Search Results (2,051)

Background: This study was a cross-sectional online survey aimed at examining health-related quality of life and the effect of different symptoms and lifestyle factors on health-related quality of life in a sample of women with endometriosis in Hungary. Methodology: A cross-sectional online survey was carried out in a sample of women with endometriosis. Self-edited and Hungarian versions of validated questionnaires were used to assess health-related quality of life (Sf-36-Health Survey—SF-36), pain (Numeric Rating Scale-NRS), effect of pelvic pain on everyday life (Pelvic Pain Impact Questionnaire—PPIQ), perceived stress levels (Perceived Stress Scale—PSS), and physical activity (Global Physical Activity Questionnaire—GPAQ). Data analysis was conducted using IBM SPSS Statistics 28.0, and the level of significance was set at p < 0.05. Multivariate linear regression analysis was performed to examine the effect of different lifestyle factors, pain-related, and physical symptoms on the participants’ health-related quality of life (HrQoL). Results: The health-related quality of life of Hungarian women with endometriosis in our sample was significantly lower than the latest Hungarian normative values. Multiple linear regression analyses revealed that psychological, pain-related, and lifestyle factors significantly predicted HrQoL across SF-36 subscales in women with endometriosis (all models, p < 0.001; Adjusted R² = 0.274–0.654). Pain self-efficacy (PSEQ) was a consistent positive predictor that was significantly associated with better scores in five SF-36 domains, including physical and social functioning. Perceived stress (PSS) is a strong negative predictor that particularly affects emotional well-being, energy/fatigue, and social functioning. Pain interference (PPIQ) was linked to poorer HrQoL in seven out of eight SF-36 domains, while average pain intensity (NRS) negatively predicted Physical Functioning and General Health. Vigorous physical activity was positively associated with Social Functioning, whereas moderate activity had no significant effect. Among the demographic factors, only age was negatively associated with Physical Functioning; BMI and education were not significant predictors. Conclusions: Psychological, lifestyle, and symptom-related factors play key roles in health-related quality of life among women with endometriosis. Self-efficacy was a strong positive predictor, whereas perceived stress and pain interference were linked to poorer outcomes. High-intensity physical activity supported better social functioning. These findings highlight the need for multidisciplinary interventions targeting psychological support, pain management, and physical activity to improve quality of life in this population. Full article

Natural latex harvest is pushing the boundaries of unmanned agricultural production in rubber milk collection via integrated robots in hilly and mountainous regions, such as the fixed and mobile tapping robots widely deployed in forests. As there are bad working conditions and complex natural environments surrounding rubber trees, the real-time and precision assessment of rubber milk yield status has emerged as a key requirement for improving the efficiency and autonomous management of these kinds of large-scale automatic tapping robots. However, traditional manual rubber milk yield status detection methods are limited in their ability to operate effectively under conditions involving complex terrain, dense forest backgrounds, irregular surface geometries of rubber milk, and the frequent occlusion of rubber milk bowls (RMBs) by vegetation. To address this issue, this study presents an unmanned aerial vehicle (UAV) imagery rubber milk yield state detection method, termed YOLOv8n-RMB, in unstructured field environments instead of manual watching. The proposed method improved the original YOLOv8n by integrating structural enhancements across the backbone, neck, and head components of the network. First, a receptive field attention convolution (RFACONV) module is embedded within the backbone to improve the model’s ability to extract target-relevant features in visually complex environments. Second, within the neck structure, a bidirectional feature pyramid network (BiFPN) is applied to strengthen the fusion of features across multiple spatial scales. Third, in the head, a content-aware dynamic upsampling module of DySample is adopted to enhance the reconstruction of spatial details and the preservation of object boundaries. Finally, the detection framework is integrated with the BoT-SORT tracking algorithm to achieve continuous multi-object association and dynamic state monitoring based on the filling status of RMBs. Experimental evaluation shows that the proposed YOLOv8n-RMB model achieves an AP@0.5 of 94.9%, an AP@0.5:0.95 of 89.7%, a precision of 91.3%, and a recall of 91.9%. Moreover, the performance improves by 2.7%, 2.9%, 3.9%, and 9.7%, compared with the original YOLOv8n. Plus, the total number of parameters is kept within 3.0 million, and the computational cost is limited to 8.3 GFLOPs. This model meets the requirements of yield assessment tasks by conducting computations in resource-limited environments for both fixed and mobile tapping robots in rubber plantations. Full article

