Search Results (73)

Despite notable advancements in smart home technologies, residential energy management continues to face critical challenges. These include the complex integration of intermittent renewable energy sources, issues related to data latency, interoperability, and standardization across diverse systems, the inflexibility of centralized control architectures in dynamic environments, and the difficulty of accurately modeling and influencing occupant behavior. To address these challenges, this study proposes an intelligent multi-agent system designed to accurately estimate and control energy consumption in residential buildings, with the overarching objective of optimizing energy usage while maintaining occupant comfort and satisfaction. The methodological approach employed is a hybrid framework, integrating multi-agent system architecture with system dynamics modeling and agent-based modeling. This integration enables decentralized and intelligent control while simultaneously simulating physical processes such as heat exchange, insulation performance, and energy consumption, alongside behavioral interactions and real-time adaptive responses. The system is tested under varying conditions, including changes in building insulation quality and external temperature profiles, to assess its capability for accurate control and estimation of energy use. The proposed tool offers significant added value by supporting real-time responsiveness, behavioral adaptability, and decentralized coordination. It serves as a risk-free simulation platform to test energy-saving strategies, evaluate cost-effective insulation configurations, and fine-tune thermostat settings without incurring additional cost or real-world disruption. The high fidelity and predictive accuracy of the system have important implications for policymakers, building designers, and homeowners, offering a practical foundation for informed decision making and the promotion of sustainable residential energy practices. Full article

Driven by growing environmental awareness and supportive regulatory frameworks, electric vehicles (EVs) are witnessing accelerating market penetration. However, a key consumer concern remains: the economic impact of battery degradation, manifesting as vehicle depreciation and diminished driving range. To alleviate this concern, EV manufacturers commonly offer performance-guaranteed free-replacement warranties, under which batteries are replaced at no cost if capacity falls below a specified threshold within the warranty period. This paper develops a symmetry-informed analytical framework to forecast time-varying aggregate warranty replacement demand (AWRD) and to design optimal battery inventory strategies. By coupling stochastic EV sales dynamics with battery performance degradation thresholds, we construct a demand forecasting model that presents structural symmetry over time. Based on this, two inventory optimization models are proposed: the Service-Level Symmetry Model (SLSM), which prioritizes reliability and customer satisfaction, and the Cost-Efficiency Symmetry Model (CESM), which focuses on economic balance and inventory cost minimization. Comparative analysis demonstrates that CESM achieves superior cost performance, reducing total cost by 20.3% while maintaining operational stability. Moreover, incorporating CESM-derived strategies into SLSM yields a hybrid solution that preserves service-level guarantees and achieves a 3.9% cost reduction. Finally, the applicability and robustness of the AWRD forecasting framework and both symmetry-based inventory models are validated using real-world numerical data and Monte Carlo simulations. This research offers a structured and symmetrical perspective on EV battery warranty management and inventory control, aligning with the core principles of symmetry in complex system optimization. Full article

Background: While the well-being and working conditions of healthcare professionals are increasingly scrutinized, there remains a critical research gap regarding the quality of life and job satisfaction of plastic surgeons in Switzerland. No prior national study has systematically examined these aspects within this specialty. Objective: This study aims to address this gap by evaluating workload, career satisfaction, and quality of life among Swiss plastic surgeons and trainees, thereby providing evidence to inform systemic improvements in the profession. Methods: A national, multilingual online survey was distributed to all members of the Swiss Society for Plastic Surgery and the Association of Young Plastic Surgeons. A total of 102 plastic surgeons responded (response rate: 22.7%). The survey assessed contractual versus actual working hours, work performed during personal time, mental health indicators (e.g., burnout), and career satisfaction. Descriptive and correlational analyses were conducted. Results: The respondents reported an average of 58 actual versus 49 contractual working hours per week, with an additional 8.1 h spent working during leisure time. Burnout symptoms were present in 29%, and 63% experienced work-related stress during their free time. While 42% wished to reduce their workload, 88.7% would still choose the profession again. Career satisfaction averaged 3.66/5, although 35% rated their salary as inadequate. Notably, 79.8% reported work negatively affecting private relationships, despite 82.65% feeling supported by their environment. Conclusion: This first nationwide assessment highlights the high workload and psychological strain faced by Swiss plastic surgeons. Key priorities include targeted burnout prevention, structural workload reduction, enhanced support for work–life integration (especially among women and younger surgeons), and improved compensation. These measures are essential to sustain the well-being of practitioners and ensure long-term quality in surgical care. Full article

