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Background: Thoracic surgery is an expanding surgical specialty, but a shortage of qualified and motivated thoracic surgery residents is expected. It is estimated that around 23 % of all surgical specialist jobs will be vacant by 2030. We therefore need to assess the current clinical situation and urgently improve the recruitment and training of our next generation of surgeons. Methods: Using the online survey (Lime Survey), a questionnaire (28 questions) was created to analyze the current nationwide situation of residency in thoracic surgery. The survey was sent to all postgraduate trainees in thoracic surgery departments in Germany. The current status on residency-programs, scientific interest, the attractiveness of thoracic surgery, and the demographics of the participants were evaluated. The survey also evaluated specific ways to increase attractiveness.The survey was conducted in collaboration with “Frauen in der Thoraxchirurgie” by the “Junges Forum der Deutschen Gesellschaft für Thoraxchirurgie”. The survey was sent to all residents and young specialists in Germany. A total of 187 participants responded. Results: Out of 187 participants, 123 questionnaires (65.8 %) were completed. Mean age was 36.3 ± 6.9 years. 62.6 % of the participants were male. About 70 % work in an independent thoracic surgery department, while the rest is affiliated with another specialty department. 50 % have completed a doctorate in medicine. Conclusion: The development of an objective and structured training plan could define the roles and responsibilities of the senior surgeon and the trainee, leading to improved training and, at the very least, ensuring good recruitment of junior thoracic surgeons.

Background: Despite recent improvements in melanoma survival rates, persistent inequalities pose barriers to care for some patients. Objective: To assess the influence of social determinants of health (SDoH) on melanoma treatment outcomes. Methods: A systematic review (Prospective Register of Systematic Reviews CRD42022346854) of manuscripts that examined the association between SDoH and melanoma treatment-related outcomes in the United States was conducted using 5 databases. Results: The analysis encompassed data from 12 retrospective manuscripts. The SDoH domains most frequently investigated were health care access and quality (n = 6 manuscripts, 50%) and economic stability (n = 7, 58.3%). Other domains included social and community context (n = 5, 41.7%) and education access (n = 3, 25%). These findings revealed significant correlations between poor melanoma survival and low levels of economic stability, limited education, government health insurance, and being uninsured and unmarried. Limitations: Many SDoH were not analyzed at the patient level. SDoH are vast categories, but manuscripts usually analyze one aspect of a particular category. Conclusions: These results highlight the need for physicians to recognize the substantial impact of SDoH on melanoma outcomes and to adopt more comprehensive strategies focused on patient-centered care. Integrating social support mechanisms into clinical practice emerges as a key mechanism to promote equitable and effective interventions.

Cardiac electrophysiology is a highly specialized field focused on the management of cardiac arrhythmias. Therefore, rigorous training is required for advanced practice providers (APPs) to competently practice independently within the specialty. An in-depth, 12-month training curriculum was created for electrophysiology in conjunction with a previously established APP Fellowship Program for the training of other complex subspecialties at an academic medical center. The Stanford Health Care Electrophysiology APP Fellowship Program is the first in the country to provide in-depth education and training for novice APPs to deliver high level care to patients with cardiac arrhythmias. The training program has proven to be successful in transitioning novice APPs to independent practitioners within the specialty since its inception in 2021.

SUMMARY: Purpose: The study was conducted to develop a customized diet education program using mobile instant messenger for people undergoing peritoneal dialysis (PD). Our goal was to examine the program's effects on diet-related self-efficacy, dietary self-care compliance, and physiological indices (hemoglobin, albumin, potassium, and phosphorus). Methods: This was a quasi-experimental study with a non-equivalent control group pre-post-test design. We applied the Cox interaction model of client health behaviors. Overall, 43 patients (21 in the experimental group and 22 in the control group) attending the renal clinic and undergoing PD at three hospitals were included. The experimental group underwent a customized diet education program using a mobile instant messenger for five weeks. Patients in the control group received routine care. This study was conducted in the following order: pre-test, treatment, post-test 1 (immediately after), and post-test 2 (four weeks after). Results: This study showed significant differences in dietary self-care compliance (F = 15.29, p

Resumen: Introducción: La toma de decisiones durante las prácticas clínicas implica una serie de procesos mentales interrelacionados como la memoria de trabajo, el control inhibitorio, la flexibilidad cognitiva y la regulación emocional, que influyen en el proceso de enseñanza y aprendizaje. Objetivo: Analizar el proceso de toma de decisiones en los estudiantes de Obstetricia y Puericultura de la Universidad de Antofagasta, Chile durante las prácticas clínicas en campos docente-asistenciales desde la neuroeducación. Método: Se realizó una investigación cualitativa exploratoria por medio de entrevistas semiestructuradas a 16 estudiantes mujeres. Los relatos fueron analizados a través de la teoría fundamentada. Resultados: Las experiencias vividas y los saberes alcanzados permitieron la consolidación de la memoria y sustentaron las decisiones correctas frente a los pacientes. La adaptación ante situaciones nuevas, eventos adversos e incidentes críticos fue condicionada por la supervisión del docente, al igual que la atención sostenida durante la toma de decisiones en entornos reales. Las emociones negativas predominaron desde el comienzo y al final de todos los procesos de decisión. Conclusión: Dado que la toma de decisiones es un proceso complejo que implica una sinergia entre la memoria de trabajo, la flexibilidad cognitiva, el control inhibitorio y la regulación emocional, independiente de la temporalidad, es recomendable fomentar una docencia sustentada en la neuroeducación, porque permite al docente comprender los procesos mentales de los estudiantes, favorecer un clima educativo armónico y fortalecer las competencias pedagógicas Abstract: Introduction: Decision-making during clinical practices involves a series of interrelated mental processes such as working memory, inhibitory control, cognitive flexibility and emotional regulation, which influence the teaching and learning process. Objective: To analyze the decision-making process in Obstetrics and Childcare students of the Universidad de Antofagasta, Chile during clinical practices in teaching-assistance fields from the neuroeducation. Method: An exploratory qualitative research was carried out through semi-structured interviews with 16 female students. The narratives were analyzed through grounded theory. Results: The experiences and knowledge gained allowed the consolidation of the memory and supported correct decisions in front of the patients. Adaptation to new situations, adverse events and critical incidents was conditioned by the teacher's supervision, as well as sustained attention during decision making in real environments. Negative emotions predominated from the beginning and at the end of all decision-making processes. Conclusion: Since decision-making is a complex process that involves a synergy between working memory, cognitive flexibility, inhibitory control and emotional regulation, independent of temporality, it is therefore advisable to promote teaching based on neuroeducation, because it allows the teacher to understand the mental processes of students, to favor a harmonic educational climate and to strengthen pedagogical skills.