Breast cancer remains a leading cause of global cancer burden, with marked differences in incidence across countries. While biological risk factors are well established, understanding the broader structural and sociocultural influences has been less comprehensive. In this study, we analyzed harmonized data from 183 countries (2017–2023), encompassing 33 variables and 7 subvariables related to demographics, nutrition, environment, health, and healthcare access, drawn from open-access international databases. Spearman correlation analysis identified strong positive associations between breast cancer incidence and discontinued breastfeeding, high LDL cholesterol, out-of-pocket healthcare expenditure, and educational attainment. Conversely, poor sanitation, lack of handwashing facilities, unsafe water, and certain nutritional deficiencies exhibited robust negative correlations, likely reflecting under detection and reporting limitations in lower-resource settings rather than true protective effects. These findings were further explored using multiple linear regression, which explained approximately 73% of the variance in global breast cancer incidence. The final model highlighted discontinued breastfeeding, prevalence of cocaine use, unsafe sanitation, high out-of-pocket healthcare expenditure, limited handwashing access, and high processed meat consumption as the most influential independent predictors. Receiver operating characteristic (ROC) analysis confirmed strong predictive value for discontinued breastfeeding and out-of-pocket expenditure, with sanitation and hygiene variables showing paradoxical inverse associations. Our results emphasize that breast cancer risk is shaped not only by individual behaviors and genetics, but also by larger-scale structural, socioeconomic, and environmental factors. These patterns suggest that targeted interventions addressing both lifestyle behaviors and systemic inequities—such as promoting breastfeeding, reducing financial barriers to healthcare, and strengthening public health infrastructure—could meaningfully reduce the global burden of breast cancer. In conclusion, this study underscores the importance of multisectoral, equity-focused prevention strategies. It also highlights the value of country-level ecological analyses in uncovering upstream determinants of cancer incidence and calls for further research to disentangle individual and contextual effects in cancer epidemiology. Full article

Background: Physical conditioning is essential to meet the operational demands of military environments. However, high-intensity exercise provokes muscle microinjuries resulting in exercise-induced muscle damage. This condition is typically monitored using serum biomarkers such as creatine kinase (CK), myoglobin (MYO), and lactate dehydrogenase (LDH). Nevertheless, individual variability and genetic factors complicate the interpretation. In this context, the rs1815739 variant (ACTN3), the most common variant related to exercise phenotypes, hypothetically could interfere with the muscle physiological response. This study aimed to evaluate the kinetics of serum biomarkers during a high-intensity activity and their potential association with rs1815739 polymorphism. Materials and Methods: 32 male cadets were selected during the Army Paratrooper Course. Serum was obtained at six distinct moments while they performed regular course tests and recovery time. Borg scale was assessed in 2 moments (~11 and ~17). Results: Serum levels of CK, CK-MB, MYO, and LDH significantly increase after exercise, proportionally to Borg’s level, following the applicability of longitudinal studies to understand biomarker levels in response to exercise. R allele carriers (ACTN3) were only slightly associated with greater levels of MYO and CK, mainly in relative kinetic levels, and especially at moments of greater physical demand/recovery. Although the ACTN3 was slightly related to different biomarker levels in our investigation, the success or healthiness in military activities is multifactorial and does not depend only on interindividual variability or physical capacity. Conclusions: Monitoring biomarkers and multiple genomic regions can generate more efficient exercise-related phenotype interventions. Full article

