Search Results (392)

Background/Objectives: Senior nurses in Taiwan shoulder layered responsibilities shaped by professional roles, gendered expectations, and family duty. Although Taiwan faces a persistent shortage of experienced clinical nurses, limited research has explored how long-serving nurses sustain identity and commitment across decades of caregiving. This study examines how senior staff nurses understand their journeys of becoming—and remaining—nurses within a culturally and emotionally complex landscape. Methods: Interviews were conducted between May 2019 and September 2023 in locations chosen by participants, with most sessions face-to-face and others undertaken via video conferencing during COVID-19. This narrative inquiry involved in-depth, multi-session interviews with five female senior staff nurses born in the 1970s to early 1980s. Each participant reflected on her life and career, supported by co-constructed “nursing life lines.” Thematic narrative analysis was conducted using McCormack’s five-lens framework and Riessman’s model, with ethical rigor ensured through reflexive journaling and participant validation. Results: Three overarching themes emerged: (1) inner strength and endurance, highlighting silent resilience and the ethical weight of caregiving; (2) support and responsibility in relationships, revealing the influence of family, faith, and relational duty; and (3) role navigation and professional identity, showing how nurses revisit meaning, self-understanding, and tensions across time. Participants described emotionally powerful moments, identity re-connection, and cultural values that shaped their paths. Conclusions: These narratives offer a relational and culturally embedded understanding of what it means to sustain a career in nursing. Narrative inquiry created space for reflection, meaning-making, and voice in a system where such voices are often unheard. Identity was not static—it was lived, reshaped, and held in story. Full article

Deliberative approaches to governance systems analysis and improvement are rare. Australia’s Great Barrier Reef (GBR) provides the context to describe an innovative approach that combines reflexive and interactive engagement processes to (a) develop and design a framework to assess the GBR’s complex governance system health; and (b) undertake a benchmark assessment of governance system health. We drew upon appreciative inquiry and used multiple lines of evidence, including an extensive literature review, governance system mapping, focus group discussions and personal interviews. Together, these approaches allowed us to effectively engage key actors in value judgements about twenty key characteristic attributes of the governance system. These attributes were organised into four clusters which enabled us to broadly describe and benchmark the system. These included the following: (i) system coherence; (ii) connectivity and capacity; (iii) knowledge application; (iv) operational aspects of governance. This process facilitated deliberative discussion and consensus-building around attribute health and priorities for transformative action. This was achieved through the inclusion of diverse perspectives from across the governance system, analysis of rich datasets, and the provision of guidance from the project’s Steering Committee and Technical Working Group. Our inclusive, collaborative and deliberative approach, its analytical depth, and the framework’s repeatability enable continuous monitoring and adaptive improvement of the GBR governance system and can be readily applied to complex governance systems elsewhere. Full article

In this paper, we argue that what is sometimes at fault for the poor attendance and lack of engagement in schools observed from historically marginalized families is a missed opportunity to increase understanding or cultural relevance on the part of schools. In this paper, we use the construct of “counter stories” which has the potential to change the script on the instrumentalist demands of quantity versus quality in parent engagement. By providing examples of what we consider “quality” engagement techniques via the staff’s interpretation of their roles within one demographically rich early learning center, the strategies used to engage parents are documented. Counter-stories of practice show family-centrism as interpreted by school leaders. By describing one community context and its practices of building relationships with newcomer families, relationally driven parent engagement techniques are revealed. The authors highlight how inquiry-based methods surpass the generic approaches described in policy. When parent engagement “arises” from within parents’ motivations and informs authentic knowing (by teachers and school leaders), community systems are elevated. Professionals’ decisions about children and community groups that are informed by families’ knowledge are consequently meaningful and authentic. Full article

Task-oriented medical dialogue systems face two fundamental challenges: the explosion of state-action space caused by numerous diseases and symptoms and the sparsity of informative signals during interactive diagnosis. These issues significantly hinder the accuracy and efficiency of automated clinical reasoning. To address these problems, we propose MA-HRL, a multi-agent hierarchical reinforcement learning framework that decomposes the diagnostic task into specialized agents. A high-level controller coordinates symptom inquiry via multiple worker agents, each targeting a specific disease group, while a two-tier disease classifier refines diagnostic decisions through hierarchical probability reasoning. To combat sparse rewards, we design an information entropy-based reward function that encourages agents to acquire maximally informative symptoms. Additionally, medical knowledge graphs are integrated to guide decision-making and improve dialogue coherence. Experiments on the SymCat-derived SD dataset demonstrate that MA-HRL achieves substantial improvements over state-of-the-art baselines, including +7.2% diagnosis accuracy, +0.91% symptom hit rate, and +15.94% symptom recognition rate. Ablation studies further verify the effectiveness of each module. This work highlights the potential of hierarchical, knowledge-aware multi-agent systems for interpretable and scalable medical diagnosis. Full article