Resumen: Introducción: El feedback es un proceso mediante el cual los estudiantes dan sentido a información procedente de diversas fuentes y la utilizan para mejorar sus desempeños. Diversos estudios han demostrado insatisfacción por parte de los estudiantes con el feedback, lo cual se relaciona a la falta de un consenso conceptual del feedback. La alfabetización en feedback en estudiantes se refiere a la comprensión y capacidades requeridas para dar sentido a la información recibida y utilizarla para mejorar desempeños, algo considerado fundamental para el feedback efectivo. En educación para profesionales de la salud, se desconocen las implicancias que la experiencia universitaria tiene sobre la alfabetización en feedback. Este estudio explora las comprensiones, capacidades y disposiciones sobre el feedback de estudiantes de carreras en Ciencias de la Salud. Metodología: Estudio de corte transversal, con un enfoque pragmático y metodología cualitativa. Se invitó a participar a estudiantes de primer y cuarto año de carreras de salud de la Pontificia Universidad Católica de Chile. Se organizaron seis grupos focales y se utilizó análisis temático. Resultados: Tres temas guiaron los datos encontrados. Existen diferencias entre primer y cuarto año en las capacidades de reconocer instancias de feedback y el cómo dan sentido a sus experiencias sobre esta estrategia educativa. Estudiantes perciben al feedback como un proceso unidireccional. Estudiantes de cursos superiores reconocen mayores instancias de feedback. Conclusiones: El conocer la alfabetización en feedback de los estudiantes permitirá realizar en un futuro intervenciones educacionales sobre los procesos de feedback en Ciencias de la Salud. Abstract: Introduction: Feedback is recognized as a process in which students make sense of information from various sources and use it to improve performance. Several studies have shown dissatisfaction from students about this process, which could mean there is no conceptual consensus about this process.Feedback literacy refers to the understanding and capacities to make sense of the information received and use it to improve performance, which is considered essential for an effective feedback process. Despite its importance, the implications that student feedback literacy has in teaching and course design have not been sufficiently taken into account, and uncertainty persists about engaging them effectively, especially in clinical settings. Methodology: Cross-sectional study with a pragmatic approach and qualitative methods. First and fourth-year students from health-related careers at the Pontificia Universidad Católica de Chile were invited to participate. Six focus groups were organized, and thematic analysis was used. Results: Three themes guided the findings. Differences exist between first- and fourth-year students regarding their capacity to recognize feedback instances and how they make sense of their experiences with this educational strategy. Students perceive feedback as a one-way process. Higher-level students recognize more instances of feedback. Conclusions: Understanding students’ feedback literacy will enable future educational interventions on feedback processes in Health Sciences.

Virtual reality (VR) integration into surgical education has gained immense traction by invigorating skill-building in ways that are unlike the traditional modes of training. This systematic review unites current literature relevant to VR in surgical education to showcase tool transferability, and subsequent impact on knowledge acquisition, skill development, and technological innovation. This review followed the PRISMA guidelines and included three databases. Among the 1926 studies that were screened, 31 studies met the inclusion criteria. ChatGPT assisted in generating variables for data extraction, and the authors reached unanimous consensus on 13 variables that provided a framework for assessing VR attributes. Surgical simulation was examined in 26 studies (83.9%). VR applications incorporated anatomy visualization (83.9%), procedure planning (67.7%), skills assessment (64.5%), continuous learning (41.9%), haptic feedback (41.9%), research and innovation (41.9%), case-based learning (22.6%), improved skill retention (19.4%), reduction of stress and anxiety (16.1%), and remote learning (12.9%). No instances of VR integration addressed patient communication or team-based training. Novice surgeons benefited the most from VR simulator experience, improving their confidence and accuracy in tackling complex procedural tasks, as well as decision-making efficiency. Enhanced dexterity compared to traditional modes of surgical training was also notable. VR confers significant potential as an adjunctive teaching method in plastic and reconstructive surgery (PRS). Studies demonstrate the utility of virtual simulation in knowledge acquisition and skill development, though they lack targeted approaches for augmenting training related to collaboration and patient communication. Given the underrepresentation of PRS among surgical disciplines regarding VR implementation in surgical education, longitudinal curriculum integration and PRS-specific technologies should be further investigated.

Background and objective: Video-based learning may be beneficial in surgical education, both in the preparation for surgery and to evaluate surgical performance. The use of a video is not yet anchored in European urology residency programs, and it is unclear how frequently residents use videos. The purpose of this study is to investigate whether and how urology residents utilize videos to prepare for surgical procedures and evaluate their surgical performance. Methods: We conducted a European-wide, survey-based, needs assessment among urology residents. The survey was distributed electronically among the participants in the European Urology Residents Education Program 2022 and all the members of the European Society of Residents in Urology. Key findings and limitations: Seventy-two surveys were completed by the residents of 12 nationalities. Of the residents, 98.6% used videos in preparation, mainly for open, laparoscopic, and robotic procedures. YouTube was by far the most used source. Of the residents, 86% believed that a postsurgical video review would be helpful. In total, 39% of the residents actually had this possibility. Of them, 30% had the opportunity to do this together with a supervisor. Conclusions and clinical implications: This study demonstrated that European urology residents often use videos to prepare surgical procedures. Considering that the majority of the respondents use YouTube as the main source of videos, this seems not to be formalized within their training. Although most residents would value a postsurgical video review, preferably together with a supervisor, the latter is not available to the majority. We recommend the use of professional, and not public, video channels and easier access to postsurgical video review. Patient summary: Video-based learning may have an important role in surgical education. Videos often are a source of education for European urology residents to prepare for surgical procedures. Although most residents would appreciate a postsurgical video review or video-based coaching, this is not available to the majority of them.

Background: Dermatoscopy is a noninvasive method of examining skin lesions under high magnification, gradually replacing the need for invasive biopsies. Training is required to gain clinical competency. Gamification employs game-like elements to enhance education engagement and is an engaging means of delivering medical education. We sought to use gamification and a mobile-based platform to deliver dermatoscopy education to physicians. Methods: We developed SKIN@GoPRIME, an interactive smartphone platform. Thirty physician participants were randomly assigned to watch an online dermatoscopy lecture or to use SKIN@GoPRIME. Twenty-eight participants completed prelearning and postlearning quizzes and provided feedback on SKIN@GoPRIME. Results: Users of SKIN@GoPRIME demonstrated a significant 1.71-point mean score improvement (P = .0018). The group that watched the online dermatoscopy lecture had a higher 2.36-point mean score improvement (P = .00021). Both family medicine and internal medicine physicians demonstrated a significant mean score increase of 1.29 (P = .049) and 2.14 (P = .023), respectively, after using SKIN@GoPRIME. Based on feedback, 83% believed that SKIN@GoPRIME can be used to acquire the applied competencies required for their job scope. Discussion and Conclusion: SKIN@GoPRIME, a novel learning tool via gamification effectively delivers dermatoscopy education, although it is not shown to be more effective than lectures. Larger studies are required to further validate the effectiveness of gamified learning techniques in dermatoscopy education. Future studies should involve the optimization of SKIN@GoPRIME to more effectively deliver dermatoscopy education.

Objective: The pathway to cardiothoracic surgery is often obscure for premedical students and aspiring applicants and requires navigating various known and unknown obstacles. Recognizing the challenges encountered on the path to a career in cardiothoracic surgery in the United States, we present this guide for students interested in the field to maximize success in their premedical, preclinical, and preresidency years. Methods: This is a joint collaboration between the Thoracic Surgery Residents Association and the Thoracic Surgery Medical Student Association. Drawing from firsthand experiences and insights gathered from numerous student applicants and current surgical residents, a comprehensive guide was constructed for students from the point of undergraduate school to advanced training options, including super-fellowship training. Results: Several intricacies to cardiothoracic surgery career planning were discussed, including differences between traditional and integrated/fast-track pathways, college and medical school selection, networking, performing during clinical rotations, extracurricular and research activities, building mentorship relationships, and pursuing alternate career and advanced training opportunities. Conclusions: For premedical students and aspiring applicants, the road to cardiothoracic surgery requires meticulous planning, grit, and thoughtful dedication. This document consolidates firsthand insights and advice from numerous aspiring and matched applicants to serve as a comprehensive guide for students seeking a career in cardiovascular and thoracic surgery.

