Search Results (876)

Early-career teachers (ECTs) entered the profession during the COVID-19 pandemic, a period that introduced unique stressors to an already-demanding career phase. This systematic review examines empirical studies published between 2020 and February 2025 to explore how the pandemic influenced ECT wellbeing, with particular attention to stressors and protective factors impacting long-term retention and professional sustainability. Guided by PRISMA protocols, databases including Web of Science, ERIC, Google Scholar, and Scopus were searched, screening 470 records and identifying 30 studies that met inclusion criteria: peer-reviewed, empirical, focused on early-career teachers (within the first five years), and situated in or explicitly addressing the pandemic and its ongoing impacts. The results of Braun and Clarke’s thematic analysis (2006) revealed that pandemic-related challenges such as increased workload, professional isolation, disrupted induction processes, and emotional strain have persisted into the post-pandemic era, contributing to sustained risks of burnout and attrition. Regardless, protective factors identified during the pandemic—including high-quality mentoring, structured induction programmes, collegial support, professional autonomy, and effective individual coping strategies—continue to offer essential support, enhancing resilience and professional wellbeing. These findings underscore the necessity of institutionalising targeted supports to address the enduring effects of pandemic-related stressors on ECT wellbeing. By prioritising sustained mental health initiatives and structural supports, education systems can effectively mitigate long-term impacts and improve retention outcomes for early-career teachers in a post-pandemic educational landscape. Full article

The highway and bridge industry is facing persistent challenges related to the high turnover of technical personnel, which poses risks to the continuity and sustainability of infrastructure development. Although Geographic Information System (GIS) training has increasingly been advocated as a strategy to stabilize the workforce, its practical application remains relatively limited across China. Drawing on the Conservation of Resources (COR) theory, this study examines whether GIS training is associated with lower turnover intention among technical staff, potentially through enhanced perceptions of career growth and reduced work-related anxiety. Based on 412 valid responses—primarily from technical personnel employed by major infrastructure enterprises such as regional subsidiaries of the China Communications Construction Group (CCCG) and China State Construction Engineering Corporation (CSCEC)—the study employs Partial Least Squares Structural Equation Modeling (PLS-SEM) to assess the proposed relationships. The findings indicate that GIS training is negatively associated with turnover intention, with career growth partially mediating this association. Additionally, work anxiety moderates the relationship, such that the link between GIS training and turnover intention appears weaker under higher levels of anxiety. This research contributes to bridging the gap between training practices and theoretical understanding, offering insights to inform workforce retention strategies in technology-intensive industries. Full article

Perturbations in the tightly regulated processes of VLDL biosynthesis and secretion can directly impact both liver and cardiovascular health. Patients with metabolic disorders have an increased risk of developing hepatic steatosis, which can lead to cirrhosis. These associated metabolic risks underscore the importance of discerning the role of different cellular proteins involved in VLDL biogenesis, transport, and secretion. Small VCP-Interacting Protein (SVIP) has been identified as a component of VLDL transport vesicles and VLDL secretion. This study evaluates the cellular effects stemming from the CRISPR-Cas9-mediated depletion of SVIP in rat hepatocytes. The SVIP-knockout (KO) cells display an increased VLDL retention with elevated intracellular levels of ApoB100 and neutral lipid staining. RNA sequencing studies reveal an impaired PPARα and Nrf2 signaling in the SVIP KO cells, implying a state of metabolic reprograming, with a shift from fatty acid uptake, synthesis, and oxidation to cells favoring the activation of glucose by impaired glycogen storage and increased glucose release. Additionally, SVIP KO cells exhibit a transcriptional profile indicative of acute phase response (APR) in hepatocytes. Many inflammatory markers and genes associated with APR are upregulated in the SVIP KO hepatocytes. In accordance with an APR-like response, the cells also demonstrate an increase in mRNA expression of genes associated with protein synthesis. Together, our data demonstrate that SVIP is critical in maintaining hepatic lipid homeostasis and metabolic balance by regulating key pathways such as PPARα, Nrf2, and APR. Full article

