Integrated Model Research Articles

Fine-tuning the needle: analysis of acupuncturist response to alarming events during gynecological oncology surgery.

Examining an intra-operative acupuncture/acupressure setting, with real-time "fine-tuning" in response to alarming events (AEvs) during gynecological oncology surgery. Narratives of acupuncturists providing intraoperative acupuncture during gynecological oncology surgery were qualitatively analyzed. These described real time "fine-tuning" in response to AEvs during surgery, identified through hemodynamic changes (e.g., systolic/diastolic arterial pressure); bispectral index (BIS) elevation; and feedback from surgeons and anesthesiologists. Documentation of acupuncturist responses to AEvs was addressed as well. Of the 48 patients in the cohort, 33 had at least one intraoperative AEv (69%), of which 30 were undergoing laparoscopic surgery and 18 laparotomies. A total of 77 AEvs were documented throughout surgery (range 1-7; mean: 2.3 events per patient), identified through increased (63 events) or decreased (8) mean arterial pressure (MAP); increased BIS levels (2), or other hemodynamic parameters (4). Integrative oncology interventions implemented in response to AEs included acupressure alone (59); combining acupressure with acupuncture (10); or acupuncture alone (4). In 54 (70%) events, documentation was provided from beginning to conclusion of the AEv, with a mean duration of 9.7 min, with 32 events including a documented anesthesiologist intervention. The present study demonstrated the feasibility of intraoperative acupuncture with acupressure, with ongoing "fine-tuning" to AEvs identified through objective pain-related parameters (MAP, heart rate and BIS) and real-time input from surgeons and anesthesiologists. Documentation of the intraoperative IO practitioner's response to these AEvs is important, and should be addressed in future research of the innovative integrative model of care. CMC-18-0037 (Carmel Medical Center, June 11, 2018).

Model and heuristics for the multi-manned assembly line worker integration and balancing problem

This paper examines the balancing of assembly lines with multi-manned stations and a heterogeneous workforce. Both topics received considerable attention in the literature, but not in an integrated fashion. Combining these two characteristics gives rise to a highly combinatorial Multi-manned Assembly Line Worker Integration and Balancing Problem. When considering multi-manned stations, the already coupled decisions on assigning tasks to heterogeneous workers and workers to stations must be further linked with task scheduling assessments. We propose a Mixed-Integer Linear Programming model and develop two heuristic solution procedures, which tackle the problem with a hierarchical decomposition approach. Computational tests on a large dataset indicate that the proposed method can obtain good primal bounds in short computational times. We demonstrate that these results can be applied to the monolithic model either as a warm start or in a proximity search procedure to obtain synergistic gains with statistically significant differences. From a managerial perspective, we show that multi-manned stations can reduce the assembly line's length even in the presence of a heterogeneous workforce, which is crucial for many industries manufacturing large-size products.

Integral Models of Moduli Spaces of Shtukas with Deep Bruhat-Tits Level Structures

Abstract We construct integral models for moduli spaces of shtukas with deeper Bruhat-Tits level structures. We embed the moduli space of global shtukas for a deeper Bruhat-Tits group scheme into the limit of the moduli spaces of shtukas for all associated parahoric group schemes. Its schematic image defines an integral model of the moduli space of shtukas with deeper Bruhat-Tits level with favourable properties. They admit proper, surjective and generically étale level maps as well as a natural Newton stratification. In the Drinfeld case, this general construction of integral models recovers the moduli space of Drinfeld shtukas with Drinfeld level structures.

Multi-scalar and diasporic integration: Kurdish populations in Europe between state, diaspora and geopolitics

Abstract This article challenges both methodological nationalist and decolonial approaches to ‘integration’ by drawing attention to how transnational factors—including trans-state diaspora networks and geopolitical relations between European states and Kurdish ‘homelands’—have direct impacts on the integration trajectories of newly arrived Kurdish displaced populations in Europe. Based on over 200 interviews with Kurdish immigrants, including refugees and asylum seekers across seventeen sites in rural and urban regions in six European countries, our research suggests the need to move beyond local and national-level understandings of integration to one which is also transnational, diasporic, and multi-scalar, taking account of the enduring effects of homeland politics on integration determinants. Such a model of integration does not throw out the concept, but recognizes both the protective and empowering role that local and national policies can play in enabling refugee and diaspora populations to function autonomously in a broader transnational and global context.

