Search Results (1,671)

Family empowerment is a key component of effective family-centered practices in healthcare, mental health, and educational services. The Family Empowerment Scale (FES) is the most commonly used instrument to evaluate empowerment in families raising children with emotional, behavioral, or developmental disorders. Despite its importance, the FES for diverse populations, especially Latinx parents, has rarely been evaluated using innovative psychometric approaches. In this study, we evaluated key dimensions and psychometric evidence of the Family Empowerment Scale (FES) for 96 Latinx parents of children with intellectual and developmental disabilities (IDD) in the United States using an exploratory graph analysis (EGA). The EGA identified a five-dimensional structure, and EGA models outperformed the original CFA 3-factor models for both parents of children with autism and other disabilities. This study identified distinct, meaningful dimensions of empowerment that reflect both shared and unique empowerment experiences across two Latinx parent groups. These insights can inform the design of culturally responsive interventions, instruments, and policies that more precisely capture and boost empowerment in Latinx families. This study contributes to closing a gap in the literature by elevating the voices and experiences of Latinx families by laying the groundwork for more equitable support systems in special education and disability services. Full article

The increasing penetration of distributed renewable energy and the emergence of large-scale, flexible loads such as data centers pose significant challenges to the economic and secure operation of distribution systems. Traditional static pricing mechanisms are often inadequate, leading to inefficient resource dispatch and curtailment of renewable generation. To address these issues, this paper proposes a hierarchical pricing and dispatch framework modeled as a tri-level Stackelberg game that coordinates interactions among an upstream grid, a distribution system operator (DSO), and multiple virtual power plants (VPPs). At the upper level, the DSO acts as the leader, formulating dynamic time-varying purchase and sale prices to maximize its revenue based on upstream grid conditions. In response, at the lower level, each VPP acts as a follower, optimally scheduling its portfolio of distributed energy resources—including microturbines, energy storage, and interruptible loads—to minimize its operating costs under the announced tariffs. A key innovation is the integration of a schedulable data center within one VPP, which responds to a specially designed wind-linked incentive tariff by shifting computational workloads to periods of high renewable availability. The resulting high-dimensional bilevel optimization problem is solved using a Kriging-based surrogate methodology to ensure computational tractability. Simulation results verify that, compared to a static-pricing baseline, the proposed strategy increases DSO revenue by 18.9% and reduces total VPP operating costs by over 28%, demonstrating a robust framework for enhancing system-wide economic and operational efficiency. Full article

The growing global demand for electricity, driven by the development of electromobility, data centers, and smart technologies, necessitates innovative approaches to energy generation. Wind power, as a clean and renewable energy source, plays a pivotal role in the global transition towards low-carbon power systems. This paper presents a comprehensive review of generator technologies used in wind turbine applications, ranging from conventional synchronous and asynchronous machines to advanced concepts such as low-speed direct-drive (DD) generators, axial-flux topologies, and superconducting generators utilizing low-temperature superconductors (LTS) and high-temperature superconductors (HTS). The advantages and limitations of each design are discussed in the context of efficiency, weight, reliability, scalability, and suitability for offshore deployment. Special attention is given to HTS-based generator systems, which offer superior power density and reduced losses, along with challenges related to cryogenic cooling and materials engineering. Furthermore, the paper analyzes selected modern generator designs to provide references for enhancing the performance of grid-synchronized hybrid microgrids integrating solar PV, wind, battery energy storage, and HTS-enhanced generators. This review serves as a valuable resource for researchers and engineers developing next-generation wind energy technologies with improved efficiency and integration potential. Full article

