Search Results (8,344)

The integration of Artificial Intelligence (AI) in higher education offers a potential solution to the scalability of personalized learning, yet empirical frameworks connecting diagnostic data with teacher-mediated interventions remain limited in developing contexts. This study adopts a sequential multi-phase research design to address this gap. Phase 1 comprised a diagnostic quantitative analysis of the National Survey on Access and Permanence in Education (ENAPE 2021), involving a representative sample of 3422 Mexican undergraduate students. Using Exploratory Factor Analysis (KMO = 0.96) and Pearson correlations, the study established a structural baseline. Phase 2 implemented a quasi-experimental exploratory pilot (N = 23) across two academic clusters (Civil Engineering and Nutrition) using “ActivAI”, a custom GPT configured with Retrieval-Augmented Generation (RAG). Results from Phase 1 revealed a strong, statistically significant correlation ($r=0.72$, $p<0.01$) between the perceived impact of education on daily life and the perception of equity, identifying “relevance” as a key driver of accessibility. Phase 2 results demonstrated high student satisfaction with AI-driven personalization (M = 4.49, SD = 0.64), although disciplinary variations in engagement were observed (SD = 0.85 in Nutrition versus 0.45 in Engineering). The study concludes by proposing the Dynamic Integration Model, which leverages AI not as a replacement for instruction but as a scalability toolkit for teacher-led orchestration, ensuring that personalization addresses dynamic student needs rather than static learning styles. Full article

The article addresses the problem of the insufficient empirical recognition of the determinants of trust in artificial intelligence (AI) algorithms in organizations operating under conditions of sustainable development. The aim of the study was to identify the factors shaping organizational trust in AI and to examine how perceived trustworthiness, transparency, and effectiveness of algorithms influence their acceptance in the work environment. The research was conducted using a quantitative survey-based approach among organizational employees, which enabled the analysis of relationships between key variables and the identification of factors that strengthen or limit trust. The results indicate that algorithmic transparency, the reliability of generated outcomes, and the perceived effectiveness of AI applications significantly foster trust, whereas concerns related to errors and the decision-making autonomy of systems constitute important barriers to acceptance. Based on the findings, a conceptual and exploratory model of trust in AI was proposed, which may be used to diagnose the level of technology acceptance and to support the responsible implementation of artificial intelligence-based solutions in organizations. The contribution of the article lies in integrating organizational and technological perspectives and in providing an empirical approach to trust in AI within the context of sustainable development. Full article

Background/Objectives: Intermittent fasting and ketogenic dietary approaches are increasingly investigated for their potential metabolic benefits in obesity. However, their long-term neuroendocrine effects—particularly those involving Orexin-A, a peptide implicated in energy regulation—remain poorly understood. The objective of this study was to compare the long-term metabolic, inflammatory, and orexinergic responses to different dietary strategies in adults with obesity. Methods: In this 12-month randomized, three-arm trial, 30 adults with obesity (BMI ≥ 30 kg/m²) were randomly assigned (1:1:1) to a hypocaloric ketogenic diet (KD), a 16:8 time-restricted eating regimen (TRF16:8), or a 5:2 intermittent fasting protocol (ADF5:2). Anthropometric parameters, body composition, fasting glucose, lipid profile, inflammatory cytokines (CRP, IL-6, TNF-α, IL-10), and plasma Orexin-A levels were assessed at baseline and every 3 months. Dietary adherence was monitored through structured logs and monthly assessments. Statistical analyses included repeated-measures models with sensitivity analyses adjusted for age and sex. Results: All participants completed the intervention. The ketogenic diet produced the largest sustained reductions in BMI, fat mass, fasting glucose, and total cholesterol over 12 months. TRF16:8 elicited more rapid early metabolic improvements and showed the most consistent longitudinal increase in Orexin-A levels. The ADF5:2 protocol resulted in moderate improvements across outcomes. In all groups, increases in Orexin-A were associated with markers of improved metabolic flexibility and reduced inflammation; however, mediation analyses were exploratory and non-causal. Between-group differences remained significant for fat mass, glucose, and Orexin-A trajectories after correction for multiple comparisons. Conclusions: The ketogenic diet was associated with the most pronounced long-term metabolic improvements, whereas 16:8 time-restricted eating yielded faster early responses and the most stable enhancement in Orexin-A levels. These findings indicate distinct metabolic and neuroendocrine adaptation profiles across dietary strategies. Given the small sample size, results should be interpreted cautiously, and larger trials are warranted to clarify the role of Orexin-A as a potential biomarker of dietary response in obesity. Full article