Purpose/Objectives: This article introduces the Key Electronic Assessment Platform (KEAP), an electronic-based assessment platform created in-house at the College of Dentistry (COD), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia. It highlights the platform’s integral value and demand within the educational system. Methods: The article introduces the KEAP system design and architecture, describes its features, tests, and implementation in addition to its maintenance and security. It also presents the outcomes of KEAP utilization and the level of users’ satisfaction. Results: The KEAP item bank has been expanded by more than 26,500 questions over the last four academic years and 1,255 exams have been administered. KEAP provides a highly secure structured framework for assessment planning, conduction, and evaluation. More than 90% of students and faculty are satisfied or very satisfied with their experience using the KEAP system indicating that it is well accepted by the end users. Conclusions: The development of KEAP is based on contextual factors in COD, KSAU-HS with the aim of creating a process for assessment that is valid, efficient, standardized, and highly secure. KEAP’s design and successful implementation can provide a successful example of implementing electronic-based assessment in higher education.

In Chemoinformatics, as in many other computational-related disciplines, it is a common practice to identify the “single best” approach or methodology, for instance, identify the best fingerprint representation, the best single virtual screening approach or protocol, the optimal representation of the chemical space, the best predictive model, to name a few. In molecular modeling, a typical example is finding the best docking program. However, it is also known that each approach has its advantages and limitations. There are examples of benchmark studies comparing different approaches to find the most appropriate solution, and it is common to find that there are no single best programs in such studies. Yet, searching for the “best” methods is still common. The main goal of this work is to survey hybrid methodologies recently developed in Chemoinformatics. The list of approaches is not exhaustive, but it aims to cover several representative applications. One of the major outcomes of the survey is that, for various purposes, individual methods do not perform as well as the combination of approaches because single methods have inherent limitations with advantages and disadvantages.

Aims: To assess clinical and metabolic parameters in patients with diabetes during Ramadan fasting. Patients and method: It was a prospective evaluative study based in the National Institute of Nutrition of Tunis (Departement C) in a population of patients with diabetes prepared for fasting by education and therapeutic adjustment. Results: 140 diabetics, mainly at high and very high risk (70.7 %), were analyzed. The frequencies of hypo and hyperglycemia were 12.1 and 11.4 % respectively. The mean weight and the mean systolic and diastolic blood pressure remained stable. Fasting blood glucose and HbA1C decreased significantly (−0.7 ± 3.1 mmol/L (p = 0.009), −0.18 ± 1.1 % (p = 0.047). The mean creatinine clearance had remained stable. Conclusion: Ramadan fasting can be well-tolerated, even for patients at high and very high risk, with an improvement in glycemic control, provided prior education and adequate therapeutic adjustment.

It is widely acknowledged that early childhood education is vital to children's success in later years. However, there is a limited exploration of parental involvement in early school education. This study was conducted against contemporary societies' increasingly neoliberal and multicultural nature, which could influence parental involvement in their early education. Vygotsky's sociocultural learning theory was used as a guide to investigate the levels of parental involvement in children's schooling. First, parents' support at home correlated to parental school involvement. Second, language proficiency was posited to moderate parental involvement and school type. The participants comprised 498 parents of children attending primary schools across Abu Dhabi. Parents completed two newly developed parental involvement scales at school or home. The data were analysed using SPSS AMOS for confirmatory factor analysis, path and moderation analyses. The results showed a relationship between the two main domains, home and involvement in school-related activities. The paper finally discusses the study's contributions, limitations, and practical implications.

The widespread popularity of ChatGPT and other AI chatbots has sparked debate within the scientific community, particularly regarding their impact on academic integrity among students. While several studies have examined AI's role in education, a significant gap remains concerning how AI chatbot usage affects students’ perceptions of academic integrity. This study aims to address this gap through rigorous quantitative techniques to explore the dynamics of student interactions with AI chatbots and assess whether this engagement diminishes academic integrity in higher education. Using a non-experimental design, the research investigates the causal relationship between AI chatbot usage and academic integrity, focusing on eight latent variables identified in the literature. A stratified sampling technique was employed to collect a representative sample of 594 participants via a 5-point Likert scale survey from four Southern Asian countries. The dataset underwent extensive statistical analysis using Structural Equation Modeling (SEM) techniques. The findings establish significant links between motivations for using AI chatbots and a decline in academic integrity. The study identifies a behavioral link between academic integrity and pedagogical limitations, highlighting traditional classroom-based pedagogy as the most impactful factor influencing students’ motivation to engage with AI chatbots. This research not only quantitatively addresses ethical concerns related to AI in academia but also offers insights into user behavior by assigning distinct weights to post-usage behavioral factors, differentiating it from earlier studies that treated these factors equally.

Summary: Background: Adolescent pregnancies pose a risk to young mothers and their babies. In Zambia, one third of 18-year-old girls have given birth. Poverty, low secondary school enrolment, misinformation, and community norms contribute to early childbearing. We assessed the effectiveness of economic support alone and combined with comprehensive sexuality education (CSE) and community dialogue on childbearing and sitting for grade nine exams among girls. Methods: This cluster randomised trial had one control and two intervention arms. In 2016, 157 rural schools (units of randomisation) were included, and girls in grade seven were eligible. After recruitment, schools were stratified by district and randomised (ratio 31:63:63). In one arm, girls and their guardians were offered economic support. Another arm combined CSE and community dialogues with the economic support. The interventions were implemented for 27 months, and the participants were followed for another 2 years. The primary outcomes were birth within 8 months of the end of the intervention period, birth before the 18th birthday, and sitting for grade nine exams. The trial is registered with ISRCTN (ISRCTN12727868). Findings: Between 3rd March and 15th July 2016, 4922 girls were recruited, with 999 randomised to the control, 2004 to the economic and 1919 to the combined arm. The combined support gave a moderate reduction in the incidence of birth within eight months of the intervention period's end (risk difference (RD) −0.042 (95% CI −0.084, −0.0003), possibly a minimal reduction in birth before the 18th birthday (RD −0.010 (95% CI −0.053, 0.032), and a substantial increase in sitting for grade nine exams (RD 0.17 (95% CI 0.11, 0.22). The economic support alone tended to give slightly smaller effects. Interpretation: Our findings suggest that a combination of economic support, CSE and community dialogue may give small reductions in adolescent childbearing. The same interventions can increase completion of basic education. Funding: The Research Council of Norway, the University of Bergen and the Swedish International Development Cooperation Agency (SIDA).

This qualitative study explores the practices and processes associated with implementing the Enviroschools approach. Enviroschools aim to nurture healthy and sustainable communities through learning and taking action collaboratively. The approach is implemented in over 1600 early childhood centres, primary, intermediate and secondary schools in Aotearoa, New Zealand. Semi-structured interviews were undertaken with 26 participating teachers, school leaders and Enviroschool facilitators and co-ordinators across 6 regions nationwide. Transcripts were analysed through thematic analysis. Two themes were developed to situate and describe participants’ experiences of implementing the approach: forming relationships through attunement and sustaining relationships through critical reflection. Both of these themes speak to the value of applying a relational lens to understand the implementation of systems approaches, particularly in school settings. Our findings also suggest that there is a need for and an appreciation of systems approaches to nurturing wellbeing and sustainability in school communities and that extending systems thinking to the implementation of these approaches can help to bring the interconnections between health and sustainability to life in meaningful ways. The participants valued viewing and approaching implementation as a journey that develops proximal and more distant currents of change over time. Further research to explore the mechansisms of change and how these lead to outcomes may help to translate the practices and processes of implementation.