Background/Objectives: Patients with pancreatic neuroendocrine tumors (PanNETs) often have a good prognosis with long overall survival. We evaluated quality of life (QoL) after surgery for PanNETs, using the new EORTC-specific questionnaires. Methods: PanNET patients operated on in our unit (1990–2023) received three EORTC questionnaires (QLQ-C30 and the new P.NET15 and P.NET19). We evaluated the following: (1) QLQ-C30 outcomes; (2) mixed domains from QLQ-C30, P.NET15, and P.NET19; and (3) domains from P.NET19 and P.NET15 only. Functional and symptom scales were investigated in relationship with clinical variables. Gamma regression and multivariable analyses were performed with R software. Results: The 100 patients enrolled (median time 133 months after surgery) showed a good QoL (median 83.3/100). Old age was related to worse QoL and physical functioning (p = 0.007 and p < 0.001, respectively). Diabetes negatively influenced QoL (p < 0.001), physical functioning (p = 0.005), and fatigue (p = 0.03). Patients undergoing parenchyma-sparing surgery showed less fatigue (p = 0.046), while non-insulinoma PanNET diagnosis was related to worse QoL (p = 0.039). Multiple comorbidities were negatively associated with physical functioning (p = 0.010), fatigue (p = 0.001), and pain (p = 0.021). According to the new questionnaires, the most affected outcome was muscle energy, depending on age (p = 0.042), diabetes (p = 0.014), type of surgery (p = 0.018), and non-insulinoma diagnosis (p = 0.007). Conclusions: A good QoL evaluated with EORTC questionnaires is reported in PanNET patients after surgery. Elderly and diabetic patients who underwent standard resection for gastrinoma/non-functioning PanNETs showed worse QoL outcomes. Full article

Background: The acquisition of adaptive skills is critical for independence and participation in activities of daily living (ADL). While caregiver perceptions provide valuable insights, most studies on autistic participation have focused on older children and relied on one-time clinic-based assessments. As a result, little is known about how autistic toddlers function in their natural environments across time. Ecological momentary assessment (EMA) is a real-time, context-sensitive method in which parents can report behaviors at multiple time points in the child’s natural environment. This pilot study aimed to examine ADL independence in autistic toddlers compared to their typically developing (TD) peers, to assess the feasibility of using EMA in early childhood, and to compare EMA-based assessments with a one-time standardized report. Methods: 23 autistic toddlers and 28 TD toddlers (aged 18–40 months) participated in the study. Parents completed a one-time report on the self-care scales of the Pediatric Evaluation of Disability Inventory (PEDI) and the Functional Independence Measure for Children (WeeFIM) and then rated their child’s independence on the WeeFIM twice a day for two weeks via their smartphones. Results: EMA was feasible with high response rates (ASD: 91.1%, TD: 88.55%). Autistic toddlers showed different participation profiles, with less independent performance in ADL compared to TD peers. In the autism group, the average EMA scores (M = 16.53, SD = 6.58) were significantly higher than the one-time WeeFIM scores (M = 13.74, SD = 5.23), t (22) = 3.23, p < 0.01, suggesting underreporting in single-time assessments. In contrast, no such difference was found in the TD group. Significant positive correlations were found between the EMA mean and the one-time WeeFIM scores in both groups (r > 0.80), indicating convergent validity. In the autism group only, greater variability in EMA was moderately associated with higher functional independence (r = 0.46, p < 0.01). Conclusions: These findings indicate that autistic toddlers demonstrated higher levels of participation in their natural environment than reflected by the one-time assessment, emphasizing the limitations of single-time-point evaluations. This underscores the importance of collecting data across multiple time points to accurately assess adaptive functioning and ADL participation. The EMA technique demonstrated in this study provides exploratory evidence of feasibility as an ecologically valid approach to assessing functional independence in autistic toddlers, offering a richer and more context-sensitive alternative to traditional one-time clinical assessments. Full article

In recent years, the convenience and potential for information extraction offered by Remote Sensing Image–Text Retrieval (RSITR) have made it a significant focus of research in remote sensing (RS) knowledge services. Current mainstream methods for RSITR generally align fused image features at multiple scales with textual features, primarily focusing on the local information of RS images while neglecting potential semantic information. This results in insufficient alignment in the cross-modal semantic space. To overcome this limitation, we propose a Multi-Scale Semantic-Aware Remote Sensing Image–Text Retrieval method (MSSA). This method introduces Progressive Spatial Channel Joint Attention (PSCJA), which enhances the expressive capability of multi-scale image features through Window-Region-Global Progressive Attention (WRGPA) and Segmented Channel Attention (SCA). Additionally, the Image-Guided Text Attention (IGTA) mechanism dynamically adjust textual attention weights based on visual context. Furthermore, the Cross-Modal Semantic Extraction Module (CMSE) incorporated learnable semantic tokens at each scale, enabling attention interaction between multi-scale features of different modalities and the capturing of hierarchical semantic associations. This multi-scale semantic-guided retrieval method ensures cross-modal semantic consistency, significantly improving the accuracy of cross-modal retrieval in RS. MSSA demonstrates superior retrieval accuracy in experiments across three baseline datasets, achieving a new state-of-the-art performance. Full article