Background: Patients with dental phobia frequently require intravenous sedation (IVS) to undergo dental treatment; however, some can gradually discontinue IVS through repeated clinical experiences. The physiological and psychological factors influencing successful IVS withdrawal remain unclear. This study aimed to compare physiological (sAA, HR) and subjective (VAS) measures between patients who discontinued IVS and those who remained dependent on IVS. Methods: This prospective cohort study included 51 patients with dental phobia treated under IVS. Participants were classified into a Non-Sedation Group (NSG; n = 25) and a Sedation-Dependent Group (SDG; n = 26) based on their ability to discontinue IVS during the course of treatment. Salivary alpha-amylase (sAA), heart rate (HR), and visual analog scale (VAS) scores for fear, tension, and anxiety were assessed at predefined time points from the waiting room to venous cannulation. Treatment satisfaction and expectations for future treatment were also evaluated. Results: sAA activity was significantly higher in the SDG than in the NSG at T0 and T1 (p < 0.05), indicating higher levels of selected physiological measures during anticipatory phases; however, the difference at T2 was not significant. HR differed significantly only in the waiting room, whereas no between-group differences were observed in self-reported VAS scores for fear, tension, or anxiety at any time point, indicating a dissociation between physiological and subjective stress measures. Treatment satisfaction and expectations for future treatment were significantly higher in the SDG. Conclusions: Patients who remained dependent on IVS showed higher levels in selected physiological measures at the group level during anticipatory stages, whereas no corresponding differences were observed in self-reported subjective measures. These findings are exploratory and descriptive in nature and do not imply predictive or causal relationships. Full article

In an increasingly digitalized work environment, the expectation of perpetual work availability—constant connectivity (CC)—has become central to employees’ daily experiences, influencing productivity, well-being, and work–life balance. This study validates the Constant Connectivity Scale in the Italian organizational context, assessing its psychometric properties through exploratory and confirmatory factor analyses with 300 employees from three organizations. Reliability and validity assessments revealed the scale’s unidimensional structure, strong internal consistency, and high construct validity, demonstrating its effectiveness in measuring perceived hyperconnectivity at work. Findings reveal important relationships between constant connectivity and employee outcomes: significant associations with increased anxiety and a paradoxical moderate positive correlation with job performance, suggesting complex mechanisms whereby connectivity simultaneously activates engagement and strain processes. The weak correlation with smart working perception indicates that organizational flexibility policies have not substantially reduced connectivity expectations in Italian organizations. This study contributes to the digital work literature by providing a validated, culturally adapted instrument for as sessing constant connectivity in the Italian workforce. The validated CCS offers organizations evidence-based measurement for understanding hyperconnectivity intensity and implementing targeted strategies for building workforce resilience and promoting mental health through better management of digital connectivity demands. Full article

