Search Results (522)

Generative AI (GenAI) technologies have been widely adopted by college students since the launch of ChatGPT in late 2022. While the debate about GenAI’s role in higher education continues, there is a lack of empirical evidence regarding whether and when these technologies can improve the learning experience for college students. This study utilizes data from a survey of 72,615 undergraduate students across 25 universities and colleges in China to explore the relationships between GenAI use and student learning engagement in different learning environments. The findings reveal that over sixty percent of Chinese college students use GenAI technologies in Academic Year 2023–2024, with academic use exceeding daily use. GenAI use in academic tasks is related to more cognitive and emotional engagement, though it may also reduce active learning activities and learning motivation. Furthermore, this study highlights that the role of GenAI varies across learning environments. The positive associations of GenAI and student engagement are most prominent for students in “high-challenge and high-support” learning contexts, while GenAI use is mostly negatively associated with student engagement in “low-challenge, high-support” courses. These findings suggest that while GenAI plays a valuable role in the learning process for college students, its effectiveness is fundamentally conditioned by the instructional design of human teachers. Full article

Understanding future changes in crop phenology and climate suitability is essential for sustaining winter wheat production in the Huang-Huai-Hai (3H) Plain under climate change. This study integrates bias-corrected CMIP6 climate projections, the DSSAT CERES-Wheat crop model, and Random Forest analysis to assess spatiotemporal shifts in winter wheat phenology and climate suitability. The assessment focuses on the mid- (2041–2060) and late 21st century (2081–2100) under the SSP2-4.5 and SSP5-8.5 scenarios. The results indicate that the vegetative and whole growing periods (VGP and WGP) will be extended in the mid-century but shorten by the late century. In contrast, the reproductive growing period (RGP) will be slightly reduced in the mid-century and extended under high emissions in the late century. Temperature suitability is projected to increase during the VGP and WGP but decline during the RGP. Precipitation suitability generally improves, except for a decrease during the reproductive period south of 32° N. Solar radiation suitability is expected to decline across all stages. Temperature is identified as the primary driver of phenological changes, with solar radiation and precipitation playing increasingly important roles in the mid- and late 21st century, respectively. Adaptive strategies, including the adoption of heat-tolerant varieties, longer reproductive periods, and earlier sowing, are recommended to enhance yield stability under future climate conditions. Full article

Recent updates to the reconstructions of Cenozoic environmental changes (global sea level, temperature, and atmospheric carbon dioxide content) have made it intriguing to compare them to paleontological records for original interpretations. Paleogene brachiopods have remained in the shadow of their Paleozoic–Mesozoic predecessors, and the reactions of their diversity to the Earth’s dramatic changes are poorly understood. The present work aims to fill this gap via a comparison of several diversity and paleoenvironmental curves. The generic diversity was established by stages with two essentially different paleontological datasets, and several fresh paleoenvironmental reconstructions were adopted. It was observed that neither Paleogene eustatic fluctuations nor changes in the atmospheric carbon dioxide content correspond well to the generic diversity dynamics of brachiopods. The changes in the total number of genera and the global temperatures demonstrate similarity at the Danian–Ypresian interval, but not later. The fluctuations in the brachiopod diversity are near the same level during the Eocene–Oligocene, despite strong paleoenvironmental changes, implying the intrinsic resistivity of these organisms to external influences. Additionally, the Cretaceous/Paleogene mass extinction, the Paleocene–Eocene thermal maximum, and the Early Eocene optimum could enhance the diversity dynamics together with the long-term temperature changes. In contrast, the influences of the Late Danian warming event and the Oi-1 glaciation were not observed. Full article

Pancreatic ductal adenocarcinoma (PDAC) remains a formidable malignancy with rising incidence and dismal long-term survival, largely due to late-stage presentation and intrinsic resistance to therapy. Recent advances in the multidisciplinary management of PDAC have reshaped treatment paradigms across disease stages. For localized disease, innovations in surgical techniques and the adoption of neoadjuvant strategies have improved resection rates and survival outcomes. In metastatic settings, multiagent chemotherapy regimens and precision therapies targeting BRCA mutations and rare gene fusions are expanding treatment options. Immunotherapeutic modalities, including checkpoint inhibitors, adoptive cell therapies, and mRNA vaccines, show emerging promise despite PDAC’s traditionally immunosuppressive microenvironment. This review synthesizes the current evidence on established therapies and critically evaluates novel and investigational approaches poised to redefine the therapeutic landscape of pancreatic cancer. Full article