Background/Objectives: Exclusive Enteral Nutrition (EEN) and the Crohn’s Disease Exclusion Diet (CDED) have been shown to induce remission in Crohn’s disease. Low-sulphur, plant-based diets are being explored for ulcerative colitis, and wholefood, low-additive approaches are emerging as significant. Although Inflammatory Bowel Disease (IBD) patients modify their diet, evidence for tolerability and benefit outside clinical trials is limited. The DELECTABLE program aimed to assess satisfaction, adherence, and efficacy of dietary therapies as part of IBD care. Methods: In this dietitian-led, open-label, prospective study, patients with Crohn’s disease were offered the CDED or a whole-food, additive-free diet (WFD), and patients with ulcerative colitis were offered a low-sulphur, plant-based diet (UCD) or WFD. Primary outcomes were 12-week diet satisfaction (modified DSAT-28) and diet adherence, including food additive intake. Secondary outcomes were quality of life (QoL) (IBDQ-9), disease activity (CDAI for Crohn’s disease, partial Mayo score for ulcerative colitis), and biochemical markers (CRP, faecal calprotectin). Analyses were conducted within, rather than between, diet arms due to the non-random nature of the study. Diet adherence and disease activity change across time points (baseline, week 6, week 12) were assessed using repeated measures ANOVA or Friedman’s test, with pairwise paired t-test or Wilcoxon Signed-Rank test. Diet satisfaction and quality of life changes across time (baseline/week 1, week 12) were assessed using a paired t-test or Wilcoxon Signed-Rank test. Results: Of 165 referrals, 76 patients enrolled, with 64 completing the 12-week program (CDED: n = 15, WFD: n = 42, UCD: n = 7). Diet satisfaction was initially high and remained stable over time on CDED (p = 0.212) and improved on WFD (p = 0.03). Patient- and dietitian-rated adherence was high at baseline and did not significantly decrease on any diet arm (p > 0.349). Food additive intake decreased on WFD (p = 0.009). QoL improved on CDED and WFD (p < 0.001). CRP, calprotectin, and CDAI were reduced on CDED (p < 0.045), and CDAI and partial Mayo were reduced on WFD (p < 0.027). Conclusions: Well-balanced therapeutic diets are feasible and well-accepted by patients with IBD, with a promising impact on disease activity. Full article

Background/Objectives: Somnological findings are often written as free texts, supported by questionnaires. The quality and structure of free-text reports (FTRs) vary between examiners and specialties, depending on the individual level of expertise and experience in sleep medicine. This study aimed to compare the quality of free-text reports (FTRs) and structured reports (SRs) from somnological consultations in otolaryngology for patients assessed for obstructive sleep apnea (OSA). Methods: This study compared free-text reports (FTRs) and structured reports (SRs) from 50 patients with suspected OSA, including medical history, clinical examination findings, and medical letters, all prepared by six examiners with similar experience levels. A web-based approach was used to develop a standardized template for structured somnological reporting. The completeness and time required for both FTRs and SRs were evaluated, and a questionnaire was administered to assess user satisfaction with each reporting method. Results: The completeness scores of SRs were significantly higher than those of FTRs (88% vs. 54.2%, p < 0.001). The mean time to complete an SR was significantly shorter than that for FTRs (10.2 vs. 16.8 min, p < 0.001). SRs had significantly higher user satisfaction compared to FTRs (VAS 8.3 vs. 2.2, p < 0.001). Conclusions: Compared to FTRs, SRs for OSA patients are more comprehensive and faster. The use of SR is more satisfactory for examiners and supports the learning effect. Full article

Aims: This pilot study assessed the potential psychosocial and therapeutic impacts of augmenting transcranial direct current stimulation (tDCS) with cognitive behavioral therapy (CBT) in treatment-naïve patients diagnosed with major depressive disorder (MDD). Methods: In this double-blind randomized controlled trial, 10 subjects were randomized into two groups—CBT with active tDCS (active tDCS; n = 6; M = 33.3 years; 4 females) or CBT with sham tDCS (Sham; n = 4; M = 31.2 years; 2 females). Severity of depression was measured with the Montgomery–Åsberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI). Participants’ secondary outcomes included life satisfaction, sleep quality, and anxiety symptoms. They were assessed at baseline, following treatment (week 6), and at 2, 4, 8, and 12-week follow-ups. Results: By week 12, the active tDCS group’s BDI scores showed greater improvement relative to the sham group. There were also significant differences between groups over time in MADRS scores. Sleep quality also improved in the active tDCS group, with many participants achieving symptom-free status—defined as BDI scores of 9 or less and supported by consistently low MADRS scores—by the end of the follow-up period. Conclusions: These preliminary data indicate that the combination of tDCS with CBT may optimize the treatment of MDD through depressive symptom relief and improved sleep, while also prolonging the benefits of treatment. Full article

