Search Results (6,669)

Background/Objectives: The concurrent use of smartphones and backpacks presents notable ergonomic challenges for students and young adults. However, the influence of walking speed on this dual-task biomechanical strain remains unclear. This study investigated how walking speed, backpack load, and gender affect postural alignment and neck–shoulder muscle activity during smartphone use. Methods: Thirty healthy university students (15 males and 15 females) were assessed using a motion capture system and surface electromyography to quantify postural alignment and muscle activity. Each participant completed twelve randomized conditions comprising three backpack loads (0%, 5%, and 10% of body weight) combined with four locomotor states (standing and walking at slow, normal, and fast speeds). Outcome measures included neck flexion, upper-trunk angle, lumbosacral angle, and normalized surface electromyography of the cervical erector spinae (CES) and upper trapezius (UTZ). A three-way ANOVA was used to evaluate main and interaction effects. Results: Increasing backpack load significantly increased neck flexion and upper-trunk angle while reducing the lumbosacral angle (all p < 0.001). Muscle activity rose proportionally with load, with UTZ activation nearly doubling from 10.7% to 21.1% maximum voluntary contraction (MVC) at 10% body weight. Faster walking increased lumbar flexion and elevated CES and UTZ activation (p < 0.05), while neck and upper-trunk postures remained stable across speeds. Females maintained more upright postures but exhibited higher muscle activity than males (p < 0.01). UTZ activation frequently exceeded the 15% MVC fatigue threshold during walking with backpacks. Conclusions: Walking speed critically modulates musculoskeletal strain during concurrent smartphone use and load carriage. The combined effects of backpack load and smartphone use can elevate neck–shoulder muscle demands, with UTZ activity occasionally approaching fatigue thresholds under moderate load and faster walking. Based on the current findings, backpack loads above 5% of body weight may increase the risk of neck–shoulder strain. Additionally, reducing smartphone use during fast walking may help prevent neck–shoulder fatigue and related musculoskeletal discomfort. Full article

Background: Prostate cancer is a major public health concern in Ghana, where most cases present late and mortality remains high. Community education is essential for improving awareness and early detection. Traditional health talks are widely used, but interactive approaches such as board games have received little evaluation. Aim: To compare the effectiveness of a Social Cognitive Theory–Socioecological Model-based literacy board game (S-S-LIBOG) with a traditional health talk in improving prostate cancer knowledge, attitudes, and perceptions. Methods: A quasi-experimental, two-arm interventional study was conducted in a semi-urban Ghanaian cohort. Participants (n = 197) were allocated to either the board game arm (n = 80) or the health talk arm (n = 61) after accounting for attrition. A structured questionnaire measured knowledge, attitudes, and perceptions (KAP) before and after intervention. Statistical analyses at 5% alpha level included chi-square tests, two-proportion Z-tests, Wilcoxon signed-rank tests, and multivariate logistic regression. Results: Among participants, 29.4% were female, 64.5% male, and 6.1% other genders. Tertiary education was reported by 81.7%, secondary 9.6%, postgraduate 5.6%, and primary 3.0%. Ethnicities: Ewe 41.6%, Akan 26.9%, Northern 13.7%, Ga 6.6%, Guan 1.5%, others 9.6%. Rural dwellers: 29.9%. LIBOG improved ‘good knowledge level’ from 35.0% at baseline to 60.0% post-intervention, compared to 35.0% to 62.3% by the Health Talk (HT). S-S-LIBOG also narrowed gender, education, and lifestyle disparities in KAP, with males showing higher odds of positive attitude (OR = 4.16, p = 0.004) and perception (OR = 2.79, p = 0.047), and rural residents having increased odds of good knowledge (OR = 4.39, p = 0.041) post—its intervention. HT similarly equalized disparities, except for perception, which remained linked to education. The significant improvements in knowledge were (LIBOG: z = 2.85, p = 0.004; HT: z = 3.10, p = 0.002). Even though health talks achieved higher overall knowledge gains, no statistically significant difference in overall effectiveness was observed between the two methods (Wilcoxon W = 102.0, p = 0.107). Acceptability of the board game was high, with over 80% of participants reporting satisfaction. Conclusions: The S-S-LIBOG board game was not inferior to the traditional health talk, showing particular strengths in enhancing attitudes and perceptions. Its interactive and culturally adapted design makes it a feasible adjunct to conventional health education methods. Future studies should examine long-term impacts and application in more diverse populations. This study was retrospectively registered by the Pan African Clinical Trial Registry on 10 October 2025; with the Trial Registration number PACTR202510512711680. Full article

