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16 pages, 608 KB  
Article
Parenting Practices and Emotional Regulation in Children with Autism Spectrum Disorder: A Mediated Moderation Model of Sibling Prosocial Behavior and Gender
by Muhammad Imran, Umaira Iftikhar, Arooj Arshad, Komal Hassan and Norah Almusharraf
Eur. J. Investig. Health Psychol. Educ. 2026, 16(2), 20; https://doi.org/10.3390/ejihpe16020020 - 3 Feb 2026
Abstract
Children with autism spectrum disorder (ASD) frequently struggle with emotion regulation, which can be influenced by parental practices and the supportive role of siblings in encouraging emotional and social development. The study aimed to examine the relationship between parenting practices and emotional regulation [...] Read more.
Children with autism spectrum disorder (ASD) frequently struggle with emotion regulation, which can be influenced by parental practices and the supportive role of siblings in encouraging emotional and social development. The study aimed to examine the relationship between parenting practices and emotional regulation of children with ASD and to explore the mediating role of the prosocial behavior of siblings between parenting practices and emotional regulation in children with ASD. Additionally, this study investigated the moderating role of sibling gender in the relationship between prosocial behavior and emotional regulation. A total of 600 parents/caregivers aged 25–40 years (M = 32.91, SD = 4.23) of children with ASD were selected from special education institutes in Lahore, Pakistan, using a non-probability, purposive sampling method. Although the majority of respondents were mothers (94.5%), the term parenting practices is used to reflect a family-level caregiving construct rather than exclusively maternal behavior. Data were interpreted through IBM SPSS Statistics 23 and PROCESS macros, revealing that authoritative parenting had a significant positive relation with emotional regulation in children with ASD. Results also indicated that the prosocial behavior of siblings partially mediated the relationship between authoritative parenting and emotional regulation in children with ASD. Furthermore, sibling gender significantly moderated the indirect effect, with female siblings showing stronger facilitation of emotional regulation through prosocial behaviors compared to male siblings. Full article
16 pages, 719 KB  
Article
Investigating the Adoption of Mixed Reality for Collaboration and Inspection in Construction
by Saddam Hussain Khurram, Shengjun Miao, Khurram Iqbal Ahmad Khan, Aboubakar Siddique, Naheed Akhtar and Xiangfan Shang
Buildings 2026, 16(3), 643; https://doi.org/10.3390/buildings16030643 - 3 Feb 2026
Abstract
Mixed Reality (MR) overlays digital content onto the physical world, holding significant promise for improving construction collaboration and inspection. This study investigates its current role via a quantitative, survey based methodology, collecting data from 125 global construction professionals. Descriptive statistics revealed limited MR [...] Read more.
Mixed Reality (MR) overlays digital content onto the physical world, holding significant promise for improving construction collaboration and inspection. This study investigates its current role via a quantitative, survey based methodology, collecting data from 125 global construction professionals. Descriptive statistics revealed limited MR adoption, with 40.8% of respondents using the technology rarely and just 12.8% reporting frequent usage. Reliability analysis confirmed strong internal consistency for perceived benefits (α = 0.935) and acceptable consistency for barriers (α = 0.762). Exploratory factor analysis (KMO = 0.932; Bartlett’s test of sphericity, p < 0.001) validated the unidimensionality of the benefits construct. Multiple regression analysis revealed no significant relationship between perceived benefits or barriers and MR usage frequency (R2 = 0.011, p = 0.512). Chi square analysis found no significant regional differences in MR use (χ2 = 115.4, p = 0.899), though this result warrants cautious interpretation given the sparse expected cell counts. The findings suggest that MR adoption may be influenced by factors beyond user perceptions, highlighting the importance of organisational readiness, training, and infrastructure support. Full article
(This article belongs to the Section Construction Management, and Computers & Digitization)
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26 pages, 9885 KB  
Article
Hybrid LQR-H2 Control of a Kestrel-Based Ornithopter with a Nature-Inspired Flow Control Device for Gust Mitigation
by Saddam Hussain, Ali Hennache, Nouman Abbasi and Dajun Xu
Biomimetics 2026, 11(2), 109; https://doi.org/10.3390/biomimetics11020109 - 3 Feb 2026
Abstract
Unsteady atmospheric disturbances significantly compromise the stability of ornithopters, necessitating advanced turbulence-mitigation strategies. In contrast, natural flyers display remarkable aerodynamic adaptability through dynamic flow-control mechanisms such as covert feathers, enabling stability across unsteady flow regimes. Drawing inspiration from this biological phenomenon, this study [...] Read more.
