Search Results (1,453)

Background: The progression of Alzheimer’s Disease (AD) deeply affects not only the diagnosed person but also their close relatives, who are often called to take on the role of informal caregivers. This transition is frequently unplanned and emotionally complex, yet poorly understood in its deeper processual dimensions. This study aims to explore and theorize the transition experienced by a family member becoming the primary informal caregiver for a person with advanced AD. Methods: A qualitative study based on the Constructivist Grounded Theory according to Charmaz’s approach (2006) was conducted. In-depth interviews were carried out with 10 participants who had become informal caregivers for a loved one with advanced AD. Data were analyzed using initial coding, focused coding, the constant comparative method, and theoretical coding. Results: Ten caregivers (mean age 39 years, range 35–54; nine females) of patients with advanced AD participated in the study. The analysis revealed a complex, emotionally intense caregiving experience marked by sacrifice, feelings of powerlessness, identity loss, and the necessity of sharing caregiving responsibilities. A core category emerged: A Silent and Certain Willingness to Care, representing the caregivers’ deep, often unconscious commitment to prioritize the care of their loved ones above their own needs. Four interconnected phases characterized the caregiving process: (1) The Changing Daily Life—involving significant sacrifices in personal and social life; (2) Feeling Powerless—confronting the inevitable decline without means to alter the course; (3) Losing Oneself—experiencing physical and psychological exhaustion and a sense of identity loss; and (4) Sharing with Others—seeking external support to sustain caregiving. These findings highlight the evolving nature of becoming a caregiver and the enduring dedication that sustains this role despite the challenges. Conclusions: The progression of AD deeply transforms the lives of caregivers, who become co-sufferers and active participants in the disease’s management. The results underscore the urgency of designing integrative care strategies—including psychological, social, and potentially technological support—that can enhance both patient outcomes and caregiver resilience. Grounded in real-world experiences, this study contributes to the broader neurodegeneration discourse by emphasizing caregiving as a critical factor in long-term disease management and therapeutic success. Full article

We present a model that integrates the mapping of the phenology and climatic suitability for the spotted lanternfly (SLF), Lycorma delicatula (White, 1845) (Hemiptera: Fulgoridae), to provide guidance on when and where to conduct surveillance and management of this highly invasive pest. The model was designed for use in the Degree-Day, Establishment Risk, and Phenological Event Maps (DDRP) platform, which is an open-source decision support tool to help to detect, monitor, and manage invasive threats. We validated the model using presence records and phenological observations derived from monitoring studies and the iNaturalist database. The model performed well, with more than >99.9% of the presence records included in the potential distribution for North America, a large proportion of the iNaturalist observations correctly predicted, and a low error rate for dates of the first appearance of adults. Cold and heat stresses were insufficient to exclude the SLF from most areas of the conterminous United States (CONUS), but an inability for the pest to complete its life cycle in cold areas may hinder establishment. The appearance of adults occurred several months earlier in warmer regions of North America and Europe, which suggests that host plants in these areas may experience stronger feeding pressure. The near-real-time forecasts produced by the model are available at USPest.org and the USA National Phenology Network to support decision making for the CONUS. Forecasts of egg hatch and the appearance of adults are particularly relevant for surveillance to prevent new establishments and for managing existing populations. Full article

High-quality green gardens can markedly enhance the quality of life and mental well-being of their users. However, health and lifestyle constraints make it difficult for people to enjoy urban gardens, and traditional methods struggle to offer the high-fidelity experiences they need. This study introduces a 3D scene reconstruction and rendering strategy based on implicit neural representation through the efficient and removable neural radiation fields model (NeRF-RE). Leveraging neural radiance fields (NeRF), the model incorporates a multi-resolution hash grid and proposal network to improve training efficiency and modeling accuracy, while integrating a segment-anything model to safeguard public privacy. Take the crabapple tree, extensively utilized in urban garden design across temperate regions of the Northern Hemisphere. A dataset comprising 660 images of crabapple trees exhibiting three distinct geometric forms is collected to assess the NeRF-RE model’s performance. The results demonstrated that the ‘harvest gold’ crabapple scene had the highest reconstruction accuracy, with PSNR, LPIPS and SSIM of 24.80 dB, 0.34 and 0.74, respectively. Compared to the Mip-NeRF 360 model, the NeRF-RE model not only showed an up to 21-fold increase in training efficiency for three types of crabapple trees, but also exhibited a less pronounced impact of dataset size on reconstruction accuracy. This study reconstructs real scenes with high fidelity using virtual reality technology. It not only facilitates people’s personal enjoyment of the beauty of natural gardens at home, but also makes certain contributions to the publicity and promotion of urban landscapes. Full article

