Search Results (2,890)

Metabolic syndrome (MetS) is a multifactorial clinical condition characterized by the co-occurrence of abdominal obesity, impaired glucose metabolism, high blood pressure, and dyslipidemia. Non-pharmacological strategies, such as hypocaloric diets (HD) and structured physical training (PT), have shown promise in improving metabolic and functional outcomes in this population. The aim of this prospective interventional study was to evaluate the effects of a 16-week program combining HD with PT on ventilatory efficiency and cardiometabolic risk markers in women with MetS. Forty-one sedentary women (aged 45–55 years) with clinically diagnosed MetS underwent anthropometric, metabolic, nutritional, and cardiopulmonary assessments before and after the intervention. Participants engaged in 60 min exercise sessions three times per week and followed a personalized hypocaloric diet targeting 5–10% weight loss. Post-intervention analyses revealed significant reductions (p ≤ 0.05) in body weight (from 86.6 kg ± 3.3 kg to 78.2 kg ± 3.3 kg), body fat percentage (40.1% ± 0.6% to 33.4% ± 1.6%), and waist circumference (105.1 cm ± 1.2 cm to 95.7 cm ± 1.9 cm). Improvements were also observed in fasting glucose (from 117.1 mg/dL to 95.1 mg/dL) and triglycerides (158.8 mg/dL ± 9.1 mg/dL to 111.8 mg/dL ± 9.1 mg/dL), and in lean mass percentage (59.9% ± 6.5% to 66.6% ± 1.7%). Cardiopulmonary variables showed enhanced ventilatory function, with increased VO₂peak (1.59 L/min ± 0.1 L/min to 1.74 ± 0.1 L/min), improved oxygen uptake efficiency slope (OUES), and a steeper VO₂/workload relationship. Resting heart rate and blood pressure declined significantly (69.9 bpm ± 2.0 bpm to 64.9 ± 1.8 bpm; 145.4 mmHg ± 3.9/80.2 ± 3.0 mmHg to 140.1 mmHg ± 2.7/75.2 ± 1.6 mmHg). In conclusion, the 16-week intervention combining HD with PT proved effective for reducing cardiometabolic risk factors and enhancing ventilatory efficiency, suggesting improved integration of oxygen uptake, transport, and utilization in the women with MetS assessed. Full article

Indigenous Fire Stewardship (IFS) has long been practiced by Indigenous Peoples to care for the land, reduce wildfire risk, and maintain ecological and cultural values. In British Columbia, Yunesit’in, a member of the Tsilhqot’in Nation, has revitalized their IFS practices following the 2017 Hanceville Fire. As climate policy increasingly supports nature-based solutions, carbon credit programs are emerging as a potential funding source for IFS. This study used grounded theory with interviews to understand Yunesit’in IFS practitioners’ and community leaders’ perspectives on carbon credits. Using the concept of “cultural signatures,” we identified core values shaping community engagement in carbon markets. While most interviewees (7/10) were initially unfamiliar with carbon credits, many saw their potential to support long-term program goals after learning more. Three cultural signatures emerged from the analysis: (1) a sense of stewardship responsibility, (2) the importance of a community-grounded program, and (3) the revitalization of Indigenous knowledge and land-based practices. Interviewees expressed concern that carbon credits might shift the program’s focus away from land and culture toward technical goals that exclude community participation. We conclude that building awareness about carbon and carbon credits among Indigenous Peoples, and supporting engagement processes that reflect cultural signatures in carbon frameworks, are both critical. Full article

