Search Results (2,320)

With the large-scale integration of high-penetration distributed photovoltaic (DPV) into distribution networks, its output volatility and reverse power flow characteristics are prone to causing voltage violations, necessitating the accurate identification of weak nodes to enhance operational reliability. This paper investigates the definition, quantification criteria, and multi-indicator comprehensive determination methods for weak nodes in distribution networks. A multi-criteria assessment method integrating voltage deviation rate, sensitivity analysis, and power margin has been proposed. This method quantifies the node disturbance resistance and comprehensively evaluates the vulnerability of voltage stability. Simulation validation based on the IEEE 33-node system demonstrates that the proposed method can effectively identify the distribution patterns of weak nodes under different penetration levels (20~80%) and varying numbers of DPV access points (single-point to multi-point distributed access scenarios). The study reveals the impact of increased penetration and dispersed access locations on the migration characteristics of weak nodes. The research findings provide a theoretical basis for the planning of distribution networks with high-penetration DPV, offering valuable insights for optimizing the siting of volatile loads such as electric vehicle (EV) charging stations while considering both grid safety and the demand for distributed energy accommodation. Full article

Background/Objectives: Evidence-based nursing practice (EBNP) is essential in high-acuity settings such as intensive care units (ICUs) and emergency departments (EDs), where nurses are frequently required to make time-critical, high-stakes clinical decisions that directly influence patient safety and outcomes. Despite its recognized importance, the implementation of EBNP remains inconsistent, with frontline nurses often facing barriers to accessing and applying current evidence. Methods: This descriptive, cross-sectional study systematically mapped and prioritized clinical questions generated by ICU and ED nurses at a tertiary hospital in South Korea. Using open-ended questionnaires, 204 clinical questions were collected from 112 nurses. Each question was coded and classified according to the Nursing Interventions Classification (NIC) taxonomy (8th edition) through a structured cross-mapping methodology. Inter-rater reliability was assessed using Cohen’s kappa coefficient. Results: The majority of clinical questions (56.9%) were mapped to the Physiological: Complex domain, with infection control, ventilator management, and tissue perfusion management identified as the most frequent areas of inquiry. Patient safety was the second most common domain (21.6%). Notably, no clinical questions were mapped to the Family or Community domains, highlighting a gap in holistic and transitional care considerations. The mapping process demonstrated high inter-rater reliability (κ = 0.85, 95% CI: 0.80–0.89). Conclusions: Frontline nurses in high-acuity environments predominantly seek evidence related to complex physiological interventions and patient safety, while holistic and community-oriented care remain underrepresented in clinical inquiry. Utilizing the NIC taxonomy for systematic mapping establishes a reliable framework to identify evidence gaps and support targeted interventions in nursing practice. Regular protocol evaluation, alignment of continuing education with empirically identified priorities, and the integration of concise evidence summaries into clinical workflows are recommended to enhance EBNP implementation. Future research should expand to multicenter and interdisciplinary settings, incorporate advanced technologies such as artificial intelligence for automated mapping, and assess the long-term impact of evidence-based interventions on patient outcomes. Full article

The siphon effect between airports has amplified the polarization in passenger throughput, undermining the balanced development and sustainability of airport clusters. The airport siphon effect occurs when one airport attracts a disproportionate share of passengers, concentrating traffic at the expense of others, which affects the overall resilience of the entire airport cluster. To address this issue, this study proposes a siphon index, expands the range of ground transportation options for passengers, and establishes a zero-siphon model to assess the impact of siphoning on the resiliency of airport clusters. Using this framework, four major airport clusters in China were selected as research subjects, with regional aviation accessibility serving as a measure of resilience. The results showed that among the four airport clusters, the siphon effect is most pronounced in the Guangzhou region. To explore the implications of this effect further, three airport disruption scenarios were simulated to assess the resilience of the Pearl River Delta airport cluster. The results indicated that the intensity and timing of disruptive events significantly affect airport cluster resilience, with hub airports being particularly sensitive. This study analyzes the risks associated with excessive route concentration, providing policymakers with critical insights to enhance the sustainability, equity, and resilience of airport clusters. The proposed strategies facilitate coordinated infrastructure development, optimized air–ground intermodal connectivity, and risk mitigation. These measures contribute to building more sustainable and adaptive aviation networks in rapidly urbanizing regions. Full article

