Search Results (794)

Background/Objectives: Human leukocyte antigens (HLAs) are major determinants of successful allogeneic hematopoietic stem cell transplantation (allo-HSCT). Their alleles are closely linked to outcomes, even in HLA-identical sibling donor (ISD) HSCT. This retrospective study analyzed the impact of HLA alleles on HLA-ISD HSCT outcomes in Omani patients. Methods: Data were collected for a heterogenous cohort of patients registered at the Sultan Qaboos University Hospital (SQUH), who underwent HLA-ISD HSCT from 2012 to 2022 (n = 153). HSCT outcomes, namely acute GVHD (aGVHD), chronic GVHD (cGVHD), chimerism status (complete or mixed) at 6 to 12 months after HSCT, neutrophil and platelet engraftment time, and patient five-year overall survival, were included. Low-resolution HLA-typing records were collected for five HLA loci: HLA-A, B, C, DRB1 and DQB1. GVHD and chimerism were analyzed by logistic regression analysis. Platelet and neutrophil engraftment times were assessed by Mann–Whitney tests. Patient overall survival was evaluated by the Kaplan–Meier model and Log-rank testing. At a 95% confidence interval, the p-value threshold was corrected using Bonferroni correction. Results: The incidence rates of aGVHD and cGVHD from all grades were 16% and 15%, respectively. Although no association between HLA alleles or any of the investigated outcomes was identified, survival curve analyses indicated a significant protective effect of HLA-DQB1*05 (p = 0.01). Patients carrying this allele had a better-estimated 5-year overall survival (90%) than did DQB1*05 negative patients (68%). Conclusions: This study suggests that HLA-DQB1*05 in the Omani population could have an impact on overall survival and might be a predictive biomarker. Further studies on a larger scale in other regional populations are needed to validate our findings and explore the underlying mechanism. Full article

Background/Objectives: Breast cancer represents a diverse group of malignancies and continues to rank among the leading causes of cancer-related deaths in women. Altered Hippo pathway signaling has been increasingly recognized as a contributor to tumor growth, therapeutic resistance, and metastatic spread. This study aimed to identify miRNAs targeting Hippo pathway-related genes that are consistently dysregulated across all five breast cancer subtypes. Methods: The study cohort included patients representing five breast cancer subtypes: 130 luminal A, 96 HER2-positive luminal B, 100 HER2-negative luminal B, 36 non-luminal HER2-positive, and 43 triple-negative breast cancer (TNBC). Tumor samples were collected during surgery, along with adjacent healthy tissue that served as controls. Expression of Hippo-related genes was analyzed using mRNA microarrays and validated with reverse transcription quantitative polymerase chain reaction (RT-qPCR). Protein levels were assessed via enzyme-linked immunosorbent assay (ELISA), while miRNA expression profiling was performed with miRNA microarrays. Potential mRNA targets were predicted using the miRDB database. Results: We identified consistent downregulation of STK4, RASSF6, and FGF1, alongside overexpression of BIRC5 and SERPINE1. miRNA analysis revealed that STK4 is potentially regulated by miR-522-3p, SERPINE1 by miR-199b-5p and miR-30a-3p, whereas RASSF6, FGF1, and BIRC5 appeared to be predominantly regulated at the transcriptional level. These alterations reflect both the suppression of upstream Hippo activation and activation of downstream oncogenic effectors across all subtypes. Conclusions: Our findings reveal a conserved Hippo dysregulation program in breast cancer, highlighting subtype-independent Hippo-related genes and their miRNA regulators as potential universal biomarkers and therapeutic targets, complementing subtype-specific treatment strategies. Full article

