Search Results (300)

The transformation of national education policy during Indonesia’s governmental era has led to regulatory disruptions through the rapid revocation of previous policies and swift introduction of new ones. This landscape requires teachers to possess technological proficiency as well as 21st-century competencies and pedagogical readiness to adopt innovative learning. This study examines the influence of technological knowledge and 21st-century competencies on teachers’ readiness to adopt deep learning pedagogy, while also exploring perceptions of opportunities and challenges. A sequential explanatory mixed-methods design was employed, involving a survey of $802$ teachers from regions of Indonesia. The instrument comprised $25$ items across three variables, validated by experts, and tested with confirmatory factor analysis, which showed acceptable fit and reliability. Quantitative data were analyzed statistically, while qualitative insights came from interviews with 30 teachers and analyzed thematically. Results indicate that 21st-century competencies $(\beta =0.639,R^2=0.432)$ exert stronger influence than technological knowledge $(\beta =0.575,R^2=0.310)$ in shaping readiness. The integration of connecting and embedding strategies revealed personal, structural, and cultural complexities in implementing deep learning. The study recommends localized training and partnerships with professional organizations, higher education institutions, and NGOs to generate systemic support for school reform toward learning organizations. Full article

Digital transformation has fundamentally altered how individuals manage their finances. The expansion of financial technologies and the digitalization of banking services underscore the need for digital financial literacy, defined as the ability to safely use financial applications and make informed decisions within virtual environments. This study examined the perceptions of financial application use across age groups and their corresponding level of digital financial literacy. This exploratory study used a convenience sample of 41 semi-structured interviews conducted in 2025. The data were analyzed using content analysis and descriptive statistics. The findings indicated that most participants prioritized digital apps over traditional channels and expressed confidence in their use, although concerns about data security remained. Participants identified key advantages, including convenience, efficiency, and centralized access, yet few used apps for financial planning. Most respondents demonstrated an intermediate level of digital knowledge, with limited proficiency in executing complex financial tasks. Perceptions revealed both optimism and apprehension: while participants valued the practicality of digital tools, they also recognized risks such as fraud, exclusion of vulnerable groups, and technological dependence. The limited and non-representative sample limits generalization, suggesting the need for broader surveys. Enhanced public policies promoting digital financial education in Brazil are recommended. Full article

Uveal melanoma (UM) is the most common primary intraocular malignancy in adults, associated with a high tendency for metastasis to the liver. Proton beam therapy (PBT) is the preferred external radiotherapy treatment for primary UM of certain sizes and locations in the eye, due to its efficacy and good local tumour control, as well as its precision to spare surrounding ocular structures. PBT is an effective alternative to surgical enucleation and other non-precision-targeted radiotherapies. Despite this, the radiobiology of UM in response to PBT is still not fully understood. This enhanced knowledge would help to further optimise UM treatment and improve patient outcomes through reducing radiation dosage to ocular structures, treating larger tumours that would otherwise require enucleation, or even offering a treatment strategy for the otherwise fatal liver metastases. In this review, we explore current knowledge of the treatment of UM with PBT, evaluating the biological responses to the therapy. Molecular factors, such as tumour size, oxygen tension levels, DNA damage proficiency, and autophagy, are known to influence the cellular response to radiotherapy, and these will be discussed. Furthermore, we examine innovative strategies to enhance radiotherapy outcomes, such as combination therapies with DNA damage repair and autophagy modulators, as well as advancements in PBT planning and delivery. By integrating current research and emerging technologies, we aim to provide opportunities to improve the therapeutic effectiveness of PBT in UM management. Full article

The Austrian education system faces the ongoing challenge of addressing linguistic diversity in classrooms where many middle school students speak a first language other than German. Yet, teaching practices often prioritize subject content over inclusion through language-sensitive approaches, limiting equitable access to education. In response, the revised Austrian middle school curriculum emphasizes “language learning and reading” as a cross-cutting theme, promoting language-sensitive teaching across all subjects, including physics. This study explores how Austrian middle school physics teachers (N = 131) perceive and implement language-sensitive practices in response to the new curriculum. Using a questionnaire, it investigates their attitudes towards (1) the revised curriculum, (2) reading, and (3) the role of language in physics lessons. Findings show that while teachers are highly motivated to implement the curriculum, they often lack the methodological knowledge necessary to effectively support learners with lower German language proficiency. Physics instruction poses specific challenges due to its reliance on subject-specific terminology and academic discourse, further disadvantaging students with lower German language skills. This research highlights the urgent need for targeted professional development to support inclusive, language-sensitive teaching, ensuring all students—regardless of linguistic background—can access and succeed in physics education. Full article