Chest wall perforator flaps (CWPFs) are a promising option for partial breast reconstruction but are underutilized, particularly in resource-limited settings. This retrospective observational study explores the feasibility and impact of CWPFs in breast-conserving surgery at our single-surgeon center, where 203 procedures were performed between 2018 and 2023. We evaluate 200 cases treated after multidisciplinary tumor board discussions and shared decision-making, assessing clinicopathological data, surgical outcomes, oncological results, cosmetic outcomes, and patient-reported outcome measures (PROMs). The median age of patients was 52.5 years. Single CWPFs were used in 75.9% and dual flaps in 24.1%. Sentinel node biopsy was performed in 76.9% of malignant cases, with no positive margins. Minor complications occurred in 11%, and no major complications were reported. At a 27-month median follow-up, the overall survival rate was 97.5%, with a disease-free survival of 92.1%. Cosmetic outcomes were good-to-excellent, and PROMs indicated high satisfaction. This largest single-surgeon study from Asia demonstrates the transformative role of CWPFs in breast conservation surgery for Indian women with sizable, locally advanced tumors. The technique offers excellent oncological and cosmetic outcomes, reduced costs, and a shorter operative time, highlighting the need for oncoplastic algorithms in resource-limited settings to improve breast conservation accessibility. Full article

Under the dual constraints of limited resources and cold climate, the built environment of small cities in cold areas has a particularly prominent impact on the outdoor activities of the elderly and the need for aging optimization. Based on a questionnaire survey and field measurement data, combined with multiple linear regression, Spearman correlation analysis, and difference analysis, this paper systematically discusses the effects of different built environment characteristics on outdoor activity behaviors (frequency, intensity, and stay time) of the elderly in Bei’an City, Heilongjiang Province, China. The difference in environmental satisfaction of the elderly with different genders, ages, and education levels was analyzed. The results show that green coverage, air quality, leisure facilities, and barrier-free facilities are the core environmental factors that significantly improve the activity behavior of the elderly. In contrast, noise level, road damage, and inadequate facility maintenance significantly inhibit the activity willingness of the elderly. It was found that older adults are more dependent on barrier-free facilities and site safety, while younger people pay more attention to sports facilities and social space. Older women pay more attention to environmental details and cultural elements, while men tend to evaluate environmental functionality and so on. Further analysis shows that green environments and leisure facilities in cold climates provide visual beauty and play an important role in improving air quality and enhancing mental health. These elements are particularly critical in winter activities for older people, demonstrating the potential of the built environment to promote health and social participation. Starting from the unique background of small cities in cold regions, this study verified the applicability of the WHO age-friendly city framework in small cities in cold climates through empirical data, and revealed the necessity of climate-adaptive design (such as winter anti-slip facilities and cold-resistant greening) to improve the activity behavior of the elderly, providing a regional supplement to the existing theories. Full article

The objectives of the study were to compare the efficacy and safety using ocular surface assessment between preserved and preservative-free brimonidine/timolol fixed-combination eye drops in glaucoma or ocular hypertension patients. Methods: This study was designed as a prospective, multicenter (three institutions), investigator-masked, parallel-grouped randomized clinical trial. The primary outcomes were corneal and conjunctival staining score, ocular surface disease index (OSDI) score, drug tolerance, and adherence rates at 12-week visits. The secondary outcomes were corneal and conjunctival staining score, OSDI score at 4-week visits and intraocular pressure (IOP), tear-film break-up time (TBUT), and bulbar/limbal hyperemia score at the 4- and 12-week visits. For safety assessment, best-corrected visual acuity (BCVA), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and physical examination at 4 and 12 weeks and adverse events during the whole study period were analyzed. Results: Overall, 59 patients were enrolled and randomized into each group (29 preserved and 30 preservative-free). At the endpoint, 5 patients in the preserved group and 2 patients in the preservative-free group dropped out, leaving 24 and 28 patients in the preserved and preservative-free groups, respectively. Baseline characteristics showed no significant difference between the groups including age and sex. At the 12-week visit, intra-group change of OSDI scores did not change significantly compared to the baseline scores in both preserved and preservative-free groups (p = 0.791, 0.478, respectively). On the contrary, the corneal staining score and the conjunctival staining score showed a significant increase compared to the baseline score in the preserved group (p = 0.015, 0.009, respectively). Regarding drug satisfaction, higher proportions of patients in the preservative-free group reported convenience of installation (p = 0.002). Also, stinging and burning sensations in drug tolerance showed better results in the preservative-free group with a significant difference (p = 0.011). Safety assessment regarding systemic side effects such as SBP, DBP, and HR showed similar results between the preserved and preservative-free groups (p = 0.711, 0.232, 0.666, respectively). Conclusions: Preservative-free brimonidine/timolol showed comparable efficacy and safety, better corneal and conjunctival staining score with convenience of installation, and lower stinging and burning sensation. It is expected to be a proper treatment option for patients with glaucoma or ocular hypertension. Full article

