Search Results (12,849)

Background and Objectives: Water polo (WP) is a high-intensity, intermittent aquatic team sport that has been extensively investigated within sports science. While contemporary literature has examined the body composition and morphological characteristics of elite and international WP players, this study aimed to define the general body composition profile of world-class WP players and determine position-specific differences. Methods: The study involved 72 national team players from Serbia, Croatia, Greece, and Italy who participated in the Olympic Games, World Championships, or European Championships. Participants’ body composition was measured using the InBody 720 multichannel bioimpedance method. Ten different variables were examined to assess body structure regarding contractile and ballast components. Results: MANOVA revealed statistically significant differences in body composition across playing positions (Wilks’ lambda = 0.239, p < 0.000, η²_p = 0.402). The variables that had the greatest impact on the difference were: body mass, body fat and body mass index with the 47.0, 44.4, and 43.7% of explained total variance of the impact on the differences (p = 0.000), respectively. Conclusions: world-class WP players assigned to different playing positions differ significantly in body composition. These positional profiles should be considered in talent identification, selection procedures, training, and nutritional strategies to optimize performance models, considering the future evolution of the game at the highest competitive level. Coaches could use this information to initially select players for different specific positions based on anthropometric and body composition criteria. Full article

The primary aim of this study was to validate a self-assessment instrument about the organisation of the Early Childhood Education and Care (ECEC) environment and to investigate how early childhood educators perceive their educational environments, including quality, intentionality (specifically, their anticipatory considerations in planning the ECEC environment) and pedagogical dynamics. The EduIn&Out Organisation of ECEC Environments Questionnaire was completed by 802 Portuguese ECEC educators (children’s ages 3–6) and explored educators’ perceptions of various aspects of the ECEC environment, including the quality of the organisation of the space, materials and equipment (both indoor and outdoor), time management and daily routines, family and child participation, coordination with the educational team and with the centre’s leadership. It also gathers educators’ characterisation of their pedagogical dynamics (routine flow, children’s agency, and the use of indoor and outdoor contexts), associated with the quality of the educational environment, and educators’ intentionality while considering different needs and interests when organising the educational environment. The tool demonstrated good psychometric characteristics. Educators reported higher quality in time and routine organisation, but lower quality in outdoor spaces, family and child participation and coordination with the centre’s leadership. Enhanced quality was associated with more stimulating, child-centred routines that balanced indoor and outdoor activities. Overall, the characteristics of the instrument highlight its potential for supporting educators’ reflection. Full article

Rural youth often face barriers to accessing mental health services, including workforce shortages, limited resources, and persistent stigma. Schools are well-positioned to address these gaps through comprehensive school mental health systems (CSMHSs) embedded within multi-tiered systems of support (MTSSs). This study evaluated the implementation and effectiveness of a CSMHS in a small Midwestern rural school district over seven years. A longitudinal case study design was used to describe implementation across seven years. Universal mental health screening data were analyzed to determine the proportion of students receiving tiered supports over time. Implementation fidelity was assessed annually using the School Health Assessment and Performance Evaluation (SHAPE) system. Across seven years, more than 80% of students consistently demonstrated mental wellness within Tier I supports, with Tier II and Tier III needs aligned with expected MTSS distributions. SHAPE data indicated steady implementation improvement, particularly in universal screening, teaming, and tiered support. Ongoing challenges included monitoring Tier II intervention fidelity and demonstrating system-level impact. Findings suggest that CSMHSs can be effectively implemented and sustained in rural school settings when aligned with existing MTSS frameworks, supported by strong partnerships, and adapted to local contexts. This study provides evidence supporting the feasibility of rural CSMHS implementation and offers implications for practice and sustainability. Full article

Background and Clinical Significance: Liver cancer incidence increases with age, and surgical resection remains the primary curative option for early-to-intermediate hepatocellular carcinoma. In elderly patients, multimorbidity and frailty complicate risk assessment, so selection should consider more than chronological age. Case Presentation: An 89-year-old woman with hypertension, heart failure, atrial fibrillation on anticoagulation, and significant proximal LAD stenosis underwent preoperative percutaneous revascularisation and a left lateral sectionectomy for a solitary liver mass. Histology confirmed hepatocellular carcinoma; the early postoperative course required brief ICU support for haemodynamic instability and supplemental oxygen, with discharge on postoperative day six. Conclusions: This case report shows that, after multidisciplinary evaluation and targeted preoperative optimisation (including cardiac intervention), selected very elderly patients with multiple comorbidities may be considered for liver resection, though they remain at increased risk of perioperative cardiopulmonary and haemodynamic events. Incorporating frailty, nutritional, and functional assessments alongside comorbidity profiling improves patient selection and supports individualised decision-making. Full article

