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This study explores eight key themes: Self-control, personalized learning, smartphone habits, future-time perspective, information overload, digital literacy, meaningful learning, and metacognitive awareness. The primary objective is to investigate the correlations among these factors. Virtual presence serves as a moderating variable, influencing the connections between smartphone habits and digital literacy, as well as between self-control and digital literacy. Additionally, it moderates the relationship between self-control and information overload. The study collected data from 597 engineering students, utilizing a quantitative research approach and employing a questionnaire as the research instrument. Statistical analysis was conducted using a partial least squares structural equation model, implemented with SmartPLS version 4. The study's hypotheses showed a significant impact on each variable, with only the relationships between information overload and meaningful learning, and smartphone habit and metacognitive awareness showing no significant effects, as indicated by the findings.

Research shows that videoconferencing tools can be used for delivering high-quality instruction in real-time to a large number of students simultaneously during and even in the aftermath of the pandemic. However, there is a lack of data on how favourable it is among students, particularly in the Philippine setting, in the field of Physical Education (PE). In this regard, this study aimed at inspecting exogenous factors linked to students' acceptance of a video-conferencing platform in learning knowledge- and skill-based concepts in Physical Education through the adaptation of the Technology Acceptance Model. After performing the Partial Least Square-Structural Equation Modelling from a purposively selected sample of 250 teacher education students, the results showed that perceived ease of use (PEOU) positively affected perceived usefulness (PU). It was also found that PEOU and PU impacted behavioural intention. Lastly, behavioural intention (BI) positively leverages actual use of the Zoom platform. It can be inferred that students can benefit greatly from using the video-conferencing platform to learn various PE concepts. Moreover, another surprising discovery was that students could use the platform to efficiently learn, thus capitalising on the university's educational system, even in the New Normal.

The study aimed to identify consensus among PE experts on using exercise as punishment (EAP) in Philippine schools. The study adopted a two-round Delphi method. In the first round, a survey with open-ended questions prompted experts to identify as many reasons as possible for the use of EAP in schools. This format gave the experts a more significant role in responding, as they could identify crucial themes related to EAP usage and then refine them into meaningful categories. The second round of the survey asked the experts to rank these identified factors based on their perceived importance. Based on the experts’ agreement, “EAP as a disciplinary tool” was ranked as the most significant dimension in the use of EAP in schools. Further factors impacting its use, including social pressure, physical health benefits, its connection to establishing authority, academic performance, athletic performance, and a lack of understanding about alternative disciplinary measures, were also identified. Despite its documented harms, the use of EAP persists in Philippine schools. This study reveals a complex web of drivers, including a persistent belief in EAP’s disciplinary effectiveness, external pressures for “tough” approaches, and a lack of awareness of positive alternatives. These factors create a cycle of conformity in which student well-being could suffer. To break this cycle, schools must prioritize fostering positive teacher-student relationships, equipping teachers, leaders, and staff with effective disciplinary strategies, and challenging misguided narratives around EAP’s supposed merits.

Introduction: The roles of nurse managers are crucial to the success of healthcare organizations, requiring specific skills and competencies. Accordingly, nurse managers are expected to possess leadership and management skills. Therefore, it is essential to investigate the relationship between leadership and managerial competencies among hospital nurse managers. This study seeks to determine the impact of three different leadership competencies, namely administrative skill, interpersonal skill, and conceptual skill, on the managerial competencies of nurse managers at Kuala Lumpur Hospital. Methods: This cross-sectional quantitative study adopted Northouse’s (2019) leadership competencies questionnaires and Mind Tool’s (2018) management skills assessment tool. A total of 247 participants, all of whom were nurse managers at the Kuala Lumpur Hospital, Malaysia, were recruited for this study. Multiple regression analysis was used to test the hypothesis. Results: The findings revealed that nurse managers at Kuala Lumpur Hospital possessed high levels of all three leadership skills and managerial competencies. However, the only significant predictor of managerial competencies among the respondents is the conceptual skill of leadership (beta = 0.820, p < 0.01). Conclusions: This study emphasizes conceptual skills (cognitive abilities, analytical reasoning, and decision-making) in predicting managerial competencies among nurse managers. Developing these skills is critical for effective leadership and smooth healthcare organization operations. Keywords: administrative skill, conceptual skill, interpersonal skill, leadership competencies, mental health

