Search Results (241)

This review aims to present an updated, comprehensive analysis of data on the diversity and challenges of current approaches to the screening and monitoring of subjects at risk of T1D, as the earliest interventions during the course of the disease. Previously, screening for T1D was justified only for research purposes. A major turning point occurred when teplizumab, an immunomodulatory drug that delays the onset of overt T1D, was approved. Nowadays, there is a growing number of screening initiatives, and this trend is spreading fast across the world. In this context, novel recommendations emphasize the need for the wider identification of subjects at risk of T1D, suggesting that screening should not include only first-degree relatives of persons with T1D. Furthermore, current experts’ opinions have shifted the detection of T1D risk in the direction of ultimate goal-screening in the general population. Also, subjects at risk should be monitored, undergo metabolic testing, be informed about their risk, and be educated about the disease. Currently, there is a diversity in approaches to the screening and monitoring of subjects at risk of T1D, predominantly in the pediatric population. Several knowledge gaps persist in this area of investigation, especially in recommendations and potential benefits for the adult population. However, the scientific community is focusing on developing and adapting screening and monitoring strategies to suit particular countries, aiming to make them more universal while refining the definition of individual risk for T1D. Nevertheless, the screening and monitoring of subjects at risk should be the earliest interventions focused on delaying T1D. Full article

Generative artificial intelligence (AI) has demonstrated significant potential in education, yet empirical research on its application in “hardware-driven” interdisciplinary design courses remains scarce. This study employed a randomized crossover experimental design in an IoT Hardware and Design Innovation course at Hunan University. Twelve industrial design undergraduates with no prior IoT background alternated between AI-assisted (ChatGPT-4o) and traditional learning resource conditions across six short-cycle tasks. The crossover design enabled each participant to serve as both experimental and control subjects, yielding 72 observation-level data points. Grounded in Cognitive Load Theory, the study examined three dimensions: process efficacy, difficulty structure, and switching adaptation costs. Results indicated that AI significantly improved perceived task completion efficiency, self-reported goal attainment, and learning experience, yet self-assessed knowledge transfer did not differ significantly between conditions. AI reduced the total number of reported difficulties but altered the difficulty-type distribution: resource-retrieval difficulties decreased while information-verification difficulties increased—a phenomenon we term “difficulty restructuring”. Furthermore, switching from AI back to traditional resources incurred significantly higher adaptation costs than the reverse transition, revealing emerging dependency risks. These findings suggest that generative AI may function more as a “difficulty restructurer” than a “difficulty eliminator” in hardware-driven design education, providing exploratory empirical evidence for incorporating verification literacy into future course design and calling for calibrated scaffold fading that may help mitigate emerging dependency risks. Full article

Financial literacy is critical for individual well-being and sustainable economic development, yet significant gaps remain among Portuguese young adults. Using a two-phase design, this study combines a diagnostic assessment and multi-criteria decision analysis to identify and prioritise effective financial education strategies. In Phase 1, a diagnostic questionnaire administered to 172 first-year university students revealed pronounced deficiencies in core financial concepts. Only 29.1% correctly answered a question on compound interest, and almost half were unable to understand the concept of inflation. Additionally, 62.8% reported low exposure to financial education during compulsory schooling, and 59.9% strongly agreed that it should be included in the mandatory curriculum, indicating both unmet need and strong receptiveness. Phase 2 employed the Analytic Hierarchy Process (AHP) to evaluate five educational alternatives across four criteria. Engagement and motivation (0.32) and knowledge acquisition (0.31) were prioritised over behavioural impact (0.22) and accessibility (0.15). Based on expert assessments weighted by student preferences, in-person courses emerged as the most effective strategy (0.42), substantially outperforming online courses (0.22), videos and digital content (0.14), books (0.13), and games (0.10). The findings point to the need for policy-driven integration of structured, educator-led financial education within formal curricula, supported by approaches that prioritise active engagement and knowledge acquisition over convenience, with digital tools serving as complements rather than replacements. Full article