Background/Objectives: Autologous dentin matrix (ADM) has been suggested as a biologically plausible biomaterial for alveolar bone regeneration after tooth extraction. However, clinical evidence regarding its biological activity and early healing outcomes is limited. This exploratory, randomized controlled pilot study aimed to descriptively assess early alveolar healing patterns and bone morphogenetic protein 4 (BMP4) expression following tooth extraction using ADM compared with other grafting approaches. Methods: Patients requiring tooth extraction were allocated to one of four groups: ADM, xenograft, ADM combined with platelet-rich fibrin, and a graft-free control group. Histological and immunohistochemical analyses were performed four months after extraction to descriptively assess cellular features of healing and BMP4 expression. The trial was registered at the Brazilian Registry of Clinical Trials (ReBEC; RBR-24mdgrf) and conducted under prior ethics committee approval. Results: BMP4 expression was detected in 67.9% of the analyzed histological fields, predominantly localized in osteocytic, osteoblastic, and medullary areas. Although descriptive differences in BMP4-positive fields were observed among the groups, no statistically significant differences were identified between the groups. Histological evaluation revealed an active cellular environment across all treatment modalities, consistent with early post-extraction healing. No adverse events related to surgical procedures or grafting materials were reported during the study period. Conclusions: Within the limitations of this pilot randomized clinical trial, ADM exhibited consistent biological behavior during early post-extraction alveolar healing. The observed BMP4 expression likely reflects a general physiological healing response rather than a material-specific effect. This finding supports the biological plausibility of dentin-derived grafts as osteoconductive biomaterials. These findings are hypothesis-generating, and larger, adequately powered randomized clinical trials with standardized molecular and histological assessments are required to determine their clinical relevance. Full article

Background and Objectives: Hypertension affects more than 27% of adults in China, and despite ongoing public health efforts, substantial gaps remain in awareness, treatment, and blood pressure control, particularly among older adults and patients with multiple comorbidities. Conventional clinic-based care often provides limited opportunity for frequent monitoring and timely treatment adjustment, which may contribute to persistent poor control in routine practice. The objective of this study was to evaluate changes in blood pressure control and related clinical indicators during implementation of a mobile-enhanced remote patient monitoring (RPM)–supported care model among hypertensive patients with comorbidities, including patterns of medication adjustment, adherence, and selected cardiometabolic parameters. Methods: We conducted a multicenter, pre–post evaluation of a mobile-enhanced remote patient monitoring (RPM) program among 6874 adults with hypertension managed at six hospitals in Chongqing, China. Participants received usual care during the pre-RPM phase (April–September 2024; clinic blood pressure measured using an Omron HEM-7136 device), followed by an RPM-supported phase (October 2024–March 2025; home blood pressure measured twice daily using connected A666G monitors with automated transmission via WeChat, medication reminders, and clinician follow-up). Given the use of different devices and measurement settings, blood pressure comparisons may be influenced by device- and setting-related measurement differences. Monthly blood pressure averages were calculated from all available readings. Subgroup analyses explored patterns by sex, age, baseline BP category, and comorbidity status. Results: The cohort was 48.9% male with a mean age of 66.9 ± 13.7 years. During the RPM-supported care period, the proportion meeting the study’s blood pressure control threshold increased from 62.4% (pre-RPM) to 90.1%. Mean systolic blood pressure decreased from 140 mmHg at baseline to 116–118 mmHg at 6 months during the more frequent monitoring and active treatment adjustment period supported by RPM (p < 0.001), alongside modest reductions in fasting blood glucose and total cholesterol. These achieved SBP levels are below commonly recommended office targets for many older adults (typically <140 mmHg for ages 65–79, with individualized lower targets only if well tolerated; and less stringent targets for adults ≥80 years) and therefore warrant cautious interpretation and safety contextualization. Medication adherence improved, and antihypertensive regimen intensity increased during follow-up, suggesting that more frequent monitoring and active treatment adjustment contributed to the early blood pressure decline. Subgroup patterns were broadly similar across age and baseline BP categories; observed differences by sex and comorbidity groups were exploratory. Conclusions: In this large multicenter pre–post study, implementation of an RPM-supported hypertension care model was associated with substantial improvements in blood pressure control and concurrent intensification of guideline-concordant therapy. Given the absence of a concurrent control group, clinic-to-home measurement differences, and concurrent medication changes, findings should be interpreted as associations observed during an intensified monitoring and treatment period rather than definitive causal effects of RPM technology alone. Pragmatic randomized evaluations with standardized measurement protocols, longer follow-up, and cost-effectiveness analyses are warranted. Full article