Background/Objectives: In selected patients with oligometastatic breast cancer liver metastases (BCLM), liver-directed therapies may provide durable local control and may delay escalation of systemic therapy. This study reports a single-center experience of percutaneous thermal ablation (radiofrequency ablation [RFA] or microwave ablation [MWA]) for BCLM, including conventional oncologic outcomes and therapy-based endpoints. Methods: This retrospective cohort included consecutive patients treated with percutaneous ablation for BCLM following multidisciplinary team approval between 2005 and 2025. Outcomes were defined according to the Society of Interventional Oncology (SIO) and DATECAN consensus terminology. Lesion-level outcomes included primary/secondary technique efficacy and local tumor progression-free survival (LTPFS). Patient-level outcomes included progression-free survival (PFS), overall survival (OS), time to change in systemic therapy (TTCST) and chemotherapy-free survival (CFS). Kaplan–Meier and Cox regression analyses were performed. Results: Forty-six patients underwent 58 ablation sessions treating 80 metastases (median tumor size 19 mm, interquartile range [IQR] 13–27 mm). Primary and secondary technique efficacy were 95% (76/80) and 99% (79/80), respectively. Major complications occurred in 2/58 sessions (3%). Local tumor progression occurred in 16/79 tumors (20%) after a median follow-up of 28 months; LTPFS rates at 1, 3 and 5 years were 84%, 75% and 75%, respectively. Median OS was 44 months (1-, 3- and 5-year OS 94%, 58%, and 40%), and median PFS was 8.3 months. Median TTCST was 13 months, and median CFS was 16.4 months. Triple-negative disease was associated with worse LTPFS and shorter CFS. Oligopersistent disease was associated with improved PFS compared with oligoprogression. Conclusions: In this selected cohort, percutaneous thermal ablation for BCLM achieved high technique efficacy, durable local control and low major complication rates. Therapy-based endpoints suggest a clinically meaningful interval without systemic therapy escalation in appropriately selected patients, although comparative studies are needed to quantify the incremental benefit. Full article

Background/Objectives: Papua New Guinea has a population of over 10 million, with its public cardiac surgical service provided by only one tertiary center. Despite the climbing burden of ischemic heart disease, no CABG operation has been performed before 2025 due to limited local surgical capacity. An international collaboration was planned in order to launch a CABG program in the country. Methods: Three cases were shortlisted after a multidisciplinary team discussion. A team-based “On-the-job” mentoring strategy was employed to facilitate skill transfer. The operation was carried out in a “twinning” fashion, with each role of the surgical team being taken up by “a pair”—the trainer (visiting team) and the learner (local team). The trainer demonstrated key skills and tips in the first case, and the “pair” switched positions in the following cases to maximize hands-on learning. The last case was performed entirely by the local team. Results: Three patients underwent CABG operations in this pilot program. A total of 2.33 grafts/case were performed on average, with no 30-day mortality. There were no major complications except for one patient developing right middle cerebral artery infarct on postoperative day 5. The patient was discharged one month later after achieving functional recovery and was started on anticoagulation therapy. Conclusions: International collaborations with strategic planning can play a critical role in starting new cardiac surgical programs in low–middle-income countries, with acceptable surgical outcomes. History has been made with the first-ever CABG operation successfully performed in Papua New Guinea. The journey ahead to sustain local cardiac surgical capacity and to provide safe and accessible cardiac surgical care for the country remains challenging. Full article

