Search Results (3,918)

Purpose: The global rise in mental health challenges among adolescents has led to the development of targeted interventions, including those designed to promote young people’s understanding and awareness of mental health. This systematic review aims to identify and evaluate interventions implemented among secondary school students with the goal of enhancing mental health literacy, and to assess their effectiveness in achieving this outcome. Methods: This review was partially aligned with the PRISMA 2020 guidelines. Studies were retrieved from four electronic databases—CINAHL Complete, PubMed, Academic Search Elite, and ERIC—and supplemented by a limited number of relevant studies identified outside the systematic search. The analysis focused on the content, delivery, design, evaluation methods, and outcomes of mental health literacy (MHL) interventions conducted in secondary schools internationally. Results: A total of 16 articles met the inclusion criteria. The articles described a variety of different MHL interventions (n = 12). The findings indicate that school-based MHL interventions have a positive impact on students’ knowledge and understanding of mental health, but stigma reduction demonstrated less consistent effects. Study population, country, intervention content, delivery, methods, outcome measures, sample sizes and participants’ age range varied notably across the studies. Conclusions: Based on the evidence synthesized in this review, school-based MHL interventions appear to be effective and may serve as a valuable component in broader efforts to promote mental health in adolescence. These findings reinforce existing evidence and provide a foundation for practical implications, but future research is highly recommended for a more solid base of evidence. Full article

Horizontal annular flow channels are widely applied in various fields, including thermal engineering, drilling engineering, and food engineering. Investigating their internal flow patterns is crucial for optimizing pipeline design, selecting appropriate equipment, and understanding the sedimentation and migration modes of multiphase flows within annular geometries. In practical engineering applications, the operational conditions of annular flow channels during gas drilling are the most complex, involving parameters such as eccentricity, rotation, surface roughness, and multiphase flow interactions. This study focuses on the flow characteristics of horizontal annular channels under real-world engineering conditions, examining variations in operational parameters. The pressure drop in annular pipelines is influenced by factors such as flow velocity, eccentricity, and rotational speed, exhibiting complex variation patterns. However, previous studies have not fully considered the impact of rough wellbore walls and the interactions among various factors. Employing experimental methods, this research analyzes the pressure drop characteristics within annular geometries. The results reveal that surface roughness significantly affects pressure drop, with the inner pipe’s roughness having a greater impact when the outer pipe surface is rough compared to when it is smooth. An increase in eccentricity substantially reduces pressure drop, with both positive and negative eccentricities demonstrating symmetric pressure drop patterns. Moreover, a significant positive correlation exists between the total rough area of the annular channel and pressure drop. Furthermore, this study establishes a predictive model through dimensional analysis. Unlike existing models, this new model incorporates the influences of both roughness and eccentricity, achieving a prediction accuracy of over 99%. This research confirms the critical role of roughness in annular flow systems and provides practical implications for selecting more reliable pump power equipment in engineering fields. Full article

Background: During maxillary sinus floor augmentation, the elevated sinus mucosa may come into close contact with the pristine mucosa. The presence of xenograft granules can lead to unintended mechanical and biological interactions between the two layers, and the resulting tissue damage remains poorly understood. The aim of this study was to perform a focused histological evaluation of graft-mediated interactions between the elevated and pristine sinus mucosae. Methods: Histological slides from five previously published rabbit sinus augmentation studies using grafts with different resorption rates were retrospectively analyzed. The following main patterns of tissue alteration were identified: (1) Proximity stage, characterized by epithelial thickening, goblet cell hyperactivity, and ciliary shortening; (2) Fusion stage, with epithelial interpenetration and loss of distinct mucosal boundaries; (3) Synechiae stage, featuring connective tissue bridges linking the two mucosae; and (4) Pristine mucosa lesions, caused by direct contact between residual graft particles and the pristine sinus mucosa. Results: A total of 192 sinuses were evaluated. Sinuses augmented with slowly resorbable grafts showed proximity stage in 22.3% of cases, fusion in 7.7%, direct lesions in 9.6%, and only one instance of synechia. In contrast, the faster resorbable xenograft presented only 11.1% of proximity stage, without further alterations. Conclusions: In this rabbit model, xenografts were associated with histological alterations of the sinus mucosa, while synechiae formation was rare. These preclinical findings should not be directly extrapolated to humans but may provide a basis for future investigations. Full article

