Search Results (9,465)

Background/Objectives: Health education plays a vital role in training health professionals and caregivers, supporting both prevention and the promotion of self-care. In this context, technology serves as a valuable ally by enabling continuous and flexible learning. Among the various domains of health education, nutrition stands out as a key element in the management of Amyotrophic Lateral Sclerosis (ALS), helping to prevent malnutrition and enhance patient well-being. Accordingly, this study aimed to evaluate the effectiveness of the teaching and learning processes within a learning pathway focused on food and nutrition in the context of ALS. Methods: This study adopted a longitudinal, quantitative design. The learning pathway, titled “Food and Nutrition in ALS,” consisted of four self-paced and self-instructional Massive Open Online Courses (MOOCs), offered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). Participants included health professionals, caregivers, and patients from all five regions of Brazil. Participants had the autonomy to complete the courses in any order, with no prerequisites for enrollment. Results: Out of 14,263 participants enrolled nationwide, 182 were included in this study after signing the Informed Consent Form. Of these, 142 (78%) completed at least one course and participated in the educational intervention. A significant increase in knowledge was observed, with mean pre-test scores rising from 7.3 (SD = 1.8) to 9.6 (SD = 0.9) on the post-test across all courses (p < 0.001). Conclusions: The self-instructional, technology-mediated continuing education model proved effective in improving participants’ knowledge about nutrition in ALS. Future studies should explore knowledge retention, behavior change, and the impact of such interventions on clinical outcomes, especially in multidisciplinary care settings. Full article

Employee turnover remains a critical challenge for organizations, prompting an examination of how leadership approaches influence employees’ intentions to leave. This study investigates the impact of transformational leadership on turnover intention, focusing on emotional exhaustion and creativity as potential mediators. The study employs a quantitative design grounded in leadership and organizational psychology theory and surveys 182 professionals working in the information technology sector across Bosnia and Herzegovina, Croatia, Serbia, and Montenegro. Structural equation modeling reveals that transformational leadership reduces turnover intention by alleviating emotional exhaustion, highlighting the importance of psychological well-being in employee retention. While transformational leadership enhances employee creativity, creativity did not significantly mediate turnover intention in this context. These findings suggest that strategies that foster engagement and reduce burnout in knowledge-intensive industries can strengthen organizational commitment and improve retention. This study contributes to the understanding of behavioral mechanisms linking leadership to employee outcomes and offers actionable insights for modern organizations aiming to address turnover through supportive, empowering leadership practices. Additional mediators and contextual variables should be explored in further research. Full article

This paper examines the effect of digital innovation on cost stickiness in manufacturing firms, focusing on the underlying mechanisms and contextual factors. Using data from Chinese A-share listed manufacturing firms from 2012 to 2023, we find that, first, for each one-unit increase in the level of digital technology, the cost stickiness index of enterprises decreases by an average of 0.4315 units, primarily through digital process innovation and digital business model innovation, whereas digital product innovation does not exhibit a statistically significant impact. Second, manufacturing servitization and the optimization of human capital structure are identified as key mediating mechanisms. Digital innovation promotes servitization by transitioning firms from product-centric to service-oriented business models, thereby reducing fixed costs and improving resource flexibility. It also optimizes human capital by increasing the proportion of high-skilled employees and reducing labor adjustment costs. Third, the effect of digital innovation on cost stickiness is found to be heterogeneous. Firms with high financing constraints benefit more from the cost-reducing effects of digital innovation due to improved resource allocation efficiency. Additionally, mid-tenure executives are more effective in leveraging digital innovation to mitigate cost stickiness, as they balance short-term performance pressures with long-term strategic investments. These findings contribute to the understanding of how digital transformation reshapes cost behavior in manufacturing and provide insights for policymakers and firms seeking to achieve sustainable development through digital innovation. Full article