The alkali–silica reaction (ASR) is an important mechanism of concrete deterioration, whereby reactive silica in aggregate interacts with cement alkalis to form expanding gel, which compromises the structural integrity of the concrete. Although the Republic of Korea has historically been classified as a low-risk region for ASR due to its geological stability, documented examples of concrete damage since the late 1990s have necessitated a rigorous reassessment of local aggregates. This study evaluated the ASR potential of 84 aggregate samples sourced from diverse Korean geological regions using standardized protocols, including ASTM C 1260 for mortar bar expansion and ASTM C 289 for chemical reactivity, supplemented by soundness, acid drainage, and weathering index analyses. The results indicate expansion within the range of 0.1–0.2%, classified as potentially deleterious, for some rock types. In addition to ASR reactivity, isolated high anomalies (e.g., high soundness, acid producing, and weathering) suggest the existence of other durability risks. Consequently, while Korean aggregates predominantly have a low ASR reactivity, the adoption of various validated ASR tests as a routine test and the integration of supplementary cementitious materials are recommended to ensure long-term concrete durability, highlighting the need for sustained monitoring and further investigation into mitigation strategies. Full article

Daoist robes in the Ming Dynasty literature underwent a marked transformation from exclusive religious vestments to widespread secular attire. Originally confined to Daoist priests and sacred rites, these garments began to appear in everyday work, entertainment, and ceremonies across social strata. Drawing on a hand-coded corpus of novels that yields robe related passages, and by analyzing textual references from Ming novels, Daoist canonical works, and visual artifacts, and applying clothing psychology and semiotic theory, this study elucidates how Daoist robes were re-coded as secular fashion symbols. For example, scholar-officials donned Daoist robes to convey moral prestige, laborers adopted them to signal upward mobility, and merchants donned them to impersonate the educated elite for commercial gain. By integrating close textual reading with cultural theory, the article advances a three-stage model, sacred uniform, ritual costume, and secular fashion, that clarifies the semantic flow of Daoist robes. In weddings and funerals, many commoners flaunted Daoist robes despite sumptuary laws, using them to assert honor and status. These adaptations reflect both the erosion of Daoist institutional authority and the dynamic process of identity construction through dress in late Ming society. Our interdisciplinary analysis highlights an East Asian perspective on the interaction of religion and fashion, offering historical insight into the interplay between religious symbolism and sociocultural identity formation. Full article

Background/Objectives: Population aging and the rise in chronic diseases challenge healthcare systems to adopt person-centered approaches, especially in palliative care (PC), where symptom management remains limited. Physiotherapy plays a key role in alleviating discomfort but faces inconsistent integration in Portugal due to lack of recognition. Variations in intervention methods hinder uniform care delivery, limiting timely patient access to comfort-focused treatments and knowledge. This study aims to deepen the understanding of physiotherapy’s role in Portuguese PC to improve its integration into teams and enhance patient access to comfort care. Methods: This study used a descriptive qualitative approach with online focus groups (FG), guided by Krueger and Casey’s methodology and adhering to the COREQ checklist. A non-probabilistic convenience sample of physiotherapists working in palliative care across mainland Portugal and the islands was selected based on inclusion criteria. Three FGs were planned with up to ten participants each. However, due to availability and attendance issues, only 15 physiotherapists participated: 5 in FG1 (in-hospital PC units), 6 in FG2 (inpatient units), and 4 in FG3, the minimum appropriate number from community-based units. Results: Physiotherapy plays a crucial yet underrecognized role in PC, emphasizing the need for its full integration into care teams rather than reliance on late, on-call referrals. Techniques such as positioning, mobilization, pain and dyspnea relief, adapted exercises, massage, music therapy, and emotional support are employed. Conventional physiotherapy tools are used and personalized according to the patient’s context, duration, setting, dosage, and individual needs. Conclusions: Physiotherapy should be recognized as a fundamental part of PC, contributing not only to the prolongation of life but also to ensuring comfort and dignity for patients and their families. To achieve this, its role within multidisciplinary teams must be strengthened and supported by regulations that guarantee access and the formal integration of physiotherapists. However, a significant gap remains in patients’ regular access to comfort-focused interventions at the appropriate time, perhaps due to the considerable variation in physiotherapy practices depending on the patient and care setting, which presents a challenge for knowledge development both in Portugal and globally. Full article

Immunotherapy has a defined role in the treatment of both early- and late-stage triple-negative breast cancer (TNBC) and is under active exploration in human epidermal receptor 2-positive as well as high-risk hormone-receptor-positive subtypes. It is critical to balance the efficacy and toxicity of immunotherapy while keeping the cost and duration of treatment in check. In addition to the immunohistochemistry testing of PD-L1 expression, which only predicts the efficacy of immunotherapy in metastatic TNBC, there is a lack of biomarkers that are better standardized to predict efficacy and treatment response, detect early relapse, and guide prognosis in breast cancer patients treated with immunotherapy. Circulating tumor DNA (ctDNA) is a minimally invasive, dynamic, real-time, blood-based biomarker that has shown promising value in the management of solid tumors, including breast cancer. This review discusses the emerging evidence for the potential application of ctDNA to further refine patient-centered care and personalize treatment based on a molecularly defined risk assessment for breast cancer patients treated with immunotherapy-based approaches. We further discuss the challenges and barriers to widespread adoption of this promising tool in the management of breast cancer patients requiring immunotherapy. Full article