Background/Objectives: Continuous renal replacement therapy (CRRT) is a critical intervention for managing acute kidney injury (AKI) in critically ill patients. Critical care nurses (CCNs) play a pivotal role in its implementation, requiring adequate knowledge, a positive attitude, and practice proficiency. This study aimed to assess the levels and factors affecting CCNs’ knowledge, attitudes, and practices (KAPs) regarding the care of patients receiving CRRT in Hail Hospitals, Saudi Arabia. Methods: A cross-sectional study was conducted with 190 registered CCNs from the critical care units of Hail Hospitals, Saudi Arabia, from March to May 2025. Data were collected using a sociodemographic characteristics sheet and the knowledge, attitudes, and practices questionnaire on CRRT. Non-parametric statistical tests (Mann–Whitney U, Kruskal–Wallis, and Spearman’s correlation tests) were used to determine the relationships between variables. A multiple linear regression analysis was used to explore the factors affecting the study variables. Results: The majority of CCNs had a high level of knowledge regarding CRRT management (66.3%), followed by moderate (21.1%) and low (16.6%) levels. Additionally, the majority had a high level of attitude regarding CRRT management (74.7%), followed by moderate (18.4%) and low (6.9%) levels. The majority of CCNs had a high level of practice regarding CRRT management (66.8%), followed by low (23.7%) and moderate (9.5%) levels. There was a significant positive correlation between CCNs’ knowledge, attitudes (rs = 0.230, p < 0.001), and practices (rs = 0.192, p < 0.001). Additionally, there was a significant positive correlation between CCNs’ attitudes and practices (r = 0.419, p < 0.001). Multiple linear regression revealed a significant model (p  <  0.001) when sociodemographic and work-related factors were analyzed as predictors of CCNs’ levels of knowledge, attitudes, and practices regarding CRRT: Having more experience, working with a nurse-to-patient ratio of 1:2, and frequently using CVVHDF as a CRRT modality were significant factors for higher knowledge levels when compared to the reference categories. In addition, having a bachelor’s degree and frequently using CVVHD, CVVHDF, or SCUF as a CRRT modality were significant factors for higher attitude levels regarding CRRT when compared to the reference categories. Having a bachelor’s degree and frequently using CVVHD or CVVHDF as a CRRT modality were significant factors for higher practice levels regarding CRRT when compared to the reference categories. Conclusions: CCNs in Hail Hospitals self-reported high levels of knowledge, attitudes, and practices regarding CRRT management, followed by moderate levels. Targeted educational programs, standardized protocols, and organizational support are recommended to improve CCN care for CRRT and to optimize patient outcomes. Full article

To address the challenges of extensive domain expertise and deficient semantic comprehension in the digital preservation of ancient ceramics, this paper proposes a knowledge question answering (QA) system integrating Low-Rank Adaptation (LoRA) fine-tuning and Graph Retrieval-Augmented Generation (GraphRAG). First, textual information of ceramic images is generated using the GLM-4V-9B model. These texts are then enriched with domain literature to produce ancient ceramic QA pairs via ERNIE 4.0 Turbo, culminating in a high-quality dataset of 2143 curated question–answer groups after manual refinement. Second, LoRA fine-tuning was employed on the Qwen2.5-7B-Instruct foundation model, significantly enhancing its question-answering proficiency specifically for the ancient ceramics domain. Finally, the GraphRAG framework is integrated, combining the fine-tuned large language model with knowledge graph path analysis to augment multi-hop reasoning capabilities for complex queries. Experimental results demonstrate performance improvements of 24.08% in ROUGE-1, 34.75% in ROUGE-2, 29.78% in ROUGE-L, and 4.52% in BERTScore_F1 over the baseline model. This evidence shows that the synergistic implementation of LoRA fine-tuning and GraphRAG delivers significant performance enhancements for ceramic knowledge systems, establishing a replicable technical framework for intelligent cultural heritage knowledge services. Full article

While Japanese universities promote English proficiency and intercultural competence, admissions still rely heavily on the standardised TOEIC test, often prioritising linguistic accuracy over cultural understanding. This emphasis can marginalise the experiential and interpersonal aspects of language learning essential for developing intercultural communicative competence (ICC). Although ICC is most effectively developed through a combination of formal instruction and informal learning, particularly involving authentic intercultural interactions, there remains a paucity of research examining how learners develop ICC beyond the classroom. Addressing this gap, the present study investigates how Japanese university students’ language repertoires, intercultural experiences, and knowledge shape their studies, and how their ICC develops throughout undergraduate education. One English major student was selected for in-depth analysis following his employment in a culturally diverse workplace that fostered meaningful intercultural interactions. His development was examined using four research tools: a survey, a journal, an interview, and TOEIC scores. The survey and test scores revealed growth in communicative assurance and language proficiency, while journal reflections and interviews captured critical incidents—including a shift from indirect to direct speech—that marked cultural adaptation. These findings suggest experiential learning fosters real-time communication, builds learner confidence, and supports transformational ICC development. Full article

