Search Results (185)

Background/Objectives: Benign paroxysmal positional vertigo (BPPV) is the most prevalent vestibular disorder encountered in clinical settings and is highly responsive to evidence-based diagnostic and therapeutic interventions. However, variations in practice patterns among physician specialties can compromise timely diagnosis and effective treatment. Understanding these variations is essential for improving clinical outcomes and standardizing care. This study aimed to assess the diagnostic and treatment practices for BPPV among Ear, Nose, and Throat (ENT) specialists, neurologists, general practitioners, and family physicians in Saudi Arabia and to examine how these practices are influenced by clinical experience and patient case exposure. Methods: A cross-sectional, questionnaire-based study was conducted between April 2023 and March 2024 at King Khalid University, Abha, Saudi Arabia. A total of 413 physicians were recruited using purposive sampling. Data were analyzed using IBM SPSS version 24.0. Parametric tests, including one-way ANOVA and chi-square tests, were used to assess differences across groups. A p-value of <0.05 was considered statistically significant. Results: Overall, all physician groups exhibited limited adherence to guideline-recommended positional diagnostic and therapeutic maneuvers. However, ENT specialists and neurologists demonstrated relatively higher compliance, particularly in performing the Dix–Hallpike test, with 46.97% and 26.79% reporting “always” using the maneuver, respectively (p < 0.001, Cramér’s V = 0.22). Neurologists were the most consistent in conducting oculomotor examinations, with 73.68% reporting routine performance (p < 0.001, Cramér’s V = 0.35). Epley maneuver usage was highest among neurologists (86.36%) and ENT specialists (77.14%) compared to family physicians (50.60%) and GPs (67.50%) (p = 0.044). Physicians with 11–15 years of experience and >50 BPPV case exposures consistently showed a greater use of diagnostic maneuvers, repositioning techniques, and guideline-concordant medication use (betahistine 76.67%; p < 0.001). Continuing medical education (CME) participation and the avoidance of unnecessary imaging were also highest in this group (46.67% and 3.33%, respectively; p < 0.001). Conclusions: Significant inter-specialty differences exist in the management of BPPV in Saudi Arabia. Greater clinical experience and higher case exposure are associated with improved adherence to evidence-based practices. Targeted educational interventions are needed, particularly in primary care, to enhance guideline implementation. Full article

Background/Objectives: This is the first study to examine age-related patterns of meniscal/chondral lesions in women undergoing first-time knee arthroscopy. Methods: We analyzed meniscal tear type/location and evaluated cartilage damage in femoral condyles and the tibial plateau in a medium-sized Romanian cohort (n = 241). Results: Age was associated significantly (p ≤ 0.004) with medial meniscal damage (O.R. = 1.04, 95% CI: 1.01–1.06), medial femoral condyle chondropathy (O.R. = 1.06, 95% CI: 1.03–1.10), and medial tibial plateau chondropathy (O.R. = 1.07, 95% CI: 1.02–1.12). Medial meniscus tear patterns differed significantly between age groups (p < 0.001, Cramér’s V = 0.32). Bucket-handle tears—the most common tear type—peaked in middle age (p < 0.001, Cramér’s V = 0.30). The two menisci showed different distributions of tear patterns in women aged ≥40 years (p ≤ 0.023, Cramér’s V ≤ 0.41). Meniscal tears most commonly involved the posterior third. The distribution of tear sites in menisci (medial vs. lateral) varied significantly in women aged 40–59 years (p = 0.020, Cramér’s V = 0.28). The medial femoral condyle and medial tibial plateau showed significant intergroup differences in ICRS scores (p ≤ 0.024, Cramér’s V ≤ 0.34). The frequency of ICRS grade 4 cartilage lesions increased markedly in the 40–59 age group at both sites, continuing to rise in older patients for the medial tibial plateau. Conclusions: Knee pathology in women worsens with age, especially in the medial compartment. Early screening (intervention) in middle-aged women may help prevent advanced joint damage. Full article

