Search Results (11,652)

This study examines the relationship between attitudes toward artificial intelligence (AI) and AI dependency among Ecuadorian university students. A cross-sectional design was used, applying two validated instruments: the Artificial Intelligence Dependence Scale (DAI) and the General Attitudes Toward Artificial Intelligence Scale (GAAIS), with a sample of 540 students. Structural equation modeling (SEM) assessed how both positive and negative attitudes predict dependency levels. Results indicate a moderate level of AI dependency and an ambivalent attitudinal profile. Both attitudinal dimensions significantly predicted dependency, suggesting dual-use behaviors shaped by perceived utility and ethical concerns. Urban students reported higher dependency and greater sensitivity to AI-related risks, highlighting digital inequalities. Although the SEM model showed adequate comparative fit (CFI = 0.976; TLI = 0.973), residual indicators (RMSEA = 0.075) suggest further refinement is needed. This study contributes to underexplored Latin American contexts and emphasizes the need for equity-driven digital literacy strategies in higher education. Findings support pedagogical frameworks promoting critical thinking, ethical reasoning, and responsible AI use. The study aligns with Sustainable Development Goals 4 (Quality Education) and 10 (Reduced Inequalities), reinforcing the importance of inclusive, learner-centered approaches to AI integration. Full article

Metallic nanolaminates generally show ultra-high strength but low ductility due to their vulnerability to shear instability during deformation. Herein, we report the simultaneous enhancement in hardness (by 11.9%) and suppression of shear instability in a 10 nm Cu/Zr nanolaminate, achieved by introducing a nanoscale Cu₆₃Zr₃₇ amorphous interfacial layer (AIL) between the crystalline Cu and Zr layers via magnetron sputtering. The effect of AIL and its thickness (h) (h = 2, 5, and 10 nm) on the hardness and shear instability behavior was explored using nano- and micro-indentation tests. An abnormal increase in hardness occurs at h = 2 nm when h is decreased from 10 to 2 nm, deviating from the prediction of the rule of mixtures. This abnormal strengthening is attributed to thinner AIL, which induces an increased density of crystalline/amorphous interfaces, thereby generating a pronounced interface strengthening effect. The micro-indentation results show that shear banding was suppressed in the nanolaminate with AIL, as evidenced by fewer shear bands as compared to its homogeneous counterpart. This enhanced resistance to shear instability may originate from the crystalline/amorphous interface that provides more sites for dislocation nucleation, emission, and annihilation. Furthermore, two distinct shear banding modes were observed in the nanolaminate with AIL; i.e., a cutting-like shear banding emerged at h = 10 nm, whereas a kinking-like shear banding occurred at h = 2 nm. The potential mechanism of the AIL-thickness-dependent shear banding was analyzed based on the crack propagation model of the Griffith criterion. This study provides a comprehensive insight into the strengthening and tunable shear instability of super-nano metallic laminates by AIL. Full article

Background/Objectives: Hispanics living in the United States have higher rates of diagnosis and mortality from certain kinds of cancers, including human papillomavirus (HPV)-related cancers. HPV vaccines can prevent 90% of HPV-associated cancers. Methods: The purpose of this study was to recruit a sample of Hispanic parents to investigate trusted sources of HPV vaccine information. An online survey was used to collect data from Hispanic parents who reported having children between the ages of 11 and 17. Results: Parents of children 11–17 years of age (n = 203, M_age = (38, SD = 6.97; female 85.1%) were included. The top five trusted sources of HPV vaccine information were medical doctors (95.1%), registered nurses (54.2%), the CDC (47.8%), the WHO (45.3%), and pharmacists (25.6%). The two least trusted sources were the president of the U.S. (7.9%) and religious leaders (3%). Hierarchical linear regression models revealed that HPV vaccine acceptance was associated with trusting registered nurses (p < 0.001) and the CDC (p = 0.026) in recommending the HPV vaccine. Importantly, the family-held belief that vaccines cause autism was strongly correlated with personal beliefs that vaccines cause autism (r = 0.58; p < 0.001). Conclusions: Findings from this study have clinical implications for the development of interventions and health communication strategies that leverage trusted sources of information including medical doctors and registered nurses to encourage preventive health behaviors. Additionally, our findings support that pharmacists should be included in these interventions as they are often an underused resource and are trusted by their patients for vaccine information. Full article