Background: Elected members of the US Congress rely on staff, including fellows with scientific and engineering expertise, to find and interpret information for use in policymaking. Factors that impede, or facilitate, the communication of scientific information within the institution thus can play a critical role in legislative capacity, but there is a limited understanding of these dynamics in the hyper-partisan body. Aims and objectives: This study presents and tests a four-dimensional model describing how the obstacles to science communication in Congress change depending on whether information is sought for use in support of established policy positions ('strategic use') or to inform decision making ('substantive use'). Methods: Data were collected between November 2017 and February 2019 through interviews with 58 congressional staff members in personal offices assigned to energy, natural resources, and science issue portfolios, and through surveys with 68 science and engineering fellows who completed their year in Congress between 2015 and 2019. Findings: Placing scientists and engineers in Congress as fellows augments staffing and institutional expertise. Yet we find that both staff and fellows experience communication-related impediments in using scientific information. Staff report more challenges in using science to substantively make policy decisions, due not only to lack of time, but also factors such as contacts, access, and information presentation. Fellows report fewer barriers and use science for policy in largely identical ways to staff. Discussion and conclusion: These findings support the proposed model and highlight the importance of staff scientific fluency and the decision-making context for science communication in Congress.

This research focuses on female managers and aims to explore the factors influencing work-life balance among female managers in Chinese higher education institutions (HEIs), while also ranking the importance of these factors within HEIs. The research is divided into five main sections and employs a two-round Delphi research method, utilizing expert discussions and opinions to thoroughly analyze the work-life balance challenges faced by female managers. The findings of the research reveal six primary dimensions that influence the work-life balance of female managers in Chinese HEIs. These factors, ranked in order of importance, are as follows: (1) family factors, (2) work-related factors, (3) cultural and social norms, (4) health factors, (5) self-management and personal skills, and (6) support and satisfaction. In conclusion, this research offers valuable recommendations for understanding and improving the work-life balance of female managers in Chinese HEIs, providing essential guidance for both these institutions and female managers in achieving a balanced development in their professional and personal lives.

IntroductionLow grade appendiceal mucinous neoplasms (LAMN) are indolent tumors that lack invasive potential but may present as pseudomyxoma peritonei. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) significantly improves both overall and recurrence free survival. While systemic chemotherapy is generally considered ineffective for LAMN, little literature is available to support this notion. We evaluated outcomes for individuals with LAMN who did and did not receive systemic chemotherapy in combination with CRS+HIPEC.MethodsA multicenter retrospective cohort study was performed using the US HIPEC Collaborative that included patients with LAMN who underwent CRS+HIPEC. The overall survival (OS) and recurrence-free survival (RFS) of patients who did and did not receive systemic chemotherapy were compared. Survival and variables associated with survival were evaluated with the Kaplan-Meier analysis and cox regression, respectively.ResultsAmong the 529 included patients with LAMN, 63 (11.9%) received systemic chemotherapy and CRS+HIPEC, while 466 (88.1%) were treated with only CRS+HIPEC. Patients selected for systemic chemotherapy had a higher burden of disease (mean peritoneal cancer index: 18.8 +/- 8.6 versus 14.3 +/- 8.8, p

