Search Results (7,374)

The rapid adoption of Generative Artificial Intelligence (GenAI) tools is transforming learning practices in higher education, raising important questions about their educational value and impact on student learning. This study examines how university students use GenAI tools in both academic and everyday contexts, with emphasis on usage patterns, applications and motivations. A large-scale voluntary survey was conducted with 788 undergraduate students from a single public university in Greece, with respondents drawn from multiple schools and disciplines. Data were collected through an online questionnaire and analyzed using descriptive and inferential statistical methods to explore frequency of use, application categories and motivations for engagement with GenAI tools. The results indicate a high level of reported GenAI engagement among the participants, with ChatGPT emerging as the most frequently used tool. Students primarily rely on GenAI tools for information searching, understanding academic content and supporting academic tasks, while creative and entertainment-related uses are less frequent. Overall, the findings suggest that students perceive GenAI tools as useful for learning support and efficiency improvement. The results indicate that GenAI tools are becoming integrated into students’ reported learning practices. They also highlight the need for clear pedagogical guidelines and systematic AI literacy integration in teaching and learning. Full article

Students with disabilities, particularly those needing additional support or intervention to manage emotions and behaviors, build healthy relationships, and navigate social and academic demands, face heightened risks of high school pushout that can be traced back to their transition into high school. Project Elevate (PE) is a multi-component intervention that strategically invests in early coordinated student, family, and school supports to prevent barriers associated with high school pushout, such as a lack of continuity of effective services across school sites. This mixed-methods pilot study examined the implementation of PE with three 8th-grade students and their parents during their last term in middle school. This study includes quantitative pre–post descriptive analyses of multi-informant reports of students’ social, emotional, and behavioral skills, as well as descriptive analyses of weekly teacher- and parent-reported behavior and student attendance. Qualitative analysis using the Framework Method was applied to student and parent interviews and open-ended responses on a satisfaction questionnaire to understand their experience receiving PE support. Session case notes were also used as contextual data to describe implementation processes and contextualize findings. Results indicated improvements in student attendance and reductions in home-based behavioral concerns, with mixed findings across school-based outcomes. Students and parents reported high satisfaction with the intervention, highlighting the value of individualized support, goal setting, and strengthened communication with schools. Findings from this intervention development pilot study provide preliminary evidence regarding the implementation and perceived value of PE. Results also highlight the importance of culturally responsive, relationship-centered practices that affirm student strengths and support access to educational opportunities. Further investigation of PE in larger studies is warranted. Full article

Background/Objectives: Recognizing and managing grief is particularly important in nursing, especially from the perspective of family caregivers. In this qualitative study, we aim to understand the grieving process of family caregivers, focusing on what happens before the death of an adult family member due to chronic illness, and to identify the factors influencing the grieving process in this context. Methods: This study is an outcome of a broader study which aimed to understand how family caregivers grieve during the first year following the death of an adult family member due to a chronic illness. This article will only address the influencing conditions that emerged from data related to events that occurred prior to the person’s death. A theoretical sample was gathered through semi-structured interviews with 20 bereaved family caregivers. Data were collected and then analyzed independently by the research team using the three stages and principles of Strauss and Corbin’s grounded theory. Results: Adaptation was identified as the central category. Before death, the family caregiver undergoes two adaptive processes: adapting to their new role and preparing for the imminent loss. As they adapt to this loss, they become aware of the seriousness of the illness and the inevitability of death, opening the possibility for the grieving process to begin. The process is influenced by personal and contextual factors as well as interaction-related factors, including access to information, satisfaction with the care provided, recognition of their efforts, and feelings of abandonment or interaction with healthcare professionals. A wide range of emotions and feelings are experienced. This experience is colored by hope and anticipatory grief. The meaning of the dying process is explored and expectations are redefined. Conclusions: The grieving process experienced by family caregivers is an adaptive process that begins before the patient’s death. Some conditions can be modified before the patient’s death; in this case, nurse interventions can enhance the experience of family caregivers. Full article

