Search Results (2,312)

Computational Thinking (CT) has been an important concept for the computer science education community in the last 20 years. In this work we performed a systematic review of the literature regarding the computational thinking of children from kindergarten to primary school. We compiled a large dataset of one hundred and twenty (120) studies from the literature. Through analysis of these studies, we tried to reveal important insights and draw interesting and valid conclusions. We analyzed various qualitative and quantitative aspects of the studies, including the sample size, the year of publication, the country of origin, the studies’ design and duration, the computational tools used, and so on. An important aspect of the work is to highlight differences between different study designs. We identified a total of 120 studies, with more than half of them (>50%) originating from Asian countries. Most studies (82.5%) conducted some form of intervention, aiming to improve their computational thinking in students. A smaller proportion (17.5%) were assessment studies in which the authors conducted assessments regarding the children’s computational thinking. On average, intervention studies had a smaller number of participants, but differences in duration could not be identified. There was also a lack of large-scale longitudinal studies. Block-based coding (i.e., Scratch) and Plugged and Unplugged activities were observed in high numbers in both categories of studies. CT assessment tools showed great variability. Efforts for standardization and reaching a consensus are needed in this regard. Finally, robotic systems have been found to play a major role in interventions over the last years. Full article

Mitochondria play a crucial role in adapting to fluctuating energy demands, particularly in various heart diseases. In addition to functional analyses such as the measurement of ROS or ATP, analysis of mitochondrial ultrastructure can be used to draw further conclusions about their functions and effects in tissue. In this protocol, we introduce a set of measurements to compare the ultrastructural and functional characteristics of human left ventricular mitochondria, using transmission electron microscopy (TEM). Measured parameters included mean size in µm², elongation, count, percental mitochondrial area in the measuring frame, and a conglomeration score. We also introduce a novel method of defining hydropic mitochondria as a comparable evaluation standard. With this cluster of measurement parameters, we aim to contribute a protocol for studying human mitochondrial morphology, distribution, and functionality. Full article

Background/Objectives: Conventional blood collection can be challenging in a non-clinical or home-based setting. In response, vacuum-assisted lancing devices for capillary blood collection (typically from the upper arm) have gained popularity to broaden access to diagnostic testing. However, these devices are often costly relative to the reimbursement rate for common laboratory testing panels. This study describes the design and evaluation of Comfort Draw™, a simplified and economical vacuum-assisted capillary blood collection device. Methods: Comfort Draw™ was evaluated by 12 participants in a preliminary study and by 42 participants in a follow-up study. Metrics assessed included the following: vacuum pressure of the device, skin temperature generated by the Comfort Draw prep warmer, blood collection volume, and analytical accuracy (for 19 common serum-based analytes). Results: Acceptable blood volume (>400 µL) and serum volume (>100 µL) were collected by Comfort Draw in 85.5% and 95.1% of cases, respectively. Seventeen of the nineteen analytes examined were within CLIA acceptance limits compared to matched venous samples. Self-reported pain scores associated with Comfort Draw collection averaged 0.39 on a scale from 0 to 10. Conclusions: In this preliminary clinical study, Comfort Draw was found to be a valid and relatively painless method for collecting capillary blood specimens. The device’s simple design and lower cost could enable broader applications compared to more complex alternative capillary blood collection devices. Full article