The Development of U.S. Immigration History: Historical Factors, Formation Mechanisms, and Migrant Groups

Regional economic integration has emerged as a significant focus for China in the post-pandemic era, as the nation seeks to establish mutually beneficial relationships with external economies and promote national development. In this study, the entropy method is employed to construct an index system tailored specifically to the four provinces within the Yangtze River Delta region. This research aims to explore the advantages and challenges of regional economic integration in China by conducting a comparative analysis of the Yangtze River Delta. The study also evaluates the merits and drawbacks of different integration models, drawing on examples from developed countries. The ultimate goal of the research is to provide insights and recommendations for China's regional economic integration, thus contributing to the country's overall prosperity. The results revealed that factors such as economic downturns caused by the pandemic have led the United States to experience a resurgence of racism and xenophobia, reminiscent of historical periods of American nativism, marked by economic insecurity and rapid demographic changes due to mass immigration. However, unlike previous eras with unrestricted immigration, the U.S. has tightened border policies and reduced the number of immigrants, using violent methods to expel unauthorized immigrants, such as Mexican migrant workers, along with their children born in the U.S., forcing them to move to a country where they may not speak the language or understand the culture.

The impact of early intervention psychosis services on hospitalisation experiences: a qualitative study with young people and their carers

BackgroundWhile a core aim of early intervention psychosis services (EIPS) is to prevent hospitalisation, many with a first episode of psychosis (FEP) will require inpatient care. We explored young people’s (YP) and their carers’ hospitalisation experiences prior to and during EIPS engagement and how factors across these services influenced these experiences.MethodsUsing purposive sampling, we recruited twenty-seven YP, all of whom had been involved with the hospital system at some stage, and twelve support persons (parents and partners of YP) from state and federally funded EIPS in Australia with different models of care and integration with secondary mental health care. Audio-recorded interviews were conducted face-to-face or via phone. A diverse research team (including lived experience, clinician, and academic researchers) used an inductive thematic analysis process.ResultsFour key themes were identified as influential in shaping participant’s hospital experiences and provide ideas for an approach to care that is improved by the effective coordination of that care, and includes this care being delivered in a trauma informed manner: (1) A two-way street: EIPS affected how participants experienced hospitalisation, and vice versa; (2) It’s about people: the quality and continuity of relationships participants had with staff, in hospital and at their EIPS, was central to their experience; (3) A gradual feeling of agency: participants viewed EIPS as both reducing involuntary care and supporting their self-management; and (4) Care coordination as navigation for the healthcare system: great when it works; frustrating when it breaks down.ConclusionsHospitalisation was viewed as a stressful and frequently traumatic event, but a approach to care founded on trust, transparency, and collaboration that is trauma-informed ameliorated this negative experience. Consistent EIPS care coordination was reported as essential in assisting YP and carers navigate the hospital system; conversely, discontinuity in EIPS staff and lack of integration of EIPS with hospital care undermined the positive impact of the EIPS care coordinator during hospitalisation. Care coordinator involvement as a facilitator, information provider, and collaborator in inpatient treatment decisions may improve the usefulness and meaningfulness of hospital interventions.

A Review on Bridging Molecular Biology and Ecological Dynamics through Integrative Approaches in Zoology

The integration of molecular biology with ecological dynamics has emerged as a transformative approach in zoology, enhancing our understanding of biodiversity, ecosystem health, and the adaptive responses of species to environmental changes. This review synthesizes key developments and methodological innovations at the intersection of molecular biology and ecological dynamics, highlighting the application of DNA barcoding, environmental DNA (eDNA) analyses, molecular phylogenetics, and advanced computational models in elucidating complex biological interactions and evolutionary patterns. Significant advancements include the use of high-throughput sequencing technologies and CRISPR-Cas systems that have expanded our ability to explore genetic diversity and manipulate genetic material for conservation purposes. The review discusses the predictive capabilities of integrative models that combine genetic with ecological data, offering insights into species resilience and ecosystem stability under varying environmental scenarios. Challenges in data integration, such as issues of scale, complexity, and the necessity for interdisciplinary cooperation, are critically examined. Technical limitations related to data management and ethical considerations in the use of genetic information are also explored. Looking forward, the review identifies emerging technologies and their potential impacts on ecological and conservation biology, emphasizing the need for policies that support sustainable management and conservation strategies. This review underscores the profound impact of integrating molecular biology with ecological dynamics, which not only enhances our scientific understanding but also provides practical frameworks for addressing global environmental challenges.