Background: Bimekizumab, secukinumab, and ixekizumab are IL-17-targeting biologics approved for the treatment of moderate-to-severe plaque psoriasis. While secukinumab and ixekizumab selectively inhibit IL-17A, bimekizumab targets both IL-17A and IL-17F, potentially providing greater anti-inflammatory efficacy. This study aimed to compare the real-world effectiveness, safety, and tolerability of these agents in a Polish dermatology center between 2019 and 2024. Methods: We conducted a retrospective analysis of 98 patients meeting at least one of the following criteria: PASI ≥ 10, BSA ≥ 10, DLQI ≥ 10, or involvement of special areas with inadequate response or contraindications to ≥2 systemic therapies. Patients with prior exposure only to IL-17 inhibitors were excluded. PASI, BSA, and DLQI scores were recorded at baseline, week 4, and week 12. Due to differences in dosing schedules, outcomes were aligned using standardized timepoints and exponential modeling of continuous response trajectories. Mixed-effects ANOVA was used to assess the influence of baseline factors (age, BMI, PsA status) on treatment outcomes. Adverse events were documented at each monthly follow-up visit. Results: Bimekizumab showed the greatest effect size for PASI reduction (Hedges’ g = 3.662), followed by secukinumab (2.813) and ixekizumab (1.986). Exponential modeling revealed a steeper response trajectory with bimekizumab (intercept = 0.289), suggesting a more rapid PASI improvement. The efficacy of bimekizumab was particularly notable in patients who were previously treated with IL-23 inhibitors. All three agents demonstrated favorable safety profiles, with no serious adverse events or discontinuations. The most frequent adverse events were mild and included upper respiratory tract infections and oral candidiasis. Conclusions: This real-world analysis confirmed that IL-17 inhibitors effectively improved PASI, BSA, and DLQI scores in moderate-to-severe psoriasis. Bimekizumab demonstrated the most rapid early improvements and a higher modeled likelihood of complete clearance, without significant differences at week 12. All agents were well tolerated, underscoring the need for further individualized, large-scale studies. Full article

Background: Obstructive sleep apnea (OSA) is a prevalent disorder in both pediatric and adult populations, characterized by substantial morbidity encompassing cardiovascular, neurocognitive, and metabolic impairments. Management strategies vary by age group and underlying etiology, with orthodontic and non-orthodontic interventions playing key roles. This narrative review synthesizes the current evidence on orthodontic and non-orthodontic therapies for OSA in pediatric and adult populations, emphasizing individualized, multidisciplinary care approaches and highlighting future research directions. Methods: A narrative review was conducted using PubMed, Scopus, and Google Scholar to identify studies on diagnosis and management of OSA in children and adults from 2000 to 2025. Results: In pediatric patients, treatments such as rapid maxillary expansion (RME), mandibular advancement devices (MADs), and adenotonsillectomy have shown promising outcomes in improving airway dimensions and reducing apnea–hypopnea index (AHI). For adults, comprehensive management includes positive airway pressure (PAP) therapy, oral appliances, maxillomandibular advancement (MMA) surgery, and emerging modalities such as hypoglossal nerve stimulation. Special attention is given to long-term treatment outcomes, adherence challenges, and multidisciplinary approaches. Conclusions: The findings highlight the need for individualized therapy based on anatomical, functional, and compliance-related factors. As the understanding of OSA pathophysiology evolves, orthodontic and adjunctive therapies continue to expand their role in achieving durable and patient-centered outcomes in sleep apnea management. Full article

Background and Objectives: Specialized nurses play an essential role in managing pulmonary fibrosis. While tele-nursing has the potential to optimize disease management, current evidence regarding its impact remains limited. This study aimed to evaluate a tele-nursing intervention that provided unscheduled access to a specialized nurse via phone or email for both patients and caregivers. Materials and Methods: This was a prospective, single-center, open-label, and pre–post pilot study. Participants and their caregivers were provided with direct access to a specialized nurse, by phone and email, for unscheduled consultations. Patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) were collected at baseline and after three months of tele-nursing access. PREMs were assessed using a 10-point Likert scale questionnaire, and PROMs were evaluated using the King’s Brief Interstitial Lung Disease (K-BILD) and the Living with Pulmonary Fibrosis (L-PF) questionnaires. Results: A total of 47 patients with pulmonary fibrosis receiving antifibrotic drugs were enrolled. At three months, 44 patients and 34 caregivers completed the questionnaires. Four patients did not complete the study due to death, lung transplantation, or transition to end-of-life care. No significant changes were observed in PROMs. However, PREMs showed significant improvements, with most scores exceeding 9/10. Patient satisfaction increased by 28% (p < 0.001), and caregiver satisfaction by 30% (p < 0.001). Caregivers of patients who did not complete the study also reported high satisfaction, comparable to that of other caregivers. Conclusions: A pragmatic and affordable tele-nursing program, based on direct phone and email consultations, may enhance patient and caregiver satisfaction in the management of pulmonary fibrosis. Full article