Metaphorical competence—the capacity to comprehend and produce metaphors in a second language (L2)—is essential for nuanced, accurate, and contextually appropriate English usage. Synthesizing 40 independent studies (N = 15,786), this meta-analysis quantified the relative contributions of cognitive, linguistic, and personal factors to L2 metaphorical competence. Effect sizes were derived from correlation coefficients and aggregated under random-effects models to account for between-study heterogeneity. Linguistic factors emerged as the dominant predictor (r = 0.421, 95% CI [0.34, 0.50]), primarily driven by vocabulary breadth/depth and reading proficiency. Cognitive factors exerted a moderate influence (r = 0.232, 95% CI [0.17, 0.30]), whereas personal variables such as gender yielded only a small effect (r = 0.216, 95% CI [0.15, 0.28]). Moderator analyses further revealed that L1 conceptual knowledge constitutes the strongest single predictor of L2 metaphor skills and highlighted distinct associations between receptive and productive metaphor abilities with linguistic versus cognitive aptitudes. The findings collectively point to lexico-semantic and literacy development as the main levers for boosting L2 metaphorical competence, with cognitive aptitudes and personal factors acting as secondary, yet important, modulators. Insight from this meta-analysis offers a robust foundation for evidence-based decisions in curriculum design, materials selection, and targeted pedagogical interventions. Full article

Extensive research on homologous-recombination-deficient (HRD) tumors has led to advancements in targeted therapies, such as PARP inhibitors (PARPis). Around 50% of high-grade serous ovarian cancer (HGSOC) cases exhibit HR deficiency, but understanding the remaining half, referred to as homologous-recombination-proficient (HRP) tumors, is limited. This review explores existing knowledge regarding HGSOC patients with HRP tumors and offers insights into potential targets for innovative treatments. Patients with HRP tumors do not experience the same benefits from PARPi and have poorer survival outcomes compared to those with HRD tumors. CCNE1 amplification is a common, well-established molecular feature in HGSOC HRP tumors, occurring in about 20% of cases. Targeting CCNE1 amplification and/or overexpression shows promise with emerging therapies like CDK2 or Wee1 inhibitors. Additionally, approaches using immunotherapy and antibody–drug conjugates could represent promising targets for HRP patients. This review also covers lesser-known molecular features in HRP tumors, such as fold-back inversions and CARM1 amplification and/or overexpression, as well as HRD tumors that acquire HR proficiency (BRCA1/2 reversion mutations, demethylation of BRCA1 and RAD51C). We also discuss controversial topics regarding HRP tumors and limitations of HRD detection. Addressing this need is critical to reduce toxicity and improve disease management. Full article

LexTALE has emerged as a popular measure of language proficiency in research studies. While it has been widely validated for L2 learners across multiple languages, its applicability to heritage language learners (HLLs)—who often show distinct language development from L2ers—has not been established. Here, we evaluate the Spanish version of LexTALE (LexTALE-Esp) as a predictor of writing proficiency among college-aged HLLs in the United States. We show that LexTALE-Esp scores significantly correlate with ACTFL-rated functional writing levels and outperform self-assessment as a predictor of proficiency. Our results suggest that, despite concerns about HLLs’ limited experience with written texts in the heritage language, vocabulary-based tasks capture core aspects of written language ability. These findings indicate that vocabulary-based tests like LexTALE-Esp capture proficiency-relevant lexical knowledge across speaker profiles and may tap into dimensions of both core and extended language competence. Full article

Background/Objectives: Minimally invasive spine surgery (MISS) is complex and requires proficiency with a variety of technological and robotic modalities. Acquiring these skills is a long and involved process, often with a steep learning curve. This paper seeks to characterize the state of MISS training in neurosurgical and orthopedic residency programs, focusing on their effectiveness at minimizing substantial learning curves in the field, as well as highlighting potential areas for future growth. Methods: We conducted a scoping review of the PubMed, Scopus, and Embase databases utilizing the PRISMA extension for scoping reviews. Results: Of the 100 studies initially identified, 16 were included in our final analysis. MISS training types could be broadly grouped into four categories: virtual simulation (including AR and VR), physical models, hybrid didactic and simulation, and mentored training. Training with these modalities led to improvements in resident performance across multiple different MISS techniques, including percutaneous pedicle screw fixation, MIS dural repair, MIS-TLIF, MIS-LLIF, MIS-ULBD, microscopic discectomy/disk herniation repair, percutaneous needle placement, and surgical navigation. Specific improvements included reduced error rate, operation time, and fluoroscopy exposure, as well as increased procedural knowledge, accuracy, and confidence. Conclusions: The incorporation of MISS training modalities in spine surgery residency leads to increases in simulated performance and could serve as a means of overcoming significant learning curves in the field. Full article