Background:. Although resection is generally necessary for curative-intent treatment of most solid organ cancers, surgery is occasionally aborted due to intraoperative findings. Following aborted cancer surgery, patients have unique care needs that specialized palliative care (PC) providers may be best equipped to manage. We hypothesized that early ambulatory PC referral following aborted cancer surgery would be feasible and acceptable. Methods:. This single-institution prospective clinical trial enrolled adult patients with gastrointestinal or hepatopancreatobiliary cancer with no prior PC exposure who had curative-intent oncologic surgery that was unexpectedly aborted. The primary endpoint was the completion of an ambulatory PC consultation within 30 days of enrollment. Secondary outcomes included changes in standardized measures of quality-of-life (QOL) and anxiety/depression during the 3-month follow-up. Results:. Among 25 enrolled participants, the mean age was 65.3 ± 9.9 years, 68% were male, and 88% were White. The most common types of cancers were pancreatic (44%), hepatobiliary (20%), and colorectal (12%); reasons for aborting surgery were occult metastatic disease (52%) and local unresectability (36%). Only 13 of 25 (52%) met the primary endpoint of ambulatory PC within 30 days, less than the prespecified threshold of 70%. Overall, 16 (64%) patients completed ambulatory PC consultation a mean of 29.2 ± 15.8 days after enrollment. Of the 9 (36%) who did not, reasons included patient preference (n = 4), withdrawal from study (n = 1), lost to follow-up (n = 1), scheduling conflict (n = 1), and required inpatient PC before discharge (n = 2). Anxiety (4.94 ± 3.56 vs 3.35 ± 2.60, P = 0.06), depression (4.18 ± 4.02 vs 4.76 ± 3.44, P = 0.49), and QOL (82.44 ± 11.41 vs 82.03 ± 15.37, P = 0.92) scores did not significantly differ at 3-month follow-up compared to baseline. Conclusions:. Barriers to early ambulatory palliative care consultation exist after aborted cancer surgery. Given the unique and complex care needs of this patient population, additional research is needed to optimize supportive care strategies.

Abstract Post‐traumatic epilepsy (PTE) is a life‐long complication of traumatic brain injury (TBI). The development of PTE is associated with neurological morbidity and increases the risk of mortality. An aim of EpiBioS4Rx (Epilepsy Bioinformatics Study for Antiepileptogenic Therapy) was to test potential therapies to prevent the development of PTE in the lateral fluid percussion injury (LFPI) rat model of TBI, in which rats were subjected to injury at the left parietal cortex. Sodium selenate has been reported to be antiepileptogenic post‐TBI in rodent models by activating protein phosphatase 2A and reducing phosphorylated tau (p‐tau) protein. We aimed to characterize the pharmacokinetics (PK) and brain uptake of sodium selenate using naïve control and LFPI rats. Rats received either a single bolus dose or a single bolus dose followed by a 7‐day subcutaneous minipump infusion of sodium selenate. Sodium selenate and selenium concentrations in plasma and brain were analyzed and used for PK estimation and brain exposure assessment. Selenium concentrations rapidly increased after sodium selenate administration, demonstrating biotransformation from sodium selenate to selenium. Sodium selenate and selenium PK parameters were estimated using non‐compartmental analysis. Sodium selenate clearance (CL/F) and volume of distribution (Vd/F) varied by dose and route of administration, suggesting differences in bioavailability and nonlinear pharmacokinetics at the doses tested. Brain‐to‐plasma partition coefficients (AUCbrain/AUCplasma) for sodium selenate and selenium were found to be 0.7–1.3 and 0.1–0.3 following single‐dose injection, respectively, indicating active transport of sodium selenate across the blood–brain barrier (BBB).

Attrition is the biggest pain point in the contact-center industry across nations. Hence, it is important to study how to retain contact center employees. This study aimed to identify the key factors influencing long-term retention among contact center employees in Malaysia. The Delphi method was implemented using purposive sampling. A total of 24 experts were selected from the contact center industry, who had been working in the field for more than five years in managerial positions. A two-round Delphi method was conducted where, in the first round, experts were requested to list the factors contributing to long-term retention among contact center employees in Malaysia. Thematic analysis was employed in the first round to identify the dimensions by grouping themes. In the second round, experts were requested to rank the dimensions from the most important to the least important. Based on the findings, the most important factors identified were supportive management, followed by work-life balance, compensation and benefits, working environment, career development, reward and recognition, training and development, and health support. Recommendation was provided to the contact center operation in Malaysia based on this finding on the initiative that can be worked on to retain the contact center employee in Malaysia.