To address the wear life prediction challenge of Guide Cones in passive compliant connectors under dynamic loads within specialized equipment, this study proposes a dynamic wear modeling and life assessment method based on the improved Archard model. Through integrated theoretical modeling, finite element simulation, and experimental validation, we establish a bidirectional coupling framework analyzing dynamic contact mechanics and wear evolution. By developing phased contact state identification criteria and geometric constraints, a transient load calculation model is established, revealing dynamic load characteristics with peak contact forces reaching 206.34 N. A dynamic contact stress integration algorithm is proposed by combining Archard’s theory with ABAQUS finite element simulation and ALE adaptive meshing technology, enabling real-time iterative updates of wear morphology and contact stress. This approach constructs an exponential model correlating cumulative wear depth with docking cycles (R² = 0.997). Prototype experiments demonstrate a mean absolute percentage error (MAPE) of 14.6% between simulated and measured wear depths, confirming model validity. With a critical wear threshold of 0.8 mm, the predicted service life reaches 45,270 cycles, meeting 50-year operational requirements (safety margin: 50.9%). This research provides theoretical frameworks and engineering guidelines for wear-resistant design, material selection, and life evaluation in high-reliability automatic docking systems. Full article

This review examines advancements in smart home security through the integration of home automation technologies. Various security systems, including surveillance cameras, smart locks, and motion sensors, are analyzed, highlighting their effectiveness in enhancing home security. These systems enable users to monitor and control their homes in real-time, providing an additional layer of security. The document also examines how these security systems can enhance the quality of life for users by providing greater convenience and control over their domestic environment. The ability to receive instant alerts and access video recordings from anywhere allows users to respond quickly to unexpected situations, thereby increasing their sense of security and well-being. Additionally, the challenges and future trends in this field are addressed, emphasizing the importance of designing solutions that are intuitive and easy to use. As technology continues to evolve, it is crucial for developers and manufacturers to focus on creating products that seamlessly integrate into users’ daily lives, facilitating their adoption and use. This comprehensive state-of-the-art review, based on the Scopus database, provides a detailed overview of the current status and future potential of smart home security systems. It highlights how ongoing innovation in this field can lead to the development of more advanced and efficient solutions that not only protect homes but also enhance the overall user experience. Full article

This study introduces a time-efficient rotating bending fatigue testing system featuring 11 dual-end spindles, enabling simultaneous testing of 22 specimens. Designed for high-throughput fatigue life (S–N curve) assessment, the system theoretically allows over 93% reduction in total test duration, with 87.5% savings demonstrated in validation experiments using AISI 304 stainless steel. The PLC-based architecture provides autonomous operation, real-time failure detection, and automatic cycle logging. ER16 collet holders are easily replaceable within one minute, and all the components are selected from widely available industrial-grade parts to ensure ease of maintenance. The modular design facilitates straightforward adaptation to different station counts. The validation results confirmed an endurance limit of 421 MPa, which is consistent with the established literature and within ±5% deviation. Fractographic analysis revealed distinct crack initiation and propagation zones, supporting the observed fatigue behavior. This high-throughput methodology significantly improves testing efficiency and statistical reliability, offering a practical solution for accelerated fatigue life evaluation in structural, automotive, and aerospace applications. Full article

