Search Results (4,509)

This article explores, from a historical and comparative perspective, how Chinese and Japanese theatre inspired the revolutionary theatre movement in 1920s and 1930s Moscow, which in turn influenced German theatre. One notable example of this intercultural transmission of aesthetics can be seen in the play I Want a Child! by Sergei Tretiakov. It showcases the impact of Asian traditions, embodying theatre as a Eurasian phenomenon—a style of staging recognised by Brecht and Meyerhold as a means of actively educating the audience. Inspired by the power of this medium in China, Tretiakov who was a friend of Brecht, attempted to develop a theatrical language that would have the strongest impact on the masses with socialist values. The selected play exemplifies art as a communicative transfer zone where Asian, Soviet, and Western theatre traditions converge. Brecht later adopted these aesthetics in relation to gender roles and conventional (“epic”) theatre techniques, with the aim of politicising the audience. The article considers these dimensions, after delving into the context of I Want a Child! and revising Tretiakov’s activities related to his work in China. Finally, it situates the Brechtian alienation effect in the intercultural, Euro-Asian dimension of instructive modernist theatre. Full article

Background/Objectives: While the health effects of economic fluctuations are well-documented, the role of policy-related uncertainty remains underexplored. The objective of this study is to examine the association between economic policy uncertainty (EPU) and mortality. Furthermore, we investigate whether changes in lifestyle behaviors are associated with EPU and may help shed light on the relationship between EPU and health outcomes. Methods: We utilize a mixed data sampling (MIDAS) framework to analyze US state-level data from 2009 to 2020. The model controls for unemployment, income, demographic characteristics, as well as state and year fixed effects. This approach enables the incorporation of high-frequency uncertainty measures to capture dynamic mortality responses. Results: The results indicate a statistically significant inverse association between EPU and total mortality. The association is negative across both genders, with a stronger effect observed among males. Across age cohorts, the retirement-age group exhibits the highest sensitivity. In terms of cause-specific mortality, EPU is positively associated with mortality from respiratory diseases and suicide, while it is negatively associated with mortality from homicide, accidents, and pneumonia and influenza. In addition, EPU is significantly associated with a lower prevalence of current drinking and smoking, a higher likelihood of being in a healthy weight range, improved self-reported health, and reduced time spent traveling. Conclusions: The findings suggest heterogeneous associations between EPU and mortality outcomes across demographic groups and causes of death, highlighting the complex and multifaceted nature of the relationship between policy-related uncertainty and population health rather than a uniform response across health outcomes. Full article

Hepatocellular carcinoma (HCC) represents one of the most lethal malignancies worldwide and is characterized by profound metabolic reprogramming during its development. Paraoxonase 1 (PON1), a liver-synthesized secretory protein involved in lipid metabolism, has an incompletely defined role in cancer biology. This study aimed to systematically investigate the expression pattern, clinical features, and biological function of PON1 in HCC through an integrated approach combining data mining, RNA-seq and experimental verification. Our results demonstrated that PON1 expression is significantly downregulated in HCC tissues compared with adjacent tissues. Clinically, significant disparities were observed in gender (χ² = 19.305, p < 0.0001), tumor stage (χ² = 18.030, p = 0.0004), and tumor grade (χ² = 13.391, p = 0.0039) between patients with high and low PON1 expression in HCC. Low PON1 expression was associated with poor prognosis (TCGA_LIHC, log-rank: χ² = 9.290, p = 0.0023; ICGC_LIRI, log-rank: χ² = 8.469, p = 0.0036; GSE14520, log-rank: χ² = 9.746, p = 0.0018). Univariate and multivariate Cox regression analyses revealed PON1 as an independent prognostic biomarker. Pathway analysis showed that PON1-positively correlated genes enriched in pathways such as peroxisome and fatty acid degradation, whereas PON1-negatively correlated genes mainly in the cell cycle pathway. Functional experiments confirmed that knockdown of PON1 promoted HCC cell proliferation, migration, invasion and inhibited apoptosis, whereas overexpression of PON1 reversed these malignant phenotypes. Mechanistically, we uncovered that PON1 exerts its tumor-suppressive effects by negatively regulating TANK and CXCL3, key molecules of the NOD-like receptor signaling pathway. In summary, our findings identify PON1 as an independent prognostic biomarker in HCC and demonstrate the tumor-suppressive role of PON1, indicating its potential as a therapeutic target for HCC. Full article

