Search Results (56)

Amid the ongoing digital transformation of higher education, increasing attention has been paid to the impact of digital technologies on teaching quality—particularly in physical education settings that require high levels of interaction and physical engagement. This study examined 1158 university students across China using a cross-sectional design, integrating interpretable machine learning models with structural equation modeling to systematically assess how the frequency of use of seven common digital technologies influences teaching quality in physical education classes. The study also investigated the mediating roles of perceived teacher support and academic self-efficacy. Nine machine learning models and logistic regression analyses were conducted to predict teaching quality, employing feature permutation importance and SHapley Additive exPlanations (SHAP) to evaluate the relative contribution of each digital tool. Results identified multimedia courseware, e-textbooks, and question banks as the most influential predictors of teaching quality. The SHAP analysis further revealed that management software, educational websites, and multimedia materials had significant positive effects and exhibited synergistic interactions in improving teaching outcomes. Structural equation modeling showed that digital technology use had a significant direct positive effect on teaching quality (B = 0.347, p < 0.001). Moreover, perceived teacher support and academic self-efficacy not only served as independent mediators (95% CI = [0.146, 0.226], p < 0.001; 95% CI = [0.024, 0.063], p < 0.001) but also functioned as a chain mediating effect (95% CI = [0.036, 0.083], p < 0.001). This study is the first to integrate interpretable machine learning with structural modeling to elucidate the mechanisms through which digital technologies influence teaching quality in university-level physical education. The findings underscore the critical mediating roles of teacher support and student self-efficacy, providing both theoretical contributions and practical implications for enhancing digital pedagogy in higher education. Full article

For patients with retroperitoneal sarcomas (RPSs), en-bloc resection with macroscopically negative margins remains the only potentially curative treatment. Textbook outcomes (TOs) are composite measures developed to compare ideal surgical outcomes for complex oncologic resections. The aims of this study were as follows: to define TO for RPS resections; to investigate the impact of treating service and other variables on TO; and to investigate the impact of treating service on achieving a TO. Population-based data from the Queensland Oncology Repository (QOR) was used to perform a retrospective review of all adult patients who underwent resection for primary RPS in Queensland between 2012 and 2022. TO was defined as follows: en-bloc resection; macroscopically negative margins; no unplanned ICU admission, no Clavien–Dindo III or greater complications; hospital length of stay of 14 days or less; no readmission within 30 days; and no 90-day mortality. A TO was achieved in 82 (56.94%) of the 144 patients included in the study. A high-grade histological subtype, the resection of three or more contiguous organs, major vascular resection and treatment outside of a high-volume sarcoma centre (HVSC) were significant negative predictors of achieving TOs (p < 0.05). On multivariate analysis, treatment at a high-volume sarcoma centre was independently associated with a 2.6-fold increase in TO (1.18–5.88, p = 0.02). Achieving a TO was associated with higher five-year DFS (61.5% vs. 41.3%, p = 0.03) and OS (76% vs. 59.4%, p = 0.02). In our state, TOs provide a measure of the quality of RPS resection across multiple health services, with patients treated at high-volume sarcoma centres more likely to achieve a TO. TO rates are associated with improved five-year DFS and OS. Full article

When students use an online eTextbook with content and interactive graded exercises, they often display aspects of two types of behavior: credit-seeking and knowledge-seeking. A student might behave to some degree in either or both ways with given content. In this work, we attempt to detect the degree to which either behavior takes place and investigate relationships with student performance. Our testbed is an eTextbook for teaching Formal Languages, an advanced Computer Science course. This eTextbook uses Programmed Instruction framesets (slideshows with frequent questions interspersed to keep students engaged) to deliver a significant portion of the material. We analyze session interactions to detect credit-seeking incidents in two ways. We start with an unsupervised machine learning model that clusters behavior in work sessions based on sequences of user interactions. Then, we perform a fine-grained analysis where we consider the type of each question presented within the frameset (these can be multi-choice, single-choice, or T/F questions). Our study involves 219 students, 224 framesets, and 15,521 work sessions across three semesters. We find that credit-seeking behavior is correlated with lower learning outcomes for students. We also find that the type of question is a key factor in whether students use credit-seeking behavior. The implications of our research suggest that educational software should be designed to minimize opportunities for credit-seeking behavior and promote genuine engagement with the material. Full article

