Search Results (923)

Innovation is widely recognised as a key driver of firm performance, yet empirical evidence from emerging economies remains limited. This study examines how different forms of innovation affect sales and employment growth among Vietnamese firms using firm-level data from the 2023 World Bank Enterprise Survey. The analysis considers product and process innovation, R&D expenditure, and R&D participation, while controlling for firm characteristics and institutional constraints. Using an instrumental variable (IV) approach with two-stage least squares (2SLS), we find that innovation is significantly associated with improvements in firm performance, with product and process innovations associated with substantial gains in sales growth. In contrast, the impact on employment growth is positive but more moderate, indicating that revenue expansion does not fully translate into job creation. R&D expenditure shows only incremental effects, suggesting limited short-term returns. Export participation is associated with stronger sales growth, whereas legal and regulatory obstacles are associated with lower employment expansion. Overall, the findings highlight that innovation is an important but context-dependent driver of firm growth in Vietnam, with more pronounced effects on revenue than on employment. Full article

Background/Objectives: The Individualized Neuromuscular Quality-of-Life Questionnaire (INQoL) is a widely used measure of quality of life in patients with various neuromuscular diseases. This study aimed to adapt and test the validity and reliability of this measure in Hungarian patients with neuromuscular disease. Methods: According to the widely accepted method of validation, we first translated the original INQoL version into Hungarian, and then a native English speaker translated it back into English to test its validity. Following a pretest procedure, the INQoL was administered to 80 patients with various muscular diseases and 30 age-matched controls. The internal consistency and test–retest reliability were assessed. Concurrent validity was measured using the 36-item Short Form Survey (SF-36) questionnaire. Results: For all INQoL subscales, Cronbach’s alpha was above 0.7, demonstrating the reliability of the subscales. The highest Cronbach alpha value was for the Weakness subscale (0.983) and the lowest for the Treatment subscale (0.794). The intraclass correlation coefficient test values ranged from 0.810 (Treatment) to 0.988 (Pain), indicating excellent test–retest reliability. There was a strong correlation between the SF-36 Physical Function and multiple INQoL subscales, including Weakness (r = 0.754, p < 0.001), Fatigue (r = 0.704, p < 0.001), Activities (r = 0.744) p < 0.001, Independence (r = 0.791 p < 0.001), Body Image (r = 0.714 p < 0.001), and overall Quality of Life (r = 0.742 p < 0.001). Conclusions: Our findings indicate that the Hungarian-language adaptation of the questionnaire possesses adequate reliability and construct validity for assessing the quality of life in patients with muscular disorders. Full article

This study scientifically assessed the safety of the Ming Dynasty official-style timber structure of Taiyuan Chongshan Temple’s Great Mercy Hall, a nationally protected cultural relic. An integrated framework was adopted, including form restoration via 3D laser scanning and manual surveying, damage detection using impedance meters, stress wave tomography and one-dimensional stress wave testing, mechanical analysis with a differentiated material finite element model, and short-term on-site monitoring at risk points. Results showed that the 303.3 mm construction ruler length was restored, with the column grid tilting northwestward; the main structure was hardwood pine, and critical columns had severe localized damage (24% internal damage rate, 13% cross-sectional damage ratio) with 42% residual strength in some members; and the structure remained elastically safe, with material degradation causing 6.3–13.3% linear displacement amplification. Two weak links (eave purlin deflection: 33–37 mm; double-eave golden column axial force concentration: 86.9–88.5 kN) and dougong’s outward inclination due to eccentric compression were identified. Short-term monitoring indicated temperature-driven elastic responses and an 8 mm cumulative residual displacement in the northern single-step beam, and a three-level early warning threshold system was proposed. This study clarified the hall’s state as “overall stable with localized weaknesses”, providing a methodological reference for the preventive protection of similar ancient timber structures. Full article