Environmental degradation represents a critical global challenge. Given its profound impact on ecosystems and societies, understanding the psychological factors that motivate individuals to engage in natural resource conservation behaviors has become increasingly important. Because efficacy beliefs (i.e., self-efficacy, response efficacy, and collective efficacy) are key psychological drivers of both plans and actions, a meta-analytic approach was used to estimate the associations between efficacy beliefs and conservation-related intentions and behaviors. The moderating roles of data collection method, population type, culture, and participants’ gender were also examined. Five meta-analyses synthesized the findings from 50 studies on conservation intentions and behaviors, revealing medium-sized positive associations with self-efficacy (intention, r = 0.47; behaviors, r = 0.41) and response efficacy (intention, r = 0.36; behaviors, r = 0.34), whereas the association with collective efficacy was small (single index, r = 0.28). Although substantial heterogeneity was observed, none of the tested moderators reached statistical significance, highlighting the need for future studies. Overall, these findings underscore the importance of strengthening individuals’ beliefs in their ability to engage in conservation behaviors. Full article

This article examines gender inequalities in scientific research in the Mediterranean, with a particular focus on STEM disciplines. It draws on qualitative data from the STEP (STEM and Equality, Diversity and Inclusion for Research Enhancement in Portugal) project, a European Commission-funded initiative aimed at embedding equality, diversity, and inclusion (EDI) principles across partner institutions in Portugal, Italy, France, and Spain. Using semi-structured interviews with five scientific leaders and an inductive thematic analysis, the study explores early-stage mechanisms in the institutionalisation of EDI policies and women’s empowerment trajectories from an intersectional perspective. The analysis identifies emergent patterns suggesting: (i) a gradual strengthening of EDI mainstreaming in contexts with initially limited awareness; (ii) the role of transnational collaboration in enhancing visibility, mentoring, and peer learning; and (iii) the potential of time-bounded initiatives to catalyse participant-observed shifts and institutional routines in formation. Rather than measuring longitudinal impact, the article traces how legitimation, routinisation, and network diffusion may enable EDI principles to extend beyond project lifespans and become embedded in governance structures. These mechanism-focused insights offer a transferable framework for future European cooperation initiatives and contribute to ongoing debates on sustainable gender and EDI policy implementation in Mediterranean research contexts. Full article

Despite the growing participation of women in higher education worldwide, they continue to face persistent challenges in their career advancement, including limited promotion opportunities, underrepresentation in leadership positions, lower research productivity, and unequal access to institutional resources. These challenges are shaped by a range of structural, institutional, and socio-cultural constraints within academia. Understanding these influencing factors is essential for promoting gender equity within universities. This study investigates the factors influencing the career advancement-related challenges experienced by women academics in Jordanian higher education institutions, focusing on career experience, family responsibilities, and organisational support. Grounded in Gendered Organisations Theory, Work-Family Conflict Theory, and Social Support Theory, the study develops and empirically tests an integrated conceptual model. Data were collected through a questionnaire survey of women academics across Jordanian universities. The quantitative data were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM), while qualitative responses on strategies for overcoming challenges were examined using directed qualitative content analysis. The findings indicate that family responsibilities represent the most influential driver of perceived challenges, highlighting the continuing tension between professional and domestic roles. Career experience is found to reduce perceived challenges, suggesting that accumulated professional capital and institutional familiarity enhance women’s ability to navigate academic environments. Organisational and social support not only directly reduce perceived challenges but also buffer the impact of family responsibilities. Multi-group analysis further reveals differences in the strength of these relationships between teaching-research academics and those occupying leadership roles. The qualitative results identify key strategies for addressing these challenges, including mentoring systems, flexible institutional policies, professional networking, and leadership development initiatives. By integrating structural modelling with qualitative insights, this study advances understanding of the complex dynamics shaping women’s academic careers and provides evidence-based recommendations for fostering more inclusive and supportive higher education environments. Full article

