Search Results (3,387)

The COVID-19 pandemic compelled higher education to resort to e-learning, posing new challenges to the teaching/learning of pharmacy students worldwide. While digital learning provided flexibility, diverse technological infrastructure and institutional availability of resources greatly influenced the student experience. This scoping review aims to assess the perceptions relating to the pivot to e-learning among pharmacy students in the League of Arab States due to the COVID-19 pandemic and how the shift affected student engagement, learning outcomes, and institutional preparedness. Following PRISMA-ScR guidelines, a comprehensive search across ten databases was conducted to identify relevant studies published between January 2020 and December 2025. Forty studies satisfied the inclusion criteria. Pharmacy students in this region responded to the transition to e-learning in diverse ways. While most appreciated the convenience of online modalities, several challenges were consistently enumerated. These were limited technological infrastructure, reduced interpersonal interaction, and disruption of hands-on practical training. Blended learning approaches were largely favored, particularly for their ability to marry online theoretical instruction with face-to-face experiential learning. Reliability and validity issues of internet-based tests were felt by both faculty and students. Stress and mental health problems among students surfaced. Student complaints in general depicted pharmacy education’s need for pedagogic reform, better infrastructure, and student mental health services during e-learning. Areas identified from this review are instructional technology infrastructure improvement, adopting a blended learning strategy, and the need to consider the mental health of students learning at a distance. Full article

Personal growth is a central aspect of development and well-being during young adulthood, yet sexually diverse and gender-diverse (SGD; a more inclusive term for LGBTQ+) young adults navigate this process within unique contexts shaped by identity, stress, and varying levels of social support. Despite growing visibility and social recognition of SGD identities in the United States, SGD individuals continue to face prejudice and discrimination, which negatively affects their physical and psychological health. Research indicates that stigmatized and marginalized populations with greater psychosocial resources are better able to cope with identity-related stressors. Yet, scholarship on coping with stigma and discrimination remains largely disconnected from research on social support, personal growth, and thriving within close relationships. The present observational study of SGD young adults (N = 400) examines how identity-affirming support from close others contributes to positive well-being outcomes, specifically personal growth, self-concept clarity, and thriving. Whereas much prior work focuses on how support buffers stress, we examine its role across stressors and opportunities for growth, experienced broadly and in relation to SGD identity. Our findings underscore the critical role that close relationships play in fostering social safety and personal growth for SGD young adults navigating identity development. Full article

Objective: To map the scientific evidence and identify knowledge gaps regarding the health of Black and Sexual and Gender Minority populations within the global context of health education. Introduction: Health education curricula should explicitly recognize, define, and address the specific needs and health disparities affecting Black and Sexual and Gender Minority populations to ensure that healthcare provision is comprehensive and inclusive in diverse settings. Eligibility criteria: Studies related to professional health training at undergraduate and graduate levels, as well as other educational modalities addressing healthcare provision for Black and Sexual and Gender Minority populations, were included. Methods: This scoping review was conducted following the JBI methodology. Studies were retrieved from Scopus, Web of Science, PubMed, Embase, MEDLINE, Virtual Health Library, CINAHL, ERIC, Cochrane Library, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations & Theses Global, EBSCO databases, and the Networked Digital Library of Theses and Dissertations, without language or time restrictions. Two independent reviewers screened the studies and extracted data using a standardized form developed for this review. Concepts, definitions, structures, results, and applications of professional health education for the care of Black and Sexual and Gender Minority populations were systematically synthesized. The results were organized and presented in tabular and graphical formats, accompanied by a narrative summary. Results: A total of 104 studies were included. The evidence was predominantly concentrated in North America, particularly in the United States, with limited representation from other regions. Most studies were published after 2020, indicating a recent expansion of research interest. The methodological profile was characterized by a predominance of quantitative and descriptive designs, alongside qualitative and mixed-methods approaches. Thematic analysis revealed a concentration of studies addressing gender-affirming care, workforce diversity, social determinants of health, and discrimination, while intersectional approaches and long-term educational outcomes remained less explored. Conclusions: The available evidence indicates that health education has increasingly incorporated themes related to equity and diversity; however, the integration of structured and mandatory curricular approaches addressing the intersectional health needs of Black and Sexual and Gender Minority populations remains limited. The findings highlight the need for broader geographic representation, stronger methodological designs, and the development of comprehensive educational strategies capable of addressing structural inequalities within health training contexts. Full article