Childhood obesity increases chronic disease risk, but no comprehensive synthesis has evaluated the impact of school-based combined nutrition education and physical activity interventions on cardiometabolic biomarkers in children aged 3 to 12 years. This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251085194). Five databases were systematically searched through June 2025. Twelve randomized controlled trials involving 18,231 children were included and assessed using the PEDro scale. Ten trials demonstrated significant improvements in at least one cardiometabolic biomarker. Blood pressure (8 studies) outcomes showed systolic reductions of 1.41–6.0 mmHg in six studies. Glucose metabolism (5 studies) improved in two studies with reductions of 0.20–0.22 mmol/L. Lipid profiles (7 studies) improved in three studies, including total cholesterol (−0.32 mmol/L). Insulin levels (5 studies) decreased significantly in two investigations. Anthropometric improvements included BMI and body fat. Physical activity increased by >45 min/week and dietary habits improved significantly. Programs with daily implementation (90-min sessions 4x/week), longer duration (≥12 months), family involvement (parent education), and curriculum integration (classroom lessons) showed superior effectiveness. Interventions targeting children with overweight/obesity demonstrated higher changes compared to the general population. However, methodological limitations included a lack of assessor blinding, absence of subject/therapist blinding, and inadequate retention rates. School-based interventions combining nutrition and physical activity can produce significant improvements in cardiometabolic biomarkers, supporting comprehensive, sustained multicomponent programs for early chronic disease prevention. Full article

Background: The education process for newly diagnosed Type 1 diabetes mellitus (T1D) patients and their families, primarily led by diabetes specialist nurses, is essential for gaining knowledge about the disease and its management. However, few assessment tools have been employed to evaluate long-term knowledge retention among T1D patients years after diagnosis. Methods: We developed a 20-question test to assess the knowledge of patients and their families at the conclusion of the initial education process and again 6–12 months later. Demographic and clinical data were also collected. Statistical analyses included comparisons between the first and second test results, as well as evaluation of potential contributing factors. The internal consistency and construct validity of the questionnaire were evaluated. Results: Forty-four patients completed both assessments, with a median interval of 11.5 months between them. The average score on the first test was 88.6, which declined to 82.7 on the second assessment (p < 0.001). In univariate analysis, factors positively associated with higher scores included Jewish ethnicity, lower HbA1c levels, and shorter hospitalization duration. Multivariate analysis revealed that parents had lower odds of experiencing a significant score decline compared to patients. Cronbach’s alpha was 0.69, and Principal Component Analysis (PCA) identified eight components accounting for 67.1% of the total variance. Conclusions: Healthcare providers should consider offering re-education to patients and their families approximately one year after diagnosis, with particular attention to high-risk populations during the initial education phase. Further studies are needed to examine this tool’s performance in larger cohorts. Full article

Background: Doppler-guided haemorrhoidal artery ligation with rectoanal repair (HAL-RAR) is a minimally invasive alternative to conventional haemorrhoidectomy. While associated with reduced postoperative pain and quicker recovery, data on its safety, recurrence rates, and applicability across haemorrhoid grades remain limited, particularly in Australian settings. Methods: A retrospective review was conducted on 128 consecutive patients who underwent elective HAL-RAR at a single institution between February 2022 and December 2024. Data on demographics, operative details, postoperative outcomes, and recurrence were collected. Outcomes were stratified by haemorrhoid grade. Multivariate logistic regression was used to identify predictors of recurrence, day-case completion, and conversion to excisional surgery. Results: The median age was 49 years, and 77.3% had Grade II or III haemorrhoids. HAL-RAR was completed as a day case in 76.6% of patients. Postoperative urinary retention occurred in 3.9%, return to theatre in 0.8%, and 30-day readmission in 7.0%. The symptomatic recurrence rate was 17.6%. Grade IV haemorrhoids were independently associated with increased recurrence (aOR 3.64, 95% CI 1.03–12.84), reduced likelihood of day-case management (aOR 0.14, 95% CI 0.03–0.93), and higher conversion to excisional haemorrhoidectomy (aOR 7.23, 95% CI 1.13–46.40). Conclusions: HAL-RAR is a safe, effective, and low-morbidity option for the management of Grade II and III haemorrhoids, suitable for day-case surgery. In selected Grade IV cases, it may offer benefit, although with higher recurrence and conversion risk. Careful patient selection is essential, and longer-term prospective studies are needed to assess durability. Full article