Background: Quality of life (QoL) after transradial access in diagnostic cerebral angiography may be shaped by procedural demands as well as by the ambulatory setting itself. This study, for the first time, prospectively explored this dimension through follow-up assessments of QoL after the procedure. Methods: In this prospective study, QoL was assessed using the 36-Item Short Form Survey (SF-36), including the Physical and Mental Component Summary (PCS and MCS) as well as eight domain-specific subscales. After right transradial cerebral angiography, the SF-36 questionnaire was administered at baseline (pre-procedure), as well as at 1-month and 3-month follow-up visits. Mean PCS and MCS values were analyzed over time using linear mixed-effects regression models. In post hoc analyses, univariate and multivariable models were used to assess the influence of potential confounders. For subgroup analysis, patients were classified as transient deteriorators if PCS and/or MCS worsened by more than 0.5 SD at 1 month compared with baseline but not at 3 months. Permanent deteriorators were defined as worsening by more than 0.5 SD at both 1 month and 3 months compared with baseline. Results: A total of 35 patients (62.9% female) were recruited over the 12-month study period, with a mean age of 59.1 ± 10.1 years. No significant overall time effect was observed for mean PCS and MCS (p = 0.970 and p = 0.076). MCS showed a significant increase at 1 month compared with baseline (p = 0.046), with a trend toward significance at 3 months (p = 0.053). In post hoc analyses, sex, neurosurgical status, and dose area product were associated with MCS in univariate analyses (p < 0.05), but these associations did not persist after multivariable adjustment. For PCS, only age showed a significant association in univariate analysis (p < 0.05). In subgroup analyses, transient deterioration was more frequent in PCS than in MCS (11.4% [95% CI 3.2–26.7%] vs. 5.7% [95% CI 0.7–19.2%]), and permanent deterioration was also more common in PCS at 1- and 3-month follow-up (14.3% [95% CI 4.8–30.3%] vs. 8.6% [95% CI 1.8–23.1%]). Impairment predominantly involved the bodily pain subscale (88.9% [95% CI 51.8–99.7%]) within PCS and the vitality (80.0% [95% CI 28.4–99.5%]) and mental health sub-scales (80.0% [95% CI 28.4–99.5%]) within MCS. Conclusions: This short-term follow-up assessment demonstrated preserved QoL following transradial diagnostic cerebral angiography. Transient or permanent deterioration occurred in no more than five patients per subgroup (14%). These findings support the notion that a radial-first approach can be safely considered for diagnostic cerebral angiography without compromising patient-reported outcomes. Full article

Background/Objectives: Physical activity behaviours are established early in life and tend to track across developmental stages. However, the role of continuity of sport participation across multiple developmental periods in shaping current physical activity levels remains insufficiently understood. This study aimed to examine the association between continuity of sport participation across developmental stages and current physical activity levels in university students, and to assess whether this association followed a graded pattern and differed by sex. Methods: A cross-sectional study was conducted among 796 fourth-year undergraduate students enrolled in a Primary School Education degree program at the University of Turin. Data were collected using an anonymous online survey. Current physical activity was assessed using the International Physical Activity Questionnaire—Short Form (IPAQ-SF) and categorised as non-active, sufficiently active, or active. Sport participation across six developmental stages was retrospectively assessed and summarised into a three-level continuity variable (discontinuous, intermediate, continuous). Associations were examined using chi-square tests and ordinal logistic regression models adjusted for sex, age, and body mass index (BMI). Predicted probabilities were estimated to aid interpretation. Results: Continuity of sport participation was significantly associated with current physical activity levels (χ²(6) = 67.55, p < 0.001), with a graded pattern evident. In adjusted models, discontinuous participation (OR = 0.24, 95% CI 0.14–0.39) and intermediate participation (OR = 0.62, 95% CI 0.46–0.82) were associated with lower odds of belonging to higher physical activity categories than continuous participation. Predicted probabilities showed a clear dose–response pattern, with progressively higher likelihoods of being active as continuity increased. This pattern was consistent across sexes, although males exhibited higher overall activity levels. Conclusions: Greater continuity of sport participation across developmental stages is associated with higher current physical activity levels. Promoting sustained engagement in sport may support the development of active lifestyles across the lifespan. Full article