Curcumin (Cur), a polyphenol with excellent antioxidant and anti-inflammatory properties, is widely used in aquaculture. However, its low water solubility limits bioavailability. This study first investigated the effects of a highly water-soluble and bioavailable valine-curcumin (Val-Cur) on growth performance, antioxidant capacity, inflammatory factor expression and gut microbiota in juvenile largemouth bass. A total of 450 healthy largemouth bass (initial weight 12.00 ± 0.45 g per fish) were randomly divided into six groups: the basal diet group (CK), the group supplemented with 60 mg/kg of curcumin (Cur), and groups that were fed with 15, 30, 60, and 120 mg/kg of Val-Cur. Each group had three replicates (25 fish per replicate). After 8 weeks, compared with both the CK and Cur groups, 30–60 mg/kg Val-Cur displayed significantly increased growth rates, specific growth rates, and protein conversion efficiency, and significantly decreased the feed conversion ratio. Quadratic regression analysis indicated that the optimal supplementation level was approximately 51.62 mg/kg Val-Cur. The Cur and Val-Cur between 30 and 60 mg/kg groups also displayed significantly improved serum biochemical indicators (↑HDL-C, ALB, LZM, CAT and SOD, and ↓MDA). These groups also promoted the expression of intestinal anti-inflammatory factors (TGF-β1 and IL-10) and physical barrier genes (Claudin1, Occludin and Claudin4). In terms of regulating the intestinal microbiota, both Cur and Val-Cur significantly reduced the bacterial diversity (↓Sobs, Chao1 and PD indices) and increased the evenness of bacterial distribution (↑Simpson, Shannon and Pielou indices). In addition, the abundance of some potential pathogens (e.g., Plesiomonas, Plesiomonas shigelloides, and Pseudomonas fluorescens) significantly decreased, while the abundance of beneficial bacteria (e.g., Faecalibaculum, Faecalibaculum rodentium and Lactobacillus murinus) significantly increased. Pearson’s correlation analysis showed that the increase in the abundance of beneficial bacteria was positively correlated with improvement in growth performance, serum biochemical and antioxidant capacity indicators. In summary, Val-Cur exerted superior biological effects at lower dietary inclusion levels than Cur. This study laid a theoretical foundation for elucidating the mechanism of Val-Cur in improving fish immunity and promoting the application of water-soluble curcumin in aquaculture. Full article

Two growth trials were conducted to evaluate the effects of solvent-extracted soybean meal (SBM), low-oligosaccharide soybean meal (LO-SBM), and enzyme-treated soybean meal (ET-SBM) on the growth performance, feed utilization, and gut microbiome of the Pacific white shrimp (Litopenaeus vannamei). Nine diets were tested, including a basal diet using solvent-extracted soybean meal as the main protein source. The solvent-extracted soybean meal was then replaced with LO-SBM or ET-SBM at 40%, 60%, 80%, and 100% on an isonitrogenous and isolipidic basis. In the 8-week outdoor green water trial, all growth metrics, FCR and apparent net protein retention (ANPR) showed no significant differences among diets (p > 0.05). However, there was a significant effect of LO-SBM on phosphorus retention. In the clear water trial, intermediate inclusion levels of LO-SBM (60–80%) slightly improved growth metrics and phosphorus retention (p < 0.05) without affecting protein utilization, while 100% LO-SBM did not provide additional benefits. Diets with ET-SBM showed similar performance; however, phosphorus retention was reduced. Diets did not affect whole-body composition (p > 0.05), except for phosphorus and moisture. Gut microbiota analysis revealed that shrimp fed 100% ET-SBM had notably higher alpha diversity (Shannon index = 5.45, observed species = 326.41) compared to those fed 100% LO-SBM (Shannon index = 4.59, observed species = 242.69), indicating improved microbial stability with ET-SBM. Nonetheless, there were no significant differences in beta diversity or taxonomic composition between treatments (p > 0.05). This study demonstrates that incorporating 60–80% LO-SBM into the diet improves shrimp growth and nutrient utilization. Additionally, ET-SBM may also support shrimp growth, nutrient efficiency, and microbial diversity, suggesting that both LO-SBM and ET-SBM can be beneficial for shrimp nutrition. Full article