Background: Type 2 diabetes (T2D) is a growing public health concern, particularly in low- and middle-income countries. Although prediabetes is a major risk factor for T2D, it remains largely underdiagnosed and untreated. Structured lifestyle interventions have proven effective in preventing diabetes, but their feasibility within the Brazilian public health system remains unclear. Methods: This multicenter pilot randomized controlled trial assessed the feasibility of a culturally adapted lifestyle intervention (PROVEN-DIA) across the five regions of Brazil. A total of 220 adults at high risk for T2D were randomized to an intervention group or a control group (usual care) and followed for three months. Both groups received similar educational content on healthy eating and physical activity, but the intervention group participated in a structured and personalized lifestyle program with regular follow-up sessions. The primary outcome was adherence to dietary recommendations, assessed using the BALANCE Index—a validated dietary score (range: 0–40) based on the Brazilian Cardioprotective Diet that classifies foods into color-coded groups according to nutritional quality—along with engagement in moderate-to-vigorous physical activity (MVPA). Secondary outcomes included diet quality (DQIR), anthropometric and metabolic parameters. Results: Feasibility was demonstrated by a 93.2% retention rate (n = 205). There was no significant difference in the primary outcome (simultaneous improvement in diet and MVPA). However, the PROVEN-DIA group exhibited significantly greater improvements in diet quality, with a 2.8-point increase in the BALANCE Index (vs. 0.5 in the control, p = 0.03), and a significant improvement in the DQIR (p < 0.001). No significant differences between groups were observed in MVPA, HbA1C, glycaemia, or body weight. Conclusions: The PROVEN-DIA intervention proved feasible within the Brazilian public health context, resulting in significant improvements in dietary quality among individuals at high risk for T2D. A larger trial with longer follow-up is warranted to evaluate its effectiveness in preventing the progression to diabetes. However, to enhance physical activity outcomes, specific adaptations and targeted strategies may be required to better support participant engagement in exercise. Full article

(1) Medical training is changing, especially for surgeons. Virtual reality simulation is an excellent way to train surgeons safely. Studies show that surgeons who train with simulation have demonstrated improved technical skills in fundamental surgical procedures. The purpose of this study is to determine the overall impact of virtual reality training on laparoscopic cholecystectomy performance and to explore whether specific training protocols or the addition of feedback confer any advantages for future surgeons. (2) MEDLINE (PubMed), Embase (Ovid SP), Web of Science, Google Scholar, and Scopus were searched for the literature related to virtual reality training, immersive simulation, laparoscopic surgical skills training, and medical education. Study quality was assessed using the Cochrane Risk of Bias Tool and NIH Quality Assessment Tool. (3) A total of 55 full-text articles were reviewed. Meta-analysis showed that virtual reality training is an effective method for learning cholecystectomy surgical skills. (4) Conclusions: Performance, measured by objective structured assessments and time to task completion, is improved with virtual reality training compared with no additional training. Positive effects of simulation training were evident in global rating scores and operative time. Continuous feedback on movement parameters during laparoscopic cholecystectomy skills training impacts skills acquisition and long-term retention. Full article

While prior work has explored learner behavior using learning management systems (LMS) data, few studies provide week-level clustering validated against external engagement labels. To understand and assist students in online learning platforms and environments, this study presents a week-level engagement profiling framework for e-learning environments, utilizing K-means clustering and label-based validation. Leveraging log data from 127 students over a 13-week course, 44 activity-based features were engineered to classify student engagement into high, moderate, and low levels. The optimal number of clusters (k = 3) was identified using the elbow method and assessed through internal metrics, including a silhouette score of 0.493 and R² of 0.80. External validation confirmed strong alignment with pre-labeled engagement levels based on activity frequency and weighting. The clustering approach successfully revealed distinct behavioral patterns across engagement tiers, enabling a nuanced understanding of student interaction dynamics over time. Regression analysis further demonstrated a significant association between engagement levels and academic performance, underscoring the model’s potential as an early warning system for identifying at-risk learners. These findings suggest that clustering based on LMS behavior offers a scalable, data-driven strategy for improving learner support, personalizing instruction, and enhancing retention and academic outcomes in digital education settings such as MOOCs. Full article