Background and Objectives: There is a worldwide increase in the demand for gender-affirming surgical treatments among transgender and gender-diverse (TGD) adults and adolescents. In Poland, transgender people generally lack trust in healthcare providers, which makes it more difficult for them to begin their transition process. This patient population is not well understood by many of the specialists who may potentially be involved in their care, in some way, reinforcing their concerns. The aim of this study is to present the sociodemographic characteristics of a group of female-to-male transgender patients who were admitted to a privately based plastic surgery center to undergo chest wall reconstruction. Materials and Methods: This study comprises a statistical analysis of data retrospectively obtained from the medical records of 100 patients from across the country undergoing female-to-male transition, who were operated on between 2021 and 2025 at a specialized private clinic in Poland. All individuals had already started gender-affirming medical treatment with testosterone at the time of first consultation. Results: The results show a trend toward a decreasing age at the time of the decision to undergo gender-affirming surgery. In the study group, 100% of patients were already undergoing hormone therapy. In our group of transgender individuals, we did not observe a correlation between cultural or social background, religion, and gender dysphoria. It is encouraging that more than half of the patients reported no longer needing psychiatric support, and that those who were still under specialist supervision stated that they experienced a significant improvement in their overall well-being. Conclusions: The rising demand for transgender healthcare highlights the need for studying and analyzing this group of patients in order to provide the best patient-centered care throughout the gender transition process by all specialists involved. Gender-affirming mastectomy, when combined with testosterone therapy, has a positive mental health impact on transgender individuals. Full article

Adolescents with Type 1 Diabetes Mellitus (T1DM) face a significantly increased risk of developing disordered eating behaviors (DEBs), a phenomenon that includes the deliberate omission of insulin, commonly referred to as diabulimia. The aim of this systematic review and meta-analysis was to determine the prevalence of diabulimia in adolescents with T1DM and consolidate the scientific evidence on this issue. Following PRISMA guidelines, observational studies published in English and Spanish involving adolescents aged 10 to 19 were identified through comprehensive searches in SCOPUS, LILACS, PubMed, Web of Science, and PsycINFO. After rigorous screening and eligibility assessment, 13 studies were included. Data were extracted independently, and meta-analyses were performed using random-effects models. Reported prevalence rates of DEB in T1DM varied widely among studies, ranging from 20.8% to 48%. The pooled prevalence in the final meta-analytic model was 11% (95% CI: 9–13%), with prevalence substantially higher in females (45%) than males (26%). These findings highlight not only the elevated risk of DEB and diabulimia among adolescents with T1DM but also considerable gender differences likely shaped by psychological, sociocultural, and biological factors. The lack of standardized diagnostic criteria for diabulimia remains a barrier to clinical management. Early detection and gender-sensitive preventive strategies are crucial for reducing complications and improving the quality of life in this vulnerable population. Full article