Background: Early feeding practices are among the most influential determinants of the infant oral microbiota during the first years of life. Breastfeeding provides bioactive components—immunoglobulins, human milk oligosaccharides (HMOs), and commensal bacteria—that may shape microbial colonisation patterns with long-term implications for oral health. However, the nature, magnitude, and clinical relevance of these effects remain poorly characterised, particularly with regard to early childhood caries (ECC) risk. Objectives: The primary objective was to evaluate the association between early feeding practices and oral microbiota composition during infancy. A secondary exploratory objective was to assess whether feeding-associated microbiota differences had been linked to subsequent dental caries outcomes. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Scopus, Web of Science, and Embase were searched from January 2010 to June 2026. Eligible studies compared at least two feeding groups and measured oral microbiota directly using culture-independent methods (16S rRNA gene sequencing, metagenomics, or quantitative PCR targeting multiple taxa). Study selection, data extraction, and risk of bias assessment using the ROBINS-E tool were performed independently. Qualitative synthesis was conducted given clinical and methodological heterogeneity. Results: Of 8582 records identified, 12 studies met the inclusion criteria (sample size range: 12–448 participants; age range at microbiota assessment: 2 days–14 years, although eligibility was based on feeding exposure during infancy; six countries). Most included studies reported differences in oral microbiota composition associated with feeding type. During the first months of life, breastfed infants generally showed lower oral microbial diversity and higher abundance of Lactobacillus, the Streptococcus mitis group and Bifidobacterium compared with formula-fed infants, who exhibited greater alpha diversity, higher transmission of maternal oral bacteria, and higher abundance of Prevotella and Actinomyces. Effects were most pronounced in the first three months of life and attenuated by 12 months in most cohorts. Only one study reported subsequent dental caries outcomes after early-life microbiota assessment, finding that Streptococcus cristatus abundance at three months was associated with dental caries at nine years of age, and that longer breastfeeding duration (≥12 months) was associated with a distinct microbiota profile and lower caries rates in this single available longitudinal study. Risk of bias was low in two studies, moderate in six, and high in four. Publication bias could not be formally evaluated. Conclusions: Early feeding practices are associated with measurable differences in oral microbiota composition during infancy, particularly during the first months of life. However, evidence linking these microbiota differences to subsequent dental caries outcomes remains extremely limited, with only one included study assessing later caries development. Therefore, the clinical significance of feeding-associated microbiota profiles remains uncertain and should be investigated through well-designed prospective longitudinal studies. Full article

(1) Background: Adolescents’ appraisals of family relationships play an important role in bridging family dynamics and maladaptive behavior in various contexts. However, the mechanism of adolescents’ appraisals remains unclear. This review aims to map the state of the art about adolescents’ appraisals of family relationships in intact family contexts from the existing global literature. (2) Methods: The article collection was performed in accordance with the PRISMA guideline and screening articles from 5 sources. Two reviewers independently screened to obtain 10 reported articles that met the inclusion criteria. (3) Results: Analyses identified that 90% of the previous study involved adolescents aged 8–19 years from the United States (USA) and predominantly White. The majority of the samples were also identified from middle to upper class socioeconomic status (n = 6), and relatively low conflict family structure (n = 5). The most commonly used variable term of adolescents’ appraisal was interparental conflict (IPC) appraisals (n = 7), and the Cognitive Contextual Framework (CCF) by Grych et al. was used as a theoretical framework. (4) Conclusions: Based on a global literature review, the findings of this review are limited, based on age, race, socioeconomic status, family structure, and certain geographical locations. The limited range of samples may affect the sensitivity of the theoretical framework and measurement tools in capturing variations in adolescents’ appraisals of family relationships in intact family contexts. Furthermore, the generalizability of these findings may be limited. Accordingly, future studies are encouraged to replicate the present research using larger samples from diverse ages, cultural and socioeconomic status, and family structure backgrounds. Future researchers could further advance this research area by incorporating a wider variety of theoretical perspectives, methodological approaches, and measurement instruments to promote the future health and well-being of adolescents. Full article