Little is known about the effectiveness of caregiver-mediated naturalistic developmental behavioral interventions (NDBIs) implemented via telehealth for autistic children served in under-resourced settings. This mixed methods pilot study examined social communication outcomes for autistic children whose families received a caregiver-mediated NDBI in a community mental health setting. Twenty-one families of Medicaid-enrolled autistic children aged 2–6 received Project ImPACT (a caregiver-mediated NDBI) via telehealth. Caregivers completed the Autism Impact Measure at 5 timepoints. We fit three, 2-level multilevel models to estimate the effect of time (weeks of Project ImPACT), child age (mean-centered), and the interaction of time x age on the Autism Impact Measure domains of Communication, Social Reciprocity, and Peer Interaction. Six caregivers completed follow-up interviews, which were analyzed using the framework method. There were statistically significant decreases in caregiver-reported peer interaction challenges. Decreases in communication challenges approached statistical significance. Scores for social reciprocity challenges did not significantly change over time. Six qualitative themes centered around how the child- and family-centered aspects of the NDBI strategies led to improvements in the children’s social communication outcomes and suggestions for improving Project ImPACT. Preliminary findings suggest that NDBIs may be feasible and potentially effective in under-resourced settings. Full article

Background/Objectives: Food selectivity is a prevalent and challenging issue in childhood, particularly in children with autism spectrum disorder (ASD), which may result in restricted dietary patterns and nutrient deficiencies. This study aimed to identify high-risk subgroups of children by combining food selectivity, diet, BMI, gastrointestinal symptoms, sensory processing, and parental feeding practices in children with ASD and in typically developing children (TDC). Methods: To achieve this aim, we ran a cross-sectional, survey-based study, including 408 children (aged 3 to 12.11 years), with gender-matched groups. Both parents completed a survey on children’s diet, anthropometric curves, gastrointestinal symptoms, and the Brief Autism Mealtime Behavior Inventory (BAMBI), Short Sensory Profile (SSP), and Caregiver’s Feeding Style Questionnaire (CFSQ). Data analysis included comparative tests, correlations, and k-means cluster analysis. Results: Children with ASD exhibited significantly greater sensory processing difficulties, higher food refusal, limited food variety in the diet, and autism-related mealtime characteristics compared with TDC across all age groups. Caregivers of children with ASD reported higher controlling and contingency management feeding practices compared to the parents of the TDC. We found a strong correlation between sensory sensitivities and feeding issues. Notably, Body Mass Index (BMI) was not significantly associated with dietary restriction or gastrointestinal symptoms. Cluster analysis revealed a high-risk sub-phenotype in both groups of children with some differences, characterized by high food selectivity, taste, tactile, and smell sensitivity, gastrointestinal symptoms, and overactive parental practices. Conclusions: The early identification of this subgroup might foster more tailored, multidisciplinary, and effective assessment and clinical intervention. Full article

This study updates the climatology of lake-effect (LE) snowfall over Lake Champlain by analyzing radar and surface data from nine winter seasons spanning 2015 to 2024. A filtering approach was applied to isolate periods with favorable LE conditions, and events were manually classified using criteria consistent with a previous climatology from 1997 to 2006. A total of 64 LE events were identified and compared across the two periods to evaluate potential changes associated with regional warming. Despite a substantial reduction in lake ice cover during the recent decades, no increase in LE frequency or duration was observed. Instead, warming has shifted the seasonal distribution of events, with fewer early-season cases and more late-season occurrences. LE events also exhibited shorter durations and higher minimum temperatures and dew points. These findings suggest that warming may constrain LE snowfall development over small lakes such as Champlain, in contrast to intensification trends reported for larger lake systems. The analysis also highlights a rarely documented transitional band type that migrated along the lake axis during synoptic shifts. Results underscore the value of observational climatologies for detecting emerging snowfall behaviors in response to climate variability. Full article

