Search Results (1,045)

This study, carried out as part of a large countrywide investigation into the sheep and goat industries in Greece, focused on respiratory problems of lambs and kids in Greece. The work was performed as part of a wider study performed in farms throughout the country with the participation of farmers, by means of an in-person questionnaire investigation. The specific objectives of the study were (a) the assessment of the presence of respiratory problems in lambs and kids and (b) the identification of variables associated with the presence of these problems in the farms. Data were collected from 325 sheep flocks and 119 goat herds. The annual incidence rate for respiratory problems in lambs was 1.4% (95% confidence intervals: 1.3–1.4%) and that in kids was 1.1% (1.0–1.2%). The annual incidence rate was significantly lower in farms that applied a semi-extensive or extensive management system (1.2% in sheep and 1.0% in goat farms) than in farms that applied an intensive or semi-intensive or extensive (1.5% and 1.3%, respectively) management system. In multivariable analysis, the lack of a barn for lambs, the proximity (<10 km) of the farm to industrial sites, and the experience of farmers emerged as significant predictors in sheep farms, and the proximity to industrial sites and the administration of antibiotics to newborns routinely emerged as significant predictors in goat farms. Sheep (27.4%) and goat (22.7%) farmers considered ‘pneumonia’ as the second most important health problem of lambs and kids. Respiratory problems were more often declared an important problem by farmers in proximity to industrial sites: 21.6% versus 12.5%. Overall, the study contributes information regarding the presence of respiratory problems in lambs and kids in Greece. A notable finding has been the association of proximity to industrial sites with a higher incidence rate of respiratory problems of lambs and kids in the farms. This has similarities to the results of relevant studies on people and potentially reflects that air pollution in the farm environment might be a factor to take into account in health management. One may also postulate that, possibly, data from farms can be employed to indicate potential risk from air pollution for humans, although further and more detailed work will be necessary to draw relevant conclusions. Full article

Introduction: Gene therapy using siRNA is a current area of research in oncology. Although siRNA formulations have not yet been approved for cancer therapy, numerous studies have demonstrated their therapeutic potential for tumor remission. Objective: To provide an overview of the formulations designed and developed to date based on synthetic siRNA for systemic administration to silence cancer genes. Methodology: A thorough search was conducted using the keywords “siRNA”, “therapy”, and “cancer”, with further classification of the resulting works into the various topics addressed in this review. Results: This review encompasses a wide range of aspects, from the design of siRNA using bioinformatics tools to the primary cellular signals and mechanisms targeted for inhibition in cancer therapy. It describes the primary chemical modifications made to siRNA chains to enhance stability, improve bioavailability, and ensure their binding to nanocarrier systems. siRNA formulations ranging from simple conjugates with biomolecules and small molecules to organic, inorganic, and hybrid nanoparticles, which are examined focusing on their advantages and disadvantages. The significance of nanosystems in dual therapy, including siRNA, for developing personalized treatments that achieve better outcomes is emphasized. Conclusions: Personalized cancer therapy appears to be the preferred approach for oncological treatments. To progress, strategies need to be tailored to the patient’s genetic profile. siRNA therapies provide a flexible platform for targeting and inhibiting critical oncogenes, enhancing the prospects of genomics-guided, patient-specific therapies. Full article

Personality assessment has long been recognized as a valuable tool for understanding individual differences with implications for self-understanding and growth-related processes. Building on the development of the Personality Spectrum Analysis (PSA), the present study evaluated the SOLACE Spectrum, a revised and expanded measure designed to provide a reliable and accessible framework for understanding personality in therapeutic and relational contexts. Data were collected from 1021 adults through online administration, and exploratory factor analysis revealed six components: Stability, Optimism, Leadership, Achievement, Compassion, and Extroversion. The instrument demonstrated strong internal consistency (α = 0.91) and robust test–retest reliability (0.851–0.922), indicating stability over time. Findings support the SOLACE Spectrum as a psychometrically sound measure that can inform understanding of personality traits, relationship processes, and personal growth processes. Its application may assist professionals in therapy, counseling, and educational or organizational settings by providing descriptive feedback on personality dimensions, highlighting areas of strength, and identifying potential areas for reflection and personal insight. Full article

