Search Results (2,333)

Background/Objectives: Incorporating parent training into cognitive-behavioral therapy for anxious youth has not been shown to significantly improve outcomes perhaps because these interventions have not addressed potential interfering psychological barriers to implementing parenting changes and rarely offer between-session support. There is growing evidence that Acceptance and Commitment Therapy (ACT) can target these psychological barriers and generate more flexible and adaptive behavioral repertoires in parents of children with a variety of presenting challenges. Methods: Following a pilot trial of “Acceptance and Commitment Therapy for Parents of Anxious Children (ACT-PAC)” a six-week group-based intervention focused on targeting psychological barriers to parenting change using mindfulness and acceptance approaches, we collected qualitative feedback from participants in two post-treatment phases by conducting individual interviews and a focus group with participants that completed the intervention. Results: Analysis of interview responses revealed that parents found ACT principles and processes to be helpful, and many also appreciated the ACT-PAC group setting that allowed parents to recognize their experiences were shared by others and to self-disclose in a non-judgmental space. Feedback from the focus group further provides preliminary evidence that ACT-PAC is acceptable to and feasible for parent participants and suggests modifications such as involving additional caregivers, making resources more readily available, and creative structural changes that may facilitate between-session practice. Conclusions: Results suggest that the group-based intervention can be both maintained and improved for future participants. Limitations to generalizability in light of possible selection bias and the small focus group sample size are addressed. Full article

The existing literature highlights that artificial intelligence (AI) creates both hope and threat perceptions among managers and workers, particularly due to concerns about potential job losses and the negative effect on continued professional development. Employee trust in AI-based systems varies depending on their features and performance. Furthermore, regardless of the performance of such systems, some individuals are inherently opposed to AI, a phenomenon known as AI aversion. In this study, an Integrative AI Adoption Framework is developed, drawing upon principles from established theories, including the technology acceptance model, behavioral decision theory, and emotion-based frameworks, to assess how perceived usefulness and perceived ease of use, along with perceived threat, trust, and AI aversion, influence human resources (HR) professionals’ attitudes and behavioral intentions to use AI-based recruitment systems. In doing so, the study conceptualizes AI-based recruitment as a socio-technical system in which a technical subsystem (the system’s instrumental and AI-specific properties) and a social subsystem (the affective and trust-related responses of HR professionals) must be jointly considered to explain adoption. The model was tested using the partial least squares structural equation modeling (PLS-SEM) approach through survey-based data collected from 242 HR professionals. The study’s findings indicate that attitude plays an important role in shaping behavioral intention, and perceived usefulness is a key driver of attitude. AI aversion negatively influences attitudes, while trust has a twofold effect of reducing AI aversion and positively influencing attitude. Additionally, perceived threat significantly increases AI aversion, which is driven by concerns over job replacement and personal development. Full article

Digital transformation has become an essential component of sustainable rural development, yet substantial inequalities persist in how communities access, adopt, and benefit from digital technologies. Understanding these disparities requires not only information about technological resources but also knowledge of the relational structures through which information, support, and opportunities circulate. This article presents a reproducible synthetic socio-digital network dataset designed to support the analysis of digital gaps in community-based tourism (CBT) environments. Rather than containing original respondent-level observations, the repository was computationally reconstructed from aggregate statistics derived from field studies conducted in three rural communities in the province of Guayas, Ecuador: Bucay (5 de Septiembre), Manglares Churute, and Ruta de los Chirijos. All node-level records, survey variables, and support relationships included in the repository were synthetically generated to preserve aggregate community characteristics while protecting participant confidentiality and preventing individual re-identification. The repository contains synthetic actor metadata, reconstructed socio-digital variables, directed support networks, graph representations in interoperable formats, and precomputed Social Network Analysis (SNA) indicators. The dataset includes 90 synthetic actors, more than one thousand generated support interactions distributed across multiple socio-digital dimensions, machine-readable metadata, and reusable scripts for preprocessing, validation, graph construction, and metric computation. The represented dimensions include financial assistance, training support, information exchange, technological support, social media promotion, institutional collaboration, trust, and emotional closeness. To facilitate reuse, all resources are distributed in standardized formats compatible with NetworkX, Gephi, Neo4j, and graph-learning frameworks. The repository follows FAIR principles and includes documentation intended to support transparency, reproducibility, and methodological benchmarking. Potential applications include social network analysis, graph mining, graph neural networks, digital inequality research, computational social science, community resilience studies, and educational activities. By providing an openly documented synthetic dataset and reproducible computational workflow, the repository contributes to the study of socio-digital systems, privacy-preserving data sharing, and community-level digital transformation processes. Full article

