Integrated Model Research Articles

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.

Gen Z consumers’ intention to adopt online collaborative consumption of second-hand luxury fashion goods

ABSTRACT Consumption of second-hand luxury fashion goods through online collaborative redistribution channels is prevalent yet under-researched. Drawing on the self-determination theory, this study aims to provide evidence to academia and the luxury resale industry regarding young adult consumers’ beliefs in sustainability and materialism in their adoption of subscribing to, renting, or purchasing second-hand luxury goods. An integrative conceptual model is proposed based on the theory to gauge the role of various factors driving Gen Z consumers’ collaborative consumption of second-hand luxury fashion goods. Using a self-administered online survey, the researchers collected 452 usable responses from Gen Z consumers and analyzed them using structural equation modeling. Results demonstrated that both intrinsic (e.g. the importance of sustainability) and internalized extrinsic factors (e.g. the importance of signaling status, the importance of expressing one’s taste) drive their online collaborative consumption of second-hand luxury goods via subscription and rental services, as well as purchasing such goods. The gap in the literature calls for investigating further motivations and behavioral intentions of Gen Z consumers’ consumption of second-hand luxury goods. By unveiling the multifaceted psychological factors influencing these consumers regarding online collaborative consumption, the researchers offer useful marketing insights for the luxury resale industry and other share-based retail industries.

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

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.

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

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

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.

Demographic responses to competition with surrounding vegetation in subalpine plant species

Alterations in biotic interactions alongside climatic factors are proposed to affect the extinction risks of alpine and subalpine plant species. We examined the population demography of Primula farinosa along gradients of vegetation coverage to assess how the population viability of high mountain plants would alter in response to changing competitive intensities. Size-based integral projection models were constructed for plots with varying vegetation coverages. Complementary to the demographic survey, the performance of P. farinosa was evaluated in controlled environments when grown with its naturally co-occurring plant, Sanguisorba hakusanensis. In field sites, population growth rates (λ) of P. farinosa declined as surrounding vegetation coverage increased. The means, elasticities, and life-table response experiment (LTRE) contributions of the vital rates also changed, but the alteration patterns depended on the vital rates. Juvenile survival (JS), adult survival (AS), and flowering probability (FP) were lower in plots with denser vegetation while the decrease of AS was not statistically significant. Notably, the elasticity of AS exhibited a positive, whereas the elasticities of JS and FP exhibited negative regression coefficients for vegetative coverage. AS and FP showed more pronounced LTRE contributions in declining λ than JS. Significant reductions in JS and FP were also observed when plants were grown with S. hakusanensis in growth-chamber environments. Both field and chamber studies demonstrated a competitive interaction between P. farinosa and neighboring vegetation, affecting diverse demographic parameters. Altered elasticities would mitigate or exacerbate the impact of decreased mean vital rates on λs in denser vegetation, emphasizing the importance of evaluating both elasticity and the mean of vital rates to predict population persistence under changing biotic interactions.

Personalized whole-brain neural mass models reveal combined Aβ and tau hyperexcitable influences in Alzheimer’s disease

Neuronal dysfunction and cognitive deterioration in Alzheimer’s disease (AD) are likely caused by multiple pathophysiological factors. However, mechanistic evidence in humans remains scarce, requiring improved non-invasive techniques and integrative models. We introduce personalized AD computational models built on whole-brain Wilson-Cowan oscillators and incorporating resting-state functional MRI, amyloid-β (Aβ) and tau-PET from 132 individuals in the AD spectrum to evaluate the direct impact of toxic protein deposition on neuronal activity. This subject-specific approach uncovers key patho-mechanistic interactions, including synergistic Aβ and tau effects on cognitive impairment and neuronal excitability increases with disease progression. The data-derived neuronal excitability values strongly predict clinically relevant AD plasma biomarker concentrations (p-tau217, p-tau231, p-tau181, GFAP) and grey matter atrophy obtained through voxel-based morphometry. Furthermore, reconstructed EEG proxy quantities show the hallmark AD electrophysiological alterations (theta band activity enhancement and alpha reductions) which occur with Aβ-positivity and after limbic tau involvement. Microglial activation influences on neuronal activity are less definitive, potentially due to neuroimaging limitations in mapping neuroprotective vs detrimental activation phenotypes. Mechanistic brain activity models can further clarify intricate neurodegenerative processes and accelerate preventive/treatment interventions.

The Development Path of Wenzhou's Integration of the Private Economy and Vocational Education Under the "Four Chain Drive" Model

Wenzhou City, one of the key areas in China for private economic development, has been actively pushing for the deep integration of the private sector and vocational education in recent years, seizing the chance presented by the "Ministry and Province Co-constructing" National Highland of Vocational Education Innovation pilot project. This study attempts to investigate the creative growth path by using the integration of the private business and vocational education in Wenzhou City as the research object and the "four-chain-driven" model as the theoretical foundation. This study determines the research status, issues, and influencing factors of the industry and education integration mode by methodically arranging the academic history and dynamics of related research both domestically and internationally. It also incorporates the chain theory into the relevant research on the evolution of the integration of industry and education, which offers the theoretical foundation for this investigation. Research on the current state of Wenzhou's integration of the private sector and vocational education, research on influencing factors, and research on the "four-chain-driven" model are all included in the study. In order to provide references for governmental decision-making, this study aims to thoroughly analyse the current state of affairs, issues, and potential mechanisms of the integration of the private economy and vocational education in Wenzhou from multiple dimensions through empirical investigation, statistical analysis, and case studies. In the end, this research seeks to create an innovative "four-chain-driven" model of industry-education integration and development that is in line with Wenzhou's real circumstances. It also offers theoretical direction and doable avenues for Wenzhou to achieve superior industry-education integration development.