Background: In this work, we examine determinants of staff departure rates in the NHS, a critical issue for workforce stability and continuity of care. High turnover, particularly among clinical staff, undermines service delivery and incurs substantial replacement costs. Methods: Here, we analyse a unique dataset derived from Electronic Staff Records at Ashford and St. Peter’s NHS Foundation Trust, using a machine learning approach to move beyond traditional survey-based methods, to assess propensity to leave. Results: In addition to established predictors such as salary and length of service, we identify drivers of increased risks of staff exits, including the distance between home and workplace and, especially for medical staff, cost centre vacancy rates. Conclusions: These findings highlight the multifactorial nature of staff retention and suggest the potential of local administrative data to improve workforce planning, for example, through hyperlocal recruitment strategies. Whilst further work will be required to assess the generalisability of our findings beyond a single Trust, our analysis offers insights for NHS managers seeking to stabilise staffing levels and reduce attrition through targeted interventions beyond pay and tenure. Full article

This paper shows that artificial intelligence is fundamentally transforming college curricula by enabling data-driven personalization, which enhances student outcomes and better aligns educational programs with evolving workforce demands. Specifically, predictive analytics, machine learning algorithms, and natural language processing were applied here, grounded in constructivist learning theory and Human–Computer Interaction principles, to evaluate student performance and identify at-risk students to propose personalized learning pathways. Results indicated that the AI-based curriculum achieved much higher course completion rates (89.72%) as well as retention (91.44%) and dropout rates (4.98%) compared to the traditional model. Sentiment analysis of learner feedback showed a more positive learning experience, while regression and ANOVA analyses proved the impact of AI on enhancing academic performance to be real. Therefore, the learning content delivery for each student was continuously improved based on individual learner characteristics and industry trends by AI-enabled recommender systems and adaptive learning models. Its advantages notwithstanding, the study emphasizes the need to address ethical concerns, ensure data privacy safeguards, and mitigate algorithmic bias before an equitable outcome can be claimed. These findings can inform institutions aspiring to adopt AI-driven models for curriculum innovation to build a more dynamic, responsive, and learner-centered educational ecosystem. Full article

Background: Intravascular albumin mass represents the total quantity of albumin circulating within the bloodstream and may serve as a physiologically relevant marker of vascular integrity and fluid distribution in sepsis. While low serum albumin levels are acknowledged as prognostic indicators, dynamic assessments based on albumin mass remain insufficiently explored in patients outside the intensive care unit. Objectives: To describe the temporal changes in intravascular albumin mass in patients with community-acquired sepsis and to examine its relationship with fluid balance and thirty-day mortality. Methods: This prospective observational study encompassed 247 adults diagnosed with community-acquired sepsis who were admitted to a high-dependency hospital ward specializing in acute medical care. The intravascular albumin mass was calculated daily for a duration of up to five days, utilizing plasma albumin concentration and estimated plasma volume derived from anthropometric and hematologic data. Net albumin leakage was defined as the variation in intravascular albumin mass between consecutive days. Fluid administration and urine output were documented to ascertain cumulative fluid balance. Repeated-measures statistical models were employed to evaluate the associations between intravascular albumin mass, fluid balance, and mortality, with adjustments made for age, comorbidity, and clinical severity scores. Results: The intravascular albumin mass exhibited a significant decrease during the initial five days of hospitalization and demonstrated an inverse correlation with the cumulative fluid balance. A greater net leakage of albumin was associated with a positive fluid balance and elevated mortality rates. Furthermore, a reduced intravascular albumin mass independently predicted an increased risk of mortality at thirty days. Conclusions: A reduction in intravascular albumin mass may suggest ineffective fluid retention and the onset of capillary leak syndrome. This parameter holds promise as a clinically valuable, non-invasive indicator for guiding fluid resuscitation in cases of sepsis. Full article