Regarding the distortion correction problem of large field of view wide-angle cameras commonly used in railway visual inspection systems, this paper proposes a novel online calibration method for non-specially made cooperative calibration objects. Based on the radial distortion divisor model, first, the spatial coordinates of natural spatial landmark points are constructed according to the known track gauge value between two parallel rails and the spacing value between sleepers. By using the image coordinate relationships corresponding to these spatial coordinates, the coordinates of the distortion center point are solved according to the radial distortion fundamental matrix. Then, a constraint equation is constructed based on the collinear constraint of vanishing points in railway images, and the Levenberg–Marquardt algorithm is used to found the radial distortion coefficients. Moreover, the distortion coefficients and the coordinates of the distortion center are re-optimized according to the least squares method (LSM) between points and the fitted straight line. Finally, based on the above, the distortion correction is carried out for the distorted railway images captured by the camera. The experimental results show that the above method can efficiently and accurately perform online distortion correction for large field of view wide-angle cameras used in railway inspection without the participation of specially made cooperative calibration objects. The whole method is simple and easy to implement, with high correction accuracy, and is suitable for the rapid distortion correction of camera images in railway online visual inspection. Full article

This study focuses on the current service/care difficulties and challenges that social institutions in Hungary are facing during their daily operations; how they can react to them utilizing their internal resources, mechanisms, and capacities; and what concrete, tangible needs and demands are emerging in terms of methodological professional support, potential forms, interventions, and direction for professional development. A total of 24 general and 55 specific service and operational problems were identified and assessed in eight different service areas (family and child welfare services, family and child welfare centers, respite care for children, care for the homeless, addiction intervention, care for people with disabilities, care for psychiatric patients, specialized care for the elderly, and basic services for the elderly). The empirical base of the study uses a database of 201 online questionnaires completed by a professional target group working for social service providers in two counties (Győr-Moson-Sopron and Veszprém), representing 166 social service providers. The questionnaires were completed between November and December of 2022. The findings will be used to develop a professional support and development problem map. Social institutions face complex and serious service/care difficulties and challenges in their daily operations. Three distinctive basic problems clearly stand out in both severity and significance from the complex set of factors assessed. The biggest problem in the social care system is clearly the complex challenge of low wages, followed by the administrative burdens in the ranking of operational difficulties, and the third key factor was the psycho-mental workload of staff. Full article

Central nervous system (CNS) insulin signaling is involved in a broad array of cardiometabolic physiology, including glucose and lipid metabolism, feeding, energy expenditure, and blood pressure regulation. A key role for hypothalamic neuroendocrine and autonomic centers in regulating insulin-associated cardiovascular and metabolic physiology has been highlighted. However, it is still unclear which CNS site(s) initiate insulin-dependent neural cascades. While some investigations have suggested that circulating insulin can access hypothalamic regions by crossing the blood-brain barrier, other studies point to a necessity of other brain areas upstream of the hypothalamus to initiate central insulin actions. In this context, accumulating evidence points to a possible involvement of the sensory circumventricular organs (CVOs), unique areas located outside of the blood-brain barrier, in insulin-dependent cardiometabolic homeostasis. Here, the multifaceted roles for the sensory CVOs in cardiovascular and metabolic regulation, with a special emphasis on insulin receptor pathways, are discussed. Full article