Unsteady atmospheric disturbances significantly compromise the stability of ornithopters, necessitating advanced turbulence-mitigation strategies. In contrast, natural flyers display remarkable aerodynamic adaptability through dynamic flow-control mechanisms such as covert feathers, enabling stability across unsteady flow regimes. Drawing inspiration from this biological phenomenon, this study presents the modeling and hybrid control of a kestrel-based ornithopter equipped with a Nature-Inspired Flow Control Device (NFCD) that replicates the adaptive feather deployment mechanism observed in kestrels. A reduced-order multibody bond-graph model (BGM) of the full ornithopter is developed, incorporating the main body, propulsion system, rigid wings, and the NFCD subsystem. The model captures key fluid-structure-interaction (FSI) effects between morphing feathers and surrounding airflow. A Linear Quadratic Regulator (LQR) ensures optimal performance under nominal gust conditions (≤3 m/s), while an H2 controller activates during high-intensity gusts (≥4 m/s) to enhance disturbance rejection through electromechanical feather actuation. A gain-scheduled transition is employed in the intermediate gust range (3–4 m/s) to ensure a smooth transition between controllers. Simulations indicate up to 70% reduction in gust-induced oscillations and 32% gust-mitigation efficiency, achieved through feather actuation in the NFCD combined with hybrid control, stabilizing the ornithopter in less than 1.4 s under higher gust conditions. The close correspondence between simulated responses and previously reported findings validates the proposed approach. Overall, by merging biomimetic aerodynamics, nature-inspired flow control, and advanced control design, the LQR-H2 governed NFCD provides a promising pathway toward gust-tolerant ornithopters capable of resilient and stable flight in unsteady atmospheric environments. Full article
(This article belongs to the Special Issue Bioinspired Aerodynamic-Fluidic Design)
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3 pages, 168 KB  
Editorial
Preface: Fifth International Conference on Advances in Mechanical Engineering 2025 (ICAME-25)
by Muhammad Mahabat Khan, Muhammad Irfan, Manzar Masud and Ghulam Asghar
Eng. Proc. 2025, 111(1), 44; https://doi.org/10.3390/engproc2025111044 - 2 Feb 2026
Abstract
The fifth International Conference on Advances in Mechanical Engineering 2025 (ICAME-25) was held on 26th August 2025 by the Department of Mechanical Engineering, Capital University of Science and Technology (CUST) [...] Full article
1 pages, 137 KB  
Editorial
Statement of Peer Review
by Muhammad Mahabat Khan, Muhammad Irfan, Manzar Masud and Ghulam Asghar
Eng. Proc. 2025, 111(1), 45; https://doi.org/10.3390/engproc2025111045 - 2 Feb 2026
Abstract
In submitting conference proceedings to Engineering Proceedings, the volume editors of the proceedings certify to the publisher that all papers published in this volume have been subjected to peer review administered by the volume editors [...] Full article
18 pages, 3291 KB  
Article
Detecting Anomalies in Radon and Thoron Time Series Data Using Kernel and Wavelet Density Estimation Methods
by Muhammad Rafique, Awais Rasheed, Muhammad Osama, Adil Aslam Mir, Dimitrios Nikolopoulos, Kyriaki Kiskira, Aftab Alam, Georgios Prezerakos, Aqib Javed, Panayiotis Yannakopoulos, Christos Drosos, Georgios Priniotakis, Nikitas Gerolimos, Michail Papoutsidakis, Kimberlee Jane Kearfott and Saeed Ur Rahman
Geosciences 2026, 16(2), 64; https://doi.org/10.3390/geosciences16020064 - 2 Feb 2026
Abstract
Long-term monitoring of radon (222Rn) and thoron (220Rn) radioactive gases has been used in earthquake forecasting. Seismic activity before earthquakes raises the levels of these gases, causing abnormalities in the baseline values of radon and thoron time series (RTTS) [...] Read more.