Background: Approximately half of U.S. adults have ≥1 cardiovascular disease (CVD) risk factors. Exercise is universally recommended as a first-line lifestyle therapy to prevent and treat CVD. Objective: We will conduct a feasibility and pilot efficacy randomized controlled trial to test the usability and user satisfaction of an evidence-based digital health tool we developed for physicians—the Prioritizes Personalizes Prescribes EXercise algorithm (P3-EX)—to treat patients with CVD risk factors (ClinicalTrials.gov: NCT07238556). Methods: We will recruit 24 physicians who do not prescribe written exercise prescriptions (ExRx) from two local CT hospitals. Physicians will recruit two patients each (N = 48); both patients must have CVD risk factors. Each physician will deliver a P3-EX ExRx to one patient (n = 24) and the Physical Activity Vital Sign ExRx to the other patient (n = 24) in a random sequence crossover design. Physicians and patients will rate the feasibility and acceptability of each ExRx method using validated questionnaires. Patients will perform their ExRx for 12 weeks and complete an exercise diary to monitor exercise adherence with weekly virtual oversight by Research Assistants. Before and after the exercise intervention, we will measure patient CVD risk factors and physical activity levels via accelerometry. Results: This trial has received Institutional Review Board approval (E-HHC-2025-0198) and will begin in January 2026, with findings published in 2027. Conclusions: This protocol provides the scientific rationale and methodology to test P3-EX within a real-world clinical setting, to inform the feasibility of using P3-EX as a digital health support tool by physicians, and preliminary efficacy of P3-EX to improve patient cardiovascular health and physical activity levels. Full article

Melasma management is challenged by heterogeneity in patient presentation, particularly among individuals with darker skin tones. This study applied k-means clustering, an unsupervised machine learning algorithm that partitions data into k distinct clusters based on feature similarity, to identify patient subgroups that could provide a hypothesis-generating framework for future precision strategies. We analysed clinical and demographic data from 150 South African women with melasma using k-means clustering. The optimal number of clusters was determined using the Elbow Method and Bayesian Information Criterion (BIC), with t-distributed stochastic neighbour embedding (t-SNE) visualization for assessment. The k-Means algorithm identified seven exploratory patient clusters explaining 52.6% of the data variability (R² = 0.526), with model evaluation metrics including BIC = 951.630 indicating optimal model fit and a Silhouette Score of 0.200 suggesting limited separation between clusters consistent with overlapping clinical phenotypes, while the Calinski-Harabasz index of 26.422 confirmed relatively well-defined clusters that were characterized by distinct profiles including “The Moderately Sun Exposed Young Women”, “Elderly Women with Long-Term Melasma”, and “Younger Women with Severe Melasma”, with key differentiators being age distribution and menopausal status, melasma severity and duration patterns, sun exposure behaviours, and quality of life impact profiles that collectively define the unique clinical characteristics of each subgroup. This study demonstrates how machine learning can identify clinically relevant patient subgroups in melasma. Aligning interventions with the characteristics of specific clusters can potentially improve treatment efficacy. Full article