Industrial hemp (Cannabis sativa L.) is gaining renewed interest as a sustainable source of natural fibres, particularly in regions like Belgium, where well-established flax processing infrastructure exists. However, region-specific data on varietal performance for long fibre production remain limited, hindering large scale adoption by both farmers and processors. This study aimed to assess the agronomic performance of early- and late-flowering hemp varieties under temperate maritime conditions through a three-year field trial at two sites in Flanders (Belgium). The evaluation focused on key parameters including emergence rate, plant morphology, long fibre yield and quality. Results showed that successful crop establishment is critical, as poor emergence influenced stem diameter (increasing with decreasing emergence) and leads to reduced long fibre yields by up to 50% between tested sites. Significant yield differences between trial years were present at both sites, with the biomass yield ranging from 10.7 to 14.5 and from 7.8 to 9.6 t ha⁻¹ for Bottelare and Beitem, respectively. Under favourable conditions, long fibre yields reached up to 2.4 t ha⁻¹ for late-flowering and 2.1 t ha⁻¹ for early- and mid-late-flowering varieties. In Western Europe, early to mid-late flowering varieties are generally favoured. Among these, the mid-late flowering variety Bialobrzeskie demonstrated strong yield potential. Overall, fibre quality across varieties was comparable to that of flax. Full article

This paper outlines a methodology for creating an educational and informative communication system for non-specialised audiences in order to preserve and pass on the heritage of ideas and practices adopted in the medieval political and administrative sphere. Through the combined use of digital technologies (such as GISs, 3D modelling and virtual tours), historical sources can potentially reveal how political and administrative aspects affected different areas within the medieval city, not just the main seats of power. Bologna, a prestigious medieval university metropolis, is chosen as a case study because of the remarkable wealth of documentation in its archives from the city’s political culture in the Middle Ages. Written historical sources, including documentary and narrative texts, are among the primary tools employed in the study of European medieval urban communities in general. Documentary sources help us understand and reconstruct the complexities of civic administration, urban policies and the economy, as well as how citizens experience them daily. The involvement of citizens in the political and administrative life of late medieval cities is explored through the management and digital processing of historical documentation. Digital humanities tools can facilitate this analysis, offering a perspective that sheds light on the formation of the pre-modern state. Although digital databases and repositories have significantly contributed to preserving and digitally archiving historical sources, these are often aimed exclusively at the academic level and remain underutilised as privileged didactic and educational tools for a broad audience. Full article

Lung cancer remains the leading cause of cancer-related mortality globally, largely due to late-stage diagnoses. While low-dose computed tomography (LDCT) has improved early detection and reduced mortality in high-risk populations, traditional screening strategies often adopt a one-size-fits-all approach based primarily on age and smoking history. This can lead to limitations, such as overdiagnosis, false positives, and the underrepresentation of non-smokers, which are especially prevalent in Asian populations. Precision medicine offers a transformative solution by tailoring screening protocols to individual risk profiles through the integration of clinical, genetic, environmental, and radiological data. Emerging tools, such as risk prediction models, radiomics, artificial intelligence (AI), and liquid biopsies, enhance the accuracy of screening, allowing for the identification of high-risk individuals who may not meet conventional criteria. Polygenic risk scores (PRSs) and molecular biomarkers further refine stratification, enabling more personalized and effective screening intervals. Incorporating these innovations into clinical workflows, alongside shared decision-making (SDM) and robust data infrastructure, represents a paradigm shift in lung cancer prevention. However, implementation must also address challenges related to health equity, algorithmic bias, and system integration. As precision medicine continues to evolve, it holds the promise of optimizing early detection, minimizing harm, and extending the benefits of lung cancer screening to broader and more diverse populations. This review explores the current landscape and future directions of precision medicine in lung cancer screening, emphasizing the need for interdisciplinary collaboration and population-specific strategies to realize its full potential in reducing the global burden of lung cancer. Full article