Background/Objectives: The co-occurrence of diabetic peripheral neuropathy and depression increases the symptom burden and risk of long-term complications. Methods: This cross-sectional study enrolled 131 patients with type 1 (age: 58.47 years; duration of diabetes: 35.61 years) and type 2 diabetes (age: 63.60 years; duration of diabetes: 11.49 years). All patients underwent assessment of socioeconomic status and evaluation using the Hospital Anxiety and Depression Scale, the Mental Component Score of the Short Form Healthy Survey Questionnaire, neuropathy disability score, nerve conduction studies, corneal confocal microscopy and intraepidermal nerve fibre density (IENFD) assessment. Results: The prevalence of foot pain (45% vs. 23.9%, p = 0.019), tingling (56.7% vs. 32.9%, p = 0.013), weakness (35% vs. 9.9%, p < 0.001), ataxia (40% vs. 16.9%, p = 0.001), and upper limb symptoms (45% vs. 19.7%, p = 0.001) were statistically significantly higher, while cold perception threshold (22.50 ± 8.47 vs. 26.34 ± 3.08, p = 0.007), corneal nerve fibre density (20.49 ± 7.55 vs. 24.16 ± 5.68, p = 0.002) and length (20.06 ± 6.98 vs. 22.95 ± 6.22, p = 0.014) were statistically significantly lower, but no differences in nerve conduction studies or IENFD were observed in patients with depression compared to patients without depression. Furthermore, patients with depression were from a lower socioeconomic class (51.7% vs. 21.1%, p < 0.001), had lower educational attainment (37.9% vs. 12.9%, p < 0.001), had lower income < £37,000 (29.3% vs. 11.4%, p = 0.010) and lived in areas of high deprivation (62.1% vs. 31.4%, p < 0.001). Conclusions: Comorbid depression in people with diabetes was linked to increased socioeconomic deprivation and a greater prevalence of neuropathic symptoms and small fibre pathology. Full article

At around 8:40 a.m. on 17 July 2024, the Wanshuitian landslide in the Three Gorges Reservoir Area (TGRA) experienced a deformation failure characterized by thrust load-caused deformations and high-speed sliding. Using geological surveys and unmanned aerial vehicle (UAV) photography, this study divided the Wanshuitian landslide area into five zones: sliding initiation (A1), secondary disintegration (A2), main accumulation (B1), right falling (B2), and left falling (B3) zones. Through monitoring data analysis and GeoStudio-based numerical simulations, this study revealed the mechanisms behind the landslide failure mode characterized by slope sliding approximately along the strike of the rock formation under the coupling effect of hydrological and geological conditions. The results indicate that factors inducing the landslide failure include the geomorphic feature of alternating grooves and ridges, the lithologic assemblage characterized by interbeds of soft and hard rocks, the slope structure with well-developed joints, and the sustained heavy rains in the preceding period. In the Wanshuitian landslide area, mudstone valleys are prone to accumulate rainwater, which can infiltrate directly into the weak interlayers of rock masses and soften the rock masses. Multi-peak rain events with a short time interval serve as a critical factor in groundwater recharge. Within 17 days preceding its failure, the Wanshuitian landslide experienced a superimposed process of heavy and secondary rain events with a short interval (four days). Rainwater from the first heavy rain event failed to completely discharge during the short interval, while the secondary rain event also caused rainwater accumulation. These led to a continuous rise in the groundwater table, a constant decrease in the shear strength of the slope, and ultimately the landslide instability. Since the landslide sliding in the dip direction of the rock formation was impeded, the main sliding direction of the landslide formed an angle of 88° with this direction. This led to a unique failure mode characterized by slope sliding approximately along the strike of the rock formation. Based on these findings, this study proposed characteristics for the early identification of the failure of similar landslides, aiming to provide a robust scientific basis for the monitoring, early warning, and prevention and control of the failure of similar landslides. Full article

Outbreaks of crown-of-thorns sea stars (CoTS) threaten coral reef integrity and biodiversity, yet local dynamics and short-term responses to control remain insufficiently described. This study characterised an outbreaking Acanthaster population in two specific sites of the coast of Khor Fakkan (Gulf of Oman, United Arab Emirates) to resolve species identity, population composition, prey selection and the effects of targeted removals. All sequenced individuals clustered in two related haplotypes belonging to the species Acanthaster planci. Benthic surveys showed moderate live-coral cover, dominated by massive Porites sp. colonies. Moreover, the observations of 139 preyed colonies revealed pronounced genus-level selectivity, with branching and complex morphologies suffering disproportionately and massive forms largely avoided. However, the selection of massive Plesiastrea and Favites genera as preferred coral prey might suggest a shift towards less preferred coral in the CoTS diet, posing a severe threat to coral reefs’ integrity. Intensive removal reduced the local density, up to 86%, and provided substantial short-term relief, but continued monitoring is required to secure long-term reef resilience. Full article

