Foundational Framework Research Articles

Mapping Public Health Nursing competencies: A comparative document analysis of competency frameworks and practice standards in the USA and Ireland.

The Public Health Nursing discipline plays a crucial role in promoting sustainable health services. The establishment of competency frameworks and practice standards pertaining to Public Health Nursing has emerged as a cornerstone for guiding practice, education, and research. This study aimed to identify contemporary Public Health Nursing competency frameworks and practice standards and establish a robust list of competency domains. This will inform a subsequent phase of this project that will conduct a review of recent scholarly literature to discern prevailing research trends and delineate strategic directives and research priorities for the discipline. A systematic search of three databases and a grey literature search was undertaken by incorporating keywords to identify existing Public Health Nursing-specific competency frameworks and practice standards. Through screening and selection based on our inclusion criteria, three documents were analyzed. A comprehensive document analysis was conducted to generate a unified domain list and associated descriptors. Three competency-based frameworks and practice standards emanating from two countries, the United States of America and the Republic of Ireland met the inclusion criteria. The document analysis identified 16 individual domains. There was consistent evidence of similarity across the three documents. There were minimal divergences featured within the frameworks which are discussed and compelling justifications for inclusion as universal domains are provided. This document analysis has generated a list of 16 common Public Health Nursing competency domains which will be utilized in phase two of this project as a foundational framework for the purpose of analyzing research trends, influencing research priorities, and enhancing the focal areas for future research agendas within the discipline.

A Critical Examination of Bangladeshi's Educational Institutions to Evaluate the Interaction of Moral Values between Servant Leadership and Power Distance

The purpose of this study is to evaluate the moral interactions between power distance and servant leadership by conducting a critical analysis of Bangladeshi educational institutions. The educational administration framework in Bangladesh is the subject of our study, with particular reference to the policies of schools, colleges, and universities. The results are measured using five Likert scale questionnaires, and they are then input into SME using STATA software. As a result, there is currently a hierarchical, top-down administration that continuously puts educational management and administration before moral principles. The moral principles that uphold the connection between the theory of power distance and the servant leader as the foundational theoretical framework for moral principles. This study opens up a new perspective on the idea that moral values are fundamental to the way society is structured because they affect how individuals interact, how institutions function, and how communities thrive. Their impact is far-reaching, touching on everything from domestic relationships to global events.

Microstructural analysis on the compatibility of various dilution oils on magnetorheological grease performance

This research explores the effects of dilution oils on the storage stability of magnetorheological grease (MRG) by studying the effect of dilution oil viscosity on the microstructure of carrier fluids medium for MRG, which can help address practical challenges encountered in the development and deployment of MRG. Three samples of MRG with 70 wt% CIP are prepared; a control, and 2 samples diluted until 10 wt% hydraulic fluid and kerosene respectively. The resulting samples were analysed using a modular compact rheometer (MCR) for oscillatory strain sweep and rotational current sweep. Rheological analyses were repeated after one year in storage. Fourier-Transform Infrared (FTIR) spectroscopy and Atomic Force Microscopy (AFM) results show significant microstructural and performance deterioration of grease thickener in the sample with kerosene, which concludes that kerosene had a very significant effect on the degradation of the grease thickener. From this study, it was revealed that low viscosity oils disrupt the reconstruction of the thickener of lithium grease, which in turn causes deteriorating shear rheological performance of MRG at off-state conditions. This comprehensive analysis explains the relationships between MRG composition, microstructural characteristics, and performance parameters, offering a foundational framework for further exploration and advancement in this scientific field.

Artificial General Intelligence: Conceptual Framework, Recent Progress, and Future Outlook

This paper explores the concept of Artificial General Intelligence (AGI), delving into its foundational framework, recent advancements, and future implications. AGI refers to the development of machines with the ability to understand, learn, and apply intelligence across a wide range of tasks, mimicking human cognitive abilities. The paper outlines the theoretical underpinnings of AGI, examining the key challenges and methodologies currently shaping its evolution. It also highlights significant milestones achieved in the field, reflecting on the progress made towards achieving true AGI. Finally, the paper discusses potential future directions, considering the ethical, technical, and societal implications of AGI, as well as the impact it may have on various industries and human life.

