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Nurses often serve as the initial responders in cases of cardiac arrest, making cardiopulmonary resuscitation (CPR) competence essential to effective resuscitation. It is therefore important for nursing students to possess sufficient CPR knowledge and skills for future clinical practice.
Objective:
The aim of this study was to examine whether CPR post-qualification training is needed in maintaining knowledge and skills and if face-to-face or online training is more effective as an educational method in preserving CPR knowledge and skills in nursing students.
Methods:
A three-group, parallel randomized-controlled, single-blind design was used. The participants were 133 nursing students, randomly assigned to the face-to-face group (n = 43), the e-learning group (n = 43), and the control group (n = 47). Before randomization, all participants (n = 133) successfully completed the European Resuscitation Council (ERC) standard five-hour Basic Life Support/Automated External Defibrillation (BLS/AED) course (t0) and a questionnaire based on the 2021 ERC Guidelines to assess their knowledge. Six months later, Group A received face-to-face training, Group B received e-learning training, and Group C had no intervention. Six months after interventions, all participants (n = 133) were re-assessed on the same questionnaire, and they were given the same scenario of cardiopulmonary arrest that was used during the initial BLS course to assess the skills that they retained (t1) with the use of the ERC CPR/AED 11-item checklist. The collected data were analyzed with inferential “among group” analysis involving Kruskal-Wallis’s and Pearson’s Chi-Squared test and inferential “within group” analysis including Wilcoxon’s Signed-Rank and McNemar’s test. Multiple linear regression was used for adjusting demographic characteristics.
Results:
Based on pairwise differences between independent groups, both intervention groups presented higher scores in knowledge at t1 (P < 0.001) and in skills at t1 (P < 0.001) compared to the control group. Moreover, both training methods demonstrated comparable effectiveness. Based on comparisons between paired groups, there was also a statistically significant decrease in the Skill Score in the control group after one year (P < 0.001). Most skills were notably higher, primarily in the e-learning group, and to a lesser extent in the face-to-face group. In specific, intervention groups demonstrated statistically significant improvement in nine of the eleven assessed skills (all P < 0.05).
Conclusion:
The current study showed that post-qualification training is needed to retain CPR knowledge and skills of nursing students, and that face-to-face and e-learning training had similar outcomes.
The present study investigated Thai speakers’ perceptions of native English accents and Thai-accented English (TaE) in two contexts: language teaching and everyday communication. Using a direct attitudinal approach, data from 125 Thai speakers revealed attitudinal patterns toward native Englishes and TaE. Native accents were viewed as highly desirable in the academic setting and served as models for participants’ aspiration. Unlike Thai teachers with TaE, those with a native-like accent received high levels of acceptance, nearly comparable to native English teachers, despite their non-native speaker status. Thus, having native(-like) accent appears to be a critical factor for suitability as a language teacher to a greater extent than nativeness. In addition, while TaE was generally accepted by most participants, this acceptance did not extend to considering TaE speakers suitable as language teachers. The present study extends the native speaker fallacy by proposing the native accent fallacy which suggests that ideal language teachers are defined by their native(-like) accents. Implications are discussed within the Global Englishes Language Teaching (GELT) paradigm to mitigate native-speakerism and language-based discrimination in teacher recruitment and pedagogy.
Identifying areas with a high risk of collision with wind turbines is crucial for the conservation of large soaring birds. However, studies often rely on different wind turbine data sources, and the effect of this heterogeneity on collision risk estimation remains poorly understood. To address this gap, we combined GPS and accelerometer data from six Griffon Vultures Gyps fulvus tracked in Sardinia (Italy) with three wind turbine data sets differing in accuracy and completeness. We estimated the vultures’ foraging grounds and calculated collision risk using each data set, including one based on aerial imagery (unbiased), one from OpenStreetMap (OSM), and a third from published literature. Results showed that turbines mapped from aerial imagery overlapped with 18.7% of foraging areas, compared with 8.7% using OSM and 15.9% using the third data set. Projections including planned wind farms indicated that 31.4% of current foraging grounds will become at risk. These findings demonstrate that wind turbine data sources significantly influence estimates of collision risk. The need for reliable, accessible, and regularly updated turbine maps to support effective conservation planning, guide mitigation actions such as selective shutdowns, and monitor cumulative impacts over time are highlighted.