Background/Objectives: To evaluate construct (convergent and divergent) validity and conduct confirmatory factor analysis (CFA) of the National Center on Health, Physical Activity and Disability (NCHPAD) Wellness Assessment (NWA) tool. Methods: A cross-sectional survey validation study utilizing secondary data. We assessed Spearman correlations between NWA and 36-Item Short Form Health Survey (SF-36), NWA and Godin Leisure-Time Exercise Questionnaire (GLTEQ) and NWA and Modified Fatigue Impact Scale (MFIS) scores to determine construct validity. A CFA was conducted to test the appropriateness of a three-factor model for NWA. Results: Data from 149 participants were used to assess construct validity and from 180 participants for CFA. Both correlations between NWA mental wellness domain and SF-36 mental component scores and between NWA emotional/spiritual wellness domain and SF-36 emotional well-being scores were 0.61 (p < 0.001 for both). The correlation between NWA physical wellness domain and SF-36 physical component score was −0.06 (p = 0.45). The correlations of NWA with GLTEQ overall and with health contribution scores were 0.26 and 0.30, respectively (p < 0.001 for both). The correlations of all NWA domain and MFIS subscale scores ranged between −0.42 and −0.25 (p < 0.05). The CFA model’s comparative fit index was 0.90. Conclusions: The NWA physical wellness domain did not demonstrate strong convergent validity, as mental and emotional/spiritual wellness domains did. All domains showed strong divergent validity, and CFA showed evidence supporting a three-factor model. Future efforts will emphasize refining and reevaluating the physical wellness domain until it achieves strong psychometric properties. Full article

Background: In the context of global population aging, nutritional risk has emerged as an important factor associated with both physical and mental health among older adults. This study aimed to examine the associations between nutritional risk, depression, and cognitive function in older adults and to explore potential variations across residential area, educational attainment, employment status, frailty status, and activities of daily living (ADL). Methods: Data were obtained from 9955 community-dwelling older adults aged 65 years and older who participated in the 2023 National Survey of Older Koreans. Nutritional risk was assessed using the DETERMINE checklist (21-point scale), a multidimensional screening tool reflecting dietary, functional, and social risk factors. Depression was measured using the Short-form Geriatric Depression Scale (15-point scale), and cognitive function was assessed using the Korean version of the Mini-Mental State Examination-2 (K-MMSE-2; 30-point scale). Hierarchical multiple linear regression, correlation, subgroup, and sensitivity analyses were conducted, adjusting for sociodemographic characteristics, health behaviors, and geriatric factors. Results: Correlation analyses showed significant associations between nutritional risk and cognitive function (r = −0.191, p < 0.05), nutritional risk and depression (r = 0.440, p < 0.05), and depression and cognitive function (r = −0.259, p < 0.05). Higher nutritional risk scores were significantly associated with greater depressive symptoms (B = 0.314, p < 0.001) and lower cognitive function (B = −0.051, p < 0.05). While some subgroup differences were observed, not all interaction effects reached statistical significance, and these findings should be interpreted with caution. Conclusions: These findings suggest that nutritional risk is associated with depressive symptoms and cognitive function in older adults. Given that the DETERMINE checklist reflects multidimensional vulnerability, the results should be interpreted as indicating broader risk contexts rather than direct nutritional status alone. These findings highlight the importance of integrated, multidimensional approaches to support older adults at nutritional risk in community settings. Full article

