Search Results (891)

Background: Reverse total shoulder arthroplasty (RTSA) is increasingly used for managing cuff tear arthropathy, osteoarthritis, complex fractures, and revision procedures. As the demand for surgical precision and reproducibility grows, immersive technologies such as virtual reality (VR), augmented reality (AR), and metaverse-based platforms are being explored for surgical training, intraoperative guidance, and rehabilitation. While early data suggest potential benefits, a focused synthesis specific to RTSA is lacking. Methods: This systematic review was conducted in accordance with PRISMA 2020 guidelines. A comprehensive search of PubMed, Scopus, and Cochrane Library databases was performed through 30 May 2025. Eligible studies included those evaluating immersive technologies in the context of RTSA for skill acquisition or intraoperative guidance. Only peer-reviewed articles published in English were included. Data were synthesized narratively due to heterogeneity in study design and outcome metrics. Results: Out of 628 records screened, 21 studies met the inclusion criteria. Five studies evaluated immersive VR for surgical training: four randomized controlled trials and one retrospective case series. VR training improved procedural efficiency and showed non-inferiority to cadaveric training. Sixteen studies investigated intraoperative navigation or AR guidance. Clinical and cadaveric studies consistently reported improved accuracy in glenoid baseplate positioning with reduced angular and linear deviations in postoperative controls as compared to preoperative planning. Conclusions: Immersive technologies show promise in enhancing training, intraoperative accuracy, and procedural consistency in RTSA. VR and AR platforms may support standardized surgical education and precision-based practice, but their broad clinical impact remains limited by small sample sizes, heterogeneous methodologies, and limited long-term outcomes. Further multicenter trials with standardized endpoints and cost-effectiveness analyses are warranted. Postoperative rehabilitation using immersive technologies in RTSA remains underexplored and presents an opportunity for future research. Full article

Background/Objectives: The increasing incidence rates of keratinocyte carcinoma (KC), particularly in fair-skinned populations, call for efforts to intensify health education of the general population in addressing this prevalent skin cancer type. As a preparatory step, this systematic review summarizes the published research on the knowledge and risk perception regarding KC among individuals without medical training. Methods: The review was registered in PROSPERO (CRD42024618851) and adheres to PRISMA guidelines. The databases PubMed, Scopus, Web of Science, PsycArticles, and PsycINFO were searched on 30 July 2024. Studies were eligible if knowledge and/or risk perception was assessed in lay people. Risk of bias (ROB) was assessed with the Joanna Briggs Institute checklist for prevalence studies. Comparable outcomes (e.g., awareness of terms for KC) were meta-analyzed. Results: Included reports (n = 17) were published between 1991 and 2024 with 16,728 individuals assessed. Awareness for the most common type of KC, basal cell carcinoma (BCC), was low (20.75% of respondents (95% confidence interval (CI): 15.24–27.61)), while more respondents were familiar with colloquial terms (60.9–72.8%). Meta-analysis indicated an underestimation of the frequency of KC, with only 7.21% (CI: 4.03–12.58) identifying BCC as the most common type of skin cancer. Furthermore, concern about developing KC as assessed in only two overlapping studies was reported by only 25–30% of respondents, indicating a significant gap in risk awareness and a lack of research on risk perception regarding KC. Conclusions: This review highlights the need for targeted health education interventions to improve knowledge and preventive behaviors regarding KC. Given the limitations of the included studies, characterized by high ROB, heterogeneity of results, and a lack of standardized assessment tools, further research is essential to enhance the understanding and awareness of KC in diverse populations. Full article

This systematic review examines how machine learning (ML) and generative AI (GenAI) have been integrated into learning analytics (LA) in higher education (2018–2025). Following PRISMA 2020, we screened 9590 records and included 101 English-language, peer-reviewed empirical studies that applied ML or GenAI within LA contexts. Records came from 12 databases (last search 15 March 2025), and the results were synthesized via thematic clustering. ML approaches dominate LA tasks, such as engagement prediction, dropout-risk modelling, and academic-performance forecasting, whereas GenAI—mainly transformer models like GPT-4 and BERT—is emerging in real-time feedback, adaptive learning, and sentiment analysis. Studies spanned world regions. Most ML papers (n = 75) examined engagement or dropout, while GenAI papers (n = 26) focused on adaptive feedback and sentiment analysis. No formal risk-of-bias assessment was conducted due to heterogeneity. While ML methods are well-established, GenAI applications remain experimental and face challenges related to transparency, pedagogical grounding, and implementation feasibility. This review offers a comparative synthesis of paradigms and outlines future directions for responsible, inclusive, theory-informed AI use in education. Full article