Long-term monitoring of radon (222Rn) and thoron (220Rn) radioactive gases has been used in earthquake forecasting. Seismic activity before earthquakes raises the levels of these gases, causing abnormalities in the baseline values of radon and thoron time series (RTTS) data. This study reports applications of kernel density estimation (KDE) and wavelet-based density estimation (WBDE) to detect anomalies in radon, thoron, and meteorological time-series data. Anomalies appearing in the RTTS data have been assessed for their potential correlation with seismic events. Using KDE and WBDE, radon anomalies were observed on 12 March, 15 August, 17 September, in the year 2017, and 19 January 2018. Thoron anomalies were recorded on 12 March, 15 August, 17 September 2017, and 28 February 2018. Irregularities in RTTS were observed several days before seismic events. Anomalies in RTTS, detected using KDE, successfully correlated five out of nine seismic events while WBDE identified four anomalies in RTTS which were successfully correlated with the corresponding seismic events. The wavelet transform has been used to reduce noise at higher decomposition levels in radon and thoron time series. Findings of the study reveal the potential of radon and thoron time series that can be used as precursors for earthquake forecasting. Full article
(This article belongs to the Special Issue Editorial Board Members' Collection Series: Natural Hazards)
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17 pages, 4838 KB  
Article
Unseen Hazard Recognition in Autonomous Driving Using Vision–Language and Sensor-Based Temporal Models
by Faisal Mehmood, Sajid Ur Rehman, Asif Mehmood and Young-Jin Kim
Appl. Sci. 2026, 16(3), 1503; https://doi.org/10.3390/app16031503 - 2 Feb 2026
Abstract
Autonomous driving (AD) systems remain vulnerable to rare, ambiguous, and out-of-label (OOL) hazards that are insufficiently represented in conventional training datasets. This work investigates perception robustness under such conditions by using the Challenge of Out-Of-Label (COOOL) benchmark dataset, which consists of 200 dashcam [...] Read more.
Autonomous driving (AD) systems remain vulnerable to rare, ambiguous, and out-of-label (OOL) hazards that are insufficiently represented in conventional training datasets. This work investigates perception robustness under such conditions by using the Challenge of Out-Of-Label (COOOL) benchmark dataset, which consists of 200 dashcam video sequences annotated with both common and uncommon traffic hazards. We analyze that the behavior of widely used methods in the perception of components and present a multimodal pipeline in which we integrate YOLO11x for object detection, Hough Transform for lane estimation, and GPT-4o for scene description, and for temporal modeling, we use Long Short-Term Memory (LSTM) networks. On the COOOL benchmark, YOLO11x achieves an mAP@0.5 of 54.1% on the common object categories, whereas the detection of rare and OFL hazards remains challenging, with a recall of 72.6%. Incorporating temporal risk modeling improves hazard recall to 71.8%, indicating a modest but consistent gain in recognizing uncommon events. Hough Transform shows the stable behavior in standard conditions for lane estimation, with a mean lateral deviation of 8.9 pixels in daylight scenes and 13.4 pixels under low-light conditions. The temporal anomaly detection module attains an AUROC of 0.65, reflecting the limitation but meaningful discrimination between nominal and anomalous driving situations. For interpretability, the GPT-4o scene description module generates context-aware textual explanations with an object coverage score of 0.72 and a factual consistency rate of 78%, as assessed through manual inspection. The end-to-end pipeline operates at approximately 10–12 frames per second on a single GPU, supporting near-real-time analysis and optimization. Our results confirm that state-of-the-art perception models struggle with OOL hazards and that multimodal vision–language–temporal integration provides incremental improvements in robustness and interpretability when evaluated under the standardized out-of-distribution conditions. Full article
(This article belongs to the Special Issue Autonomous Vehicles and Robotics—2nd Edition)
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13 pages, 613 KB  
Article
Prevalence, Determinants, and Temporal Dynamics of Multidrug-Resistant Gram-Negative Bacilli in Urinary Tract Infection Patients from Central Portugal (2018–2022)
by Muhammad Adnan, Patrícia Coelho, Miguel Castelo-Branco and Francisco José Barbas Rodrigues
Bacteria 2026, 5(1), 8; https://doi.org/10.3390/bacteria5010008 - 2 Feb 2026
Abstract
Background: Multidrug-resistant (MDR) Gram-negative bacilli (GNBs) significantly compromise the effective management of urinary tract infections (UTIs) worldwide. As antimicrobial resistance varies across regions, locally tailored data are essential to guide empirical therapy. This study investigated the prevalence, determinants, and temporal dynamics of MDR [...] Read more.