Artificial Intelligence (AI), particularly Generative AI (GenAI) and Large Language Models (LLMs), is rapidly reshaping higher education by transforming teaching, learning, assessment, research, and institutional management. This entry provides a state-of-the-art, comprehensive, evidence-based synthesis of established AI applications and their implications within the higher education landscape, emphasizing mature knowledge aimed at educators, researchers, and policymakers. AI technologies now support personalized learning pathways, enhance instructional efficiency, and improve academic productivity by facilitating tasks such as automated grading, adaptive feedback, and academic writing assistance. The widespread adoption of AI tools among students and faculty members has created a critical need for AI literacy—encompassing not only technical proficiency but also critical evaluation, ethical awareness, and metacognitive engagement with AI-generated content. Key opportunities include the deployment of adaptive tutoring and real-time feedback mechanisms that tailor instruction to individual learning trajectories; automated content generation, grading assistance, and administrative workflow optimization that reduce faculty workload; and AI-driven analytics that inform curriculum design and early intervention to improve student outcomes. At the same time, AI poses challenges related to academic integrity (e.g., plagiarism and misuse of generative content), algorithmic bias and data privacy, digital divides that exacerbate inequities, and risks of “cognitive debt” whereby over-reliance on AI tools may degrade working memory, creativity, and executive function. The lack of standardized AI policies and fragmented institutional governance highlight the urgent necessity for transparent frameworks that balance technological adoption with academic values. Anchored in several foundational pillars (such as a brief description of AI higher education, AI literacy, AI tools for educators and teaching staff, ethical use of AI, and institutional integration of AI in higher education), this entry emphasizes that AI is neither a panacea nor an intrinsic threat but a “technology of selection” whose impact depends on the deliberate choices of educators, institutions, and learners. When embraced with ethical discernment and educational accountability, AI holds the potential to foster a more inclusive, efficient, and democratic future for higher education; however, its success depends on purposeful integration, balancing innovation with academic values such as integrity, creativity, and inclusivity. Full article

Context: Population segmentation is a critical health system planning activity that enables more integrated, needs-responsive, and sustainable care. This paper describes the development and evaluation of a Systemic Health System Population Segmentation Model based on the person-centred and needs-based Unified Care Model by Yishun Health, a regional population health system in Singapore. We highlight three implications to enhance health systems operational relevance: (i) psychosocial factors as key determinants of outcomes, (ii) accountability and resource allocation across differentiated segments, and (iii) integration of lifelong and episodic care needs. Methods: Three interdependent models were developed, a Lifelong Care Segmentation Model, a Needs-Based Sub-Segmentation Model, and an Episodic Care Segmentation Model, all underpinned by the Unified Care Model. These models systematically stratify residents into mutually exclusive and collectively exhaustive population groups based on biopsychosocial needs across different health system levels. An expert-driven design process was used, supported by integrated administrative and clinical data. Model evaluation examined the ability to stratify patients into distinct risk groups using healthcare utilisation, costs, and readmission outcomes. Findings: In 2022, 78,810 residents were segmented into seven lifelong care segments, with 43,473 residents with chronic conditions further stratified into sub-segments reflecting varying complexity and psychosocial needs. Additionally, 14,335 emergency admissions were categorised into six episodic care segments. Healthcare utilisation and annual healthcare costs differed significantly across needs-based sub-segments (p < 0.001). Higher episodic care needs were associated with longer hospital stays, higher rates of emergency readmissions, and admission costs (p < 0.001). Psychosocial issues consistently emerged as a key determinant of poorer outcomes, underscoring implications for more systemic and systematic accountability assignment and more deliberate resource planning, especially for care integration horizontally. The integration of lifelong and episodic care needs further enabled operational redesign for vertically integrated health systems. Conclusions: By incorporating psychosocial drivers, focusing on clarifying accountability and resource allocation, and lifelong-episodic care integration, our Systemic Health System Population Segmentation Model strengthens the operational utility of segmentation as a foundation for population health system transformation and provided a robust framework for health systems governance and leadership system redesign globally. Full article

