve this problem. Based on the perspective of the heterogeneity of agricultural technology training organizations, this study conducts a discussion on the indicators of the difference in training organization and technology adoption behavior, and uses the Oprobit and IV-Oprobit models to conduct an empirical analysis on 782 Chinese farmers’ survey data. Finally, we find: (1) Technical training has a positive impact on farmers’ GPT adoption at the 1% level. For each additional training, the probability of adopting five GPT increased by 2.6%; (2) Different training organizations have different impacts on the farmers’ technology adoption. The training of profit-oriented organizations represented by agricultural enterprises has the most obvious promotion effect on GPT adoption by farmers. The overall effect of the training of government agricultural extension departments is better than that of quasi-public welfare organizations such as scientific research institutions; (3) The above effects also have obvious heterogeneity among farmers of different ages, education levels, family social networks, planting scale, family incomes and structure. Based on this, we put forward policy suggestions such as building a diversified agricultural extension training system. Full article