Background: Maxillofacial trauma can impair crucial functions of the stomatognathic system. Mandibular condyle fractures, in particular, often lead to temporomandibular joint (TMJ) dysfunction. Methods: This study evaluated the effectiveness of open rigid internal fixation (ORIF) in restoring TMJ function, using the Helkimo Index to compare pre- and post-operative outcomes. Results: A total of 395 patients who underwent ORIF for condylar fractures were analyzed (302 males, 93 females). TMJ function improved significantly from baseline to 6-month follow-up (p < 0.001), with a mean reduction of 2.18 grades on the Helkimo Index. Higher post-operative Helkimo grades (2–3) occurred more frequently during warm months than during cold months (p < 0.05). Low body mass index (BMI) was associated with a greater risk of post-surgical TMJ dysfunction (p < 0.001). TMJ function correlated with facial nerve recovery: patients with poorer pre-operative TMJ function showed additionally slower facial nerve recovery during the first five months after surgery. Age, gender, place of residence, injury characteristics, comorbidities, delay of surgery, duration of surgery, surgical approach, fixing material and laboratory blood tests showed no significant association with post-operative TMJ function. Residual TMJ dysfunction was observed in 3% of treated patients (Di = 3). Conclusions: ORIF, combined with appropriate post-operative physiotherapy, effectively restores TMJ function after condylar fractures—including severe injuries. Simple clinical indices such as the Helkimo Index reliably capture functional improvement. Full article

Background/Objectives: Despite progress in recognizing sexual diversity, homophobic bullying persists. This study had four objectives: (1) to identify the prevalence of homophobic bullying (victims, perpetrators, and bystanders); (2) to explore whether differences exist between victims and perpetrators as a function of sexual orientation with respect to emotional factors and psychopathological symptoms; (3) to analyze whether victims and perpetrators of homophobic bullying have sought psychological assistance significantly more often; and (4) to identify predictive variables of victimization and perpetration of homophobic bullying. Methods: The sample comprised 1558 Bolivian students aged 13 to 17 years (M = 14.64; SD = 0.96), who completed six standardized assessment instruments. Results: (1) A substantial percentage of students reported homophobic bullying behaviors. Victims: 76.6% reported experiencing homophobic behaviors, with significantly higher rates among non-heterosexual students (χ² = 7.40, p < 0.01) and no gender differences (χ² = 0.013, p > 0.05). Perpetrators: 11.8% admitted engaging in homophobic aggressive behaviors, with no differences by sexual orientation (χ² = 0.306, p > 0.05) but significantly higher rates among males (χ² = 8.49, p < 0.01). Bystanders: 51.9% reported witnessing homophobic behaviors, with significantly higher prevalence among non-heterosexual students (χ² = 7.03, p < 0.01) and females (χ² = 4.98, p < 0.05). (2) Analyses of variance showed that non-heterosexual victims scored significantly lower on emotional regulation, empathic joy, overall empathy, and happiness, and significantly higher on fear of negative social evaluation, overall social anxiety, all psychopathological symptom dimensions assessed (somatization, obsession–compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism), and the global severity index. Non-heterosexual perpetrators also displayed significantly higher scores on several psychopathological symptoms (depression, anxiety, hostility, paranoid ideation, psychoticism) and on the global severity index. Effect sizes were moderate for psychopathological symptoms and small for emotional variables. (3) Victims (OR = 1.392, 95% CI [1.04, 1.86], p = 0.024) and perpetrators (OR = 1.507, 95% CI [1.07, 2.10], p = 0.017) of homophobic bullying reported significantly higher rates of seeking psychological assistance in the past year compared to those uninvolved in bullying. (4) Hierarchical regression analyses identified significant predictors of victimization (R² = 18.6%): non-heterosexual orientation, male gender, higher somatization, paranoid ideation, fear of negative evaluation, and lower happiness. For perpetration, only being male and higher levels of phobic anxiety emerged as significant predictors in the final model, explaining 5.1% of the variance. Conclusions: The findings underscore the urgency of implementing school-based psychoeducational anti-bullying prevention programs that include activities designed to foster tolerance toward sexual diversity. Full article