Traditional dementia care training often falls short in equipping staff with the knowledge and skills needed to improve quality of life for people with dementia. Virtual Reality (VR)-based experiential learning has emerged as a promising approach, enhancing learning outcomes and training experience for individuals receiving education and training related to dementia care. This scoping review mapped VR education tools used in dementia care, the UX-related measurement methods employed, and the extent to which UX design has been integrated into these tools. Guided by Arksey and O’Malley’s framework, a systematic search was conducted across seven databases (Scopus, Web of Science, ProQuest, MEDLINE, CINAHL, IEEE Xplore, PubMed). PRISMA ScR guidelines were used to map gaps in UX design and engagement strategies within VR learning systems. Data were extracted using a comprehensive UX framework for immersive VR to synthesize user experience components. Twenty-four peer-reviewed publications were included, covering VR scenario development and UX. The findings suggest potential benefits of integrating UX principles into VR education tools to support training experience, learner satisfaction, and care quality. A key gap was identified: limited and inconsistent integration of UX design components and measurement methods within existing VR tools. Drawing on these insights, the review provides practical guidance for optimizing VR training programs in dementia care. Full article

Aquatic recreation significantly enhances well-being; however, individuals experiencing functional limitations remain frequently marginalized from this form of tourism due to infrastructural and environmental barriers. This study investigates the perceived operational risks and apprehensions encountered by users with specific accessibility needs during yacht sailing, aiming to inform inclusive vessel design aligned with the social dimension of sustainable development. A survey of 277 participants with diverse, officially certified functional limitations was conducted to evaluate their maritime experiences and safety concerns. Participants identified a mean of 11 pre-voyage apprehensions out of 19 distinct risk categories. The most prevalent concerns included stumbling, slipping, or falling on board (79%), the risk of falling overboard (73%), and seasickness (70%), with an overall moderate severity ($\overline{X}$ = 2.2 on a 4-point scale). Crucially, severe safety concerns (e.g., vessel sinking or falling overboard) were significantly mitigated following practical sailing experience. Conversely, everyday functional and ergonomic challenges—such as moving between the deck and crew quarters ($\overline{X}$ = 2.6), operating rigging ($\overline{X}$ = 2.7), embarkation ($\overline{X}$ = 2.6), and utilizing sanitary facilities ($\overline{X}$ = 2.1)—persisted irrespective of experience level. Statistical analysis revealed that gender and age had negligible effects on concern levels. Extensive maritime experience reduced apprehensions regarding balance and swimming competencies, while concurrently increasing awareness of communication and comfort-related operational challenges. This study highlights a distinct divergence between initial psychological anxiety—which is largely mitigated by experience—and persistent architectural barriers inherent in standard yacht design. The results underscore that achieving meaningful inclusivity in water tourism requires prioritizing interior spatial layouts, accessible sanitary facilities, and barrier-free vertical circulation in naval architecture, rather than focusing exclusively on emergency safety systems. These insights directly support the advancement of Sustainable Development Goal 10 and the integration of universal and human-centered design principles within the maritime recreation sector. Full article