Sickle Cell Disease (SCD) is a pervasive monogenic disorder characterized by chronic hemolytic anemia, unpredictable vaso-occlusive crises, and progressive multi-organ damage, representing a significant global health burden. Driven by a point mutation in the β-globin gene, the resulting abnormal Hemoglobin S (HbS) polymerizes under deoxygenated conditions, leading to erythrocyte sickling and systemic endothelial dysfunction. While supportive therapies such as hydroxyurea and transfusions manage symptoms, the mandate for definitive curative therapies is urgent. Historically, allogeneic hematopoietic stem cell transplantation (HSCT) utilizing matched sibling donors (MSD) has been the sole curative option, offering high survival rates but constrained by limited donor availability and the risk of graft-versus-host disease (GVHD). Consequently, alternative donor sources, including matched unrelated donors, umbilical cord blood, and haploidentical donors, have expanded patient access, particularly with the integration of post-transplant cyclophosphamide (PTCy) to mitigate alloreactivity. Concurrently, the advent of autologous gene therapy, encompassing lentiviral gene addition (Lyfgenia) and CRISPR-Cas9 gene editing (Casgevy) offers a revolutionary donor-independent approach that eliminates GVHD risk. Lyfgenia employs a lentiviral vector to introduce an anti-sickling βT87Q hemoglobin variant into autologous hematopoietic stem cells, while Casgevy employs CRISPR-Cas9 to disrupt the erythroid-specific enhancer of the BCL11A transcription factor, derepressing γ-globin expression and elevating fetal hemoglobin. This review synthesizes the pathophysiological mechanisms of SCD, evaluates the clinical outcomes and limitations of both allogeneic HSCT and autologous gene therapies, and outlines the clinical decision-making paradigms and future innovations required to achieve equitable global access to these transformative treatments. Full article

Special education teachers often lack training to implement research-evaluated writing programs with fidelity, which contributes to insufficient instruction for students with disabilities. This study addresses a research gap: the limited documentation of implementation fidelity in French spelling interventions that integrate assistive technologies (ATs) for learners aged 9–12 with dysorthographia. Grounded in a theoretical foundation that coordinates alphabetic, orthographic, and morphographic processes within an explicit instruction sequence (explanation, modeling, guided practice, and independent application), the program aligned text-to-speech and word prediction with targeted spelling goals. Using a mixed-methods design, six elementary students participated in a single-case protocol with a transformative sequential design over 20 weeks. Four teachers received targeted training (theoretical + practical) and delivered explicit, individualized instruction during a 10-week intervention. Content analysis of teacher and researcher logs showed high, yet context-responsive, fidelity with variations by student profile, school context, and teacher. Converging quantitative and qualitative patterns suggest improvements in word-level accuracy/fluency and highlight training/coaching as a driver of fidelity. The discussion provides actionable implications for professional learning, school scheduling and dosage protection, and future research that multimodalizes fidelity evidence and instruments AT orchestration across the writing cycle. Full article

Background: Women remain the primary caregivers globally, especially in rural, low-resource settings plagued by poverty, unemployment, low education and poor infrastructure. These factors limit caregiving capacity, heighten vulnerability and increase the risk of food insecurity in female-headed households. Objective: To establish a baseline profile of caregivers of primary school children. Methods: Phase 1 (baseline) of the study was conducted using a quantitative, exploratory cross-sectional survey design among 75 female caregivers of children aged 7–13 years in Qwa-Qwa, Free State Province. Participants were recruited using convenience sampling. Data were collected with a structured, pre-validated questionnaire on socio-demographics, alongside anthropometric measurements. Data were analysed using descriptive statistics. Results: Most participants were unemployed (73.3%) and had low educational attainment, with 86.7% having completed primary school or less. A substantial proportion of households (80.0%) reported a monthly income below R1000. Food insecurity was common, with 69.3% of caregivers reporting experiences of food shortages. Household infrastructure was limited, particularly in refuse removal services (96.0% without access). Despite these socio-economic constraints, a high prevalence of overweight and obesity (72.5%) was observed amongst the participants. Conclusions: Caregivers experience severe, overlapping socio-economic and environmental vulnerabilities alongside a high prevalence of overweight and obesity. The study highlights the need for multi-sectoral interventions focused on poverty reduction, rural infrastructure development, improved service delivery, women’s empowerment and strengthened livelihood opportunities to improve household nutrition and resilience. Full article

Learning agility is considered a key competence for adapting to rapidly changing educational and technological environments. Although entrepreneurial tendencies have been associated with adaptive learning outcomes, the psychological mechanisms underlying this relationship remain insufficiently understood. This study examined whether self-regulation and artificial intelligence (AI) awareness sequentially mediate the relationship between individual entrepreneurial tendencies and learning agility among high school students. The study involved 564 high school students (55% girls, 45% boys; aged 14–19 years, M = 17.02, SD = 1.28) from two public schools in Türkiye. Participants completed validated measures of entrepreneurial tendencies, self-regulation, AI awareness, and learning agility. The hypothesized serial mediation model was tested using PROCESS Macro Model 6. Entrepreneurial tendencies were positively associated with learning agility both directly and indirectly. Self-regulation emerged as a significant independent mediator, and a significant sequential mediation pathway was identified through self-regulation and AI awareness. The findings suggest that entrepreneurial tendencies are associated with higher levels of self-regulation and AI awareness, which are in turn associated with learning agility. The results highlight the importance of self-regulation and AI awareness as factors associated with the relationship between entrepreneurial tendencies and learning agility. Educational practices that foster entrepreneurship, self-regulation, and AI awareness may support students’ adaptability and readiness for rapidly evolving digital learning environments. Full article