Osteoarthritis involves complex interactions between articular joint tissues and the immune system, which is implicated in molecular trafficking via barrier-function modulating cytokines. The current study aims to test effects of an acute spike in TNF-α or TGF-β on vascular barrier function at multiple length scales, from the heart to tissue compartments of the knee, and cellular inhabitants of those respective compartments, in a spontaneous guinea pig model of osteoarthritis. First we quantified the intensity of a fluorescent-tagged 70 kDa tracer, similar in size to albumin, the most prevalent transporter protein in the blood, in tissue compartments of bone (periosteum, marrow space, compact bone, and epiphyseal bone) and cartilage (superficial cartilage, calcified cartilage, and the interface between, i.e., the epiphyseal line), as well as at sites of tendon attachment to bone (entheses). We then examined tracer presence and intensity in the respective pericellular and extracellular matrix zones of bone and cartilage. Acute exposure to TGF-β reduced barrier function (increased permeability) at nearest vascular interfaces in four of eight tissue compartments studied, compared to TNF-α where one of eight tissue compartments showed significant diminishment in barrier function. The increase in permeability associated with reduced barrier function was observed at both tissue compartment and cellular length scales. The observation of pericellular transport of the albumin-sized molecules to osteocytes contrasts with previous observations of barrier function in healthy, untreated animals and is indicative of increased molecular transport in pericellular regions of musculoskeletal tissues in cytokine-treated animals. Understanding age- and disease-related changes in molecular transport within musculoskeletal structures, such as the knee joint, is crucial for elucidating the etiology and pathogenesis of osteoarthritis. Full article

Background: Adolescents with obesity participate in self-directed weight loss attempts, and these may be associated with disordered eating. This study aimed to understand prior engagement with a dietitian and previous dieting practices of adolescents presenting for obesity treatment. Additionally, we aimed to understand the association between prior dieting and eating disorder risk, binge eating, weight bias internalisation and body image. Methods: This cross-sectional study included 141 adolescents (median [IQR] age: 14.8 [13.8–15.7] years) with BMI 35.28 (31.99–38.57) kg/m² and ≥1 related complication presenting for a prescriptive dietary intervention. Adolescents were asked whether they had previously seen a dietitian (yes/no) and/or previously trialled any other diets for weight management. Associations between reported diets and the Eating Disorder Examination Questionnaire (EDE-Q), the Binge Eating Scale, the Weight Bias Internalisation scale and Body Appreciation Scale scores were assessed using multiple one-way ANOVAs. Results: A total of 68 (48.2%) adolescents had previously seen a dietitian and 106 (75.2%) had trialled at least one diet. Most adolescents had used one diet type (n = 74; 52.5%), and 29 (20.6%) had used two or three different diets. Most adolescents reported following a healthy eating pattern (n = 76; 53.9%), with 11 trying a low-carbohydrate diet (7.8%) or a specific eating plan, e.g., low sugar, vegetarian (n = 11; 7.8%). There were no associations between dieting attempts and scores of measures of disordered eating, weight bias or body appreciation. Conclusions: Many adolescents presenting for obesity treatment will have trialled diets, with or without the support of a dietitian. Clinicians providing nutrition education and prescribing dietary interventions should be aware of this and the potential influence on adolescent perceptions of dieting practices. Full article