Background/Objectives: New licensing regulations for dentists in Germany offered the opportunity to modernize the dental curriculum regarding content, methodology and structure. This paper aims to evaluate the newly requested preclinical curriculum “Dental Propaedeutic—Focus on Prevention” by dental students and dental educators and to describe the process of development. Methods: The curriculum was developed according to the Kern cycle and the National Competence-Based Learning Objectives Catalog for Dentistry. Lesson planning was based on Bloom’s taxonomy and the taxonomy of significant learning, according to the principle of constructive alignment. A variety of evidence-based teaching methods were implemented. For evaluation, dental students answered a written questionnaire, graded eight topics and added free text. Dental educators were interviewed. Results: Thirty out of fifty-four dental students’ enrolled in the third semester participated in the survey, giving the highest grades to the learning atmosphere. All dental educators involved in the delivery of the curriculum participated in the interview. Dental students and educators expressed satisfaction with this comprehensive teaching approach of prevention in an early stage of the dental curriculum. Dental educators reflected on the high workload for development but valued the opportunity to participate in an evidence-based development process and to introduce various modern teaching and examination methods. Conclusions: The expenditure of time for the development, performance and examination was high. In order to perform 240 teaching units for eight ECTS credits, 419 h of conceptualization/preparation and 344 h for examination had to be invested. This paper might help to facilitate better understanding of the chances and efforts accompanied by curricular changes. Full article

The information interaction characteristics of connected vehicles are distinct from those of non-connected vehicles, thereby exerting an influence on the conventional traffic flow model. The original lane-changing model for non-connected vehicles is no longer applicable in the context of the new traffic flow environment. The modelling of the new hybrid traffic flow, comprising both connected and ordinary vehicles, is set to be a pivotal research topic in the coming years. The objective of this paper is to present a methodology for optimal mixed traffic flow dynamic modelling and cooperative control in intelligent and connected environments (ICE). The study utilizes the real-time perception and information interaction of connected vehicles for traffic information, taking into account the access characteristics of both connected and non-connected vehicles. The satisfaction-based free lane-changing and mandatory lane-changing models of connected vehicles are designed. Secondly, a mixed traffic flow lane-changing model based on influence characteristics is constructed for the influence area of connected vehicles. This model takes into account the degree of influence that connected vehicles have on non-connected vehicles, with different distances being considered respectively. Subsequently, a vehicle guidance strategy for mixed traffic flows comprising grid-connected and conventional vehicles is proposed. A variety of speed guidance scenarios are considered, with an in-depth analysis of the speed optimization of connected vehicles and the movement law of non-connected vehicles. This comprehensive analysis forms the foundation for the development of a vehicle guidance strategy for mixed traffic flows, with the overarching objective being to minimize the average delay of vehicles. In order to evaluate the effectiveness of the proposed method, the intersection of Gaota Road and Fangshui North Street in Yanqing District, Beijing, has been selected for analysis. The results of the study demonstrate that by modifying the density of the mixed traffic flow, the overall average speed of the mixed traffic flow declines as the density of vehicles increases. The findings reported in this study reflect the role of connected vehicles in enhancing road capacity, maximizing intersection capacity and mitigating the occurrence of queuing phenomena, and improving travel speed through the mixed traffic flow lane-changing model based on impact characteristics. This study also provides some guidance for future control of the mixed traffic flow formed by emergency vehicles and social vehicles and for realizing a smart city. Full article