Human cytomegalovirus (HCMV) establishes lifelong latency following primary infection, residing within myeloid progenitor cells and monocytes. To achieve this, the virus employs multiple immune evasion strategies. It suppresses innate immune signaling by inhibiting Toll-like receptor and cGAS-STING pathways. In addition, the virus suppresses major histocompatibility complex (MHC)-dependent antigen presentation to evade T cell recognition. As the downregulation of MHC molecules may trigger NK cell activation, the virus compensates for this by expressing proteins such as UL40 and IL-10, which engage inhibitory NK cell receptors and block activating signals, thereby suppressing NK cell immune surveillance. Viral proteins like UL36 and UL37 block host cell apoptosis and necroptosis, allowing HCMV to persist undetected and avoid clearance. In settings of profound immunosuppression, such as after allogeneic hematopoietic stem cell transplantation (allo-HSCT) or solid organ transplantation, slow immune reconstitution creates a window for viral reactivation. Likewise, immunosenescence and chronic low-grade inflammation during aging increases the risk of reactivation. Once reactivated, HCMV triggers programmed cell death, releasing viral PAMPs (pathogen-associated molecular patterns) and host-derived DAMPs (damage-associated molecular patterns). This release fuels a potent inflammatory response, promoting further viral reactivation and exacerbating tissue damage, creating a vicious cycle. This cycle of inflammation and reactivation contributes to both transplant-related complications and the decline of antiviral immunity in the elderly. Therefore, understanding the immune regulatory mechanisms that govern the switch from latency to reactivation is critical, especially within the unique immune landscapes of transplantation and aging. Elucidating these pathways is essential for developing strategies to prevent and treat HCMV-related disease in these high-risk populations. Full article

Despite being a preventable disease, cervical cancer remains a significant public health concern in low- and middle-income countries, including those in Latin America (LATAM), where mortality rates are nearly three times higher than in North America. HPV vaccination represents one of the most important strategies for cervical cancer elimination; however, uptake in these regions has been consistently suboptimal. The aim of this review is to analyze the current status of HPV vaccination programs across LATAM, examines the underlying challenges, and proposes strategies to enhance vaccine coverage. Multiple obstacles to widespread vaccine adoption persist, including limited awareness, cultural stigma, and regional disparities in healthcare access, often driven by socioeconomic and infrastructural limitations. Addressing these challenges through multifaceted interventions—such as school-based vaccination programs, healthcare provider engagement, digital dissemination, simplified dosing schedules, and supportive policy measures—is essential to effectively improve vaccination rates and reduce disease burden. Full article

Background/Objectives: Type 2 diabetes (T2D) is a pressing public health challenge in the United States (U.S.). Community-based diabetes education programs equip individuals with T2D with the knowledge and skills to improve dietary behaviors, build confidence, and better manage their condition to reduce complications. However, few studies evaluate self-care adherence and self-efficacy together. This study examined participant adherence to diabetes self-care practices and confidence in managing diabetes through a community-based education program. Methods: Do Well, Be Well with Diabetes (DWBWD) is a 5-week program focused on reinforcing the best practices in diabetes management through dietary practices, physical activity, and gaining self-confidence in managing T2D. The program was evaluated among 137 participants across 14 Texas counties using pre- and post-surveys that assessed the number of days per week participants engaged in diabetes self-care practices, as well as their confidence in performing these behaviors (rated on a scale from 1 = not at all confident to 5 = extremely confident). Results: Participants were mostly male (75.9%), White (60.6%), and over 65 years (58.4%). Most participants had T2D (57.7%) or prediabetes (27.0%). Compared to the program entry, participants reported improvements (p < 0.001) in self-care practices, as reflected by their mean differences (MD), including following a healthful eating plan (MD −1.46), consuming five servings of fruit and vegetables (MD −0.87), spacing carbohydrate intake evenly throughout the day (MD −1.64), engaging in at least 30 min of daily physical activity (MD −0.74), testing blood glucose (MD −1.08), and checking their feet (MD −1.09). Confidence in performing all self-care behaviors significantly improved (p < 0.001), with MDs between −0.53 and −1.13, indicating higher post-program scores. Conclusions: Participation in the DWBWD program increased confidence in diabetes management and enhanced engagement in key health behaviors associated with reducing diabetes complications. Full article

This study presents a vertically integrated Project-Based Learning (PBL) and Community-Based Learning (CBL) framework that connects postgraduate and undergraduate programs in Applied Chemistry and Agricultural Engineering. Postgraduate students synthesized zeolite-based materials for nutrient recovery, which were subsequently applied by undergraduate students in field trials conducted in collaboration with rural farming communities. The project was evaluated using rubrics, surveys, focus groups, and reflective journals. Results demonstrated substantial development of technical, communication, and critical thinking skills, with students highlighting the value of linking theory to practice. Community feedback confirmed the perceived benefits of the material for soil improvement and fertilizer efficiency, while also underscoring the need for sustained engagement. Despite challenges such as curricular coordination and resource constraints, the model effectively fostered interdisciplinary learning and social impact. These findings highlight the contribution of this sequentially instructional design to STEM education by connecting research, teaching, and outreach within a constructivist, sustainability-oriented approach. Full article