Background: Hypoxic–ischemic encephalopathy (HIE) is a leading cause of severe neurological impairments in childhood. Therapeutic hypothermia (TH) is both safe and effective in neonates born at ≥36 weeks gestation with moderate to severe HIE. We aimed to evaluate short-term outcomes—including brain injury detected on magnetic resonance imaging (MRI)—in infants born at 34–35 weeks of gestation drawing on our clinical experience with neonates under 36 weeks of gestational age (GA). Methods: In this retrospective cohort study, 20 preterm infants with a GA of 34 to 35 weeks and a matched cohort of 80 infants with a GA of ≥36 weeks who were diagnosed with moderate to severe HIE and underwent TH were included. Infants were matched in a 1:4 ratio based on the worst base deficit in blood gas and sex. Maternal and neonatal characteristics, brain MRI findings and short term outcomes were compared. Results: Infants with a GA of 34–35 weeks had a lower birth weight and a higher rate of caesarean delivery (both p < 0.001). Apgar scores, sex, intubation rate in delivery room, blood gas pH, base deficit and lactate were comparable between the groups. Compared to infants born at ≥36 weeks of GA, preterm neonates were more likely to receive inotropes, had a longer time to achieve full enteral feeding, and experienced a longer hospital stay. The mortality rate was 10% in the 34–35 weeks GA group. Neuroimaging revealed injury in 66.7% of infants born at 34–35 weeks of gestation and in 58.8% of those born at ≥36 weeks (p = 0.56). Injury was observed across multiple brain regions, with white matter being the most frequently affected in the 34–35 weeks GA group. Thalamic and cerebellar abnormal signal intensity or diffusion restriction, punctate white matter lesions, and diffusion restriction in the corpus callosum and optic radiations were more frequently detected in infants born at 34–35 weeks of gestation. Conclusions: Our study contributes to the growing body of literature suggesting that TH may be feasible and tolerated in late preterm infants. Larger randomized controlled trials focused on this vulnerable population are necessary to establish clear guidelines regarding the safety and efficacy of TH in late preterm infants. Full article

Background and Objectives: Rumors, disinformation, and fake news are problems of contemporary society. We live in a world where the truth no longer holds much importance, and the line that divides the truth from lies, between real news and disinformation, becomes increasingly blurred and difficult to identify. The purpose of this study is to describe this concept, to draw attention to one of the “pandemics” of the 21st-century world, and to find methods by which we can defend ourselves against them. Materials and methods. A cross-sectional study was conducted based on a sample of 442 respondents. Results. For 77.8% of the people surveyed, the concept of “fake news” is important in Romania. Regarding trust in the mass media, a clear dominance (72.4%) was observed among participants who have little trust in the mass media. Although 98.2% of participants detect false information found on the internet, 78.5% are occasionally deceived by the information provided. Of the participants, 47.3% acknowledged their vulnerability to disinformation. The main source of disinformation is the internet, as 59% of the interviewed subjects believed. As the best measure against disinformation, the study group was divided almost equally according to the three possible answers, all of which were considered to be equally important: imposing legal restrictions and blocking the posting of certain news (35.4%), imposing stricter measures for authors (33.9%), and increasing vigilance among people (30.5%). Conclusions. According to the statistics based on the participants’ responses, the main purposes of disinformation are propaganda, manipulation, distracting attention from the truth, making money, and misleading the population. It can be observed that the main intention of disinformation, in the perception of the study participants, is manipulation. Full article

Background: The quality of decision-making processes is increasingly recognized as critical to public trust and policy sustainability. Objectives: This narrative review aims to identify and describe process-focused decision support models (DSMs) applied in pharmaceutical policy, and to examine their potential contributions to improving procedural quality in decisions related to pricing, reimbursement, and access to medicines. Methods: Relevant peer-reviewed and gray literature published between 2000 and 2025 was considered, drawing from key databases (e.g., PubMed and Scopus) and international policy reports (e.g., WHO, ISPOR, and HTA agencies). Studies were included if they provided insights into DSMs addressing at least one dimension of decision process quality. Results: Findings are synthesized narratively and organized by tool type, application context, and key quality dimensions. Frequently referenced tools included the Quality of Decision-Making Orientation Scheme (QoDoS), WHO-INTEGRATE, and AGREE II. QoDoS emerged as the only tool applied across regulatory, HTA, and industry settings, evaluating both individual- and organizational-level practices. WHO-INTEGRATE highlighted equity and legitimacy considerations but lacked a structured format. Overall, most tools demonstrated benefits in promoting internal consistency, transparency, and stakeholder engagement; however, their adoption remains limited, especially in low- and middle-income countries. Conclusions: Process-focused DSMs offer promising avenues for enhancing transparency, consistency, and legitimacy in pharmaceutical policy. Further exploration is needed to standardize evaluation approaches and expand the use of DSMs in diverse health systems. Full article