Application of Fuzzy - AHP - Topsis in Online Shopping Selection On B2C E-Commerce Websites

In today's digital age, online shopping is not only a trend but also an indispensable part of our daily lives. With the convenience and diversity of e-commerce websites, consumers can easily experience and choose goods and services from all over the world in just a few clicks. However, making online shopping decisions is not always easy. Consumers often have to face a number of factors such as price, product quality, brand, after-sales service, delivery time and many other factors, as well as facing uncertainty and ambiguity in the information. reviews. To help users choose products effectively, the Fuzzy - AHP - Topsis integration model has been applied in this research topic to propose evaluation criteria for choosing to buy products on 4 B2C websites including Shopee, Tiki, Lazada, Sendo.

Drug discovery and development in the era of artificial intelligence: From machine learning to large language models

Drug Research and Development (R&D) is a complex and difficult process, and current drug R&D faces the challenges of long time span, high investment, and high failure rate. Machine learning, with its powerful learning ability to characterize big data and complex networks, is increasingly effective to improve the efficiency and success rate of drug R&D. Here we review some recent examples of the application of machine learning methods in six areas: disease gene prediction, virtual screening, drug molecule generation, molecular attribute prediction, and prediction of drug combination synergism. We also discuss the advantages of integrative learning in multi-attribute prediction. Integrative models based on base learners constructed from data of different dimensions on the one hand fully utilize the information contained in these data, and on the other hand improve the average prediction performance. Finally, we envision a new paradigm for drug discovery and development: a large language model acts as a central hub to organize public resources into a knowledge base, validating the knowledge with computational software and smaller predictive models, as well as high-throughput automated screening platforms based on organoidal technologies, to speed up development and reduce the differences in efficacy between disease models and humans to improve the success rate of a drug.

Energy‐consumption model for rotary‐wing drones

AbstractWith technological advancement, the use of drones in delivery systems has become increasingly feasible. Many companies have developed rotary‐wing drone (RWD) technologies for parcel delivery. At present, the limited endurance is the main disadvantage of RWD delivery. The energy consumption of RWDs must be carefully managed, and it is necessary to develop an effective energy‐consumption model to support RWD flight planning. Because the interaction between the forces on the RWD and its flying environment is very complex, it is challenging to estimate accurately the RWD energy consumption. This study summarizes several energy‐consumption models proposed in the literature, then we develop an RWD energy‐consumption model (called the integrated model) based on analyzing the dynamic equilibrium of forces and power consumption in flight phases (including climb, descent, hover, and horizontal flight). Computational experiments involving several commercial RWDs indicate that the integrated model is more effective than several models in the literature. In the case where an RWD completed one flight segment, on average, 87.63% of the battery capacity was consumed in the horizontal flight phase. We also analyzed the effects of the total mass and horizontal airspeed on the RWD endurance and found that a larger mass corresponded to shorter endurance, and in the experimental range of the horizontal airspeed, a higher horizontal airspeed corresponded to longer endurance. Moreover, the total mass affected the RWD endurance more significantly than the horizontal airspeed.