Background: Cognitive disorders are highly prevalent in individuals with alcohol use disorder. Treatments have so far mainly focused on the amelioration of the cognitive impairments, but interventions to prevent relapse tailored to people with alcohol-related cognitive disorders are lacking. Here we present a new intervention aimed at people with alcohol-related cognitive disorders. Methods: In total, 59 inpatients with alcohol-related cognitive impairments participated in this study. A total of 37 completed the Relapse Prevention for patients with Alcohol-related Cognitive Disorder (RP-ACD) intervention and 22 received treatment as usual (TAU). The RP-ACD is a tailored group intervention for substance use disorder consisting of 12 one-hour group sessions. Outcome measures were the Alcohol Abstinence Self-Efficacy Measure (AASE-12), the Alcohol Urge Questionnaire (AUQ) and the Social Support Questionnaire (SSQ6). The overall experience was explored using a short in-house developed questionnaire. Results: Post-treatment, patients reported an improved self-efficacy compared to the pre-treatment baseline, but no differences were found on the other measures. No significant changes were found in the TAU group. Overall experiences and acceptability were rated positively. Conclusions: The RP-ACD intervention is a feasible and promising group-based addiction treatment for patients with alcohol-related cognitive impairment. A randomized and controlled study in a larger sample is required to establish its efficacy and effectiveness. Full article

Background: A cataract is a clouding of the normally clear lens that obscures the passage of light, effectively reducing clarity and sharpness of vision. Although this disease can affect both children and adults, the most common type is the age-related cataract (ARC). The literature describes many potential agents associated with cataract development. However, this study focuses on modifiable factors, especially nutritional ones and those that may induce oxidative stress. The objective of the present study was to assess serum selenium (Se), copper (Cu), and zinc (Zn) concentrations, as well as the copper/zinc molar ratio (Cu/Zn molar ratio), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI), of patients with ARC in relation to their dietary habits. Methods: A total of 68 patients with ARC and 64 healthy volunteers, with ages ranging from 48 to 92 years, were included in this study. The experimental material collected from the participants consisted of blood samples, which were tested for Se, Cu, and Zn concentrations using atomic absorption spectrometry (AAS). Oxidative stress (OS) parameters, such as TAS and TOS, were estimated spectrophotometrically. In addition, a food frequency questionnaire (FFQ) was used to collect information on the dietary habits of ARC patients. Results: Statistical analysis of the data revealed that the concentrations of Se, Cu, and Zn in serum were significantly lower in ARC patients compared to the controls. In the ARC group, some elements of dietary behavior had a significant effect on the levels of the examined elements and OS parameters. Conclusions: Thus, eventual alterations to one’s diet appear to be worth considering in the context of maintaining homeostasis and adequate mineral levels in ARC patients. Full article

The appropriate selection of renovation plaster properties is essential for ensuring the durability and effectiveness of conservation works. This study focused on the design and characterization of cement-based renovation mortars modified with synthetic zeolites with different Si/Al ratios. It was assumed that high-silica zeolites would provide more favorable mechanical and hygric performance than low-silica types. Owing to their porous structure and pozzolanic reactivity, zeolites proved to be effective additives, enhancing both the microstructure and functionality of the mortars. The modified mixtures exhibited increased total porosity, higher capillary absorption, and improved moisture transport compared with the reference mortar based on CEM I 52.5R. Dynamic vapor sorption tests confirmed that the zeolite-containing mortars achieved Moisture Buffer Values (MBV) above 2.0 g/m², which corresponds to the “excellent” moisture buffering class. Electrical resistivity measurements further demonstrated the relationship between denser microstructure and enhanced durability. At the frequency of 10 kHz, the electrical resistivity of the reference mortar reached 43,858 Ω·m, while mortars with 15% ZSM-5 and 15% Na-A achieved 62,110 Ω·m and 21,737 Ω·m. These results show that the addition of high-silica zeolite promotes the formation of a denser and more insulating matrix, highlighting the potential of this method for non-destructive quality assessment. The best overall performance was observed in mortars containing the high-silica zeolite ZSM-5. A 35% replacement of cement with ZSM-5 increased compressive strength by 10.5% compared with the reference mortar R (4.3 MPa). Frost resistance tests showed minimal mass loss (0.03% at 15% and 1.79% at 35% replacement), and ZSM-5 mortars also maintained integrity under salt crystallization. These improvements were attributed to the reaction of reactive SiO₂ and Al₂O₃ from the zeolites with Ca(OH)₂, leading to the formation of additional C-S-H. A higher Si/Al ratio promoted a denser, fibrous C-S-H morphology, as confirmed by SEM, which explains the improved strength and durability of mortars modified with ZSM-5. Full article