Cyber threats are one of the main concerns in this growing technology epoch. To tackle this issue, highly skilled and motivated cybersecurity professionals are increasingly in demand to prevent, detect, respond to, or even mitigate the effects of such threats. However, the world faces a workforce shortage of qualified cybersecurity professionals and practitioners. To address this dilemma, several cybersecurity educational programs have been introduced, such as specialized cybersecurity courses in computer science graduate programs. With the increasing demand, different cybersecurity courses are introduced at the high school level, undergraduate computer science and information systems programs, and even at the government level. Due to the peculiar nature of cybersecurity, educational institutions face many issues when designing a curriculum or cybersecurity activities. In this paper, we study existing cybersecurity curriculum approaches and activities. We also present case studies on cybersecurity education around the globe.

Background: The “Young NaPHOS” project was launched in 2021, by Young SIOPE, the group for junior members of the European Society for Paediatric Oncology (SIOPE). The Young NaPHOS project aims to build a network of national representatives of young paediatric haematologists and oncologists to discuss organisational and educational aspects at national and European level, differences in the training paths, and the needs to be addressed in the future. Methods: From June 2021 until September 2022, three online meetings took place and one online survey was conducted. The meetings focused on presenting the structure and organisational aspects of existing national junior organisations in paediatric haematology and oncology, including their national activities. The survey aimed to investigate the European landscape of national organisations and training paths by inviting 39 young national representatives. Results: Ten out of 34 responders confirmed the existence of a junior organisation in their country. Diversity was noted among the countries for the existence of such organisations, the organisations’ activities, or the membership criteria. Further, the training path to become a paediatric oncologist/haematologist differs a lot. Young paediatric oncologists also shared common concerns, especially regarding networking, international collaboration, and educational opportunities. Conclusion: This project resulted in the creation of a European network among young paediatric oncologists and haematologists, in spreading ideas and offering support, and identified differences and areas for future action of Young SIOPE.

Virtual Reality (VR) revolutionises education, offering a uniquely immersive and engaging learning experience. It fosters personalised learning, ignites creativity, and enhances understanding through interactive 3D models. These models transport students into a virtual world, facilitating better comprehension and memory retention. VR also addresses crucial educational challenges, such as catering to students with special needs and enabling remote learning. Nevertheless, VR also faces challenges like high initial investment and, hence, has limited adoption in education. Thus, to overcome this challenge, Additive Manufacturing (AM) is identified as an emerging technology that complements VR in education. VR provides a digital model, whereas AM provides 3D physical models, enhancing understanding in students. These technologies reduce paperwork, promote a sustainable environment, and facilitate students to learn from their homes, reducing their travelling requirements. This paper highlights that using these technologies in education contributes to achieving many United Nation's Sustainable Development Goals.This is a review-based research, where a scoping review has been presented, with articles and research papers from the relevant sources collected and analysed to address the well identified research objectives. It also compares traditional and VR-based teaching-learning, provides a broad classification for the different education segments targetable through VR, the economic impact of VR on education, and significant applications and advantages of VR in education. We also propose using AM as a cost-effective enabler for VR in education, facilitating sustainability by achieving many of the SDG goals. Further, limitations and VR's implications in academia are presented to show a way forward.

This study explores the nexus of gamification, artificial intelligence (AI), and mathematics cognition. Sample size of 71 responded in an intervention using game-based learning (GBL) approach. The purpose of designing the GBL was to enhance computational thinking and mathematical skills. The research employed multigroup partial least squares structural equation modelling (MGA-PLS-SEM) and artificial neural networks (ANN) through multilayer perceptron (MLP) as data analysis technique. The findings showed significant positive influence on class engagement, attitudes toward mathematics, as well as student performance. The analysis also revealed gender-related variations, which affirmed the model's consistency across diverse groups. The study validated the hypothesis and consequently advocated for the transformative potential of gamification, in preparation of 21st-century learners for AI-driven digital landscape. The implications are to ensure the integration of gamified elements into educational strategies, benefiting educators, curriculum developers, and policymakers resonating strongly for educators, curriculum developers, and policymakers.

Objectives: Excessive consumption of sugar-sweetened beverages (SSBs) contributes to adverse health outcomes but is differentiated by socio-economic indicators. The study analyses the educational disparities in adults frequent consumption of sugar-sweetened beverages (SSBs) in Estonia and its temporal changes between 2006 and 2022. Study design: Repeated cross-sectional survey. Methods: Nationally representative data from 9 biennial cross-sectional surveys on 25–64-year-old Estonian residents (n = 20396) was used for the study. Changes in frequent (on 6–7 days per week) consumption of SSBs by study year, sex, age, and education is analysed using descriptive statistics and binomial logistic regression. Prevalence and odds ratios (OR) with 95 % confidence intervals (CIs) are presented focusing on temporal and educational patterns in frequent SSB consumption. Results: The prevalence of frequent SSB consumption among Estonian adults declined consistently from 2006 (14.0 %) to 2018 (5.2 %), followed by statistically non-significant increases in 2020 (6.8 %) and 2022 (7.1 %). Prevalence of frequent SSB consumption was significantly (p

The development of creativity and creative thinking in early school-age children is a strategy to foster future capabilities for innovation and change. It is also a strategy to instill resilience in these children, enabling them to face the challenges posed by the various environments that surround teaching and learning processes. This article analyzes the dreams and fears expressed by children from educational institutions located in municipalities affected by the armed conflict in Colombia, within the framework of a route designed to develop creativity and innovative thinking. A qualitative narrative analysis methodology was used to characterize and analyze the narratives of 68 co-creativity teams, involving 408 children. The results show that the narratives are influenced not only by the context in which the children live but also by the consequences of the armed conflict in the areas where the schools are located. The findings suggest that educational strategies like the one studied must incorporate elements that allow for adaptation to the context from the design stage, with a differential approach, to generate the expected positive effects in the territories where they are implemented.

Using the metaverse can impact how information is interacted with in educational settings. However, despite extensive research on the topic, there is still a lack of understanding of how learners perceive and experience this technology. To design learning experiences, designers must know the current landscape of metaverse implementation and digestion by student users. This article provides an overview of metaverse implementation examples to address this gap and then examines learners' perceptions of using the metaverse in education. Through a qualitative study, we aim to explore the potential advantages and obstacles of applying the metaverse to learning from an informal learning perspective, as perceived by learners. Compared to current implementation strategies, student feedback suggests a diversity of motivations and experiences in valuing the Edu-metaverse. Therefore, our study provides valuable insights into how the metaverse learning design can enhance learner engagement, interaction, and collaboration while identifying potential challenges and limitations. Ultimately, this research helps designers and educators better understand how metaverse technology can impact and improve learning experiences.

The COVID-19 pandemic has accelerated digitalization in various work environments, including the education sector, leading to increased teacher stress levels and negative impacts on well-being. Despite the importance of teachers' well-being, there is a lack of understanding of the factors contributing to their motivation and performance. This study aimed to investigate the impact of meaning in life on teachers' work performance by examining the mediating role of intrinsic and extrinsic motivation. To evaluate the hypothesis, a sample of 1114 teachers from Ecuador participated in this study, they completed self-reported questionnaires, and provided data for the structural equation model (SEM) analysis. The results indicate that teachers with presence´s high levels in the meaning of life show greater intrinsic motivation, which positively influences the effort and quality of their work. Additionally, teachers with search´s high levels in the meaning in life show higher extrinsic motivation, which also positively influences the effort and quality of their work. These findings offer insights for improving compensation policies in the education sector, highlighting the importance of fostering meaning in life among teachers to enhance their workplace performance.