A vast proportion of scientific data remains locked behind dynamic web interfaces, often called the deep web—inaccessible to conventional search engines and standard crawlers. This gap between data availability and machine usability hampers the goals of open science and automation. While registries like FAIRsharing offer structured metadata describing data standards, repositories, and policies aligned with the FAIR (Findable, Accessible, Interoperable, and Reusable) principles, they do not enable seamless, programmatic access to the underlying datasets. We present FAIRFind, a system designed to bridge this accessibility gap. FAIRFind autonomously discovers, interprets, and operationalizes access paths to biological databases on the deep web, regardless of their FAIR compliance. Central to our approach is the Deep Web Communication Protocol (DWCP), a resource description language that represents web forms, HyperText Markup Language (HTML) tables, and file-based data interfaces in a machine-actionable format. Leveraging large language models (LLMs), FAIRFind combines a specialized deep web crawler and web-form comprehension engine to transform passive web metadata into executable workflows. By indexing and embedding these workflows, FAIRFind enables natural language querying over diverse biological data sources and returns structured, source-resolved results. Evaluation across multiple open-source LLMs and database types demonstrates over 90% success in structured data extraction and high semantic retrieval accuracy. FAIRFind advances existing registries by turning linked resources from static references into actionable endpoints, laying a foundation for intelligent, autonomous data discovery across scientific domains. Full article

Procedural physician-scientists have made significant contributions to medicine and science, with twelve proceduralists receiving a Nobel Prize. Unfortunately, several systemic challenges have jeopardized the existence, let alone the flourishing, of procedural physician-scientists: the widening gap in the National Institutes of Health salary cap, decreasing funding from nonfederal public and private agencies, and shifting priorities among U.S. hospitals, payers, and policymakers toward relative value unit productivity-based compensation and fee-for-service models. Additional pressures include prolonged training pathways and the need to maintain clinical continuity. Adopting a team science approach may offer a powerful strategy to mitigate these competing demands, support rigorous scientific inquiry, and address the growing complexity of biomedical research. Concerted efforts by the federal government, policymakers, corporations, institutions, and procedural departments will also be crucial to restoring the vitality of this diminishing workforce. Full article

This study delivers a rigorous and in-depth bibliometric examination of 693 scholarly publications addressing the intersection of metaverse technologies and banking, retrieved from the Web of Science Core Collection. Through advanced scientometric tools, including VOSviewer and Bibliometrix, the research systematically unpacks the evolving intellectual and thematic contours of this interdisciplinary frontier. The co-occurrence analysis of keywords reveals a landscape shaped by seven core thematic clusters, encompassing immersive user environments, digital infrastructure, experiential design, and ethical considerations. Factorial analysis uncovers a marked bifurcation between experience-driven narratives and technology-centric frameworks, with integrative concepts such as technology, information, and consumption serving as conceptual bridges. Network visualizations of authorship patterns point to the emergence of high-density collaboration clusters, particularly centered around influential contributors such as Dwivedi and Ooi, while regional distribution patterns indicate a tri-continental dominance led by Asia, North America, and Western Europe. Temporal analysis identifies a significant surge in academic interest beginning in 2022, aligning with increased institutional and commercial experimentation in virtual financial platforms. Our findings argue that the incorporation of metaverse paradigms into banking is not merely a technological shift but a systemic transformation in progress—one that blurs the boundaries between speculative innovation and tangible implementation. This work contributes foundational insights for future inquiry into digital finance systems, algorithmic governance, trust architecture, and the wider socio-economic consequences of banking in virtualized environments. Whether a genuine leap toward financial evolution or a sophisticated illusion, the metaverse in banking must now be treated as a systemic phenomenon worthy of serious scrutiny. Full article

This article examines the persistent conceptual and structural obstacles that pluralism faces within the Euro-United-Statesian art system, particularly in the fields of criticism, art history, and aesthetics. The study situates its inquiry within broader debates around the politics of difference and the decolonization of knowledge, aiming to understand how theoretical frameworks historically incorporated plurality in ways that ultimately neutralize its disruptive potential. Methodologically, the article combines philosophical analysis with a critical rereading of canonical texts by figures such as Clement Greenberg and Arthur Danto, juxtaposed with insights from Indigenous, Black, and decolonial thinkers. The findings suggest that pluralism, while rhetorically embraced, is frequently rendered compatible with a teleological and universalizing narrative that privileges Western aesthetic trajectories. As a result, forms of difference are tolerated only insofar as they can be translated into hegemonic terms. The article concludes by advocating for critical practices that sustain rather than resolve difference, calling for frameworks capable of embracing dissonance, incommensurability, and multiple ontologies without collapsing them into sameness. In doing so, it repositions the contemporary struggle over meaning in art not as a problem to be overcome, but as a necessary symptom of epistemic plurality. Full article