Impact and flexibility support capability estimation model of urban electric vehicles based on the integration of urban traffic network and Urban Distribution Network

Electric Vehicle (EV) is regarded as the bridge between Urban Road Network (URN) and Urban Distribution Network (UDN). It can not only make negative impact on power grid, but can also provide flexibility support capability to power grid. Whether the benefit is negative or positive depends on the dynamical behavior of EVs. So with the rapid development of EVs in the urban area, accurate evaluation of both negative impact and flexibility support capability of dispersed EVs in the urban area is very important for V2G application. In order to get the accurate evaluation results, the interaction between transportation system and electric power system should be taken into consideration. In this paper, an estimation model of the impact and flexibility support capability of urban dispersed EVs considering the interaction between URN and UDN is proposed. In order to improve the accuracy of the estimation model, the interaction between URN and UDN is modeled as an integration model based on EV trip chain. It takes EVs’ temporal and spatial dynamic stochastic characteristics into consideration simultaneously and can be used to describe the energy interaction between URN and UDN. An indices set consist of multi-index is proposed to evaluate the impact and flexibility support capability of urban EVs based on the integration model. Three numerical cases are conducted to verify the validity of the proposed model. The results show that the proposed integration model of URN and UDN based on EV trip chain can not only be used to describe the energy interaction between URN and UDN, but also to estimate the impact and flexibility support capability of urban dispersed electric vehicles.

Genetically manipulated chloroplast stromal phosphate levels alter photosynthetic efficiency.

The concentration of inorganic phosphate (Pi) in the chloroplast stroma must be maintained within narrow limits to sustain photosynthesis and to direct the partitioning of fixed carbon. However, it is unknown if these limits or the underlying contributions of different chloroplastic Pi transporters vary throughout the photoperiod or between chloroplasts in different leaf tissues. To address these questions, we applied live Pi imaging to Arabidopsis (Arabidopsis thaliana) wild-type plants and two loss-of-function transporter mutants: triose phosphate/phosphate translocator (tpt), phosphate transporter 2; 1 (pht2; 1), and tpt pht2; 1. Our analyses revealed that stromal Pi varies spatially and temporally, and that TPT and PHT2; 1 contribute to Pi import with overlapping tissue specificities. Further, the series of progressively diminished steady-state stromal Pi levels in these mutants provided the means to examine the effects of Pi on photosynthetic efficiency without imposing nutritional deprivation. ΦPSII and nonphotochemical quenching (NPQ) correlated with stromal Pi levels. However, the proton efflux activity of the ATP synthase (gH+) and the thylakoid proton motive force (pmf) were unaltered under growth conditions, but were suppressed transiently after a dark to light transition with return to wild-type levels within 2 minutes. These results argue against a simple substrate-level limitation of ATP synthase by depletion of stromal Pi, favoring more integrated regulatory models, which include rapid acclimation of thylakoid ATP synthase activity to reduced Pi levels.

Mapping-based design method for high-quality integral projection system

A general method for designing an integral projection system is proposed, including optical design and digital preprocessing based on the mapping within the projection system. The per-pixel mapping between the sub-images and the integral projection image is generated by incorporating an integral projection imaging model as well as the ray data of all sub-channels. By tracing rays for sparsely sampled field points of the central sub-channel and constructing the mapping between the central sub-channel and other sub-channels, the efficient acquisition of ray data for all sub-channels is achieved. The sub-image preprocessing pipeline is presented to effectively address issues such as overlapping misalignment, optical aberrations, inhomogeneous illumination, and their collective contribution. An integral projection optical system with a field of view (FOV) of 80°, an F-number of 2, and uniform image performance is given as a design example. The ray tracing simulation results and quantitative analysis demonstrate that the proposed system yields distortion-free, uniformly illuminated, and high-quality integral projection images.

Multimodal Mass Spectrometry Identifies a Conserved Protective Epitope in S. pyogenes Streptolysin O.