Background/Objectives: Hispanic adolescents experience elevated rates of disordered eating behaviors and body dissatisfaction, yet limited research has examined how gender and weight status interact to shape these risks within this population. Methods: A cross-sectional survey was conducted among 680 Hispanic adolescents (ages 9–15) from a predominantly Mexican-American middle school. Participants completed the Modified Kids Eating Disorder Survey (M-KEDS), and height and weight were objectively measured to determine BMI-for-age percentile. Chi-square tests, Mann–Whitney U tests, and logistic regression were used to assess differences by gender and weight status, including interaction effects. Bonferroni correction was applied for multiple comparisons. Effect sizes (Cramér’s V, odds ratios with 95% CI) were reported. Results: Approximately 73% of participants reported body dissatisfaction, with significant differences observed by gender and weight status. Adolescents with overweight/obesity reported significantly higher negative weight attitudes and extreme weight control behaviors than healthy-weight peers (p < 0.001), with large effect sizes. Females endorsed more disordered attitudes and behaviors, except for exercise to lose weight, which was more common among overweight/obese males. Conclusions: These findings underscore the high prevalence and significance of disordered eating behaviors in Hispanic adolescents, including those at a healthy weight. Results highlight the importance of culturally tailored, gender-sensitive screening and prevention strategies. Schools serve as critical settings for early identification, and tools like the M-KEDS can help address disparities in care access and improve outcomes among Hispanic youth. Full article

Maedi-visna virus (MVV), a small ruminant lentivirus causing chronic multisystemic disease in sheep, poses significant economic burdens due to reduced productivity and a lack of effective treatments. Despite its worldwide prevalence, epidemiological data from Algeria remain absent. This first national seroprevalence study aimed to elucidate MVV distribution, risk factors, and transmission dynamics in Algerian sheep herds. A cross-sectional survey of 1400 sheep across four regions (East, Center, West, South) was conducted, with sera analyzed via indirect ELISA (IDvet). Risk factors (geography, age, sex, breed, farming system) were evaluated using chi-square tests and Cramer’s V. Overall seroprevalence was 9.07% (95% CI: 7.57–10.57), with significant variation by sex (females: 20.44% vs. males: 3.68%; p < 0.05), age (1–5 years: 6.86% vs. <1 year: 0.29%; p = 0.01), and region (Central: 3.36% vs. Eastern: 0.86%; p < 0.05). Notably, no association was found with breed or farming system (p ≥ 0.08), contrasting prior studies and suggesting region-specific transmission dynamics. Females exhibited heightened seropositivity, implicating prolonged herd retention and vertical transmission risks. Geographic disparities highlighted industrialized farming in central Algeria as a potential transmission amplifier. Strikingly, seronegative animals in high-prevalence herds hinted at genetic resistance, warranting further investigation. This study provides foundational insights into MVV epidemiology in North Africa, underscoring the need for targeted surveillance, ewe-focused control measures, and genetic research to mitigate transmission. The absence of prior national data elevates its significance, offering actionable frameworks for resource-limited settings and enriching the global understanding of SRLV heterogeneity. Full article

Background/Objectives: Childhood cancer leads to significant physical, cognitive, and psychosocial consequences that adversely affect the development and quality of life. Occupational Therapy (OT) has the potential to mitigate these effects. However, its integration into pediatric oncology care in Spain remains limited and underexplored. This study aims to examine the availability, characteristics, and perceived impact of OT services within pediatric oncology units across Spain and to identify key barriers to their implementation. Methods: A descriptive, cross-sectional study using a mixed-methods approach was conducted. An online questionnaire was distributed to healthcare professionals working in pediatric oncology units nationwide. Quantitative data were analyzed using descriptive statistics, Fisher’s exact test, and odds ratios with 95% confidence intervals to explore associations. Effect sizes were calculated using Cramér’s V where applicable. Qualitative responses underwent inductive thematic analysis. Results: A total of 42 hospital centers from 12 autonomous communities participated. Only 16 reported having OT services in pediatric oncology, with notable regional disparities. A significant proportion of respondents were unaware of the integration of OT in their institutions. Identified barriers included lack of resources, insufficient specialized training, and limited institutional recognition of OT. Nonetheless, professionals familiar with OT interventions reported positive outcomes, particularly in improving patients’ functional autonomy, emotional well-being, and social participation. Conclusions: OT remains insufficiently integrated into pediatric oncology care in Spain. To optimize the quality of care, it is essential to address educational, structural, and institutional challenges and promote OT as a key component of multidisciplinary teams. Full article