Background/Objectives: Leadership in physical education plays a critical role in the holistic development of students, influencing variables such as satisfaction, group cohesion, and performance. Despite the abundance of cross-sectional studies, there is a paucity of longitudinal evidence exploring the temporal stability of these perceptions in adolescent populations, which limits the current understanding of leadership development in educational settings. This longitudinal study investigates how secondary and high school students perceive and prefer different leadership styles in PE and how these relate to gender, academic level, and sport participation, grounded in the multidimensional leadership model. The analysis is further contextualized by recent research emphasizing adaptive, evidence-based pedagogical approaches in physical education, the influence of competitive environments on leadership expectations, and the role of emotional support in training contexts. Methods: Using validated questionnaires (LSS-1 and LSS-2), five dimensions were assessed: Training and Instruction, democratic behavior, autocratic behavior, Social Support, and positive feedback, considering variables such as gender, academic level, and extracurricular sport participation. Data were collected at two time points over a 12-month interval, enabling the identification of temporal patterns in students’ perceptions and preferences. Sampling procedures were clearly defined to enhance transparency and potential replicability, and the choice of a convenience sample from two private schools was justified by accessibility and continuity in longitudinal tracking. Although no a priori power analysis was conducted, the sample size (n = 370) was deemed adequate for the non-parametric analyses employed, with an estimated statistical power ≥ 0.80 for medium effect sizes (Cohen’s d = 0.3–0.5). Results: The results revealed a marked preference for leadership styles emphasizing social support and positive feedback, particularly among students engaged in sports. Statistically significant differences (p < 0.05) were identified based on gender and academic maturity, with female students favoring democratic behavior and students in the fourth year of compulsory secondary education showing a stronger inclination toward styles prioritizing emotional support. Trends toward statistical significance (p < 0.10) were also reported, following precedents in the sport psychology and sport sciences literature, as they provide potentially relevant indications for future research directions. The congruence between perceived and preferred leadership emerged as a key factor in student satisfaction, confirming that adaptive leadership enhances students’ learning experiences and overall well-being. However, this satisfaction was inferred from congruence measures, rather than directly assessed, representing a key methodological limitation. Conclusions: This study underscores the importance of physical education teachers tailoring their leadership styles to the individual and group characteristics of their students. The findings align with methodological approaches used in preference hierarchy analyses in sport contexts and support calls for individualized pedagogical strategies observed in sports medicine and training research. By providing longitudinal evidence on leadership perception stability and integrating recent cross-disciplinary findings, the study makes an original contribution to bridging the gap between educational theory and practice. The results address a gap in the literature concerning the temporal stability of leadership perceptions among adolescents, offering a theoretically grounded basis for future research and the design of pedagogical innovations in PE. Full article

Advanced Gastric Signet Ring Cell Carcinoma (SRCC) is characterized by aggressive behavior, high metastatic potential, and extremely poor prognosis. There is an urgent need for effective imaging modalities to evaluate systemic metastatic lesions and to dynamically monitor disease progression during treatment. We report a rare case of a 26-year-old female with advanced SRCC presenting with extensive systemic metastases, clinically staged as IV (cT4N3M1). High-frequency and conventional ultrasound imaging revealed metastatic lesions involving the scalp soft tissues, cervical lymph nodes, intercostal soft tissues, pancreatic-splenic hilum region, pelvic cavity, peritoneum and omentum. The ultrasonographic findings were highly consistent with contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) results. The patient received seven cycles of a modified BEMA regimen (oxaliplatin, leucovorin and 5-fluorouracil) combined with nivolumab. Serial ultrasound monitoring indicated continuous disease progression. Due to poor therapeutic response, the patient succumbed to acute obstructive renal failure caused by tumor progression seven months after diagnosis. This report provided a comprehensive ultrasonographic assessment of widespread and rare metastatic sites in advanced SRCC, a scenario seldom documented. The combination of high-frequency ultrasound and Super Microvascular Imaging (SMI) offered precise, radiation-free, and repeatable evaluation of both superficial and deep lesions, proving particularly valuable for real-time monitoring of treatment response in critically ill patients. These findings underscore the unique role of systemic ultrasound in enhancing metastatic detection and therapeutic evaluation for advanced SRCC. Full article