Backgroud. Endometriosis is a chronic, estrogen-dependent inflammatory disease characterized by the ectopic presence of endometrial-like tissue. Although genome-wide association studies (GWAS) have identified susceptibility variants, their tissue-specific regulatory impact remains poorly understood. Objective. To functionally characterize endometriosis-associated variants by exploring their regulatory effects as expression quantitative trait loci (eQTLs) across six physiologically relevant tissues: peripheral blood, sigmoid colon, ileum, ovary, uterus, and vagina. Methods. GWAS-identified variants were cross-referenced with tissue-specific eQTL data from the GTEx v8 database. We prioritized genes either frequently regulated by eQTLs or showing the strongest regulatory effects (based on slope values, which indicate the direction and magnitude of the effect on gene expression). Functional interpretation was performed using MSigDB Hallmark gene sets and Cancer Hallmarks gene collections. Results. A tissue specificity was observed in the regulatory profiles of eQTL-associated genes. In the colon, ileum, and peripheral blood, immune and epithelial signaling genes predominated. In contrast, reproductive tissues showed the enrichment of genes involved in hormonal response, tissue remodeling, and adhesion. Key regulators such as MICB, CLDN23, and GATA4 were consistently linked to hallmark pathways, including immune evasion, angiogenesis, and proliferative signaling. Notably, a substantial subset of regulated genes was not associated with any known pathway, indicating potential novel regulatory mechanisms. Conclusions. This integrative approach highlights the com-plexity of tissue-specific gene regulation mediated by endometriosis-associated variants. Our findings provide a functional framework to prioritize candidate genes and support new mechanistic hypotheses for the molecular pathophysiology of endometriosis. Full article

Under the rapid development of the digital economy, the interactive relationship between exports and the digital economy has become an important issue for promoting regional economic growth. Based on the panel data of 31 provinces and municipalities in China from 2012 to 2022, this paper systematically examines the impact of exports on economic growth and the moderating role of the digital economy, and it introduces research and development (R&D) investment to test its mediating mechanism. The research finds that exports significantly promote regional economic growth. The digital economy has a negative moderating effect on the export growth effect, and it is significant in the eastern region but not significant in the central and western regions, showing obvious regional heterogeneity. R&D investment has played a partial mediating role between exports and economic growth. This paper suggests that the government should focus on regional differences, promote the deep integration of the digital economy and exports, enhance technological innovation capabilities, formulate differentiated policies based on local conditions, strengthen the construction of digital infrastructure, optimize the export structure, support the development of R&D-driven enterprises, and build a digital export system that promotes regional coordination and high-quality growth, so as to achieve high-quality coordinated sustainable regional development. This paper also has certain reference value for other developing economies, in promoting the integration of the digital economy and trade. Full article

In the context of increasing Artificial Intelligence integration in higher education, understanding the factors influencing university teachers’ adoption of AI tools is critical for effective implementation. This study adopts a perception–intention–behavior framework to explores the roles of perceived usefulness, perceived ease of use, perceived trust, perceived substitution crisis, and perceived risk in shaping teachers’ behavioral intention and actual usage of AI tools. It also investigates the moderating effects of peer influence and organizational support on these relationships. Using a comprehensive survey instrument, data was collected from 487 university teachers across four major regions in China. The results reveal that perceived usefulness and perceived ease of use are strong predictors of behavioral intention, with perceived ease of use also significantly influencing perceived usefulness. Perceived trust serves as a key mediator, enhancing the relationship between perceived usefulness, perceived ease of use, and behavioral intention. While perceived substitution crisis negatively influenced perceived trust, it showed no significant direct effect on behavioral intention, suggesting a complex relationship between job displacement concerns and AI adoption. In contrast, perceived risk was found to negatively impact behavioral intention, though it was mitigated by perceived ease of use. Peer influence significantly moderated the relationship between perceived trust and behavioral intention, highlighting the importance of peer influence in AI adoption, while organizational support amplified the effect of perceived ease of use on behavioral intention. These findings inform practical strategies such as co-developing user-centered AI tools, enhancing institutional trust through transparent governance, leveraging peer support, providing structured training and technical assistance, and advancing policy-level initiatives to guide digital transformation in universities. Full article