Nurses are healthcare professionals who can play a leading role in preventing antimicrobial resistance, given their direct assistance to patients. For this reason, in-depth university training is desirable. This study was conducted to detect possible weak points in the university training about an important public health topic represented by general knowledge about antibiotics and antibiotic resistance. We carried out a survey on Knowledge, Attitudes, and Practices of students attending the Nursing Sciences course at the University of Messina, Italy, by administering an online standardised questionnaire that included general and specific questions about antibiotics and antibiotic resistance. General and specific scores were calculated. Some gaps were found about the knowledge of antibiotics (mean score: 3.6/4) and, especially, antibiotic resistance (mean score: 3.2/5). As expected, most of the incorrect answers to both antibiotic and antibiotic-resistance knowledge were given by students in the first year, but some gaps were also found among students in the last year. Given the growing role nurses can play in combating antibiotic resistance, these findings point to a possible information gap in the study course and highlight the need to enhance the current university training programmes with activities designed to increase knowledge on these important public health issues. Full article

Background: Maternity care for vulnerable pregnant women presents a particular challenge within midwifery practice. In Germany, maternity services lack standardized frameworks to adequately address the specific needs of individuals who have experienced, among other factors, sexualized violence, poverty, female genital mutilation/cutting (FGM/C), or discrimination. Limited access to healthcare among these populations contributes to increased maternal and neonatal morbidity and mortality. Emerging evidence indicates that comprehensive medical and psychosocial support provided by midwives can substantially improve obstetric outcomes for marginalized pregnant women. Methods: An elective course, Antenatal Care for Vulnerable Women, was offered in the sixth semester of the Bachelor’s program in Midwifery Science at the University of Tübingen in 2025. The course provided insights into the psychosocial challenges faced by vulnerable pregnant women and prepared students for these specific aspects of midwifery practice. The curriculum incorporated foundational lectures and innovative teaching formats aimed at cultivating constructivist approaches to problem-solving. All sixth-semester midwifery students were asked to assess their knowledge and skills across five vulnerability categories: asylum-seeking, FGM/C, intimate partner violence, trauma, and racism. A pilot pre–posttest analysis using a 6-point Likert scale (1 = very good, 6 = poor) was conducted as hypothesis-generating and curriculum-guiding. The pretest included 38 respondents. The posttest included 11 respondents who attended the course. Results: Students who attended the course demonstrated observable gains in knowledge and skills across all categories, with the greatest improvements in asylum-seeking, median of 5 (IQR 4–5) vs. 2 (2–3); FGM/C, 5 (4–5) vs. 2 (2–3); and racism, 5 (3–5) vs. 2 (2–3). Conclusions: Innovative teaching methods may contribute to preparing midwifery students for targeted care of vulnerable pregnant women. Findings from the pre- and posttests provide preliminary insight into the potential value of experiential learning and may inform the further development of practice-oriented teaching methods. Full article

Engineering Materials courses are characterized by dense conceptual content, cumulative knowledge structures, and heterogeneous student learning trajectories. Existing teaching reform studies often focus on isolated instructional techniques or digital tools, while paying limited attention to the systemic organization of learning activities, assessment, feedback, and instructional decision-making. This study proposes a system-oriented teaching framework for an undergraduate Engineering Materials course within an urban underground space engineering program. The framework conceptualizes course instruction as a closed-loop process driven by continuous learning evidence and feedback regulation. The framework was implemented in an undergraduate Engineering Materials course with 50 students over a 16-week semester using a learning management platform. Multiple sources of process data were collected, including platform access records, assignment submissions, weekly quiz performance, pre- and post-course concept assessments, instructor feedback logs, and instructional adjustment records. The results indicate that the proposed framework supported timely instructional regulation and adaptive responses to heterogeneous learning states. Observable improvements were found in student engagement patterns and assessment outcomes across the semester. Mean concept test scores increased from 55.7 to 72.2. Students with lower initial scores gained an average of 22.3 points, compared to 11.8 points for their higher-performing peers. A total of 312 feedback messages were delivered, with a median latency of three days. These improvements were observed in association with the implementation of the framework, although causal attribution is limited by the non-experimental, single-cohort design. The study provides an exploratory case showing that system-oriented teaching design may offer a coherent and practically feasible approach for enhancing engineering education in data-rich instructional environments, while also contributing to the application of systems thinking in teaching reform. Full article