Subtle Patterns of Altered Responsiveness to Delayed Auditory Feedback during Finger Tapping in People Who Stutter

Differences in sensorimotor integration mechanisms have been observed between people who stutter (PWS) and controls who do not. Delayed auditory feedback (DAF) introduces timing discrepancies between perception and action, disrupting sequence production in verbal and non-verbal domains. While DAF consistently enhances speech fluency in PWS, its impact on non-verbal sensorimotor synchronization abilities remains unexplored. A total of 11 PWS and 13 matched controls completed five tasks: (1) unpaced tapping; (2) synchronization-continuation task (SCT) without auditory feedback; (3) SCT with DAF, with instruction either to align the sound in time with the metronome; or (4) to ignore the sound and align their physical tap to the metronome. Additionally, we measured participants’ sensitivity to detecting delayed feedback using a (5) delay discrimination task. Results showed that DAF significantly affected performance in controls as a function of delay duration, despite being irrelevant to the task. Conversely, PWS performance remained stable across delays. When auditory feedback was absent, no differences were found between PWS and controls. Moreover, PWS were less able to detect delays in speech and tapping tasks. These findings show subtle differences in non-verbal sensorimotor performance between PWS and controls, specifically when action–perception loops are disrupted by delays, contributing to models of sensorimotor integration in stuttering.

Integrating TOGAF and Big Data for Digital Transformation: Case Study on the Lending Industry

In today’s digital era, the strategic integration of enterprise architecture frameworks with Big Data technologies is crucial in driving digital transformation, especially within the lending industry. This research aims to identify and analyze how The Open Group Architecture Framework (TOGAF) can be integrated with Big Data to enhance innovation, operational efficiency, and decision-making in the lending sector. This study examines Indonesian financial institutions using qualitative case studies, exploring the intricate practices, challenges, and benefits of the combination of TOGAF and Big Data. The qualitative methodology focuses on in-depth interviews and document analysis to gather contextual insights into the implementation dynamics and impacts of these technologies. Findings indicate that integrating TOGAF and Big Data not only streamlines workflows but also significantly enhances data security and risk management—critical elements in the lending industry. A vital outcome of this study is the development of a robust integration model that serves as a blueprint for companies in similar sectors to navigate their digital transformation journeys. Additionally, this research provides strategic recommendations to overcome integration and implementation challenges. These guidelines facilitate the transition to a more cohesive and strengthened digital architecture, equipping financial institutions to manage the complexities of modern digital economies effectively. Ultimately, this study delivers a comprehensive framework that enriches theoretical understanding and offers practical insights for effective technology integration in financial services.

Barriers and drivers of public engagement in palliative care, Scoping review

BackgroundThe integral model of Palliative Care recognizes the community as essential element in improving quality of life of patients and families. It is necessary to find a formula that allows the community to have a voice. The aim of this scoping review is to identify barriers and facilitators to engage community in PC.MethodsSystematic search was conducted in NICE, Cochrane Library, Health Evidence, CINAHL and PubMed database. Keywords: Palliative care, End of life care, community networks, community engagement, public engagement, community participation, social participation, barriers and facilitators.ResultsNine hundred seventy-one results were obtained. Search strategy and inclusion criteria yielded 13 studies that were read in detail to identify factors influencing community engagement in palliative care, categorized into: Public health and public engagement; Community attitudes towards palliative care, death and preferences at the end of life; Importance of volunteers in public engagement programs; Compassionate communities.ConclusionSocietal awareness must be a facilitated process to catalyse public engagement efforts. National policy initiatives and regional system support provide legitimacy and focus is essential for funding. The first step is to get a sense of what is important to society, bearing in mind cultural differences and to channel those aspects through health care professionals; connecting the most assistential part with community resources. The process and long-term results need to be systematically evaluated.

Fostering Psychological Safety: Building Team-Based Care Communication Skills

As health systems continue to advance integrated models of care, communication remains a central facet of how interprofessional team members can concurrently address physical health, behavioral health, and social needs.

Implementation of Tafsîr Ûlul Albâb in Indonesian Islamic Education

Islam views the holy book as not only regulating matters of worship which are vertical between servants and God. The holy book is also seen as a guide for humans in managing all world affairs, including the world of education. The development of Islamic education today, directly or indirectly, often links its vision to the formation of the ûlul albâb generation (QS. Ali Imran; 190-194). Even though the vision is the same, the implementation of Islamic education often appears to vary. Islamic educational institutions in Indonesia exist in the form of pesantren, boarding schools, madrasah, and also schools. So what is meant by the ûlul albâb generation and how is Islamic education implemented in producing the ûlul albâb generation? This research is intended to find out the views of commentators regarding the meaning of ûlul albâb and at the same time to describe the models of Islamic education that have developed to date in Indonesia. This research is library research and the methods used are the maudlu'i (thematic) interpretation method and the qualitative descriptive method. Based on this research, it can be concluded that ûlul albâb is a self-image that combines academic qualities, spirituality, and charity. In this perspective, Islamic education is a process of improving the quality of humanity in its various dimensions, namely making scholars who believe and do good deeds. To achieve this goal, Islamic education in Indonesia is developing an integrative education model, namely institutional integration and curriculum integration.