This study presents a comprehensive bibliometric analysis of 217 publications on nanomaterials for soil and groundwater remediation, sourced from the Scopus database, covering the period from 2010 to 2024. The findings highlight significant contributions from various countries, with India identified as the leading contributor, followed by China and the United States. This reflects robust international collaboration in addressing environmental contamination. The analysis also identifies influential journals in this field, particularly “Science of the Total Environment” and “Environmental Science and Technology”, which are recognized for their high citation impact and play a crucial role in disseminating research findings and advancing knowledge in nanomaterials for environmental remediation. A keyword co-occurrence analysis reveals six distinct clusters that emphasize critical research themes. The first cluster focuses on environmental toxicity, underscoring the risks posed by contaminants, particularly heavy metals and emerging pollutants such as PFAS, highlighting the need for advanced monitoring strategies. The second cluster showcases innovative nanoremediation technologies, particularly zero-valent iron (nZVI) and carbon nanotubes (CNTs), which are noted for their effectiveness in pollutant removal despite challenges like surface passivation and high production costs. The third cluster addresses heavy metals and phytoremediation, advocating integrated strategies that enhance crop resilience while managing soil contamination. The fourth cluster explores photocatalysis and advanced oxidation processes, demonstrating how nanomaterials can enhance pollutant degradation through light-activated catalytic methods. The fifth cluster emphasizes adsorption mechanisms for specific contaminants, such as arsenic and pharmaceuticals, suggesting targeted remediation strategies. Finally, the sixth cluster highlights the potential of nanomaterials in agriculture, focusing on their role in improving soil fertility and supporting plant growth. Overall, while nanomaterials demonstrate significant potential for effective environmental remediation, they also pose risks that necessitate careful consideration and further research. Future studies should prioritize optimizing these materials for practical applications, addressing both environmental health and agricultural productivity. Full article

Background/Objectives: This study evaluates students’ awareness and perceptions of interdisciplinary education. It focuses specifically on digital dentistry among students in the Department of Dental Technology. The findings aim to support the development of interdisciplinary courses and programs to enhance students’ skills in response to the growing digitalization of dental healthcare. Methods: A cross-sectional survey was conducted using a 23-item online questionnaire administered to a total of 203 students to collect data on general characteristics, perceptions of interdisciplinary education, the perceived necessity of such education, and the demand for interdisciplinary training, including topics related to CAD/CAM and 3D printing technologies. A t-test was performed to analyze grade-level differences in perceptions. Correlation analysis was conducted between perceptions and digital dental laboratory technology skills. Results: Despite the relatively low level of awareness regarding interdisciplinary education, students expressed a strong perceived need for it. A total of 76.6% of respondents preferred to collaborate with the Department of Dental Hygiene. No clear link exists between students’ perceptions of interdisciplinary education and their digital dental competencies. Practical training is more important than awareness. A significant difference in competencies was seen between lower- and higher-year students, indicating that advanced programs for higher-year students may be effective. Conclusions: Clear guidance on interdisciplinary education can enhance student understanding and acceptance. Interdisciplinary education with the dental hygiene department may increase engagement. Full article

