Search Results (1,051)

Background: Point-of-care ultrasound (POCUS) is gaining recognition as a valuable diagnostic tool in various fields of medicine, including pediatrics. Its application at the point of care enables real-time clinical decision-making, which is particularly advantageous in pediatric settings. Although global interest in POCUS is growing, many European countries—including Poland—still lack formal training programs for POCUS at both the undergraduate and postgraduate levels. Nevertheless, the number of pediatricians incorporating POCUS into their daily clinical practice in Poland is increasing. However, the extent of its use and perceived value among pediatricians remains largely unknown. This study aimed to evaluate the current level of POCUS utilization in pediatric care in Poland, focusing on pediatricians’ self-assessed competencies, perceptions of its clinical utility, and key barriers to its implementation in daily practice. Methods: This cross-sectional study was conducted between July and August 2024 using an anonymous online survey distributed to pediatricians throughout Poland via national professional networks, with a response rate of 7.3%. Categorical variables were analyzed using the chi-square test of independence to assess the associations between key variables. Quantitative data were analyzed using descriptive statistics, and qualitative data from open-ended responses were subjected to a thematic analysis. Results: A total of 210 pediatricians responded. Among them, 149 (71%) reported access to ultrasound equipment at their workplace, and 89 (42.4%) reported having participated in some form of POCUS training. Only 46 respondents (21.9%) reported frequently using POCUS in their clinical routine. The self-assessed POCUS competence was rated as low or very low by 136 respondents (64.8%). While POCUS was generally perceived as a helpful tool in facilitating and accelerating clinical decisions, the main barriers to implementation were a lack of formal training and limited institutional support. Conclusions: Although POCUS is perceived as clinically valuable by the surveyed pediatricians in Poland, its routine use remains limited due to training and systemic barriers. Future efforts should prioritize the development of a validated, competency-based training framework and the implementation of a larger, representative national study to guide the structured integration of POCUS into pediatric care. Full article

Background: Cochlear implantation (CI) in pediatric patients with cochlear nerve deficiencies (CND) remains controversial due to a highly variable clinical population, lack of evidence-based guidelines, and mixed research findings. This study assessed current clinical perspectives and practices regarding CI candidacy in children with CND among hearing healthcare professionals in the USA. Methods: An anonymous 19-question online survey was distributed to CI clinicians nationwide. The survey assessed professional background, experience with aplasia and hypoplasia, and perspectives on CI versus auditory brainstem implant (ABI) candidacy, including imaging practices and outcome expectations. Both multiple-choice and open-ended responses were analyzed to identify trends and reasoning. Results: Seventy-two responses were analyzed. Most clinicians supported CI for hypoplasia (60.2%) and, to a lesser extent, for aplasia (41.7%), with audiologists more likely than neurotologists to favor CI. Respondents cited lower risk, accessibility, and the potential for benefit as reasons to attempt CI before ABI. However, many emphasized a case-by-case approach, incorporating imaging, electrophysiological testing, and family counseling. Only 22.2% considered structural factors the best predictors of CI success. Conclusions: Overall, hearing health professionals in the USA tend to favor CI as a first-line option, while acknowledging the limitations of current diagnostic tools and the importance of individualized, multidisciplinary decision-making in CI candidacy for children with CND. Findings reveal a high variability in clinical perspectives on CI implantation for pediatric aplasia and hypoplasia and a lack of clinical consensus, highlighting the need for more standardized assessment and imaging protocols to provide greater consistency across centers and enable the development of evidence-based guidelines. Full article

Background and Objectives: Diabetes is a global public health challenge, with increasing prevalence worldwide. The implementation of artificial intelligence (AI) in the management of this condition offers potential benefits in improving healthcare outcomes. This study primarily investigates the barriers and facilitators perceived by healthcare professionals in the adoption of AI. Secondarily, by analyzing both quantitative and qualitative data collected, it aims to support the potential development of AI-based programs for diabetes management, with particular focus on a possible bottom-up approach. Materials and Methods: A scoping review was conducted following PRISMA-ScR guidelines for reporting and registered in the Open Science Framework (OSF) database. The study selection process was conducted in two phases—title/abstract screening and full-text review—independently by three researchers, with a fourth resolving conflicts. Data were extracted and assessed using Joanna Briggs Institute (JBI) tools. The included studies were synthesized narratively, combining both quantitative and qualitative analyses to ensure methodological rigor and contextual depth. Results: The adoption of AI tools in diabetes management is influenced by several barriers, including perceived unsatisfactory clinical performance, high costs, issues related to data security and decision-making transparency, as well as limited training among healthcare workers. Key facilitators include improved clinical efficiency, ease of use, time-saving, and organizational support, which contribute to broader acceptance of the technology. Conclusions: The active and continuous involvement of healthcare workers represents a valuable opportunity to develop more effective, reliable, and well-integrated AI solutions in clinical practice. Our findings emphasize the importance of a bottom-up approach and highlight how adequate training and organizational support can help overcome existing barriers, promoting sustainable and equitable innovation aligned with public health priorities. Full article