Emotion vocabulary is essential for recognising, expressing, and regulating emotions, playing a critical role in language proficiency and emotional competence. However, traditional vocabulary assessments have largely overlooked emotion-specific lexicons, limiting their ability to identify learners’ gaps in this area. Therefore, this study addresses this gap by developing and validating the Productive Emotion Vocabulary Size Test (PEVST), a tool designed to evaluate productive emotion vocabulary knowledge in ESL/EFL contexts. The PEVST incorporates low-, mid-, and high-frequency emotion words, assessed through context-rich vignettes, offering a comprehensive tool for measuring productive emotion vocabulary knowledge. The study recruited 156 adult participants with varying language proficiency levels. Findings revealed that word frequency significantly influenced production accuracy: higher frequency words were more easily retrieved, while lower frequency words often elicited higher frequency synonyms. Rasch analysis provided validity evidence for the test’s scoring, highlighting the effectiveness of a granular scoring system that considers nuanced responses. However, some limitations arose from misfitting items and the homogeneity of participants’ language proficiency, calling for further evidence with a more linguaculturally diverse target group and careful control for individual differences. Future iterations should address these challenges by incorporating cultural adaptations and accounting for individual differences. The PEVST offers a robust foundation for advancing emotion vocabulary assessment, deepening our understanding of the interplay between language, emotions, and cognition, and informing emotion-focused language pedagogy. Full article

The L1 molecule is a cell adhesion molecule (L1CAM) that was originally implicated in neuronal development. In recent years, studies of several large cohorts of patients with endometrial cancer have revealed that L1CAM acts as a poor prognostic factor, in most cases independent of other parameters. It seems to be an important factor, especially in the non-specific molecular profile subgroup (p53 normal expression, MMR proficient, POLE not mutated) of endometrial cancer, and a factor predictive of the response to chemotherapy. This review aims to gather most of the current knowledge regarding this promising prognostic factor. Full article

This study examined the literacy outcomes of 368 deaf elementary students in the United States, focusing on reading and writing performance and their connections with demographic and language variables. Standardized assessment data were analyzed from students in grades 3–6. Results indicated wide variability in reading and writing performance, from scores at a standard deviation above the mean to more than 3 below the mean. There were demonstrated disparities in mean literacy outcomes based on disability status. A strong positive correlation was found between reading and writing scores, suggesting interconnected development of literacy skills. Notably, writing outcomes were consistently higher than reading across analyses. Performance trajectories differed by grade, with literacy gaps widening over time. Gender, race, and hearing level explained 2–3% of the variance in literacy outcomes, while language proficiency (in ASL and/or spoken English) and phonological knowledge (fingerspelled and/or spoken) predicated 55–63% of the models. These findings highlight the need for early accessible language exposure and responsive literacy instruction aligned with deaf learners’ language strengths. Full article

In Chinese character learning, distinguishing similar characters is challenging for learners regardless of their proficiency. This is due to the complex orthography (visual word form) linking symbol, pronunciation, and meaning. Multimedia learning is a promising approach to implement learning strategies for Chinese characters. However, the availability of multimodal resources specifically designed for distinguishing similar Chinese characters is limited. With the advanced development of generative artificial intelligence (GenAI), we propose a practical framework for constructing multimodal resources, enabling flexible and semi-automated resource generation for Chinese character learning. The framework first constructs image illustrations due to their broad applicability across various learning contexts. After that, other four types of multimodal resources implementing learning strategies for similar character learning can be developed in the future, including summary slide, micro-video, self-test question, and basic information. An experiment was conducted with one group receiving the constructed multimodal resources and the other receiving the traditional text-based resources for similar character learning. We explored the participants’ learning performance, motivation, satisfaction, and attitudes. The results showed that the multimodal resources significantly improved performance on distinguishing simple characters, but were not suitable for non-homophones, i.e., visually similar characters with different pronunciations. Micro-videos introducing character formation knowledge significantly increased students’ learning motivation for character evolution and calligraphy. Overall, the resources received high satisfaction, especially for micro-videos and image illustrations. The findings regarding the effective design of multimodal resources for implementing learning strategies (e.g., using visual mnemonics, character formation knowledge, and group reviews) and implications for different Chinese character types are also discussed. Full article