This paper offers content priorities, justifications, and pedagogical approaches for the integration of climate change education into the training of teachers, and thus into public schooling. To meet urgent imperatives presented by the polycrisis of the Anthropocene, climate change education must be inclusive, comprehensive, flexible, and regionally responsive. Climate change education can be achieved by adapting regional programs for teacher education to meet those requirements. An example is the Climate Education in Teacher Education (CETE) project in northern British Columbia, Canada. Using the Education Design-Based Research methodology, the project addresses critical questions for curricular and pedagogical development of teachers to address the following three questions: (a) what content and outcomes to prioritize, (b) why these elements matter, and (c) how to implement them effectively. Over two years, CETE engaged pre-service and in-service teachers through workshops, reflective practices, and consultations with Indigenous communities. Our tentative answers emphasize the importance of adapting curriculum and pedagogy to foster community resilience, address climate anxiety, and promote an ethical renewal toward sustainability. The iterative development of objectives as “High-Level Conjectures” provides flexibility and reflexivity in the design process in the face of rapid contextual change. CETE developed practical pedagogical tools and workshop strategies that align educational priorities with local and global needs. This study offers a replicable framework to empower educators and communities in diverse locations to navigate the complexities of the climate crisis in their quest for a more secure and sustainable future. Full article

Background/Objectives: Pain neuroscience education (PNE) has demonstrated efficacy in adults with chronic pain, but the pediatric evidence is still developing, despite its increasingly frequent use. Evidence for the effectiveness of PNE in pediatrics remains fragmented across settings and outcomes, which justifies a systematic evaluation focused on children and adolescents. Methods: Following PRISMA, two reviewers independently screened records (PubMed, Web of Science, PEDro; through 21 July 2025), extracted data, and assessed risk of bias (RoB 2 for randomized controlled trials; NIH/CASP for non-randomized studies). Given the heterogeneity, we conducted a structured narrative synthesis (SWiM) and rated the certainty of evidence with GRADE. PROSPERO: CRD420251062922. Results: Eleven studies met the inclusion criteria. PNE consistently improved pain-related knowledge, with effects maintained at follow-up (moderate certainty); effects on pain intensity, function, and emotional outcomes were small and inconsistent (low certainty), with more favorable patterns when PNE was combined with exercise and/or booster sessions. Digital and gamified formats proved feasible and engaging; parental outcomes showed small improvements where measured. Conclusions: PNE is a promising, low-cost, and scalable component of pediatric chronic pain care, strengthening self-efficacy and adaptive coping. Integration into biopsychosocial, multidisciplinary programs—particularly alongside exercise and family involvement—may optimize outcomes. Larger, standardized trials with long-term follow-up and systematic adverse-event reporting are needed to solidify guidance for clinical practice. Full article

In higher education, institutional quality is traditionally assessed through metrics such as academic programs, research output, educational resources, and community services. However, it is important that their activities align with student expectations, particularly in relation to interactive learning environments, learning management system interaction, curricular and co-curricular activities, accessibility, support services and other learning resources that ensure academic success and, jointly, career readiness. The growing popularity of student engagement metrics as one of the key measures to evaluate institutional efficacy is now a feature across higher education. By monitoring student engagement, institutions assess the impact of existing resources and make necessary improvements or interventions to ensure student success. This study presents a comprehensive analysis of student feedback from the StudentSurvey.ie dataset (2016–2022), which consists of approximately 275,000 student responses, focusing on student self-perception of engagement in the learning process. By using classical topic modelling techniques such as Latent Dirichlet Allocation (LDA) and Bi-term Topic Modelling (BTM), along with the advanced transformer-based BERTopic model, we identify key themes in student responses that can impact institutional strength performance metrics. BTM proved more effective than LDA for short text analysis, whereas BERTopic offered greater semantic coherence and uncovered hidden themes using deep learning embeddings. Moreover, a custom Named Entity Recognition (NER) model successfully extracted entities such as university personnel, digital tools, and educational resources, with improved performance as the training data size increased. To enable students to offer actionable feedback, suggesting areas of improvement, an n-gram and bigram network analysis was used to focus on common modifiers such as “more” and “better” and trends across student groups. This study introduces a fully automated, scalable pipeline that integrates topic modelling, NER, and n-gram analysis to interpret student feedback, offering reportable insights and supporting structured enhancements to the student learning experience. Full article