The Relative Age Effect (RAE) refers to the advantage that relatively older athletes within the same age group may have in sports. While this phenomenon has been widely documented in numerous disciplines, its presence in orienteering remains largely unexplored. This study aimed to analyse the existence of RAE among Spanish orienteers selected for international competitions organised by the International Orienteering Federation (IOF) between 1987 and 2023. A total of 384 participations (225 male, 159 female) were examined across the European Youth Orienteering Championships (EYOC), Junior World Orienteering Championships (JWOC), and the European and World Orienteering Championships (EOC + WOC). The distribution of birth dates by quartiles and semesters was compared using chi-square tests, Cramér’s V, Z-tests, and odds ratios with 95% confidence intervals. The results revealed a significant RAE in male athletes, particularly in JWOC, where those born in the first quartile were up to 3.77 times more likely to be selected than those in the third quartile. In contrast, no significant associations were found in female athletes, which may reflect structural or developmental differences related to sex. These gender-based disparities highlight the importance of integrating sex-specific considerations into selection policies. Overall, the findings suggest a selection bias favouring relatively older males, which may hinder the development of late-born talent. Therefore, it is recommended that selection criteria be reassessed to ensure fairer and more inclusive talent identification and development in youth and elite orienteering. Full article

Background/Objectives: Complications of edentulism include bone resorption, muscular dysfunction, temporomandibular joint disorders (TMJ), and stomatognathic system dysfunctional syndrome (SSDS). The objectives of the study were as follows: to analyze the distribution of edentulism complications related to sociodemographic and clinical parameters and to quantify the strength of relationships between edentulism complications and these socio-demographic or clinical variables. Materials and Methods: This cross-sectional study investigated 150 edentulous subjects (mean age 61.54 +/− 8.99 years) scheduled for hybrid prosthetic therapy. The distribution of edentulism complications was assessed in relation to sex-specific and age-specific patterns, edentulism location (maxillary vs. mandibular), edentulism extension (partial reduced, partial extended, subtotal, complete edentulism), and Kennedy classification (class I vs. class II vs. class IV). Cramér’s V was used to measure the strength of the association between edentulism complications and sociodemographic and clinical factors. Results: The most prevalent complications were more frequent in males—bone resorption (74.2% vs. 40.9%), malocclusion (97.5% vs. 84.9%), TMJ disorders (74.2% vs. 57.0%), muscular disorders (62.5% vs. 31.2%), dyshomeostasis (64.2% vs. 31.2%), and SSDS (79.2% vs. 53.8%). The most relevant associations were found between age group and clinical variables such as irregular ridge (Cramer’s V = 0.737), long/thick frenum (0.711), and SSDS (0.544), while edentulism category was strongly associated with irregular ridge (0.585), TMJ disorders (0.493), and bone resorption (0.492). Conclusions: The type and stage of edentulism emerged as key determinants of complication severity, with complete and subtotal edentulism being associated with the highest rates of muscular and temporomandibular joint dysfunctions. Full article

Background: Severe psychiatric disorders are frequently associated with disruptions in health-related behaviors, including diet and lifestyle. This cross-sectional study aimed to assess and compare selected dietary and lifestyle behaviors among long-term psychiatric inpatients diagnosed with unspecified dementia (F03) or organic delusional disorder (F06.2) and a control group of mentally healthy individuals. Methods: A 50-item validated questionnaire was administered to 28 hospitalized patients and 10 control participants. Analyses included nutritional habits, physical activity, stimulant use, and hydration, using non-parametric tests and effect size indicators (Cramér’s V). Results: Significant differences were observed in meal regularity, frequency of meals, types of beverages consumed, and physical activity. Strong associations were found for meal types (V = 0.590) and stress-induced eating (V = 0.525). Conclusions: The observed behavioral differences may reflect disease-related effects, demographic variation, or a combination of both. Despite these limitations, the findings suggest key areas for further investigation and support the need for targeted dietary and lifestyle interventions in psychiatric settings. Full article