Ensemble learning has been widely adopted in fraud detection; however, conventional ensemble strategies rely on uniform or performance-based weighting schemes that treat explainability as a post hoc annotation rather than an architectural component. This study addresses the research goal of whether SHAP attribution values can serve as a principled, instance-specific weighting mechanism within an ensemble, thereby embedding interpretability directly into the aggregation process. A SHAP-Weighted Ensemble (SWE) framework is proposed in which the L2 norm of each base model’s SHAP attribution vector, computed at prediction time, is used to derive instance-specific voting weights via Softmax normalization. Three linear base learners (logistic regression, robust LR, calibrated linear SVM) are combined, with LinearSHAP providing exact attribution values. A comprehensive evaluation protocol was applied on a real-world vehicle insurance claims dataset, including bootstrap 95% confidence intervals, McNemar’s test, a three-way ablation study comparing equal weighting, SWE, and validation-AUC weighting, F1-optimal threshold selection, expected calibration error, and cost-sensitive evaluation under asymmetric misclassification costs. The central finding is that SWE achieves performance statistically comparable to both simpler baselines across all evaluated metrics (ROC-AUC = 0.774, 95% CI [0.681, 0.862]; F1 = 0.679, 95% CI [0.569, 0.774]; McNemar p = 1.000), while producing a transparent, per-claim weighting trace that equal-weight voting cannot provide. A KernelSHAP influence analysis conducted directly on the SWE confirms that SHAP-derived weights are substantially aligned with actual model influence ratios (LR: 1.05×, LR_R: 1.05×, SVM: 0.81×), validating the weighting mechanism empirically. An exploratory analysis of a seven-model equal-weight diagnostic ensemble reveals a negative correlation (r = −0.721, p = 0.067) between individual model performance and ensemble influence; a theoretically coherent finding that does not reach statistical significance at conventional thresholds. The primary contribution of SWE is architectural and interpretability-driven: it produces an auditable, instance-level model-weighting mechanism grounded in SHAP attribution theory, supporting regulatory accountability under GDPR Article 22 and the EU AI Act. Full article

Essential host functions are often maintained by conserved molecular systems, but in biological contexts shaped by evolutionary conflict, the genes that execute such functions may be unstable, replaceable, or repeatedly recruited from different evolutionary sources. Mammalian placentation provides a striking example of this principle. Trophoblast cell fusion is essential for placental development, yet this function is mediated in different mammalian lineages by distinct endogenous retrovirus-derived envelope proteins, including syncytin-1, syncytin-2, and other lineage-specific Env-derived fusogens. Here, I propose the Baton Pass model as a conceptual framework for explaining how host-level biological functions can be maintained despite turnover of the molecular agents that execute them. This model differs from conventional examples of antagonistic coevolution, which often emphasize recurrent mutations within the same interacting genes, and from non-orthologous gene displacement, which generally concerns replacement among cellular genes. In the syncytin paradigm, the molecular executors are repeatedly supplied by exogenous retroviral env genes that become endogenized, domesticated, and incorporated into host developmental programs. I further discuss how receptor compatibility, placental expression control, and host–virus evolutionary conflict may together destabilize individual Env–receptor systems while allowing the host-level function of trophoblast fusion to persist. Analogous functional reassignment is also observed in primate lentiviruses, where antagonism of BST-2 shifts among distinct viral genes. The Baton Pass model therefore describes a testable evolutionary principle: essential host functions can be preserved not only through conservation of specific genes, but also through dynamic succession of genes of distinct evolutionary origins. Full article