Background: Multidrug-resistant (MDR) Gram-negative bacilli (GNBs) significantly compromise the effective management of urinary tract infections (UTIs) worldwide. As antimicrobial resistance varies across regions, locally tailored data are essential to guide empirical therapy. This study investigated the prevalence, determinants, and temporal dynamics of MDR GNBs in UTI patients from Central Portugal between 2018 and 2022. Methods: We conducted a retrospective observational study at a hospital center in Central Portugal, analyzing data from 2018 to 2022. Data from 5194 UTI patients with GNB-positive cultures were analyzed. Binary logistic regression was used to identify determinants of MDR GNBs, defined as resistance to ≥1 agent in ≥3 antibiotic classes. Results: The study population had a mean age of 64.5 ± 25.3 years, and females represented two-thirds of the sample (67.0%). The overall prevalence of MDR GNBs was 35.8%. Advanced age (≥75 years), male sex, and specific treatment contexts—particularly day treatment and laboratory-only cases—were independently associated with MDR. SBL-producing Enterobacterales and non-fermenting GNBs showed the highest risk levels. Conclusions: MDR GNBs are highly prevalent among UTI patients in Central Portugal, and their increasing trend—particularly in 2022—highlights an urgent need for strengthened surveillance and updated empirical treatment strategies. The observed temporal increase highlights the urgent need for strengthened regional surveillance and updated empirical treatment guidelines. Full article
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37 pages, 3366 KB  
Article
Fractional Calculus and Adaptive Balanced Artificial Protozoa Optimizers for Multi-Distributed Energy Resources Planning in Smart Distribution Networks
by Abdul Wadood, Bakht Muhammad Khan, Hani Albalawi, Babar Sattar Khan, Herie Park and Byung O Kang
Fractal Fract. 2026, 10(2), 101; https://doi.org/10.3390/fractalfract10020101 - 2 Feb 2026
Abstract
This paper presents two enhanced variants of the Artificial Protozoa Optimizer (APO), namely the Adaptive Balanced Artificial Protozoa Optimizer (AB-APO) and the Fractional Calculus-Enhanced Artificial Protozoa Optimizer (FC-APO), for optimal multi-Distributed Energy Resources (DERs) planning in smart radial distribution networks. The proposed framework [...] Read more.