The institutionalization of environmental courts enhances regional environmental enforcement efficacy, which in turn exerts intensified regulatory pressure on local pollution intensive enterprises. Empirical evidence confirms that such judicial mechanisms significantly improve the supply chain financing capacity of regulated firms through a green governance channel. This causal pathway operates via three interrelated mechanisms: increased environmental disclosure transparency, strategic recruitment of executives with environmental expertise, and systematic ESG performance upgrades. Collectively these adaptations enable polluting enterprises to achieve better supply chain financing conditions. Subgroup analysis identifies three dimensions of heterogeneous treatment effects. First, the financing enhancement effect is more pronounced among larger enterprises due to their greater resource allocation flexibility. Second, firms with gender-diverse leadership, particularly those employing female executives, demonstrate stronger responsiveness to environmental regulations. Third, enterprises operating in less technology intensive sectors benefit more substantially from compliance driven financing improvements, as their operational structures are more amenable to rapid environmental governance adjustments. Full article

Background/Objectives: Individuals who have sustained a hip fracture are at an increased risk of experiencing a recurrent fracture. The issue of recurrent fractures in post-acute settings has been scarcely studied. Our aim was to identify independent predictors associated with fracture recurrence. Methods: Data were extracted from the Clalit Health Services Research Data Sharing Platform, powered by MDClone. Chi-square and t-tests compared categorical and continuous variables between the two patient groups. Logistic regression analysis was used to identify independent predictors of recurrent fractures following hip fracture. Results: The study population comprised 40,391 Clalit Health Services insured patients aged ≥ 65 years who had sustained a hip fracture between the years 2016 and 2023; 23,027 (57%) sustained a single hip fracture during the study period; 17,364 (43%) experienced a recurrent fracture. Independent predictors of recurrent fractures included a documented diagnosis of osteoporosis at the time of the first fracture and a history of cerebrovascular disease, depression, and female gender. Conclusions: These findings underscore the multifactorial nature of recurrent fracture risk in older adults following an initial hip fracture. Proactive identification of patients with these risk factors and the implementation of targeted secondary prevention strategies may reduce the incidence of subsequent fractures. Full article

Background and Objectives: Reports of respiratory function in COVID-19 survivors are still rare, especially in children. This study aims to determine the prevalence and prognostic factors that influence long-term respiratory function in children after COVID-19. Materials and Methods: An observational analytical study with a retrospective cohort design was conducted between January and June 2024. The subjects were pediatric patients aged 5–18 years with confirmed history of COVID-19. Respiratory function was evaluated with spirometry. The analyzed prognostic factors included clinical classification of COVID-19, gender, age, comorbidities, history of ventilator support, history of hospitalization and persistent symptoms. Results: A total of 100 subjects were included in this study. The subjects were 53% female, 52% aged ≥ 12–18 years, and 76% had at least one comorbidity, the most common being obesity (27%). The majority (73%) had a history of mild COVID-19, and 78% were not hospitalized. The prevalence of impaired lung function was 47%, dominated by restrictive lung pattern. The prevalence of long COVID was 18%, with the most common symptom being fatigue (13%). The presence of persistent symptom is significantly associated with abnormal spirometry result (p = 0.03, RR 1.99; 95% CI 1.38–2.87). Undernourished status and moderate-to-severe and critical COVID-19 significantly influence long-term respiratory function with p = 0.002, aOR 5.64; CI 95% 1.89–16.85 and p = 0.006, aOR 5.18; and CI 95% 1.59–16.89, respectively. Conclusions: The prevalence of impaired lung function in children after COVID-19 was 47%. Persistent symptoms, undernourished status, and moderate-to-critical severity of COVID-19 were found to be associated with impaired long-term respiratory function in post-COVID-19 pediatric patients. Further prospective studies are needed to confirm these findings and clarify causal mechanisms. Full article