Breast cancer is the most prevalent malignancy among women. The disease and its treatments often lead to physical and psychosocial impairments, compromising quality of life. While exercise and music-based interventions have individually demonstrated benefits on these symptoms, the advantages of their combination remain unexplored. This study evaluates whether a concurrent exercise program, including aerobic and strength training performed while listening to music based on individual preferences, is more effective than the same exercise program without music in improving self-esteem, body image, cancer-related fatigue, physical function (upper and lower limb strength and cardiorespiratory endurance), quality of life, sleep quality, and intolerance of uncertainty in female breast cancer survivors. A single-blind, two-arm, parallel-group, randomized controlled trial will be conducted including 42 women who completed primary treatment for stage 0–III breast cancer at least six months before enrollment. Participants will be randomly assigned to a music-listening concurrent exercise training group (MLTG), or a no music exercise training group (NMLTG), both performing the same 8-week exercise program. The primary outcome will be self-esteem (Rosenberg Self-Esteem Scale). Secondary outcomes include body image, fatigue, upper and lower limb strength, cardiovascular endurance, quality of life, sleep quality, and intolerance of uncertainty. Measurements will be collected using validated and reliable questionnaires and standardized functional tests at baseline, post-intervention, and at 6 months. Data will be analyzed under the intention-to-treat principle. Music listening, particularly when based on individual preferences and synchronized with movement, may enhance mood and exercise performance while modulating reward-related neural pathways. This trial will provide new evidence on a feasible and low-cost strategy to enhance supportive care and physical and psychosocial outcomes in breast cancer survivors. ClinicalTrials.gov (NCT07045961). Ethics Committee code: 2025-0855. Full article

Background: Return to play (RTP) after total hip arthroplasty (THA) is increasingly expected by younger and more physically active patients. Current activity recommendations remain heterogeneous and are largely derived from expert opinion and indirect biomechanical modelling approaches, rather than direct in vivo biomechanical evidence. The aim of this article is to systematically map and synthesize the evidence from instrumented hip implant studies and to clarify how direct in vivo telemetry data can inform RTP counselling after THA. Methods: A scoping review was conducted according to a predefined Open Science Framework protocol and reported following PRISMA-ScR guidelines. MEDLINE (PubMed) and Scopus were searched from inception. Peer-reviewed clinical studies reporting direct in vivo biomechanical measurements obtained from instrumented hip implants were included. Conference proceedings, technical notes, reviews, and in vitro or computational-only studies were excluded. Data were extracted and synthesized descriptively according to activity domain, biomechanical variables, and implant technology. Results: Fifty studies met the inclusion criteria. Early investigations established feasibility and evolved from wired strain-gauge systems to fully implantable telemetric prostheses capable of measuring three-dimensional forces, moments, and friction-related parameters. Across cohorts, level walking consistently produced peak hip contact forces of approximately 2–3 times body weight, serving as a clinically meaningful reference loading envelope. Several recreational activities—including cycling, aquatic exercise, Nordic walking, and most gym-machine exercises—generally remained within or close to this range when performed with controlled technique. In contrast, certain rehabilitation tasks, forward-bent postures, lifting maneuvers, and perturbation events generated loads equal to or exceeding those observed during walking. Importantly, frictional moments and load direction showed substantial variability and may be more relevant to implant fixation than peak force magnitude alone. Conclusions: Instrumented hip implants provide objective biomechanical benchmarks that support principle-based and individualized RTP counselling, grounded in directly measured mechanical exposure rather than sport classification alone. Full article

Feline Infectious Peritonitis (FIP) has been transformed from a fatal disease to a treatable condition following the introduction of GS-441524, a nucleoside analogue targeting feline coronavirus replication. However, the widespread use of unregulated compounded formulations and the absence of validated analytical tools for therapeutic drug monitoring (TDM) represent critical gaps in clinical FIP management. This study describes the development and full ICH M10-compliant validation of a high-throughput LC-MS/MS method for the quantification of GS-441524 in feline serum, incorporating an automated protein precipitation protocol and a PBS-BSA surrogate matrix in accordance with 3Rs principles. The method met all acceptance criteria across validated parameters, including linearity (0.1–50 µg/mL), accuracy (bias within ±12.5%), precision (CV ≤ 10.9%), selectivity, extraction recovery (87.5–107.9%), and stability under clinically relevant storage conditions. Matrix equivalence between PBS-BSA and authentic feline serum was confirmed, enabling routine calibration without animal-derived materials. The validated method was applied to clinical TDM in cats undergoing GS-441524 treatment for FIP, providing preliminary evidence of inter-individual pharmacokinetic variability. The compounded formulations administered to the TDM cohort were independently verified by LC-MS/MS, confirming drug content within ±15% of labelled claims and excluding pharmaceutical quality as a confounding factor in the interpretation of serum drug concentrations. Full article