This paper addresses a human resource allocation problem with spatial-temporal constraints (HRAP-SC) in the parallel assembly of complex products, such as satellites and aircraft. It involves coordinating a limited pool of multi-skilled workers across geographically distributed workstations, subject to rigorous constraints including team collaboration requirements, operation priorities, technological tail times (e.g., curing), and strict 8 h workdays. Existing exact approaches typically fail to converge due to the combinatorial explosion arising from the strong coupling of shared resources across workstations, while meta-heuristic methods often suffer from performance instability caused by hyper-parameter sensitivity. To overcome these limitations, we propose a pattern-based decomposition algorithm (PDA), a novel parameter-free exact solution framework. By exploiting the inherent symmetry of identical jobs and parallel workstations, PDA defines a set of canonical patterns to drastically reduce the search space. It employs an efficient traversal mechanism reinforced by rigorous mathematical bounds and pruning rules to eliminate unpromising solutions. Computational experiments demonstrate that PDA significantly outperforms state-of-the-art Mixed-Integer Programming (MIP) and Constraint Programming (CP) solvers. Unlike standard solvers, which frequently time out (3600 s), PDA strictly evaluates only a single pattern when proving optimality, and robustly scales to large industrial instances (e.g., six jobs comprising 78 operations) to provide high-quality schedules. By successfully solving complex scheduling problems that remain intractable for monolithic solvers, PDA provides a robust and automated decision-support tool for production management in complex manufacturing systems. Full article

Drawing on signaling theory, this study investigates the role of lead founders’ human capital signals in the success outcomes of equity crowdfunding (ECF) campaigns. While prior research emphasizes entrepreneurial teams or broadly defined founder characteristics, the role of dominant entrepreneurial actors remains underexplored. We focus on the lead founder, defined as the individual combining founder status, CEO authority, and ownership concentration, as the primary signal carrier in ECF contexts. Using a multi-platform dataset of 1067 campaigns from Republic Europe, Crowdcube, Mamacrowd, and Invesdor (2012–2024), we examine how lead founders’ education and experience shape investor decisions. Our results indicate that industry-related education is the strongest predictor of the number of investors. Furthermore, while industry experience alone can positively predict investor engagement, its role disappears once education is accounted for, suggesting that education in industry-related fields can outweigh industry experience in shaping investor perceptions. Additionally, our findings suggest that entrepreneurial experience and attendance at a top-ranked university do not contribute meaningfully to explaining investor participation. Accordingly, the study contributes to the human capital signaling literature by showing that investors evaluate the incremental informational value of human capital signals rather than assessing each signal independently, and highlights the centrality of the lead founder in decision-making under highly uncertain crowdfunding environments. Full article

The cutting-edge era emphasizes developing key solutions to improve productivity and promote economic growth within limitations. To achieve this, the production management team employs various process improvement approaches to empower operations management. The aim of this article is to examine the recent trends in operations management scenarios in which industry professionals seek an ingenious path for selecting process improvement approaches through a systematic literature review. The study employed the PRISMA framework for a systematic literature review of 176 papers published from 2000 to 2026. The key finding shows the methodologies used for operations management scenarios, considering Industry 3.0–6.0. The methodologies include traditional approaches, concurrent approaches, data-driven assessment, real-life assessment for competent approaches, and sustainable approaches. The study focused on identifying obstacles to selecting and implementing a suitable decision-making process improvement approach to mitigate operations management issues in the Industry 3.0–6.0 work environment. These obstacles are recognized as several challenges and problems that arise on the shop floor and reduce the organization’s sustainability. This study identifies an emerging research area: the development of innovative, AI-driven operations management platforms for flexible, emerging work settings. Full article

Background: In Chuckwagon racing, teams of four Thoroughbreds with two lead horses in front and two wheel horses directly behind pull a 600 kg wagon around a racetrack. Our study focuses on stride parameters that have previously retrospectively predicted impending injuries. We hypothesize that in aid of the initiation of the tight figure-of-eight turn at the start of the race, the more agile lead horses gallop with higher stride frequency (SF) and reduced stride length (SL), and that differences are exacerbated in the initial accelerative race segments. Methods: Speed, SF, and SL were quantified with global navigation satellite system (GNSS) loggers over consecutive 100 m segments over 5 furlongs in sixty horses competing in Chuckwagon racing. Mixed models for SF and SL (p < 0.05, Bonferroni correction) investigated the effect of speed (fixed covariate), race segment (100 m to 1000 m), and position (lead or wheel horse) as fixed factors and their two-way interactions. Results: SF and SL were significantly affected by all two-way interactions (all p ≤ 0.025). At the average speed of 55.5 km/h, SF was 2.333 and 2.293 Hz, SL was 6.624 and 6.735 m for lead and wheel horses, respectively. Larger SF and SL differences between lead and wheel horses were found at the start and the end of the race. Conclusions: Particularly at the start and end of a Chuckwagon race, there are distinct differences in stride parameters between lead and wheel horses. Specific speed–SF–SL models for Chuckwagon lead and wheel horses might benefit from incorporating race phase. Full article

