Search Results (8,714)

Background/Objectives: Enteral nutrition (EN), delivered either exclusively (EEN) or partially (PEN) in combination with the Crohn’s Disease Exclusion Diet (CDED), represents an evidence-based dietary therapy for active Crohn’s Disease (CD), recommended in clinical guidelines. However, adherence to this therapy remains suboptimal among adult patients. This study aimed to explore the intention to repeat CDED & PEN alongside perceived factors affecting adherence to CDED & PEN in CD adult patients. Methods: A single-center, cross-sectional qualitative study was conducted between October 2025 and March 2026 at a private dietetic practice in Larissa, Greece. Semi-structured interviews were undertaken and analyzed using thematic analysis. Results: Out of the 88 patients screened, 15 adults with CD participated in semi-structured interviews. Four overarching themes emerged: (1) intention to repeat CDED & PEN, with all participants reporting willingness to repeat CDED & PEN in the event of future relapse; (2) barriers to CDED & PEN adherence, including challenges in social situations involving food; (3) facilitators of CDED & PEN adherence, such as improved symptom control and increased sense of security; and (4) dual factors affecting CDED & PEN adherence, whereby meal preparation demands, taste and variety, and social and environmental support acted as either facilitators or barriers against adherence depending on individual circumstances. Conclusions: Greek adults with CD showed strong willingness to reinitiate CDED & PEN during relapse. Addressing modifiable barriers, particularly dietary monotony and financial burden, alongside strengthening structured dietitian support and personalized dietary guidance, may help optimize adherence in clinical practice. Full article

Classical readability formulas are widely used to evaluate academic abstracts, yet the evidence on what they register is mixed, and disciplinary differences are often invoked to explain that inconsistency. This study examines within-field variation, treating forestry-related research as a set of knowledge domains and scoring 4191 English-language Web of Science abstracts from 2008 to 2019 with four classical indices. The abstracts were consistently demanding on all four indices. The most difficult domain was forest economics, policy, governance and social dimensions, with ecology and conservation being intermediate and inventory and management not being distinguishable from tree biology and silviculture. The contrasts persisted within journals, though the distributions overlapped substantially, and most variation remained within domains. With domain and covariates being controlled, no index showed a statistically distinguishable association with normalized citation impact, and the interaction tests did not establish domain heterogeneity. Domain was modestly associated with citation impact, but readability did not account for it. The indices, therefore, register systematic differences in linguistic form across knowledge domains while giving no dependable signal of scholarly uptake. For authors and editors, such scores work best as prompts for closer reading with a domain and an audience in view, not as field-wide standards or proxies for expected citation. Full article

The core predicament of energy transition lies not in the availability of clean technologies, but in whether an economy possesses the institutional capacity and social foundation to systematically regulate its carbon-energy metabolic processes. Drawing upon co-evolutionary theory from evolutionary economics, this paper constructs a composite indicator of Low-Carbon Green Energy Eco-Co-evolution (LCEE) encompassing three functional dimensions: efficiency advancement, kinetic energy replacement, and boundary adherence. Concurrently, by integrating innovation ecosystem theory with inclusive development theory, we propose the concept of “Inclusive Potential of Regional Innovation Ecosystems” (IEP), characterizing the systemic potential for transforming innovation outcomes into social welfare across four dimensions: Knowledge Matrix Abundance (KMF), Cultural Capillary Permeation (CCP), Technological Community Succession (TCS), and Social Root Nourishment (SRN). Taking China’s 2016 intellectual property (IP) powerhouse construction pilot as the institutional prototype of Industrial Intellectual Property Upgrading Reform (IPR), we incorporate IPR, IEP, and LCEE into a unified causal analytical framework, proposing a testable transmission logic of ‘institutional supply → ecological development → co-evolutionary synergy. Using panel data from 30 Chinese provincial-level administrative regions over 2010–2022, we employ a Spatial Durbin Difference-in-Differences (SDM-DID) model to identify the direct and spatial spillover effects of IPR on LCEE, and embed a Double Machine Learning (DML) framework to test the mediating mechanism of IEP while controlling for high-dimensional nonlinear interference. The findings reveal that IPR exerts a significant and robust direct promoting effect on LCEE, generating positive spatial spillovers to neighboring regions through the public disclosure of patent information. IEP significantly promotes local LCEE, yet its spatial spillover lacks statistical support due to structural conflicts in inter-dimensional transmission attributes. IEP plays a significant partial mediating role between IPR and LCEE, with the indirect effect accounting for over one-third of the total effect, a finding robust to alternative machine learning algorithms, sample split adjustments, and exclusion of contemporaneous competing policies. Sub-path tests reveal that KMF bears the strongest mediating efficacy, serving as the primary transmission channel, while CCP exhibits full mediation—the institutional effect on LCEE in the cultural dimension depends almost entirely on the mediating transformation through the public cultural service system. Heterogeneity analysis further demonstrates full mediation in the Low-Carbon Green Energy Eco-Kinetic Replacement (KER) dimension, indicating that the institutional catalytic effect on clean energy substitution must be realized through IEP transformation. This paper provides empirical evidence for the proposed causal pathway through which institutional public goods indirectly enhance the synergistic quality of carbon-energy transition via the inclusive potential of innovation ecosystems, providing theoretical foundations and policy implications that, while grounded in China’s institutional context, may offer valuable reference points for emerging market economies facing similar dual pressures of technological constraints and green transition. Full article