Background: Functional pancreatic neuroendocrine tumors (FpNETs) are extremely rare in childhood and adolescence, with an incidence of less than 0.1 per million. Since there is currently no systematic review of the literature on FpNETs in children, this study aims to summarize findings from studies focusing on clinical characteristics, diagnostics, treatment modalities, and outcomes. Methods: A systematic review was conducted following the PRISMA guidelines. A literature search was performed using three electronic databases: PubMed, Scopus, and Web of Science. An age filter was used during the search to limit results to childhood and adolescence. There was no limit set in relation to the type and the language of the article. Results: Out of 80,742 records identified, 91 studies met the inclusion criteria and were included in the review. Two studies included patients with insulinoma and gastrinomas, that is, insulinomas and glucagonoma. Of the included studies, 71 were insulinomas, 10 were gastrinomas, 3 were glucagonomas, 6 were VIPomas, and 3 were mixed FpNETs. A total of 163 children with FpNETs were analyzed, with a median age of 12 years. A total of 48 cases were reported in childhood, while 115 cases were reported in adolescence. The results indicate that FpNETs were more prevalent in males. Almost all patients presented with symptoms appropriate to the type of tumor. A significant proportion of tumors were associated with MEN1. In almost all patients, the symptomatology was accompanied by elevated levels of specific hormones. US, CT, PET-CT, MRI, and EUS were the dominant imaging modalities. Surgical approaches and types of resections, depending on the type, association with the syndrome, location, and size of the tumor, were quite heterogeneous. Grade 1 and Grade 2 tumors were nearly equally represented. There was no recurrence in most patients. Conclusions: Early suspicion based on specific clinical symptomatology is essential for timely diagnosis. Accurate localization and size based on modern radiological diagnostics, accompanied by biochemical and genetic testing, are essential for optimal management. Adequate surgical resection offers the best chance of cure, with the lowest risk of recurrence. Additional multicenter registries and studies are needed in the future to better understand tumor behavior, optimal management, and outcomes of FpNETs. Full article

Climate change poses an existential threat, spurring businesses and financial markets to integrate environmental accounting and ESG (Environmental, Social, and Governance) disclosures into decision-making. This study aims to examine how environmental accounting practices and ESG reporting contribute to climate change mitigation in organizations. It seeks to highlight the significance of these tools in enhancing transparency and accountability, thereby driving more sustainable corporate behavior. By synthesizing the recent literature, the study contributes a comprehensive overview of best practices and challenges at the intersection of accounting and climate action, addressing a noted gap in consolidated knowledge. We conducted a systematic literature review (SLR) following PRISMA guidelines. A broad search (2010–2024) across Scopus, Web of Science, and Google Scholar identified 73 records, which were rigorously screened and distilled to 47 relevant peer-reviewed studies. These studies span global contexts and include both conceptual and empirical work, providing a robust dataset for analysis. Environmental accounting was found to play a pivotal role in measuring and managing corporate carbon footprints, effectively translating climate impacts into quantifiable metrics. Firms that implement rigorous carbon accounting and internalize environmental costs tend to set more precise emission reduction targets and justify mitigation investments through a cost–benefit analysis. ESG disclosure frameworks emerged as critical external tools: a high-quality climate disclosure is linked with greater stakeholder trust and even financial benefits such as lower capital costs. Leading companies aligning reports with standards like TCFD or GRI often enjoy enhanced credibility and investor confidence. However, the review also uncovered challenges, like the lack of standardized reporting, risks of greenwashing, and disparities in adoption across regions, that impede the full effectiveness of these practices. The findings underscore that while environmental accounting and ESG reporting are powerful means to drive corporate climate action, their impact depends on improving consistency, rigor, and integration. Harmonizing global reporting standards and mandating disclosures are identified as key steps to improve data comparability. Strengthening the credibility of ESG disclosures and embedding environmental metrics into core decision-making are essential to leverage accounting as a tool for climate change mitigation. The study recommends that policymakers accelerate moves toward mandatory, standardized ESG reporting and urges organizations to proactively enhance their environmental accounting systems that will support global climate objectives and further research on actual emission outcomes. Full article