This paper presents two enhanced variants of the Artificial Protozoa Optimizer (APO), namely the Adaptive Balanced Artificial Protozoa Optimizer (AB-APO) and the Fractional Calculus-Enhanced Artificial Protozoa Optimizer (FC-APO), for optimal multi-Distributed Energy Resources (DERs) planning in smart radial distribution networks. The proposed framework addresses the coordinated allocation of Electric Vehicle Charging Stations (EVCSs), photovoltaic (PV) units, and Battery Energy Storage Systems (BESS). The AB-APO introduces an adaptive balancing mechanism that dynamically regulates exploration and exploitation to improve convergence stability and robustness, while the FC-APO incorporates fractional-order dynamics to embed long-memory effects, enhancing numerical stability and search smoothness. The proposed optimizers are evaluated on the IEEE-33 and IEEE-69 bus systems under eight DERs penetration scenarios. Simulation results demonstrate significant reductions in real and reactive power losses, improved voltage profiles, and effective mitigation of EV-induced network stress. Real power loss reductions exceeding 54%, 38.53%, 53.78%, 38.20%, 61.68%, and 60.72% are achieved for the IEEE-33 system, while reductions of 64.32%, 63.51%, 64.33%, 63.51%, 67.31%, and 67.04% are obtained for the IEEE-69 system across Scenarios 3–8. Overall, the results highlight the effectiveness of adaptive balancing and fractional-order modeling in strengthening APO-based optimization and confirm the suitability of the AB-APO and FC-APO as efficient planning tools for future smart distribution networks. Full article
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15 pages, 1766 KB  
Article
Metaheuristic Optimizer-Based Segregated Load Scheduling Approach for Household Energy Consumption Management
by Shahzeb Ahmad Khan, Attique Ur Rehman, Ammar Arshad, Farhan Hameed Malik and Walid Ayadi
Eng 2026, 7(2), 65; https://doi.org/10.3390/eng7020065 - 1 Feb 2026
Viewed by 46
Abstract
In the face of escalating energy demand, this research proposes a demand-side management (DSM) strategy that focuses on appliance-level load shifting in residential environments. The proposed approach utilizes detailed energy consumption forecasts that are generated by ensemble machine learning models, which predict usage [...] Read more.
In the face of escalating energy demand, this research proposes a demand-side management (DSM) strategy that focuses on appliance-level load shifting in residential environments. The proposed approach utilizes detailed energy consumption forecasts that are generated by ensemble machine learning models, which predict usage at both whole-household and individual appliance levels. This granular forecasting enables the development of customized load-shifting schedules for controllable devices. These schedules are optimized using a metaheuristic genetic algorithm (GA) with the objectives of minimizing consumer energy costs and reducing peak demand. The iterative nature of GA allows for continuous fine-tuning, thereby adapting to dynamic energy market conditions. The implemented DSM technique yields significant results, successfully reducing the daily energy consumption cost for shiftable appliances. Overall, the proposed system decreases the per-day consumer electricity cost from 237 cents (without DSM) to 208 cents (with DSM), achieving a 12.23% cost saving. Furthermore, it effectively mitigates peak demand, reducing it from 3.4 kW to 1.2 kW, which represents a substantial 64.7% reduction. These promising outcomes demonstrate the potential for substantial consumer savings while concurrently enhancing the overall efficiency and reliability of the power grid. Full article
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22 pages, 5571 KB  
Article
Precision Planting for Smallholder Maize Crop in Pakistan—A Sustainable Mechanization and Engineering Design Approach
by Hafiz Sultan Mahmood, Hafiz Md-Tahir, Muzammil Husain, Muhammad Adnan Islam, Badar Munir Khan Niazi, Hadeed Ashraf, Mahmood Ali and Ayesha Khalil
AgriEngineering 2026, 8(2), 42; https://doi.org/10.3390/agriengineering8020042 - 1 Feb 2026
Viewed by 48
Abstract
Precision planting is critical for improving crop establishment and productivity in smallholder farming systems in Pakistan, where manual seeding remains labour-intensive, imprecise, and inefficient. The limited availability of suitable small planters and the impracticality of larger precision seeders for fragmented holdings further constrain [...] Read more.