An important element of antibody-guided vaccine design is the use of neutralizing or opsonic monoclonal antibodies to define protective epitopes in their native three-dimensional conformation. Here, we demonstrate a multimodal mass spectrometry-based strategy for in-depth characterization of antigen-antibody complexes to enable the identification of protective epitopes using the cytolytic exotoxin Streptolysin O (SLO) from Streptococcus pyogenes as a showcase. We first discovered a monoclonal antibody with an undisclosed sequence capable of neutralizing SLO-mediated cytolysis. The amino acid sequence of both the antibody light and the heavy chain was determined using mass-spectrometry-based de novo sequencing, followed by chemical cross-linking mass spectrometry to generate distance constraints between the antibody fragment antigen-binding region and SLO. Subsequent integrative computational modeling revealed a discontinuous epitope located in domain 3 of SLO that was experimentally validated by hydrogen-deuterium exchange mass spectrometry and reverse engineering of the targeted epitope. The results show that the antibody inhibits SLO-mediated cytolysis by binding to a discontinuous epitope in domain 3, likely preventing oligomerization and subsequent secondary structure transitions critical for pore-formation. The epitope is highly conserved across >98% of the characterized S. pyogenes isolates, making it an attractive target for antibody-based therapy and vaccine design against severe streptococcal infections.

Media Influence on Bystander Intervention for Health Protective Norms: The Integrative Model of Behavioral Prediction Perspective

Drawing upon the Integrative Model of Behavioral Prediction (IM) and the Bystander Intervention Model, this study investigates the impact of media health information on individuals’ intentions to address violations of health norms, specifically noncompliance with mask-wearing during the COVID-19 pandemic. Our survey results (n=1,426) indicate a positive correlation between seeking health information from the media and the intention to confront norm violators regarding mask-wearing. This correlation is mediated through three intermediary pathways: attitudes, normative beliefs, and perceived behavioral control. These discoveries address a previously unexplored area concerning pro-social health behaviors, bystander intervention, and contribute to the field of health communication by linking them to research on media influences. Combining media and peer interventions could lead to more effective health outcomes. The discussion covers both theoretical and practical implications.

Retrospective Assessment of Translational Pharmacokinetic-Pharmacodynamic Modeling Performance: A Case Study with Apitolisib, a Dual PI3K/mTOR Inhibitor.

Despite significant progress in biomedical research, the rate of success in oncology drug development remains inferior to that of other therapeutic fields. Mechanistic models provide comprehensive understanding of the therapeutic effects of drugs, which is crucial for designing effective clinical trials. This study was performed to acquire a better understanding of PI3K-AKT-TOR pathway modulation and preclinical to clinical translational bridging for a specific compound, apitolisib (PI3K/mTOR inhibitor), by developing integrated mechanistic models. Integrated pharmacokinetic (PK)-pharmacodynamic (PD)-efficacy models were developed for xenografts bearing human renal cell adenocarcinoma and for patients with solid tumors (phase 1 studies) to characterize relationships between exposure of apitolisib, modulation of the phosphorylated Akt (pAkt) biomarker triggered by inhibition of the PI3K-AKT-mTOR pathway, and tumor response. Both clinical and preclinical integrated models show a steep sigmoid curve linking pAkt inhibition to tumor growth inhibition and quantified that a minimum of 35-45% pAkt modulation is required for tumor shrinkage in patients, based on platelet-rich plasma surrogate matrix and in xenografts based on tumor tissue matrix. Based on this relationship between targeted pAkt modulation and tumor shrinkage rate, it appeared that a constant pAkt inhibition of 61% and 65%, respectively, would be necessary to achieve tumor stasis in xenografts and patients. These results help when it comes to evaluating the translatability of the preclinical analysis to the clinical target, and provide information that will enhance the value of future preclinical translational dose-finding and dose-optimization studies to accelerate clinical drug development. ClinicalTrials.gov NCT00854152 and NCT00854126.

Career adaptation in higher education: a study with non-working and working students

The career construction and sociocognitive career theories were considered to test an integrative model of career adaptation in higher education. Participants were 523 Portuguese university students (non-working, n = 335, Mage = 20.64; working, n = 188, Mage = 29.05), who completed measures of social support, protean orientation, adaptability and adapting as adaptation predictors, and career certainty, academic wellbeing, and life satisfaction as adaptation outcomes. Multigroup path analysis results indicated a good fit of the model and invariance across groups after some changes. Although more studies are needed to explore the range and limits of the proposed model validity, our findings allow the career development literature extension while informing the practice. Career counselors might facilitate university students’ adjustment by helping them expand their social network and develop their career attitudes.

Integrated decision of production scheduling and condition-based maintenance planning for multi-unit systems with variable replacement thresholds

In practice, production scheduling and maintenance planning are two popular technologies that are interdependent, but they are most often performed independently. In this study, we have developed an integrated model for coordinating single-machine scheduling and condition-based maintenance planning. Firstly, we build upon existing scheduling research that often views the system as a whole and further consider the degradation and maintenance of multiple units within the system during the scheduling process. Secondly, in contrast to traditional degradation modeling which usually assumes a single threshold to trigger maintenance/replacement, we also consider the variability of replacement thresholds caused by the heterogeneity of scheduling tasks. Based on this foundation, we propose an integrated policy that considers both scheduling and condition-based maintenance. Furthermore, we have developed an integrated decision model for multi-unit systems. The model aims to minimize the total weighted expected completion time over the entire scheduling time horizon. Moreover, the genetic algorithm was employed to optimize the integrated model. Finally, we present an example of an SA adjustable multi-axis machine and conduct a sensitivity analysis of key parameters to validate the integration policy.