This article addresses the task of building personalized educational recommendations based on a heterogeneous knowledge graph that integrates data from university curricula, job vacancies, and online courses. To solve the problem of course recommendations by their relevance to a user’s competencies, a graph neural network (GNN)-based approach is proposed, specifically utilizing and comparing the Heterogeneous Graph Transformer (HGT) architecture, Graph Sample and Aggregate network (GraphSAGE), and Heterogeneous Graph Attention Network (HAN). Experiments were conducted on a heterogeneous graph comprising various node and relation types. The models were evaluated using regression and ranking metrics. The results demonstrated the superiority of the HGT-based recommendation model as a link regression task, especially in terms of ranking metrics, confirming its suitability for generating accurate and interpretable recommendations in educational systems. The proposed approach can be useful for developing adaptive learning recommendations aligned with users’ career goals. Full article

Anterior cruciate ligament reconstruction (ACLR) results in prolonged muscle weakness, impaired neuromuscular control, and delayed return to sport. Cross-education (CE), unilateral training of the uninjured limb, has been proposed as an adjunct therapy to promote bilateral adaptations. This scoping review evaluated the functional and neuroplastic effects of CE rehabilitation post-ACLR. Following PRISMA-ScR and JBI guidelines, PubMed, Scopus, Web of Science, and PEDro were searched up to February 2025. A bibliometric analysis was also conducted to report keyword co-occurrence and identify trends in this line of research. Of 333 screened references, 14 studies (price index: 43% and low-to-moderate risk of bias) involving 721 participants (aged 17–45 years) met inclusion criteria. CE protocols (6–12 weeks; 2–5 sessions/week) incorporating isometric, concentric, and eccentric exercises demonstrated strength gains (10–31%) and strength preservation, alongside improved limb symmetry (5–14%) and dynamic balance (7–18%). There is growing interest in neuroplasticity and corticospinal excitability, although neuroplastic changes were assessed heterogeneously across studies. Findings support CE as a feasible and low-cost strategy to complement early-stage ACLR rehabilitation, especially when direct loading of the affected limb is limited. Standardized protocols for clinical intervention and neurophysiological assessment are needed. Full article

Background/Objectives: Artificial intelligence (AI) is rapidly emerging as a transformative force in healthcare education, including orthodontics. This systematic review and meta-analysis aimed to evaluate the integration of AI into orthodontic training programs, focusing on its effectiveness in improving diagnostic accuracy, learner engagement, and the perceived quality of AI-generated educational content. Materials and Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Embase through May 2025. Eligible studies involved AI-assisted educational interventions in orthodontics. A mixed-methods approach was applied, combining meta-analysis and narrative synthesis based on data availability and consistency. Results: Seven studies involving 1101 participants—including orthodontic students, clinicians, faculty, and program directors—were included. AI tools ranged from cephalometric landmarking platforms to ChatGPT-based learning modules. A fixed-effects meta-analysis using two studies yielded a pooled Global Quality Scale (GQS) score of 3.69 (95% CI: 3.58–3.80), indicating moderate perceived quality of AI-generated content (I² = 64.5%). Due to methodological heterogeneity and limited statistical reporting in most studies, a narrative synthesis was used to summarize additional outcomes. AI tools enhanced diagnostic skills, learner autonomy, and perceived satisfaction, particularly among students and junior faculty. However, barriers such as limited curricular integration, lack of training, and faculty skepticism were recurrent. Conclusions: AI technologies, especially ChatGPT and digital cephalometry tools, show promise in orthodontic education. While learners demonstrate high acceptance, full integration is hindered by institutional and perceptual challenges. Strategic curricular reforms and targeted faculty development are needed to optimize AI adoption in clinical training. Full article

E-commerce growth has reshaped consumer behavior and retail services, driving parcel demand and challenging last-mile logistics. Existing research predominantly relies on survey data and global regression models that overlook intra-urban spatial heterogeneity in shopping behaviors. This study bridges this gap by analyzing e-commerce demand’s spatial distribution from a retail service perspective, identifying key drivers, and evaluating implications for omnichannel strategies and logistics. Utilizing waybill big data, spatial analysis, and multiscale geographically weighted regression, we reveal: (1) High-density e-commerce demand areas are predominantly located in central districts, whereas peripheral regions exhibit statistically lower volumes. The spatial distribution pattern of e-commerce demand aligns with the urban development spatial structure. (2) Factors such as population density and education levels significantly influence e-commerce demand. (3) Convenience stores play a dual role as retail service providers and parcel collection points, reinforcing their importance in shaping consumer accessibility and service efficiency, particularly in underserved urban areas. (4) Supermarkets exert a substitution effect on online shopping by offering immediate product availability, highlighting their role in shaping consumer purchasing preferences and retail service strategies. These findings contribute to retail and consumer services research by demonstrating how spatial e-commerce demand patterns reflect consumer shopping preferences, the role of omnichannel retail strategies, and the competitive dynamics between e-commerce and physical retail formats. Full article