The justice system has increasingly applied AI techniques for legal judgment to enhance efficiency. However, most AI techniques focus on decision-making outcomes, failing to capture the deliberative nature of the real-world judicial process. To address these challenges, we propose a large language model-based multi-agent framework named AgentsBench. Our approach leverages multiple LLM-driven agents that simulate the discussion process of the Chinese judicial bench, which is often composed of professional and lay judge agents. We conducted experiments on a legal judgment prediction task, and the results show that our framework outperforms existing LLM-based methods in terms of performance and decision quality. By incorporating these elements, our framework reflects real-world judicial processes more closely, enhancing accuracy, fairness, and societal consideration. While the simulation is based on China’s lay judge system, our framework is generalizable and can be adapted to various legal scenarios and other legal systems involving collective decision-making processes. Full article

This study proposes a multi-objective optimization scheduling method for edible oil transportation in smart manufacturing, focusing on centralized control and addressing challenges such as complex pipelines and shared resource constraints. The method employs the A* and Dijkstra pathfinding algorithm to determine the shortest pipeline route for each task, and estimates pipeline resource usage to derive a node cost weight function. Additionally, the transport time is calculated using the Hagen–Poiseuille law by considering the viscosity coefficients of different oil types. To minimize both cost and time, task execution sequences are optimized based on a Pareto front approach. A 3D digital model of the pipeline system was developed using C#, SolidWorks Professional, and the Helix Toolkit V2.24.0 to simulate a realistic production environment. This model is integrated with a 3D visual human–machine interface(HMI) that displays the status of each task before execution and provides real-time scheduling adjustment and decision-making support. Experimental results show that the proposed method improves scheduling efficiency by over 43% across various scenarios, significantly enhancing overall pipeline transport performance. The proposed method is applicable to pipeline scheduling and transportation management in digital factories, contributing to improved operational efficiency and system integration. Full article

Background/Objectives: Emotional intelligence has emerged as a key factor in shaping nursing performance and care quality, yet its specific mechanisms and impact within the Greek public healthcare context remain underexplored. This study aimed to investigate the role of emotional intelligence in ethical behavior, crisis management, and the perceived quality of care among nurses working in Greek public hospitals. Methods: A cross-sectional survey was conducted among practicing nurses using validated instruments to assess emotional intelligence, ethical compliance, crisis management skills, and care quality. Data were analyzed using covariance-based structural equation modeling (CB SEM) to examine both direct and indirect relationships among variables. Results: The results indicated that emotional intelligence training had a strong and significant effect on nurses’ ethical behavior and their ability to manage critical situations. However, the direct effect of emotional intelligence on the perceived quality of care was not significant; instead, its influence was mediated through improvements in ethics and crisis management. Conclusions: These findings suggest that the benefits of emotional intelligence in nursing are most evident when integrated with supportive organizational practices and ongoing professional development. Overall, this study highlights the need for comprehensive emotional intelligence training and a supportive workplace culture to enhance ethical standards, resilience, and patient care quality in Greek healthcare settings. Full article

Background/Objectives: Respectful maternity care involves privacy, dignity, and informed choice within the process of delivery as stipulated by the World Health Organization (WHO). Informed consent is a cornerstone of patient-centered care, representing not just a formal document, but an ongoing ethical and clinical process through which women are offered objective, understandable information to support autonomous, informed decision-making. Methods: This narrative review critically examines the literature on informed consent in maternity care, with particular attention to both obstetric-led and midwifery-led models of care. In addition to identifying institutional, cultural, and systemic obstacles to its successful implementation, the review examines the definition and application of informed consent in perinatal settings and evaluates its effects on women’s autonomy and satisfaction with care. Results: Important conclusions emphasize that improving women’s experiences and minimizing needless interventions require active decision-making participation, a positive provider–patient relationship, and ongoing support from medical professionals. However, significant gaps persist between legal mandates and actual practice due to provider attitudes, systemic constraints, and sociocultural influences. Women’s experiences of consent can be more effectively understood through the use of instruments such as the Mothers’ Respect (MOR) Index and the Mothers’ Autonomy in Decision Making (MADM) Scale. Conclusions: To promote genuinely informed and considerate maternity care, this review emphasizes the necessity of legislative reform and improved provider education in order to close the gap between policy and practice. Full article