Background/Objectives: Rare diseases have a substantial impact not only on affected individuals but also on their families, particularly parents who assume primary caregiving roles. Despite increasing attention to rare conditions, parents’ experiences remain fragmented across the literature. This integrative review aimed to synthesise existing evidence on the experiences and multidimensional impact of caring for a child with a rare disease on parents. Methods: An integrative review was conducted following Whittemore and Knafl’s methodology and reported according to PRISMA 2020 guidelines. A systematic search was performed across MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and Scopus from 1 November 2025 to 31 January 2026. Twenty-two studies (qualitative, quantitative, mixed-methods, and reviews) were included. Data were analysed using thematic synthesis. Results: Three interrelated themes were identified: (1) the diagnostic journey, characterised by prolonged uncertainty, fragmented care, and the pivotal role of communication; (2) multidimensional caregiving burden, encompassing emotional, social, economic, and physical impacts, with notable gender differences; and (3) adaptive trajectories, involving dynamic coping processes, parental upskilling, and meaning-making. Across studies, caregiving burden emerged as a cumulative and system-influenced phenomenon, while adaptation was found to coexist with ongoing uncertainty rather than representing a linear resolution. Conclusions: Caring for a child with a rare disease profoundly affects parents across multiple domains. The findings highlight the need for integrated, family-centred care models, improved diagnostic communication, and sustained psychosocial support. Implications for nursing practice: Nurses play a key role in recognising caregiver burden, supporting adaptive processes, and promoting effective communication throughout the diagnostic and care trajectory. Full article

Background: Inflammation is believed to play a significant role in the pathophysiology of hypertension (HT). The aim of this study was to evaluate the relationship between the systemic immune-inflammation index (SII) and the pan-immune-inflammation value (PIV) and HT in adults. Methods: A total of 1060 adult individuals who presented between 1 December 2025 and 1 February 2026, were included. Participants were grouped according to the presence of HT. SII and PIV were calculated. Univariate and multivariate logistic regression analyses were performed to identify factors independently associated with HT. Due to the high correlation between SII and PIV, they were evaluated in separate models. Discriminatory performance was examined using ROC analysis, and correlations were assessed using the Spearman test. Results: HT was present in 18.1% of participants. In the HT group, SII and PIVs were significantly higher (p < 0.001 for both). In univariate analysis, older age (p < 0.001), male gender (p = 0.030), presence of comorbidities (p < 0.001), high SII (p < 0.001), and high PIV (p < 0.001) were found to be associated with HT. In multivariate analyses, age and comorbidities remained independent predictors in both models (all p < 0.001). In the multivariable models adjusted for available covariates, high SII was significantly associated with HT in the SII model (adjusted OR: 2.035; 95% CI: 1.374–3.010; p < 0.001). Similarly, high PIV was significantly associated with HT in the PIV model (adjusted OR: 5.577; 95% CI: 3.398–9.160; p < 0.001). In the ROC analysis, both indices demonstrated modest predictive ability, with PIV showing slightly higher performance compared to SII (AUC: 0.648 vs. 0.623). A positive correlation was observed between the duration of HT and both SII (r = 0.700; p < 0.001) and PIV (r = 0.847; p < 0.001). Conclusions: The finding that SII and PIV were significantly associated with HT after adjustment for available covariates supports the potential role of systemic inflammation in the pathophysiology of HT. These indices, which can be easily calculated from routine laboratory parameters and do not require additional costs, may potentially assist in risk assessment in clinical practice. Full article

Generative artificial intelligence (GenAI) is reshaping learning in higher education, with particularly pronounced implications for the humanities and social sciences (HSS), where learning outcomes are commonly expressed through written and interpretive forms that align closely with GenAI’s capabilities. Yet, systematic evidence on the educational impacts of GenAI on HSS students remains limited. Addressing this gap, this study draws on a large-scale survey of HSS students in China to examine its role in academic development. Guided by relevant learning theories, this study focuses on four dimensions: patterns of use, effects on learning processes and academic performance, challenges associated with GenAI use, and preferred approaches to curricular integration. We found that more than half perceived enhanced learning motivation, independent thinking and creativity, although a substantial minority reported little change or even decline. Comparatively, a notably larger majority reported academic performance gains, although these gains may partly reflect limitations in conventional assessment practices. The study identifies variations in perceived learning and performance improvements among students with differing durations of GenAI experience, along with observable disciplinary differences and modest gender differences. While an overwhelming majority valued the importance of ethical considerations, only slightly more than half were satisfied with privacy protection. Limited accuracy and overreliance emerged as the most pressing concerns reported by students. Students favored partial or optional curricular integration supported by practice-oriented training, and widely recognized GenAI’s significance for their future professional development. Grounded in student perspectives, this study offers evidence-based recommendations for the responsible and pedagogically meaningful integration of GenAI. Full article

