11237 research outputs found
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Effectiveness of the live zoster vaccine in patients with type 2 diabetes: a nationwide emulated target trial
No full textObjectives: Real-world studies on its effectiveness in patients with type 2 diabetes mellitus (T2DM) remain limited. This study aimed to evaluate the effectiveness of the live zoster vaccine in patients with T2DM more than 10 years.Methods: In this target trial emulation study, we utilized a large-scale, nationwide cohort in South Korea, consisting of individuals aged 50 years and older with T2DM from January 1, 2012 to December 31, 2021 (n = 934 945). This cohort was integrated using health insurance data from the Korea Health Insurance Review and Assessment Service, national health screening results from the Korean National Health Insurance Service, and live zoster vaccination data from the Korea Disease Control and Prevention Agency. Vaccine effectiveness in preventing herpes zoster (HZ), postherpetic neuralgia, and hospital admissions for HZ based on International Classification of Diseases 10th edition codes was evaluated in patients with T2DM. In a propensity score-based overlap weighted cohort, Cox proportional hazard models were used to evaluate the adjusted hazard ratios (aHRs) and 95% CIs for the effectiveness of the live zoster vaccine among patients with T2DM.Results: After propensity score-based overlap weighting, 253 660 patients with T2DM were included (mean age, 62.4 years [standard deviation, 2.3 years]; 138 338 males, 54.5%). Live zoster vaccination was associated with a reduced risk of HZ (aHR 0.59 [95% CI: 0.57–0.61]), postherpetic neuralgia (aHR 0.59 [95% CI: 0.57–0.61]), and hospital admissions for HZ (aHR 0.41 [95% CI: 0.36–0.47]). Vaccine effectiveness was highest within the first-year post-vaccination, with a sustained protective effect lasting up to 6 years. Furthermore, the effectiveness was greater in the non-insulin treatment group compared with the insulin treatment group.Discussion: Our target trial highlighted that live zoster vaccination significantly reduced the risk of HZ, postherpetic neuralgia, and hospital admissions in patients with T2DM. However, its effectiveness was attenuated in those undergoing insulin treatment.</p
Fiction writing workshops to explore staff perceptions of artificial intelligence (AI) in higher education
No full textThis study explores perceptions of artificial intelligence (AI) in the higher education workplace through innovative use of fiction writing workshops. Twenty-three participants took part in three workshops, imagining the application of AI assistants and chatbots to their roles. Key themes were identified, including perceived benefits and challenges of AI implementation, interface design implications, and factors influencing task delegation to AI. Participants envisioned AI primarily as a tool to enhance task efficiency rather than fundamentally transform job roles. This research contributes insights into the desires and concerns of educational users regarding AI adoption, highlighting potential barriers such as value alignment.</p
Justice
No full textThis chapter explores the evolving justice pillar of transitional justice, with a focus on the role of technology and economic actors in shaping access to justice and accountability. It analyzes how emerging technologies, such as AI and digital platforms, influence judicial processes, enhancing efficiency but also raising concerns about privatization, data commodification, and bias. The chapter examines the integration of forensic technologies in investigating human rights violations and discusses case prioritization fea in post-conflict settings, such as focusing on high-profile perpetrators while potentially sidelining smaller, yet significant cases. It further delves into the critical role of victim participation, exploring how digital platforms can democratize access to justice but may also reinforce existing inequalities due to the digital divide. Drawing from examples in Latin America, the chapter underscores the need for robust regulatory frameworks to ensure that technology serves the broader goals of justice and accountability rather than profit-driven interests.</p
Improving theme park performance in UAE