Background: Biliary tract cancer (BTC) is an aggressive malignancy often diagnosed at an advanced stage and is associated with a poor prognosis. Non-invasive approaches can facilitate the early detection and identification of biomarkers to inform treatment strategies. Liquid biopsy, particularly through the analysis of circulating tumor DNA (ctDNA), has recently emerged as a valuable clinical and prognostic tool for guiding BTC management. Methods: The PubMed, Cochrane Library, and Wiley databases were searched for terms related to BTC and ctDNA, aiming to include studies evaluating the value of ctDNA as a predictor of overall (OS), progression-free (PFS), disease (DFS), and recurrence-free survival (RFS). Results: Twelve studies encompassing 2374 patients were considered eligible. The detection of ctDNA was associated with higher mortality and progression risk (HR 2.61, 95%CI 2.19–3.11 and HR 2.69, 95%CI 1.82–3.98, respectively), regardless of the ctDNA sampling time. The variant allele frequency (VAF) emerged as a valuable predictive marker, with higher VAF values being associated with higher mortality and progression risk (HR 2.37, 95%CI 1.83–3.06, and HR 2.22, 95%CI 1.40–3.53, respectively) compared with low levels of VAF. This association was observed regardless of chemotherapy administration, suggesting that VAF may serve as a potential marker of treatment resistance. Conclusions: This review underscores the clinical relevance of ctDNA status and related markers, such as VAF, in the management and prognostic evaluation of BTC. The findings support the integration of liquid biopsy into clinical practice to improve risk stratification, enable the early detection of relapse, and inform personalized treatment strategies, ultimately contributing to more precise and effective patient care in BTC. Full article

This article presents the first comprehensive study of six unprovenanced Sasanian clay bullae from Iran, held at the Framji Dadabhoy Alpaiwalla Museum in Mumbai. Bearing impressions from personal, official, and administrative seals, the seal impressions are here analysed for their iconography, stylistic characteristics, and Middle Persian inscriptions. The study proposes a chronological framework for the seals that produced their impressions on the bullae and situates the visual motifs within broader Sasanian artistic and symbolic traditions. It explains how these seal impressions reflect the intersection of visual culture, administrative function, and personal identity in Sasanian society, highlighting the complexity of interpreting sigillographic material where artistic convention and institutional roles converge. The inscriptions have been deciphered and enhance our knowledge of administrative practices in the Sasanian Empire. In particular, the study revisits the much debated term ⟨mgwh⟩ within the context of Sasanian administrative epigraphy. Full article

Food antioxidant supplementation has been widely proposed for cancer prevention and adjuvant therapy due to the pleiotropic role of antioxidants. Herein, particular attention is given to recent clinical trials based on the use of dietary supplements in cancer patients, both as monotherapy and in combination with standard treatments, exploring both their potential benefits and risks. This review focuses on the efficacy of the most important food antioxidants, highlighting how their action may change depending on different factors such as cancer type, dose, timing of administration and antioxidant status of the patient. The results of clinical trials are often contradictory, and the clinical benefit of dietary antioxidants appears more consistent in patients with a baseline antioxidant deficiency. Furthermore, by analyzing the mechanisms underlying the contradictory clinical evidence and critically addressing the issues related to the methodologies used in preclinical models, this review could be helpful in guiding the personalized use of antioxidant supplementation in cancer patients. Full article

Given the nexus between food insecurity and body dissatisfaction, a deeper understanding of this complex relationship in college students is needed. The purpose of this cross-sectional study, using the American College Health Association—National College and Health Assessment 2021 (n = 2003) at a large public university, was to explore the associations between food insecurity, personal appearance distress, and compensatory behaviors associated with body dissatisfaction. An analysis of variance with Tukey’s post hoc comparisons was performed to assess the relationship of outcomes associated with personal appearance distress by food security status. Structural equation modeling, using multivariable logistic and ordinal regression, were constructed to explore the impact of personal appearance distress, perception of body weight, weight control attempts, and dietary behaviors, adjusting for age, sex, race/ethnicity, body mass index, and food security status. Food insecurity was associated with lower grade point average, higher overall stress, and personal appearance distress. Personal appearance distress was associated with fewer servings of vegetables (p = 0.006) and fruits (p = 0.01), higher perceived body weight (p < 0.001), and more weight modification attempts (p < 0.05). The associations between food insecurity, personal appearance distress, and compensatory behaviors could extend to disordered eating behaviors, necessitating awareness and interventions from college campus programming and administration. Full article