High-rise construction presents heightened safety risks due to vertical complexity, spatial constraints, and workforce variability. Conventional safety management often proves insufficient, especially in rapidly urbanizing or resource-limited settings. This study proposes a hybrid methodological framework to systematically identify and prioritize the critical factors influencing occupational safety in Vietnamese high-rise construction projects. Based on 181 valid survey responses from construction professionals, 23 observed variables were developed through extensive literature review and expert consultation. Exploratory Factor Analysis (EFA) was employed to empirically group 23 validated indicators into five key latent dimensions: (1) Safety Training and Inspection, (2) Employer’s Knowledge and Responsibility, (3) Worker’s Competence and Compliance, (4) Working Conditions and Environment, and (5) Safety Equipment and Signage. These dimensions were then structured into an Analytic Hierarchy Process (AHP) model, with pairwise comparisons conducted by industry experts to calculate consistency ratios and derive factor weights across three high-rise project case studies. The findings provide actionable insights for construction managers, safety professionals, and policymakers in developing and underdeveloped countries, supporting data-driven decision-making for safer and more sustainable urban development. Full article

Background: Nemaline myopathy is a rare congenital neuromuscular disease associated with progressive weakness and frequent respiratory complications. In emergency situations, families often serve as the first and only responders. The aim of this study is to explore how parents in Spain care for children with nemaline myopathy during emergency situations, focusing on the clinical responses performed at home and the organizational challenges encountered when interacting with healthcare systems. Methods: A qualitative phenomenological study was conducted with 17 parents from 10 families belonging to the Asociación Yo Nemalínica. Semi-structured interviews were performed via video calls, transcribed verbatim, and analyzed using Giorgi’s descriptive method and ATLAS.ti software (version 24). Methodological rigor was ensured through triangulation, reflexivity, and member validation. Results: Four themes were identified. First, families were described as acting under extreme pressure and in isolation during acute home emergencies, often providing cardiopulmonary resuscitation and respiratory support without professional backup. Second, families managed ambiguous signs of deterioration using clinical judgment and home monitoring tools, often preventing fatal outcomes. Third, parents frequently assumed guiding roles in emergency departments due to a lack of clinician familiarity with the disease, leading to delays or errors. Finally, the transition to the Pediatric Intensive Care Unit was marked by emotional distress and rapid decision-making, with families often participating in critical choices about invasive procedures. These findings underscore the complex, multidisciplinary nature of caregiving. Conclusions: Parents play an active clinical role during emergencies and episodes of deterioration. Their lived experience should be formally integrated into emergency protocols and the continuity of care strategies to improve safety and outcomes. Full article

Background/Objectives: End-of-life care is a vital part of nursing education that has been overlooked until recent years. Advance care planning should be incorporated into the prelicensure nursing curriculum to build student nurses’ confidence in aiding patients and families with their preferred future care plans. Advance care planning tools, such as the Advance Health Care Directive (AHCD) and Five Wishes, provide experiential learning opportunities that bridge theoretical knowledge with real-world patient advocacy. In this study, students were asked to complete either the AHCD or Five Wishes document as though planning for their own end-of-life care, encouraging personal reflection and professional insight. Embedding these assignments into nursing education strengthens students’ confidence in facilitating end-of-life discussions. This study applied Kolb’s experiential learning theory, including concrete experience, reflective observation, abstract conceptualization, and active experimentation, to explore student nurses’ perspectives on the Advance Health Care Directive and Five Wishes assignments, as well as their understanding of end-of-life care. Methods: This study used an exploratory–descriptive qualitative design featuring one open-ended question to collect students’ views on the assignments. Results: The final sample comprised 67 prelicensure student nurses from Bachelor of Science and Entry-Level Master’s programs. The Advance Health Care Directive and/or Five Wishes assignment enhanced students’ understanding of end-of-life decision-making. Conclusions: It is essential to complete the assignment and immerse oneself in an end-of-life situation to grasp patients’ perspectives and concerns regarding when to engage in difficult conversations with their patients. Full article