Background: Understanding the determinants of children’s outdoor play is an important element for child development and broader public health outcomes. There is growing evidence that children’s opportunities for play, particularly outdoor risky play, are diminishing. Parents are concerned with keeping their child safe while affording them independence to play. This study explored parents’ attitudes to risky play and practices around children’s independent mobility in Ireland with the aim of informing public health strategies promoting healthy childhood environments. Methods: An online survey comprising validated scales and standardised questions was completed by a nationally represented sample of 376 parents of children up to 16 years. Data was analysed via descriptive statistics, chi-square tests, and regression analysis. Results: A total of 376 participants accessed the survey, of which 349 completed it. A total of 84% of participants were female. A total of 74% agreed that children need regular exposure to actual risk to develop risk management skills, and 71% trusted their children to play safely. Chi-square tests reveal significant associations between outdoor play in the rain and school travel (p < 0.01), and appropriate age to begin activities at home and in educational settings (p < 0.05). A moderate association was found between the method of school travel and children’s permission to play in the rain (Cramer’s V = 0.51). Respondents considered supervision to be a necessity to ensure their children’s safety. Overall, the results indicate that parents were risk-averse in three of the six categories of risky play, namely, play near dangerous elements, play with adult tools, and out-of-sight play. Conclusions: This study presents a descriptive analysis of findings from the Ireland State of Play Survey. Findings indicate that although parents recognise the benefits of risky play, there is some contradiction between parental attitudes and actual practices, with a lack of willingness or confidence in permitting their children to participate in all such activities. Full article

Background: Motor competence (MC) plays a critical role in shaping children’s physical activity, health-related fitness, and weight status. However, few studies have explored these interrelationships during middle childhood. Objectives: The current study aimed to examine the relationships between MC and physical activity (PA), health-related fitness (HRF), and weight status (WS) in children during middle childhood (9–10 years). Simultaneously, the study aimed to find possible differences in PA, HRF, and WS between children with different levels of MC. Methods: In this cross-sectional study, the TGMD-2 (MC), UNIFITTEST 6–60 (HRF), ActiGraph GT3X (PA), and anthropometry (WS) were administered to 86 children (59 boys, age range of 9–10 years and mean age of 10.1 ± 0.6 years). Results: A significant strong association was observed between MC and HRF (p < 0.01, Cramer‘s V = 0.42). Significant moderate associations were observed between MC and WS (p < 0.05, Cramer’s V = 0.34) and between MC and PA (p < 0.05, Cramer‘s V = 0.25). Children with high MC proficiency demonstrated significantly higher levels of HRF (p < 0.01; large ES) and PA (p < 0.05; moderate ES) and a healthier WS (p < 0.01; moderate ES) than those with low MC proficiency. Similarly, children with moderate MC proficiency outperformed children with low MC in terms of HRF and WS. Conclusions: The strong associations between MC and key health indicators such as PA, HRF, and WS suggest that movement proficiency in middle childhood should be viewed as a cornerstone of health promotion. Although no causal claims can be made, the results emphasize the practical importance of integrating targeted motor skill development—especially FMSs—into school-based physical education and extracurricular programs. Supporting MC at this age may be a decisive step toward fostering long-term engagement in physical activity and improving children’s overall health trajectories. Full article