Background: Aortic stenosis (AS) has long been considered a degenerative disease and is typically diagnosed in older men at an advanced stage. However, accumulating evidence has highlighted the similarities between AS and atherosclerosis, particularly regarding shared risk factors and overlapping pathophysiological mechanisms. This connection has led to a paradigm shift, suggesting that AS may be preventable in its early stages. Methods: This narrative review synthesizes the existing literature exploring the parallels between AS and atherosclerosis, focusing on common risk factors, pathogenic pathways, and evolving therapeutic strategies. Clinical trials and translational studies were examined to assess the effectiveness of atherosclerosis-based treatments for AS. Results: Multiple studies have confirmed the shared inflammatory, lipid-mediated, and calcific mechanisms of AS and atherosclerosis. Despite these similarities, therapeutic strategies effective in atherosclerosis, such as statin therapy, have not consistently shown benefits in AS. New medical approaches aim to delay aortic valve replacement and reduce the associated morbidity. The partially overlapping pathogenesis continues to guide future research. Conclusions: While AS and atherosclerosis share several pathogenic features, their clinical courses and treatment responses diverge. Understanding the limits and potential of their overlap may inform future preventive and therapeutic strategies. Earlier detection and targeted intervention in AS remain key goals, drawing on insights from cardiovascular disease management. Full article

Background: The rehabilitative treatment of muscle injuries is mostly conservative, but it does not always follow precise protocols. Appropriate physiotherapy, exercises, and training are essential components of the rehabilitation and reconditioning of injured muscles. The purpose of this review is to assess the good rehabilitative practices in the treatment of patients affected by muscle injuries. Methods: We performed research on Medline and Cochrane Database. Guidelines focusing on the rehabilitative treatment of muscle injuries were evaluated for inclusion. Statements about non-rehabilitative treatments were also reported only for the guidelines that mainly focused on rehabilitative treatments. Results: Eight guidelines meeting the inclusion criteria were included in the review. Results were framed into a narrative overview. Two of them mainly focused on hamstring rehabilitation, the others focused on several muscular districts. Conclusions: Conservative treatment of muscle injuries is currently the gold standard, with good results in terms of both rehabilitation times and post-injury sports performance. However, there is not a complete agreement on the type of exercises and the timing of rehabilitation when these should be performed. More research is needed to draw conclusions about the use of physical therapy instruments and other rehabilitation approaches and techniques. Full article

The article describes examples of reliability models of a renewable technical object. The proposed models are mathematical models that, according to the author, are best suited to presenting problems resulting from the operation of the analyzed technical objects. These objects are special vehicles, in this case garbage trucks with plate compaction and rear loading of waste containers. The author described two models: one where a model was analyzed and the replacement of a worn part with a brand new part was assumed, and a model where the worn element was repaired (renewed), so that after the repair, the element showed features as if it were a brand new element. Each of the examples was considered based on operational data from city cleaning companies. Data obtained from service books was used for calculations. The analyzed examples are concluded with short conclusions. In turn, the entire article ends with a summary in the form of conclusions resulting from the use of these specific models. The author draws attention to the reasonableness of their use in the scope analyzed by him, and the benefits that result from the use of these models. Full article

In the context of pursuing the goal of strategic imperatives of sustainable development, the ESG performance of enterprises has become a key yardstick for measuring their comprehensive environmental contribution and economic efficiency. Enhancing ESG performance has far-reaching significance in promoting green and sustainable development of enterprises and society. Drawing on the upper echelons theory, this paper investigates the impact of the chief executive officer’s (CEO’s) green experience on corporate environmental, social, and governance (ESG) performance, utilizing a sample of publicly listed Chinese companies from 2011 to 2023. The study demonstrates that CEOs with green experience significantly enhance corporate ESG performance, a conclusion that remains consistent following a series of rigorous robustness checks. Mechanistic analysis reveals that CEOs’ green experience primarily facilitates corporate ESG performance enhancement through green innovation initiatives. Furthermore, CEO discretion amplifies the positive influence of green experience on ESG performance. Heterogeneity analysis demonstrates that the influence of the CEOs’ green experience on ESG performance is more pronounced in high-tech enterprises, in markets characterized by lower levels of competition, and in firms situated in regions exhibiting higher degrees of social trust. These findings impart both theoretical and practical implications for enhancing corporate ESG performance and offer novel strategic perspective to advance environmental stewardship, social responsibility, and corporate governance frameworks. Full article