No full textThe theme park industry in the United Arab Emirates (UAE) is a significant and promising sector, expected to contribute notably to the nation’s economic development. However, the industry has encountered substantial challenges, including its early stage of its regional development, limited resources and the absence of a comprehensive performance management framework, among other obstacles and issues. Effective performance management is essential for delivering value to both customers and stakeholders, yet research in this area remains limited compared to sectors such as banking, healthcare and other service industries. This research aims to enhance theme park performance in the UAE by developing a performance management framework specifically tailored for the industry, considering a variety of variables and their interactions.To achieve this aim, the researcher adopted a qualitative, exploratory, mono-method research design, utilising a semi-structured interview strategy with representatives from seven theme parks in the UAE and six of the top twenty performing theme parks in Europe/UK. The analysis incorporated cross-regional thematic analysis. The research is conceptually grounded in Systems Theory, which views theme parks as open systems whose performance depends on the causal interrelationships among variables. Contingency Theory further supports the framework by emphasising that effective management depends on context-specific external factors and their alignment with organisational factors.The research developed a tailored performance management framework for UAE theme parks that integrates both financial and non-financial measures, alongside internal and external enablers. As part of this framework, three core financial performance measures were identified: Cost, Revenue and Profitability, each supported by a set of key metrics that capture detailed financial dynamics. In addition, six non-financial performance indicators—Brand Value, Employee Engagement, Guest Attendance Number, Guest Loyalty, Guest Satisfaction and Sustainability Indicators—were determined to be essential for effective performance evaluation. Corresponding indicator metrics were identified to provide a nuanced understanding of non-financial performance. Furthermore, eight internal enablers were established: Brand Management; Constant Reinvestment; Guest Experience Management; Human Resource Management and Organisational Culture; Leadership Roles; Park Facilities and Attractions; Park Location and Accessibility; and Park Strategies, each comprising multiple underlying factors that influence related performance measures. The study also incorporated six external enablers, based on the PESTEL framework—Political, Economic, Social, Technological, Environmental and Legal—with detailed underlying factors explored under each dimension to reflect the broader macro-environmental influences. Collectively, these variables constitute a comprehensive performance management framework designed to support continuous performance improvement within the UAE theme park sector.To the best of the researcher’s knowledge, this research is the first to explore performance management specifically in the UAE theme park industry. It is anticipated that the findings will not only contribute to improving theme park performance in the UAE but also fill critical gaps in the existing literature and stimulate further research and exploration in this underdeveloped field.</p
Age-Related Changes in Lens Elasticity Contribute More to Accommodative Decline Than Shape Change
No full text Purpose: To determine whether lens biomechanical or geometric changes contribute to the decline in the accommodative capacity of the human eye, and to examine any differences in zonular function between different age groups.Methods: Eighteen finite element whole eye models were developed to simulate the accommodative process. Six models were constructed in each of the two age cohorts, from the fourth and the sixth decades of life using data from ex vivo human lenses. An additional six models combining the material properties of lenses from the fourth decade with the geometry of those from the sixth decade were included. Optical lens models developed based on the results of mechanical simulations were used to calculate the central optical power (COP).Results: The change in COP was significantly greater for both the fourth-decade models and the mixed models compared with the sixth-decade models. The rates of the change in geometric parameters relative to the increment of change in COP in the mixed models were greater than those in the fourth-decade models. The distribution of zonular force was consistent across all three groups. However, the sixth-decade models and mixed models exhibited similar distributions of zonular angles, both of which were greater than those in the fourth-decade models.Conclusions: Both biomechanical and geometric age-related changes contribute to the accommodative decline, with the material property manifesting a more substantial impact. Age-related changes in the lens do not influence the distribution of zonular tension, but do affect the angles that the zonule makes with the lens surface. </p
The Ocular Manifestations of Individuals With Down Syndrome: A Systematic Review and Meta‐Analysis