Analysis of Factors Influencing Community Resilience during the (COVID)-19 Pandemic: A Case Study from China

Objectives: In this study, we explore the factors affecting community resilience during the COVID-19 pandemic. Methods: We adopted an extensive case study methodology and employed snowball sampling to select 10 typical interviewees for semi-structured interviews. Data collected were analyzed through reading, coding, thematic analysis, and classification to extract the key variables influencing community resilience implementation. Results: Organizational systems, volunteer engagements, and technological innovations play indispensable roles in enhancing urban community resilience. The organizational system emerges as the foundational framework underpinning the realization of community resilience. Proactive involvement in emergency volunteer services constitutes the actionable cornerstone for community resilience, effectively mitigating personnel shortages in community operations. Digital technologies emerge as pivotal enablers of technological prerequisites for community resilience, fostering seamless information dissemination among diverse stakeholders within the community. Conclusion: This study offers a compelling case study of a Chinese community's response to the COVID-19 pandemic. The investigation reveals that 3 pivotal mechanisms – organizational systems, volunteer engagements, and technological innovations –assume indispensable roles in bolstering urban community resilience. The experiential insights gleaned from China's response to major public health emergencies offer invaluable lessons for the advancement of community resilience initiatives worldwide.

Systematic analysis of bZIP gene family in Suaeda australis reveal their roles under salt stress

BackgroundSuaeda australis is one of typical halophyte owing to high levels of salt tolerance. In addition, the bZIP gene family assumes pivotal functions in response to salt stress. However, there are little reports available regarding the bZIP gene family in S. australis.ResultsIn this study, we successfully screened 44 bZIP genes within S. australis genome. Subsequently, we conducted an extensive analysis, encompassing investigations into chromosome location, gene structure, phylogenetic relationship, promoter region, conserved motif, and gene expression profile. The 44 bZIP genes were categorized into 12 distinct groups, exhibiting an uneven distribution among the 9 chromosomes of S. australis chromosomes, but one member (Sau23745) was mapped on unanchored scaffolds. Examination of cis-regulatory elements revealed that bZIP promoters were closely related to anaerobic induction, transcription start, and light responsiveness. Comparative transcriptome analysis between ST1 and ST2 samples identified 2,434 DEGs, which were significantly enriched in some primary biological pathways related to salt response-regulating signaling based on GO and KEGG enrichment analysis. Expression patterns analyses clearly discovered the role of several differently expressed SabZIPs, including Sau08107, Sau08911, Sau11415, Sau16575, and Sau19276, which showed higher expression levels in higher salt concentration than low concentration and a response to salt stress. These expression patterns were corroborated through RT-qPCR analysis. The six differentially expressed SabZIP genes, all localized in the nucleus, exhibited positive regulation involved in the salt stress response. SabZIP14, SabZIP26, and SabZIP36 proteins could bind to the promoter region of downstream salt stress-related genes and activate their expressions.ConclusionsOur findings offer valuable insights into the evolutionary trajectory of the bZIP gene family in S. australis and shed light on their roles in responding to salt stress. In addition to fundamental genomic information, these results would serve as a foundational framework for future investigations into the regulation of salt stress responses in S. australis.