Demand response (DR) is increasingly recognized as a critical flexibility resource for modernizing power systems, enabling the large-scale integration of renewable energy and enhancing grid stability. While the field of general electricity load forecasting is supported by numerous systematic reviews, the specific subfield of DR potential forecasting has received comparatively less synthesized attention. This gap leaves a fragmented understanding of modeling techniques, practical implementation challenges, and future research problems for a function that is essential for market participation. To address this, this paper presents a PRISMA-2020-compliant systematic review of 172 studies to comprehensively analyze the state-of-the-art in DR potential estimation. We categorize and evaluate the evolution of forecasting methodologies, from foundational statistical models to advanced AI architectures. Furthermore, the study identifies key technological enablers and systematically maps the persistent technical, regulatory, and behavioral barriers that impede widespread DR deployment. Our analysis demonstrates a clear trend towards hybrid and ensemble models, which outperform standalone approaches by integrating the strengths of diverse techniques to capture complex, nonlinear consumer dynamics. The findings underscore that while technologies like Advanced Metering Infrastructure (AMI) and the Internet of Things (IoT) are critical enablers, the gap between theoretical potential and realized flexibility is primarily dictated by non-technical factors, including inaccurate baseline methodologies, restrictive market designs, and low consumer engagement. This synthesis brings much-needed structure to a fragmented research area, evaluating the current state of forecasting methods and identifying the critical research directions required to improve the operational effectiveness of DR programs. Full article

Background: The Pharm2Home Initiative’s Community Health Arm adopts a health-equitable approach to chronic disease education and medication therapy management (MTM). We serve senior residents of Solano County, California, who live in affordable housing and have limited financial resources. Aim: This evaluation assesses the uptake of chronic disease management recommendations provided by clinical pharmacists during MTM sessions at community events. Methods: The program engaged clinical pharmacists to provide tailored education and healthcare interventions in senior housing facilities. The goal was to empower seniors to manage their health effectively. The sessions covered various topics, including expired or duplicated medications, incorrect medication use, consultations on medication management, immunizations, and lifestyle adjustments. Results: Over an 18-month period, from January 2022 to August 2023, the program involved 65 participants across ten community health events. These events provided approximately 65 h of direct intervention. Many participants reported significant improvements in understanding their treatment plans and navigating their health needs more confidently. Feedback from 60 seniors after the sessions indicated that 88% felt much better informed about their medications, and 75% expressed that their concerns were addressed extremely well. Conclusions: These outcomes demonstrate the importance of clinical pharmacist-led interventions in improving seniors’ medication use and chronic disease management. The initiative’s approach advocates for integrating clinical pharmacists into community health settings, suggesting a scalable model for enhancing person-centered care. However, further studies are necessary to assess the long-term impacts of these interventions and explore their effectiveness across diverse age groups and more complex conditions. Full article

Background/Objectives: Childhood obesity rates in Jordan have reached alarming levels, with 28% of school-age children classified as overweight or obese. School-based gardening interventions show promise for promoting healthy eating behaviors, yet limited research exists in Middle Eastern contexts. This study evaluated the effectiveness of a five-month school-based vegetable gardening and nutrition education intervention on anthropometric measures, dietary intake, and knowledge, attitudes, and practices (KAP) regarding vegetable consumption among Jordanian primary school children. Methods: A quasi-experimental controlled trial was conducted with 216 students (ages 10–12 years) from two demographically matched schools in Amman, Jordan. The intervention group (n = 121) participated in weekly one-hour gardening sessions combined with nutrition education and vegetable tasting activities over five months, while the control group (n = 95) continued the standard curriculum. Outcomes measured at baseline and post-intervention included anthropometric assessments, dietary intake via 24 h recalls, and vegetable-related KAP using a validated questionnaire. Data were analyzed using paired t-tests and repeated measures ANCOVA. Results: The intervention group demonstrated significant improvements in body composition, including reductions in BMI (−1.57 kg/m²), weight (−1.88 kg), and BMI z-score (−0.37), while controls showed minimal increases. Vegetable intake showed significant time × group interaction (p-value = 0.003), with a non-significant increase in the intervention group (2.7 to 2.9 times/day) and a non-significant decrease in the controls (2.5 to 2.4 times/day). Dietary quality improved, including increased fiber intake (+2.36 g/day) and reduced saturated fat consumption (−9.24 g/day). Nutrition knowledge scores increased substantially in the intervention group (+22.31 points) compared to controls (+1.75 points; p-value ≤ 0.001). However, attitudes and practices toward vegetable consumption showed no significant changes. Conclusions: This intervention effectively improved body composition, dietary quality, and nutrition knowledge among Jordanian primary school children. These findings provide evidence for implementing culturally adapted school gardening programs as childhood obesity prevention interventions in Middle Eastern settings, though future programs should incorporate family engagement strategies to enhance behavioral sustainability. Full article