Olympic women’s judo has increased in complexity and competitiveness, demanding detailed tactical analysis. This observational study aimed to examine the relationship between the results of combats (Wazari [half point] vs. Ippon [full point]) and the techniques used in women’s judo combats in the Rio 2016 and Tokyo 2020 Olympic Games. A significant association was found between technique type and contest outcome (χ² = 40.004, df = 6, p < 0.001): Nage Waza (throwing techniques) produced 92.3% of Wazari, whereas Katame Waza (groundwork techniques) accounted for 61.1% of Ippon. Subgroup analysis confirmed these relationships (χ² = 17.217, df = 6, p = 0.009; Cramer’s V = 0.745), with Ashiwaza (foot/leg techniques) dominating Wazari. Uchimata was the most frequently used technique in the repechage (20%), bronze medal (22.6%), and final (23.1%) matches. In lightweights, Katame Waza dominated Ippon in finals (53.8%, χ² = 4.000, p = 0.046), while Nage Waza secured all Wazari. Middleweights also showed strong associations (χ² = 14.745, df = 1, p < 0.001; 93.9% of Wazari by Nage Waza). Although no significant association was found for heavyweights (χ² = 7.535, df = 1, p = 0.095), Katame Waza prevailed in Ippon (69.2%). These findings provide a tactical framework for tailoring technique-specific training by weight category and tournament phase to optimize outcomes in elite female judo. Full article

Introduction: Humanitarian Corridors are part of Protected Entry Procedures (PEPs), which allow for the safe and legal arrival in Europe of refugees in need of protection (art. 25 of Regulation (CE) n.810/2009) and were implemented for the first time in Italy in 2015. They represent an alternative to dangerous journeys, and they also bring benefits to local communities. The National Institute for Health, Migration and Poverty (NIHMP) represents the first filter at entry with regard to health needs, as it guarantees an overall individual health assessment to verify the possible presence of ongoing infectious pathologies and of issues that may require management and medical investigation. The aim of this study is to expose the organizational activity and analyze the sociodemographic and health data relating to the Humanitarian Corridors implemented in Italy and in which the NIHMP has participated from 2018 to 2024. Materials and Methods: The organizational lists and health data of each corridor were collected. The analysis was carried out in relation to trend, sociodemographic characteristics of the sample, identification, reception and health. The p-value was considered statistically significant if less than 0.01. In all cases in which the p-value was found to be statistically significant, Cramer’s V was calculated to evaluate the strength of the individual correlation. Results: The NIHMP has participated in 14 Humanitarian Corridors, allowing 1250 refugees to enter Italy; a total of 174 unaccompanied foreign minors (UFMs) arrived, and there were 451 refugees reported as vulnerable (36.1%). Contagious infectious conditions were identified in 223 refugees (17.8%), and other health findings were identified in 414 refugees (33.1%). In the analysis by sex, there are statistically significant differences in the reports of vulnerability and in nationality and education. The inferential analysis carried out by age groups presents statistically significant differences in the reports of vulnerability and in sex and nationality. The analysis relating to the differences by nationality shows statistically significant results in the individual corridors in the reports of vulnerability and in schooling, skin manifestations and infectious diseases and the presence of other health findings. Conclusions: The data reported and analyzed in this work can be considered the first attempt at a complete and detailed analysis regarding the actual implementation and effectiveness of Humanitarian Corridors as programs for legal and safe entry into Italy. The significant gap in research is the reason why there are characteristics of our sample that have no counterpart in the literature. Despite this, for other characteristics, it is possible to find statistical significance and scientific value in line with the data reported both on the websites dedicated to the topic and on the limited scientific literature on the subject. Full article