Thus Spoke a Couple: a Corpus-Based Content Analysis of Spousal Duties Fatwas

Abstract This study explores the topic of spousal duties within the Arab-Muslim world, using a corpus of fatwa inquiries to investigate how Muslim spouses perceive and negotiate their rights and duties within the marital relationship. Acknowledging the complexity of the causes underlying the failure to fulfill spousal rights, this study capitalizes on the rewarding potentials of digital tools by examining the questions posed by the mustaftīs (inquirers). A corpus of 150,000 fatwas, drawn from Islamweb.net and encapsulating approximately 11 million tokens, serves as the data for our analysis. Using the semantic network tool ConceptNet, a lexicon delineating spousal rights is created and employed to assess the prominence and relationships of certain themes in the dataset. Central themes – treatment, housing, financial support, sexual relationship, and obedience – emerge as the primary axes for examining the nuances of marital obligations and rights. The findings reveal the nuanced interplay between traditional norms and contemporary religious discourse, with implications for understanding gender roles and authority within Arab-Muslim marriages. The study confirms that while Shariʿah offers a foundational framework, there remains a need for context-specific interpretation, often sought through fatwa consultations. The study also underscores the potential of corpus linguistics to deepen our understanding of religious texts and their application to modern marital issues, advocating for further research into fatwas across different languages and cultures.

Investigation of the heating characteristics of turbulent non-premixed gas combustion in the industrial-scale walking beam type reheating furnace

Oxygen-enriched combustion is widely used in industrial furnaces. To elucidate the multi-physics properties of reheating process, this study numerically explores the flow and combustion characteristics of syngas oxygen enrichment combustion in an industrial-scale walking beam type reheating furnace. The findings demonstrate that gas flow patterns at the furnace inlet primarily encompass the billet periphery, enhancing heat transfer efficiency. Oxygen-enriched combustion achieves lower temperature differences, higher heating temperature and CO2 emissions. Additionally, increasing levels of oxygen enrichment correlates with elevated temperatures, though the increments diminish progressively. Specifically, temperatures at the outlet of the preheating section range from 1100 K to 1200 K, with the middle region of the heating section displaying slightly lower temperatures compared to the areas adjacent to the burner. High temperature zones are primarily concentrated around the burners in soaking and heating sections. In terms of heating temperature and thermal uniformity, 30 % oxygen-enriched condition yields superior performance, evidenced by higher heating temperatures and reduced temperature differentials. Moreover, oxygen-enriched combustion enlarges CO2 emissions, with a 124.5 % enhancement observed. The lowest NO emission content at the outlet occurs during combustion with 21 vol% air and 45 vol% oxygen enrichment, however, these values remain relatively high. The insights derived from this study provide a foundational framework and guiding principles for furnace design and optimization of multi-gradient oxy-enriched combustion.

Optimizing Formulation Conditions of PLGA Microparticles to Enhance Indomethacin Encapsulation

AbstractDrug delivery systems can avoid the drawbacks of Indomethacin (IND), a non‐steroidal anti‐inflammatory drug used to treat osteoarthritis and arthritis, which requires high doses to reach therapeutic plasma levels leading to significant systemic side effects. This study aims to optimize poly(lactic‐co‐glycolic acid) (PLGA) microparticles (MPs) for intra‐articular IND administration. MPs are prepared by solvent evaporation and freeze‐dried for stability. Initial formulations with Tween 80 yield rubbery samples with low drug loading (1%); replacement of Tween 80 with Gelatin produces a stable powder with syringable MPs (particles size: 7 µm), although, DL (3%) and EE (30%) remain suboptimal, due to IND polymorphic transformation. Differential Scanning Calorimetry and Fourier‐Transform Infrared spectroscopy demonstrate a molecular dispersion of IND in PLGA. Adjusting the aqueous phase to pH 3 in the formulation process, i.e below IND pKa, significantly enhances EE (90%) due to the reduction of drug solubility in the external aqueous phase. In vitro release study shows prolonged IND release over several days, confirming an effective drug encapsulation. This study provides a foundational framework toward the optimization of the successful encapsulation of IND in PLGA MPs, potentially advancing future clinical applications of such drug delivery systems.