The Fei Qian (飞箝) Argumentation Scheme, one of the core rhetorical schemes of the School of Diplomacy (Zonghengjia, 纵横家) aimed at controlling others, has yet to receive systematic theoretical analysis, and its significance within the history of Chinese logic remains underexplored. Drawing primarily on the Guiguzi (《鬼谷子》) and related pre-Qin period sources, this article examines the Fei Qian Argumentation Scheme across three dimensions: its structural logic, its intended targets, and its practical application. The analysis reveals that the Fei Qian Argumentation Scheme exhibits a fundamental asymmetry in evaluative standards—it demands factual reliability of the premises while judging the conclusion solely by the criterion of audience acceptability. Operationally, the scheme proceeds by deploying external flattery (fei, 飞) to draw upon captivating words (Gou Qian zhi ci, 钩箝之辞), supplemented where necessary by inward emotional manipulation (Gou Qian, 钩箝). Its application is further stratified by social hierarchy: the scheme is directed upward at rulers (zhi tian xia, 制天下) and laterally at peers (zhi ren, 制人), while subordinates may be directed without recourse to it. In practice, the Fei Qian Scheme presupposes a careful assessment of power and capacity (duo quan liang neng, 度权量能), pursues the goal of winning willing compliance (cong hua, 从化), and resorts to the compound strategy of “encumber responsibilities and reveal weaknesses” (chong lei–zi hui, 重累—訾毁) when the primary scheme fails. The emergence of the Fei Qian scheme form and the broader rise in the School of Diplomacy were inseparable from the specific socio-cultural and historical context of the Spring and Autumn and Warring States periods. To a significant degree, the argumentation theories and practices of the School of Diplomacy advanced the development of bianxue (辩学, the art of disputation) and of Chinese logic as a whole. Full article