Quality assurance (QA) in higher education has become increasingly vital in response to global competition, digital transformation, and evolving sustainability demands. This study examines the leading QA frameworks—namely the European Standards and Guidelines (ESG), the EFQM Excellence Model, and ISO 9001—while integrating advanced analytical methodologies, including Data Envelopment Analysis (DEA), the Analytic Hierarchy Process (AHP), and Bayesian modeling, to propose a comprehensive framework for assessing university performance. Through empirical analysis and comparative case studies of internationally ranked universities, this study demonstrates that combining objective indicators with quantitative methods significantly improves institutional efficiency, transparency, and competitiveness. Additionally, the role of digital education, ESG-driven sustainability strategies, and AI-based student feedback systems emerge as being crucial to the effectiveness of QA practices. The results suggest that hybrid evaluation models—blending traditional QA principles with data-driven analytics—promote continuous improvement, optimize resource management, and enhance educational outcomes. This research ultimately highlights the growing relevance of advanced quantitative frameworks in modernizing QA systems and supporting universities in addressing dynamic global challenges. Full article

Background and Objectives: The revised international prognostic scoring system (IPSS-R) remains the most widely used prognostic tool for myelodysplastic syndrome (MDS). There is growing evidence that inflammation and immunological dysregulation are important in the pathogenesis of MDS. Moreover, monocytopenia and lymphocytopenia are correlated with adverse outcomes in patients with MDS. However, standard guideline-driven diagnostic and prognostic models do not evaluate host immunity parameters. This study explored the prognostic relevance of monocytopenia and lymphocytopenia at diagnosis for overall survival (OS) as medical endpoints independent of IPSS-R. Materials and Methods: This retrospective study included 217 patients with MDS diagnosed and treated at the University Clinical Center of Serbia between July 2019 and July 2024. MDS was diagnosed based on the 2016 World Health Organization (WHO) criteria. Results: Univariate analysis revealed that patients with monocytopenia (absolute monocyte count (AMC) < 0.3 × 10⁹/L) had adverse outcomes compared to individuals with normal AMC (AMC ≥ 0.3 × 10⁹/L) (median OS with/without risk factor 20 months vs. 60 months, respectively, log rank test p = 0.0009). Moreover, lymphocytopenia (absolute lymphocyte count (ALC) < 1.2 × 10⁹/L) was shown to have a significant impact on survival (median OS with/without risk factor 17 months vs. 29 months, respectively; log-rank p = 0.0182). In further multivariate analysis, IPSS-R, AMC < 0.3 × 10⁹/L, ALC < 1.2 × 10⁹/L, and DMAs/HSCT were identified as independent prognostic factors for OS (Cox multivariate model, p < 0.001, p = 0.0237, p = 0.006, p < 0.001, respectively). Conclusions: Our findings suggest that ALC and AMC can serve as readily accessible and verifiable prognostic tools in MDS at presentation. Combined with IPSS-R, these markers may provide additional prognostic insights, enabling better risk stratification in MDS patients who could benefit from future immunotherapies. Full article

Cortical transcriptional dysregulation is widespread in Huntington’s disease (HD). We re-examined prefrontal Brodmann Area 9 (BA9) RNA-seq (GSE64810; 20 HD, 49 controls) using BH-FDR and GEO2R to obtain differential-expression statistics for downstream in silico integration. A compact, direction-aware 80-gene panel was assembled for visualization/ranking only, while inference relied on validated target sets and full-universe testing. At FDR < 0.05, we detected Up = 2923 and Down = 2448 genes (ratio 1.19), indicating a mild predominance of up-regulation. MIR219A2 was strongly down-regulated, and four experimentally validated targets (FOXC1, NFKBIA, SLC38A2, SLC6A20) overlapped the up-regulated core; as expected for n = 4, no GO/KEGG/Reactome term met FDR < 0.05, and STRING returned no high-confidence edges. Beyond the curated panel, we tested MIR219A2 (hsa-miR-219a-5p; hsa-miR-219a-1-3p; hsa-miR-219a-2-3p) targets against the full FDR-significant BA9 up-regulated universe. Two orthogonal, experimentally supported resources—miRTarBase functional assays and ENCORI/starBase CLIP—showed direction-consistent, FDR-controlled enrichment, with effect sizes and uncertainty reported in the main text, supporting a BA9-specific, MIR219A2-aligned association signal. On the TF axis, MSigDB C3:TFT (gene symbols) revealed significant over-representation of TF target sets among BA9-Up under the same BA9 expressed-gene background after BH-FDR (e.g., NFAT motifs, C/EBP, FOXA/HNF3), while TRRUST v2 applied to the MIR219A2 CLIP–BA9-Up subset provided target-level transparency. MIR219A2 enrichments were robust to composition sensitivity analyses (marker-excluded and neuron/glia-stratified backgrounds). Exploratory GO–Biological Process bubbles are shown for trend summarization only; no term met FDR < 0.05 in the primary analysis. All conclusions are analysis-only; no wet-lab or biofluid/peripheral assays were performed, and findings are BA9-specific—generalization to other regions remains hypothesis-generating. Full article