Dentist–patient communication is at the core of providing quality dental care. This study aims to review the importance, challenges, strategies, and training of dentist–patient communication. The World Dental Federation (FDI) emphasizes the importance of effective communication between oral healthcare providers and patients as a critical component of high-quality care. Effective dentist–patient communication allows dentists to accurately and effectively pass on essential medical information to patients. It improves the dentist’s efficiency, boosts self-confidence, reduces occupational stress, and minimizes the risks of complaint or litigation. Moreover, it alleviates dental anxiety and fear, helps build trust between dentists and patients, addresses patients’ needs and preferences, increases patients’ adherence to improved treatment outcomes, and ultimately leads to enhanced patient satisfaction. Nonetheless, it has been widely acknowledged that dentists universally encounter the repercussions arising from suboptimal communication strategies. Time constraints, difficulties in establishing rapport, the oral-health illiteracy of the patients, the poor communication skills of the dentists, dentists’ perceptions, and language barriers often hinder dentist–patient communication. Dentists should take the patient-centered approach as a premise and acquire verbal and non-verbal communication skills to overcome these communication barriers. The patient-centered approach comprises the understanding of patients’ illness, shared decision-making, and intervention with mindfulness of the patient’s own pace. Simple, succinct, and jargon-free language should be used in verbal communication. Proper body postures and gestures are fundamental for showing positive attitudes towards patients. Communication training for dental students should involve a structured pedagogical approach that includes didactic instruction, role-playing exercises, patient interviewing, and ongoing assessments. Key components of effective communication skills training in dental education include motivational interviewing, open-ended questioning, affirmations, reflective listening, and summaries to enhance patient engagement and adherence to treatment plans. Full article

Introduction: The life satisfaction of parents of children with cerebral palsy should be assessed. Parenting a child with a disability may bring more challenges and efforts, impacting overall quality of life. Aim of the Study: the study aimed to evaluate the satisfaction with life of parents of children with cerebral palsy. Material and Methods: The study was designed to assess the satisfaction with life of parents of children with cerebral palsy. To measure this outcome, we developed an original survey consisting of 29 questions inspired by the Satisfaction With Life Scale (SWLS). The study involved 43 parents or legal guardians of children diagnosed with cerebral palsy. Results: A correlation was identified between parental life satisfaction and the amount of leisure time reported by parents (p = 0.004, R = 0.46). The research indicates that parental life satisfaction does not depend on the parent’s satisfaction with the level of therapy (p > 0.05) and the degree of improvement in the child’s functioning (p > 0.05). Conclusions: The level of parental life satisfaction does not depend on the level and outcome of therapy. The more leisure time the parents have, the greater their life satisfaction is. Parents of children with cerebral palsy should take care of their free time. Full article

Patient satisfaction and operational efficiency are critical in healthcare. Long waiting times negatively affect patient experience and hospital performance. Addressing these issues requires accurate system time predictions and actionable strategies. This paper presents a hybrid framework combining predictive modeling and optimization to reduce system times and enhance satisfaction, focusing on registration, vitals, and doctor consultation. We evaluated three predictive models: multiple linear regression (MLR), log-transformed regression (LTMLR), and artificial neural networks (ANN). The MLR model had the best performance, with an $R^2$ of 0.93, an MAE of 7.29 min, and an RMSE of 9.57 min. MLR was chosen for optimization due to its accuracy and efficiency, making it ideal for implementation. The hybrid framework combines the MLR model with a simulation-based optimization system to reduce waiting and processing times, considering resource constraints like staff and patient load. Simulating various scenarios, the framework identifies key bottlenecks and allocates resources effectively. Reducing registration and doctor consultation wait times were identified as primary areas for improvement. Efficiency factors were applied to optimize waiting and processing times. These factors include increasing staff during peak hours, improving workflows, and automating tasks. As a result, registration wait time decreased by 15%, vitals by 20%, and doctor consultation by 25%. Processing times improved by 10–15%, leading to an average reduction of 22.5 min in total system time. This paper introduces a hybrid decision support system that integrates predictive analytics with operational improvements. By combining the MLR model with simulation, healthcare managers can predict patient times and test strategies in a risk-free, simulated environment. This approach allows real-time decision-making and scenario exploration without disrupting operations. This methodology highlights how reducing waiting times has a direct impact on patient satisfaction and hospital operational efficiency, offering an applicable solution that does not require significant structural changes. The results are practical and implementable in resource-constrained healthcare environments, allowing for optimized staff management and patient flow. Full article

To maximize resource usage, minimize disputes, and improve academic experience, professors must schedule teaching activities efficiently. This study provides an optimized automated schedule creation technique. The system generates schedules that aim to be conflict-free and efficient, utilizing evolutionary algorithms along with multi-objective optimization. Resource usage, scheduling problems, and faculty/student satisfaction are the goals of the research. The system optimizes scheduling based on room limitations, instructor availability, and student preferences. The project uses system design, model creation, algorithm implementation, and performance analysis to solve the difficult timetable-generating problem. This research should save administrators time, improve academic operations, and improve staff and student academic experiences. Scalability and flexibility allow the system to be used in multiple faculties and incorporate new limits and requirements. This paper presents a complete approach to faculty scheduling, including insights and recommendations for future study and application in educational institutions. Full article