Background/Objectives: Borderline personality disorder (BPD) is a severe mental disorder characterised by emotion dysregulation, impulsivity and interpersonal hypersensitivity. Its prevalence ranges from 0.5% to 6.4%. Eye tracking and pupillometry provide objective indices of social attention and inhibitory control, but the BPD literature using these techniques has not been systematically reviewed. The aim of this work was to synthesise the empirical evidence on visuo-attentional and pupillary alterations in BPD. Methods: Following the PRISMA 2020 statement, Web of Science, Scopus and PubMed were searched up to 13 March 2026, with no date or language restrictions. Search terms combined borderline personality disorder and eye-tracking constructs. Two reviewers independently screened records with complete inter-rater agreement at the title-and-abstract stage (Cohen’s κ = 1.00); two generative artificial-intelligence assistants (ChatGPT, NotebookLM) were additionally consulted as a non-systematic plausibility check and returned no eligible studies beyond the database search. Risk of bias was appraised with the framework appropriate to each study design (RoB 2 for randomised trials and Newcastle–Ottawa Scale logic for observational studies, with ROBINS-I held in reserve for non-randomised intervention designs). Results: Seventeen studies met the inclusion criteria, with sample sizes ranging from 19 to 164 participants and predominantly adult female samples. Designs included antisaccade and oculomotor tasks, free-viewing, dot-probe, affective priming and pharmacological challenge. Four findings recurred across studies. First, patients with BPD showed an early reflexive vigilance to the eye region of emotional and neutral faces, followed by reduced time on positive stimuli during longer presentations. Second, self-reported impulsivity was elevated, but laboratory inhibition was largely preserved; the deficits that did emerge were limited to preparatory control and were greater in patients with comorbid ADHD or under induced negative affect. Third, autonomic dysregulation was indexed by lower heart-rate variability and a larger baseline pupil size; in a single longitudinal study, pupillary reactivity was prospectively associated with subsequent symptom change. Finally, intranasal oxytocin reduced amygdala-driven vigilance. Conclusions: Eye-tracking and pupillometric measures appear to capture meaningful aspects of the BPD clinical picture. The two-stage profile of early vigilance followed by reduced sustained engagement is most parsimoniously described as a vigilance–avoidance pattern, which is compatible with, but not uniquely explained by, the hypersensitivity hypothesis of emotion dysregulation. Because thirteen of the seventeen studies recruited women only, these conclusions apply primarily to adult women with BPD. Methodological heterogeneity, the predominance of female samples and the scarcity of longitudinal data justify the need for standardised protocols, transdiagnostic comparisons and the inclusion of male and gender-diverse populations in future research. Full article

Background: Suryanamaskar (Sun Salutation) is a dynamic sequence of yoga that incorporates movement, breath and mindfulness, and is known for its many potential multidimensional health benefits. Despite the increasing volume of research, a comprehensive and domain-specific synthesis examining the multidimensional effects of Suryanamaskar and yoga-based interventions incorporating Suryanamaskar remains limited. Hence, the present study was designed to systematically review and synthesize the existing evidence related to the effects of Suryanamaskar and yoga-based interventions using Suryanamaskar sequence on various populations and outcome domains. Methods: This systematic review was conducted in accordance with the PRISMA 2020 statement and Cochrane Handbook recommendations. Literature searches were performed in PubMed, Scopus, Web of Science, and Google Scholar from database inception to 31 December 2025. Studies involving human participants and Suryanamaskar-based interventions reporting measurable physical, physiological, or psychological outcomes were included. Fourteen studies met the eligibility criteria. Study characteristics, intervention protocols, and outcome measures were extracted. Risk of bias was assessed using RoB 2 for randomized studies and ROBINS-I for non-randomized studies. Due to substantial heterogeneity, findings were synthesized narratively. Results: A total of 14 studies met the inclusion criteria. Overall, Suryanamaskar and yoga-based interventions incorporating Suryanamaskar were associated with improvements in physical fitness, physiological health, psychological well-being, and body composition across diverse populations. Most included studies reported favourable changes in physical fitness, physiological, psychological, and body-composition outcomes; however, the magnitude and consistency of findings varied substantially across study designs, participant populations, intervention protocols, and outcome measures. Conclusions: Promising but heterogeneous evidence suggests that Suryanamaskar and yoga-based interventions incorporating Suryanamaskar may contribute to improvements in physical fitness, physiological function, psychological well-being, and body composition across diverse populations. However, these findings should be interpreted with caution because of variability in study designs, intervention protocols, participant characteristics, and risk of bias. Although Suryanamaskar appears to be a practical, low-cost, and holistic intervention with potential applications in educational, sports, and health-promotion settings, further high-quality randomized controlled trials with standardized protocols and larger sample sizes are required to strengthen the evidence base. Full article