Record linkage projects provide powerful opportunities to enrich cohort data with administrative and clinical information from national registries. The Netherlands Twin Register (NTR) is a large population-based twin-family cohort with longitudinal data collection that has established multiple record linkage initiatives to expand research on genetic and environmental determinants of health, disease, behaviour, development, and fertility. In this article we summarize and discuss NTR record linkage projects. Clinical and pathology registries have provided essential data on chorionicity, reproductive history, neonatal thyroid function, and cancer diagnoses, facilitating studies on prenatal environment, disease heritability, and polygenic risk prediction for diseases. Linkage with health insurance data has enabled validation of medication use and health research. Collaborations with Statistics Netherlands allow linkage to nationwide population-based data via secure infrastructures such as Open Data Infrastructure for Social Science and Economic Innovations (ODISSEI), supporting genomewide association studies of, for example, healthcare expenditure. Finally, linkage to environmental exposure datasets has permitted exposomewide analyses of health and wellbeing. Together, these projects illustrate the feasibility, scientific value, and challenges of record linkage in the Dutch context, highlighting its role in advancing twin research, genetic epidemiology, and population health studies.
Internet-based interventions vary with respect to the level of support provided, and the impact of support levels on outcomes has been unclear.
Aims
To evaluate the relative effectiveness and acceptability of support levels in internet-based cognitive–behavioural therapy (iCBT) for depression.
Method
This network meta-analysis included randomised controlled trials of stand-alone iCBT for adults with elevated levels of depressive symptoms, identified via systematic searches of PubMed, EMBASE, PsycINFO and the Cochrane Library (1 January 2025). The primary outcome was post-intervention effectiveness. The secondary outcome was study drop-out risk. Risk of bias was assessed with Cochrane RoB-2. A frequentist random-effects model was conducted (preregistered at https://osf.io/amw4r).
Results
We included 141 trials with 169 comparisons (n = 32 197). iCBT with therapeutic support had the greatest effect in terms of reducing depressive symptoms compared with care-as-usual (g = 0.42; 95% CI: 0.30 to 0.55). Such interventions outperformed offers with minimal coaching (encouragement only; g = 0.19, 95% CI: 0.03–0.35) and technical support (g = 0.27, 95% CI: 0.08–0.45) but had similar effects to those with full coaching (i.e. standardised feedback), automated support, on-demand support or no support. Interventions providing technical support represented the least effective iCBT format and were not statistically superior to care as usual (g = 0.15, 95% CI: −0.02 to 0.33). For acceptability, iCBT with minimal coaching showed the lowest drop-out rate (risk ratio = 1.13, (95% CI: 0.88–1.46), whereas technical support showed the highest (risk ratio = 1.6, 95% CI: 1.21–2.15). With pre-intervention human contact, all support levels were similarly effective; without it, therapeutic support outperformed other types of support (g = 0.32–0.68) and drop-out risks increased.
Conclusions
Low-intensity supported iCBT can be as effective as therapist-guided iCBT when initial human contact is present. Evidence regarding the potential harms of no-human support is needed before implementation.
Recent scholarship has directed attention to how racial discourse, and colorblind racism in particular, influences urban redevelopment in U.S. cities. This study employs a theory of strategic racialization to better understand how developers use race-related discourse to seek public support for their projects and how community members respond. Focusing on a series of public meetings regarding three competing proposals to build a casino in the city of Chicago, we find that racial meanings and categories played a central role in efforts by developers and community members to characterize, support, and challenge the casino project. Comparing public interactions across three different communities, we argue that developers deployed a shifting array of discursive strategies—territorial ascription, multiculturalism, colorblind racialization, and a more novel variety of racial equity claims—to mobilize the unique geographic and organizational characteristics of their proposed projects as assurances of racial equity. We identify three distinct discourses that organized the racial equity claims of developers and community members: Black-led capitalism, racially representative capitalism, and spatially connective capitalism. We conclude that while community members actively contested developers’ claims and called for greater specificity concerning beneficiaries, they did not challenge the capitalist logic that merely redistributing the benefits of development among owners and workers—however racialized—could bring about racial equity.