Insufficient investment in wildlife that lacks strong aesthetic or emotional appeal to humans poses a significant obstacle to achieving broader conservation goals. Species that are not considered charismatic are nonetheless vital to ecosystems and deserve attention from conservationists, researchers, and the public. However, effective strategies for bridging the gap between these species and traditionally charismatic ones remain underexplored. Our exploratory study introduced the concept of charisma orientations to examine their influence on pro-bird behaviors, such as following guidelines, reporting disturbances, and participating in community advocacy. We identified six relational and socially negotiated orientations—ecological importance, intrinsic right to exist, protection support, affective meaning, and perceived decline—that together represent key perspectives through which waterbirds are understood. A survey of 615 Texas coastal recreationists revealed that relying solely on positive charisma diminishes the appeal of waterbirds for participants. The species likeability frame was relevant only in the context of reporting disturbances, while a moral policy stance (the belief that waterbirds need protection) was significant in predicting advocacy. Younger males and individuals who felt current regulations were adequate were less likely to engage in waterbird conservation behaviors. Our findings suggest that examining the intersection of contested charismatic species and various charisma orientations can uncover subtle nuances often overlooked due to an overemphasis on positive charisma and emotional resonance, which may only partially apply or not apply at all. Full article

Objectives: The aim of the present study was to adapt the Sharenting Evaluation Scale to Turkish and to test its reliability and validity. Methods: Through an online data collection platform, we recruited 391 parents (M_age = 42.2, SD_age = 5.6, 76% female). They have at least one child under 18 years of age and actively engage with social media. Sharenting Evaluation Scale consists of 17 items rated on a 6-point Likert scale. Its Turkish adaptation underwent a two-phase process: exploratory and confirmatory factor analyses, along with testing for construct validity. Results: The exploratory factor analysis revealed that the 17 items in the questionnaire were loaded onto two factors (Social Behavior and Implications). The confirmatory factor analysis indicated that the two-factor model fitted the current sample well. To evaluate the construct validity of the Sharenting Evaluation Scale, we compared groups at the extreme ends of the scoring spectrum. A t-test was conducted to compare the scores of both groups across subscales, revealing a significant difference. We observed positive correlations between sharenting and parental self-regulation, authoritative parenting, permissive parenting, and digital media literacy which indicate the criterion validity. Conclusions: In conclusion, the current study demonstrates that the Turkish version of the Sharenting Evaluation Scale is a reliable and valid tool. Full article

(1) Background: Neonatal sepsis continues to be one of the leading causes of mortality and morbidity, particularly in underdeveloped countries. We aimed to compare laboratory parameters between clinical early-onset sepsis (clinEOS) and NNNon-clinEOS groups and to evaluate the association between TLR2-Arg753Gln, TLR4-Asp299Gly, IL6-174G/C, and IL10-1082G/A gene single-nucleotide polymorphisms and clinical EOS susceptibility in preterm newborns. (2) Materials and Methods: Genotyping of the TLR2, TLR4, IL6, and IL10 polymorphisms was performed in 36 preterm neonates with polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis (RFLP). Logistic regression analysis was used to test the associations between the studied gene polymorphisms and EOS susceptibility. (3) Results: Statistically significant differences in gestational age and birth weight were observed between the two groups, with preterm neonates with clinical EOS having a lower mean gestational age (mean (SD): 29.4 (2.8) weeks vs. 32.6 (1.1); p = 0.00002) and a lower mean birth weight (1342.1 (446.5) gr. Vs. 1984 (376.9)) than preterm neonates without clinical EOS. C-reactive protein (CRP) values measured on the first day significantly increased in the clinEOS group compared with the non-clinEOS group (median, 95% CI: 0.80 [0.40, 1.15] vs. 0.30 [0.02, 0.50]). The mean number of neutrophils significantly decreased in the preterm neonates with clinical EOS (mean difference: 17.3%; 95% CI: [4.0%, 30.5%]; p = 0.0126) and non-clinEOS group (mean difference: 20.8%; 95% CI: [1.8%, 39.9%]; p = 0.0354) between the first and seventh hospitalization days. In the dominant model, the A/G + A/A variant genotype of the IL10-1082G/A polymorphism significantly increased the odds of clinical EOS compared with the GG genotype (OR = 5.25; p = 0.0322), but the gestational-age-group adjusted model yielded p = 0.0752. (4) Conclusions: The results of the current study suggest that IL10-1082G/A gene polymorphism is a significant risk factor for clinical early-onset sepsis development in preterm neonates, but there was no evidence of a gestational age-group independent direct effect of IL10-1082G/A gene polymorphism on clinical EOS susceptibility. The results should be considered as exploratory. Full article