As artificial intelligence (AI) becomes increasingly embedded in organizational development, understanding how leadership shapes employee responses to AI is critical for fostering workplace innovation. Drawing on trait activation theory, this study develops a theoretical model in which employee AI trust enhances innovative performance through AI crafting. Paternalistic leadership serves as a situational moderator, while the leader’s AI opportunity perception functions as a higher-order moderator. A three-wave survey was conducted with 523 employees from 14 AI-intensive manufacturing firms in China. Results show that the interaction between AI trust and paternalistic leadership positively predicts both AI crafting and innovative performance. In addition, AI crafting mediates the effect of the interaction term on innovative performance. Furthermore, the leader’s AI opportunity perception moderates this interactive effect: when this perception is high, the positive impact of AI trust and paternalistic leadership on AI crafting is significantly stronger; when it is low, the effect weakens. These findings contribute to the literature by clarifying the situational and cognitive conditions under which AI trust promotes innovation, thereby extending trait activation theory to AI-enabled workplaces and offering actionable insights for leadership development in the intelligent era. Full article

Zinc finger proteins are frequently implicated in a wide range of neurodevelopmental disorders (NDDs). In this study, we report a case of mild intellectual disability (ID), global developmental delay (GDD), and developmental coordination disorder (DCD) in an individual with unaffected parents. Trio-based whole-exome sequencing (WES) identified a de novo variant (c.1530dup, p.Glu511ArgfsTer16) in the ZNF496 gene of the proband. According to ACMG guidelines, this novel variant is classified as pathogenic. It creates a frameshift that introduces a premature stop codon, resulting in a truncated protein of 525 amino acids (compared to the wild-type 587 residues). Notably, NMDEscPredictor analysis predicted that the transcript escapes nonsense-mediated decay (NMD) despite the frameshift. Computational analyses suggest the potential pathogenetic effects of the identified variant. As documented, ZNF496 interacts with JARID2, a gene associated with NDDs, ID and facial dysmorphism (MIM: #620098). In silico analyses suggest that the identified mutation disrupts this interaction by deleting ZNF496’s C2H2 domain, potentially dysregulating JARID2 target genes. To our knowledge, this is the first reported association between ZNF496 and NDDs, and the variant has been submitted to the ClinVar database (SCV006100880). Functional studies are imperative to validate ZNF496’s role in NDDs and confirm the mutation’s impact on ZNF496-JARID2 interactions. Full article

Mesenchymal stem cells (MSCs), i.e., adult stem cells with immunomodulatory and secretory properties, contribute to tissue growth and regeneration, including healing processes. Some metal nanoparticles (NPs) are known to exhibit antimicrobial activity and may further potentiate tissue healing. We studied the effect of Ag, CuO, and ZnO NPs after in vitro exposure of mouse MSCs at the transcriptional level in order to reveal the potential toxicity as well as modulation of other processes that may modify the activity of MSCs. mRNA–miRNA interactions were further investigated to explore the epigenetic regulation of gene expression. All the tested NPs mediated immunomodulatory effects on MSCs, generation of extracellular vesicles, inhibition of osteogenesis, and enhancement of adipogenesis. Ag NPs exhibited the most pronounced response; they impacted the expression of the highest number of mRNAs, including those encoding interferon-γ-stimulated genes and genes involved in drug metabolism/cytochrome P450 activity, suggesting a response to the potential toxicity of Ag NPs (oxidative stress). Highly interacting MiR-126 was upregulated by all NPs, while downregulation of MiR-92a was observed after the ZnO NP treatment only, and both effects might be associated with the improvement of MSCs’ healing potency. Overall, our results demonstrate positive effects of NPs on MSCs, although increased oxidative stress caused by Ag NPs may limit the therapeutical potential of the combined MSC+NP treatment. Full article