Student dropout remains a persistent challenge in higher education, with substantial personal, institutional, and societal costs. We developed a modular dropout prediction pipeline that couples data preprocessing with multi-model benchmarking and a governance-ready explainability layer. Using 17,883 undergraduate records from a Moroccan higher education institution, we evaluated nine algorithms (logistic regression (LR), decision tree (DT), random forest (RF), k-nearest neighbors (k-NN), support vector machine (SVM), gradient boosting, Extreme Gradient Boosting (XGBoost), Naïve Bayes (NB), and multilayer perceptron (MLP)). On our test set, XGBoost attained an area under the receiver operating characteristic curve (AUC–ROC) of 0.993, F1-score of 0.911, and recall of 0.944. Subgroup reporting supported governance and fairness: across credit–load bins, recall remained high and stable (e.g., <9 credits: precision 0.85, recall 0.932; 9–12: 0.886/0.969; >12: 0.915/0.936), with full TP/FP/FN/TN provided. A Shapley additive explanations (SHAP)-based layer identified risk and protective factors (e.g., administrative deadlines, cumulative GPA, and passed-course counts), surfaced ambiguous and anomalous cases for human review, and offered case-level diagnostics. To assess generalization, we replicated our findings on a public dataset (UCI–Portugal; tables only): XGBoost remained the top-ranked (F1-score 0.792, AUC–ROC 0.922). Overall, boosted ensembles combined with SHAP delivered high accuracy, transparent attribution, and governance-ready outputs, enabling responsible early-warning implementation for student retention. Full article

Primary and secondary school teachers in China bear a substantial additional administrative workload. However, no quantitative study has examined the effects of this workload on teachers. Drawing on the Job Demands–Resources model and Conservation of Resources theory, we examined the relationship between extra-administrative workload (school level), emotional exhaustion (personal level), and work engagement (personal level) by administering questionnaires and estimating a multilevel linear model. A total of 318 teachers from 51 primary and secondary schools participated in the study. The results indicated that (a) school-level extra-administrative workload significantly and positively predicted teachers’ emotional exhaustion, and (b) emotional exhaustion, in turn, significantly and positively predicted teachers’ work engagement. These findings provide an empirical basis for school management and policy formulation in primary and secondary education and offer practical guidance for promoting teachers’ mental health. Full article

This study examines the financial behavior of university students in Economics, Business Administration, and Accounting in Tegucigalpa, Honduras, using the FB–13 instrument. Exploratory and confirmatory factor analyses validate a three-dimensional structure: (1) financial planning and control, (2) savings and financial preparation, and (3) fulfillment of obligations, with high internal consistency (α = 0.915), supporting its psychometric robustness in Latin American academic contexts. Based on a sample of 714 students with diversity in gender, age, work experience, and parental status, the analyses confirmed that the FB–13 model best fits a three-factor structure. Significant correlations were identified between financial behavior and experiential variables such as age, work experience, and parenthood, while traditional sociodemographic attributes such as gender, residence, marital status, employment, and educational level showed limited associations. These findings suggest that personal experiences have a greater influence on the configuration of financial practices than conventional demographic categories. The study acknowledges limitations related to cross-sectional design, non-probabilistic sampling, and self-reported data, yet these do not diminish its contributions. By validating the FB–13 in Honduras, the research offers comparative evidence and promotes cultural diversity in financial behavior literature. Future research should move toward longitudinal and qualitative studies that explore the role of family dynamics, work contexts, and personal aspirations in responsible financial behaviors. Full article