Although Turkey’s authoritarian turn is often interpreted as a reaction to the Gezi resistance of 2013, this article argues that its foundations were laid much earlier through the gradual accumulation of infrastructure and legal frameworks. Rather than emerging as a sudden response to dissent, Turkey’s networked authoritarianism must be understood as the outcome of long-term infrastructural decisions that have extended through successive waves of privatization, legal control, and market consolidation. Drawing on a cartographic ethnographic methodology, this article maps the entanglement of media ownership, regulatory centralization, and expert discourse, as reflected in the Internet Conferences of Turkey (INET-TR) conferences, to show how early quiescence and missed interventions enabled a gradual shift toward centralized control. Unlike fully nationalized Internet models, Turkey’s approach is hybrid and strategic: it maintains international connectivity and commercial integration while exercising tight control over domestic information flows through a combination of layered legal and technical instruments. This historical context complicates linear narratives of rupture and resistance, demonstrating that authoritarian consolidation in digital infrastructures is not only about state repression but also about infrastructural and institutional standardization of control.
Since the days of logical empiricism, quantitative theories of degrees of confirmation have commonly been built upon the calculus of (conditional) probabilities. This work proposes a generalized account of degrees of confirmation in which probabilities naturally arise as a special case. I argue that probabilities can often—but not always—be chosen by convention out of a large class of calculi to represent degrees of confirmation.
Industrial development is rapidly altering ecosystems, with consequences for species that are culturally and ecologically important. Indigenous researchers with Swan River First Nation (SRFN) co-produced this research with Western scientists to examine how landscape change influences mammals within their traditional territory in the boreal foothills of Alberta (Canada). Community-identified concerns about declining mammal populations guided the study’s objectives, spatial focus and hypotheses and informed interpretation of the results. Using remote camera traps, we modelled species-specific responses to natural and anthropogenic landscape features. We applied generalized linear models to evaluate competing hypotheses for species occurrence–disturbance relationships. While some species–disturbance relationships matched community observations and patterns from neighbouring regions, others differed. Notably, and consistent with SRFN observations, moose (Alces alces) occurrence declined with increasing road and seismic line density, probably overriding positive effects of patch features. Integrating Indigenous knowledge with the study design and interpretation clarified potential mechanisms underlying declines and strengthened inference for management. These findings demonstrate the value of braiding Indigenous knowledge with ecological data to support conservation and management in rapidly changing landscapes.
Increasing the methionine (Met) supply to lactating cows will increase mammary cell proliferation. Activating transcription factor 4 (ATF4) is a regulator of cellular amino acid sensing, linking nutrient signals to cellular anabolism; however, its role in regulating bovine mammary epithelial cell (BMEC) proliferation remains largely unknown. In this study, ATF4 expression paralleled that of Cyclin D1 in mammary tissues from dairy cows at different developmental stages (puberty, lactation and dry period), suggesting that ATF4 is associated with cell proliferation. In BMECs, knockdown of ATF4 increased the number of cells arrested in the G1 phase (∼11%; P < 0.05; control) and downregulated Cyclin D1 expression (∼40%; P < 0.05; control), indicating that ATF4 is required for cell proliferation. Treatment of BMECs with increasing concentrations of Met (0, 0.3, 0.6, 0.9, 1.0 and 1.2 mM) showed that 0.6 mM Met enhanced mammalian target of rapamycin (mTOR) phosphorylation and increased protein expression of ATF4 and Cyclin D1, without activating canonical endoplasmic reticulum stress markers. Inhibition assays demonstrated that mTOR is required for Met-induced ATF4 activation. Functional studies further revealed that ATF4 is a key mediator of Met-regulated cell proliferation. Mechanistically, Met facilitated the physical interaction between ATF4 and glycogen synthase kinase-3β (GSK3β), promoting GSK3β phosphorylation at Ser9 and subsequently increasing Cyclin D1 expression. Collectively, these findings indicate that Met promotes BMEC proliferation through the mTOR-ATF4-GSK3β signalling pathway, providing a potential nutritional strategy to enhance mammary cell proliferation in dairy cows.
This paper investigates the use of large Reconfigurable Intelligent Surfaces (RISs), also known as “Smart Skins,” to improve outdoor-to-indoor millimeter-wave (mmWave) propagation, taking advantage of ventilation holes commonly found – or easily implemented – in European buildings. By using a transmissive, focusing RIS, the signal can be concentrated and routed through the opening, enhancing signal penetration into the indoor space even in modern, highly insulated buildings that particularly hinder signal penetration. Using Ray Tracing simulations, we compare scenarios with and without RIS at 29 GHz, demonstrating significant indoor signal coverage improvements in the first case. The study highlights the use of RIS – or Smart-Skins – as a cost-effective solution to address the challenges of mmWave propagation in modern building designs.