Background: Depressive symptoms have become a significant public health issue faced by middle-aged and older adults in China. Although previous studies have primarily focused on demographic and socioeconomic factors, the association between modifiable lifestyle behaviors and depressive symptoms still requires further investigation. Objective: To examine the associations between sleep duration, physical activity, digital participation, social participation, and depressive symptoms as well as life satisfaction among middle-aged and older adults in China. Methods: A cross-sectional analysis was conducted using data from the 2020 China Health and Retirement Longitudinal Survey (CHARLS). Depressive symptoms were defined as CES-D-10 scores ≥10, with 13,576 individuals included in the analysis sample. Adjusted prevalence ratios (aPRs) were estimated using modified Poisson regression, while ordinal logistic regression was employed to analyze life satisfaction. The analysis controlled for covariates such as demographics, socioeconomic status, and health status, and accounted for the complex sampling design. Results: The weighted prevalence of depressive symptoms was 44.5%. Sleep deprivation (<7 h/day) was significantly associated with elevated depressive symptoms (aPR = 1.49, 95% CI: 1.33–1.68); participation in recreational activities was significantly associated with reduced depressive symptoms (aPR = 0.86, 95% CI: 0.77–0.96); adequate physical activity was associated with a higher prevalence of elevated depressive symptoms (aPR = 1.17, 95% CI: 1.04–1.32); watching videos (aPR = 0.87, 95% CI: 0.76–0.99) and playing online games (aPR = 0.65, 95% CI: 0.50–0.83) were significantly associated with reduced depressive symptoms; and overall internet use was correlated with lower life satisfaction (OR = 0.90, 95% CI: 0.81–1.00). Women, rural residents, and low-income groups exhibited higher prevalence of elevated depressive symptoms. Conclusion: Sleep deprivation, as well as different types of social engagement, physical activity, and digital behavior, exhibit distinct associations with depressive symptoms in middle-aged and older adults. Behavioral intervention strategies targeting sleep hygiene, leisure activities, and tailored digital behaviors warrant further attention. Full article

Background: Pain is a multidimensional experience shaped not only by nociceptive input but also by cognitive, emotional, and social processes. In musculoskeletal (MSK) rehabilitation, outcome variability among patients with similar clinical presentations suggests that determinants beyond tissue pathology may influence pain perception and recovery. Contextual factors (CFs)—communication, therapeutic relationship, patient expectations, and environmental cues—are increasingly recognized yet remain inconsistently integrated into routine practice. Objective: To map how CFs are represented in the physiotherapy literature indexed under that terminology, and to identify where empirical evidence in MSK rehabilitation is present and where it is absent. Methods: A narrative review with a systematic search strategy, reported following SANRA, was conducted in PubMed and Scopus, searched on 31 March 2026. Records were screened against predefined eligibility criteria, including publication from 2006 onwards and English language. Two reviewers independently screened records and resolved disagreements by consensus. Methodological quality was appraised using the Cochrane RoB2 tool for randomized controlled trials and an adapted Newcastle–Ottawa Scale for observational and cross-sectional studies. Conceptual publications were not formally appraised. Each publication was classified as direct clinical evidence (Tier A), indirect mechanistic or implementation-level evidence (Tier B), or conceptual contribution (Tier C). Results: Eight publications were included: no source provided direct clinical evidence in a musculoskeletal rehabilitation population (Tier A), five provided indirect mechanistic or implementation-level evidence (Tier B), and three were conceptual contributions (Tier C). The single randomised controlled trial retrieved was conducted in asymptomatic volunteers and was at high risk of bias for the between-group comparisons of all reported outcomes. Findings are organised as contextual domains, mediating mechanisms, and outcomes. No direct clinical evidence was retrieved; claims regarding expectations, therapeutic alliance, non-verbal communication, and the clinical environment rest on indirect or conceptual sources. Conclusions: CFs may contribute to pain and rehabilitation variability through cognitive, emotional, and relational pathways, complementing rather than replacing evidence-based care. The scarcity of direct clinical evidence within the literature indexed under this terminology is itself a finding. Construct-level searches and pragmatic trials are required to clarify the contribution of individual contextual domains. Full article

This study examines how gay-Mizrahi men in Israel navigate the communicative processes through which workplace subjectivities are constructed, negotiated, and legitimized. Mizrahiness refers to a Jewish ethno-cultural position associated with Middle Eastern and North African ancestry, historically shaped by unequal relations with Ashkenazi hegemony and intersecting class, geographic, cultural, and gendered hierarchies. Based on semi-structured interviews with self-identified gay-Mizrahi men across diverse occupational sectors, this study examines how sexuality, ethnicity and professionalism are read together in everyday organizational interactions. The findings reveal three strategic mechanisms: identity calibration, hyphenated subjectivity, and compensatory professionalism. Identity calibration refers to the ongoing tuning of identity visibility, timing, intensity, and communication. Hyphenated subjectivity captures the relational process through which gayness and Mizrahiness are not simply combined but continuously negotiated in relation to social expectations and organizational norms. Compensatory professionalism describes intensified investment in excellence, credentials and self-control to counter anticipated devaluation. These mechanisms show that organizational belonging is not a static outcome of diversity or inclusion but an advanced communicative achievement. Thus, this study contributes to workplace communication and Diversity, Equity and Inclusion (DEI) scholarship by illustrating how marked workers achieve professional legibility. We argue that DEI practice must move beyond visible categories of diversity towards affective and communicative dimensions through which inequality is reproduced. Full article