Maedi-visna virus (MVV), a small ruminant lentivirus causing chronic multisystemic disease in sheep, poses significant economic burdens due to reduced productivity and a lack of effective treatments. Despite its worldwide prevalence, epidemiological data from Algeria remain absent. This first national seroprevalence study aimed to elucidate MVV distribution, risk factors, and transmission dynamics in Algerian sheep herds. A cross-sectional survey of 1400 sheep across four regions (East, Center, West, South) was conducted, with sera analyzed via indirect ELISA (IDvet). Risk factors (geography, age, sex, breed, farming system) were evaluated using chi-square tests and Cramer’s V. Overall seroprevalence was 9.07% (95% CI: 7.57–10.57), with significant variation by sex (females: 20.44% vs. males: 3.68%; p < 0.05), age (1–5 years: 6.86% vs. <1 year: 0.29%; p = 0.01), and region (Central: 3.36% vs. Eastern: 0.86%; p < 0.05). Notably, no association was found with breed or farming system (p ≥ 0.08), contrasting prior studies and suggesting region-specific transmission dynamics. Females exhibited heightened seropositivity, implicating prolonged herd retention and vertical transmission risks. Geographic disparities highlighted industrialized farming in central Algeria as a potential transmission amplifier. Strikingly, seronegative animals in high-prevalence herds hinted at genetic resistance, warranting further investigation. This study provides foundational insights into MVV epidemiology in North Africa, underscoring the need for targeted surveillance, ewe-focused control measures, and genetic research to mitigate transmission. The absence of prior national data elevates its significance, offering actionable frameworks for resource-limited settings and enriching the global understanding of SRLV heterogeneity. Full article

Promoting domestic fire safety is crucial for preventing and effectively managing risky situations. This study evaluated the effectiveness of virtual environments (VEs) in fire drills to improve citizens’ knowledge and safe behavior in domestic settings. Conducted at the Citizen School for Risk Prevention (CSRP) in Zaragoza (Spain), the experiment involved 20 participants facing a simulated kitchen fire using a combination of physical and virtual extinguishing equipment. A theoretical session accompanied the drills to reinforce learning. Participants were divided into two groups: one completed the drill before and after the theoretical session, while the other completed it only afterward. Performance was assessed based on the ability to extinguish, control, or lose control of the fire. Surveys administered before, immediately after, and three months after training measured knowledge retention and behavioral changes. The results indicate a significant improvement in fire safety awareness and lasting adoption of safe practices. Participants also emerged as safety advocates. This study highlights the potential of combining theoretical instruction with immersive practical training and identifies strategies for replicating this approach in other prevention schools. Full article

Glucose-responsive insulin delivery systems that effectively regulate insulin retention and release in response to real-time fluctuation of glucose levels are highly desirable for diabetes care with minimized risk of hypoglycemia. Herein, we report a class of glucose-sensitive copolymer microgels, prepared from a simple one-pot precipitation copolymerization of 4-vinylphenylboronic acid (VPBA), 2-(dimethylamino) ethyl acrylate (DMAEA), and oligo(ethylene glycol) methyl ether methacrylate (M_w = 300, MEO₅MA), for gated glucose-responsive insulin release within the physiologically desirable glucose level range. The composition of the p(VPBA-DMAEA-MEO₅MA) copolymer microgels were analyzed using NMR and FTIR spectra. The cis-diols of glucose can reversibly bind with the −B(OH)₂ groups of the VPBA component in the microgels, resulting in the formation of negatively charged boronate esters that induce the volume phase transition of the microgels. The DMAEA component is incorporated to reduce the pK_a of VPBA, thus improving the glucose sensitivity of the microgels at physiological pH. The neutral hydrophilic MEO₅MA component is used to tune the onset of the glucose responsiveness of the microgels to the physiologically desirable levels. The more the MEO₅MA component copolymerized in the microgels, the greater the glucose concentration required to initiate the swelling of the microgels to trigger the release of insulin. When the onset of the glucose response was tuned to 4−5 mM, the copolymer microgels retained insulin effectively in the hypo-/normo-glycemic range but also released insulin efficiently in response to the elevation of glucose levels in the hyperglycemic range, which is essential for diabetes management. The copolymer microgels display no cytotoxicity in vitro. Full article