Urban health planning requires a multi-scalar understanding of the territory, capable of capturing socio-economic inequalities and health needs at the local level. In the case of Rome, current administrative subdivisions—Urban Zones (Zone Urbanistiche)—are too large and internally heterogeneous to serve as effective units for equitable health planning. This study presents a methodology for the territorial redefinition of Rome’s Municipality III, aimed at supporting healthcare planning through an integrated analysis of census sections. These were grouped using a combination of census-based socio-demographic indicators (educational attainment, employment status, single-person households) and real estate values (OMI data), alongside administrative and road network data. The resulting territorial units—21 newly defined Mesoareas—are smaller than Urban Zones but larger than individual census sections and correspond to socio-territorially homogeneous neighborhoods; this structure enables a more nuanced spatial understanding of health-related inequalities. The proposed model is replicable, adaptable to other urban contexts, and offers a solid analytical basis for more equitable and targeted health planning, as well as for broader urban policy interventions aimed at promoting spatial justice. Full article

Securing thermal comfort while minimizing energy consumption in educational buildings is vital for achieving sustainable development goals. Drawing on the Environmental, Social, and Governance (ESG) framework, this systematic review synthesizes findings from 84 peer-reviewed studies published over the past decade, with a focus on how thermal comfort and energy use are assessed in educational contexts. The review identifies three primary research themes: climate resilience, multidimensional human-centric design, and energy decarbonization. However, it also reveals that existing studies have placed disproportionate emphasis on the environmental dimension, with insufficient exploration of issues related to social equity and governance structures. To address this gap, this study introduces an ESG-driven theoretical framework encompassing seven dimensions: thermal environment stability, multimodal thermal comfort assessment integration, sustainable energy use, heterogeneous thermal demand equality, passive–active design synergy, participatory thermal data governance, and educational thermal well-being inclusivity. By fostering interdisciplinary convergence and emphasizing inclusive stakeholder engagement, the proposed framework provides a resilient and adaptive foundation for enhancing indoor environmental quality in educational buildings while advancing equitable climate and energy strategies. Full article

This study assesses the effects of the COVID-19 pandemic on catastrophic health expenditures and income inequality in Benin. A microsimulation was calibrated to estimate the impact of the pandemic under three different shock scenarios: low, moderate, and severe. The analysis relies on secondary data from household living condition surveys. The results indicate that the COVID-19 crisis would lead to a significant average income loss of up to 20% and income inequality, while the number of households with catastrophic health expenditures would increase by 4%. More importantly, the findings reveal heterogeneous impacts across households, with urban residents, younger individuals, more educated households, and male-headed households experiencing the greatest income decline. These findings underscore the need for targeted health coverage and employment policies to better protect vulnerable populations in Benin in the face of future shocks. Full article

The Inner Mongolia Plateau (IMP), situated in the arid and semi-arid ecological transition zone of northern China, is particularly vulnerable to both climate change and human activities. Understanding the spatiotemporal vegetation dynamics and their driving forces is essential for regional ecological management. This study employs Sen’s slope estimation, BFAST analysis, residual trend method and Geodetector to analyze the spatial patterns of Normalized Difference Vegetation Index (NDVI) variability and distinguish between climatic and anthropogenic influences. Key findings include the following: (1) From 1982 to 2022, vegetation cover across the IMP exhibited a significant greening trend. Zonal analysis showed that this spatial heterogeneity was strongly regulated by regional hydrothermal conditions, with varied responses across land cover types and pronounced recovery observed in high-altitude areas. (2) In the western arid regions, vegetation trends were unstable, often marked by interruptions and reversals, contrasting with the sustained greening observed in the eastern zones. (3) Vegetation growth was primarily temperature-driven in the eastern forested areas, precipitation-driven in the central grasslands, and severely limited in the western deserts due to warming-induced drought. (4) Human activities exerted dual effects: significant positive residual trends were observed in the Hetao Plain and southern Horqin Sandy Land, while widespread negative residuals emerged across the southern deserts and central grasslands. (5) Vegetation change was driven by climate and human factors, with recovery mainly due to climate improvement and degradation linked to their combined impact. These findings highlight the interactive mechanisms of climate change and human disturbance in regulating terrestrial vegetation dynamics, offering insights for sustainable development and ecosystem education in climate-sensitive systems. Full article

