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  • Effects of vitamin D supplementation on vitamin D status and physical performance in football players: A systematic review and meta-analysis

    by Jinfa Gu, Yu Zhang, Luhua Xiao

    Background/Objectives

    Low vitamin D status is frequently reported among athletes, but whether vitamin D supplementation improves physical performance in football players remains uncertain. This systematic review and meta-analysis aimed to evaluate the effects of vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D] concentration, jump performance, sprint performance, aerobic capacity, and muscular performance in association football and futsal players.

    Methods

    PubMed, Embase, the Cochrane Library, Scopus, and Web of Science were searched from database inception to 31 May 2026. Controlled intervention studies comparing vitamin D supplementation with control conditions were eligible. Standardized mean differences were calculated as Hedges’ g and pooled using random-effects meta-analyses. Two reviewers independently extracted data and assessed risk of bias using RoB 2 or ROBINS-I. The certainty of evidence was assessed using GRADE. The protocol was prospectively registered in PROSPERO (CRD420261430873).

    Results

    Eleven reports representing nine independent studies and 312 players were included. In RCT-only primary analyses, vitamin D supplementation was associated with higher circulating 25(OH)D concentrations (g = 1.41, 95% CI 0.90 to 1.92; I² = 58.0%). Pooled effects were not statistically significant for jump performance (g = 0.21, 95% CI −0.10 to 0.53), sprint performance (g = −0.03, 95% CI −0.40 to 0.34), aerobic capacity (g = 0.00, 95% CI −0.45 to 0.45), or muscular performance (g = 0.19, 95% CI −0.14 to 0.51). The certainty of evidence was low for circulating 25(OH)D, jump performance, and muscular performance, and very low for sprint performance and aerobic capacity.

    Conclusions

    Vitamin D supplementation was associated with increased circulating 25(OH)D concentrations, whereas current evidence is insufficient to support a consistent improvement in physical performance. Given the low to very low certainty of evidence, these findings should be interpreted cautiously. Larger, well-designed randomized controlled trials using standardized, football-relevant performance tests are warranted.



  • E-Service quality and customer satisfaction in online shopping: Implications for sustainable digital commerce

    by Mohammed AL Awadh

    The rapid growth of e-commerce has intensified competition among online retailers, making e-service quality increasingly important for building customer trust, satisfaction, and sustainable customer–platform relationships. This study examines the relationships among e-service quality, customer trust, customer satisfaction, and customer loyalty using a second-order Structural Equation Modeling (SEM) framework. The five SERVQUAL dimensions such as empathy, responsiveness, reliability, assurance, and tangibles were modeled as first-order constructs reflecting the higher-order construct of service quality. Data were collected through an online questionnaire from 402 respondents with prior online-shopping experience. Confirmatory Factor Analysis (CFA) and SEM were employed to assess the measurement and structural models. The measurement model demonstrated satisfactory reliability, convergent validity, discriminant validity, and overall model fit. The structural results showed that service quality significantly and positively influenced customer trust and customer satisfaction, while customer trust significantly enhanced satisfaction. Trust also partially mediated the relationship between service quality and satisfaction, indicating that e-service quality improves satisfaction both directly and through increased customer confidence. The SERVQUAL dimensions contributed positively to overall service quality, with responsiveness and assurance showing particularly strong contributions, while empathy exhibited a comparatively moderate contribution. In contrast, customer loyalty had no significant direct effect on trust or satisfaction, and its indirect effect on satisfaction through trust was also nonsignificant. These findings demonstrate that reliable, responsive, secure, and well-designed digital services are important for strengthening trust and satisfaction in competitive e-commerce environments. By identifying trust as a key mechanism linking multidimensional e-service quality with customer satisfaction, the study contributes to SERVQUAL and digital-commerce literature and provides implications for the economic and relational sustainability of e-commerce platforms through more resilient and durable customer relationships.

  • Tranexamic acid for anemia in women of reproductive age: A systematic review of randomized trials

    by Sima Berendes, Katharine Ker, Hilary O. D. Critchley, Raoul Mansukhani, Ian Roberts

    Objective

    The global target to halve the prevalence of anemia by 2025 has not been met. New strategies are needed. This systematic review examined the effect of tranexamic acid on anemia, menstrual health and wellbeing in women of reproductive age.

    Methods

    We searched six databases from inception to 30 August 2025 and reference lists of seven related reviews. We included randomized trials comparing the effects of tranexamic acid with placebo or standard care on uterine bleeding. Eligible participants had normal menstrual bleeding or any type of non-pregnant abnormal uterine bleeding. Outcomes included hemoglobin concentration and anemia prevalence as the primary outcome, estimated blood loss, quality of life, thromboembolic events, and other adverse events. We conducted meta-analyses and assessed risk of bias (Cochrane risk-of-bias tool for randomized trials) and the certainty of evidence.

    Results

    We included 17 trials in the review and 15 in the meta-analyses. None of the trials reported adequate data on hemoglobin concentration. For the anemia outcome, only one small trial contributed data (risk ratio 0.15, 95% confidence interval 0.01 to 2.74, very low certainty). Meta-analyses of secondary outcomes showed that tranexamic acid reduced objectively measured menstrual blood loss among women with heavy menstrual bleeding (6 trials, mean difference −47.0 milliliters, 95% confidence interval −56.6 to −37.4, I2 = 13%, moderate certainty) and in women with intrauterine devices (3 trials, mean difference −41.6 milliliters, 95% confidence interval −52.2 to −30.9, I2 = 64%, low certainty) and improved quality of life in women with heavy menstrual bleeding (2 trials, mean difference 0.5, 95% confidence interval 0.4 to 0.7, I2 = 0%, moderate certainty). The risk of nausea or vomiting was similar between groups (4 trials, risk ratio 1.0, 95% confidence interval 0.6 to 1.8, I2 = 0%, moderate certainty). Certainty of evidence for other outcomes ranged from very low to low, including for thromboembolic events, with only one event reported in the control arm of one trial.

    Conclusions

    Tranexamic acid appears to reduce menstrual blood loss, but its impact on anemia is unclear. High-quality randomized trials of TXA for menstruating women with anemia are needed.



  • Editorial Note: Early Growth Response Gene-2 (Egr-2) Regulates the Development of B and T Cells

    by The PLOS One Editors



  • Artificial intelligence (AI) adoption and Chinese art teachers’ career exploration behavior: The roles of job substitution risks, job insecurity, and organizational AI readiness

    by Jia Li, Yun Gao

    The increasing use of artificial intelligence (AI) in art education raises questions about teachers’ professional security and career development. Drawing primarily on Conservation of Resources (COR) theory and, in a complementary manner, on Career Construction Theory (CCT), this cross-sectional study examined associations among AI adoption, perceived job substitution risk, job insecurity, career exploration behavior, and organizational AI readiness. Survey data from 381 Chinese art teachers were analyzed using Mplus 7.4. AI adoption was positively associated with career exploration behavior. Statistically significant indirect associations were observed through job substitution risk, job insecurity, and their hypothesized sequential combination. Organizational AI readiness positively moderated the AI adoption–career exploration relationship: the association was stronger at higher readiness. COR theory offers a resource-threat interpretation of the indirect associations, while CCT highlights that career exploration may reflect threat-related coping, growth-oriented development, or both. The data did not separately measure these motivations or establish causal ordering. The findings provide context-specific insights into career exploration among art teachers during AI-related technological change.