Social media (SM) use and the burden on healthcare systems have concurrently increased, with the latter resulting in longer wait times and higher costs. As a result, more people seem to use social media to access health information (HI). This study explores how SM is used for accessing HI within an under-resourced community. In this mixed methods study, respondents (N = 256) completed online English and Spanish Qualtrics surveys assessing their use of healthcare services and social media, and its use for HI. We also explored respondents’ experience in understanding and using the HI they found on SM. Qualitative inquiries (N = 7) included focus groups and key informant interviews and expanded on the survey results. Results indicated that most participants used SM for HI. Instagram, Snapchat and TikTok were associated with looking up HI before and after receiving care and for health decision-making and for considering treatments or medication after seeing information about these on social media. To create effective messaging that is accepted, relatable and easy to access for the audiences they seek to reach, healthcare organizations must understand how SM is used as a source of HI. Exploring the associations between SM algorithms, health literacy, access to healthcare and SM use can help improve health communication strategies to be used on SM platforms. Full article

Amid growing concern about labour market resilience in an era of digital and green transitions, this study carries out an investigation on how academic innovation and industrial transformation jointly shape sustainable employment outcomes across EU-27 member states. We frame this inquiry within the emerging concept of the “employment trilemma”, which posits inherent tension between competitiveness, innovation, and social inclusiveness in modern economies. Drawing on a dynamic panel dataset (2005–2023) and employing System SMM estimations, we test the hypothesis that the alignment of academic innovation systems and industrial transformation strategies enhances long-term employment sustainability. Our results reveal a nuanced relationship: academic innovation significantly supports employment in countries with high knowledge absorption capacity, whereas industrial transformation contributes positively only when embedded in cohesive, inclusive economic frameworks. Thus, these findings provide valuable insights for international business due to their emphasis on the importance of cross-sectoral collaboration, policy synchronisation, and investment in human capital for firms navigating increasingly volatile labour markets. Likewise, the study offers actionable insights for business leaders, policymakers, and universities striving to balance innovation with equitable labour market outcomes in an integrated European economy. Full article

To address the issues of insufficient feature extraction, single-fall judgment method, and poor real-time performance of traditional fall detection algorithms in occluded scenes, a top-down fall detection algorithm based on improved YOLOv8 combined with BAM-HRNet is proposed. First, the Shufflenetv2 network is used to make the backbone of YOLOv8 light weight, and a mixed attention mechanism network is connected stage-wise at the neck to enable the network to better obtain human body position information. Second, the HRNet network integrated with the channel attention mechanism can effectively extract the position information of key points. Then, by analyzing the position information of skeletal key points, the decline speed of the center of mass, the angular velocity between the trunk and the ground, and the human body height-to-width ratio are jointly used as the discriminant basis for identifying fall behaviors. In addition, when a suspected fall is detected, the system automatically activates a voice inquiry mechanism to improve the accuracy of fall judgment. The results show that the accuracy of the object detection module on the COCO and Pascal VOC datasets is 64.1% and 61.7%, respectively. The accuracy of the key point detection module on the COCO and OCHuman datasets reaches 73.49% and 70.11%, respectively. On the fall detection datasets, the accuracy of the proposed algorithm exceeds 95% and the frame rate reaches 18.1 fps. Compared with traditional algorithms, it demonstrates superior ability to distinguish between normal and fall behaviors. Full article

Climate scientists, systems theorists, and policymakers increasingly suggest that global sustainability challenges stem from dysfunctional worldviews and values that drive individual and collective behaviors, undermining both human flourishing and planetary health. Recognizing that paradigmatic shifts in values and worldviews can arise from transformative experiences, this study employed Integral Inquiry in a mixed-methods design to examine the nature of the relationship between such experiences and engagement with sustainability. A sample of 145 adults was recruited based on self-identification of having undergone a life-changing experience and demonstrated evidence of transformative growth and integration. In the qualitative phase, 73 participants completed an open-text survey detailing their perspectives on sustainability and their related practices and behaviors. Ten individuals from this subset were interviewed to explore the depth and dimensions of their engagement with sustainability. Using Constructivist Grounded Theory analysis, three tentative themes emerged: intraconnection, personal equilibrium, and defining social change. Whilst the study was exploratory in nature, the analysis indicated that transformative experiences seemed to foster a profound felt sense of intraconnection—a deep awareness of interconnectedness with all life. This awareness appeared to naturally clarify participants’ values and beliefs, aligning their actions toward sustainability. Moreover, participants emphasized the importance of cultivating personal equilibrium—a state of inner balance and congruence in daily choices—as a foundation for meaningful social and environmental change. This study tentatively highlights the role transformative experiences can play in bringing about more pro-ecological behavior, and it underscores the need for further research into how such experiences can be more readily integrated to support global sustainability efforts. Full article