Macrophage-mediated inflammation is known to be involved in the epithelial–mesenchymal transition (EMT) of various types of cancer. This makes macrophage-derived inflammatory factors prime targets for the development of new treatments. This study uncovers the therapeutic potential and action mechanism of DAB-2-28, a small-molecule derived from para-aminobenzoic acid, in the treatment of breast cancer. The luminal MCF-7 and the triple-negative MDA-MB-231 cancer cell lines used in this study represent, respectively, breast cancers in which the differentiation states are related to the epithelial phenotype of the mammary gland and breast cancers expressing a highly aggressive mesenchymal phenotype. In MCF-7 cells, soluble factors from macrophage-conditioned media (CM-MØ) induce a characteristic morphology of mesenchymal cells with an upregulated expression of Snail1, a mesenchymal marker, as opposed to a decrease in the expression of E-cadherin, an epithelial marker. DAB-2-28 does not affect the differential expression of Snail1 and E-cadherin in response to CM-MØ, but negatively impacts other hallmarks of EMT by decreasing invasion and migration capacities, in addition to MMP9 expression and gelatinase activity, in both MCF-7 and MDA-MB-231 cells. Moreover, DAB-2-28 inhibits the phosphorylation of key pro-EMT transcriptional factors, such as NFκB, STAT3, SMAD2, CREB, and/or AKT proteins, in breast cancer cells exposed to different EMT inducers. Overall, our study provides evidence suggesting that inhibition of EMT initiation or maintenance is a key mechanism by which DAB-2-28 can exert anti-tumoral effects in breast cancer cells. Full article

Background: Workplace mobbing is a widespread phenomenon with serious psychological and emotional consequences on employees’ emotional well-being. Psychological resilience has been identified as a potential protective factor against such adverse outcomes. Aim: This study investigates the relationship between workplace mobbing and emotional well-being, as expressed through positive and negative affect, and examines the mediating role of psychological resilience in this association. Methods: Ninety nurses participated in this cross-sectional study. Data were collected using the Connor–Davidson Resilience Scale (CD-RISC), the Workplace Psychologically Violent Behaviors (WPVB) scale, and the Positive and Negative Affect Schedule (PANAS). Statistical analyses included correlation, multiple regression, and mediation using bootstrapped confidence intervals. Results: Resilience was strongly associated with positive affect (r = 0.74, p < 0.001) and inversely with negative affect (r = −0.46, p < 0.001). Mobbing was significantly related to increased negative affect (β = 0.12, p < 0.001) but not to positive affect. Resilience emerged as the strongest predictor of emotional outcomes and partially mediated the relationship between “Attack on professional role” and negative affect. Conclusions: Psychological resilience plays a key protective role in moderating the emotional impact of workplace mobbing. Enhancing resilience in healthcare professionals may mitigate the negative emotional effects of mobbing, although it does not fully buffer against all its consequences. Full article

This review explores the biofilm architecture and drug resistance of Enterococcus faecalis in clinical and environmental settings. The biofilm in E. faecalis is a heterogeneous, three-dimensional, mushroom-like or multilayered structure, characteristically forming diplococci or short chains interspersed with water channels for nutrient exchange and waste removal. Exopolysaccharides, proteins, lipids, and extracellular DNA create a protective matrix. Persister cells within the biofilm contribute to antibiotic resistance and survival. The heterogeneous architecture of the E. faecalis biofilm contains both dense clusters and loosely packed regions that vary in thickness, ranging from 10 to 100 µm, depending on the environmental conditions. The pathogenicity of the E. faecalis biofilm is mediated through complex interactions between genes and virulence factors such as DNA release, cytolysin, pili, secreted antigen A, and microbial surface components that recognize adhesive matrix molecules, often involving a key protein called enterococcal surface protein (Esp). Clinically, it is implicated in a range of nosocomial infections, including urinary tract infections, endocarditis, and surgical wound infections. The biofilm serves as a nidus for bacterial dissemination and as a reservoir for antimicrobial resistance. The effectiveness of first-line antibiotics (ampicillin, vancomycin, and aminoglycosides) is diminished due to reduced penetration, altered metabolism, increased tolerance, and intrinsic and acquired resistance. Alternative strategies for biofilm disruption, such as combination therapy (ampicillin with aminoglycosides), as well as newer approaches, including antimicrobial peptides, quorum-sensing inhibitors, and biofilm-disrupting agents (DNase or dispersin B), are also being explored to improve treatment outcomes. Environmentally, E. faecalis biofilms contribute to contamination in water systems, food production facilities, and healthcare environments. They persist in harsh conditions, facilitating the spread of multidrug-resistant strains and increasing the risk of transmission to humans and animals. Therefore, understanding the biofilm architecture and drug resistance is essential for developing effective strategies to mitigate their clinical and environmental impact. Full article