This study examines pediatric cardiomyopathies by analyzing genetic and clinical data from 55 patients (2021–2024) at Beijing Anzhen Hospital. Four subtypes were studied: dilated (DCM, 24), hypertrophic (HCM, 22), arrhythmogenic right ventricular (ARVC, 7), and restrictive (RCM, 2). Clinical data, imaging, labs, and family histories were collected, with whole-exome sequencing (WES) identifying disease-causing variants classified via ACMG guidelines. Statistical analysis revealed a median age of 11 years, a proportion of 58% male participants, and ethnic diversity (21 northern Han, 29 southern Han, 5 minorities). In the cohort, 13 cases had an LVEF below 35%. Pathogenic/likely pathogenic (P/LP) variants were found in 21.8% of the patients, and variants of uncertain significance (VUS) were present in 38.2%, with MYH7 (seven cases) and MYBPC3 (five) being the most common. The WES positivity rates varied, at 58.3% (DCM), 72.7% (HCM), and 33.3% (ARVC/RCM). DCM patients with P/LP/VUS variants showed better contractile function (Fractional Shortening: 29.0% vs. 16.5%, p = 0.008). Females in the DCM group had poorer cardiac function (lower LVEF, higher LVESd, lower cardiac output) compared to males, with more females (nine vs. three) exhibiting an LVEF < 35% (p = 0.041). No significant gender differences were observed in the HCM cases. These findings highlight genotype–phenotype correlations and underscore the need for early intervention in female DCM patients. Full article

Mining activities have led to contamination of natural resources by heavy metals (HMs). Biomagnification studies of HMs within food webs are necessary for understanding the progressive increase in metal burdens across trophic levels and their potential ecotoxicological consequences. This study examined the trophic transfer of Cd, Cu, Pb, and Zn in a tri-trophic model involving maize plants (Zea mays), their herbivore, the grasshopper Sphenarium purpurascens, and their predator, the spider Neoscona oaxacensis, under controlled conditions. Samples from all individuals were collected in Huautla, Morelos, Mexico, where three tailing deposits are present, containing approximately 780,000 tons of waste rich in HMs. We evaluated the body biomass of the grasshopper and the percentage of maize leaf material consumed with and without HMs. HM bioaccumulation in maize, grasshopper, and spider tissues was analyzed, and the enrichment process, along with gender related effects on HM bioaccumulation in females and males of S. purpurascens, was studied. The results revealed enrichment of Pb, Cd, and Cu in maize leaf tissue, except for Zn. Grasshoppers exhibited biomagnification of the same metals, except for Cd. Metal bioaccumulation resulted in a reduced biomass of female and male grasshoppers, accompanied by an increased leaf consumption compared to grasshoppers fed maize leaves without HMs. The HMs’ bioaccumulation levels differed between genders, with males recording significantly higher concentrations of Zn and Pb. The excretion of HMs in feces and their bioaccumulation in exoskeletons are two efficient metal detoxification strategies in grasshoppers. This study revealed biomagnification in the spider N. oaxacensis, confirming metal biomagnification to higher trophic levels and providing critical insight into exposure pathways, risks to wildlife and humans, and how metal pollutants may disrupt ecosystem integrity. Full article

This study examined the utilization of artificial intelligence (AI) in inquiry-based science learning among gifted and non-gifted students. The participants included 484 students (197 gifted and 287 non-gifted; 226 males and 233 females) who completed three validated questionnaire instruments: the AI-Assisted Scientific Inquiry Learning Questionnaire (AASILQ), the AI-Assisted Science Learning Questionnaire (AASLQ), and the AI Literacy Questionnaire (AILQ). Factor analyses confirmed four latent constructs in the AASILQ, two in the AASLQ, and four in the AILQ, with all scales demonstrating strong internal consistency. Group comparisons were conducted according to educational placement and gender. The results indicated significant differences regarding educational placement: gifted students reported lower levels of AI-Assisted Scientific Inquiry Learning yet demonstrated higher AI literacy and greater confidence in the safe use of AI. Gender analyses revealed that female students expressed heightened concern regarding privacy issues. These findings extend the literature on AI integration in science education by highlighting nuanced differences in how gifted and non-gifted learners engage with AI, thereby offering implications for the design of equitable and responsive AI-supported learning environments. Full article