Resumen: Objetivo: Establecer un decálogo de competencias en autocuidado para guiar la educación durante los programas de rehabilitación cardiaca (RC) en pacientes con insuficiencia cardiaca con fracción de eyección preservada (IC-FEp), mediante un consenso multidisciplinario. Diseño: Estudio e-Delphi en tres rondas a partir de un cuestionario inicial de 23 competencias basado en las principales recomendaciones de las guías de RC y autocuidado. Emplazamiento: Enmarcado bajo la ética de un ensayo clínico aleatorizado desarrollado en el Hospital Regional de Málaga. La encuesta se diseñó y difundió como un cuestionario en línea. Participantes: El panel de expertos integró dos pacientes con IC-FEp, y 13 profesionales de medicina interna (n = 3), cardiología (n = 2), fisioterapia (n = 3), enfermería (n = 3) y terapia ocupacional (n = 2). Método: El análisis de resultados incluyó el índice de validez de contenido (IVC), porcentaje de acuerdo (PA%), concordancia mediante kappa de Fleiss (k) y alpha de Krippendorff (α). Resultados: Tras la tercera ronda, se identificaron 20 competencias en autocuidado agrupadas en 12 dominios, con consenso suficiente para su inclusión en el decálogo. Conclusiones: El decálogo de competencias en autocuidado generado a partir del consenso multidisciplinar proporciona una guía para la educación en pacientes con IC-FEp, abordando de manera sistemática y adaptada a los pacientes los contenidos educativos en la práctica clínica habitual de los programas de RC. Abstract: Objectives: To develop a decalogue of self-care competencies to manage educational intervention during Cardiac Rehabilitation (CR) programs in Heart Failure with preserved Ejection Fraction (HFpEF) patients through multidisciplinary consensus. Design: 3-round e-Delphi study using an initial questionnaire of 23 competencies based on the main recommendations of the CR and self-care guidelines. Site: It was framed under the ethics of a randomised clinical trial developed at the Regional Hospital of Malaga. The survey was designed and disseminated as an online questionnaire. Participants: The expert panel comprised two patients with HFpEF and 13 healthcare professionals from Internal Medicine (n = 3), Cardiology (n = 2), Physiotherapy (n = 3), Nursing (n = 3) and Occupational Therapy (n = 2). Method: The analysis of results included the content validity index, the percentage of agreement, and the concordance using Fleiss Kappa and Krippendorff's alpha. Results: After the third round, 20 self-care competencies were identified, grouped into 12 domains, with sufficient consensus for their inclusion in the decalogue. Conclusions: The decalogue of self-care competencies generated from the multidisciplinary consensus guides education in patients with HFpEF, systematically addressing educational content tailored to patients for clinical practice in CR programs.

Objective: To examine whether medical student empathy changes throughout the five years of a UK medical school. Methods: Students completed an online version of the Jefferson Scale of Empathy (JSE-S) during the 2022–2023 academic year. Comparisons of empathy scores were made using analysis of variance (ANOVA), and independent t-tests. Results: Empathy scores varied across different years of medical school (P ≤ 0.001), with a small drop in empathy between the pre-clinical and clinical phases of medical school (Mean difference = 1.82, P = 0.025). Male students scored lower than female students and there was no statistically significant difference between the mean empathy score and speciality interest. Conclusions: Students' empathy appeared declined slightly as they progressed through medical school. As a crucial component of good clinical care, interventions in medical education to enhance empathy should be prioritised. Innovation: This is the first time following the COVID-19 pandemic that medical student empathy was measured across all five years of a medical school. Unlike many previous related studies, we identified the point at which empathy appears to decline, providing guidance for educators who can target empathy enhancing interventions where they are most needed.

This paper details the design and development of an immersive and self-guided Virtual Reality training system (iSGVRTS) for learning cleanroom microfabrication operations, with a specific emphasis on the photolithography process, within a college-level semiconductor laboratory curriculum. It presents the thorough construction of the iSGVRTS environment as well as the incorporation of integrated instructional methodologies. To assess the impact of the iSGVRTS intervention, pre-and post-tests were administered to evaluate learners' performance. The implementation of iSGVRTS yielded a notable enhancement for learners in laboratory operational proficiency, evidenced by improvements in task correct rates, reduction in procedural errors, and knowledge acquisition. Moreover, post-session interviews revealed learners’ reported increased confidence, a heightened sense of presence, manageable cognitive load, and positive feedback regarding the immersive learning experience.

Widespread harmful gender stereotypes against adolescent pregnant school girls (APSGs) often characterise schools, teachers and education officials’ response to pregnancy in schools in sub Saharan Africa. These gender stereotype which underly school exclusion of APSGs include, for example, the stereotype that the girls got pregnant because they engaged in immoral sexual activity. In this regard, the exclusion is seen as a punitive measure—penalising the girls for their immorality and serving as a deterrent to other girls getting pregnant. In line with the theme of this special issue, the study argues that the gender stereotyping and exclusion of APSGs is discriminatory against the girls and by implication women, as it targets them based on their sex, their unique capacity to become pregnant and their actual pregnancy status. It therefore violates the rights to equality and non-discrimination in the area of education which are guaranteed under several international human rights treaties including the Convention on the Elimination of All Forms of Discrimination against Women 1979 (CEDAW) which this study focuses on. This study goes on to bring together the obligations of States Parties to eliminate harmful gender stereotypes These obligations which are scattered across the CEDAW Committee's jurisprudence, provide a clear framework for both upholding the rights of girls and holding States Parties accountable under an international human rights paradigm.

This study assessing the effect of home-to-school distance on student's dropout rate in Adi-Keyih sub-zone, Southern administrative region, Eritrea. In the current study, correlational method is used to test the significance of home-to-school distance on dropout rate of students. The population of the study embraces all 24 schools in Adi-Keyih sub-zone and their 15,457 students. Out of the total students there were 1215 dropout students (7.9 %) and all of them have been included in the study. For comparative and inferential purposes, the same number of non-dropout students (1215) were selected using systematic random sampling methods and the sample of non-dropout students from each school is proportional to the active student population in each school. This approach yielded a total of 2430 students, which is 15.7 % of the total population. Data were collected from student's personal files by conducting field visits to each school and analysed using simple Chi-Square and logistic model. The finding of logistic regression analyses show that home-to-school distance has a direct effect on dropout rate: as home-to-school distance increases, the likelihood for a dropping out also increases. The relationship is statistically significant at P < 0.10. The study clearly demonstrates that home-to-school distance affect the dropout rate in Adi-Keyih sub-zone, but this result could not be generalized across the whole country as it requires a bigger and more detailed study.