Precision planting is critical for improving crop establishment and productivity in smallholder farming systems in Pakistan, where manual seeding remains labour-intensive, imprecise, and inefficient. The limited availability of suitable small planters and the impracticality of larger precision seeders for fragmented holdings further constrain mechanization. This study addressed these limitations by redesigning and enhancing a vertical-plate, single-row precision planter through the integration of a straight seed delivery path and shutter mechanism and evaluating it alongside three other manually operated precision planters. Laboratory experiments quantified the seed physical properties, metering accuracy, calibration performance, and seed damage, while field trials assessed the spacing precision, plant population, labour demand, field efficiency, and operating costs across 1000 m2 test plots. The punch-wheel planter exhibited the best performance, achieving a spacing precision coefficient of 6.79%, a field efficiency of 88.2%, and the lowest operating cost (PKR 799 acre−1), while the remaining planters also met acceptable operational standards. In comparison with manual sowing (20–25 man-hours acre−1), precision planters reduced labour to 6–8 man-hours acre−1, saving PKR 7000–9000 acre−1. Enhanced spacing uniformity improved the stand establishment and yield potential. These low-cost precision planters reduce drudgery, particularly for women farmers, minimize soil disturbance, and contribute to the Sustainable Development Goals of the United Nations by promoting sustainable smallholder mechanization. Full article
(This article belongs to the Special Issue Design and Optimization of Intelligent Planting Machinery)
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16 pages, 4097 KB  
Article
Actuator Fault-Tolerant Control of Anthropomorphic Manipulator Using Adaptive Backstepping and Neural Estimation of LuGre Friction Torque
by Khurram Ali, Khurram Shehzad, Sikender Gul, Syed Ali Ajwad and Adeel Mehmood
Machines 2026, 14(2), 156; https://doi.org/10.3390/machines14020156 - 30 Jan 2026
Viewed by 192
Abstract
This paper presents a fault-tolerant control (FTC) strategy for a six-degree-of-freedom (DoF) anthropomorphic manipulator operating under actuator faults and complex friction dynamics. The proposed framework integrates a backstepping control methodology with LuGre friction modeling and a feedforward neural network (FFNN) for friction estimation. [...] Read more.
This paper presents a fault-tolerant control (FTC) strategy for a six-degree-of-freedom (DoF) anthropomorphic manipulator operating under actuator faults and complex friction dynamics. The proposed framework integrates a backstepping control methodology with LuGre friction modeling and a feedforward neural network (FFNN) for friction estimation. Actuator faults are considered in the form of multiplicative efficiency losses and additive disturbances. An adaptive control law is developed to estimate and compensate for both friction and actuator faults in real time. The stability of the closed-loop system is guaranteed through Lyapunov theory. The simulation results validate the effectiveness and robustness of the proposed approach in ensuring precise trajectory tracking despite faults and friction uncertainties. Full article
(This article belongs to the Special Issue Machine Learning Application in Robots)
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11 pages, 709 KB  
Article
Complexity of Inheritance of Pathogenic Mutations Associated with Epilepsy in Consanguine Families from Pakistan
by Khajista Tahira, Anwar Ullah, Fazl Ullah, Jeena Aziz, Muhammad Ishaq Javed, Aasma Kiyani, Azra Khanum, Kerstin Hallmann, Tobias Baumgartner, Rainer Surges, Pakeeza Arzoo Shaiq and Wolfram S. Kunz
Genes 2026, 17(2), 157; https://doi.org/10.3390/genes17020157 - 29 Jan 2026
Viewed by 125
Abstract
Background/Objectives: Consanguine families are helpful to identify recessive candidate genes for inherited diseases, but can also show an unusual inheritance pattern of pathogenic mutations. In this case series, we demonstrate this in five consanguine families with epilepsy from Pakistan. Methods: We [...] Read more.
Background/Objectives: Consanguine families are helpful to identify recessive candidate genes for inherited diseases, but can also show an unusual inheritance pattern of pathogenic mutations. In this case series, we demonstrate this in five consanguine families with epilepsy from Pakistan. Methods: We performed whole exome sequencing of respective index patients, analyzed the data using two different models for inheritance of mutations and determined the segregation pattern of relevant mutations in the families by bi-directional Sanger sequencing. Results: Apart from mutations in classical dominant epilepsy genes (TSC2, DEPDC5, and CACNA1I), pathogenic mutations in rare recessive epilepsy-related genes (PGAP2, NOVA2, and CCDC88C) were also identified. Interestingly, we were able to provide evidence that GALR2 is potentially an additional gene associated with a recessive form of epilepsy. In one family, a homozygous ‘pathogenic’ TRAF3IP1 p. Gly387* nonsense mutation was identified, which, most probably due to stop-codon read-through, did not contribute to the phenotype. Conclusions: Our case series of consanguine families with epilepsy exemplifies the inheritance pattern of mutations in rare recessive epilepsy genes, and shows that mutations in classical epilepsy genes showing dominant or sporadic inheritance can also be relevant. That requires the analysis of whole exome data on the basis of different inheritance models. Full article
(This article belongs to the Special Issue Molecular Genetics of Neurodevelopmental Disorders: 2nd Edition)
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16 pages, 304 KB  
Article
Exploring the Link Between Working Hours and Quality of Life: Cross-Country Evidence from 62 Countries
by Talal H. Alsabhan, Mohammed Jaboob, Osama Aljameel, Shatha Salem Alruwali, Muhammad Tahir and Umar Burki
Soc. Sci. 2026, 15(2), 66; https://doi.org/10.3390/socsci15020066 - 27 Jan 2026
Viewed by 193
Abstract
This research paper focuses on the role of average working hours (AVHs) of the labor force in explaining the variation in QOL across countries, which is an important but unexplored area in the empirical literature. Using data from 62 countries and employing several [...] Read more.