This article examines the relationship between human capital accumulation, household income, and shared prosperity using 2005–2018 household surveys in Cameroon, Ethiopia, Kenya, Nigeria, and Uganda. Human capital is found to be positively and significantly correlated with household wellbeing in all five nations. Health’s indirect benefits in Cameroon, Ethiopia, and Kenya augment its direct benefits. Education has monotonic welfare benefits from primary to tertiary levels in all countries. Human capital and labour market participation are strongly associated with household wellbeing. The equalization of human capital endowments increases income for the 40% of the least well-off groups in three of the sample countries. All countries except Uganda record a decrease in human capital deprivation over the period studied. Redistribution is associated with a reduction in human capital deprivation, although less systematically than in the growth scenario. These results suggest that sizeable reductions in human capital deprivation are more likely to be accomplished by interventions that focus on boosting general human capital outcomes than those that redistribute the human capital formation inputs. In countries with declining human capital deprivation, the within-sector interventions seem to account for this success. Substantial heterogeneity in human capital poverty exists within and across countries and between rural and urban areas. Full article

Background: In a global panorama marked by a progressive rise in obesity, metabolic syndrome, and chronic non-communicable disease prevalence, nutrition education (NE) might play a pivotal role in restoring adoption and strengthening adherence to dietary patterns that protect human health. Therefore, the primary purpose of this work is to review the existing scientific literature studying NE programs aimed at schoolchildren in the decade 2014–2024 and evaluate the effectiveness of intervention tools. Methods: During the first phase of this research, a qualitative analysis was conducted to track similarity in intervention tools and strategies used in nutrition education programs. In the second phase, a quantitative analysis was carried out, extracting common parameters among studies and assessing their potential influence in improving adherence to the Mediterranean diet (MD). Results: A high degree of heterogeneity was observed in educational program designs and intervention tools, which were usually not properly described and justified. All studies that measured adherence to the MD registered an improvement after the intervention, in some cases even higher than 10%. However, this study found no relationship between common parameters (i.e., number of formal tools, number of non-formal tools, lesson duration, and program length) used in NE and the improvement in students’ adherence to MD. Conclusions: This research has contributed to outlining a general framework of NE and to promoting a systematic approach in this research field. Full article

The sustainable development of higher education exhibits a strong and measurable association with the level of regional innovation capacity. Drawing on panel data covering 31 provincial-level administrative regions in China from 2010 to 2022, we construct evaluation frameworks for both higher education and regional innovation capacity using the entropy weight method. These are complemented by kernel density estimation, spatial autocorrelation analysis, Dagum Gini coefficient decomposition, and the Obstacle Degree Model. Together, these tools enable a comprehensive investigation into the spatiotemporal evolution and driving mechanisms of coupling coordination dynamics between the two systems. The results indicate the following: (1) Both higher education and regional innovation capacity indices exhibit steady growth, accompanied by a clear temporal gradient differentiation. (2) The coupling coordination degree shows an overall upward trend, with significant inter-regional disparities, notably “higher in the east and low in the west”. (3) The spatial distribution of the coupling coordination degree reveals positive spatial autocorrelation, with provinces exhibiting similar levels tending to form spatial clusters, most commonly of the low–low or high–high type. (4) The spatial heterogeneity is pronounced, with inter-regional differences driving overall imbalance. (5) Key obstacles hindering regional innovation include inadequate R&D investment, limited trade openness, and weak technological development. In higher education sectors, limitations stem from insufficient social service benefits and efficiency of flow. This study recommends promoting the synchronized advancement of higher education and regional innovation through region-specific development strategies, strengthening institutional infrastructure, and accurately identifying and addressing key barriers. These efforts are essential to fostering high-quality, coordinated regional development. Full article

This study investigates the impact of cultural openness on intertemporal consumption behavior in the Middle East and North Africa (MENA) region, using panel data from 14 countries spanning 2010 to 2022. Unlike prior research that primarily focused on lifestyle shifts or product preferences, this study explores how cultural globalization influences the trade-off between present consumption and future savings, as captured by the consumption-to-savings ratio (LCESR). Cultural openness is operationalized using the Cultural Globalization General Index (LCGGI), and its effect is analyzed alongside key control variables including Internet penetration, real GDP per capita, inflation, and tourism. To address endogeneity and unobserved heterogeneity, this study employs the system Generalized Method of Moments (GMM) estimator, supported by robustness check models. The findings reveal a significant positive relationship between cultural openness and LCESR in both the short and long run, indicating that increased exposure to global cultural flows enhances consumption tendencies in the region. Internet penetration and inflation negatively affect saving behavior, while GDP per capita shows a positive effect. Tourist arrivals exhibit limited influence. This study also highlights the importance of historical consumption behavior, as the lagged dependent variable strongly predicts the current LCESR. Robustness checks confirm the consistency of the results across all models. These insights suggest that cultural openness, digital infrastructure, and macroeconomic stability are pivotal in shaping consumption/saving patterns. The results carry important implications for financial education, digital consumption governance, and cultural policy strategies in the MENA region and similar emerging markets undergoing rapid cultural integration. Full article