Objective: To assess the added value of a novel, mobile educative application to standard counselling on aspirin adherence during pregnancy versus standard counselling alone. Methods: Participants were randomly assigned for additional use of a mobile educative application or standard counselling alone. Main outcome measures were adherence to aspirin measured by two validated questionnaires: Simplified Medication Adherence Questionnaire (SMAQ), Believes and Behaviour Questionnaire (BBQ), and patients reported tablet intake >90%. Results: A total of 174 women with an indication for aspirin during pregnancy were included. The questionnaires were filled in by 126 out of the 174 participants (72.4%). Similar results were found in the app group and the standard counselling groups for both validated questionnaires. Tablet intake >90% was seen in 88.7% and 87.5% (p = 0.834) of the app group and standard counselling group respectively. Subgroup analyses demonstrated a negative effect of BMI and a positive effect of educational level on adherence. Conclusions: Our study revealed no added effect of a novel, mobile educative application to standard counselling on aspirin adherence during pregnancy. Tablet intake was equally high in both groups probably explained by our high educated population. Innovation: Future studies should focus on tailored counselling on medication to pregnant women's needs including medication reminders, addressing concerns, adequate health literacy and side effects, offering rewards to further stimulate aspirin adherence in pregnancy with optimal outcome for mother and their neonate.

This study aims to evaluate the role of AI as an educational tool from an ethical and pedagogical perspective as it delves into the perceptions of the teaching community whose resistance to technology integration into conventionally managed classrooms has been well established in a large number of studies. The study uses a mixed methods design to gather data from 50 English, Translation, and Linguistics faculty members at Ha'il University whose collective and individual views on the ethical and pedagogical issues are analyzed using a questionnaire and individual interviews. Results indicate an overall high perception (M = 3.49, Std = 0.808) among the teachers towards the ethical use of AI in their teaching experience and (M = 3.84, Std = 0.833), on the pedagogical implications of AI in the learning process. Findings also indicate that educators are aware of solutions to ensure maintenance of ethics with inclusion of AI in teaching, including training students on the use of AI, regulating the learning environment, using AI-based plagiarism detector and reformulating the assessment systems. They also report pedagogical considerations that help in the integration of AI tools in the EFL classroom. The study concludes with recommending that both EFL instructors and students be aware about the ways and need to ensure safer use of AI in the learning process.

Rationale & Objective: Investigating the effect of a quality improvement intervention aimed at enhancing the choice of home dialysis among patients through improved educational sessions on dialysis modalities. Study Design: A new referral protocol initiated on September 15, 2022, sought to direct patients with advanced kidney disease to modality education sessions. This protocol involved an updated referral form and process, requiring nephrologists to refer patients with an estimated glomerular filtration rate below 15 mL/min/1.73 m2 or specified Kidney Failure Risk Equation scores to modality educators for education. The impact was measured by the uptake of the education and the choice of home dialysis by patients. Setting & Participants: The study took place at Sunnybrook Health Sciences Centre in Toronto, Canada, involving 532 patients across 1,723 clinical encounters from October 2019 to June 2023. Predictor: The intervention was predicted to lead to an increase in both the number of patients receiving modality education and those choosing home dialysis. Outcomes: The primary outcome measured was the selection of home dialysis following modality education, with a secondary focus on the proportion of patients educated post intervention. Analytical Approach: Statistical process charts were used for monitoring changes in education uptake and home dialysis selection rates following the intervention. Results: After implementing the standardized referral system, the proportion of patients receiving modality education increased from 27.1%-56.7%. However, the rate of selecting home dialysis remained constant at 50.9%. Overall home dialysis prevalence at our center averaged 19.6%, remaining lower than the provincial average of 24.4% by the end of the study period. Limitations: The study was limited to 1 center, without evaluating patient satisfaction or dissecting the complexity of educational content and delivery. Conclusions: We succeeded in boosting education rates but failed to achieve higher home dialysis choice rates, possibly owing to the complexity involved in modality choices. We plan to further investigate the factors influencing patient choices during modality education to better promote home dialysis selection. Plain-Language Summary: The study focused on whether teaching patients more about their dialysis options would encourage them to choose home dialysis. A new system was introduced at an academic hospital in Toronto, requiring doctors to refer patients with advanced kidney disease to educational sessions. The aim was to see if patients who learned more about dialysis would be more likely to manage their treatment at home. The result was more patients received these educational sessions, but this did not lead to more of them choosing home dialysis. Future research must investigate what other factors influence patients’ decisions to consider dialysis treatments at home.

Exposure models are essential for a range of contexts involving exposure science. The Exposure Models Working Group, established under ISES Europe, identified that to improve model use, suitable training and education is required. However, there is currently no formal educational training programme for exposure modelling in Europe. We present results from an online survey disseminated to the European exposure science community to identify modelling training needs. The questionnaire had three sections: background information about the respondents and interests in exposure science, previous attendance of exposure modelling courses, interest in future training and education in exposure modelling and their coverage and format.A total of 88 survey recipients completed the survey. Most respondents were from governmental organizations (36 %), with 50 % of all respondents having less than 10 years of experience. About two-thirds of the respondents stated that they had previously attended exposure modelling courses. These were mostly focused on specific models, up to one day in duration and took place in-person. Two thirds of respondents expressed interest in attending future exposure modelling training modules, with the most important topics being interpretation of model results and use of models to meet regulatory standards/requirements. Preferred attendance of training courses was virtual or blended. Costs and certificates of attendance seemed less influential when selecting a training course. Our survey suggests that there is a demand for training in exposure modelling and provides insight to inform the development of training modules that are suitable to fulfil the training needs of exposure scientists and practitioners.

The future of the bioeconomy requires strong youth action and leadership as outlined in the Bioeconomy Youth Vision. A common vision is fundamental to define a path that guides various actors towards the goals set. With this comment we want to promote and support this vision by sharing our observation from a young researchers’ perspectives. We see the intersection of education, communication and research as the right place to take necessary actions for driving the transformation towards a more sustainable (bio)economy. We advocate for top-down support and bottom-up initiatives. Top-down, in the form of a policy frameworks that create enabling factors for the transition, supports communication and dissemination of bioeconomy topics and promotes youth participation. Bottom-up, such as joint university-led programs to educate young change makers.

Background: When considering the significant prevalence of transgender and gender nonconforming individuals, it is imperative that physicians work to understand the unique needs of this population including paths to family building and fertility preservation. Objective: To understand the thoughts and opinions about fertility preservation and family building within the transgender community. Study design: Survey-based study and qualitative study at a single, large hospital-affiliated fertility center. A 16-question survey followed by a 30-minute virtual interview was utilized. Forty-three participants completed the survey and were used for quantitative analysis, and 40 audio files were used for qualitative analysis. Results: The average age of participants was 27.0±7.3 years old. The majority of participants were assigned female at birth (70.7%); however, most participants’ gender identities were transgender (54.8%) or nonbinary (47.6%). The average age at which participants realized they were transgender and disclosed their identity to a friend, or partner, was 16.2±7.0 (range 3–30) and 20.1±5.6 (range 11–33), respectively. The average age that participants disclosed their gender identity to their parents, siblings, or other family was 22.4±5.9 (range 12–35). Five categories were utilized to summarize the experiences and opinions of the participants: family building and parenthood goals, influences of family background/partner on parenthood goals, awareness and knowledge about fertility preservation, barrier to family building, and recommended healthcare provider communication and education. Sixteen participants (40.0%, n/N=16/40) were interested in having children in the future, 18 (45.0%, n/N=18/40) were unsure/dependent on their partner, and 6 (15.0%, n/N=6/40) were not interested in having children. Of those interested in having children (n/N=16/40), the majority wished to utilize adoption to build their family (68.8%, n/N=11/16). Nine participants (22.5%, n/N=9/40) reported that fertility preservation was never discussed. Most participants agreed that gender dysphoria, cost, inadequate counseling, and improvements in healthcare knowledge about transgender individuals were key influences on their opinions about pursuing fertility preservation or parenthood. Conclusion: Transgender individuals want to build families, and the majority consider adoption the preferred method. There are still transgender individuals who are not counseled about fertility preservation. It is imperative the healthcare system continues to improve the education of healthcare providers about management and care of transgender individuals to provide the best care for this vulnerable population.