In late nineteenth-century Natal, members of the family of the missionary Bishop John William Colenso established relations with members of the Zulu royal family that were recognised as ties of kinship, mutually acknowledged by the reciprocal use of kinship terms between the two families. The Colenso family played a part in the struggle to defend Zulu sovereignty in the face of a colonial government intent on undermining the Zulu nation by diminishing the authority of the Zulu King. The visit by the Zulu king, Cetshwayo, to Queen Victoria in 1882 was seen by subsequent generations of Zulu as evidence of a connection between the British and Zulu royal families. While in exile on the island of St Helena, through adopting western dress and lifestyle, Cetshwayo’s son, Dinuzulu, sought to model his family on the British royal family. Bishop Colenso’s daughter, Harriette, played a role in facilitating this image, appearing as if a matriarch of Dinuzulu’s family in photographs which were perhaps intended to compare the two royal families, while also conveying a strong message that succession to the throne was secured by heredity, a message conveyed in representations of the British royal family from the sixteenth century to the present. Full article

Purpose/Objective: The clinical implementation of MR-guided radiotherapy on MR-linacs (MRL) hasrapidly increased in recent years. The advantages represented by the MR-based daily online plan adaptation and real-time monitoring have been exploited for different tumor sites. Nevertheless, some concerns remain, mainly related to the longer treatment time and limited patient eligibility. We report here the experience of our center, where a 1.5T MRL was clinically implemented in 2019 and, since then, more than 1200 patients have been treated. Material and Methods: The first 1000 patients treated at the MRL in our department were selected. Technical information such as treatment time and adaptive technic have been prospectively recorded, while toxicity data were retrospectively collected. Results: Between October 2019 and June 2024, 1000 patients for a total of 1061 treatment courses were included. Prostate and prostate bed were irradiated in 57.1% and 10.2% of the cases, respectively, including regional pelvic lymphnodes in 4.7%. Other frequent treated sites were lymph node metastases, pancreas and liver. The most frequent prescribed doses were 36.25 Gy (31%), 35 Gy (28.3%) and 30 Gy (9.4%) in five fractions. On a total of 9076 administered fractions, 80.8% were performed with adapt-to-shape and 19.2% with adapt-to-position method. The mean in-room time was 38 min (range, 18–103), with 74.4% of patients completing the session within 40 min. Acute grade (G) 3 toxicity was recorded in 1.6% of the cases, while, on a total of 858 patients available for late toxicity, G3 was recorded in 0.3% of the cases, with no >G3. Conclusions: Our real-world experience of an early-adopter center confirms that MRL treatments are feasible for different tumor entities in several anatomical sites. We showed that most of the patients could be treated within 40 min and showed low toxicity rates. Protocols for dose escalation and margin reduction, by adopting new comprehensive motion monitoring strategies, are under development. Full article

After the arrival of Jesuits in China during the late Ming dynasty, they adopted a strategy of aligning Catholicism with Confucianism, referring to themselves as “Western Confucians” to gain sympathy and support from the Chinese literati. However, during the early Qing dynasty, particularly during the late Kangxi era, because of the resurgence of traditional Confucian ideology and the consolidation of Manchu rule, literati attitudes toward Catholicism shifted significantly. This paper uses the early Qing scholar Dong Han (董含, 1626–?) from the Songjiang region as a case study, with his Notes in Three Hills 三冈识略 as the primary textual source, to analyze his critiques of Western learning (including Catholicism and Western science). Additionally, it examines Catholic responses to these critiques, based on the manuscript Refute the False Accusation 辩诬 collected in the BnF (Bibliothèque nationale de France). Through an analysis of Dong Han’s attitude toward Western learning and the responses it provoked, the paper aims to shed light on the changing attitudes of early Qing literati in the Jiangnan area toward Western learning, as well as the challenges faced by Catholicism in establishing their legitimacy in early modern China. It points out that the fundamental differences between Western learning and Confucianism prevented it from making an effective argument for legitimacy in China. The lack of support from the literati and the emperor led to the eventual fate of Catholicism—being prohibited. Full article

The increasing global demand for conventional energy has led to significant challenges, particularly due to rising CO₂ emissions and the depletion of natural resources. In the U.S., light-duty vehicles contribute significantly to transportation sector emissions, prompting a global shift toward electrified vehicles (EVs). Among the challenges that thwart the widespread adoption of EVs is the insufficient charging infrastructure (CI). This study focuses on exploring the complex relationship between EV adoption and CI growth. Employing a graph theoretic approach, we propose a graph model to analyze correlations between EV adoption and CI growth across 137 counties in six states. We examine how different time granularities impact these correlations in two distinct scenarios: Early Adoption and Late Adoption. Further, we conduct causality tests to assess the directional relationship between EV adoption and CI growth in both scenarios. Our main findings reveal that analysis using lower levels of time granularity result in more homogeneous clusters, with notable differences between clusters in EV adoption and those in CI growth. Additionally, we identify causal relationships between EV adoption and CI growth in 137 counties and show that causality is observed more frequently in Early Adoption scenarios than in Late Adoption ones. However, the causal effects in Early Adoption are slower than those in Late Adoption. Full article