The precise characterization of surface rupture zones and associated co-seismic displacement fields from large earthquakes provides critical insights into seismic rupture mechanisms, earthquake dynamics, and hazard assessments. Stereo-photogrammetric digital elevation models (DEMs), produced from high-resolution satellite stereo imagery, offer reliable global datasets that are suitable for the detailed extraction and quantification of vertical co-seismic displacements. In this study, we utilized pre- and post-event WorldView-2 stereo images of the 2024 Ms7.1 Wushi earthquake in Xinjiang to generate DEMs with a spatial resolution of 0.5 m and corresponding terrain point clouds with an average density of approximately 4 points/m². Subsequently, we applied the Iterative Closest Point (ICP) algorithm to perform differencing analysis on these datasets. Special care was taken to reduce influences from terrain changes such as vegetation growth and anthropogenic structures. Ultimately, by maintaining sufficient spatial detail, we obtained a three-dimensional co-seismic displacement field with a resolution of 15 m within grid cells measuring 30 m near the fault trace. The results indicate a clear vertical displacement distribution pattern along the causative sinistral–thrust fault, exhibiting alternating uplift and subsidence zones that follow a characteristic “high-in-center and low-at-ends” profile, along with localized peak displacement clusters. Vertical displacements range from approximately 0.2 to 1.4 m, with a maximum displacement of ~1.46 m located in the piedmont region north of the Qialemati River, near the transition between alluvial fan deposits and bedrock. Horizontal displacement components in the east-west and north-south directions are negligible, consistent with focal mechanism solutions and surface rupture observations from field investigations. The successful extraction of this high-resolution vertical displacement field validates the efficacy of satellite-based high-resolution stereo-imaging methods for overcoming the limitations of GNSS and InSAR techniques in characterizing near-field surface displacements associated with earthquake ruptures. Moreover, this dataset provides robust constraints for investigating fault-slip mechanisms within near-surface geological contexts. Full article

Background/Objectives: This study explores the perspectives of mental health professionals on tailoring the Mentis Plus intervention to enhance positive mental health (PMH) in individuals experiencing First-Episode Psychosis (FEP). Although the Mentis Plus Program has been previously implemented in other contexts, it has not yet been applied to FEP care. Therefore, this study aimed to adapt the intervention for future implementation through expert consultation. Methods: A qualitative exploratory-descriptive design was employed. Data were collected via three focus groups comprising multidisciplinary professionals experienced in FEP care. Qualitative content analysis was used to examine the data. Results: Participants viewed the tailored Mentis Plus intervention as a valuable, recovery-oriented tool. Key recommendations included a flexible, group-based format with eight weekly sessions. Suggested intervention components encompassed gratitude journaling, emotional regulation techniques, and collaborative problem-solving exercises. Group delivery was highlighted as essential for mitigating isolation and promoting peer support. Practical implementation strategies included phased session structures and routine emotional check-ins. Identified barriers to implementation included the need for specialized training, limited therapeutic spaces, and the heterogeneity of participant needs. Facilitators included a person-centered approach, institutional backing, and sufficient resources. Conclusions: The findings support the feasibility and clinical relevance of a tailored Mentis Plus FEP Program—Brief Version. Expert-informed insights provide a foundation for adapting mental health interventions to early-psychosis care and inform future research and implementation strategies. Full article

Background and objectives: Neurosurgical intervention on the newborn’s developing brain is a risk factor for neurodevelopmental disorders (NDDs). These patients necessarily require regular, coordinated follow-up. The ventricular subgaleal shunt (VSGS) technique has been used since 2013 at Rouen University Hospital. Like any change in practice, this technique must be evaluated. In this paper, we describe the population of patients with hydrocephalus treated by VSGS, the complications associated with the procedure, and the outcome of these patients at two and six years old. Methods: This study was an observational, descriptive, retrospective, single-center study. Children included were those less than three months old with hydrocephalus treated by VSGS at Rouen University Hospital from January 2013 to December 2023. Data were anonymized and collected using EDSaN software. A descriptive analysis was performed. Results: Thirty-two patients were included in our study. Of these, 22 (69%) were born prematurely; 16 (50%) of these 22 had postnatal intraventricular hemorrhage (IVH) requiring treatment with VSGS. A total of three patients (13.6%) died within the first year of life; twenty-four patients (75%) required definitive shunting. Twenty-two patients were over 2 years old in our study. Only 10 of them acquired the ability to walk (45%). Cerebral palsy was present in 10 (45%) patients. Fifteen patients were over 6 years old; thirteen (87%) attended school, but six (40%) had special needs (the need of an assistant, or part-time schedule). In our study, only 24 patients (82%) were followed by a pediatrician trained in neurodevelopment at Rouen University Hospital, and 27 (93%) were followed by a neurosurgeon. Conclusions: This study describes all patients with hydrocephalus treated by VSGS at Rouen University Hospital between January 2013 and December 2023, as well as their complications and their neurological outcomes. The follow-up of these children at risk of NDDs is essential. Full article