Background: Sustainability in supply chain management (SCM) practices is becoming increasingly important as environmental responsibility and social concerns, as well as enterprises’ competitiveness in terms of innovation, risk, and economic performance, become increasingly urgent. This paper aims to identify and prioritize concepts for implementing sustainable supply chains, drawing on sustainable supply chain management (SSCM) and green supply chain management (GSCM) techniques. Corporate supply chain managers across various industries, markets, and supply chain segments brainstormed management practices to enhance the sustainability of their supply chains. Four industry sectors were surveyed across five different value chain segments. Methods: A group concept mapping (GCM) approach incorporating multi-dimensional scaling (MDS) and hierarchical cluster analysis (HCA) was used. A hierarchy of practices is proposed, and hypotheses are developed about achievability and impact. Results: A decision-making matrix prioritizes eight solution concepts based on two axes: impact (I) and ease of implementation (EoI). Conclusions: Eight concepts are prioritized based on the optimal effectiveness of implementing the solutions. Pattern matching reveals differences between emerging and developed markets, as well as supply chain segments, that decision-makers should be aware of. By analyzing supply chains from a multi-part perspective, this research goes beyond empirical studies based on a single industry, geographic region, or example case. Full article

Background/Objectives: Cardiovascular diseases (CVDs) encompass a wide range of heart and vascular conditions and remain the leading cause of death worldwide. Acceptance and Commitment Therapy (ACT) is a psychotherapeutic approach that integrates acceptance, mindfulness, and commitment to value-based actions. This systematic review aims to explore the current evidence on the potential role of ACT interventions in supporting psychological well-being among individuals with CVDs. Methods: A systematic review was conducted in accordance with PRISMA guidelines. A search of the literature was conducted through Scopus, PubMed, Web of Science, Cochrane, and PsycINFO databases. Six studies met the inclusion criteria. Results: The reviewed studies suggest that ACT may promote psychological flexibility, emotion regulation, and self-care behaviors in patients with CVDs. Reported outcomes include improved mindfulness, reduced distress, and enhanced quality of life. However, the evidence base is limited in both size and methodological rigor, with included studies varying in design and population. Conclusions: While preliminary findings indicate that ACT shows promise in addressing psychological aspects of CVDs, the current evidence remains insufficient to draw definitive conclusions. Further high-quality, large-scale studies are needed to evaluate the effectiveness and clinical applicability of ACT in cardiovascular populations. Full article

This study introduces the concept of DEEPEIA, a novel deep learning (DL) platform designed to recommend the optimal export market, and its ideal foreign champion, for any product or service offered by a small and medium-sized enterprise (SME). Drawing on expertise in SME internationalization and leveraging recent advances in generative artificial intelligence (AI), this research addresses key challenges faced by SMEs in global expansion. A systematic review of existing platforms was conducted to identify current gaps and inform the conceptualization of an advanced generative DL recommender system. The Discussion section proposes the conceptual framework for such a decision optimizer within the context of contemporary technological advancements and actionable insights. The conclusion outlines future research directions, practical implementation strategies, and expected obstacles. By mapping the current landscape and presenting an original forecasting tool, this work advances the field of AI-enabled SME internationalization while still acknowledging that more empirical validation remains a necessary next step. Full article

Despite decades of intense interest and investment in cognitive science, there remains a not only incomplete but also highly inconsistent body of evidence regarding how adult brains recover from even the most focal injuries associated with stroke. In this paper, I provide a broad narrative review of the studies of post-stroke aphasia recovery that have sought to identify the mechanisms of language recovery through longitudinal functional imaging. I start with studies that used functional imaging in groups of neurotypical individuals that have revealed areas of the brain that are reliably activated by language tasks and are functionally connected, referred to here as the “language network.” I then review group studies in which functional imaging data were averaged across groups of people with post-stroke aphasia to characterize the neurobiology of recovery. These group studies of post-stroke aphasia have yielded very different results and have led to conflicting conclusions. Subsequently, I examine results of studies of single subjects that have employed longitudinal functional imaging to identify mechanisms of language recovery. Together, these single subject studies make it clear that mechanisms of neural recovery are far from uniform, even in people with very similar lesions and time since stroke. On this basis, I argue that it is not justifiable to average functional imaging data across individuals with post-stroke aphasia to draw meaningful insights into how brain networks change to support language recovery. Each individual’s brain networks change over time, but in divergent ways that depend on the extent of disruption to the normal language network, interventions to facilitate recovery, the health of the intact brain, and other variables yet to be identified. While averaging results across participants with post-stroke aphasia might be able to identify certain changes in the networks that are correlated with specific language gains, uncovering the range of mechanisms and dynamics of language recovery after stroke requires longitudinal imaging of individuals. Full article