Tunisia faces significant challenges related to climate change, which deeply affect its natural and agricultural resources. This reality threatens not only food security but also the economic stability of rural communities and mainly rural women. This research aims to assess the impact of climate change on rural women in the agricultural development group in Sidi Bouzid, focusing on the strategies adopted and the support provided by various stakeholders to mitigate this impact. To achieve this, we developed a rigorous methodology that includes structured questionnaires, focus group discussions, and topological analysis through Multiple Correspondence Analysis (MCA). The results revealed that rural women were categorized into three groups based on their vulnerability to climate change: severely vulnerable, vulnerable, and adaptive. The findings highlighted the significant impact of climate change on water resources, which has increased family tensions and reduced agricultural incomes, making daily life more challenging for rural women. Furthermore, a deeper analysis of interactions with external stakeholders emphasized the important role of civil society, public organizations, and research institutions in strengthening the climate resilience of rural women. Given these findings, strategic recommendations aim to enhance stakeholder coordination, expand partnerships, and improve access to essential technologies and resources for women in agricultural development groups. Full article

Microfluidic platforms offer a powerful approach for ultimately replicating vascularization in vitro, enabling precise microscale control and manipulation of physical parameters. Despite these advances, the real-time ability to monitor and quantify mechanical forces—particularly pressure—within microfluidic environments remains constrained by limitations in cost and compatibility across diverse device architectures. Our work presents an advanced experimental module for quantifying pressure within a vascularizing microfluidic platform. Equipped with an integrated Arduino microcontroller and image monitoring, the system facilitates real-time remote monitoring to access temporal pressure and flow dynamics within the device. This setup provides actionable insights into the hemodynamic parameters driving vascularization in vitro. In-line pressure sensors, interfaced through I2C communication, are employed to precisely record inlet and outlet pressures during critical stages of microvasculature tubulogenesis. Flow measurements are obtained by analyzing changes in reservoir volume over time (dV/dt), correlated with the change in pressure over time (dP/dt). This quantitative assessment of various pressure conditions in a microfluidic platform offers insights into their impact on microvasculature perfusion kinetics. Data acquisition can help inform and finetune functional vessel network formation and potentially enhance the durability, stability, and reproducibility of engineered in vitro platforms for organoid vascularization in regenerative medicine. Full article

In an era where digitalization shapes economic and social landscapes, the intersection of digital skills, ethics, and integrity plays a crucial role in understanding the vulnerability of youth classified as NEET (Not in Education, Employment, or Training). This study explores how risky internet use and digital skill gaps contribute to socio-economic exclusion, integrating a multivariate and spatial approach to assess regional disparities in Europe. This study adopts a systems thinking perspective to explore digital exclusion as an emergent outcome of multiple interrelated subsystems. The research employs logistic regression, Principal Component Analysis (PCA) with Promax rotation, and Geographic Information Systems (GIS) to examine the impact of digital behaviors on NEET status. Using Eurostat data aggregated at the country level for the period (2000–2023) across 28 European countries, this study evaluates 24 digital indicators covering social media usage, instant messaging, daily internet access, data protection awareness, and digital literacy levels. The findings reveal that low digital skills significantly increase the likelihood of being NEET, while excessive social media and internet use show mixed effects depending on socio-economic context. A strong negative correlation between digital security practices and NEET status suggests that youths with a higher awareness of online risks are less prone to socio-economic exclusion. The GIS analysis highlights regional disparities, where countries with limited digital access and lower literacy levels exhibit higher NEET rates. Digital exclusion is not merely a technological issue but a multidimensional socio-economic challenge. To reduce the NEET rate, policies must focus on enhancing digital skills, fostering online security awareness, and addressing regional disparities. Integrating GIS methods allows for the identification of territorial clusters with heightened digital vulnerabilities, guiding targeted interventions for improving youth employability in the digital economy. Full article