Food and water security are essential components for Panama’s advancement toward the Sustainable Development Goals. This study aimed to quantify the prevalence of household food insecurity and water insecurity, and to explore the association between them using standardized measurement tools. A cross-sectional survey was conducted between January and June 2024 using an online questionnaire administered via Google Forms. The survey collected sociodemographic data and applied the Food Insecurity Experience Scale (FIES) and the Household Water Insecurity Experiences (HWISE) scale to assess water and food insecurity, respectively. A total of 222 adult household heads were included (66.2% female), with a median age of 31.4 years. The prevalence of moderate and severe food insecurity was 29.7% (95% CI: 24.8–34.6%) and 6.1% severe food insecurity (95% CI: 3.7–8.4%), while water insecurity affected 27% of households (10.4% high; 16.7% moderate). Multiple linear regression showed that moderate to severe food insecurity was significantly associated with water insecurity (β = 0.19; 95% CI: 0.08–0.31) and lower income levels. Specifically, food insecurity was associated with households reporting no income (β = 0.25; 95% CI: 0.05–0.44) and those with monthly income between 501 and 1000 USD (β = 0.11; 95% CI: 0.01–0.22), compared to households with income above 1000 USD. The results suggest that food insecurity is significantly associated with water insecurity, supporting the need for integrated approaches in public policy to address basic resource access in vulnerable populations. Full article

Objective: Suicide is a major public health problem with multiple biological and psychosocial determinants. Although the kynurenine/tryptophan (KYN/TRP) pathway has been implicated in the neurobiology of suicidal behavior, clinical findings remain inconsistent. This study aimed to evaluate serum tryptophan, kynurenine, and the KYN/TRP ratio in patients presenting to the emergency department after a suicide attempt and to examine their association with suicide risk. Methods: This prospective, cross-sectional, and comparative study was conducted between November 2024 and June 2025 in the Emergency Department of Konya City Hospital. A total of 120 participants were enrolled, including 60 suicide attempt cases and 60 healthy controls. Serum tryptophan and kynurenine levels were measured using the ELISA method, and the KYN/TRP ratio was calculated in molar units. The Beck Suicide Intent Scale (SIS) was administered to the case group. Group comparisons and correlation analyses were performed using appropriate statistical tests, and effect sizes with 95% confidence intervals were reported. Results: Compared with controls, patients showed significantly lower levels of tryptophan (median 35.4 vs. 54.4; p = 0.002), kynurenine (median 1534.5 vs. 2384.0; p < 0.001), and the KYN/TRP ratio (40.9 ± 16.2 vs. 48.8 ± 20.8; p = 0.02). No significant correlations were found between SIS scores and tryptophan (p = 0.180), kynurenine (p = 0.668), or the KYN/TRP ratio (p = 0.246). Subgroup analyses based on psychiatric history or psychiatric consultation recommendations also revealed no significant differences. Conclusions: Serum tryptophan, kynurenine, and the KYN/TRP ratio were significantly reduced in patients with suicide attempts compared to healthy controls. However, these biochemical parameters were not associated with SIS scores. Our findings suggest that tryptophan, kynurenine, and the KYN/TRP ratio may serve as complementary biomarkers but cannot replace clinical and psychometric assessments. Larger, multicenter, and longitudinal studies are needed to clarify their potential clinical value. Full article

Low-level wind shear (LLWS) is a critical issue in aviation meteorology, posing serious risks to flight safety—especially at plateau airports with high elevation and complex terrain. This study investigates a convective wind shear event at Xining Airport on 29 May 2021. Multi-source observations—including the Doppler Wind Lidar (DWL), the Doppler weather radar (DWR), reanalysis datasets, and automated weather observation systems (AWOS)—were integrated to examine the event’s fine-scale structure and temporal evolution. High-resolution simulations were conducted using the Large Eddy Simulation (LES) framework within the Weather Research and Forecasting (WRF) model. Results indicate that the formation of this wind shear was jointly triggered by convective downdrafts and the gust front. A northwesterly flow with peak wind speeds of 18 m/s intruded eastward across the runway, generating multiple radial velocity couplets on the eastern side, closely associated with mesoscale convergence and divergence. A vertical shear layer developed around 700 m above ground level, and the critical wind shear during aircraft go-around was linked to two convergence zones east of the runway. The event lasted about 30 min, producing abrupt changes in wind direction and vertical velocity, potentially causing flight path deviation and landing offset. Analysis of horizontal, vertical, and glide-path wind fields reveals the spatiotemporal evolution of the wind shear and its impact on aviation safety. The WRF-LES accurately captured key features such as wind shifts, speed surges, and vertical disturbances, with strong agreement to observations. The integration of multi-source observations with WRF-LES improves the accuracy and timeliness of wind shear detection and warning, providing valuable scientific support for enhancing safety at plateau airports. Full article