Postural stability is influenced by several anthropometric factors as well as age. The aim of this study was to investigate the relationship between body height, body mass, BMI, and arch index with stabilometric parameters in physically active young adults. A total of 169 sport science university students participated in the study. Their arch index and their stabilometric parameters were measured using the P-Walk BTS platform. Spearman’s rank correlations showed a significant positive correlation between body mass and arch index (r = 0.25, p = 0.001), and BMI and arch index (r = 0.30, p < 0.001). Also, negative correlations were observed between body height and CoP speed (r = −0.22, p = 0.004) and CoP distance (r = −0.23, p = 0.003), as well as body weight and CoP speed (r = −0.17, p = 0.028) and CoP distance (r = −0.19, p = 0.015). Age was negatively correlated to postural sway variables (i.e., CoP distance, CoP area, and CoP speed). The findings suggest that, in physically active people, larger anthropometric values may confer stabilizing advantages, potentially due to increased body volume. Also, the significant correlation of age to stability metrics may highlight enhanced proprioceptive integration or adaptive neural mechanisms. The results highlight the importance of individualised proprioceptive training programmes, particularly for athletes of lower body mass or stature. Future research should extend on the results’ potential training and rehabilitative implications. Full article

Reflective practice is vital for bridging theory and professional application in undergraduate public health education, yet its use in non-Western contexts is underexamined. This mixed-methods study evaluated the Minor in Public Health at the Saw Swee Hock School of Public Health, National University of Singapore, using a convergent parallel design. Using a longitudinal student survey (baseline upon entry: n = 289; graduation upon completion: n = 78) and cross-sectional stakeholder survey (n = 17), quantitative analysis included chi-square tests for competency changes and Wilcoxon rank-sum tests for group comparisons. Thematic analysis of open-ended responses highlighted strengths in systems thinking, analytical skills, and interdisciplinary integration, but also gaps in practical experience, specialised knowledge, and professional communication. Students reported significant improvements in 10 of 13 competencies from baseline to graduation and rated their attainment higher than stakeholders across all competencies. Those who achieved all competencies also gave significantly more positive ratings of the programme in the domains of teaching and learning, and in engagement, assessment, and feedback. These findings underscore the role of reflective practice in aligning education with workforce needs and offer a scalable approach for curriculum development. The study provides actionable insights for educators to design responsive and reflective curricula that support the preparation of competent public health professionals in diverse global contexts. Full article

Universities continue to offer international students opportunities to study abroad and gain an education in a highly ranked, world-recognised system, providing exposure to a broad cultural experience. While students cite that gaining exposure to a culturally different experience enhances study opportunities, there are also deeper considerations in globalised education. It is important to recognise that diverse classrooms may experience philosophical dichotomies. As business education across the world is increasingly using the United Nations Sustainable Development Goals (SDGs) to underpin programmes that also address sustainability, these dichotomies cannot be ignored. This paper explores how educators must be aware of how complex culturally referenced norms are questioned when SDGs are incorporated into programmes. Using an action learning cycle of observation, action, and results, and drawing upon the example of teaching ethics and SDGs to large cohorts of international university students, we explain how transformative learning can occur without students feeling judged for past practices and experiences that are situated in culturally accepted norms that breach the SDGs. This paper thus provides practical ideas for teaching SDGs and includes the importance of understanding culturally referenced norms in light of the SDGs when teaching international students. Full article