Background and Aims: Severe acute respiratory distress syndrome (ARDS) in patients with long COVID remains associated with extremely high mortality and significant long-term sequelae. Non-invasive ventilatory strategies such as continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC) are widely used before endotracheal intubation (ETI). Still, their comparative effectiveness in this population is not well established. Understanding survival outcomes and sequelae can help refine treatment strategies for this high-risk group. This study aimed to evaluate outcomes, sequelae, and treatment strategies in long COVID patients with severe ARDS, focusing on non-invasive ventilatory support before ETI. Materials and Methods: A retrospective cohort analysis was performed using a study comparing severe ARDS patients with and without COVID-19. The inclusion criterion was a Horovitz quotient (PaO₂/FiO₂) < 50 mmHg. Results: The study included a total of 59 patients diagnosed with long COVID-19 ARDS, with a mortality rate of 85%. A significant proportion of the patient population was male, accounting for 75%. The highest survival rate was observed among patients who initially received CPAP support, with a survival rate of 23.08%, in contrast to those treated solely with HFNC or those who alternated between HFNC and CPAP. Among patients who required endotracheal intubation and subsequent mechanical ventilation, survival rates were 40% for those who had previously received CPAP, 10% for those treated with alternating HFNC and CPAP, and 0% for those managed exclusively with HFNC before ETI. Survivors often exhibited sequelae, such as impaired pulmonary function, persistent dyspnea, and diminished physical performance. Conclusions: Patients with long COVID who develop severe ARDS (PaO₂/FiO₂ < 50 mmHg) face exceptionally high ICU mortality, with outcomes determined mainly by age, comorbidities, and profound hypoxemia. Although CPAP showed a trend toward improved survival, the data do not establish superiority and should be regarded as hypothesis-generating. Rather, they highlight the complexity of managing this underrepresented subgroup and underscore the need for larger, multicenter studies with broader inclusion criteria to confirm or refute these preliminary observations. Full article

The Yellow River Delta is one of China’s most ecologically fragile regions, experiencing prolonged pressures from rapid urbanization and ecological degradation. Existing research, however, has predominantly focused on constructing ecological security patterns under single scenarios, with limited systematic multi-scenario comparisons and insufficient statistical support. To address this gap, this study proposes an integrated framework of “land use simulation—multi-scenario ecological security pattern construction—statistical comparative analysis.” Using the PLUS model, three scenarios were constructed—Business-as-Usual (BAU), Priority Urban Development (PUD), and Priority Ecological Protection (PEP)—to simulate land use changes by 2040. Habitat quality assessment, Multi-Scale Pattern Analysis (MSPA), landscape connectivity, and circuit theory were integrated to identify ecological source areas, corridors, and nodes, incorporating a novel hexagonal grid partitioning method. Statistical significance was evaluated using parametric tests (ANOVA, t-test) and non-parametric tests (permutation test, PERMANOVA). Analysis indicated significant differences in ecological security patterns across scenarios. Under the PEP scenario, ecological source areas reached 3580.42 km² (12.39% of the total Yellow River Delta), corresponding to a 14.85% increase relative to the BAU scenario and a 32.79% increase relative to the PUD scenario. These gains are primarily attributable to stringent wetland and forestland protection policies, which successfully limited the encroachment of construction land into ecological space. Habitat quality and connectivity markedly improved, resulting in the highest ecosystem stability. By contrast, the PUD scenario experienced an 851.46 km² expansion of construction land, resulting in the shrinkage of ecological source areas and intensified fragmentation, consequently increasing ecological security risks. The BAU scenario demonstrated moderate outcomes, with a moderately balanced spatial configuration. In conclusion, this study introduces an ecological restoration strategy of “five zones, one belt, one center, and multiple corridors” based on multi-scenario ecological security patterns. This provides a scientific foundation for ecological restoration and territorial spatial planning in the Yellow River Delta, while the proposed multi-scenario statistical comparison method provides a replicable methodological framework for ecological security pattern research in other delta regions. Full article