Background: The early or latent phase of labour (early labour) is a time when women feel unsupported and have limited access to quality midwifery support, often being advised to stay at home. As a result, women seek online information and often turn to hospital websites as a trusted source of this information. Women from underserved and marginalised groups may be particularly reliant on online information. The aim of this study was to systematically evaluate the availability, accessibility, content, and evidence base of online early labour information provided by UK hospitals, with a focus on inclusivity, and equity in information provision. Methods: A systematic search of NHS and HSC maternity websites across the UK (England, Scotland, Wales, and Northern Ireland) was undertaken to identify publicly available guidance on early labour. Eligible materials included webpages, downloadable leaflets, and multimedia resources. The identified guidance was evaluated in terms of availability, accessibility, content, and transparency of evidence. Data were synthesised descriptively and presented using narrative summaries and tables. Results: A total of 146 hospital websites were reviewed, of which 72 (49%) provided guidance specific to early labour or included a dedicated section on the latent phase. There was marked variation in availability, accessibility, and content. Accessibility was often limited, with few multilingual resources, alternative formats, or inclusive visual materials. Most guidance was text-heavy, with minimal use of multimodal or user-friendly formats and limited representation of diverse populations. Clinical content also varied, particularly in definitions of early labour and recommendations for pain management. Only a minority of resources referenced supporting evidence. Conclusions: Online early labour information provided by UK maternity services varies in availability, accessibility, and inclusivity, raising important equity concerns. Limitations in accessibility, consistency, and transparency of evidence may contribute to disparities in understanding and decision-making, particularly among women from disadvantaged or marginalised groups. There is a clear need for standardised, evidence-based, and inclusive information that is accessible to diverse populations to support equitable maternity care during early labour. Full article

Background: Chemsex, or sexualized drug use, exists along a continuum ranging from non-problematic, consensual recreational practice across diverse populations to problematic behaviors linked with clinical vulnerabilities, substance dependence, or compulsive disorders. Within nursing practice, understanding this spectrum is essential to mitigate healthcare-related stigma. Objective: To map and synthesize evidence on stigma and attitudes among nurses regarding chemsex, identifying implications for practice and research. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Searches were performed across PubMed/MEDLINE, Scopus, Web of Science, CINAHL, EMBASE, and LILACS. Studies involving nurses or healthcare teams focused on stigma, attitudes, or related constructs in chemsex care were included. Data underwent descriptive and thematic synthesis. Results: Six studies met the inclusion criteria, showing substantial heterogeneity. Only one focused exclusively on nurses. Stigma and attitudes were rarely assessed explicitly, emerging instead as underlying factors influencing clinical practice, communication, and patient engagement. Key themes included the necessity for non-judgmental care, significant gaps in knowledge and training, variability in clinical practice, and the impact of organizational barriers. A schematic representation was developed to illustrate the interrelationships between stigma, knowledge, professional attitudes, and structural factors influencing healthcare practice. Conclusions: This review positions stigma as a central mechanism influencing nursing care in chemsex contexts. The findings underscore critical gaps in nursing-specific evidence and emphasize the need for targeted training, validated measurement tools, and integrated care models. Strengthening stigma-informed, patient-centered approaches is essential to improve care delivery and health outcomes for this population. Full article

As a city rich in historical and cultural heritage, Guangzhou has made substantial efforts to protect and revitalise its historic districts. This study examines Yongqing Fang, a well-known commercialised historic district in Guangzhou, to understand how tourism-driven development reshapes everyday life and the interactions among its diverse users. Using comparative analysis, interviews, and NVivo 12 coding, the research explores how longstanding residents and newer occupants adjust to the rapidly evolving environment. The findings reveal that urban renewal and commercialisation have undermined local culture and social networks, altering how spaces are used. While lifestyle differences are evident among different user groups, the study also highlights instances of alienation and conflict, as well as moments of positive interaction and mutual support. The research emphasises the importance of inclusive strategies in heritage renewal and raises the question, drawing attention to the challenges faced by marginalised users in commercialised historic districts. It offers recommendations for policymakers, urban planners, and other stakeholders to balance heritage preservation with the social and economic needs of communities, fostering sustainable integration of tourism and local life in historic districts. Full article