This paper develops a procedure for assessing both supply chain processes and strategic criteria in the context of platform-based supply chains, addressing the problem that organizations often invest in digital platforms without a clear understanding of how process effectiveness, process dysfunction, and strategic platform priorities jointly influence implementation success. The main research objective is to evaluate how effective and dysfunctional supply chain processes, together with prioritized strategic platform criteria, shape performance, productivity, and resilience outcomes in platform-based supply chain integration. The paper further discusses how identified dysfunctional processes and prioritized strategic criteria relate to operational vulnerabilities and resilience-building measures. The research adopts a multi-criteria decision-making (MCDM) approach to address the challenges of digital transformation and platform integration. An exploratory study was conducted applying the analytic hierarchy process (AHP) to evaluate functional and dysfunctional processes, complemented by the best worst method (BWM) to prioritize critical strategic criteria. The combined assessment highlights effective and dysfunctional processes while also identifying the most influential factors driving platform-based adoption and their potential implications for operational vulnerability and resilience. The results demonstrate how platform integration contributes to performance improvement, process alignment, and productivity gains across supply chain operations. The study contributes to both theory and practice by integrating MCDM techniques to support structured decision-making, enhancing responsiveness, resilience, and alignment with platform-oriented strategies. The primary contribution lies in providing a dual-level framework that enables supply chain managers to diagnose weaknesses, leverage strengths, and strategically guide the transition toward platform-based supply chain operations, with a measurable impact on organizational performance and productivity development. Full article

Background and Objectives: Evidence on motor performance in children with autism spectrum disorder (ASD) is scarce and inconsistent. The association of motor impairments with autism severity and intelligence remains insufficiently studied. We aimed to examine motor performance parameters in children with ASD compared with typically developing (TD) peers. Materials and Methods: In this cross-sectional study, a convenience sample of 26 children with ASD, aged 4–10 years, was recruited from specialized centers in KSA, alongside 27 age- and sex-matched TD children. For the ASD group, severity (Childhood Autism Rating Scale, CARS-2) and intelligence quotient (Stanford–Binet Intelligence Scale, SB5) were extracted from medical records. CARS-2 score was utilized to categorize children with ASD into two groups (mild-to-moderate and severe groups). All study children were assessed for gross and fine motor skills using the Movement Assessment Battery for Children-2 (MABC-2), balance, muscle strength, endurance, and flexibility. Results: ASD groups recorded significantly lower scores in all MABC-2 component areas when compared to the TD group (p < 0.001). Aiming and catching percentile was significantly lower in the severe ASD group compared to the mild-to-moderate group (p = 0.05). Furthermore, children with ASD exhibited increased hypermobility, predominantly at the elbow joints, reduced grip strength, shorter distance in the modified 6 min walk test, and lower standing long-jump performance (p < 0.001) when compared to TD group; however, no significant difference was recorded between the ASD groups. Spearman correlation revealed that aiming and catching was negatively correlated with autism severity (CARS-2) (r = −0.38, p = 0.05) and positively with IQ (r = 0.51, p = 0.03). Aiming and catching was positively correlated with grip strength (r = 0.55, p = 0.003), endurance (r = 0.58, p = 0.002), and jump distance (r = 0.44, p = 0.03), while balance was positively correlated with grip strength (r = 0.44, p = 0.02). Conclusions: Children with ASD exhibit significant impairments in gross and fine motor performance compared with TD peers, accompanied by hypermobility, reduced strength, and diminished endurance. Notably, aiming and catching ability correlated with both IQ and autism severity as well as specific motor parameters, suggesting its potential as a clinical marker of motor–cognitive interaction in ASD. Full article