Background: The most common female endocrinopathy is polycystic ovary syndrome (PCOS), affecting 10–20% of women of reproductive age. It is associated with a wide range of hormonal and biochemical abnormalities and long-term metabolic and cardiovascular risks. It is characterized by infertility due to chronic anovulation, hyperandrogenism, polycystic ovarian morphology, and is often associated with insulin resistance (IR) and obesity. Hyperinsulinemia further increases androgen production and reduces sex hormone-binding globulin (SHBG) levels, thereby aggravating symptoms. In addition, vitamin D deficiency is often present in PCOS patients, and increasing evidence suggests that it may also be associated with insulin resistance and hyperandrogenism. Objective: This study aimed to evaluate the relationships between insulin resistance, vitamin D deficiency, body mass index (BMI), and androgen levels in women with PCOS. Method: A cross-sectional study was conducted in which data from 195 women diagnosed with PCOS and not yet receiving therapy at a gynecologic endocrinology unit of a university-based tertiary clinical center, between 2019 and 2024, were analyzed. The parameters recorded were age, body mass index (BMI), 25(OH) vitamin D levels, androgen hormone levels (testosterone, androstenedione), glucose-insulin responses during a 3-point oral glucose tolerance test (OGTT). Statistical analyses, including linear regression, Pearson, and Spearman correlation tests were used to assess associations between variables. Results: The mean age of the patients was 24.8 years (18–42), and the mean BMI was 30.6 kg/m² (17–51). Vitamin D deficiency was observed in 84.1% of patients, hyperandrogenism in 45.8%, and insulin resistance in 44.5%. A significant inverse correlation was found between BMI and vitamin D levels (r = −0.31, p =< 0.01) indicating that higher BMI is associated with lower vitamin D status. Similarly, BMI also showed a significant negative correlation with SHBG levels (r = –0.45, p < 0.01), suggesting that increasing body weight is linked to reduced SHBG concentrations. In addition, BMI was significantly positively correlated with 2 h insulin levels (r = 0.43, p =< 0.01) and with testosterone levels (r = 0.21, p = 0.01). These findings suggest that increased adiposity intensifies insulin resistance and is linked to both vitamin D deficiency and elevated androgen levels. Moreover, the combination of hyperinsulinemia and low vitamin D further disrupts hormonal balance by promoting ovarian androgen production and decreasing SHBG levels, thereby increasing the bioavailability of testosterone. A significant inverse correlation was found between vitamin D levels and 2 h insulin levels (r = −0.28, p =< 0.01), indicating that lower vitamin D status is associated with increased insulin resistance. Furthermore, 2 h insulin levels showed a significant positive correlation with testosterone levels (r = 0.32, p =< 0.01), suggesting that greater insulin resistance is linked to higher androgen production. Additionally, vitamin D levels were inversely correlated with testosterone (r = −0.18, p = 0.02), demonstrating that a lower vitamin D status may further contribute to the hyperandrogenic environment. Vitamin D levels also showed a significant positive correlation with SHBG concentrations (r = 0.29, p < 0.01), indicating that a higher vitamin D status may be associated with increased SHBG levels. In contrast, 2 h insulin levels were inversely correlated with SHBG (r = −0.43, p < 0.01), reflecting the suppressive effect of hyperinsulinemia on SHBG production. Conclusions: Insulin resistance, BMI, and vitamin D deficiency are closely related to each other and to the severity of PCOS, which is confirmed by the correlations with androgen levels. The revealed relationships draw attention to the special importance of vitamin D supplementation and the correction of carbohydrate metabolism in alleviating the symptoms of the disease and reducing long-term health risks. Full article