Background/Objectives: Cognitive Disengagement Syndrome (CDS) is a clinical condition primarily characterized by inattention, hypoactivity, and mind-wandering, which has not yet been recognized as an official diagnostic category. Although there are overlaps between CDS and ADHD, evidence supports the semi-independence of CDS from the ADHD-Inattentive subtype. Importantly, while the impact of ADHD on parenting styles has been studied, no previous research has investigated the potential influence of CDS difficulties on parenting behaviors. Both CDS and ADHD are associated with internalizing and externalizing symptoms, which are influenced by negative parenting styles. The severity of ADHD is known to predict the use of dysfunctional parenting patterns; however, no studies have yet investigated how CDS difficulties might affect parenting styles. Due to the similarities between CDS and ADHD, it is reasonable to hypothesize a similar relationship. This study aims to examine the potential mediating role of parenting styles—both negative and positive—in the relationship between CDS difficulties and internalizing and externalizing symptoms. Methods: The sample is composed of 369 Italian school-aged children (9.38 ± 2.34 years old). Parents reported on their children’s psychopathology, CDS difficulties, and their own parenting strategies. Results: Analyses conducted using Hayes’ PROCESS tool indicated that only negative parenting styles partially mediated the relationship between CDS difficulties and parent-reported youth anxiety, depression, and oppositional defiant disorder. Conclusions: These findings highlight the importance of interventions aimed at addressing both CDS in children and improving parenting strategies to enhance youth psychopathological outcomes. Full article

Background/Objectives: This multicenter retrospective study aims to evaluate the role of Ablative Radiotherapy (RT) in patients with unresectable pleural mesothelioma (PM) who experienced radiological progression after at least one line of chemotherapy, with a maximum involvement of three pleural or extrapleural sites. Methods: Adult patients (≥18 years) with PM treated with stereotactic radiotherapy between 2011 and 2022, limited to a maximum of three pleural or extrapleural sites, were included in the analysis. Ablative RT was required to be administered with radical intent. Endpoints were time to further systemic therapy (TFST), local control (LC), progression-free survival (PFS), overall survival (OS), and acute and late radiotherapy-related toxicity. Results: A total of 56 patients were identified from six Italian and one Swiss radiotherapy center. Treatment was generally well tolerated. Ten patients experienced grade 1 or 2 acute toxicity, while four patients reported persistent chest pain, with one case reaching grade 3 as late toxicity. The median TFST was 18.6 months, with TFST rates of 61.7% and 46.4% at 12 and 24 months, respectively. The median OS was 37.63 months, with 1- and 2-year OS rates of 85.2% and 65.6%. Local control was favorable (79% at 1 year), but most patients experienced disease recurrence outside the SABR treatment volume. The median disease progression-free survival (DPFS) was 8.17 months, with 1- and 2-year DPFS rates of 36% and 19%, respectively. Smoking history correlated with OS and DPFS in univariate analysis, while statistical significance for OS was maintained in multivariate analysis. Additionally, nodal status and PTV volume were associated with OS. Conclusion: SABR is a safe and effective approach for the treatment of oligorecurrent/oligoprogressive PM. The time to further systemic therapy was extended up to 18 months. At two years, 10% of patients remained disease-free, and more than half were alive at three years, suggesting a potentially indolent biological behavior in oligometastatic PM. Full article