Virtual influencers (VIs) on e-commerce platforms are becoming increasingly popular, enhancing the consumer experience. This study examines the consumer–brand relationship (CBR) with VIs through the perspective of social presence. Data from 1041 e-commerce platform users (e.g., Douyin, RED, Weibo) were collected and analyzed using Structural Equation Modeling (SEM). The findings reveal that both the visual and mental human-likeness of VIs significantly strengthen CBR, with social presence acting as a mediator. Additionally, the interaction between visual and mental human-likeness positively impacts social presence, which in turn enhances CBR. Moreover, consumers’ need for uniqueness moderates the relationship between social presence and CBR, providing valuable insights for virtual influencer strategies in e-commerce. This research suggests the feasibility of leveraging VI design both visually and mentally to capture new trends in developing effective virtual campaigns with digitization and metaverse technologies. This study extends the stream of research VIs use for interactive marketing, highlighting the role of parasocial relationships in interactive marketing. These findings can provide managers with a better understanding of VI design from both visual and mental aspects. Full article

Chemotherapy remains a cornerstone in the treatment of esophageal cancer (EC), yet chemoresistance remains a critical challenge, leading to poor outcomes and limited therapeutic success. Mitochondrial DNA (mtDNA) has emerged as a pivotal player in mediating these responses, influencing cellular metabolism, oxidative stress regulation, and apoptotic pathways. This review provides a comprehensive overview of the mechanisms by which mtDNA alterations, including mutations and copy number variations, drive chemoresistance in EC. Specific focus is given to the role of mtDNA in metabolic reprogramming, including its contribution to the Warburg effect and lipid metabolism, as well as its impact on epithelial–mesenchymal transition (EMT) and mitochondrial bioenergetics. Recent advances in targeting mitochondrial pathways through novel therapeutic agents, such as metformin and mitoquinone, and innovative approaches like CRISPR/Cas9 gene editing, are also discussed. These interventions highlight the potential for overcoming chemoresistance and improving patient outcomes. By integrating mitochondrial diagnostics with personalized treatment strategies, we propose a roadmap for future research that bridges basic mitochondrial biology with translational applications in oncology. The insights offered in this review emphasize the critical need for continued exploration of mtDNA-targeted therapies to address the unmet needs in EC management and other diseases associated with mitochondria. Full article

Governments worldwide are mandating e-invoicing and real-time VAT reporting, yet many cash-intensive service SMEs continue to under-report VAT, eroding fiscal revenues. This study investigates whether financial technology (FinTech) adoption can reduce this under-reporting among tourism SMEs in Greece—an economy with high seasonal spending and a persistent shadow economy. This is the first micro-level empirical study to examine how FinTech tools affect VAT compliance in this sector, offering novel insights into how technology interacts with behavioral factors to influence fiscal behavior. Drawing on the Technology Acceptance Model, deterrence theory, and behavioral tax compliance frameworks, we surveyed 214 hotels, guesthouses, and tour operators across Greece’s main tourism regions. A structured questionnaire measured five constructs: FinTech adoption, VAT compliance behavior, tax morale, perceived audit probability, and financial performance. Using Partial Least Squares Structural Equation Modeling and bootstrapped moderation–mediation analysis, we find that FinTech adoption significantly improves declared VAT, with compliance fully mediating its impact on financial outcomes. The effect is especially strong among businesses led by owners with high tax morale or strong perceptions of audit risk. These findings suggest that FinTech tools function both as efficiency enablers and behavioral nudges. The results support targeted policy actions such as subsidies for e-invoicing, tax compliance training, and transparent audit communication. By integrating technological and psychological dimensions, the study contributes new evidence to the digital fiscal governance literature and offers a practical framework for narrowing the VAT gap in tourism-driven economies. Full article