Global policy narratives on livestock development increasingly emphasize environmental concerns, often overlooking the social dimensions of the sector. In the case of dairy, the world’s most valuable agricultural commodity, its role in social and economic development remains poorly quantified. Our study contributes to a more balanced vision of the UN SDGs thanks to the inclusion of a socio-economic dimension. Here we present a novel empirical approach to assess the socio-economic impacts of dairy development using a new global dataset and non-parametric modelling techniques (local polynomial regressions), with yield as a proxy for sectoral performance. We find that as dairy systems intensify, the number of farm households engaged in production declines, yet household incomes rise. On-farm labour productivity also increases, accompanied by a reduction in employment but higher wages. In dairy processing, employment initially grows, peaks, and then contracts, again with rising wages. The most substantial impact is observed among consumers: an increased milk supply leads to lower prices and improved affordability, expanding the access to dairy products. Additionally, dairy development is associated with greater agricultural value added, an expanding tax base, and the increased formalization of the economy. These findings suggest that dairy development, beyond its environmental footprint, plays a significant and largely positive role in social transformation, yet is having to adapt sustainably while tackling labour force relocation, and that dairy development’s social impacts mimic the general agricultural sector. These results might be of interest for the assessment of policies regarding dairy development. Full article

Background: Breast cancer remains a major public health challenge in Latin America, where access to personalized risk assessment tools is still limited. This study aimed to evaluate the implementation of a polygenic risk score (PRS)-based stratification model combined with remote genomic counseling in Colombian women with sporadic breast cancer and healthy women. Methods: In 2023, an embedded mixed-methods observational study was conducted in Medellín involving 1997 women aged 40–75 years who underwent clinical PRS testing. The intervention integrated PRS-based risk categorization with individualized risk factor assessment and lifestyle recommendations delivered through a remote counseling platform. Results: PRS analysis classified 9.7% of women as high risk and 46% as low risk. Healthier lifestyle patterns were significantly associated with lower PRS categories (p = 0.034). Physical activity showed a protective effect (OR = 0.60, 95% CI: 0.5–0.8), while prior smoking, elevated BMI, and sedentary behavior were associated with higher risk. The counseling model achieved high delivery (93%) and satisfaction (85%) rates. Qualitative insights revealed improved understanding of genomic risk and greater engagement in preventive behaviors. Only one new case of breast cancer was detected among intermediate-risk participants, with a diagnostic lead time of 12 months. Conclusions: These findings support the feasibility, acceptability, and potential impact of integrating PRS and genomic counseling in cancer prevention strategies in middle-income settings. Full article

Urban areas are facing increasing traffic congestion, pollution, and infrastructure strain. Traditional urban transportation systems are often fragmented. They require users to plan, pay, and travel across multiple disconnected services. Mobility-as-a-Service (MaaS) integrates these services into a single digital platform, simplifying access and improving the user experience. This review critically examines the role of MaaS in fostering sustainable mobility ecosystems. MaaS aims to enhance user-friendliness, service variety, and sustainability by adopting a customer-centric approach to transportation. The findings reveal that successful MaaS systems consistently align with multimodal transport infrastructure, equitable access policies, and strong public-private partnerships. MaaS enhances the management of routes and traffic, effectively mitigating delays and congestion while concurrently reducing energy consumption and fuel usage. In this study, the authors examine MaaS as a new mobility paradigm for a sustainable transportation system in smart cities, observing the challenges and opportunities associated with its implementation. To assess the environmental impact, a sustainability index is calculated based on the use of different modes of transportation. Significant findings indicate that MaaS systems are proliferating in both quantity and complexity, increasingly integrating capabilities such as real-time multimodal planning, dynamic pricing, and personalized user profiles. Full article