Downhole kick is one of the most severe safety hazards in deep and ultra-deep well drilling operations. Traditional monitoring methods, which rely on surface flow rate and fluid level changes, are limited by their delayed response and insufficient sensitivity, making them inadequate for early warning. This study proposes a real-time monitoring technique for gas content in drilling fluid based on the attenuation principle of Ba-133 γ-rays. By integrating laboratory static/dynamic experiments and Geant4-11.2 Monte Carlo simulations, the influence mechanism of gas–liquid two-phase media on γ-ray transmission characteristics is systematically elucidated. Firstly, through a comparative analysis of radioactive source parameters such as Am-241 and Cs-137, Ba-133 (main peak at 356 keV, half-life of 10.6 years) is identified as the optimal downhole nuclear measurement source based on a comparative analysis of penetration capability, detection efficiency, and regulatory compliance. Compared to alternative sources, Ba-133 provides an optimal energy range for detecting drilling fluid density variations, while also meeting exemption activity limits (1 × 10⁶ Bq) for field deployment. Subsequently, an experimental setup with drilling fluids of varying densities (1.2–1.8 g/cm³) is constructed to quantify the inverse square attenuation relationship between source-to-detector distance and counting rate, and to acquire counting data over the full gas content range (0–100%). The Monte Carlo simulation results exhibit a mean relative error of 5.01% compared to the experimental data, validating the physical correctness of the model. On this basis, a nonlinear inversion model coupling a first-order density term with a cubic gas content term is proposed, achieving a mean absolute percentage error of 2.3% across the full range and R² = 0.999. Geant4-based simulation validation demonstrates that this technique can achieve a measurement accuracy of ±2.5% for gas content within the range of 0–100% (at a 95% confidence interval). The anticipated field accuracy of ±5% is estimated by accounting for additional uncertainties due to temperature effects, vibration, and mud composition variations under downhole conditions, significantly outperforming current surface monitoring methods. This enables the high-frequency, high-precision early detection of kick events during the shut-in period. The present study provides both theoretical and technical support for the engineering application of nuclear measurement techniques in well control safety. 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

Forest fire detection is an essential application in environmental surveillance since wildfires cause devastating damage to ecosystems, human life, and property every year. The effective and accurate detection of fire is necessary to allow for timely response and efficient management of disasters. Traditional techniques for fire detection often experience false alarms and delayed responses in various environmental situations. Therefore, developing robust, intelligent, and real-time detection systems has emerged as a central challenge in remote sensing and computer vision research communities. Despite recent achievements in deep learning, current forest fire detection models still face issues with generalizability, lightweight deployment, and accuracy trade-offs. In order to overcome these limitations, we introduce a novel technique (FireNet-KD) that makes use of knowledge distillation, a method that maps the learning of hard models (teachers) to a light and efficient model (student). We specifically utilize two opposing teacher networks: a Vision Transformer (ViT), which is popular for its global attention and contextual learning ability, and a Convolutional Neural Network (CNN), which is esteemed for its spatial locality and inductive biases. These teacher models instruct the learning of a Swin Transformer-based student model that provides hierarchical feature extraction and computational efficiency through shifted window self-attention, and is thus particularly well suited for scalable forest fire detection. By combining the strengths of ViT and CNN with distillation into the Swin Transformer, the FireNet-KD model outperforms state-of-the-art methods with significant improvements. Experimental results show that the FireNet-KD model obtains a precision of 95.16%, recall of 99.61%, F1-score of 97.34%, and mAP@50 of 97.31%, outperforming the existing models. These results prove the effectiveness of FireNet-KD in improving both detection accuracy and model efficiency for forest fire detection. Full article