The conflict between individual rationality and collective rationality, as revealed by the tragedy of the commons, constitutes the core dilemma of collective action in ecological and environmental governance. The key to resolving this dilemma lies in systematically diagnosing the social–ecological system and identifying the crucial factors that hinder cooperation. However, existing diagnostic frameworks have largely focused on identifying the conditions for collective action formation. Thus, those frameworks establish a diagnostic logic centered on conditional principles, but they neglect the capture of the formation process of collective action. To address this gap, this paper further introduces a procedural principle centered on “squeeze-out → transformation → return” into the traditional diagnostic framework. This is achieved by constructing an integrated analytical framework that combines procedural and conditional principles. This study takes the ecological and environmental governance of the Dawangtan Reservoir in Nanning, Guangxi Zhuang Autonomous Region, China, as a case study. The limitations of the traditional framework in diagnosing complex social–ecological systems are also examined. Further, this study demonstrates how the proposed integrated diagnostic framework enables problem identification and dilemma resolution by capturing the formation process of collective action. This research not only enriches the theoretical understanding of the formation process of collective action in complex contexts, but also helps practitioners more efficiently identify context-specific solutions to collective action problems. Full article

Reproductive efficiency is a critical determinant of productivity and profitability in both dairy and beef cattle systems. Progesterone-based estrus synchronization protocols have emerged as essential tools to control the timing of ovulation, enhance artificial insemination efficiency, and optimize herd reproductive performance. These protocols exploit the physiological regulation of the hypothalamic–pituitary–ovarian axis, maintaining elevated progesterone levels to suppress ovulation and coordinating luteolysis and follicular wave emergence through prostaglandins, GnRH analogues, and, in some cases, equine chorionic gonadotropin. In beef cattle, progesterone supplementation facilitates fixed-time artificial insemination, shortens calving intervals, and improves calf crop uniformity, whereas in dairy cows it mitigates poor estrus detection, enhances service rates, and reduces days open. Fertility outcomes are influenced by cow physiological status, metabolic condition, and protocol adherence, with pregnancy per AI typically ranging from moderate to high in beef cattle and lower in lactating dairy cows. Economic evaluation indicates that these protocols are cost-effective in herds with moderate to large size, low estrus detection efficiency, and intensive management, although labor, drug costs, and handling requirements must be considered. Critical analysis suggests that synchronization cannot compensate for underlying nutritional, health, or metabolic deficiencies, and future research should focus on precision application, individualized protocols, and integration with automated reproductive monitoring to improve both biological and economic efficiency. This review summarizes physiological principles, protocol designs, practical applications, fertility outcomes, and economic considerations of progesterone-based estrus synchronization in cows, highlighting current challenges and perspectives for enhanced reproductive management. Full article