External resources, digital competence, and psychological characteristics have each been linked to Artificial Intelligence (AI) literacy, but almost always in isolation, so the unique contribution of any one domain remains unknown. Grounded in social cognitive theory, this study models all three domains jointly. Data were collected from 303 undergraduates at a liberal arts university in Hong Kong and analysed using hierarchical multiple regression. Perceived resources and perceived teacher support explained 29% of the variance in AI literacy; prior digital competence added a further 3%; and personal innovativeness, technology anxiety, and growth mindset in technology added a further 6%, with all three being significant in the final model (total R² = 0.39). The external predictors remained significant throughout but attenuated substantially, indicating that institutional provision is necessary but not sufficient. Technology anxiety, which correlated negatively with AI literacy at the zero-order level, emerged as a positive predictor once other determinants were controlled. Analyses of the five AI literacy subdimensions localised this effect to critical evaluation and ethical competence and found no association with the three performance-oriented dimensions, suggesting that anxiety operates through heightened vigilance rather than enhanced operational skill. These findings, which no single-domain design could have produced, indicate that fostering AI literacy requires attention to students’ psychological readiness and foundational digital skills alongside the provision of infrastructure. Full article

Depression represents a growing public health concern globally, with the mental health of college students requiring targeted attention. Drawing on the social cure theory, self-determination theory, and the agency-communion model, the current study explored the mechanisms linking school identification to depressive mood among Chinese college students. Specifically, this cross-sectional study aimed to investigate the association between school identification and depressive mood, and whether social exclusion and sense of control mediate this relationship. A sample of 981 college students (464 males and 517 females) completed self-reported measures of school identification, depressive mood, social exclusion, and sense of control. Results showed that (1) School identification was negatively associated with college students’ depressive mood. (2) School identification affected depressive mood through three significant indirect pathways: the single mediating path via social exclusion, the single mediating path via sense of control, and the chain mediating path from social exclusion to sense of control. These findings reveal that the mechanism by which school identification alleviates depressive mood lies in first providing communion resources (reducing social exclusion) and then enhancing agency resources (increasing sense of control), thereby providing empirical support for the agency-communion model and offering practical implications for educational interventions targeting college students’ depressive mood. Full article

In-storage food loss is a persistent yet under-addressed source of economic, environmental, and social waste in small and medium-sized enterprise (SME) cold chains, where continuous monitoring and lean workflows are typically absent. This study asks how such loss can be reduced under SME constraints and what benefits an intervention designed for that setting could yield. Following a design science approach in a Thai chilled warehouse case, it develops an integrated intervention coupling an Internet of Things (IoT) early-warning platform—ESP-32 and DHT22 sensing with commodity-specific alerting through the LINE Messaging API—with value stream mapping (VSM) of the depositing and withdrawing workflows. Monitoring showed that 7.4% of quality-controlled readings exceeded the 6 °C control threshold. Value stream analysis established that elapsed time is governed by information latency rather than physical work and that produce spends 290 min per handling cycle outside controlled conditions. The redesigned workflows project lead-time reductions of 47.5% and 69.4% and remove 125 min of that exposure. An ex ante Triple Bottom Line assessment estimates approximately 19,700 kg of avoided produce loss, 6500 kg CO₂e, and 590,000 THB retained annually. This study contributes a complementarity account of digital monitoring and process improvement, advancing SDG Target 12.3. Full article