This paper presents an innovative ‘strain acceleration method’ for determining the onset of diffuse necking in sheet forming tests using data obtained from digital image correlation (DIC). The method identifies the onset time of diffuse necking and provides the corresponding in-plane principal strain values by detecting a local extreme in the second derivative of the minor principal in-plane strain with respect to time at the edges of the sheet surface region where diffuse necking occurs. Results obtained from applying the method to tensile testing on two different materials and comparisons with available methods based on force-time or principal strain rate evolutions confirm its accuracy and validity. The new method was implemented in a computer software to be used for research and education that also enables determination of localized necking and fracture and plotting the strain loading paths in principal strain space.

Introduction: This study aimed to outline the perspectives of obstetricians/gynecologists (physicians) and midwives regarding the alarmingly high rates of cesarean sections (CSs) to identify areas for improvement and describe the role of a regional obstetric quality initiative. Material and methods: A cross-sectional study was performed utilizing real-world data from questionaries provided to Greek midwives and obstetricians. Primary outcomes included the attitudes of Greek physicians and midwives toward the CS rates in Greece and around the world, as well as identifying potential solutions for lowering these rates. The secondary outcome was the potential correlation between the answers of the participants and their demographic parameters. Results: A total of 456 physicians and 234 midwives participated in the survey. Greek CS rates (>50 %) were considered “acceptable” and inevitable by 29.7 % and 32 % of the participants, respectively. Stratified analysis based on profession showed that significantly fewer midwives compared to obstetricians would agree with current CS rates. Participants who had obtained their degrees abroad were more likely to consider all CS rates more justified than physicians and midwives who had graduated from Greek medical schools. For all questions, the younger age subgroups responded in a way toward the non-acceptability of CS rates and favored the implementation of rules and practice control according to guidelines. The responses did not differ significantly between male and female physicians. Conclusions: Greek midwives, to a greater degree than obstetricians/gynecologists, consider the current CS rates unjustified and agree on the importance of implementing appropriate interventions to reduce them.

Background: Diabetic ketoacidosis is a severe metabolic emergency often associated with the onset of Type 1 Diabetes Mellitus, with significant morbidity and mortality. Its incidence as the initial presentation of Type 1 Diabetes Mellitus varies widely by country. In Morocco, there is a lack of comprehensive research on the prevalence and risk factors of diabetic ketoacidosis in children with newly diagnosed Type 1 Diabetes Mellitus, highlighting the need for this study. Objectives: The aim of our study was to analyze the predictive factors of diabetic ketoacidosis at the onset of Type 1 Diabetes Mellitus in children and adolescents at a single medical center in Morocco to develop prevention and management strategies. Methods: A retrospective, single-center study including 200 patients aged between 1 and 18 years at Type 1 Diabetes Mellitus onset, between September 2019 and September 2023. The population was divided into two groups according to the presence or absence of diabetic ketoacidosis. Medical records provided data for analysis with SPSS v21, employing Chi-square and Student's t-tests, followed by logistic regression to identify predictors of diabetic ketoacidosis. Results: Multivariate regression identified several factors that were significantly associated with diabetic ketoacidosis at presentation, including age below 5 years (OR: 3.98; p = 0.021 compared to 6–10 years and OR: 5.07; P = 0.003 compared to 11–18 years), rural living (OR: 2.95; p = 0.032), low family income (OR: 9.22; p < 0.001), delayed diagnosis (OR: 21.27; p < 0.001), longer symptom duration before diagnosis (OR: 1.02; p = 0.010), preceding infections (OR: 2.72; p = 0.019), and lower vitamin D levels (OR: 0.90; p = 0.011). Conclusion: Our findings underscore the critical need for increased awareness, education, use of point-of-care glucose testing, and targeted interventions in rural areas, in order to reduce the incidence of diabetic ketoacidosis. We also highlight the potential role of vitamin D in increasing the risk of diabetic ketoacidosis at the onset of Type 1 Diabetes Mellitus. This study provides important information on the present state of pediatric diabetes care in our country, and suggests target points for future interventions and research.

Background: Multiple sclerosis (MS) is a prevalent disease of the central nervous system that often leads to diminished resilience and quality of life in affected individuals. This study aims to compare the effects of nursing and peer education on improving the quality of life and resilience in patients with multiple sclerosis. Materials and methods: This three-group clinical trial study was conducted before and after interventions at the MS Society in Hamedan, Iran. In this study, 120 patients with MS were randomly selected and assigned to three groups: nurse education, peer education, and control. Quality of life and resilience questionnaires were self-reported before and two months after the completion of the intervention. The educational sessions were conducted over five meetings, each lasting between 45 and 60 min, held every two days. Group one received education led by nurses, while group two participated in peer-led education sessions. Results: The results indicated that before the intervention, there were no significant statistical differences in demographic variables, resilience, and quality of life among the three groups (p > 0.05). However, after the intervention, both the peer and nurse groups showed a significant increase in quality of life and resilience compared to the control group (p 0.05). Conclusions: Both nursing and peer education methods had an equal impact on enhancing the resilience and quality of life of patients with MS. It is recommended that peer support be utilized to empower MS patients, especially in contexts where there is a shortage of nurses.

Celiac disease (CD) has a significant impact on the quality of life for those affected, particularly in social settings. One major challenge for these individuals is dining out, as they must constantly avoid cross-contact with gluten, contend with a limited range of restaurant options, and often encounter unknowledgeable or misinformed staff. This study aims to evaluate the effectiveness of an educational program designed to enhance the understanding of CD and gluten-free diet (GFD) among future catering staff, thereby improving the social experiences of individuals with CD. A 3-h theoretical and practical session was developed for professional cookery students, focusing on predefined competencies and learning outcomes related to GFD. The study involved a sample of 100 students from Vitoria-Gasteiz, Spain. Following the intervention, students demonstrated increased knowledge regarding gluten content in foods and the application of GFD principles, including cross-contact prevention. However, during the practical activity, the gluten-free dish they prepared was not safe for CD patients to consume. Additionally, the students' perception of the difficulty in providing a GFD remained unchanged. Future sessions should emphasise the importance of interpreting food labels and practising cross-contact prevention. The strong interest in training hospitality students to promote social inclusion of CD patients highlights the need for more programmes to enhance their dining options and safety.

The metaverse, an immersive virtual environment enabling users to engage with digital experiences, has the potential to revolutionize education. However, research pertaining to this area is still in its early stages. This study investigates the variables that influence the acceptance of educational metaverses and the intention to use them. It also presents an expanded model called the Unified Theory of Acceptance and Use of Metaverse Technology (UTAUMT) to provide guidance to educators and decision-makers. The study involved 253 Vietnamese teachers and students who had experience with metaverse, selected through purposive sampling. The UTAUMT provides a comprehensive framework that encompasses various factors, including metaverse performance expectancy (MPE), metaverse effort expectancy (MEE), metaverse social influence (MSI), metaverse hedonic motivation (MHM), metaverse price value (MPC), metaverse self-efficacy (MSE), and metaverse facilitating conditions (MFC). These factors were assessed using a self-administered questionnaire. The findings indicate that MEE, MSI, MFC, MSE, and MBI have a considerable impact on the educational metaverse MUB. The extended UTAUMT model makes a theoretical contribution by including metaverse-specific elements into the technology acceptance framework. The managerial implications focus on the integration of the metaverse, training of users, and providing support to enhance the adoption rate. This study explores the elements that contribute to the adoption of metaverse technology in education and contributes to the existing literature on the acceptance of metaverse technology.