Background/Objectives: With increasing frequency in sublobar resections, accurate intraoperative localization has become essential to ensure adequate resection margins and spare lung parenchyma. Our study evaluates the efficacy of shape-sensing robotic bronchoscopy (SS-RAB) with integrated mobile cone-beam CT (mCBCT) for intraoperative localization of lung tumors using indocyanine green (ICG). We further aimed to explore the feasibility of a single intubation-single positioning technique for bronchoscopy and surgery. Methods: We retrospectively reviewed patients who underwent SS-RAB with integrated mCBCT for ICG marking, followed by minimally invasive sublobar resection. ICG marking was deemed successful when it allowed the operative team to localize and resect the lesion with adequate pathology margins. Results: A total of 28 patients with 30 pulmonary lesions from a single institution were included. Median tumor size was 10.5 mm (IQR, 8.7–14.6 mm) and distance from pleura 7.8 mm (IQR, 2.45–13.8 mm). Twenty lesions (66.6%) were solid, 5 lesions (16.6%) semi-solid, and 5 lesions (16.6%) ground-glass. ICG localization was successful in 28 lesions (93%). Nineteen patients (68%) were intubated only with a double-lumen endotracheal tube (DL-ETT), used for bronchoscopy and surgery, and in 10 patients (36%) ICG marking and surgery were both performed in lateral decubitus. One patient developed a small pneumothorax during bronchoscopy which did not prevent ICG injection. Conclusions: SS-RAB with integrated mCBCT for ICG marking is successful and safe. Single intubation with DL-ETT and lateral decubitus positioning for both bronchoscopy and surgery are feasible. Further studies are needed to prove a potential increase in efficiency with this technique. Full article

Background/Objectives: Caffeinated chewing gum is a practical, rapidly absorbed ergogenic aid increasingly used in team sports, yet its interaction with different small-sided soccer game (SSG) formats in young male players remains unclear. This study evaluated the effects of acute caffeinated (CAF) chewing gum on psychophysiological responses and kinematic profiles during intermittent (INT) and continuous (CON) 3-a-side SSGs. Methods: Twenty-four young male soccer players (18.4 ± 0.5 years) completed four 3-a-side SSG sessions separated by 48 h in a randomized, double-blind, placebo (PLA)-controlled, crossover design (CAF-INT, PLA-INT, CAF-CON, PLA-CON). Participants chewed 300 mg of CAF or PLA gum for 5 min, with mastication completed 5 min before warm-up session. The heart rates and kinematic profiles were recorded during the SSGs, and the ratings of perceived exertion (RPE), exercise enjoyment scale (EES), and visual analogue scale (VAS) to perceived mental fatigue (MF) were assessed post-game. Results: Compared with the PLA, the CAF increased the heart rate responses (HR), EES, total distance (TD), player load (PL), acceleration (ACC), and distances covered in selected speed zones (from Z0 to Z5), while reducing the RPE and MF. Significant format × supplementation interactions indicated that CAF-induced changes in high-intensity kinematic outcomes (TD, PL, ACC, Z2–Z5) and HR responses (HR_mean, HR_max) were generally greater in INT, whereas CAF-induced increases in low-intensity running distances (Z0 and Z1) and %HR_max were more pronounced in the CON format (all p < 0.05 for the reported effects; ${\eta }_p^2$ = 0.16–0.93 for CAF main effects [large effects]). The EES improvements were more pronounced in the CON format, whereas the MF and RPE reductions were more pronounced in the INT format. Conclusions: CAF chewing gum may be a practical acute strategy for modulating psychophysiological responses and kinematic profiles during SSGs, with the effects depending partly on the game format. Full article