Background: Autonomic nervous system (ANS) and vascular factors are associated with glaucoma. However, the association between systemic comorbidity burden and ANS and hemodynamic function in patients with glaucoma remains unclear. This study aimed to examine the association between heart rate variability (HRV) and acceleration plethysmography (APG) parameters and the age-adjusted Charlson Comorbidity Index (ACCI) in patients with glaucoma. Methods: A total of 260 subjects (260 eyes), including 186 with primary open-angle glaucoma (PG) and 74 with exfoliation glaucoma (EG), were enrolled at Shimane University Hospital from June 2023 to July 2024. HRV and APG were assessed using a sphygmograph (TAS9 Pulse Analyzer Plus View). HRV parameters included time-domain measures (SDNN, RMSSD, CVRR) and frequency-domain measures (TP, VLF, LF, HF, LF/HF). APG parameters included the a, b, c, d, and e components of the accelerated pulse wave, and the following vascular types: Type A, Type B, and Type C. The association between ACCI and HRV and APG parameters was evaluated using Spearman’s rank correlation and multivariate regression adjusted for sex, body mass index, pulse rate, systolic and diastolic blood pressure, intraocular pressure, medication score, mean deviation, and glaucoma type. Results: By univariate analysis, against ACCI, significant inverse correlations were observed for several parameters: LnLF (R = −0.17, p = 0.0062); LnLF/LnHF (R = −0.24, p = 0.00012); b peak (R = −0.14, p = 0.031); d peak (R = −0.17, p = 0.0072); and e peak (R = −0.15, p = 0.015). Regarding HRV parameters, multivariate linear regression models showed that ACCI was significantly positively associated with RMSSD (coefficient: 2.861; 95% CI: 0.447 to 5.274) and significantly negatively associated with the frequency-domain parameters LnLF (coefficient: −0.127; 95% CI: −0.245 to −0.009) and LnLF/LnHF (coefficient: −0.038; 95% CI: −0.062 to −0.014). In APG parameters, the c peak was significant associated with ACCI (coefficient: −12.6; 95% CI: −22.5 to −2.69). ACCI was significantly associated with Type B (coefficient: 0.305; 95% CI: 0.057 to 0.552). Conclusions: Greater systemic comorbidity burden may be related to impaired ANS regulation and increased vascular stiffness in glaucoma patients. Full article

Background/Objectives: Cardiac sarcoidosis (CS) is a granulomatous inflammatory cardiomyopathy with heterogeneous presentations, from palpitations to heart failure and sudden cardiac arrest. Despite advances in imaging and immunosuppressive (IS) therapy, relapse patterns and long-term outcomes remain poorly defined. This study aimed to characterize relapse and identify predictors of relapse and major adverse cardiac events (MACE) in a real-world CS cohort. Methods: This retrospective single-center study included 25 adults diagnosed with CS at Geneva University Hospitals between 2016 and 2024, classified per the 2024 American Heart Association diagnostic criteria. Relapse was defined as clinical, arrhythmic, or imaging deterioration requiring treatment escalation. MACE included cardiovascular hospitalization, device therapy, left ventricular assist device, heart transplant, or death. Statistical methods included Kaplan–Meier analysis with log-rank tests and multivariable Cox regression adjusted for age and sex. Results: Relapse occurred in 13 patients (56%), frequently subclinical (61.5%) and detected incidentally on routine PET-CT during IS tapering. In the multivariate model, predictors of relapse included right ventricular FDG uptake (aHR 13.1; 95% CI 1.3–133.7; p = 0.03) and second-line immunosuppression duration ≤24 months (aHR 20.1; 95% CI 1.1–363.8; p = 0.04). Relapse-free patients were more often maintained on dual or triple IS therapy (71.4% vs. 15.4%; p = 0.02) and low-dose prednisone (<10 mg/day) (57.1% vs. 7.7%; p = 0.03). Conclusions: Relapse is common in CS, often subclinical, and associated with PET-CT findings and premature IS tapering. Maintenance therapy may reduce risk. Multimodal imaging remains critical for disease monitoring, though tracers with higher specificity are needed. Further research should refine relapse definitions and support personalized treatment strategies. Full article