In 2023, the USDA reported that 17.9% of U.S. households with children were food insecure, meaning they had limited or uncertain access to adequate food. However, there is evidence that far more children experience food insecurity than is currently being reported, and the effects of that insecurity on child health and development are broad and far-reaching. Childcare and early childhood education centers are particularly well-positioned to make a difference yet are often not discussed in the scientific literature. Childcare arrangements provide meals and snacks to the children they serve, buffer the effects of food insecurity by supporting children’s cognitive and social–emotional development, and provide an important point of intervention for food-insecure families. In this report, we unpack the definition of food insecurity and who is considered food insecure, review how food insecurity impacts child health and development across physical, social–emotional, and cognitive domains, and explore the evidence behind childcare’s role in addressing childhood food insecurity. Additionally, we make recommendations for policy and practice, advocating for a multi-stakeholder approach, with a special focus on how childcare providers can change to best combat children’s food insecurity. Full article

Background and Objectives: The transition from pediatric to adult-oriented healthcare is challenging and data on parental involvement and perception regarding the transition of children with chronic digestive diseases are scarce. Materials and Methods: Legal guardians of adolescents with chronic digestive diseases receiving care at a North-Eastern Romanian tertiary center and private offices were administered a 30-item survey. Results: There were 124 responders; 73.4% lived in rural areas; 81.5% were patients’ mothers. Positive correlations were found between parents’ perception of the child’s readiness for health-related decisions and appreciation of the children’s preparedness for transition (0.544; p = 0.000), between parents encouraging their children to maintain healthcare records and their perception of the children’s knowledge about their disease (0.67; p = 0.000), between parents’ fear of therapeutic breaks during transition and their perception of the need for transition training (0.704; p = 0.000), between fears for children’s impropriate health-related choices, fears of therapeutic breaks (0.573; p = 0.00) and parental perception that the adult physicians would be more patient-oriented and less family-centered (0.453; p < 0.000) and between parents’ trust in their children’s self-management skills and encouraging them to make decisions on their own (0.673; p < 0.000). Conclusions: The results of our study highlight the importance of addressing parental fears during special parent–children counseling sessions and promoting a child’s independence, chronic disease knowledge, records and alone consultations. Full article

The increasing integration of 3D technologies and machine learning is fundamentally reshaping mineral sciences and cultural heritage, establishing the foundation for an emerging “Mineralogy 4.0” framework. However, public engagement with digital 3D collections is often limited by complex or costly interfaces, such as VR/AR systems and traditional touchscreen kiosks, creating a clear need for more intuitive, accessible, and more engaging and inclusive solutions. This paper presents PETRA, an open-source, gesture-controlled system for exploring 3D rocks and minerals. Developed in the TouchDesigner environment, PETRA utilizes a standard webcam and the MediaPipe framework to translate natural hand movements into real-time manipulation of digital specimens, requiring no specialized hardware. The system provides a customizable, node-based framework for creating touchless, interactive exhibits. Successfully evaluated during a “Long Night of Museums” public event with 550 visitors, direct qualitative observations confirmed high user engagement, rapid instruction-free learnability across diverse age groups, and robust system stability in a continuous-use setting. As a practical case study, PETRA demonstrates that low-cost, webcam-based gesture control is a viable solution for creating accessible and immersive learning experiences. This work offers a significant contribution to the fields of digital mineralogy, human–machine interaction, and cultural heritage by providing a hygienic, scalable, and socially engaging method for interacting with geological collections. This research confirms that as digital archives grow, the development of human-centered interfaces is paramount in unlocking their full scientific and educational potential. Full article