The purpose of this research is to examine the determinants that impact employee job satisfaction in the manufacturing industry of Malaysia in the midst of technological progress and economic changes that have been further complicated by the COVID-19 pandemic. The study utilizes the Delphi method to ascertain and rank workplace factors that influence job satisfaction. By employing a qualitative Delphi approach, the study amasses expert consensus in order to investigate the complex dimensions of job satisfaction within the manufacturing sector. The study solicits input from industry experts via two rounds of surveys in order to evaluate the significance of a variety of working environment factors. The analysis is guided by theoretical frameworks, including Maslow’s Hierarchy of Needs and Herzberg’s Two-Factor Theory. In descending order of importance, industry experts agreed that compensation and benefits are the most significant determinant of employee job satisfaction, followed by support for work-life balance, rewards and recognition, organizational support, and opportunities for career growth and development. This research contributes to the body of knowledge on job satisfaction by utilizing the Delphi method, which is an innovative approach in this particular domain, to obtain expert consensus regarding the factors that influence job satisfaction in the manufacturing industry. This approach overcomes the constraints of quantitative methodologies by offering comprehensive analyses of the qualitative dimensions of employee satisfaction. In addition, the study provides policymakers and industry stakeholders with actionable suggestions, underscoring the importance of implementing comprehensive approaches to improve job satisfaction.

Retaining a devoted and skilled workforce has become of paramount importance in China’s dynamic and competitive education sector. The consequences of employee turnover bear weight, especially for institutions striving for global excellence, impacting both institutional continuity and the quality of education. This study explores the factors influencing employee turnover intention within Chinese academic institutions and prioritizes these factors based on their significance. A two-round Delphi method was employed to solicit and synthesize expert opinions through iterative rounds. Nineteen experts from private education institutions in Fuzhou, China, were selected using a combination of purposeful and snowball sampling. In the first round, experts listed the factors contributing to employee turnover intentions, which were then analyzed using thematic analysis. In the second round, the experts ranked these dimensions from most to least important. The study identifies five pivotal factors affecting turnover intentions, listed in order of importance: (1) compensation, benefits, and employee recognition; (2) career development and advancement opportunities; (3) professional growth, training, and job security; (4) leadership, management support, and organizational culture; and (5) work-life balance and work environment. This research proffers actionable recommendations to discern and counteract contributors to employee turnover. The insights furnish invaluable guidance for Chinese educational institutions, underscoring the necessity of employee contentment and laying the groundwork for a sustained and driven workforce.

Considering the concerning increase in overweight and obesity rates among Filipino youth, this study seeks to evaluate the effectiveness of a housework-based exercise program. This program capitalizes on the inherent familiarity of traditional household chores, transforming them into structured exercise routines designed to improve the physical fitness levels of overweight and obese Filipino adolescents. A one-group pretest-posttest design was employed. The intervention transformed traditional household chores into structured exercise routines. Fitness parameters, including Body Mass Index (BMI), cardiovascular endurance, flexibility, and muscular strength & endurance, were assessed before and after the intervention. Statistical analysis was conducted using SPSS software version 29, with Q-Q plots used to confirm the normality of the data. Paired sample t-tests evaluated pre- and post-intervention changes, while independent sample –t-tests determined gender differences. Findings showed that males experienced a greater reduction in BMI (+13.37%, p < .001, effect size = 1.393), while females showed more improvement in cardiovascular endurance (+8.82%, p < .001, effect size = 2.354) and flexibility (left: −46.12%, p < .001, right: −8.31%, p < .001). Both sexes achieved similar gains in muscular strength and endurance (push-up: −35.33%, p < .001, plank: −30.77%, p < .001). This research supports the value of everyday activities beyond structured exercise programs, highlighting the potential of a culturally sensitive approach that utilizes familiar household chores. The program promotes physical activity in a way that resonates with Filipino adolescents and their families, offering a promising, cost-effective intervention to address childhood obesity within the Filipino community.