Trichinella spiralis cathepsin B proteins (TsCB) are highly antigenic molecules secreted by the parasite and represent promising candidates for vaccine development. Nanoliposomes are efficient and advanced drug delivery systems that enhance antigen stability and immunogenicity.
Objective
This study aimed to evaluate the protective efficacy of T. spiralis cathepsin B proteinase antigen (TsCBPA), either alone or loaded onto nanoliposomes, with or without aluminium hydroxide as an adjuvant, in a murine model of trichinellosis.
Material and Methods
Sixty male Swiss albino mice were divided into two main groups: a control (non-infected and T. spiralis-infected subgroups) and a vaccinated groups, the later subdivided into four subgroups according to vaccination protocols. Parasitological assessment was performed on the 8th day post-infection (dpi) to evaluate adult worm burden and on the 35th dpi to assess larval burden. Histopathological examination was conducted during both the intestinal and muscular phases. Enzyme-linked immunosorbent assay (ELISA) was used to measure circulating larval antigen, immunoglobulin M (IgM), and immunoglobulin G1 (IgG1). Real-time polymerase chain reaction (PCR) was performed to quantify larval DNA in intestinal and muscular tissues.
Results
Vaccinated groups showed significant reductions in adult worm and larval counts, accompanied by improved inflammatory responses. Circulating larval antigen levels and larval DNA quantities were markedly reduced, while serum IgM and IgG1 levels were significantly increased. The highest protective efficacy was observed in mice vaccinated with nanoliposome-loaded TsCBPA combined with aluminium hydroxide.
Conclusion
TsCBPA and its nanoliposome formulation showed strong protection against murine trichinellosis, with aluminium hydroxide significantly enhancing vaccine efficacy.
This article reveals an untold transnational history of the Chinese Communist Party’s (CCP) legal transplant of maternity protection from Europe and the United States. Article 49 of the Chinese Constitution stipulates that the state shall protect mothers. However, this clause also includes an obligation to practice the family planning policy, which is notorious for forced sterilizations and abortions. Why does a clause meant to protect mothers come with controls over reproductive autonomy and potential harm to mothers? This article argues that the combination of the protection of mothers with family planning policies emerged through the malleability of maternity protection within the CCP’s legal framework. This malleability originated from the evolving interplay between the political challenges—both international and domestic—the CCP encountered and the diverse backgrounds of mothers directly affected by this legal principle. Maternity protection proved an effective vehicle for the Party to address challenges across contexts by reconstructing its functionalities. This article identifies three ways in which the CCP interpreted maternity protection to further its political agendas: political movements, public health, and birth control. These interpretations aligned with the political challenges of expanding influence, ensuring wartime survival, and consolidating the socialist regime, as well as with the targeted audiences of urban workers, rural peasants, and socialist nationals.
This paper proposes the concept of gynecological violence as a necessary expansion of obstetric violence to encompass a broader range of experiences and affected groups. While obstetric violence primarily focuses on pregnancy, childbirth, and postpartum, gynecological violence includes healthcare experiences throughout the entire life cycle of individuals assigned female at birth, beyond maternity. The concept aims to highlight physical, psychological, or sexual abuses in medical settings that undermine bodily autonomy and reproductive rights. A review of evidence from feminist research and public health is conducted to provide an integrated perspective. It is argued that gynecological violence should be understood within the broader context of the hegemonic medical system, where gender biases and unequal power relations between healthcare providers and patients persist. This proposal seeks to expand the conceptual framework to enable critical analysis and inform public policies aimed at preventing such violence, ensuring respectful gynecological care that is free from discrimination and centered on human rights.
This article introduces the Markov Riding Position Sampler (MaRiPoSa) for simulating Canadian elections under alternative configurations of electoral district boundaries. Despite Canada’s strictly non-partisan system of boundary design, MaRiPoSa demonstrates that, for a single Canadian election, there are alternative, allowable and more equitable configurations of boundaries to return either Liberal or Conservative governments without changing the vote or location of a single voter. If the same votes in the same places produce different governments depending on which valid configuration of boundaries happens to be used, to what extent can we say that it is voters and their territorial distributions that determine the outcome of Canadian elections? Canada will need to adjust principles and institutions to prepare for the new technological environment brought about by advances in computing and artificial intelligence.