Traditional craft education relies heavily on hands-on practice; however, novice learners often struggle with procedural complexity, material behavior, and the tacit knowledge typically transmitted through prolonged apprenticeship. This paper presents an integrated framework that combines semantic Knowledge Graphs (KGs), real-time Finite Element Method (FEM) simulation, and high-fidelity physically based rendering (PBR) to support the teaching, understanding, and preservation of traditional crafts. Craft processes are modelled as ontologically grounded KGs that capture tools, materials, actions, decision points, and common procedural errors through an extensible representation aligned with CIDOC-CRM. These semantic structures drive an interactive FEM-based simulation that enables learners to enact craft actions in a virtual environment while receiving predictive feedback and corrective guidance derived from expert-defined execution parameters. The resulting workpiece states are visualized using PBR techniques, providing perceptually accurate cues essential for assessing surface changes, deformation patterns, and material conditions. The methodology is embedded within an eLearning ecosystem that supports the generation of structured courses, multimodal exemplars, and instructional design informed by Cognitive Load Theory. A use case involving wood and aluminum carving demonstrates the system’s ability to simulate realistic tool–material interactions and produce visually interpretable outcomes. The results indicate that coupling executable semantic knowledge modelling with physically grounded simulation offers a viable pathway toward scalable, safe, and contextually rich craft training while supporting the long-term preservation of domain expertise. Full article

Background/Objectives: Nutritional medicine remains underrepresented in medical education despite its relevance across specialties. Online learning offers a resource-efficient option to address this gap, yet evidence on the effectiveness and acceptability of online learning modules (OLMs) is limited. Methods: In this exploratory randomized controlled single post-test trial, medical students were assigned to either an OLM or an in-person lecture (IPL) on nutritional medicine (n = 91, no a priori sample size calculation performed). After course completion, students took a knowledge test and completed a questionnaire on their learning experience. Group differences were analyzed using permutation Welch t-tests, Wilcoxon–Mann–Whitney tests, or Fisher’s exact tests, depending on variable characteristics, with α = 0.05. Results: OLM students achieved significantly higher test scores than IPL students (mean difference: 2.4 points on a 0–40 scale), resulting in differences in grade classification (p < 0.05). OLM was further rated more favorably regarding content delivery, overall course evaluation, and exam preparation (all p < 0.05), while self-reported attention, concentration, and involvement did not differ between groups. Flexibility, time savings, and convenience were the most frequently reported advantages of OLM over IPL. Conclusions: This study suggests that OLM in nutritional medicine may be associated with higher test performance and more favorable student evaluations compared to IPL. These findings highlight the potential of online learning as a scalable, resource-efficient approach that may help address persistent gaps in nutritional medicine education. Building on this evidence, future work should examine how such modules can be optimally integrated into medical curricula to complement existing teaching structures. Full article