Problem-based learning (PBL) has been recognized for enhancing student motivation and key competencies. However, its integration with emerging topics such as ESG (Environmental, Social, and Governance) in general education remains underexplored. This study implemented a PBL-based instructional design in a general education course titled “Organizational Greenhouse Gas Inventory and Net-Zero Transition,” integrating practical tasks and ESG case studies to enhance students’ sustainability literacy and core competencies. Pre- and post-course assessments were conducted using the University Career and Competency Assessment Network (UCAN) questionnaire, analyzed through paired sample t tests and Wilcoxon signed rank tests. Results showed significant improvements in the innovation and communication aspects, with upward trends observed in other domains. Students also demonstrated strong engagement and learning motivation through tasks such as carbon footprint estimation, data integration, and field-based assessments. The findings support the feasibility of embedding ESG and PBL frameworks in general education. Future course iterations will consider differentiated instructional design and the incorporation of qualitative methods to accommodate diverse student backgrounds and enhance learning outcomes, contributing to the advancement of sustainability education in higher education. Full article

In Italy, several changes to academic and professional standards and rules in kinesiology and sport have recently occurred. On the university side, no data collection has started regarding these changes and effects on specific scholars. The aim of this study was to evaluate the opinions of Italian university scholars in Exercise and Sport Sciences regarding recent disciplinary reclassifications, the emergence of the kinesiologist as a formal profession, and related curricular updates. Specifically, this study aimed to measure scholars’ views on the usefulness of unification, hybridization with other fields of knowledge, interdisciplinarity with pedagogy, the distinctiveness of undergraduate education in light of the new kinesiologist profile, and the inclusion of Technical and Laboratory Activities (TLA) credited through the European Credit Transfer System (ECTS). These aspects were explored through an eight-question survey offering three multiple-choice answers. An exploratory survey was distributed to a defined population of 261 Italian scholars (48 full professors, 137 associate professors, and 76 researchers). A total of 83 responses were collected: 14 full professors, 45 associate professors, and 24 researchers (response rate: 31.8%). Descriptive statistics and inferential analyses (Chi-Square tests, Cramér’s V, and Pearson/Spearman correlations) were conducted. Results indicated that 72.3% perceived overlap between pedagogical and medical disciplinary groups, and 85.5% considered practical/laboratory activities essential to the kinesiologist’s role. Significant differences in keyword-sharing perceptions across academic ranks emerged (p = 0.012; V = 0.3), and a near-significant trend was found regarding the importance of discipline-aligned research (p = 0.058; V = 0.3). Full agreement was found on the use of updated scientific evidence in lectures (100%), and 81.9% supported standardized education for the kinesiologist profession (Q6). Positive correlations were observed between support for keyword sharing and belief in its usefulness for promoting interdisciplinarity among full professors (r = 0.58, p = 0.02), associate professors (r = 0.68, p < 0.01), and researchers (r = 0.83, p < 0.01). Conversely, negative correlations emerged between the importance placed on practical activities and support for interdisciplinarity among associate professors and researchers, with values ranging from r = −0.31 to −0.46. The results are significant and tended toward autonomy from pedagogy, training aligned with the bachelor’s and master’s degree kinesiologist, and interdisciplinarity inherent in typical Exercise and Sport Sciences (ESS) keywords. This study should be replicated to increase the sample and to expand the ad hoc questionnaire to other issues. These findings highlight the need for greater alignment between academic training, disciplinary definitions, and professional practice through shared epistemological frameworks and updated descriptors that reflect scientific and labor market developments. Full article