Aim: Older adult pedestrians are at greater risk of severe injuries than younger pedestrians due to gradual physical changes and coexisting medical conditions. This leads to longer hospital stays, increased mortality risk, and higher inpatient costs. Focusing on the aging population, this study explores the characteristics and injury profiles of pedestrian crossing accidents in the capital city of Bern, Switzerland. Methods: Our retrospective cohort study comprised adult patients admitted to our ED between 1 January 2013 and 31 December 2023, as crossing (or zebra crossing)-related pedestrian victims. Two cohorts were formed on the basis of age < 65 and ≥65 years and compared according to the setting of the accident, type, pattern of the injury, and clinical outcomes (short-term mortality, ICU/hospital length of stay). Results: Of a total of 124 patients, 31.5% (n = 39) of patients were elderly (65+ group). In contrast to the younger patients, the aging population was predominantly admitted as inpatients (64.1% vs. 35.3%, p = 0.001) and was hospitalised in the intensive care unit (20.5% vs. 6%, p = 0.020). Older patients were more likely to be polytraumatised (41% vs. 11.8%, p = 0.001) and to have been tossed or hurled than patients under 65 years (75% vs. 47.3%, p = 0.016). Fractures of the upper extremities (17.9% vs. 4.7%, p = 0.016), pelvis (30.8% vs. 9.4%, p = 0.003), and thoracic spine (12.8% vs. 2.4%, p = 0.019) were significantly more common in the elderly population. Intracranial haemorrhage (35.9% vs. 17.6%, p = 0.026), abdominal trauma (17.9% vs. 5.9%, p = 0.035), and relevant vessel damage (30.8% vs. 3.5%, p < 0.001) were also significantly higher in geriatric patients. Trauma indices were slightly more increased in the older population than in the younger group (ISS; p = 0.004 and AIS > 2 of chest and thoracic spine; abdomen, pelvic contents, and lumbar spine; extremities & bony pelvis p < 0.05). The 65+ group had a longer length of hospital stay (p = 0.001) and ICU stay (p = 0.002). A hospital stay longer than 7 days was also significantly more common in elderly individuals (p = 0.007). In-hospital (15.4% vs. 1.2%, p = 0.001) and 30-day mortality (17.9% vs. 1.2%, p < 0.001) were significantly higher in patients over 65 years of age. Conclusion: In our study, the impact of pedestrian crossing accidents was more severe in the elderly, as indicated by the severity of injuries, hospitalisation rate, longer length of hospital and ICU stays, and higher mortality rates. These findings underline the importance of developing tailored strategies to reduce crosswalk accidents and to optimise management approaches for these vulnerable patients. Full article

Introduction: Multiple sclerosis (MS) is a chronic neurodegenerative disease that entails high costs, progressive disability, and reduced quality of life (QoL). Telerehabilitation (TR), supported by new technologies, is emerging as an alternative or complement to in-person rehabilitation, potentially lowering socioeconomic impact and improving QoL. Aim: The objective of this study was to evaluate the effect of TR on the QoL of people with MS compared with in-person rehabilitation or no intervention. Materials and methods: A systematic review of randomized clinical trials was conducted (March–May 2025) following PRISMA guidelines. Searches were run in the PubMed-Medline, EMBASE, PEDro, Web of Science, and Dialnet databases. Methodological quality was assessed with the CASP scale, risk of bias with the Risk of Bias 2 tool, and evidence level and grade of recommendation with the Oxford Classification. The protocol was registered in PROSPERO (CRD420251110353). Results: Of the 151 articles initially found, 12 RCTs (598 total patients) met the inclusion criteria. Interventions included (a) four studies employing video-controlled exercise (one involving Pilates to improve fitness, another involving exercise to improve fatigue and general health, and two using exercises focused on the pelvic floor muscles); (b) three studies using a monitoring app to improve manual dexterity, symptom control, and increased physical activity; (c) two studies implementing an augmented reality system to treat cognitive deficits and sexual disorders, respectively; (d) one platform with a virtual reality headset for motor and cognitive training; (e) one study focusing on video-controlled motor imagery, along with the use of a pain management app; (f) a final study addressing cognitive training and pain reduction. Studies used eight different scales to assess QoL, finding similar improvements between groups in eight of the trials and statistically significant improvements in favor of TR in four. The included trials were of good methodological quality, with a moderate-to-low risk of bias and good levels of evidence and grades of recommendation. Conclusions: TR was more effective in improving the QoL of people with MS than no intervention, was as effective as in-person treatment in patients with EDSS ≤ 6, and appeared to be more effective than in-person intervention in patients with EDSS between 5.5 and 7.5 in terms of QoL. It may also eliminate some common barriers to accessing such treatments. Full article