Investigation of linear energy transfer (LET)-dependence behavior and dosimetric response of a flat-panel detector in pencil beam scanning proton therapy

PurposeThis study aims to elucidate the dependence of the flat-panel detector’s response on the linear energy transfer (LET) and evaluate the practical viability of employing flat-panel detectors in proton dosimetry applications through LET-dependent correction factors. MethodsThe study assessed the flat-panel detector’s response across varying depths using solid water and distinct 100, 150, and 200 MeV proton beams by comparing the flat-panel readings against reference doses measured with an ionization chamber. A Monte Carlo code was used to derive LET values, and an LET-dependent response correction factor was determined based on the ratio of the uncorrected flat-panel dose to the ionization chamber dose. The implications of this under-response correction were validated by applying it to a measurement involving a spread-out Bragg peak (SOBP), followed by a comparative analysis against doses calculated using the Monte Carlo code and MatriXX ONE measurement. ResultsThe association between LET and the flat-panel detector’s under-response displayed a positive correlation that intensified with increasing LET values. Notably, with a 10 keV/µm LET value, the detector’s under-response reached 50 %, while the measurement points in the SOBP demonstrated under-response greater than 20 %. However, post-correction, the adjusted flat-panel profile closely aligned with the Monte Carlo profile, yielding a 2-dimensional 3 %/3mm gamma passing rate of 100 % at various verification depths. ConclusionThis study successfully defined the link between LET and the responsiveness of flat-panel detectors for proton dosimetric measurements and established a foundational framework for integrating flat-panel detectors in clinical proton dosimetry applications.

Review of Theoretical Frameworks in Audiovisual Translation

Audiovisual Translation has gained massive popularity among translators as a thriving genre of translation studies. This reality is represented by the massive role played by audiovisual translation in shaping global communication within modern societies. Therefore, the paper attempts to analyze the overlap of the most fundamental theories within the scope of audiovisual translation. The primary purpose of this analysis is to identify the relationship and intersection between several theories to provide an overall and comprehensive overview of these theories, their underlying principles and paradigms, the purposes and justifications of their application, and their functioning and consequences within rendering meaning from audiovisual products with various modes such as subtitling, dubbing, and voice-over, to name but a few. Consequently, Audiovisual Translation, which has grown into a distinct area of research with its own limitations and unique characteristics, is supported by various theories designed for different modes of delivery and reception. This growth encompasses creating and applying diverse strategies, methods, and technologies and examining and comprehending how it is received and impacted. Nonetheless, the researchers discovered that the creation of theories specific to Audiovisual Translation must either align with or, at the very least, be influenced by the foundational theoretical frameworks, primarily from translation studies.

On the tractive rolling nanocontact of an exponentially graded coating-substrate structure

This paper studies the tractive rolling nanocontact occurring between an exponentially graded coating-substrate structure and a circular rigid indenter. Employing the framework of Steigmann–Ogden surface elasticity, it models the surface effects inherent in the nanocontact of graded coatings. The contact area is assumed to comprise a central stick zone bounded by two distinct slip zones. Central to the investigation is the utilization of the nonclassical Flamant solution, which serves as the foundational framework for deriving integral equations governing the continuity of both vertical and tangential displacement gradients. Utilizing Gauss–Chebyshev quadratures, the paper discretizes and collocates these integral equations, along with the force equilibrium conditions and shear traction smooth condition at the leading side stick/slip transition point. An iterative algorithm is then developed to tackle the resultant algebraic system, particularly concerning the discretized contact pressure and friction traction. The paper rigorously validates its proposed solution method and numerical algorithm against existing literature results, showcasing their accuracy and reliability. Moreover, it conducts extensive parametric studies to unravel the effects of various parameters, such as surface material properties, coefficient of friction, inhomogeneity index, and thickness of the exponentially graded coating. These analyses uncover the significant role of surface effects in shaping contact pressure, frictional traction, stresses, subsidence distributions, and stick–slip zones. Notably, the inclusion of surface effects is found to reduce maximum stress and subsidence while inducing a shift of the stick region towards the rolling direction. The parametric exploration of graded coating properties also offers insights into tailoring nanocontact responses for gradient nanostructures.