This study evaluates hierarchical clustering methodologies to identify patterns associated with timeout requests for EuroLeague basketball games. Using play-by-play data from 3743 games spanning the 2008–2023 seasons (over 1.9 million instances), we applied Principal Component Analysis to reduce dimensionality and tested multiple agglomerative and divisive clustering techniques (e.g., Ward and DIANA) with different distance metrics (Euclidean, Manhattan, and Minkowski). Clustering quality was assessed using internal validation indices such as Silhouette, Dunn, Calinski–Harabasz, Davies–Bouldin, and Gap statistics. The results show that Ward.D and Ward.D2 methods using Euclidean distance generate well-balanced and clearly defined clusters. Two clusters offer the best overall quality, while four clusters allow for meaningful segmentation of game situations. The analysis revealed that teams that did not request timeouts often exhibited better scoring efficiency, particularly in the advanced game phases. These findings offer data-driven insights into timeout dynamics and contribute to strategic decision-making in professional basketball. Full article

The large language model (LLM) has significant potential for application in the field of electricity markets, but there are shortcomings in professional evaluation methods for LLM: single task, limited dataset coverage, and lack of depth. To this end, this article proposes the ELM-Bench framework for evaluating the LLM of the Chinese electricity market, which evaluates the model from 3 dimensions of understanding, generation, and safety through 7 tasks (such as common-sense Q&A and terminology explanations) with 2841 samples. At the same time, a specialized domain model QwenGOLD was fine-tuned based on the general LLM. The evaluation results show that the top-level general model performs well in general tasks due to high-quality pre-training, while QwenGOLD performs better in tasks such as prediction and decision-making in professional fields, verifying the effectiveness of domain fine-tuning. The study also found that fine-tuning has limited improvement on LLM’s basic abilities, but its score in professional prediction tasks is second only to Deepseek-V3, indicating that some general LLMs can handle domain data well without professional training. This can provide a basis for model selection in different scenarios, balancing performance and training costs. Full article

In today’s increasingly data-driven educational landscape, teachers are expected to use data to inform instructional decisions. However, effective data use depends not only on statistical competence but also on motivation, attitudes, and academic self-concept. This study examines how these factors influence student teachers’ readiness to engage with standardized assessment data. A survey of 164 Flemish primary education student teachers assessed their motivation, attitudes toward data use, and academic self-concept. Cluster analysis identified four distinct profiles, ranging from highly competent yet disengaged users to low-performing but externally motivated individuals, highlighting significant variability in data engagement. A pre- and post-test study design involving an e-course on basic statistical concepts demonstrated that targeted instruction can enhance perceived competence, particularly in areas such as box plot interpretation. Findings suggest that technical training alone is insufficient to promote sustained data use; fostering intrinsic motivation, positive attitudes, and a strong academic self-concept is essential for long-term engagement with data. Full article

Hospital layouts play a critical role in supporting efficient care processes, which are continually evolving. While care processes adapt over time, the spatial needs of care professionals are expected to remain relatively stable. This study proposes an evaluation framework combining cognitive mapping and space syntax analysis (SSA) to assess how hospital layouts align with these spatial needs. The framework is applied to a real-world emergency department (ED) with two distinct layout configurations. Cognitive mapping captures spatial needs from the perspective of care professionals, while SSA evaluates how the layout supports or constrains these needs. Drawing on the open building approach, we interpret layout adaptability through a layered system of primary (rigid), secondary (adaptable), and tertiary (care process) levels. Our results show that the choices in primary and secondary system designs can limit the functionality of the tertiary system. This approach supports informed decision-making by addressing multiple spatial needs simultaneously, offering insights into the coherence between spatial configuration and care delivery, and enabling quantitative comparison across different layout designs. Full article

This study explored the experiences of Hungarian minority parents of children with severe disabilities from Romania. Examining individual life paths and becoming a parent is difficult in all aspects, but the issue of parental responsibility for raising a child with a severe disability suggests a much more complex approach. Participants were parents (female = 8; male = 3) who were purposively sampled from an urban setting (Bihor area) and whose children attended SEN schools in the same area. Data were collected using semi-structured interviews and were thematically analysed. It turned out from the interviews that the challenges parents of children with severe disabilities encounter at home, school, and in society are accumulated emotional stress and exhaustion; however, they also face material challenges. The analysis also revealed that the parents were unsure of what was expected of them in making educational or habilitation–rehabilitation decisions on behalf of their children. The parents’ difficulty with decision-making and their unpreparedness put them under serious stress, often characterized by depressive life stages. The findings reveal the need for ongoing professional development and the establishment of organizational–community networks. Parents of children with disabilities face serious, unresolved challenges that are difficult to overcome. In order to overcome these challenges, we need to develop policies that take the needs of parents into consideration. Full article