In today’s world, where people are exposed to ever-increasing flows of information, children may find it difficult to regulate their emotions, attention, thoughts and behaviour. Self-regulation is widely recognised as a key factor in children’s learning, emotional well-being and social functioning, yet there remains a lack of research analysing how processes related to self-regulation can be conceptually explored in museum, experiential and sensory educational settings. To address this gap, this study examines the conceptual links between the exhibits and educational activities at the Museum of Feelings, established in Lithuania in 2025, and children’s emotional, cognitive and behavioural self-regulation. The study employed qualitative deductive content analysis. The museum’s exhibits and the associated educational activities were analysed using a coding system derived from the academic literature. The analysis identified three main categories of self-regulation: emotional, cognitive and behavioural. The results of this study reveal that the museum’s exhibits and activities were conceptually linked to all three categories. The activities analysed were linked to the development of emotional vocabulary, the recognition and naming of emotions and bodily sensations, reflection on the interrelationships between thoughts, feelings, bodily sensations and behaviour, attention regulation, impulse control, and the exploration of constructive ways of responding to complex emotions and social situations. By revealing how these aspects of self-regulation are given meaning within the experiential museum environment, this study offers a new theoretical perspective on the educational potential of museum activities. However, the identified links are conceptual and theoretical in nature and should therefore not be interpreted as empirical evidence of the museum’s impact on children’s self-regulation. Full article

Background: Delirium management remains inconsistently implemented in intensive care units (ICUs), and existing studies provide limited insight into how assessment capability, organisational opportunity, and emotional motivation interact in Chinese tertiary care settings. Aim: To explore ICU nurses’ perceived barriers and facilitators to delirium assessment and management using the Capability, Opportunity and Motivation model of Behaviour (COM-B). Methods: A qualitative descriptive exploratory study was conducted with 14 registered ICU nurses from two tertiary hospitals in Chongqing, China, between December 2025 and February 2026. Purposive sampling captured variation in clinical experience, educational background, and ICU type. The first author conducted face-to-face interviews in Mandarin Chinese and completed the initial coding. COM-B informed both the interview guide and the deductive organisation of the analysis, while six themes and 33 lowest-level factors were developed within the three domains. During revision, the fixed analytic structure was audited against all 14 Mandarin transcripts, and the second author independently applied the fixed codebook to five complete transcripts selected for maximum variation; disagreements were resolved by returning to the original Mandarin context and predefined coding boundaries. Results: Eighteen barriers and fifteen facilitators were identified across six themes within the COM-B domains. Capability was strengthened by clinical experience, senior nurses’ intuitive pattern recognition, and conversational assessment, but constrained by difficulty recognising hypoactive delirium, uncertainty when assessing older adults, inconsistent use of CAM-ICU, and insufficient targeted training. Opportunity was enhanced by staffing, environmental control, peer support, family engagement, and physician collaboration, but restricted by fragmented visibility, sensory overstimulation, workload, restrictive visiting, and delayed medical responses. Motivation reflected the tension between professional duty and accountability for safety on one hand and emotional burden, verbal abuse, and violence on the other. Cross-domain accounts showed that opportunity constraints could amplify anxiety and safety-first motivation, narrowing feasible behaviour toward containment, whereas social support could sustain relational care. Conclusions: Delirium management was shaped by interacting behavioural, organisational, and emotional conditions. Strengthening assessment capability alone is unlikely to produce consistent practice without staffing, workflow, environmental, and interprofessional support. Mapping the findings to Behaviour Change Wheel intervention functions highlighted training, environmental restructuring, enablement, and modelling as priority candidate functions for prospective evaluation; education alone was unlikely to be sufficient. Reporting Method: This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Patient or Public Contribution: No patient or public contribution was involved in the design, conduct or reporting of this study. Participants were registered intensive care unit nurses. Full article