Background/Objectives: Anemia of inflammation (AI) is a prevalent condition linked to systemic inflammation in several chronic diseases, including chronic liver diseases. Hypovitaminosis D is frequently identified in patients with chronic diseases, and its pathogenic role in anemia is currently under investigation. The aim of this study was to prospectively investigate changes in hemoglobin concentration and inflammatory markers in vitamin D-deficient/-insufficient patients with decompensated cirrhosis after initiating vitamin D supplementation, in addition to the supplementation of other micronutrients if needed. Methods: Patients with cirrhosis discharged from decompensation were assessed at baseline and 3 months after vitamin D supplementation. Laboratory parameters of red cell series, nutrition, and micronutrients were assessed in both visits, together with markers of systemic inflammation. Results: Thirty-nine patients were included in the study, of whom 33 completed the 3-month evaluation and were analyzed [age: 62.7 ± 10.7 years; gender: n = 29 (87.9%) males; Charlson index: 5.9 ± 1.6; Model for End-Stage Liver Disease (MELD): 12.4 ± 4.5; baseline hemoglobin (Hb): 11.7 ± 1.8 g/dL (anemia n = 24 (72.7%)); mean 25-hydroxyvitamin D (25OHD) plasma level: 15.5 ± 8.6 µg/L]. A significant increase in plasma 25OHD (40.1 ± 17.8, p < 0.001) and in Hb (12.4 ± 2.0, p = 0.01) was observed at 3 months with a decrease in the prevalence of anemia (n = 17, p = 0.015) and of Interleukin 6 in plasma levels [IL-6, 10.7 (5.8–23.3) vs. 6.5 (4.1–11.8), p = 0.016]. A greater rise in hemoglobin was correlated with higher plasma IL-6 concentration at baseline. Milder anemia and indexes of hypoferremia at baseline, along with optimal renal function and plasma levels of 25OHD at 3 months, were linked to resolution of anemia. Conclusions: Treating vitamin D deficiency together with other micronutrient deficits is associated with inflammation amelioration and improvement in anemia in patients with cirrhosis following discharge from acute decompensation. This paper supports the potential role of vitamin D in the management of anemia in patients with decompensated cirrhosis by modulating systemic inflammation. Full article

Aim: This study aimed to evaluate self-reported digital health literacy levels and work engagement among nurses in the United Arab Emirates (UAE), while also examining associations with demographic factors and the interplay between digital health literacy and work engagement. Background: The integration of digital technologies into healthcare has transformed patient care, clinical practice, and administration. Nurses, as frontline practitioners, play a crucial role in utilizing digital tools to enhance patient interactions and navigate complex healthcare systems. Methods: Between May and August of 2024, 364 nurses in the United Arab Emirates participated in a cross-sectional design study. A standardized 21-item self-reported Digital Health Literacy questionnaire and a 9-item Utrecht Work Engagement Scale were administered. Descriptive statistics were used, with t-tests, ANOVA, correlations, and multiple linear regression applied. Results: The average score for self-reported digital health literacy (3.05 ± 0.57) and work engagement (4.83 ± 1.13) was high. Gender, age, work experience, and education level showed varying patterns of association with self-reported DHL and work engagement across total and subscale scores. Education level was significantly associated with self-reported DHL but not with work engagement. The overall work engagement score and its subscales were positively correlated with self-reported DHL. Conclusions: Our findings provide a robust basis for subsequent research on DHL and work engagement. These findings support the relevance of self-reported DHL as a factor associated with nurses’ work engagement in digitally intensive healthcare settings. The study reveals that nurses reported high levels of digital health literacy and work engagement. Full article

Timor-Leste, Asia’s youngest nation since its independence in 2002, has been making progress in its education sector. However, these gains have not translated into leadership representation as expected, with women remaining significantly underrepresented in senior academic and managerial roles in higher education. While existing studies highlight the potential of intersectional disaggregated data to enhance the visibility of layered inequalities and inform more targeted leadership interventions, its application in Timor-Leste remains at an early stage. This study examines respondents’ perception of barriers and enablers influencing the collection and use of intersectional disaggregated data, and their association with perceived leadership interventions aimed at advancing women in higher education leadership in Timor-Leste. A survey design was employed, with questionnaires administered to purposively selected academic and non-academic staff across selected universities in Timor-Leste. Data were analysed using descriptive and inferential techniques, including the Kruskal–Wallis test, and Spearman’s rank correlation (ρ). The findings suggest that respondents perceive key leadership interventions to include women’s leadership development programmes, mentorship, mental health support, and establishment of dedicated equality and diversity units Respondents also identified key enablers and barriers influencing the collection and use of intersectional disaggregated data, including staff training in ethical data practices, the use of mixed-method approaches, and the provision of privacy protections, alongside constraints related to data systems, capacity, and leadership support. Spearman’s analysis showed significant associations between perceived enablers and barriers influencing the collection and use of intersectional disaggregated data and perceived leadership interventions. This study contributes to the gender equity literature by providing empirical insights on perceived institutional conditions, reported barriers, enablers and perceived mechanisms through which intersectional data may inform leadership-related interventions in the context of Timor-Leste’s higher education system. Full article