Background: Subclinical psychological symptoms—such as low mood, perceived stress, and poor sleep—affect a large portion of the population and can impair quality of life despite remaining below clinical thresholds. The gut–brain axis has emerged as a promising target for interventions that support emotional and psychological resilience. Probiotics and postbiotics are gaining attention for their potential to modulate mood and stress via microbiome-related mechanisms, but human evidence remains limited, particularly in non-clinical populations. Objectives: We aimed to assess the effects of a two-strain combination of live microorganisms alongside a two-strain combination of heat-treated inactivated microorganisms on outcomes associated with anxiety, mood, perceived stress, and quality of life in healthy adults experiencing mild stress. Methods: This study was conducted in two parts. In Part I, a randomized, double-blind, placebo-controlled study, 100 participants were randomized to receive either a blend of live microorganisms (Bifidobacterium longum CECT 7347 and Lactobacillus rhamnosus CECT 8361) or an identical placebo once daily for 12 weeks. In Part II, a pilot feasibility study, a subset of eight placebo non-responders from Part I received the heat-inactivated preparation of the same bacterial strains in a 6-week trial extension phase. For Parts I and II, the primary outcome was the change in the Hamilton Anxiety Rating Scale (HAM-A). Secondary outcomes included measures of mood (Beck Depression Inventory (BDI); Patient Health Questionnaire-9 (PHQ-9)), stress (state and trait anxiety inventory (STAI); Perceived Stress Scale (PSS)), sleep (Pittsburgh Sleep Quality Index (PSQI)), quality of life (36-item Short Form Survey (SF-36)), gastrointestinal symptoms (Gastrointestinal Symptom Rating Scale (GSRS)), salivary cortisol and microbiome modulation. Results: In Part I, there were no significant effects of the live blend on the HAM-A, indicating that the primary endpoint was not met. In addition, no significant effects were seen on the STAI or PSS scores when compared to the placebo. However, participants consuming the live blend trended toward a reduction in total PHQ-9 scores compared to placebo (p = 0.089), whilst preliminary exploratory analyses suggested an improvement in anhedonia (p = 0.045). Furthermore, there was a significant improvement in the vitality domain of the SF-36 compared to placebo (p = 0.017). On microbiome analysis, it was noted that consumption of the live blend was linked to the preservation of butyrate-producing bacteria, particularly members of the Pseudoflavonifractor genus and the Clostridium SGB6179 species. Furthermore, the abundance of B. longum species was found to be inversely associated with the total PSS Scores. In Part II, supplementation with the inactivated preparation resulted in significant within-group improvements for the vitality (p = 0.006) and social functioning (p = 0.010) domains of the SF-36 and improvements in PSS scores compared to baseline (p = 0.050). Conclusions: Supplementation with either the dual-strain live or inactivated formulations was associated with significant improvements in the vitality domain of the SF-36, whilst participants receiving the inactivated formulation demonstrated lower perceived stress and improved social functioning compared to baseline. Overall, the findings from this pilot study suggest that these two biotic consortia are well-tolerated and may be associated with improvements in measures of vitality in individuals with subclinical psychological symptoms. The subtle observations detected for stress and anhedonia suggest that further well-powered trials are needed to better characterize these findings, potentially in populations with greater baseline symptomatology. Full article

Climate change poses a significant threat to the livelihoods of smallholder farmers in South Africa, particularly in rural areas where dependence on rain-fed agriculture and limited institutional support heighten vulnerability. This study investigates how different forms of social capital (bonding, bridging, and linking) influence climate change adaptation strategies among smallholder farmers in Bergville, KwaZulu-Natal. A mixed-methods design was employed, combining a household survey (n = 150), focus group discussions, and key informant interviews. Households engaged in smallholder farming were purposively identified and randomly selected within the study ward. To accommodate varying literacy levels, structured questionnaires were administered through interviewer-led surveys. Quantitative data were analysed using descriptive statistics, chi-square tests, and a probit regression model, while qualitative data were thematically analysed to contextualise adaptation decisions and social dynamics. The findings show that trust in peer information, farmer group membership, collective action, and access to extension services significantly increase the likelihood of adopting climate adaptation practices (p < 0.05). While bonding social capital supports short-term coping, limited bridging and linking social capital constrain access to institutional resources and climate information. By explicitly operationalising and empirically distinguishing these dimensions of social capital, the study provides context-specific evidence on how uneven social networks shape adaptation outcomes. Strengthening inclusive institutional linkages and extension services is essential for promoting long-term climate resilience among smallholder farmers in rural South Africa. This study contributes to the international literature by providing empirical evidence on the differentiated roles of social capital dimensions in shaping adaptation outcomes in resource-constrained rural contexts. The findings highlight the need for policy interventions that strengthen institutional linkages, improve extension service delivery, and promote inclusive access to adaptation resources to enhance long-term climate resilience. Full article