Community engaged learning (CEL) is a teaching methodology which aims to bridge the gap between academia and society by collaborating on community-based projects. Inspired by theories of experiential learning and social constructivism, CEL celebrates learning by doing and is a rather novel teaching methodology within the predominantly theoretical bachelor medical curriculum. Despite CEL’s potential benefits, its implementation faces significant challenges. Here, we investigated how students, accustomed to traditional academic teaching, learn during CEL-infused courses, specifically studying student perception of their learning and identifying the various facilitators and barriers to learning during CEL. The study conducted at Utrecht University’s Faculty of Medicine included second-year medical students participating in a newly introduced CEL course. Using thematic analysis, the study analyzed students’ written reflections collected before and after completion of the course. CEL contributed to developing valuable competencies like empathy, leadership, and communication skills, which go beyond the realm of textbook and classroom-based knowledge. The study further identified key barriers and facilitators, both at personal and organizational levels influencing learning outcome of students. Based on these data, several recommendations have been formulated for all involved parties (students, academic institutions, community partners) which could contribute towards a sustainable embedding of CEL. Full article

Despite the fact that more than 65 million Spanish speakers across Latin America use vos as the informal second-person singular pronoun instead of tú, vos remains underrepresented in U.S. Spanish curricula. Meanwhile, vosotrxs, the informal second-person plural pronoun used exclusively in Spain, is regularly included in textbooks. This study qualitatively examines how postsecondary Spanish instructors navigate these pronouns and their conjugations, particularly in relation to their perceptions of students’ learning outcomes and future communication needs. Through a comparative analysis of interview data from 32 participants, we find that instructors are more likely to address vosotrxs than vos. Even those who personally use vos outside the classroom avoid it in their teaching, citing concerns about potential confusion and a perceived lack of relevance for students’ future communication. This study highlights a persistent gap between instructors’ stated commitment to regional linguistic diversity and the reality of Spanish language instruction: while instructors affirm that incorporating dialectal variation would enhance students’ linguistic and cultural competence, minoritized features like vos remain largely absent from the curriculum. Full article

Background and Objectives: The aim of this study was to comprehensively analyze the evolution in textbook outcome (TO) achievement after liver resection for hepatocellular carcinoma (HCC) over two decades at a single tertiary referral center. Materials and Methods: All consecutive liver resections for HCC at Seoul National University Bundang Hospital from 2003 to 2022 were analyzed. The included 1334 patients were divided into four groups by time intervals identified through change point analysis. TO was defined as no intraoperative transfusions, positive margins, major complications, 30-day readmission or mortality, and prolonged length of hospital stay (LOS). Results: Multiple change point analysis identified three change points (2006, 2012, 2017), and patients were divided into four groups. More recent time interval groups were associated with older age (59 vs. 59 vs. 61 vs. 63 years, p < 0.0001) and more comorbidities. Minimally invasive procedures were increasingly performed (open/laparoscopic/robotic 37.0%/63.0%/0%) vs. 43.8%/56.2%/0% vs. 17.1%/82.4%/0.5% vs. 22.9%/75.9%/1.2%, p < 0.0001). TO achievement improved over time (1.9% vs. 18.5% vs. 47.7% vs. 62.5%, p < 0.0001), and LOS was the greatest limiting factor. Conclusions: TO after liver resection improved with advances in minimally invasive techniques and parenchymal sparing procedures, even in older patients with more comorbidities and advanced tumors. Full article

Background: There is an upward shift in the incidence and localization of gastric cancer (GC). Proximal gastrectomy (PG) has been advocated as an alternative operation for upper-third GC. An uneventful postoperative course is currently measured using a well-defined textbook outcome (TO), which represents a composite of surgical quality metrics. The aim of this study was to compare TO after two reconstruction methods following PG: double-tract reconstruction (DTR) and posterior esophagogastrostomy with partial neo-fundoplication (EGF). Materials and Methods: Primary proximal gastric adenocarcinoma patients who had undergone PG with DTR or EGF were included in this study. In a prospectively collected database, DTR and EGF were identified in 30 and 30 patients, respectively. Results: Patients with DTR had a 5.5-fold higher chance of achieving TO compared to those with EGF (OR = 5.67; p = 0.0266). No statistically significant differences in overall survival were noted when both reconstruction methods were compared. Conclusion: In patients with proximal GC undergoing PG, TO is more likely to be achieved using DTR compared to EGF, with similar overall survival. Randomized controlled trials are warranted to indicate the preferred reconstruction technique after PG. Full article

In recent years, the integration of technology into education has significantly transformed teaching methods, especially in science education. Tools like PhET simulations have proven highly effective in enhancing student engagement and comprehension. Research has highlighted the value of simulation-based learning in fostering critical thinking and problem-solving skills. This study aimed to explore the impact of simulations, with a focus on PhET, on improving elementary students’ learning outcomes, an area that remains under-researched. The study compared the performance of two groups of third-grade students: one group learned about solubility using PhET simulations, while the other relied on traditional textbook instruction. Each group comprised fifty students. The study lasted for a two-month period. The instructional approach was investigative learning. Data were gathered through student responses to materials science questions aligned with Bloom’s Taxonomy, allowing for a detailed evaluation of their understanding and application of scientific concepts. Responses were assessed for accuracy and scored accordingly. We ran an independent-sample t-test to decide whether the difference in the mean score in science achievement between the two research groups was significant. The results showed that students using PhET simulations not only achieved significantly higher scores but also demonstrated their ability to explain their reasoning during problem-solving tasks. These findings emphasize the substantial advantages of incorporating digital tools like PhET simulations into elementary science education, as they enhance conceptual understanding and better equip students to tackle future scientific challenges. The present research results complement the previous research on using technology in the chemistry elementary classroom and add the issue of simulations to this research. The results of this study are centered on the topic of solubility. To broaden the generalizability of these findings, future research should examine the effects of simulations on student achievement in a wider range of elementary science topics. Full article