Towards Semantic Interoperability: An Information Model for Autonomous Mobile Robots

The collaboration among autonomous mobile robots (AMRs), including unmanned aerial vehicles (UAVs), unmanned ground vehicles (UGVs), and/or unmanned surface vehicles (USVs), significantly enhances their capabilities by enabling them to tackle more complex tasks exceeding those of individual robots. However, to fully exploit this collaboration, a common understanding of exchanged information—referred to as semantic interoperability—is crucial. Achieving semantic interoperability between these robots requires a deep understanding of relevant information and its underlying structure. To address this challenge, this paper presents a platform- and technology-independent information model developed specifically for AMRs. This model aims to facilitate collaboration by structuring information in a way that ensures semantic interoperability. The paper outlines the model's development process, beginning with a structured consolidation of information from pertinent scientific literature, resulting in a foundational framework for representing knowledge and semantics within the domain of AMRs. The practical application of the information model is demonstrated through a use case involving multiple AMRs. Additionally, the paper provides insights into the employed methodology, emphasizing the significance of systematic literature reviews and collaboration with practitioners to refine and validate the model. It also discusses theoretical and practical implications, addressing potential limitations encountered during the research.

Does artificial ecosystem recharge make sense? based on the coupled water orbit research framework

By formulating an innovative Coupled Water Orbit Research Framework (CWORF) in cohesion with the modified Hypothesis Extraction Method (HEM), this study undertakes a comprehensive examination and assessment of the Autonomous Water Orbit (AWO) linkages within each sector. Building upon this foundation, the CWROF also integrates Structure Path Analysis (SPA) to scrutinize the critical paths of the AWO in each sector. Additionally, the framework quantifies specific water consumption at different layers of the production chain, enabling a more precise assessment of water consumption and inter-sectoral water usage linkages compared to existing studies. By applying this framework, existing water conservation policies can be refined, thereby achieving enhanced environmental sustainability. The study utilizes six Input-Output (IO) tables and water resource bulletins spanning from 2002 to 2020, as published by the China Bureau of Statistics. It is instrumental in dissecting the current interplay between water resource utilization and economic development. This research aims to analyze the structural nuances of water consumption and the dependency characteristics across diverse sectors within the production chain. It strategically identifies pivotal paths and sectors in the production chain where water consumption is most pronounced, and highlights critical chains contributing to water stress. The results indicate that sectors such as “Farming, Forestry, Animal Husbandry, Fishery, and Water Conservancy” exhibit high water consumption. Furthermore, light industries, represented by “Food and Tobacco” and “Textile Product” sectors, significantly impact indirect water usage across sectors. The study also reveals that the strength of the water feedback loop in the economic system diminishes as the number of layers increases, with the aforementioned sectors frequently appearing in transmission paths and serving as key interface nodes. This research underscores the critical interconnections between water usage and economic activities providing a foundational framework for refining water conservation policies and enhancing water allocation and management capabilities. The introduced CWORF extends beyond conventional methods, offering a more precise and nuanced approach to measuring inter-sectoral water utilization.

Multi-physics analysis of squeezing fluid flow with rotational, magnetic field, and heat transfer interactions

This research paper presents a comprehensive study on the intricate interplay of rotational, magnetic field and heat transfer effects in squeezing fluid flow, utilizing the foundational framework of Navier–Stokes equations. Fluid flow in confined geometries has significant applications in various industrial processes, including lubrication systems, microfluidics, and heat exchangers. The integration of rotational motion, magnetic fields, and heat transfer phenomena into this context holds immense potential for optimizing performance and efficiency. The study commences with the derivation and analysis of the coupled Navier–Stokes equations, incorporating the Coriolis force due to rotational motion, the Lorentz force arising from magnetic fields, and the energy equation for heat transfer. This comprehensive model accounts for the complex interactions between these physical phenomena, offering a holistic perspective on squeezing fluid flow dynamics. Numerical analysis are conducted to investigate the behavior of fluids under the influence of rotational, magnetic field, and heat transfer effects. The results reveal intricate flow patterns, including vortex formation and heat transfer enhancement. Furthermore, the impact of key parameters such as rotational speed, magnetic field strength, and temperature gradients on flow characteristics is systematically analyzed. The Dufour effect pertains to the transfer of energy resulting from a gradient in mass concentration, occurring as a correlated consequence of irreversible processes. It functions as the inverse of the Soret effect. The temperature changes due to the concentration gradient, amplifying as the Dufour number increases. The most significant temperature rise is observed at the midpoint of the fluid domain. Conversely, the Soret number behaves in a similar but opposite manner. Tables 4–10 has been created to offer a comprehensive analysis of the optimal alignment between Homotopy Analysis Method (HAM) and BVP4c. Specifically, it demonstrates a continuous decrease in skin friction for ξSo, ξRd, and ξR2, while showing an increase for ξSc, ξDo, and ξRem. Meanwhile, the skin friction remains constant for ξPr. The research centers on analyzing heat and mass transfer properties within an incompressible fluid confined between two rotating and stretching disks amidst an unpredictable flow pattern. The study employs a blend of analytical and numerical approaches to solve the governing equations, delving into the intricate fluid dynamics and the intricate processes of heat and mass transfer within this intricate system.