Introduction: The colossal European catfish (Silurus glanis) is the largest invasive freshwater fish on the Iberian Peninsula, reaching up to 2.8 metres and 130 kg in weight. Its large size makes it a highly valued target for recreational anglers, leading to repeated illegal introductions across several Iberian watersheds. Despite its appeal to anglers, this species is recognised as a high-impact invasive predator with substantial ecological consequences for European freshwater ecosystems. Recently, large catfish aggregations have been reported by anglers and environmentalists in several areas of Portugal and Spain. These impressive aggregations are frequently documented on videos and posted on social media networks (Facebook, WhatsApp groups, etc) or shared directly with our team members. Objective: Such records provide a valuable source of information for identifying the habitats and seasonal periods associated with aggregation behaviours and may therefore support more efficient management and population control actions. Methodology: We compiled information on European catfish aggregation events in Southern Iberia, namely date and location. The catfish aggregations were mapped, and their general habitat characteristics were described. Results: We recorded 10 catfish aggregation events, most of which occurred between May and June. These were generally located in transitional areas between lentic and lotic habitats, especially in narrower river sections. Possible explanations include hydromorphological constraints, seasonal environmental conditions, and species-specific behavioural responses, although these mechanisms require further investigation. Conclusions: Within the LIFE PREDATOR project, which focuses on the management of European catfish in the Tagus watershed, knowledge of aggregation locations is important to direct population control efforts aimed at reducing the abundance of this invasive fish. Moreover, the identification of common habitat characteristics may help predict other potential aggregation sites and improve the planning of future management actions. Full article

Background/Objectives: Despite growing evidence on the importance of compassionate care, it receives little attention in geriatrics literature. The aim is to study the variation and key components of team compassionate care and its relation to individual healthcare provider (HCP) emotional exhaustion in acute geriatric units (AGUs). Methods: A cross-sectional survey study, from February to April 2025, with a convenience sample of HCPs in five Belgian AGUs (70% response rate). Validated questionnaires were used: The Sinclair Compassion Questionnaire (SCQ), Emotional Exhaustion (EE) subscale of Maslach Burnout Inventory and Ethical Decision-Making Climate Questionnaire (EDMCQ). Results: In total, 118 HCPs participated: 11% team leaders, 28% paramedics, 61% nursing professionals. Mean AGU SCQ scores ranged from 3.62 to 4.28 on a scale from one (lowest) to five (highest). Multivariate linear regression models showed significant differences in team compassion scores across AGUs (estimate 0.084, p = 0.003) and increased with higher ethical climate scores (estimate per point on the EDMCQ 0.035, p < 0.001). Two EDMCQ domains (open interprofessional reflection and mutual respect) were associated with team compassionate care beyond the effect of AGUs, whereas demographics and self-reported emotional exhaustion were not (R² = 0.283). Emotional exhaustion was significantly associated with professional role (estimate −3.004, p = 0.011), but not with AGUs (estimate 0.768, p = 0.269), ethical climate (estimate per point on the EDMCQ −0.248, p = 0.117) and team-based compassion scores (R² = 0.115). Nursing professionals were significantly at higher risk for emotional exhaustion compared to paramedics (estimate 4.497, p = 0.037). Conclusions: The level of team compassionate care differed across AGUs and was correlated to the perceived ethical climate of the workplace, and not to individual HCP demographic variables or emotional exhaustion. Mutual respect and open interprofessional reflection may be specific areas for future research in improving high-quality compassionate care. Full article

Students’ reading preferences and voices are increasingly relevant for informing teaching practices and strengthening students’ motivation and engagement with reading, thus making their reading experiences meaningful. However, in Chile, there is still little evidence regarding the reading preferences and perspectives of primary school students. Therefore, this study analyzes students’ preferences and perceptions of the texts assigned by their teachers, as well as the pedagogical practices for reading mediation applied across various subjects in the La Araucanía Region of southern Chile. To this end, using a qualitative, multiple-case study design, we conducted 9 discussion groups on reading mediation and discourse genres with 96 students in grades 3–6, each connected to one of 6 outstanding teachers. Thus, we applied an inductive content analysis, constructing categories through initial coding, focused coding, and interpretive analysis, all of which underwent triple review and calibration by team members. The findings show that, in general, students value the support and scaffolding their teachers provide to facilitate reading, comprehension, and participation. However, they express a desire for greater agency in selecting texts and for more opportunities to engage in dialogue around these texts, especially in subjects other than Language Arts. These results highlight the importance of reading mediation across subjects, including student text selection and dialogic interaction, to promote motivation and sustained reading practices in primary education. Full article