Industry 4.0 is speeding up the move to connected, data-driven, and automated production, where the Internet of Things (IoT) enables sensing, communication, and real-time support for decisions. At the same time, rapid growth in industrial IoT studies has led to scattered technologies, architectures, and results. This paper fills this gap through a systematic literature review on IoT for Industry 4.0. It also helps readers compare methods and choose suitable building blocks for real deployments today. We focus on key technologies, integration architectures, application areas, challenges, trends, and reported benefits. Using PRISMA 2020, we searched five major databases (Scopus, MDPI, IEEE Xplore, ScienceDirect, and Web of Science) for 2020–2025 and found 584 records. After removing duplicates and screening, we kept 96 peer-reviewed studies for detailed analysis. Results show that most studies use a layered stack that combines sensing/actuation, industrial networking, data collection pipelines, and analytics across edge, fog, and cloud resources. MQTT, OPC UA, CoAP, LPWAN, and 5G connectivity are often used for communication, while RAMI 4.0, IIRA, and similar layered models guide system design. Many architectures follow an edge–cloud pattern, with growing focus on digital twin/CPS links and security-by-design. Applications are mainly smart manufacturing, predictive maintenance, and logistics, with added work in energy management, Construction 4.0, and agri-food monitoring. The key barriers remain interoperability, data quality and evaluation gaps, cybersecurity risks, legacy integration, and deployment limits. The review points to future work on edge AI/TinyML, deterministic connectivity, scalable digital twins, trusted data sharing, and sustainable industrial IoT. Full article

Background and Objectives: Child dental neglect is a clinically significant form of maltreatment that frequently reflects broader challenges related to caregiving within the family environment. Although oral manifestations have been described in prior research, the socio-behavioral profile of responsible caregivers remains insufficiently characterized, particularly in Central and Eastern European contexts. This study aimed to identify caregiver-level socio-behavioral characteristics associated with child dental neglect and to examine their relationships with clinical outcomes. Materials and Methods: A retrospective cross-sectional analytical study was conducted on 333 children (aged 4–17 years) diagnosed with dental neglect, presenting at a municipal hospital and a private dental practice in Oradea, Romania (2020–2024). Caregiver-level variables included age, educational attainment, socioeconomic status, health condition, substance use, and family structure. Associations were analyzed using Fisher’s Exact Test, Pearson Chi-Square, and Mann–Whitney U test, with Bonferroni correction applied where appropriate. Results: Most caregivers were young adults (93.1%), with low educational attainment (40.2% had no formal schooling) and high rates of alcohol use (47.1%). Low family income was present in 89.2% of cases and was significantly associated with non-adherence to the dental treatment plan (p  =  0.039). Caregivers without formal education were associated with neglect in rural areas (43.4% vs. 26.2%; p  <  0.001). Children of drug-using caregivers were significantly older at presentation (median: 12 vs. 8 years; p  =  0.014), and caregiver drug use was more prevalent in urban settings (18.0% vs. 1.8%; p  <  0.001). Over half of the children (52.9%) came from disrupted family environments. Conclusions: Dental neglect was consistently associated with young, poorly educated, and financially disadvantaged caregivers exhibiting high rates of substance use and unstable family structures. These factors may interact in complex ways, highlighting the multifactorial nature of dental neglect. Dental professionals are well positioned for early identification and have a professional and ethical responsibility to integrate child safeguarding into routine clinical practice. Full article