Strawberries are among the most consumed fruits in Europe, but intensive cultivation requires frequent pesticide use, raising food safety concerns. This study evaluated pesticide residues and dietary risk in strawberries from the Agro Aversano area (Southern Italy). A total of 83 samples collected in 2023–2024 were analyzed using a validated QuEChERS-LC–MS/MS method targeting 850 active substances. Thirty-one pesticides were detected, predominantly fungicides, followed by acaricides and insecticides. Cyflumetofen and pyrimethanil were the most frequent residues, while compounds with low toxicological thresholds, including emamectin benzoate, lambda-cyhalothrin, acetamiprid, and tetraconazole, were also identified. Dietary risk assessment was conducted with the EFSA PRIMo model (v.3.1), focusing on the NL toddler subgroup. Despite occasional exceedances of European Maximum Residue Limits (MRLs), both acute and chronic exposures remained well below toxicological reference values (ADI and ARfD). Overall, the results indicate negligible health risks but highlight the relevance of cumulative exposure, underscoring the need for continuous monitoring and sustainable pest management practices to ensure strawberry safety. Full article

Background: Aviation is one of the most demanding professions, exposing pilots to persistent stressors such as fatigue, irregular schedules, and high safety responsibility. These conditions heighten vulnerability to depression, anxiety, and stress (DAS), yet the protective mechanisms mitigating such effects remain less well understood. Objective: This study examined the roles of resilience, coping strategies, and fatigue in predicting DAS among commercial airline pilots. Method: A sample of 200 pilots completed validated self-report measures: the Connor–Davidson Resilience Scale (CD-RISC), the Coping Inventory for Stressful Situations (CISS), the Fatigue Severity Scale (FSS), and the Depression Anxiety Stress Scale (DASS-21). Data were analyzed using bivariate correlations, hierarchical multiple regression, and mediation/moderation analyses via the PROCESS macro. Results: Resilience was negatively correlated with total DAS scores (r = −0.46, p < 0.001), while fatigue (r = 0.42, p < 0.001) and avoidance coping (r = 0.38, p < 0.001) were positively correlated. The regression model accounted for 46% of the variance in DAS (R² = 0.46). Task-focused coping predicted lower stress levels, whereas avoidance coping predicted higher anxiety and depression. Resilience moderated the relationship between stress and depression, buffering the impact of stress on mood outcomes. Mediation analyses indicated that coping styles partially explained the protective effect of resilience. ANOVA results confirmed that pilots with high resilience reported significantly lower depression scores than those with medium or low resilience, F(2, 197) = 6.72, p < 0.01. Conclusions: Resilience emerged as both a direct and indirect buffer against psychological strain in aviation. These findings underscore the importance of promoting adaptive coping and resilience training, alongside effective fatigue management, to enhance pilot well-being and maintain safety in aviation systems. Full article

Reliable toxicity assessments are essential for protecting biological processes in wastewater treatment plants (WWTPs). This study focuses on quantifying the measurement uncertainty of the ISO 8192:2007 method, which determines the inhibition of oxygen consumption in activated sludge. Using the GUM guideline and Monte Carlo Simulation (MCS), up to 29 uncertainty contributions were evaluated in terms of oxygen consumption rate and percentage inhibition. The results reveal that temperature tolerance, measurement interval, and oxygen probe accuracy are dominant contributors, accounting for over 90% of the total uncertainty. The GUM results for oxygen consumption rates were validated by Monte Carlo Simulation, confirming their reliability. The percentage inhibitions showed asymmetric distributions and were underestimated by the GUM method, especially at lower toxicant concentrations. This highlights the necessity of simulation-based approaches for asymmetric systems. Notably, the consideration of correlations in the GUM analysis had minimal impact on outcomes. The findings emphasize the need for the precise recording of measurement time intervals, temperature control, the regular calibration of oxygen probes, and repeat measurements at low toxicant concentrations. Overall, this study enhances the robustness of ISO 8192:2007-based toxicity testing and provides practical guidance for reducing measurement uncertainty. Full article