Objective: This study investigates the relationship between social media use and consumer purchase intentions or out-of-home food choices in the Polish gastronomic market, focusing specifically on variations across generations. Methodology: Data were collected between May and July 2024 through a diagnostic survey using the Computer-Assisted Web Interviewing (CAWI) technique (N = 1099). Respondents were recruited via a non-probability quota sampling approach based on strict demographic inclusion criteria. To test the research hypotheses regarding generational variations in market behaviour, a multivariate discriminant function analysis was performed using Statistica 13.1 PL. A preliminary pilot study (N = 30) confirmed the initial questionnaire readability and overall consistency (Cronbach’s alpha = 0.87), while subscales were treated independently during the main analysis. Results: Multivariate models were found to be highly significant, revealing clear differences between age groups. The youngest cohort (aged 18–35) relies heavily on Instagram and TikTok, showing distinct patterns regarding visual triggers such as “instagrammable” aesthetics, digital validation, and menu uniqueness alongside weight loss claims. Conversely, seniors (aged 61 and older) lean unexpectedly towards X. This older segment displays pragmatic, utility-driven motives, searching for detailed textual data about ingredients and the health-promoting properties of food. General product quality and calorie control were identified as universal factors that do not vary by generation. Conclusions and Managerial Implications: The digital transformation of the Polish restaurant industry does not follow a single path. Social media is closely linked to modern customer journeys, with physical dining spots frequently serving as spaces for socialisation. Consequently, restaurant operators should move away from mass communication and adopt a selective omnichannel strategy, where message formats shift from visual appeal to factual, nutrition-oriented text that is tailored to the digital literacy and dietary needs of each generation. Full article

Deep learning and social–emotional learning (SEL) are increasingly recognized as essential for preparing children to thrive in an increasingly complex and interconnected world. However, research examining the relationship between SEL and deep learning among children with autism spectrum disorder (ASD) remains limited. This study investigated the association between SEL and deep learning during inclusive play among 13 children with ASD (IQ ≤ 50; 2 females and 11 males; Mage = 6.23 years, SD = 0.60). The results indicated that (1) children’s social–emotional competencies (SECs) were significantly higher at post-test than at pre-test over the period of participation in inclusive play; (2) children with ASD demonstrated changes in SEL within a dynamic process involving teacher scaffolding, interactions with diverse peers, imitation of peer behaviors, and internalization of activity routines during inclusive play; and (3) Several SEC dimensions were positively associated with deep learning, and regression analyses indicated a significant predictive relationship between SECs and deep learning. These findings highlight the potential of inclusive play for supporting both SEL and deep learning among children with ASD and provide empirical support for considering the development of SECs as a potential predictor of deep learning. However, the findings should be interpreted cautiously given the small sample size (n = 13) and the absence of a control group. Full article

This examines the development of the saltpeter industry in Chile after the War of the Pacific (1879–1883), a conflict between Chile and a Bolivian–Peruvian alliance. Chile’s victory meant the annexation of the territories of Antofagasta and Tarapacá, effectively controlling the production of sodium nitrate and the global saltpeter monopoly. Industrial development was reflected through changes in foreign and Chilean capitals, technologies, and work practices. In Tarapacá, the most important investments in the 19th century were British and German. In Antofagasta, Chilean, English, German, and Croatian investments were prominent in the 19th and 20th centuries. And since 1926, American capitals have occupied the spotlight. The dominant technologies were the Shanks system between 1880–1926, the Guggenheim from 1926–1954, and the introduction of Solar Evaporation in the 1950s. Work evolved from manual artisanal labor without legal protection to mechanization under social laws. Saltpeter represented, in the social and economic history of Chile, the rise of the proletariat, communal social movements, a strong labor press, and a series of strikes and massacres. From the saltpeter era sprouted powerful literature, poetry, and music throughout the 20th century until today. The nitrate industry reached its peak between 1881 and 1917. During this period, it had to confront competition from synthetic nitrate and ceased to be the main source of revenue for the national treasury of Chile. This was followed by a period of decline and crisis from 1918 to 1931, the latter intertwined with the global financial crisis. Various state and business measures made it possible for a small number of nitrate oficinas (processing plants and settlements) in Tarapacá and Antofagasta to continue operating until the nationalization of the nitrate industry in 1971. The nitrate industry took place during the first globalization of liberalism, one that brought flows of capital, migration from Europe to the American Continent, changes to marine navigation, and the opening of various markets in Asia, Europe, and Africa. Nitrate became the most effective fertilizer for agriculture and replaced guano in crop production. In order to analyze this topic, we will utilize the results of the main monographic studies, texts used for historical and political context, and works with interpretative theses about specific periods of nitrate production. Full article