Background/Objectives: Hepatitis B virus (HBV) remains a significant diagnostic and public health challenge worldwide. Despite widespread vaccination, underdiagnosis persists among adults in Saudi Arabia. This study estimated HBV prevalence and identified sociodemographic, clinical, and behavioral predictors relevant to improving targeted diagnostic screening. Methods: A cross-sectional study of 1196 Saudi adults aged ≥18 years was conducted between September 2024 and February 2025 using a structured questionnaire. Data on demographics, clinical history, and behavioral exposures were analyzed using chi-square tests and multivariate logistic regression to identify independent determinants of HBV infection. Results: The study included 1196 adults (60.0% female, mean age 31 ± 12 years). HBV prevalence was 2.0% (95% CI: 1.3–3.0%). Independent predictors included divorced/widowed marital status (OR = 3.99, p = 0.023), diabetes mellitus (OR = 3.59, p = 0.039), family history of HBV (OR = 2.55, p < 0.001), and massage exposure (OR = 3.99, p = 0.025). No significant associations were found with gender, education, or transfusion history. Conclusions: HBV infection persists among high-risk Saudi adults despite immunization success. Integrating HBV testing into diabetes care, premarital and household screening, and regulation of personal care services may enhance early diagnosis and advance national elimination goals. Full article

Digital sexual harassment (DSH) perpetration among youth is a concerning issue that requires further research attention. This study examined the prevalence of DSH perpetration according to gender, age, sexual orientation, and relationship status, and explored risk factors (hostile sexism, benevolent sexism, and moral disengagement) and protective factors (online ethical values). A total of 1098 Spanish adolescents and young adults aged 13–23 years (Mage = 16.07, SDage = 2.38) completed a self-report survey. Descriptive, correlational, and binomial regression analyses were conducted. Results showed that 13.4% of participants engaged in DSH in the past 12 months. Male participants reported more than twice the rates observed among female participants (21.1% vs. 7.9%), and adolescents reported higher prevalence than young adults, whereas no differences emerged for sexual orientation or relationship status. Regression analyses indicated that benevolent sexism was a consistent predictor, while gender moderated the effects of hostile sexism and moral disengagement. Hostile sexism predicted perpetration only among female participants and predicted moral disengagement only among male participants. Importantly, online ethical values emerged as a novel protective factor, substantially reducing the likelihood of perpetration and buffering, though not eliminating, the risks associated with high moral disengagement. These findings provide evidence for prevention strategies and underscore the role of ethical values in addressing gendered forms of online violence. Full article

Within the structure of organised criminal groups (OCGs), women were traditionally relegated to peripheral and support roles (e.g., mothers and partners), with men primarily engaged in serious forms of criminality. However, more recent research has highlighted the varied roles women occupy within OCGs, including as traffickers, recruiters, and strategic advisors. Within this growing field of research, the present study sought to explore the role of female offenders in OCGs within Australia through a gynocentric and intersectional lens. Drawing on a content analysis of 84 court judgement transcripts involving convicted female offenders between 2010 and 2024, this study centres women’s experiences within OCGs. The findings reveal that women occupy a spectrum of roles across a range of offences such as drug trafficking, money laundering, and fraud. Many offenders had histories of trauma, mental illness, and economic precarity, reflecting structural inequalities that shape pathways into criminality. The findings provide a preliminary understanding of female involvement within OCGs in Australia, including relational, survival-based, professional, entrepreneurial, and subordinate offenders. This study affirms the need for a gender-sensitive criminological framework that accounts for agency, coercion, and structural constraint. By focusing on the experience of women, the study contributes to a growing body of literature seeking to highlight the complexity and centrality of women’s roles within OCGs, while providing the groundwork for future studies. Full article