Background/Objectives: Correct inhalation technique (IT) is crucial in the management of airway obstructive diseases. However, inhaler misuse among patients is frequent. The aim of the study was to assess IT and analyze factors influencing inhalation errors in adults with asthma and COPD. Methods: This single-center case–control study involved 180 adults with asthma or COPD. IT was evaluated using a checklist of common errors, a four-grade dedicated scale, and peak inspiratory flow. Patients with correct and incorrect IT were compared across multiple factors, including demographics, disease duration and severity, motivation for treatment, spirometry results, cognitive function, visual or hearing disorders and prior training in inhaler use. Results: A total of 115 patients with asthma and 65 patients with COPD were analyzed. Among them, only 59 patients (32.8%) were treated with 1 inhaler. Sixty-eight patients (37.8%) used all their inhalers properly. Correct IT was observed more frequently among DPI compared to MDI users (p < 0.001). Only 76 patients (42.2%) reported previous training in IT. No differences were found between correct and incorrect inhaler users (MDI or DPI) regarding age, gender, education, treatment motivation, visual or hearing impairments or cognitive disorders. Among MDI users, those with correct IT more often read the drug leaflet (p = 0.015). Among DPI users, proper technique was associated with better self-assessment (p = 0.046) and a higher rate of prior inhalation training (p = 0.001). Conclusions: Most adults with asthma or COPD do not use their inhalers properly, particularly patients using MDI. Insufficient education in the field of proper IT is still a burning issue. Full article

Background: Poor adherence to antihypertensive therapy is a major barrier to effective blood pressure control, particularly in countries with a high burden of non-communicable diseases. In Kazakhstan, improving adherence is a key objective of the “Densaulyk” State Health Program (2020–2025). Objective: To assess medication adherence among patients with arterial hypertension in Kazakhstan and identify associated socio-demographic and clinical factors. Methods: A cross-sectional survey was conducted among outpatient hypertensive patients at a major urban medical center. Adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8). Socio-demographic characteristics, disease duration, and the number of prescribed medications were analyzed in relation to adherence levels. Results: Adherence was significantly associated with age, ethnicity, education, marital and financial status, disease duration, and treatment complexity. A notable share of participants demonstrated low to moderate adherence. The use of self-reported data may have introduced bias. Conclusions: Medication adherence in Kazakhstan is influenced by multiple interrelated factors. Targeted and culturally appropriate interventions—such as simplified regimens, digital tools, and broader access to subsidized drugs—are essential to improve long-term outcomes in hypertension management. Full article

Autoimmune diseases are characterized by immune response dysregulation against self-components, leading to chronic inflammation and tissue damage. Vitamin C (VitC), a water-soluble vitamin with established functions in antioxidant defence and collagen synthesis, has also been of interest based on its potential immunomodulatory effects. This review discusses the role of VitC in the course and progression of (A) autoimmune diseases (multiple sclerosis, rheumatoid arthritis, Sjögren’s disease, type 1 diabetes, Hashimoto’s thyroiditis, pernicious anaemia, antiphospholipid syndrome), (B) other immune-mediated diseases (Crohn’s disease, periodontitis), and (C) Alzheimer’s disease, a neurodegenerative disorder with autoimmune features. Results from clinical, observational, and experimental trials show that VitC deficiency is common in many of these diseases and may contribute to increased oxidative stress and immune disequilibrium. Supplementation has been associated with improved antioxidant levels, control of inflammatory mediators, and, in some cases, clinical outcomes like disease activity decrease or symptom load. Although findings vary across conditions and few large, randomized trials are available, the overall evidence indicates that maintaining good VitC status can be useful in maintaining immune homeostasis and reducing inflammation. VitC should be viewed as an adjunct to be employed safely, perhaps and ideally within larger treatment regimens, but not in place of effective therapies. Further research, including large-scale clinical trials, will be required to determine more clearly optimal dosing, timing of treatment, and patient population most likely to benefit. By integration of current knowledge, this review recognizes both promise in VitC for treatment of autoimmune/immune-mediated disease and promise in its potential use within future treatment regimens. Full article