Summary: Background: School-age children in sub-Saharan Africa suffer an underappreciated burden of malaria which threatens their health and education. To address this problem, we compared the efficacy of two school-based chemoprevention approaches: giving all students intermittent preventive treatment (IPT) or screening and treating only students with detected infections (IST). Methods: In a three-arm, open-label, randomized, controlled trial (NCT05244954) in Malawi, 746 primary school students, aged 5–19 years, were individually randomized within each grade-level to IPT (n = 249), IST with a high-sensitivity rapid diagnostic test (hs-RDT, n = 248), or control (n = 249). At six-week intervals three times within the peak malaria transmission season (February–June 2022) treatment with dihydroartemisinin-piperaquine (DP) was administered to girls

In 2015, we conducted a survey of the corporate members of FIRM on the human resources and training required in the field of regenerative cell therapies and reported the results in this journal. After that, industrialization of regenerative medicine has progressed and some cell products have been approved, and infrastructures, such as laws and educational systems, have been improved. To capture the changing demands for human resources in response to the shift in social circumstances, we conducted another survey. Consequently, now, there is an increasing demand for highly specialized skills and knowledge in the field of regenerative medicine. Furthermore, it was found that QA/QC managers and specialists of pharmaceutical affairs are strongly demanded, rather than technicians of cell culture. In addition, it became evident that there are still relatively few companies that have established their own internal education systems, and, in most cases, employees are trained by senior stuff. The establishment of efficient education systems in public institutions and academic societies is desired.

Objective: To evaluate the association between embryo transfer techniques and pregnancy outcomes. Design: This is a prospective observational study with a retrospective cohort. Setting: University Clinic. Patients: Patients underwent embryo transfers between 2015 and 2020. Intervention/Exposure: Fourteen physicians performed 25 mock embryo transfers on the embryo transfer simulator and completed a questionnaire assessing preferred embryo transfer techniques. Quantitative performance metrics on the embryo transfer simulator were measured. Individual physician embryo transfer success rates were retrospectively collected from all fresh and cryopreserved embryo transfers between January 1, 2015, and January 1, 2020. Associations between embryo transfer techniques (preferred technique and simulator performance metrics) and each physician’s historical patient pregnancy outcomes were assessed. Main Outcome Measures: Associations between embryo transfer techniques and live births were assessed. Results: There were significant differences in embryo transfer techniques between physicians, including touches to the fundus, distance to the fundus, duration of embryo transfer, duration of the complete procedure, time spent navigating the cervical canal, velocity of embryo expulsion, time waited after embryo expulsion, and total score on the embryo transfer simulator. After controlling for confounders and multiple transfers per physician, the duration of embryo transfer was significantly associated with live birth, with longer durations associated with decreased live birth rates. Shorter placement distance to the fundus and higher velocity of embryo expulsion were both significantly associated with higher rates of ectopic pregnancy. Conclusions: This study revealed significant differences in transfer techniques among physicians. The use of the embryo transfer simulator for physicians in practice can elucidate differences and create opportunities for data-driven improvement in embryo transfer success rates.

Background/purpose: Blended learning offers the advantages of both instructor-led and self-instruction methods in basic life support (BLS). Our study aims to compare the effects of blended learning with those of traditional instructor-led methods on the performance of laypersons taking BLS courses. Methods: A total of 108 participants were randomly assigned to three groups: traditional instruction (group A, n = 36), blended learning with two rounds of practice (group B, n = 36), and blended learning with three rounds of practice (group C, n = 36). Group A received a 90-min lecture and a 30-min hands-on practice session using a manikin and a metronome. Participants in groups B and C received 18-min standardized online video lessons and performed hands-on practice twice and thrice, respectively. The primary outcome was chest compression at a correct speed (100–120 compressions per min) after the training course. Secondary outcomes included knowledge test scores, attitudes and confidence, and individual skill performance after training. Results: Patient characteristics were similar between the groups. Blended learning with practicing thrice resulted in the highest compressions at a correct speed (group A vs. B vs. C, 68.09 vs 80.03 vs 89.42, p = 0.015) and the shortest average hands-off time (group A vs. B vs. C, 1.12 vs 0.86 vs 0.17 s, p = 0.015). Both blended groups performed better in confirming environmental safety (p

Background: Medical school clerkship grades are used to evaluate orthopedic surgery residency applicants, however, high interinstitutional variability in grade distribution calls into question the utility of clerkship grades when evaluating applicants from different medical schools. This study aims to evaluate the variability in grade distribution among medical schools and look for trends in grade distribution over recent years. Methods: Applications submitted to Rush University's orthopedic surgery residency program from 2015, 2019, and 2022 were collected from the Electronic Residency Application Service. Applications from the top 100 schools according to the 2023–2024 U.S. News and World Report Research Rankings were reviewed. The percentage of “honors” grades awarded by medical schools for the surgery and internal medicine clerkships were extracted from applicants' Medical Student Performance Evaluation letters. Results: The median percentage of honors given in 2022 was 36.0 % (range 10.0–82.0) for the surgery clerkship and 33.0 % (range 6.7–80.0) for the internal medicine clerkship. Honors were given 6.6 % more in the surgery clerkship in 2022 compared to 2015. There was a negative correlation between a higher (worse) U.S. News and World Report research ranking and the percentage of honors awarded in 2022 for the surgery and internal medicine clerkships. Conclusion: There is substantial interinstitutional variability in the rate that medical schools award an “honors” grade with evidence of grade inflation in the surgery clerkship. Residency programs using clerkship grades to compare applicants should do so cautiously provided the variability demonstrated in this study.

Background: The annual meetings hosted by the American Shoulder and Elbow Surgeons (ASES) present the latest prepublication literature in shoulder and elbow surgery, facilitating early dissemination of novel findings that impact clinical decision-making. Evaluating the publication rate of presented abstracts at ASES conferences becomes crucial in assessing the quality of research showcased, as these presentations often precede the peer-review process. Methods: The ASES conference programs from 2015-2019 were reviewed to identify presented abstracts. For each abstract, the title, author(s), conference year, and meeting type (open vs. closed) were recorded. The names of the author(s) of each abstract were searched in the PubMed and Google Scholar databases to determine if there was an associated published manuscript. For each identified manuscript, the title, author(s), date of publication, publishing journal, impact factor of the publishing journal, level of evidence, and number of citations were recorded. Results: A total of 316 abstracts were presented as podium lectures at ASES open and closed meetings between 2015 and 2019. Within 3 years of presentation, 240 (75.9%) of the presented abstracts resulted in publication. There was an increase in the proportion of abstracts resulting in publication within 3 years of the presentation from 2015-2019 (R = 0.8733, P = .053). Overall, the proportion of presented abstracts that went on to publication in peer-reviewed journals also increased (R = 0.8907, P = .043). Manuscripts of abstracts presented at open meetings had a shorter time to publication (8.78 vs. 11.82 months; P = .0160) and were cited more often (40.89 vs. 30.11, P = .0099) than those presented at closed meetings. Conclusion: There has been an increase in the publication rate of abstracts presented at ASES annual meetings in the study period. Published manuscripts of abstracts presented at ASES open conferences were published faster, and were cited more often, than closed conferences. ASES conferences allow for the presentation of high-quality prepublication literature in shoulder and elbow surgery.