Naomi Goldenberg’s model of religion as a “vestigial state” is an excellent interrogation of how religion interacts with the state. To Goldenberg, religions traditionally functioned in the same manner as nation-states before being conquered and delineated as semi-autonomous institutions under the larger secular apparatus. However, I argue in this paper that Goldenberg’s “vestigial state” fails to account for the dynamism that religions have in their relationships to the state. I propose seeing religions as “alternative authorities”, which can be subordinate, cooperative, or hostile to the secular state. These perspectives as an alternative authority are seen best in the evolution of American fundamentalism and Christian nationalism, whose adherents have historically distinguished themselves from the state while simultaneously engaging in the effort to reshape it. In looking at how these movements develop, we understand that religions are constantly evolving in how to achieve and maintain power.

The purpose of the present study was to conduct a process evaluation of intervention delivery for a randomized controlled trial (RCT) conducted during the COVID-19 pandemic (NCT 03915548). The RCT tested the effects of a telephone-delivered behavioral intervention on changes in breast cancer survivors’ satisfaction with social roles and activities, as compared to an attention control condition. This process evaluation examined (a) fidelity monitoring scores; (b) participants’ perceived benefit ratings for gaining confidence, reducing distress, adjusting habits and routines, setting goals, and increasing exercise; and (c) field notes, email communications, and transcripts of coach supervision and debriefing sessions. The behavioral and attention control conditions were delivered with a high degree of fidelity (global quality rating score for the BA/PS condition was M = 4.6 (SD = 0.6) and M = 4.9 (SD = 0.3) for the attention control condition, where “5” is the highest rating). The behavioral intervention participants perceived greater benefits than the control participants pertaining to goal setting, t(248) = 5.73, p = t(248) = 2.94, p = 0.0036, and increasing exercise, t(248) = 4.66, p =

Background and Study Aim. Studies on exercise as punishment (EAP) have focused on students and coaches, but less attention has been given to the perspectives of physical education (PE) teachers. This study examined the factors that influence Filipino PE teachers' intentions to use EAP. Specifically, the study examined the role of socio-demographic characteristics, attitudes, and subjective norms in predicting intentions to use EAP in PE classes. Material and Methods. A cross-sectional study was conducted to collect data from 397 PE teachers from all 16 regions of the Philippines. A researcher-made questionnaire was used to collect data on the participants' socio-demographic characteristics, attitudes, subjective norms, and intention to use EAP in their classes. Descriptive statistics and regression analysis were used to analyze the data. Results. The results showed that attitude was the strongest predictor, followed by gender (male), subjective norms, and age (over 45 years). This analysis suggests that the intention to use EAP is more prevalent among males and those over 45 years. It also shows that attitudes significantly predict these intentions. This suggests that teachers who perceive exercise as a tool for improving physical fitness and enforcing adherence to rules in a physical education setting are more likely to have such intentions. In addition, respondents with higher social pressure in employing exercise as a disciplinary measure in PE classes showed greater intentions to use EAP. Conclusions. The intention to use EAP is more prevalent among male PE teachers, those who are older, and those with positive attitudes towards exercise. Additionally, teachers who feel more social pressure to use exercise as a disciplinary measure are also more likely to intend to use EAP. These findings can be used to inform the development of PE teacher training programs and policies that promote the use of positive reinforcement and other non-punitive methods of discipline in PE classes.

The liver maintains a balance between immune tolerance and activation in its role as a filtration system. Chronic inflammation disrupts this immune microenvironment, thereby allowing for the rise and progression of cancer. Hepatocellular carcinoma (HCC) is a liver tumor generally diagnosed in the setting of chronic liver disease. When diagnosed early, the primary treatment is surgical resection, liver transplantation, or liver directed therapies. Unfortunately, patients with HCC often present at an advanced stage or with poor liver function, thereby limiting options. To further complicate matters, most systemic therapies are relatively limited and ineffective among patients with advanced disease. Recently, the IMbrave150 trial demonstrated that the combination of atezolizumab and bevacizumab was associated with better survival compared to sorafenib among patients with advanced HCC. As such, atezolizumab and bevacizumab is now recommended first-line therapy for these patients. Tumor cells work to create an immunotolerant environment by preventing the activation of stimulatory immunoreceptors and upregulating expression of proteins that bind inhibitory immunoreceptors. ICIs work to block these interactions and bolster the anti-tumor function of the immune system. We herein provide an overview of the use of ICIs in the treatment of HCC.