Development of best performance evaluation indicators based on value-based healthcare for general hospital nursing: A Delphi study.

To establish and validate a set of best nursing practice indicators for medical groups in Chinese general hospitals based on value-based healthcare (VBHC) theory. A modified Delphi method. This study engaged experienced clinical nurses from public hospitals and multidisciplinary experts in operations management. Through a literature review and structured brainstorming, a comprehensive framework for assessing best nursing practices in Chinese general hospital medical groups was developed. A modified Delphi method was then employed to establish an indicator framework, followed by the Combined Empowerment-MABAC method to weight and validate the indicators using empirical data collected between June 2023 and October 2023. The CREDES checklist guided the reporting of this study. Sixteen experts, each with at least 10 years of experience in nurse management from nine healthcare organizations, participated in two rounds of consultation. The experts' responses and suggestions for rewording, deleting and adding items were incorporated into each round. Of the 34 proposed indicators, 25 were approved, covering healthcare service capacity, efficiency, quality and safety, patient experience and cost. The Delphi survey reached a consensus on necessary actions to improve nursing performance. The developed indicator system provides a foundational framework for standardizing the monitoring of care quality and performance assessment in Chinese clinical healthcare groups, with broad applicability. This study provides a reliable basis for developing a nursing performance assessment database, offering crucial insights for measuring quality of care and improving patient value. No Patient or Public Contribution.

Does intellectual property rights protection matter for low-carbon transition? The role of institutional incentives

Intellectual Property Rights Protection (IPRP) can affect knowledge dissemination and talent flow. However, few studies have examined its effect on regional low-carbon transition and the low-carbon economy. Using carbon emission efficiency (CEE) to measure China's low-carbon transition, we consider the “National Intellectual Property Rights Demonstration Cities” policy as a quasi-experiment and apply a staggered difference-in-differences model to examine IPRP's effect on CEE. We find that IPRP boosts CEE through green innovation and energy intensity and is stronger in coastal, eastern, resourced-based, and big cities. Finally, the significantly positive spillover impact of IPRP boosts CEE in adjacent cities. This study highlights the critical role of the institutional environment in driving low-carbon transitions, offering a foundational framework for developing countries to promote IPRP.

Untangling island biogeography of terrestrial vertebrates in protected areas of America

Island Biogeography Theory (IBT) is a foundational framework in conservation science, yet its application to large-scale protected area (PA) design remains relatively understudied. This research investigates the influence of IBT-derived variables on terrestrial vertebrate richness and threatened species abundance within 4990 PAs across continental America. By examining the effects of area, shape, isolation, elevation, latitude, and human influence, we assessed the relative importance of these factors in shaping vertebrate diversity patterns. Our findings reveal that while IBT principles, such as the positive relationship between area and species richness, are evident, the influence of human activities is pervasive. Specifically, latitude and elevation significantly influenced species richness for most taxonomic groups, while area positively affected amphibians, birds, reptiles, and threatened mammals and reptiles. Shape and isolation exhibited varying degrees of impact across different taxa. Critically, human influence emerged as a dominant factor, particularly for birds, including threatened species. These results underscore the complex interplay between natural and anthropogenic processes in shaping biodiversity patterns. To effectively conserve terrestrial vertebrates, and overall biodiversity, PA managers and policy-makers must integrate IBT principles with strategies that address the impacts of human activities, such as habitat loss, fragmentation, and climate change.