No full textBackground: Down syndrome (DS) is the most common genetic cause of intellectual disability. Ocular manifestations occur frequently in people with DS (pwDS) but to date, there is no systematic review or meta‐analysis of these conditions across the lifespan.Methods: PubMed, Medline, Embase, Web of Science and Scopus were searched for observational studies reporting ocular manifestations in pwDS, without limiting publication date. The proportion of pwDS with specific ocular manifestations were meta‐analysed to obtain a pooled incidence using a random effects model. Sources of heterogeneity were assessed using a meta‐regression analysis. For manifestations reported, but without sufficient prevalence data available, a narrative approach was adopted.Results: The search identified 1208 papers. Reviewers independently screened the abstracts, and 54 studies were found to fit the criteria. The age range of the individuals was birth to 88.7 years. Ocular manifestations from highest to lowest prevalence included refractive errors (69.97%, 95% CI 59.95%–79.13%), strabismus (31.41%, 95% CI 24.66%–38.57%), lens opacities (13.79%, 95% CI 8.61%–19.86%), nystagmus (12.72%, 95% CI 9.02%–16.92%) and keratoconus (9.34%, 95% CI 2.47%–19.26%). Alterations of lens and corneal morphology, posterior segment anomalies (including glaucoma) and Brushfield spots were also identified.Conclusions: The ocular manifestations of pwDS are common but varied. Age and/or ethnicity may influence the prevalence of certain ocular manifestations. The level of intellectual disability may also affect the prevalence of ocular manifestations as the prevalence of ocular disorders is known to increase with the severity of intellectual disability in pwDS.</p
I teach; therefore, I lead: teacher leadership and teacher evaluation to enhance the effectiveness of Greek primary schools
No full textThis research investigates teachers' perceptions of teacher leadership and teacher evaluation. This research also examines the connection between teacher evaluation and teacher leadership in a context of distributed leadership, based on the "Critical Pedagogy" model, suggesting that teachers should be committed to emancipatory educational practices rather than simple transmission of skills and knowledge. Hence, this study draws on a wide range of research literature to explore the available empirical data on teacher leadership and evaluation. In a mixed-methods approach, an exploratory sequential mixed-methods design is selected. The sample of participants consists of 372 primary school teachers and headteachers of an urban area in Greece. Based on specific criteria, fifteen volunteers were selected among the respondents to participate in semi-structured interviews. Results were analysed using descriptive and inferential statistics as well as thematic and discourse analysis before being presented in a comprehensive interpretation. The research shows that the participants' views on teacher leadership inform their views on teacher evaluation. Most teachers participating in the study believe that primary education teachers act as leaders in their educational community. Most respondents are favourably disposed towards teacher evaluation. The factors of age, work status (headteachers, deputy headteachers, permanent or substitute teachers), and years of service in the same school affect teachers` perceptions of teacher leadership. The themes of time, trust and training are linked with teacher leadership and evaluation. This research provides empirical evidence about the potential of teacher leadership and explores a new model of teacher evaluation linked to the role of teacher leaders. Additionally, the study provides insight into teachers` perceptions of an optimum evaluation model, the Teacher Leadership for Teacher Evaluation Model, designed to help teachers improve their professional practice and contribute to school effectiveness. Ultimately, this research brings together the ideas of critical pedagogy and distributed leadership models, indicating that they are compatible educational approaches leading to school effectiveness by empowering teachers to act as leaders in their schools and take ownership of their evaluation.</p
(Mis)Education in Authoritarian Regimes: The Case of Eritrea
No full textThere is a debate on the role of education as a tool to challenge or enforce authoritarian attitudes. Many posit that education, particularly higher education, reduces authoritarianism; whereas vast research indicates that education can be used as an authoritarian tool for regime survival. This suggests that there are other intervening factors, such as the curriculum used, the teaching methodology implemented, and the educational administration employed, to securitise the academic space and impose authoritarian attitudes. Informed by the notion of hegemony and the banking concept of education, this article explores the nexus between education and authoritarianism, determining the role of education as an authoritarian tool for regime survival. We use the case of Eritrea, a country that has been under authoritarian government for more than two decades. The article is based on a literature review because it is risky to conduct an objective empirical study on the “politics of education” in Eritrea, given the country’s political sensitivity. The findings suggest that the Eritrean government politicises the curriculum and militarises secondary and higher education levels to create false consciousness and maintain power. The article contributes to advancing knowledge regarding the nexus of authoritarianism and education, helping people understand the state of the politics of education.</p