Recent years have brought new, highly effective systemic treatments to clinical practice, which can be used to treat patients with locally advanced or metastatic skin cancers. Using these regimens in neoadjuvant strategy influences surgical treatment by facilitating surgical resection, avoiding extensive resections with complex reconstructions and even omitting surgery in some cases. Integrating systemic therapy with surgery is ongoing and requires novel quality measures of surgical treatment to capture the clinical benefits of multidisciplinary strategies better. The Textbook Outcome (TO) is a novel measure of surgical quality, which captures the short-term outcomes of surgery and reflects long-term survival. Textbook Outcomes match a particular type of surgery, are intuitive to interpret, and may be widely applied in surgical oncology and general surgery. Therefore, this review aims to describe recent findings on neoadjuvant skin cancer treatment and their implications for surgical proceedings in the context of Textbook Outcomes. Full article

This narrative review evaluates the literature on the management of mandibular condyle fractures in growing patients. It aims to illustrate some fundamental biological principles and to offer a series of considerations applicable to clinical practice. The discussion is based on 116 papers published in PubMed and two relevant textbooks. Condylar fractures may be overlooked, especially in pre-scholar children, where compliance is usually reduced. However, these injuries can have disabling sequelae such as ankyloses, facial deformities, malocclusion, and chronic pain in some patients if not diagnosed and managed correctly. Due to their significance, mandibular condyle fractures in children are a subject of considerable clinical interest. As of today, there is consensus about their treatment. Four management options are available: expectative (analgesia, soft food and follow-up), functional protocols (guiding elastics, orthodontic appliances and exercises), maxillomandibular fixation (MMF), and open reduction and internal fixation (ORIF). Nondisplaced and minimally displaced fractures should be treated expectantly; severely displaced non-comminuted fractures can be safely operated on if the expertise is available, even in patients with deciduous dentition. Moderately displaced fractures can be managed with functional protocols or operatively, depending on the background and know-how of the specialist. Functional protocols can achieve good outcomes, especially in patients with deciduous dentition. MMF should be foregone in children due to its many drawbacks. Full article

Backgorund: Textbook outcome (TO) is a composite measure that reflects the most desirable surgical results as a single indicator. The aim of this study was to assess the achievement of TO at a hepatopancreatobiliary (HPB) surgery unit in a Spanish tertiary hospital. Methods: We performed a retrospective observational study of all consecutive patients who underwent HPB surgery over a 4-year period. Morbidity according to the Clavien-Dindo classification at 30 days, hospital stay, risk of morbidity and mortality according to the POSSUM, and mortality and readmissions at 90 days were recorded. TO was considered when a patient presented no major complications (≥IIIA), no mortality, no readmission, and no prolonged length of stay (≤75th). Results: 283 patients were included. Morbidity >IIIA was reported in 21.6%, and 5.7% died; the median postoperative stay was 4 days. TO was achieved in 56.2% of patients. Comparing patients who presented TO with those who did not, significant differences were recorded for the type of procedure and the expected risk of morbidity and mortality calculated according to the POSSUM scale. There were significant differences between patients with major resections (TO rates: major hepatectomy (46.3%) and major pancreatectomy (52.5%)) and those with minor resections (TO rates minor hepatectomy (67.7%) and minor pancreatectomy (40.4%)). Conclusions: TO is a useful management tool for assessing postoperative results. Full article

Digital platforms are increasingly prevalent among young students in K-12 education, offering significant opportunities but also raising concerns about their effects on self-assessment and academic performance. This study investigates the effectiveness of Kahoot! compared to traditional instructional methods in enhancing mathematics achievement and its impact on multiple screen addiction (MSA) among Greek students aged 9 to 12 during a STEM summer camp. A quasi-experimental design was employed with a purposefully selected sample of one hundred and ten (n = 110) students, who were non-randomly divided into two groups: (a) an experimental group of fifty-five students (n = 55) who engaged with Kahoot! (using dynamic visual aids and interactive content) and (b) a control group of fifty-five students (n = 55) who received traditional instruction (using digital textbooks and PowerPoint slides with multimedia content) on laptops and tablets. The findings revealed a statistically significant difference in MSA scores, with the experimental group exhibiting lower MSA scores compared to their counterparts, indicating a positive impact on reducing screen addiction levels. While Kahoot! led to lower MSA levels, it significantly improved overall mathematical achievement, with a substantial effect size, suggesting a strong positive impact on learning outcomes. The current study highlights the importance of aligning educational tools with the intended outcomes and recommends further research to explore the broader impact of gamified learning on student engagement, screen addiction, and learning outcomes. Full article