This paper reexamines the enduring role of esoteric traditions, as articulated by Frances Yates, in shaping the intellectual landscape of the scientific revolution and their resonance in the digital age. Challenging the linear, progress-centered narratives of traditional historiographies, it explores how esoteric principles—symbolized by transformative motifs like the Philosopher’s Stone—provided a framework for early scientific inquiry by promoting hidden knowledge, experimentation, mathematics, and interdisciplinary synthesis. This paper argues that moments of accelerated scientific and technological development magnify the visibility of esoteric structures, demonstrating how the intellectual configurations of Renaissance learned circles persist in contemporary expert domains. In particular, artificial intelligence exemplifies the revival of esoteric modes of interpretation, as AI systems—much like their Renaissance predecessors—derive authority through the identification of unseen patterns and the extrapolation of hidden truths. By bridging Renaissance esotericism with the modern information revolution, this study highlights how such traditions are not mere relics of the past but dynamic paradigms shaping the present and future, potentially culminating in new forms of digital mysticism. This study affirms that the temporal gap during periods of rapid technological change between industrial practice and formal scientific treatises reinforces esoteric knowledge structures. Full article

The discovery of oncogenes and tumor suppressor genes provided important insights into the molecular pathogenesis of cancer but also revealed some contradictions in the prevailing somatic mutation theory. The evidence that noncoding RNAs (ncRNAs) form an elaborate network that regulates the flow of genetic information in eukaryotic cells offers an explanation for the inconsistencies. ncRNAs comprise a wide variety of molecules that interact with one another as well as with other RNAs, DNA, and proteins, over whose activities they exert a regulatory influence. The outcome of the dynamic interactions of the cell’s biomolecules is the emergence of higher-order states of equilibrium, called attractor states, which correspond to the gene-expression configurations of distinct cell types. Attractor states are relatively stable systems, but they are susceptible to perturbation by a disturbing force, such as mutation. Mutations that disrupt the ncRNA network can enable the cell to undergo a state transition towards a potentially neoplastic one. This is the crux of tumorigenesis. An inquiry into the architecture of the ncRNA network and its role in tumorigenesis is required to complement our knowledge of the well-known cancer genes as well as serve as a guide in the design of new anticancer therapeutics. Full article

Background/Objectives: Chat Generative Pretrained Transformer (ChatGPT) is a useful resource for individuals working in the healthcare field. This paper will include descriptions of several ways in which ChatGPT-4 can achieve greater accuracy in its diagnosis and treatment plans for ulcerative colitis (UC) and Crohn’s disease (CD) by following the guidelines set out by the European Crohn’s and Colitis Organization (ECCO). Methods: The survey, which comprised 102 questions, was developed to assess the precision and consistency of respondents’ responses regarding the UC and CD. The questionnaire incorporated true/false and multiple-choice questions, with the objective of simulating real-life scenarios and adhering to the ECCO guidelines. We employed Likert scales to assess the responses. The inquiries were put to ChatGPT-4 on the initial day, the 15th day, and the 180th day. Results: The 51 true or false items demonstrated stability over a six-month period, with an initial accuracy of 92.8% at baseline, 92.8% on the 15th day, and peaked to 98.0% on the 180th day. This finding suggests a negligible effect size. The accuracy of the multiple-choice questions was initially 90.2% on Day 1, reached its highest point at 92.2% on Day 15, and then decreased to 84.3% on Day 180. However, the reliability of the data was found to be suboptimal, and the impact was deemed negligible. A modest, transient increase in performance was observed at 15 days, which subsequently diminished by 180 days, resulting in negligible effect sizes. Conclusions: ChatGPT-4 demonstrates potential as a clinical decision support system for UC and CD, but its assessment is marked by temporal variability and the inconsistent execution of various tasks. Essential initiatives that should be carried out before involving artificial intelligence (AI) technology in IBD trials are routine revalidation, multi-rater comparisons, prompt standardization, and the cultivation of a comprehensive understanding of the model’s limitations. Full article