This study aimed to evaluate the feasibility of using serious games for the (tele)rehabilitation of children with disabilities affected by the Ukrainian war. Additionally, it provides requirements for technologies that can be used in war-affected areas. Structured interviews and Likert scale assessments were conducted on-site and remotely with patients of the tertiary care facility in Ukraine. All participants used the telerehabilitation platform for motor and cognitive training. Nine serious games were employed, involving trunk tilts, upper limb movements, and head control. By mid-September 2023, 186 positive user experiences were evident, with 89% expressing interest in continued engagement. The platform’s accessibility, affordability, and therapeutic benefits were highlighted. The recommendations from user feedback informed potential enhancements, showcasing the platform’s potential to provide uninterrupted rehabilitation care amid conflict-related challenges. This study suggests that serious games solutions that suit the sociopolitical and economic context offer a promising solution to rehabilitation challenges in conflict zones. The positive user experiences towards using the platform with serious games indicate its potential in emergency healthcare provision. The findings emphasize the role of technology, particularly serious gaming, in mitigating the impact of armed conflicts on children’s well-being, thereby contributing valuable insights to healthcare strategies in conflict-affected regions. Requirements for technologies tailored to the context of challenging settings were defined. Full article

Suspension dome structures are widely utilized due to their superior performance compared to conventional structures. The condition of the cables, particularly the forces they experience, is critical for ensuring the safety of the overall structures. However, friction between cables and joints significantly disrupts cable force distribution, particularly during pre-stressing construction. This paper integrates a tension-compensation method with a numerical approach that accurately accounts for friction effects. A computational flowchart was introduced and subsequently applied to analyze a practical suspension dome structure. We assessed the impact of friction on cable forces, structural deformations, and the mechanical state of the cable–strut system. Furthermore, we quantified the consequences of excessive tensioning. The findings demonstrate that the method presented in this paper can efficiently be employed for the analysis of large-scale complex structures and is readily accessible to structural designers. Full article

At the Politecnica Salesiana University (UPS) in Guayaquil, Ecuador, urban mobility challenges were addressed with the aim of improving students’ quality of life and promoting sustainability. This study evaluated the technical, economic, and social feasibility of implementing a shared transportation (carpooling) system using a quantitative-descriptive approach. Surveys were applied to a stratified sample of 256 students to analyze transportation habits. Route planning was performed using ArcGIS software, and costs were calculated with Microsoft Excel. Social impact assessment involved focus groups and analysis of variables such as changes in mobility patterns, system acceptance, and perceived safety, comfort, and accessibility. Key indicators included the percentage of students willing to participate in the pilot (82.7%), satisfaction with travel time savings (85.7% fully satisfied), and positive perceptions of safety and comfort. The results suggest that the proposed system is not only economically viable but also widely accepted by students, contributing to reduced stress, travel time, and single-occupancy vehicle use. This study demonstrates the feasibility of shared transport in urban universities and provides a replicable model to guide sustainable mobility policies that improve safety, comfort, and efficiency in student commuting. Full article

Background and Objectives: Specialized nurses play an essential role in managing pulmonary fibrosis. While tele-nursing has the potential to optimize disease management, current evidence regarding its impact remains limited. This study aimed to evaluate a tele-nursing intervention that provided unscheduled access to a specialized nurse via phone or email for both patients and caregivers. Materials and Methods: This was a prospective, single-center, open-label, and pre–post pilot study. Participants and their caregivers were provided with direct access to a specialized nurse, by phone and email, for unscheduled consultations. Patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) were collected at baseline and after three months of tele-nursing access. PREMs were assessed using a 10-point Likert scale questionnaire, and PROMs were evaluated using the King’s Brief Interstitial Lung Disease (K-BILD) and the Living with Pulmonary Fibrosis (L-PF) questionnaires. Results: A total of 47 patients with pulmonary fibrosis receiving antifibrotic drugs were enrolled. At three months, 44 patients and 34 caregivers completed the questionnaires. Four patients did not complete the study due to death, lung transplantation, or transition to end-of-life care. No significant changes were observed in PROMs. However, PREMs showed significant improvements, with most scores exceeding 9/10. Patient satisfaction increased by 28% (p < 0.001), and caregiver satisfaction by 30% (p < 0.001). Caregivers of patients who did not complete the study also reported high satisfaction, comparable to that of other caregivers. Conclusions: A pragmatic and affordable tele-nursing program, based on direct phone and email consultations, may enhance patient and caregiver satisfaction in the management of pulmonary fibrosis. Full article