Adjuvant endocrine therapy for early breast cancer significantly reduces recurrence but increases bone fragility. Given limited data on denosumab (60 mg every 6 months) in premenopausal patients receiving endocrine therapy for early breast cancer, we conducted a retrospective real-world study at the Gemelli Hospital (September 2018–January 2025). A descriptive analysis was performed. The primary endpoint was to assess efficacy, evaluated by changes in bone mineral density via dual-energy X-ray absorptiometry and by monitoring bone turnover markers, particularly serum C-terminal telopeptide of type I collagen. Safety was evaluated based on adverse endocrine therapy events (osteoporotic fractures) and adverse denosumab events (osteonecrosis of the jaw). Sixty-nine patients were eligible for the study. Endocrine therapy included ovarian function suppression with exemestane (89.8%) or tamoxifen (10.1%). Baseline spinal osteoporosis decreased from 20.3% to 5.8%, osteopenia from 39.1% to 34.8%, with normal T-scores rising from 17.4% to 34.8%. Femoral improvements were similar. Serum C-terminal telopeptide of type I collagen levels (evaluated in 35.8%) showed stable reduction in 97%. Denosumab adherence was 89.9%. One osteonecrosis of the jaw case occurred (1.4%); no fractures were reported. Denosumab demonstrated efficacy in improving bone density and reducing bone turnover, with excellent adherence and favorable safety. Longer follow-up is needed to assess post-discontinuation effects. Full article

Sexual consent is one of the most important tools used in the prevention of sexual violence, for which adolescents are especially vulnerable. However, it is unclear how sexual consent processes are defined and used by this population. To bridge this gap in knowledge, this scoping review sought to identify and synthesize the existing empirical research findings on sexual consent conceptualizations and processes among adolescents, as well as determine critical gaps in knowledge. Forty-three articles were reviewed following a systematic search of six academic databases. Articles were included if they were original empirical work published in English between January 1990 and March 2020, included adolescents aged 10 to 17 in their sample, and specifically studied sexual consent conceptualization, communication, and/or behavior. Seventeen articles, diverse in study design and geography, met these criteria and were analyzed. The findings suggest a propensity for adolescents to abstractly define sexual consent as verbal and direct in nature while simultaneously espousing indirect and non-verbal behavioral processes when presented with “real life” scenarios (e.g., vignettes, reflections on personal experience). In addition, the results reveal the significance of concepts like gender norms, normative refusals, and silence as key aspects of adolescent sexual consent. This review demonstrates that research on sexual consent among adolescents is highly limited overall, and the findings that are available indicate some concerning perceptions. Full article

Background/Objectives: Cystic fibrosis (CF) is a multi-system disorder characterized by chronic respiratory failure, malnutrition, and impaired growth. Achieving linear growth above the 50th percentile is associated with better pulmonary outcomes. Since October 2022, Elexacaftor/Tezacaftor/Ivacaftor (ETI) has been approved in Italy for children aged ≥6 years. However, data on its impact on height velocity (HV) remain lacking. This study aims to evaluate growth patterns by HV and explore differences according to the CFTR variant genotype. Methods: We conducted a prospective single-center study at the CF Unit of Bambino Gesù Children’s Hospital involving 24 children aged 6–11 years eligible for ETI treatment. Baseline assessments included height, weight, body mass index (BMI), bone mineral density (BMD), body composition (via bioelectrical impedance analysis, BIA), and muscle strength (one-minute sit-to-stand test (1STST)). Height, weight, HV, and BMI standard deviation scores (SDS) were calculated for the 6 months before and after ETI initiation. Results: The mean age of the cohort was 8.7 ± 1.9 years (F/M: 12/12), with most patients naïve to CFTR modulators. A significant increase in HV was observed post-ETI: from 4.2 ± 2.0 cm/year (−1.96 ± 2.4 SDS) in the 6 months before treatment to 7.1 ± 3.0 cm/year (+1.5 ± 3.7 SDS) after treatment initiation (p < 0.0001). Patients with F508del/minimal function (F/MF) genotypes (n = 11) showed significantly greater HV compared to those with F508del/F508del (F/F, n = 5) and F508del/residual function (F/RF, n = 8) genotypes (p < 0.0001). No significant differences were observed among genetic groups in baseline BMD or lean mass. Conclusions: ETI treatment significantly and rapidly improves HV in children with CF, particularly in those with F/MF genotypes. These findings underscore the role of CFTR modulator therapy in promoting linear growth, a key indicator of health in pediatric CF populations. Full article