Background/Objectives: Extraction and replacement of hopeless teeth is a common practice in dentistry. Tooth autotransplantation (TA) offers several advantages as a viable and biological treatment option. However, its utilization in Saudi Arabia appears limited. Understanding dentists’ knowledge and attitudes toward TA is crucial for promoting its adoption in clinical practice. Therefore, the aim of this study is to assess the knowledge and attitudes of dentists in Saudi Arabia toward tooth autotransplantation. Methods: A cross-sectional study was conducted using a web-based questionnaire distributed to dentists across Saudi Arabia. The questionnaire included 19 questions assessing demographic characteristics, knowledge of TA, and attitudes toward its clinical application. Data were analyzed using SPSS v23 with chi-square and Cramér’s V tests to explore associations between variables (p < 0.05). Results: 253 dentists participated in this study. All participants had heard of TA, while only 26.5% reported moderate-to-high familiarity. Female dentists showed significantly greater interest in adopting TA than males (p = 0.038, Cramér’s V = 0.183). Specialists expressed higher familiarity than general dentists and underscored the importance of clinical guidelines, evidence-based outcomes, confidence in their capacity to engage in a TA team, the total number of required appointments, and malpractice concerns (p < 0.05) in their decision-making process. Nevertheless, general dentists demonstrated significantly more interest in implementing TA (p = 0.025, Cramér’s V = 0.192). Participants with more than 5 years of clinical dental experience were significantly more familiar with TA (p = 0.015, Cramér’s V = 0.204) and were more influenced by appointment numbers in decision-making (p = 0.012, Cramér’s V = 0.225). Conclusions: The study reveals limited familiarity but notable interest among dentists in Saudi Arabia toward TA. Addressing educational gaps by integrating TA training into dental curricula and offering clinical exposure opportunities to students, along with providing evidence-based clinical guidelines, and improving access to advanced imaging technologies, may enhance the adoption of TA as a viable treatment modality for tooth replacement. Full article

Background/Objectives: Ultrasonography is a diagnostic modality characterized by high sensitivity in detecting hepato-biliary pathology, particularly intrahepatic biliary duct dilation. This study compares the sonographic findings obtained by a radiographer/sonographer in a Basic Emergency Service (BES) using Point-of-Care Ultrasonography (POCUS) in Portugal with the sonographic findings from the same patients acquired by radiologists at a referral hospital (RH) for suspected intrahepatic biliary dilatation. Methods: Nineteen patients presenting with right upper quadrant (RUQ) pain and suspected abdominal pathology underwent sonographic screening using POCUS in the BES. Subsequently, the same patients were referred to the RH, where a radiologist performed a comprehensive ultrasound. Both examinations were compared to determine whether the findings obtained in the BES were confirmed by radiologists in the RH. Results: Cholestasis, cholangitis, lithiasis, pancreatitis, peri-ampullary lithiasis, and neoplasms were observed in association with intrahepatic biliary dilation in this study sample. All six variables showed a strong association between the BES and RH findings (Cramer’s V > 0.6; p < 0.006). A strong kappa measure of agreement between the radiographer and radiologist findings was obtained in “cholelithiasis/sludge/gallbladder acute sonographic changes” (k = 0.802; p = 0.000). A moderate kappa value was obtained for the variable “abdominal free fluid”, (k = 0.706; p = 0.001). Conclusions: In this study, all patients referred from the BES to the RH required hospitalization for treatment and additional imaging exams. Although pre-hospital screening ultrasound is not intended for definitive diagnoses, the early detection of intrahepatic biliary tract dilatation through screening sonography played a significant role in the clinical referral of patients, with a sensitivity of 94% and specificity of 75%. Full article

In the rapid process of urbanization, urban agglomerations have become a key driving factor for regional development and spatial reorganization. The formation and development of urban agglomerations rely on communication between cities. However, the spatiotemporal characteristics of intercity travelers are not fully grasped throughout the entire trip chain. This study proposes a spatiotemporal analysis method for intercity travel in urban agglomerations by constructing origin-to-destination (OD) trip chains using smartphone data, with the Beijing–Tianjin–Hebei urban agglomeration as a case study. The study employed Cramer’s V and Spearman correlation coefficients for multivariate feature selection, identifying 12 key variables from an initial set of 20. Then, optimal cluster configuration was determined via silhouette analysis. Finally, the K-prototypes algorithm was applied to cluster 161,797 intercity trip chains across six transportation corridors in 2019 and 2021, facilitating a comparative spatiotemporal analysis of travel patterns. Results show the following: (1) Intercity travelers are predominantly males aged 19–35, with significantly higher weekday volumes; (2) Modal split exhibits significant spatial heterogeneity—the metro predominates in Beijing while road transport prevails elsewhere; (3) Departure hubs’ waiting times increased significantly in 2021 relative to 2019 baselines; (4) Increased metro mileage correlates positively with extended intra-city travel distances. The results substantially contribute to transportation planning, particularly in optimizing multimodal hub operations and infrastructure investment allocation. Full article