Background/Objectives: Adolescence is a critical period for the adoption of health-risk behaviors and the development of non-communicable diseases (NCDs). Schools represent a strategic setting for health promotion interventions; however, Italian studies simultaneously assessing NCD-prevention knowledge and lifestyle behaviors in the same adolescent population remain scarce. The study aimed to evaluate improvements in knowledge regarding nutrition and other lifestyle-related behaviors among Italian adolescents following a school-based educational intervention. Secondary objectives included describing lifestyle behaviors within the study population and exploring participants’ evaluation of the intervention. Methods: A quasi-experimental pre-post study was conducted between March and May 2025 in five lower secondary schools. A total of 410 adolescents aged 11–16 years were enrolled through a two-stage cluster sampling procedure. The intervention, lasting approximately two hours, was delivered by a trained nurse-researcher and addressed four health domains: nutrition, physical activity, screen exposure, and substance use. Results: Following the intervention, a measurable increase in overall knowledge scores (mean increase: +3.9 points) was observed, with 88.9% of participants showing improvement. The largest improvements were observed in nutrition-related knowledge and awareness of passive smoking harms. Despite these gains, unhealthy behaviors remained prevalent, including low adherence to physical activity recommendations (36.1%), suboptimal dietary quality (39.9%), and high screen exposure. A linear regression model identified five independent determinants of higher knowledge improvement: older age, female gender, higher screen exposure, having at least one employed parent, and lower pre-intervention test scores. The intervention was positively evaluated, with high levels of satisfaction, clarity, and perceived usefulness. Conclusions: Nevertheless, the persistent gap between knowledge and behavior underscores the need to integrate motivational and environmental components, gender-sensitive approaches, and longitudinal evaluations to foster sustainable, healthy choices and contribute to NCD prevention. Full article

Student-initiated bullying against teachers has become an increasingly visible yet understudied issue in educational research, particularly in regions like Lebanon, where such dynamics remain largely unspoken. This mixed-methods pilot study explored the experiences of 53 educators working in Lebanese private schools, combining survey responses with in-depth interviews from a purposive subsample of 11 teachers across elementary, middle, and high school levels. Guided by Bronfenbrenner’s Ecological Systems Theory and the Power Relations in Education framework, the study examined how intersecting layers of influence, from classroom interactions to institutional cultures and broader societal norms, and patterns of student-to-teacher aggression. The findings revealed frequent occurrences of verbal defiance, emotional manipulation, and cyberbullying. Many teachers reported feeling unsupported by school administrations and constrained by cultural attitudes that silenced discussions about teacher vulnerability. Educators described emotional exhaustion, professional frustration, and a growing sense of disempowerment in the face of persistent aggression. Their voices underscored the pressing need for structural reforms, including clear policies, sustained training, and a cultural shift that reinforces respect for educators. This research contributes to a broader understanding of the emotional and professional impact of student bullying on teachers and highlights the need for inclusive, context-sensitive strategies that prioritize educator well-being and authority in the school environment. Full article

Background: Hepatocellular carcinoma (HCC) is a leading indication for liver transplantation (LT), representing a curative treatment option for selected patients. A remaining clinical challenge is the recurrence of HCC after transplantation, impacting long-term graft and patient survival. The impact of different bridging therapies (BTs) such as transarterial chemoembolization (TACE), local ablation or liver resection on recurrence rates remains unclear. We assessed post-transplant HCC recurrence and survival focusing on the role of pre-transplant bridging therapies. Methods: Adult recipients undergoing LT for HCC at Hannover Medical School from January 2007 to September 2022 were retrospectively analyzed (n = 185). Recurrence was defined as confirmed intra or extrahepatic HCC after LT. Overall survival (OS) and recurrence-free survival (RFS) were analyzed using Kaplan–Meier estimation and log-rank testing; multivariable Cox proportional hazards regression was used to identify independent factors influencing OS. Results: Pre-transplant BT was administered in 85.4% of patients, consisting of only TACE, (n = 20; 10.8%), local ablation, (n = 32; 17.3%), liver resection (n = 27; 14.6%) or a multimodal approach (n = 50; 27%). Post-transplant HCC recurrence rate was 9.2% with a median time to recurrence of 845 days (range 126–3978 days). Patients with post-transplant HCC recurrence had a significantly higher prevalence of viral hepatitis (70.6% vs. 57.1%; p = 0.01), higher pre-transplant AFP peak levels (37.5 vs. 10 ng/mL; p = 0.03), larger tumor sizes (median 3.95 cm vs. 2.6 cm; p = 0.03) and more poorly differentiated tumors (G3; 25.0% vs. 5.3%, p = 0.04). Kaplan–Meier analysis showed significant overall differences in OS and RFS among bridging therapy groups (p = 0.03). In the subgroup of early HCC < 3 cm, local ablation was associated with significantly improved OS compared to TACE (p = 0.035). Last measured pre-transplant AFP < 15 ng/mL was a significant predictor of both improved OS (p = 0.006) and RFS (p = 0.008), whereas peak AFP did not reach significance after correction. Multivariable Cox regression revealed HCC recurrence, high recipient BMI and low LabMELD as independently associated with reduced OS after LT. Median OS after HCC recurrence was 13 months. Conclusions: Our monocentric retrospective data indicate that post-transplant HCC recurrence is uncommon but remains a challenge regarding life expectancy and is influenced by pre-transplant bridging therapy. In the subgroup of early HCC < 3 cm, local ablation was associated with significantly improved OS compared to TACE. Last measured pre-transplant AFP < 15 ng/mL was associated with both improved OS and RFS, suggesting that treatment response may also represent a prognostically relevant factor. Further prospective validation of contemporary locoregional and systemic bridging approaches, especially in the context of tumor biology and treatment response, is warranted. Full article