Exploring the resistance to e-health services in Nigeria: an integrative model based upon the theory of planned behavior and stimulus-organism-response

Despite the evident advantages of electronic health services (eHS), there is a noticeable opposition to their acceptance, which has raised a crucial question about why people, particularly in developing nations, oppose the acceptance of eHS. This study was designed to obtain a comprehensive understanding of the factors that influence the rigid opposition to eHS by integrating two theoretical models: the Stimulus-Organism-Response theory and the Theory of Planned Behavior. In our detailed survey, 543 respondents over 18 years old from various regions of Nigeria participated. We evaluated the proposed model using partial least squares structural equation modeling (PLS-SEM). The findings indicated that lower health literacy was associated with a greater opposition to using eHS. In addition, communication and choice overload and perceived risk contributed to a negative attitude toward eHS. Subjective norms played a significant role in influencing the intention not to use eHS, which highlights social pressure’s effect. Further, a greater perception of behavioral control reduced the intention not to use eHS. Ultimately, the intention not to use eHS affected eHS rejection behavior significantly, which makes resistance to it a substantial problem. This research unveils factors that contribute to this behavior and provides insights for policymakers in the health field, with the goal to improve people’s acceptance of eHS. Further research is recommended in different geographical samples and contexts to gain a better understanding of the factors related to eHS rejection behavior.

Enhanced predictive validity of integrative models for refractory hyperthyroidism considering baseline and early therapy characteristics: a prospective cohort study

Enhanced predictive validity of integrative models for refractory hyperthyroidism considering baseline and early therapy characteristics: a prospective cohort study

Cyberfraud, usage intention, and cybersecurity awareness among e-banking users in India: an integrated model approach

Cyberfraud, usage intention, and cybersecurity awareness among e-banking users in India: an integrated model approach

Trustworthiness of Policymakers, Technology Developers, and Media Organizations Involved in Introducing AI for Autonomous Vehicles: A Public Perspective

Qualities of organizations constitute dimensions of trustworthiness. Guided by the integrative model of organizational trust, we developed dimensions of trustworthiness of policymakers, technology developers, and media organizations that are involved in introducing artificial intelligence for autonomous vehicles. We collected data through six focus group discussions with the public in Singapore. In addition to the core dimensions of trustworthiness, the public would consider acclaim, collaboration, public communication, and affiliation. Further, we identified all the dimensions of trustworthiness as either ability-, recognition-, relation-, or principle-based. These findings carry important implications for the development of the model and stakeholders’ communication about science and technology.

Identification of the existing Integrated Farming Systems in Udaipur District of Rajasthan

The integrated farming system (IFS) is an integrative whole-farm-oriented technique mainly used to resolve the problems of small and marginal farmers to enhance income and employment, living standards, etc. Due to numerous crises and challenges such as unawareness, poverty, droughts, dry climate, the small and marginal distribution of land, etc., the identification of an appropriate integrated farming system model is highly required. So, this research aims to deliver a solution for the identification and finalization of the IFS model which is a critical task in front of farm families, Agri-scientists, policy-makers, and business organizations. This study is conducted through a field survey in the district of Udaipur, Rajasthan. This work experimented with randomly selecting 4 panchayat samitis out of 20 panchayat samitis, 4 villages selected from each panchayat samiti ee to identify existing integrated farming systems among farm families. This study observed the prominent integrated farming system model among the considered models. This work identifies the IFS models which are the most prominent farming system (M1: crop+ dairy) and are adopted by most farm families. This research work also identified integrated farming models M1 and M2 as the most preferred, profitable, and very suitable for business decision-making. Similarly, M3 and M4 are also good but less preferred than M1 and M2.