The expansion of ruminant production has increased methane (CH₄) emissions, highlighting the need for nutritional strategies that improve productivity while mitigating environmental impacts. Yaks, generally considered low CH₄ producers, are increasingly raised under intensive winter-housed systems on the Qinghai–Xizang Plateau, highlighting the need to assess how dietary concentrate-to-forage (C:F) ratios affect both CH₄ emissions and growth performance. This study investigated the effects of three dietary C:F ratios [L-C (48:52), M-C (60:40), H-C (72:28)] on growth performance, ruminal fermentation, microbial diversity (n = 6 per group) and CH₄ emission (n = 3 per group) in winter-housed yaks. The results indicated that average daily gain (ADG) was significantly higher in M-C and H-C, while the feed-to-gain ratio (F/G) was significantly lower in M-C and H-C than in L-C (p < 0.05). Total CH₄ production (g/day) did not differ among treatments (p > 0.05), while CH₄ yield per unit body weight gain (CH₄/BWG) was significantly reduced in M-C and H-C (p < 0.05). The protozoal count was significantly lower in H-C, and the proportions of isobutyrate and isovalerate were significantly higher in H-C and M-C compared with L-C (p < 0.05). 16S rRNA gene sequencing revealed that increasing the C:F ratio reduced the relative abundance of the archaeal genus Methanobrevibacter, while Thermogymnomonas exhibited a significant increase (p < 0.05). Collectively, these findings indicate that increasing the C:F ratio in winter-housed yaks improves growth efficiency and lowers CH₄/kg BWG, with the M-C group showing the most favorable balance between productivity and environmental sustainability. Full article

This study proposes an integrated model examining the relationship between teacher educators’ digital proficiency and the frequency of their pedagogical use of digital tools. By promoting long-term capacity-building in digital competence, the model contributes to sustainable development goals in education, particularly in ensuring inclusive, equitable, and high-quality learning environments. The study involved 156 faculty members from five teacher-training colleges in Israel. Digital proficiency was measured using a validated self-assessment questionnaire adapted from the SELFIE framework (Self-Reflection on Effective Learning by Fostering the Use of Innovative Educational Technologies). The questionnaire assessed perceived competence across three dimensions: (1) filtering and enhancing digital resources, (2) assessment, feedback, communication, and active learning, and (3) adaptive and creative learning. A second questionnaire examined how frequently educators used specific digital tools across four categories: collaboration, diversity and special needs, active and creative learning, and distance and hybrid learning. Data were analyzed using Item Response Theory (IRT) to generate proficiency scores and Structural Equation Modeling (SEM) to test associations. Results indicated moderate overall digital proficiency, with stronger competence in collaboration and communication and lower use of tools related to personalization and creativity. Significant positive associations were found between digital proficiency and all categories of tool use, especially creative and student-centered learning. Use also varied by gender, seniority, and professional role. The study underscores the importance of pedagogically informed professional development to support meaningful and inclusive digital integration. Full article

The proliferation of generative artificial intelligence (GenAI) has precipitated an urgent, global reassessment of how higher education evaluates critical thinking, creative agency, and academic integrity. However, scholarly and institutional responses remain fragmented across cultural contexts, impeding the development of robust, flexible, and discipline-adaptable assessment frameworks. Responding to the imperative to move beyond the traditional standardized assessment paradigm, this study conducts a comparative discourse analysis of 5368 academic articles in Anglophone/Western scholarly discourse (Web of Science, WoS) and Chinese (CNKI). Using LDA topic modeling and Word2Vec-enhanced semantic analysis, the study identifies two divergent orientations: an Anglophone/Western discourse that frames AI as an instrument for cognitive augmentation, efficiency optimization, and functional human–AI collaboration; and a Chinese discourse that emphasizes epistemic sovereignty, the reconstruction of creative subjectivity, and systemic institutional rebuilding against technological alienation. These pathways are mapped onto a tripartite framework of Tools, Creative Subjectivity, and Organizational Ecosystems. The findings demonstrate that AI integration is culturally embedded rather than technically determined, carrying profound implications for assessment validity, academic integrity policy, and equitable access to AI-enhanced learning. The study synthesizes these insights into a culturally responsive assessment framework that redirects evaluation from standardized, product-centric outputs toward process-oriented, transparent, and ethically governed human–AI co-authorship. By centering critical autonomy, AI literacy, and epistemological diversity, this framework offers actionable strategies for inclusive assessment redesign, institutional policy development, and sustainable competency cultivation in the GenAI era. Full article