This study investigates the “competence–performance gap” between cognitive ability (measured by the WISC-IV) and actual adaptive performance (measured by the ABAS-II) in children with autism spectrum disorder (ASD), and examines the moderating role of family environment, specifically parental education levels. We applied Latent Profile Analysis (LPA) to cross-sectional data from 3246 children with ASD (aged 6–16 years). The analysis identified three distinct cognitive–adaptive subgroups: the Balanced High-Functioning group (33%), the Classic Mismatch group (44%), and the Cognitively Vulnerable group (23%). Notably, the Classic Mismatch group was characterized by adaptive performance that significantly trailed cognitive potential. Multinomial logistic regression revealed that maternal education—but not paternal education—significantly predicted a child’s likelihood of being in the “Balanced High-Functioning” group. This moderating effect was especially pronounced during the school-age years. These findings highlight the critical role of environmental factors in the translation of intellectual potential into practical social adaptive functioning, providing theoretical support for targeted family-based interventions. Full article

Science Festivals are public events focused on showcasing science, technology, engineering, and mathematics in a celebratory and engaging setting similar in atmosphere to an arts or music event. Aimed at the general public, science festivals vary widely in form and duration, lasting from anywhere between a day and several weeks, and featuring interactive activities such as hands-on workshops, live demonstrations, lectures, and performances. Many include dedicated programming for schools, but they differ from school-based science fairs, which are aimed primarily at students and parents and are typically held on school premises. Their aims include sparking curiosity, promoting scientific literacy, enabling visitors to interact with working scientists, and making science fun and accessible. Festivals are distinct from other informal science engagement formats due to their temporary, joyful nature and diversity of offerings. The modern science festival concept originated in Edinburgh in 1989 and has since experienced rapid global spread. Hundreds of events now take place annually throughout Europe and North America, and to a lesser extent other parts of the world, supported by associations such as the UK Science Festivals Network, the European Science Engagement Association, and, in the USA and Canada, the Science Festival Alliance. Some of the largest festivals see attendance figures in the hundreds of thousands, and across the world, millions of people participate every year. An emerging body of research literature, situated within a variety of social science disciplines and lenses, suggests that festivals are greatly enjoyed by their attendees, and succeed in boosting science interest, increasing knowledge, and improving perceptions of science among visitors, making them a potential asset for societies that place a high value on scientific activity among the population. However, the events have also attracted criticism for their limited audience diversity, with visitors being disproportionately drawn from highly educated and affluent groups, prompting suggestions that they are ‘preaching to the converted’. In response, some festivals have introduced targeted initiatives such as community outreach and partnerships to attract audiences from underrepresented communities. Despite these ongoing challenges, science festivals continue to evolve and grow as platforms for inspiring curiosity and fostering meaningful public dialogue around key scientific topics. Full article

Background: The use of sports supplements among adolescents is rising globally, driven by fitness trends and social media influence, yet knowledge gaps persist. This study aimed to assess supplement usage patterns, knowledge, attitudes, information sources, and the impact of a social media educational intervention among Serbian secondary school students. Methods: A single-group pre–post educational intervention study was conducted in secondary school students (aged 14–18) in Vojvodina, Serbia. A 21-question anonymous questionnaire was distributed to 1000 students along with parental informed consent forms. Pre-intervention survey assessed sociodemographics, physical activity and social media habits, supplement use information sources, and awareness of risks and banned substances. Based on the initial findings, an educational campaign delivered 56 short videos (≈70 s each) on Instagram and TikTok covering most frequently used supplements (e.g., creatine, proteins, caffeine, energy drinks). After, the intervention survey was repeated. The data were analyzed using the McNemar–Bowker test of symmetry. Results: In this study, 65% of Serbian secondary school adolescents reported being physically active, engaging predominantly in gym workouts and team sports. The majority of participants initiate dietary supplement use independently, without consulting healthcare professionals or adults. The most commonly used supplements were vitamins and minerals, while energy drinks ranked notably high. Social media intervention had a limited impact due to its short duration; however, certain changes were detected. Conclusions: Serbian adolescents frequently use sports supplements without adequate professional guidance. Long-term TikTok/Instagram interventions could be used in the future in order to influence behaviors and improve knowledge about sport supplement use. Full article