Several studies show that financial vulnerability is not determined solely by low levels of wealth, but also by behavioural and social factors that shape financial behaviour. From this perspective, the social environment and financial knowledge can influence how investors evaluate their investment experiences. However, most of the literature has focused on how these aspects affect participation in financial markets, rather than on how they shape perceptions of the investment experience itself. This study explores how interactions with one’s social environment and both objective and subjective levels of financial knowledge contribute to how people evaluate the outcomes of their investments. To do so, we analyse a sample of undergraduate students using multivariate regression and Oaxaca–Blinder decompositions across three social environments—family, workplace, and banking advisors—and three types of financial assets: stocks, investment funds, and pension funds. The results show that perceptions of investment experience are shaped not only by individual factors but also by financial knowledge and the social environment—and these effects differ between men and women. There are also differences across types of financial assets, suggesting varying levels of vulnerability. These findings highlight the importance of personal characteristics, financial knowledge, and social context in explaining investment perceptions and differences in financial vulnerability. Full article

Objectives: Despite the critical role fathers play in family health decisions, most research on HPV vaccination focuses predominantly on mothers. This study examines gender differences in HPV knowledge and vaccination attitudes among Greek parents, addressing a significant gap in the literature. Methods: A cross-sectional study using convenience sampling was conducted in waiting rooms of public primary healthcare settings in the Larissa prefecture of central Greece, between September and December 2024. Of 250 distributed questionnaires, 208 were returned (response rate: 83%), of which 192 were eligible for analysis. The analysis compares responses from fathers (n = 42) and mothers (n = 150) regarding HPV knowledge, intentions to vaccinate their sons, and general vaccine attitudes; no explicit restriction to one respondent per family was applied. Statistical comparisons employed chi-square tests, Fisher’s exact test, and binary logistic regression. Results: Fathers demonstrated significantly lower HPV awareness compared to mothers (42.9% vs. 64.0%, χ² = 10.907, p = 0.004). Vaccination intentions for sons were similar between groups (fathers: 85.7%, mothers: 85.3%, p = 0.540). No statistically robust association between HPV awareness and vaccination intention was identified in either group, likely reflecting the high overall intention rates and limited outcome variability. Binary logistic regression identified female sex as the only significant independent predictor of HPV awareness (OR = 2.26, 95% CI: 1.12–4.58, p = 0.024). Conclusions: While fathers exhibit significantly lower HPV knowledge than mothers, they demonstrate equal willingness to vaccinate their sons. These findings suggest that knowledge gaps do not necessarily translate to vaccine hesitancy, but highlight the need for targeted, father-inclusive health education interventions. Public health programs should actively engage fathers in HPV vaccination discussions to capitalize on their positive vaccination intentions while addressing their information needs. Full article

This online survey aimed to elaborate on the salary, working conditions, and job satisfaction of employed veterinarians in Germany. The focus was on factors influencing salaries, violations of German laws, and comparisons between employees of owner- and corporate-managed practices. Answers of up to 1184 veterinarians were analyzed, representing 6% of employed veterinarians. The hourly salary increased by around 19% compared to a study in 2020, but remained significantly lower than in comparable professions and did not rise as much as the national average over the last five years. A multifactorial linear model showed that working experience, additional qualifications, leadership role for other veterinarians, section (pets, equines, farm animals, or non-curative), and gender significantly influenced the salary. The adjusted gender pay gap was about 7%. Employees of corporations earned significantly more than veterinarians being employed in owner-managed practices, but not when salary was adjusted for overtime. Moreover, employees of corporations had significantly lower job satisfaction. Requirements of the German Working Hours Act were regularly not complied with, as e.g., around 40% of respondents reported not being able to take their legally required break at least once per week. Results indicate that, despite improvements, there is still a need to address working conditions to retain veterinarians in the profession. Full article