Tucatinib and trastuzumab in HER2-mutated metastatic breast cancer: a phase 2 basket trial
No full textHuman epidermal growth factor receptor 2 (HER2, also known as ERBB2) signaling promotes cell growth and differentiation, and is overexpressed in several tumor types, including breast, gastric and colorectal cancer. HER2-targeted therapies have shown clinical activity against these tumor types, resulting in regulatory approvals. However, the efficacy of HER2 therapies in tumors with HER2 mutations has not been widely investigated. SGNTUC-019 is an open-label, phase 2 basket study evaluating tucatinib, a HER2-targeted tyrosine kinase inhibitor, in combination with trastuzumab in patients with HER2-altered solid tumors. The study included a cohort of 31 heavily pretreated female patients with HER2-mutated metastatic breast cancer who were also HER2 negative per local testing. Hormone receptor (HR)-positive patients also received fulvestrant. The overall response rate (primary endpoint) was 41.9% (90% confidence interval (CI): 26.9–58.2). Secondary endpoints of duration of response and progression-free survival were 12.6 months (90% CI: 4.7 to not estimable) and 9.5 months (90% CI: 5.4–13.8), respectively. No new safety signals were detected. Responses were observed across various HER2 mutations, including mutations in the tyrosine kinase and extracellular domains. The chemotherapy-free regimen of tucatinib and trastuzumab showed clinically meaningful antitumor activity with durable responses and favorable tolerability in heavily pretreated patients with HER2 mutations. These data support further investigation of HER2-targeted therapies in this patient population. ClinicalTrials.gov registration: NCT04579380.</p
Directed forgetting and emotion regulation in middle- to older-aged adults
No full textIt is well documented that the happiness and mental health of many older adults exceeds that of younger adults, a phenomenon termed the age-related positivity effect that is attributed in part to more efficient use of emotion regulation strategies in older age groups. While it has been argued that one important strategy by which people can enhance their happiness is by avoiding retrieval of unpleasant memories while rehearsing retrieval of pleasant memories, the link between memory control and emotion regulation strategies used in response to exogenous stress has been little investigated. As a first step in addressing this gap in the literature, the primary aim of the present thesis was to explore the relations between self-reported emotion regulation strategies and success at directed forgetting (DF) in adults aged 40+.In three studies, participants were assessed for emotion regulation strategies, executive function, and DF. Stimuli for the DF task were everyday nouns and adjectives (Study 1), personality trait descriptors rated previously for self-relevance (Study 2), and autobiographical memories (Study 3). Studied items were each followed by an instruction to either remember or forget the item and, following a retention interval, participants underwent a surprise memory test for all studied items regardless of initial instruction. In Studies 2 and 3, participants were additionally asked to report what techniques they used to maximise their success with the ‘remember’ versus ‘forget’ directives.Result for all three studies indicated a significant DF effect (i.e., to-be-forgotten items were recognised or recalled less well than to-be-remembered items). While for younger adults the size of the effect was best predicted by inhibitory control, there was no influence of executive function on the DF of adults aged 40+. Instead, performance on the DF task was best predicted by engagement-oriented emotion regulation strategies. Moreover, adults aged 40+ who reported greater use of engagement-oriented strategies were more likely to say that they used elaborative techniques to commit the to-be-remembered items to memory, while those who reported greater use of disengagement-oriented strategies were more likely to employ ‘push from mind’ techniques to limit the processing of to-be-forgotten items.These results provide important preliminary evidence that the emotion regulation strategies used habitually by adults aged 40+ to deal with stressors in everyday life are related meaningfully to the remember/forget strategies they apply in the DF task.</p
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