The global rise in urban-related health issues poses significant challenges to public health, particularly in cities facing socio-economic crises. In Lebanon, 70% of the population is experiencing financial hardship, and healthcare costs have surged by 172%, exacerbating the strain on medical services. Given these conditions, improving the quality and accessibility of green spaces offers a promising avenue for alleviating mental health issues in urban areas. This study investigates the psychological impact of nine urban public spaces in Beirut through a comprehensive survey methodology, involving 297 participants (locals and tourists) who rated these spaces using Likert-scale measures. The findings reveal location-specific barriers, with Saanayeh Park rated highest in quality and Martyr’s Square rated lowest. The analysis identifies facility quality as the most significant factor influencing space quality, contributing 73.6% to the overall assessment, while activity factors have a lesser impact. The study further highlights a moderate positive association (Spearman’s rho = 0.30) between public space quality and mental well-being in Beirut. This study employs a hybrid methodology combining Research for Design (RfD) and Research Through Designing (RTD). Empirical data informed spatial strategies, while iterative design served as a tool for generating context-specific knowledge. Design enhancements—such as sensory plantings, shading systems, and social nodes—aim to improve well-being through better public space quality. The proposed interventions support mental health, life satisfaction, climate resilience, and urban inclusivity. The findings offer actionable insights for cities facing public health and spatial equity challenges in crisis contexts. Full article

Background/Objectives: Frailty is a multifactorial clinical syndrome characterized by diminished physiological reserves and increased vulnerability to stressors. It is increasingly recognized as a predictor of poor outcomes in cardiac rehabilitation (CR). However, how frailty is defined, assessed, and addressed across outpatient CR programmes remains unclear. This scoping review aimed to map the extent, range, and nature of research examining frailty in the context of outpatient CR, including how frailty is measured, its impact on CR participation and outcomes, and whether sex and gender considerations or participation barriers are reported. Methods: Following the PRISMA-ScR guidelines, we conducted a comprehensive search across six electronic databases (from inception to 15 May 2025). Eligible peer-reviewed studies included adult participants assessed for frailty using validated tools and enrolled in outpatient CR programmes. Two reviewers independently screened citations and extracted data. Results were synthesized descriptively and narratively across three domains: frailty assessment, sex and gender considerations, and barriers to CR participation. The protocol was registered with the Open Science Framework. Results: Thirty-nine studies met inclusion criteria, all conducted in the Americas, Western Pacific, or Europe. Frailty was assessed using 26 distinct tools, most commonly the Kihon Checklist, Fried’s Frailty Criteria, and Frailty Index. The median pre-CR frailty prevalence was 33.5%. Few studies (n = 15; 38.5%) re-assessed frailty post-CR. Sixteen studies reported sex or gender data, but none applied sex- or gender-based analysis (SGBA) frameworks. Only eight studies examined barriers to CR participation, identifying physical limitations, emotional distress, cognitive concerns, healthcare system-related factors, personal and social factors, and transportation as key barriers. Conclusions: The literature on frailty in CR remains fragmented, with heterogeneous assessment methods, limited global representation, and inconsistent attention to sex, gender, and participation barriers. Standardized frailty assessments and individualized CR programme adaptations are urgently needed to improve accessibility, adherence, and outcomes for frail individuals. Full article