Short-form video (SFV) platforms have become a central part of older adults’ digital lives, yet their psychological implications remain theoretically contested. Drawing on social empowerment theory, Self-Determination Theory, attachment theory, and the displacement hypothesis, this study examined whether different sources of social support—family, peer, and community—exert differential effects on life satisfaction through SFV engagement and social connectedness. Survey data were collected from 385 community-dwelling Chinese older adults (mean age = 70.6 years) and analyzed using bootstrapped serial mediation models with 5000 resamples. The results revealed clear source differentiation, as family support most strongly predicted SFV engagement and showed the largest total association with life satisfaction, consistent with a social empowerment mechanism. Community participation showed a weaker but still positive association with engagement, whereas peer support was unrelated to engagement. Across pathways, higher SFV engagement was associated with lower social connectedness, while greater social connectedness was associated with higher life satisfaction. However, none of the chained indirect effects reached significance, suggesting that social support influenced life satisfaction primarily through direct rather than serially mediated pathways. These findings demonstrate the importance of disaggregating social support by source and contribute to a more precise framework for understanding older adults’ digital well-being. Full article

Heavy episodic drinking (HED) is prevalent in young adulthood, yet its relationship with psychosocial well-being remains complex. This study examines the association between HED and perceived social isolation among young adults and tests whether this relationship varies by sexual orientation. Using pooled, nationally representative data from the 2022 and 2024 Health Information National Trends Survey (HINTS), this study analyzed adults aged 18–29 (N = 723). Perceived social isolation was measured using the PROMIS Social Isolation Short Form. Weighted multivariable linear regression models assessed interactions between sexual orientation and HED occasions (0 vs. 1+), adjusting for sociodemographic variables and psychological distress. 45.5% reported HED. Lesbian/gay (B = 5.62, SE = 0.58, p < 0.001) and bisexual (B = 1.66, SE = 0.34, p < 0.001) young adults reported higher isolation than straight peers; HED was inversely associated with isolation (B = −1.71, SE = 0.20, p < 0.001). A significant interaction indicated that among lesbian/gay young adults, heavy drinking was associated with lower perceived isolation (B = −5.77, SE = 0.98, p < 0.001). Interventions should account for the social meanings of alcohol use to avoid unintentionally increasing isolation among sexual minoritized populations. Full article

Background/Objectives: Digital health ecosystems increasingly integrate content, behavioral interventions, and commercial offerings across multiple platforms. While design consistency is established as critical for trust in commercial contexts, its associations with health behavior change and objective health outcomes remain underexplored. This study examined how cross-platform design consistency and aesthetic experience are associated with behavioral adoption through psychological pathways and investigated relationships between design-driven adoption and objective health outcomes. Methods: A convergent mixed-method design comprised five integrated studies: systematic content analysis of short-form videos (N = 200), expert evaluation and user testing (N = 33), a cross-sectional survey (N = 186), semi-structured interviews (N = 15), and a 3-month longitudinal health outcome analysis (N = 143). Structural equation modeling tested pathways from design features through psychological mediators and COM-B components (capability, opportunity, motivation) to behavioral adoption and health outcomes. Results: Design consistency was significantly associated with trust (β = 0.52), perceived value (β = 0.68), and reduced perceived risk (β = −0.41; all p < 0.001). Aesthetic experience predicted emotional resonance (β = 0.71, p < 0.001) and moderated design–trust associations. COM-B components mediated 75% of the intention-to-adoption pathway (total indirect effect = 0.51, p < 0.001). High-adoption users showed clinically meaningful improvements in weight (−2.8 kg, d = 0.89), HbA1c (−0.7%, d = 0.65), fasting glucose (−0.9 mmol/L, d = 0.72), and LDL-C (−0.4 mmol/L, d = 0.51) over three months. Conclusions: Within a single, influencer-centered Chinese digital health ecosystem, design consistency and aesthetic experience were significantly associated with trust, psychological readiness, and behavioral adoption. These findings are observational; randomized controlled trials and multi-site replication are required to establish causal mechanisms and assess generalizability. Full article