Background and Objectives: In recent years, there has been a significant increase in interest in the health benefits of contact with nature. The theoretical and practical aspects of this issue are constantly being investigated. It is worth noting, however, that there is a large group of people for whom the only available form of contact with nature can only be through images (the view outside the window, photos and films about nature), recorded sounds of nature or descriptions of nature. Research indicating how much exposure to nature in the dimension of virtual reality achieves improvements in well-being, mood and vitality is therefore urgently needed. Material and Methods: The main goal of the experiment was to examine whether watching a 20-min 2D video of forest environment or reading a textbook on forest knowledge for 20 min would bring any psychological benefits. The order of both exposures was intentionally changed (reversed) for every second participant in this study to reduce the order effect. A group of 16 volunteers, students of Warsaw University of Life Sciences, took part in the experiment. The psychological tests before and after each of the two parts of the experiment (viewing a picture with sound and reading a book) were established using five questionnaires: Profile of Mood State (POMS); Positive and Negative Affect Scale (PANAS); Restorative Outcome Scale (ROS); Subjective Vitality Scale (SVS) and State-Trait Anxiety Inventory (STAI). Results: As a result of the analyses, a 20-min viewing of a 2D video of a forest with natural sounds of nature was shown to have a positive effect on the psychological relaxation of the subjects in the form of an increase in restorativeness and vitality in the participants of the experiment, as well as a greater decrease in negative feelings, tension and anger than when reading a forest-themed book. Watching a video of a landscape can reduce tension and anger levels significantly, which can be an important guideline in relation to the interior design of public spaces and the protection of employees from the adverse effects of psychosocial working conditions, as well as the desire to stabilize anger and maintain emotional stability in everyday life. Full article

Human contact with the natural environment effectively counteracts negative symptoms of stress and has many positive psychological effects. For this reason, forests within city limits are increasingly seen as part of public health promotion. Being in an urban forest can take many forms, but there is still little known about whether being in a forest alone, without engaging one’s senses, is as effective for human renewal as an experience that involves greater, more conscious activation of the senses of sight, hearing, smell. A study measuring the effect of the forest (spring aspect) on human mental relaxation during passive exposure was conducted on a sample of 19 Polish young adults. The experiment consisted of two series. In the first, participants read an academic textbook in a tree stand for 20 min, while in the next session—conducted at the same location—they contemplated the landscape. Before the experiment and after each of the two series of tests, four psychological questionnaires were administered: the Profile of Mood State (POMS), Positive and Negative Affect Schedule (PANAS), the Restorative Outcome Scale (ROS) and the Subjective Vitality Scale (SVS). Analyses showed that being in a forest environment positively influenced the subjects’ mental relaxation, while the level of benefit from the activation of the senses, especially vision (looking at the forest) was significantly higher compared to the passive activity of reading a text. The research indicates that forest bathing is the best form of relaxation that can be obtained through contact with the forest. Full article

Background/Objectives: The textbook outcome (TO) is a composite tool introduced to uniform surgical units and regulate surgical quality and outcomes. A patient is considered TO only if all predetermined items are met. In colorectal surgery, TO represents a new tool that can achieve important results given the prevalence of colorectal cancers. However, at present, there is a lack of uniformity in the TO’s definition. This study utilized the Delphi process to define an Italian version of the TO in colorectal cancer. Methods: The survey consisted of two rounds of online questionnaires submitted to an expert panel in colorectal oncological surgery, renowned academic surgeons, who had attended multiple scientific conferences and who were authors of papers on this specific topic. Five main topics with 26 questions were investigated through an online modified Delphi method. Items with almost 75% agreement achieved consensus. Results: Twenty-eight Italian experts were selected and participated in the two rounds. The Italian version of the textbook outcome in colorectal surgery was defined as the presence of 90-day postoperative survival, negative margins and at least 12 lymph nodes, a minimally invasive approach, ostomy fashioning if preoperatively planned, postoperative complication < Clavien–Dindo 3b, at least 10 ERAS items, no readmission, proper CHT and RT regimens, complete colonoscopy after or before surgery and Tumor Board Evaluation. Conclusions: The textbook outcome in colorectal cancer patients is a quality instrument providing a complete overview of the care of such patients, from diagnosis to treatment. We hereby propose an Italian version of the TO with outcomes chosen by an expert panel. Full article