This research paper focuses on the role of average working hours (AVHs) of the labor force in explaining the variation in QOL across countries, which is an important but unexplored area in the empirical literature. Using data from 62 countries and employing several econometric techniques, we show that long AVHs are detrimental for improved QOL. The sub-sample results demonstrate that AVHs have a significant detrimental impact on the QOL of the population only in the case of developing countries. However, in the case of developed countries, the influence of AVHs is insignificant as these countries are enjoying relatively reduced AVHs as compared to developing countries. Moreover, our results indicate that the labor force participation rate, human capital, government expenditures, internet use, and electricity consumption are the main driving forces behind a better QOL both in developed and developing countries. Finally, we found evidence that trade openness is an irrelevant factor in explaining the variation in QOL as it is insignificant in most of the specifications despite possessing a positive coefficient. Full article
14 pages, 293 KB  
Article
Erectile Dysfunction and Its Impact on Health-Related Quality of Life in Prostate Cancer Patients: A Multicenter Cross-Sectional Study from Pakistan
by Mateen Abbas, Márió Gajdács, Georgina Balogh, Sana Ahmed, Rabia Mahfooz and Abad Khan
Epidemiologia 2026, 7(1), 17; https://doi.org/10.3390/epidemiologia7010017 - 27 Jan 2026
Viewed by 183
Abstract
Background/Objectives: Prostate cancer (PC) is one of the most commonly diagnosed malignancies globally; depending on the treatment strategy used, erectile dysfunction (ED) is a frequently reported adverse outcome among PC patients. The current study evaluated ED prevalence among Pakistani PC patients and its [...] Read more.
Background/Objectives: Prostate cancer (PC) is one of the most commonly diagnosed malignancies globally; depending on the treatment strategy used, erectile dysfunction (ED) is a frequently reported adverse outcome among PC patients. The current study evaluated ED prevalence among Pakistani PC patients and its effects on physical, psychological, and social well-being, aiming to address critical gaps in survivorship care for this population. Methods: A cross-sectional, multicenter, observational, questionnaire-based study was conducted in Rawalpindi and Islamabad, Pakistan, from February to April 2025. Health-related quality of life (HRQoL) among PC patients was measured using the Short Form Health Survey 36 (SF-36), while ED prevalence and severity were assessed by the International Index of Erectile Function (IIEF) instrument. Results: Among N = 400 PC patients, surgical treatments predominated (radical prostatectomy: 61.0%; n = 244), while hormonal (androgen-deprivation therapy: 31.5%; n = 126) and chemotherapy (23.3%; n = 93) were also commonly utilized. ED experience was high among PC patients in the erectile function (40.8%; n = 163) and in the intercourse satisfaction (45.0%; n = 180) domains; these showed moderately strong and significant positive correlations across all SF-36 domains, particularly physical functioning (r = 0.52; p < 0.001) and social functioning (r = 0.49; p < 0.001). Regression analysis confirmed sexual function domains explained 60% of HRQoL variance (adjusted R2 = 0.60). Conclusions: This study reveals high rates of treatment-related ED—and its biopsychosocial impact–among Pakistani PC patients, with significant negative impacts on HRQoL. The findings underscore the urgent need to integrate sexual health management into standard oncological care practices to improve holistic patient outcomes. Full article
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