Since the 21st century, Russia has pursued the construction of world-class universities as a core reform goal in higher education, aiming to address the inadequacies of its post-Soviet higher education system in adapting to international competition. This study systematically examines the historical evolution, strategic framework, key characteristics, and practical challenges of Russia’s efforts over more than two decades. Russia’s practice has gone through three distinct stages: foundational construction (2003–2012), marked by joining the Bologna Process and establishing federal and national research universities; in-depth advancement (2012–2020), driven by initiatives such as the “5–100 Plan,” Global Education Program, and regional flagship universities; and adjustment and optimization (2020–present), represented by the “Priority-2030” plan. These efforts have formed a strategic framework centered on system construction, internationalization, balanced development, and operational support. Key characteristics of Russia’s practice include the integration of strategic stability and tactical flexibility, the complementarity of tiered and classified development, and the coordination of government leadership and university autonomy. However, challenges persist, such as underperformance in global rankings, insufficient funding, uneven resource distribution, and severe talent drain. Full article

The number of students studying outside their home countries has increased in recent years, and the United Kingdom has long been positioned as a leading destination, consistently being ranked among the top five English-speaking countries for international education. However, in 2024, the UK experienced a significant decline in international student enrolments, with Australia surpassing the UK to take second place globally. This decline coincided with an increasingly restrictive political climate, particularly reflected in changes to student visa policies and new limitations on dependents. The reduction in international student numbers poses serious financial risks to UK universities, many of which rely heavily on tuition from overseas students, and brings broader organizational challenges, including staffing cuts, programme restructuring, and reduced support services. Societally, it impacts local economies, reduces cultural diversity, and weakens the UK’s soft power and global educational influence. This entry explores the current state of the UK’s international student supply chain, examines emerging post-2024 challenges, and outlines key implications to inform institutional and policy-level responses. Full article

Background/Objectives: The COVID-19 pandemic and the development of vaccines provided the opportunity to monitor disease prevalence and outcomes, vaccinations, their side effects and serological responses in patients with inflammatory bowel disease (IBD). Methods: IBD patients of the outpatient clinic at the University Hospital Heidelberg who completed at least one questionnaire on COVID-19 and related vaccinations from July 2021 to August 2022 were included. Spike-IgG antibody titres were determined. Friedman tests, Wilcoxon signed-rank tests and Kruskal–Wallis tests were used for comparisons. The influence of IBD therapy was analysed using linear models with mixed effects. Results: The cohort included 520 patients (269 females, mean age = 45.3 years, 60.6% with Crohn’s disease, 35.4% with ulcerative colitis, and 4.0% with unclassified IBD). Four hundred eighty patients (92.3%) received at least one COVID-19 vaccination, and 154 patients (29.6%) were infected by SARS-CoV-2. Among all of them, 94.4% achieved seroconversion. Triple-vaccinated patients with additional SARS-CoV-2 infection developed the highest serological responses (χ² = 16.51, p < 0.001, df = 3). An antibody decay over time was observed after the second (p < 0.001) and third vaccinations (p < 0.001). Regarding individual IBD medications, no differences in mean titres were found after two (χ² = 6.60, p = 0.36, df = 6) versus three vaccinations (χ² = 4.97, p = 0.42, df = 5). Linear models with mixed effects revealed no influence of IBD therapies on serological responses. Conclusions: The highest serological responses were observed in IBD patients after three vaccinations plus SARS-CoV-2 infection without significant differences between IBD therapies. Full article