Effects of Tree Leaf Color on Human Physical and Mental Recovery from a Looking-Up Perspective

Numerous studies have demonstrated the benefits of understory spaces and plants on human well-being, but most spatial research has focused on a horizontal perspective. Additionally, there is a lack of research on the effects of plant color on human recovery, especially with respect to color proportions. This study classifies the leaf colors of trees in autumn, which are observed from a looking-up perspective, into green, red, and yellow. On this basis, we created monochromatic, two-color, and three-color groups with varying color proportions to assess their recovery effects and preferences. A total of 30 participants participated in this experiment, and their physiological, psychological, and preference-related indicators were evaluated. The results revealed that the following. (1) The two-color groups had the greatest reduction effect on systolic blood pressure. Monochromatic groups were most effective at reducing diastolic blood pressure. The three-color groups had the greatest effect on lowering the pulse rate. (2) EEG responses varied by color type. (3) The three-color groups had the best recovery effects on the psychological measures. (4) The three-color groups were most favored by participants, with a red–yellow–green ratio of 0.2/0.4/0.4 being the most preferred. These findings demonstrate the differing recovery potentials of various leaf color proportions from a looking-up perspective. This study can provide valuable references for the planning and design of urban forest parks, supplementing the theoretical foundation and research framework for evaluating and creating environments that meet people’s restorative needs.

A deep learning approach to identify the fetal head position using transperineal ultrasound during labor

ObjectivesTo develop a deep learning (DL)-model using convolutional neural networks (CNN) to automatically identify the fetal head position at transperineal ultrasound in the second stage of labor. Material and methodsProspective, multicenter study including singleton, term, cephalic pregnancies in the second stage of labor. We assessed the fetal head position using transabdominal ultrasound and subsequently, obtained an image of the fetal head on the axial plane using transperineal ultrasound and labeled it according to the transabdominal ultrasound findings. The ultrasound images were randomly allocated into the three datasets containing a similar proportion of images of each subtype of fetal head position (occiput anterior, posterior, right and left transverse): the training dataset included 70 %, the validation dataset 15 %, and the testing dataset 15 % of the acquired images. The pre-trained ResNet18 model was employed as a foundational framework for feature extraction and classification. CNN1 was trained to differentiate between occiput anterior (OA) and non-OA positions, CNN2 classified fetal head malpositions into occiput posterior (OP) or occiput transverse (OT) position, and CNN3 classified the remaining images as right or left OT. The DL-model was constructed using three convolutional neural networks (CNN) working simultaneously for the classification of fetal head positions. The performance of the algorithm was evaluated in terms of accuracy, sensitivity, specificity, F1-score and Cohen’s kappa. ResultsBetween February 2018 and May 2023, 2154 transperineal images were included from eligible participants across 16 collaborating centers. The overall performance of the model for the classification of the fetal head position in the axial plane at transperineal ultrasound was excellent, with an of 94.5 % (95 % CI 92.0––97.0), a sensitivity of 95.6 % (95 % CI 96.8–100.0), a specificity of 91.2 % (95 % CI 87.3–95.1), a F1-score of 0.92 and a Cohen’s kappa of 0.90. The best performance was achieved by the CNN1 – OA position vs fetal head malpositions – with an accuracy of 98.3 % (95 % CI 96.9–99.7), followed by CNN2 – OP vs OT positions – with an accuracy of 93.9 % (95 % CI 89.6–98.2), and finally, CNN3 – right vs left OT position – with an accuracy of 91.3 % (95 % CI 83.5–99.1). ConclusionsWe have developed a DL-model capable of assessing fetal head position using transperineal ultrasound during the second stage of labor with an excellent overall accuracy. Future studies should validate our DL model using larger datasets and real-time patients before introducing it into routine clinical practice.