Background/Objectives: Workplace violence remains an important vocational psycho-social risk for nurses employed in the emergency department (ED). We investigated the characteristics of workplace violence against ED nurses, and associations with self-assessed resilience, socio-demographic and vocational parameters, including turnover intention. Methods: ED nurses employed in all public hospitals in the Republic of Cyprus (RC) participated. After obtaining informed consent, data were collected using census sampling (January–June 2024) via the translated 2016 Italian National Survey on Violence towards Emergency Nurses Questionnaire (QuINVIP16) for investigating workplace violence characteristics, and the Connor-Davidson Resilience Scale (CD-RISC-25) for assessing self-perceived resilience. Results: A total of 132 nurses (53.0% response rate) participated. Verbal violence was reported by 70.5% to 92.4% of participants. Long waiting times, overcrowded EDs, and perception of inadequate attention from healthcare professionals were reported as the primary triggers for violence towards participants by patients/visitors. One-third of participants reported that violence-reporting systems were unclear, while 1 out of 4 reported inadequate safety measures against violence. Participants with higher scores of self-perceived resilience were less likely to report turnover intention due to workplace violence (p < 0.001), while those with lower self-perceived resilience reported a significant decrease in work motivation (p = 0.005). Those who experienced decreased work motivation after exposure to a violent episode were more likely to consider a) leaving the profession [OR (95%CI): 79.1(17.7–353.2); p < 0.01], and b) moving to a different work setting [OR (95%CI): 17.0(3.8–76.2); p < 0.01], and actually applying to be transferred to a different work setting [OR (95%CI): 19.6(4.2–91.5); p < 0.01]. Moreover, those who had not attended communication skills training were 4 times more likely to consider leaving the profession following exposure to violence [OR (95%CI): 4.2(1.1–16.2); p = 0.04]. Conclusions: This study is among the few to link workplace violence with both resilience and actual turnover behaviors among emergency nurses, in general and particularly in the post-pandemic era. By showing how personal resilience in the face of violence is shaped by organizational support, such as reporting systems and training, the present findings move beyond individuals-level explanations, and highlight workplace violence as a systematic administrative challenge. This insight represents an important advance in current knowledge, and calls for multifaceted interventions that strengthen both personal and institutional capacity to address violence. Full article

Background: hearing loss represents, today, one of the most significant health problems affecting the world’s population. This clinical condition, particularly manifest in adulthood, can arise or be aggravated by both the presence of specific pathologies and by taking multiple classes of drugs at the same time. Methods: to understand this relationship, the present non-interventional observational study aimed to investigate the relationship between worsening hearing abilities in 1651 patients aged between 18 and 99 years. In particular, the thorough history of patients allowed us to evaluate the pathological profiles, pharmacological profiles, and therapeutic regimens adopted. This allowed us to evaluate its association with self-reported hearing loss, assessed through the administration of the HHIE-S-It questionnaire. Furthermore, given the presence of multimorbidity, the possible correlation between self-reported hearing loss and the specific classes of drugs, categorized using the Anatomical Therapeutic Classification (ATC) system, was evaluated. Results: the results highlighted how patients taking drugs, both in mono- and polytherapy regimens, had higher hearing deficits than patients not taking drugs. Furthermore, an apparent dose–response effect, in which the risk of moderate to severe impairment progressively increased with the number of drugs taken, was also observed. Different classes of drugs, particularly those used for the treatment of diseases of the cardiovascular system, as well as drugs for acid-related disorders, were significantly linked to an increased risk of perceived hearing impairment. On the contrary, agents belonging to the antidiabetic category have proven to be drugs capable of offering a potential protective effect. Conclusion: this study highlighted how both the number of drugs taken and some specific categories of drugs can contribute to perceived hearing impairment. While this evidence highlights the importance of integrating audiological evaluation into the management of patients in polypharmacy, the cross-sectional nature of the design precludes the inference of causality. This evidence still favors safer and more personalized therapeutic strategies. Full article

Background/Objectives: Family physicians are key stakeholders in the implementation of cancer prevention strategies, including risk factor assessment, lifestyle counseling, and early detection. Despite this, integration of personalized prevention into routine practice remains limited. This study aimed to explore family physicians’ perspectives on barriers, training needs, and collaboration opportunities in cancer prevention. Methods: A mixed-methods study was conducted using an exploratory sequential design. The qualitative phase involved semi-structured interviews with 12 family physicians from the North-West Region of Romania. Thematic analysis was employed to identify main challenges and opportunities. Findings informed the development of a structured online survey completed by 50 family physicians. Descriptive and comparative statistical analyses were applied to assess trends and subgroup differences. Results: Interviews and survey data revealed multiple barriers to cancer prevention in primary care: insufficient consultation time, limited access to diagnostic tools, administrative workload, and low patient health literacy. Physicians reported moderate familiarity with personalized prevention but expressed strong interest in further training, particularly through flexible and interactive learning formats. Collaboration with cancer centers was considered suboptimal; participants emphasized the need for streamlined referral pathways and improved communication. Conclusions: The study highlights systemic and educational gaps affecting cancer prevention efforts in family medicine. Tailored training programs, digital integration with cancer centers, and targeted policy adjustments are needed to enhance prevention capacity within primary care. Full article