Apart from vigilance and flight, anti-predator defense behavior in horses has not been well documented despite its importance during natural selection. In this study, observations of a feral herd (around 140) of Venezuelan horses sympatric with puma and jaguar divided such defense into precaution and reaction. Group living and the avoidance of danger areas are precautionary measures enhanced by the stallion’s vigilance and his actions to keep small foals with the band. Reactions to perceived threats comprise communication of alarm; bunching, or cohesion, as a primary response; massed flight following self-organizing principles; and reassembly of bands. Stallions usually initiated this behavioral process. Stallions’ initial reactions to perceived threats were “investigation”, “move away”, “run away”, and “stampede”, and resulting herd behavior was categorized into 27 responses. Data analysis through Observation Oriented Modeling indicated that each category of initial stallion response to perceived threats was associated with a recurring pattern of subsequent herd behavior. Prominent behaviors enhanced cohesion and synchrony, as well as velocity and direction matching. A fourth observed category was the cohesive “run to band” of a startled outlying member, in which the individual’s alarm might transmit to the band or the band’s calm transmit to the individual. The results emphasize the importance of communication, social cohesion, and synchronous action in times of perceived threats, their continuous practice during maintenance activities, and the social needs and understanding management of domestic horses. Full article

Background and Clinical Significance: “Hikikomori”—a state of prolonged social withdrawal affecting an estimated 2% of Japan’s working-age population—is frequently associated with underlying anxiety disorders, such as gaze phobia, and contributes to the socio-economic burden known as the “8050 problem,” in which aging parents support their socially isolated adult children. While Morita therapy is effective for such conditions, nursing support has historically lacked a systematic theoretical framework. This case report presents a novel nursing model analyzing the transformation process from toraware (mental preoccupation) toward mokuteki-hon-i (purpose-driven action). It proposes the ‘side-by-side’ nursing approach as a potentially important element in supporting patient autonomy in similar clinical settings. Case Presentation: A man in his 20s, diagnosed with gaze phobia and experiencing long-term withdrawal following traumatic bullying, was referred to our specialized short-care program. After initial preparation through structured psychoeducation regarding Morita therapy principles (toraware, sei-no-yokubo, mokuteki-hon-i), he participated in a 14-month Morita therapy-based short-care program combining individual and group interventions. Initially, the patient exhibited severe social avoidance and was trapped in a cycle of seishin-kogo-sayo (psychic interaction). Nurses applied ‘Strategic Inattention to Symptoms’ (shojo-fumon) and provided specific role suggestions, such as serving as a secretary in group discussions, to elicit his sei-no-yokubo (desire for life). Through the reframing of his anxiety as a constructive drive, the patient shifted to a purpose-driven stance. Outcomes showed improved self-adjustment skills in public spaces and successful social reintegration through sustained part-time employment. Conclusions: Nursing care characterized by ‘intentional non-intervention’—which involves waiting in a ‘side-by-side’ manner within a minimally structured environment—may contribute to fostering patient autonomy in similar clinical contexts. This ‘experience-oriented’ approach appeared to elicit inner strengths and support self-regulation in this case, warranting further investigation in multi-case designs. The relative contributions of individual nursing support and group therapeutic milieu cannot be disentangled in a single-case design. Full article

Objective: Osteosynthesis in the case of a sternal wound infection is challenging. It requires osteosynthesis systems that go beyond the usual wire techniques. In principle, there are three different systems, namely plates with locking screws, clips, and distance systems, which are the original methods used in chest wall reconstruction. The aim of this study is to assign these systems to the corresponding sternal pathologies. Patients and methods: This is a retrospective single-center analysis. Bone pathology is divided into three grades: grade I (good substance/no fractures), grade II (good substance/few transverse fractures), grade III (poor substance/substance defects/multiple transverse fractures). The individual osteosynthesis systems are assigned to the different grades accordingly. The suitability of the individual systems is analyzed in the short term and long term. Results: A total of 130 patients were included. Stable osteosynthesis was achieved in all patients. For grade I defects, 75 plates and 24 clips were used. For grade II defects, mainly plates (255) but also clips (16) were used. A distance system was used 24 times for grade III defects. One plate fractured. No other implant-related complications occurred. Discussion: If the different osteosynthesis systems are used according to the bone pathology, a stable chest wall can be restored in all patients. The individual systems have their own specific characteristics, which must be taken into account with regard to the suitability and invasiveness of the procedure. No single system is suitable for treating all sternal pathologies. Full article