Background/Objectives: Fluoroquinolones (FQs) are broad-spectrum antibiotics associated with a constellation of severe, long-lasting adverse effects termed Fluoroquinolone-Associated Disability (FQAD), which often includes neuropsychiatric and gastrointestinal (GI) symptoms. Despite patient reports, GI dysfunction is not formally recognized within FQAD. This study aimed to establish a rodent model to investigate whether ciprofloxacin (CPX), the most commonly prescribed FQ, exposure induced long-lasting anxiety-like behavior and/or GI motility alterations. Methods: To test our hypothesis, Sprague Dawley rats were orally administered 20 mg/kg CPX, amoxicillin (AMX, antibiotic control), or saline (CTL) daily for 14 days. Anxiety-like behaviors were assessed weekly for 4 weeks post-treatment using the Elevated Plus-Maze, Marble Burying, and Open Field tests. GI transit was measured 2 weeks post-treatment via phenol red dye recovery analysis from the stomach and portions of the small intestine. Results: Our results demonstrated that CPX induced a transient, mild anxiety-like phenotype in rats, with behavioral changes largely resolving by week 4, becoming statistically indistinguishable from the CTL group. In contrast, CPX significantly accelerated GI transit, similar to the known prokinetic AMX, as evidenced by increased fractional dye recovery in the stomach and distal small intestine. This accelerated GI motility persisted weeks after CPX discontinuation. Conclusions: These findings establish a putative rodent model for FQAD, providing evidence that even small doses of CPX can induce acute, transient neuropsychiatric effects and, critically, persistent GI dysmotility. This supports the inclusion of GI dysfunction in FQAD symptomatology and highlights the need for judicious FQs prescription and comprehensive patient monitoring. Full article

Background: A health-promoting lifestyle is a concept that involves sociodemographic factors interacting with health-promoting lifestyle behaviors (HPLBs), such as exercise and nutrition, to promote health and wellbeing. Given the persistent socioeconomic disparities all over Italy, health interventions and outcomes may be less effective. Accordingly, this cross-sectional study examines the relationship among sociodemographics, HPLBs, and wellbeing in Italy, aiming to inform updated health campaigns. Methods: A Google-Form survey of twelve sociodemographic items and two validated questionnaires on HPLBs (HPLP II, twenty-six items) and wellbeing (WHO-5) was conducted. Three hundred two participants, aged 18 to 70, were recruited in Italy via social media. Descriptive and inferential statistics were performed. Statistical significance was set at p < 0.05, considering effect sizes. Results: Women reported higher health responsibilities (p < 0.05) and lower BMIs than men (p < 0.001). An improved financial status was associated with the healthy cut-off points of the WHO-5, HPLP II total score, and spiritual growth and interpersonal relationship subscales (p < 0.001), the latter correlating also with university education (p < 0.05). Better nutrition was noted in older adults, those with chronic disease, and people from Northern Italy (p < 0.05). Residing with minors and adults related to health responsibility (p < 0.05). A significant correlation (p < 0.001) was found between following HPLBs and wellbeing and among all the HPLBs. Conclusions: This study underscores the interplay among sociodemographic factors, HPLBs, and wellbeing among Italian adults. The findings advocate for education-based, inclusive health promotion strategies tailored to specific macroregions, age classes, and sexes in Italy, intending to enhance overall health and wellbeing across the country. Full article

Thiamine is a vitamin essential for the function of central metabolic enzymes, of which pyruvate dehydrogenase (PDH) possesses one of the broadest regulations. Diurnal effects of thiamine supplementation on energy metabolism have previously been shown for the rat brain. Here, we report data on the diurnal changes and the effects of thiamine administration to rats on the function of thiamine-dependent enzymes in the cerebral cortex, heart, and liver. The most pronounced diurnal differences were found at the level of cerebral PDH activity. Analysis of PDH phosphorylation in five rat tissues revealed diurnal and thiamine-dependent differences in the cerebral cortex and heart. The expression of tissue-specific PDH kinases PDK3 and PDK4 showed a daytime-dependent response to thiamine administration in the cerebral cortex and heart, respectively. In addition, cardiac PDK4 expression was doubled in the evening, compared to morning. Furthermore, cerebral cortex demonstrated tissue-specific diurnal changes in thiamine diphosphate (ThDP) and monophosphate levels. Elevation of blood, cardiac, and cerebral ThDP was more effective upon the evening thiamine administration. Importantly, only ThDP was elevated in the rat cerebral cortex exclusively after evening thiamine supplementation. Coenzyme role of ThDP and/or other thiamine functions in nerve tissue reduced the existing daytime changes in animal behavior and ECG parameters. The reported data on diurnal regulation of central energy metabolism as well as the diurnal difference in thiamine accumulation in the cerebral cortex, heart, and other tissues are of clinical importance, as high doses of thiamine are used for the treatment of acute thiamine deficiencies and many other mostly neurological diseases in patients. Full article