Background and Objectives: Social Determinants of Health (SDoH) are factors that can contribute to health inequities. Improving the conditions in which people are born, grow, and live requires collaboration between professionals from different health sectors. Given their health and well-being-focused care, nurses are crucial to promoting health equity in the care they provide. Thus, their knowledge, attitudes, and actions—i.e., practice—(KAP) regarding SDoH could serve as a helpful starting point for promoting care that also focuses on non-medical factors. This study aims to map the SDoH assessed in the literature in relation to nurses’ and nursing students’ KAPs, using the Dahlgren–Whitehead Rainbow Model as a logical framework. Methods: Following PRISMA guidelines, a systematic literature review was conducted using PubMed, Scopus, Web of Science, CINAHL, and PsycINFO. Records published until June 2024 were selected from primary studies involving nurses and nursing students, with no time limits. The assessed determinants were adapted and categorised according to the Rainbow Model Levels. Results: 22 results were eligible. The SDoH (in general), poverty, social justice, social gradient, social inclusion and exclusion, discrimination, diversity, equity and inequality, food insecurity and access to nutritious food, employment status, geographical isolation, healthcare services, housing difficulties, transportation, social support, individual lifestyle factors, and health literacy were assessed on KAPs. Conversely, health equity has been assessed just for knowledge and attitudes. Considering the latter level of the Rainbow Model and the relative categorisation of the results, age, sex, and constitutional factors were not examined in the studies included in this review. Conclusions: This review maps the most and least frequently assessed SDoH in relation to KAP. As nurses are essential to providing care that considers SDoH, improving health outcomes, and addressing health inequities, and advocating for community health, it would be valuable to enhance nursing education from baccalaureate through postgraduate courses. Moreover, a strong relationship with different healthcare professionals is needed. Full article

Bipolar affective disorder (BD) is a severe mental illness characterized by recurrent episodes of mania, hypomania, and depression, accompanied by progressive neurobiological changes that go beyond the classical concepts of neurotransmitter dysregulation. Increasing evidence points to the key role of the interaction between inflammatory processes, mitochondrial dysfunction, and disturbances within neural networks in the pathogenesis, course, and treatment response of BD. Neuroinflammatory processes, including elevated levels of pro-inflammatory cytokines, chemokines, and microglial activation, are consistently reported in patients with BD and linked to cognitive impairment, accelerated neuroprogression, and treatment resistance. At the same time, mitochondrial abnormalities—such as impaired oxidative phosphorylation, excessive production of reactive oxygen species, and disturbances in calcium homeostasis—contribute to oxidative stress, synaptic dysfunction, and increased neuronal vulnerability, forming the biological substrate of mood instability. Findings from neuroimaging studies provide consistent evidence of structural and functional alterations within the cortico-limbic networks regulating emotions, including the prefrontal cortex, anterior cingulate cortex, amygdala, and hippocampus. Importantly, a growing number of studies demonstrate correlations between neuroimaging changes and inflammatory and metabolic biomarkers, making it possible to link molecular pathology with dysfunctions at the level of neural networks. The use of multimodal methods—encompassing structural and functional magnetic resonance imaging, spectroscopy, and molecular analyses—allows for a more precise explanation of these complex interactions and the identification of biomarkers of clinical states, progression, and treatment response. This review synthesizes current knowledge on the molecular and neuroimaging correlates of BD, emphasizing the interdependence of inflammatory processes, mitochondrial function, and neural networks. The integration of molecular biomarkers with imaging-based phenotyping opens new perspectives for precision medicine in BD. Full article

Background/Objectives: Point-of-care ultrasound (POCUS) is an accessible and low-cost diagnostic tool that is seldom used by orthopedic residents. This study aims to assess the efficacy of a POCUS training program within an orthopedic surgery residency curriculum in terms of knowledge retention and clinical usage among the group of residents. Methods: This study included didactic and hands-on teaching sessions. The impact of the teaching sessions was evaluated through surveys (pre-course, immediate post-course, and 6 months post-course). The surveys were divided into three sections: participant’s interest in and usage of POCUS, ultrasound-related knowledge, and perceived limitations related to the usage of ultrasound. All orthopedic residents who attended the teaching sessions and completed all the surveys were included. Results: There were 14 participants. There was a significant increase in interest in POCUS (scale 1 to 5) from 3.36 ± 0.50 in the pre-course survey to 3.93 ± 0.83 in the final post-course survey (p = 0.04). However, there was no significant change in the amount of POCUS usage in clinical settings. Levels of comfort with ultrasound-related procedures significantly increased immediately following the teaching session but did not stay significantly higher after 6 months. When tested on knowledge, the residents’ scores were still significantly greater than they were at the time of the pre-course test at 6 months (p = 0.01). Lack of ultrasound-related knowledge, lack of time, and site culture were the two most prevalent perceived barriers. Conclusions: This study demonstrates that POCUS teaching for orthopedic residents yields long-term benefits in terms of interest and knowledge. However, recurrent teaching sessions and further efforts are required to address perceived obstacles to PoCUS usage and increase clinical implementation. Full article