Background/Objectives: Overweight and obesity continue to increase globally, a trend that has been exacerbated by the pandemic. This retrospective study examines the impact of suspending sports activities during the pandemic on the physical and psychological well-being of young Italian adults engaged in sports, paying particular attention to their nutritional status. In particular, the study focused on sex-related differences in perceptions, lifestyle, and body mass index (BMI) changes. Methods: A cross-sectional online survey was conducted among 515 students enrolled in the Sport Sciences program. All the students were aged 18 years or older. Participants completed an 18-item questionnaire assessing their experiences during the pandemic on a five-point Likert scale and retrospectively reported changes in physical activity and body weight. Results: Overall, 38.3% of males and 43% of females reported that restrictions negatively affected their lives, with notable differences emerging in habits, behaviors, and perceptions between sexes. Multivariate regression analysis showed that current BMI was influenced by anthropometric characteristics and variables related to lockdown experiences, in both sexes. Conclusions: The current BMI of examined students was significantly influenced by changes in weight status during the pandemic, resulting from an increased sedentary lifestyle and changes in eating habits, especially among males. These findings highlight that the pandemic differentially affected the lifestyles and perceptions of physically active young adults, with sex-specific consequences for mental and physical health. Full article

Initial teacher education is an important contributor to teacher retention through teachers’ identity and their resilience in teaching. Relationships are key elements of teachers’ resilience and identity formation. During teacher education, professional learning communities can build these relationships and dispositions that support pre-service teachers’ persistence during challenges they encounter professionally and as students during their teacher education program. While previous research has shown the value of learning communities in professional experience in teacher education, the effects of a learning community approach to the delivery of an entire teacher education program has not previously been examined. A professional learning community approach to delivery of a postgraduate initial teacher education program was designed and has been implemented at regional campuses of an Australian university since 2018. This interpretivist study evaluated the contribution of the program to pre-service teachers’ personal resources for their professional lives as teachers. Focus groups were held with all students enrolled in the regional program in 2018 and 2021, and self-selected alumni of the program in 2022, as well as four teacher educators involved in delivering the regional program in 2021 and 2022. A thematic approach was employed to analyze the transcripts. The professional learning communities built a number of resources for teaching, including relational resilience in the form of strong relationships that offered support during the program, teacher education student engagement, and teacher identity. In the process, the learners obtained skills and dispositions that would equip them to continue to work in professional learning communities during their teaching careers. The findings highlight the importance of relationships in teacher education and have implications for the design of initial teacher education programs for teacher retention. Full article

This study examines the evolution and current challenges of Catholic Higher Education (CHE) in South Korea within the context of globalization and neoliberal educational reform. It explores how Korean Catholic universities balance their distinctive mission with intensifying pressures for competitiveness, external validation, and adaptation to secular academic norms. Drawing on P. Boudieu’s field theory and H. Richard Niebuhr’s typology of Christian responses to culture, the analysis frames the ways institutions of Korean CHE navigate the sometimes contrary currents of their institutional aims—simultaneously striving for academic excellence and maintaining Catholic identity. Case studies of three major Korean Catholic universities illustrate how leadership and curricular programs reflect the ongoing negotiation between mission-driven imperatives and market demands. The paper contends that living within this tension is not a sign of deficiency. It can actually be a source of resilience and innovation. The Korean experience of CHE offers insights for Catholic universities facing similar dilemmas globally, suggesting that engaging proactively with the seemingly contrary paradoxical demands can sustain the integrity of mission while fostering adaptive capacity amid the rapidly changing landscape of higher education. Full article