It is critical to provide life-sustaining treatment to OHCA patients before ambulance care arrives. However, incorrectly performed resuscitation maneuvers reduce the chances of survival and recovery for the victims. Therefore, we must train regularly and learn how to do it correctly. To facilitate regular chest compression training, this study aims to improve the accuracy of a chest compression evaluation system using posture estimation and to develop a web application. To analyze and enhance accuracy, the YOLOv8 posture estimation was used to examine compression depth, recoil, and tempo, and its accuracy was compared to that of the manikin, which has evaluation systems. We conducted comparative experiments with different camera angles and heights to optimize the accuracy of the evaluation. The experimental results showed that an angle of 30 degrees and a height of 50 cm produced superior accuracy. For web application development, a system has been designed to allow users to upload videos for analysis and obtain appropriate compression parameters. The usability evaluation of the application confirmed its ease of use and accessibility, and positive feedback was obtained. In the conclusion, these findings suggest that optimizing recording conditions significantly improves the accuracy of posture-based chest compression evaluation. Future work will focus on enhancing real-time feedback functionality and improving the user interface of the web application. Full article

Stroke often leads to severe motor impairment, especially in the upper limbs, greatly reducing a patient’s ability to perform daily tasks. Effective rehabilitation is essential to restore function and improve quality of life. Traditional therapies, while useful, may lack engagement, leading to low motivation and poor adherence. Gamification—using game-like elements in non-game contexts—offers a promising way to make rehabilitation more engaging. The authors explore a gamified rehabilitation system designed in Unity 3D using a Kinect V2 camera. The game includes key features such as adjustable difficulty, real-time and predominantly positive feedback, user friendliness, and data tracking for progress. The evaluations were conducted with 18 healthy participants, most of whom had prior virtual reality experience. About 77% found the application highly motivating. While the gameplay was well received, the visual design was noted as lacking engagement. Importantly, all users agreed that the game offers a broad range of difficulty levels, making it accessible to various users. The results suggest that the system has strong potential to improve rehabilitation outcomes and encourage long-term use through enhanced motivation and interactivity. Full article

Background/Objectives: Aging is often accompanied by physical and cognitive decline, affecting older adults’ mobility. Virtual reality (VR) offers innovative opportunities to safely practice everyday tasks, such as street crossing. This study was designed as a feasibility and pilot study to explore acceptance, usability, and preliminary effects of a VR-based road-crossing intervention for older adults. It investigates the use of virtual reality (VR) as an innovative training tool to support senior citizens in safely navigating everyday challenges such as crossing roads. By providing an immersive environment with realistic traffic scenarios, VR enables participants to practice in a safe and controlled setting, minimizing the risks associated with real-world road traffic. Methods: A VR training application called “Wegfest” was developed to facilitate targeted road-crossing practice. The application simulates various scenarios commonly encountered by older adults, such as crossing busy streets or waiting at traffic lights. The study applied a single-group pre-post design. Outcomes included the Timed Up and Go test (TUG), Falls Efficacy Scale-International (FES-I), and Montreal Cognitive Assessment (MoCA). Results: The development process of “Wegfest” demonstrates how a highly realistic street environment can be created for VR-based road-crossing training. Significant improvements were found in the Timed Up and Go test (p = 0.002, d = 0.784) and fall-related self-efficacy (FES-I, p = 0.005). No change was observed in cognitive function (MoCA, p = 0.56). Participants reported increased subjective safety (p < 0.001). Discussion: The development of the VR training application “Wegfest” highlights the feasibility of creating realistic virtual environments for skill development. By leveraging immersive technology, both physical and cognitive skills required for road-crossing can be effectively trained. The findings suggest that “Wegfest” has the potential to enhance the mobility and safety of older adults in road traffic through immersive experiences and targeted training interventions. Conclusions: As an innovative training tool, the VR application not only provides an engaging and enjoyable learning environment but also fosters self-confidence and independence among older adults in traffic settings. Regular training within the virtual world enables senior citizens to continuously refine their skills, ultimately improving their quality of life. Full article