Background/Objectives: Children in paediatric palliative care often face school attendance barriers due to complex health needs. This study describes post-training perceptions of a training program by a pediatric hospice team to prepare school care assistants to safely include children with complex conditions, focusing on procedural skills, knowledge of the child, and family partnership. Methods: Care assistants who completed a structured course at the Paediatric Palliative Care Centre, University Hospital of Padua (2023–2024), were surveyed immediately after training. The program combined classroom instruction with hands-on simulation using high-fidelity mannequins and standard devices, including suction, pulse oximetry, ventilation, enteral feeding, and tracheostomy care. It also covered modules on urgent and emergency management, as well as family communication. An anonymous online questionnaire gathered socio-demographic data, prior training, clinical tasks performed, self-efficacy levels, and open-ended feedback. Quantitative results were analyzed descriptively, while qualitative comments were subjected to thematic analysis. Results: Of 130 invited assistants, 105 participated (81%). Participants reported strong perceived confidence: 85% selected the upper end of the 5-point scale (“very” or “extremely”) for routine-management ability, and 60% selected these same response options for emergency-management ability. In the most severe events recalled, 60.5% of incidents were resolved autonomously, 7.6% involved contacting emergency services, and 3.8% involved community or hospice nurses. Seventy-five percent judged the course comprehensive; thematic analysis of 102 comments identified satisfaction, requests for regular refreshers, stronger practical components, and requests for targeted topics. Conclusions: Immediately after the session, participants tended to select the upper end of the self-assurance item for both routine and emergency tasks. Combining core emergency procedures with personalized, child-specific modules and family-partnership training may support safety, trust, and inclusion. Regular refreshers and skills checks are advised. Full article

Medical students experience fluctuations in their motivation, influenced by various factors, including curricular rigor, mental health, and institutional factors. Based on Self-Determination Theory (SDT) and the Four Pillars of Academic Engagement (HPEE), this study, conducted at a private Mexican university, examined motivational variation according to academic year, curricular impact, gender differences, and its relationship with mental health. Methods: A quantitative, cross-sectional, descriptive study was conducted using qualitative tools for contextualization (n = 1326). Mann–Whitney U tests, Kruskal–Wallis tests, logistic regression, and psychological network analysis were performed. Results: Motivation showed cross-sectional variation: high in preclinical years 1 and 2, decreasing in clinical years 3 and 4 (p < 0.001), and rebounding in year 6. The reformed curriculum (elective subjects, student-centered active learning) resulted in greater motivation (OR = 10.68, p < 0.001). Women tended to have slightly higher motivation (p = 0.050), higher grade point averages (p < 0.001), but also greater stress (p < 0.001). Network analysis revealed that intrinsic achievement (centrality = 1.11) and curiosity about knowledge (predictability = 84.5%) are the main drivers, while demotivation was linked to the later years. The qualitative part of the study showed altruism/curiosity as the main motivators; mistreatment/workload (demotivators). Conclusions: Motivation is context-sensitive, peaks in the preclinical stage, and recovers with autonomy but is vulnerable during clinical immersion. Autonomy in course selection, active student-centered pedagogies, and gender-sensitive support foster sustained participation. The centrality of intrinsic factors in the network highlights that achievement motivation and knowledge are general and independent motivators. Qualitative data reveal systemic barriers. Stage-specific interventions, such as mentoring, student support programs, and reporting mistreatment, can be crucial for strengthening resilience and performance. Longitudinal and multi-institutional studies are needed to validate the causality and generalizability of this study. Full article

Nontuberculous Mycobacteria (NTM), often referred to as environmental or atypical mycobacteria, are opportunistic pathogens phylogenetically as well as clinically distinct from both the Mycobacterium tuberculosis complex and Mycobacterium leprae. In the pediatric age group, NTM disease manifests with a diverse range of clinical phenotypes. Cervicofacial lymphadenitis stands out as the most common presentation among children who are immunocompetent. Conversely, skin and soft tissue infections, pulmonary disease and disseminated infections constitute less prevalent, yet clinically important, disease forms. Accurate identification is paramount, as differentiating NTM infections from tuberculosis (TB) remains challenging based solely on clinical symptoms, initial laboratory analyses, or standard radiological findings. This distinction is critical because treatment protocols for NTM infections differ substantially from those for tuberculosis. This narrative review offers a comprehensive and up-to-date summary of NTM infections in children. It examines the spectrum of clinical presentations and their prevalence, addresses the complexities of diagnosis and therapy, and underscores the importance of differential diagnosis against tuberculosis. Furthermore, we explore current diagnostic strategies, available therapeutic options, and the link between specific clinical syndromes and tailored management, pointing out existing knowledge gaps and suggesting priorities for future research. The absence of rapid, species-specific diagnostic tools often results in delayed initiation of targeted treatment, while overlapping clinical features with TB can lead to misdiagnosis. Therapeutic management is complicated by the necessity for prolonged drug courses, frequent occurrences of drug intolerance, limited availability of child-appropriate formulations, and the rising tide of antimicrobial resistance. Successfully tackling these issues demands enhanced surveillance, precise species-level identification, the creation of child-friendly drug formats, and the development of evidence-based treatment guidelines specifically designed for the pediatric population. Full article

Background and Objectives: The masseteric nerve (Mn) is increasingly used for facial reanimation because of its reliable location, high axon count, low donor morbidity, and favorable clinical outcomes. Precise topographic knowledge of the Mn relative to reproducible intraoperative landmarks is essential for safe dissection. This study investigated the intramuscular position of the Mn relative to two defined reference lines. Materials and Methods: Seventy-two hemicrania from 36 individuals (aged 54–99 years) embalmed postmortem using the Thiel method were examined. Measurements were referenced to two defined anatomical lines: the angle–canthus line (ACL), extending from the mandibular angle to the lateral canthus of the eye, and the articular eminence line (AEL), extending from the articular eminence to the base of the zygomatic temporal process. Results: The Mn crossed the ACL at an average distance of 39.9 ± 5.9 mm from the mandibular angle with up to four branches. The first intramuscular branch arose 15.6 ± 4.7 mm superior to the ACL. The Mn was located 4.9 ± 1.9 mm anterior to the articular eminence and 4.7 ± 1.5 mm inferior to the AEL, coursing at an average angle of 68.5 ± 11.6° to the AEL. The AEL and ACL provide reliable and clearly defined reference lines for locating the Mn and improve intraoperative reproducibility. The Mn followed a predictable oblique course and was consistently identified in the masseter muscle (Mm) beneath an intramuscular aponeurosis. Nerve diameter varied by site, underscoring the need for standardized measurement locations. Distal localization along the ACL may enable preservation of early intramuscular branches and reduce donor morbidity. Further studies should evaluate axon counts at defined points and clarify the relationship of the Mn to the masseteric artery for better intramuscular orientation during dissection. Conclusions: The Mn can be located within a 63 mm² area beneath the AEL at the masseter entry and more distally on the ACL. ACL-based access may protect the first intramuscular branch of the Mn and the temporal branch of the facial nerve (TBFN), and it represents a potential alternative for smile reconstruction for patients with preserved eye closure. Full article