Search Results (2,807)

Higher Education Institutions (HEIs) are increasingly tasked with fostering pro-environmental agency to address the global climate crisis. Within physical activity and sport sciences, future nautical sports managers occupy a unique role as stewards of marine ecosystems. This study investigates the sustainability consciousness of 170 undergraduate university students from a single institution. It focuses on analyzing the knowledge–action gap within the framework of the 2030 Agenda. Utilizing the Sustainability Consciousness Questionnaire (SCQ-S), this work assessed knowledge, attitudes, and behaviors to quantify this dissonance through a robust non-parametric statistical pipeline. Results indicate a significant knowledge–action gap (r_B = 0.903), representing a large matched-pairs rank-biserial correlation effect size for the Wilcoxon test. Furthermore, Kruskal–Wallis analyses reveal that this discrepancy is transversal across student profiles, suggesting a state of informed paralysis within this specific cohort, where high theoretical mastery fails to translate into sustainable professional routines. Crucially, the frequency of engagement in nature-based sports, encompassing both nautical and terrestrial outdoor activities, does not significantly reduce this dissonance. These contextual findings indicate that physical exposure to nature does not automatically mitigate the knowledge–action gap, highlighting the need for explicit reflective pedagogies in higher education. Full article

Background: Children with IBD are at increased risk of suboptimal maintenance of vaccine-induced immunity, particularly when the MMR vaccination course is incomplete before diagnosis and initiation of immunosuppressive therapy. We conducted a prospective study to evaluate the durability of antibody responses to measles, mumps, and rubella in pediatric IBD patients and to determine how completeness of MMR vaccination influences long-term antibody persistence over 12 months. Methods: Sixty children with IBD were included. Demographic characteristics, clinical disease activity (PUCAI/PCDAI), inflammatory markers (CRP, ESR), and fecal calprotectin were extracted from electronic medical records. Vaccination completeness was ascertained from documented immunization history. Serum antibodies to measles, rubella, and mumps were measured at baseline and after 12 months. Seroprotection was defined using standard laboratory thresholds. Antibody decay over time was assessed with paired non-parametric tests, and time to loss of seroprotection was analyzed using Cox proportional hazards models. In addition, Bayesian ANOVA modeling was applied to quantify evidence for differences in antibody concentrations and decay kinetics according to vaccination status. Results: Overall, 66.7% of patients had completed the full MMR vaccination course. At baseline, seroprotection rates were 48.3% for measles, 76.7% for rubella, and 70% for mumps. After 12 months, median antibody concentrations declined significantly for all three antigens. Corresponding seroprotection rates changed to 46.7% for measles (p = 0.414), 70% for rubella (p = 0.046), and 66.7% for mumps (p = 0.157). Incomplete MMR vaccination was identified as a major modifiable risk factor for accelerated antibody waning in children with IBD. Cox regression demonstrated that incompletely vaccinated patients had a 2.13-fold higher risk of losing measles seroprotection (95% CI 1.07–4.24; p = 0.032), a 5.27-fold higher risk for rubella (95% CI 1.86–14.95; p = 0.002), and a 4.82-fold higher risk for mumps (95% Cl 1.68–13.85; p = 0.004). Bayesian analyses provided decisive evidence that vaccination completeness strongly influences baseline antibody levels. Conclusions: Incomplete MMR vaccination is associated with markedly reduced durability of vaccine-induced immunity to measles, mumps, and rubella in children with IBD. These findings underscore the need for systematic prevaccination screening, timely completion of age-appropriate vaccination before initiation of immunosuppressive therapy when feasible, and individualized serological monitoring to identify patients at highest risk of vaccine-preventable infections. Full article

Background: Outdoor activity is essential for healthy aging, yet the affective, cognitive, and behavioral pathways linking perceived neighborhood environment to outdoor activity in middle-aged and older Chinese adults remain underexplored. Objective: This cross-sectional study examined associations between perceived spatial environment and outdoor activity, and tested five candidate mediators in a parallel-mediation framework, among community-dwelling adults aged ≥ 50 in Xiamen, China. Methods: Of 251 returned questionnaires, 99 cases with inconsistent response patterns and 12 high-leverage cases (Cook’s D > 3/n) were excluded, yielding N = 140. Hierarchical regression and non-parametric bootstrap mediation (5000 resamples; bias-corrected 95% Cis) were conducted, with sensitivity analyses, Fornell–Larcker discriminant-validity assessment, and Harman’s single-factor test for common-method bias. Results: Perceived spatial environment was strongly associated with outdoor activity (β = 0.96, p < 0.001). Bootstrap analyses identified four significant indirect pathways—place attachment (0.26 [0.13, 0.39]), perceived social environment (0.21 [0.11, 0.31]), service environment (0.18 [0.09, 0.28]), and attitudinal preferences (0.17 [0.05, 0.29])—whereas the a priori hypothesized behavioral mediator, social interaction, did not reach statistical significance (0.10 [−0.000, 0.205]). Sensitivity analyses confirmed coefficient stability across outlier-trimmed and untrimmed samples. Conclusions: Findings are consistent with an environment–behavior model in which affective and cognitive constructs—particularly place attachment—appear to be more proximal mediators than enacted social-interaction frequency. Given high inter-construct correlations (limited discriminant validity) and a self-selected community-active sample, results are best interpreted as hypothesis-generating and require replication with longitudinal and multi-method designs. Full article

Background: The aim of this ex vivo study was to compare the resistance to lateral wall failure during sequential implant site preparation using osseodensification (OD) burs and conventional rotary drills in a standardized narrow ridge model. The primary outcome was the drill diameter at first lateral wall perforation. Secondary outcomes included paired perforation occurrence at a clinically relevant diameter (4.0 mm) and perforation morphology (length and width). Methods: Twenty standardized trabecular bone blocks were prepared in a paired within-specimen design, with each block receiving two osteotomies: one prepared using conventional rotary drills and the other using OD burs. Osteotomy diameter was sequentially increased according to the manufacturers’ protocols until lateral wall perforation occurred. The drill diameter at first perforation was recorded. Perforation morphology (length and width) was quantified using high-resolution extraoral digital scanning and software-based measurements. Statistical analysis was performed using paired non-parametric tests (α = 0.05). Results: OD burs significantly delayed lateral wall perforation compared with conventional drills (median 4.30 vs. 4.00 mm; p = 0.0000171). At the 4.0 mm drill step, perforation occurred in 16/20 (80%) conventional versus 2/20 (10%) OD preparations (p = 0.0013). Perforation length was significantly greater with conventional drilling (p = 0.000681), while no significant difference was observed for perforation width (p = 0.073). Conclusions: Within the limits of this decorticated trabecular ex vivo model, OD increased resistance to lateral wall failure, delayed perforation onset, and reduced perforation length compared with conventional drilling. Full article

Background: The nursing process provides a structured framework for delivering safe, holistic, and patient-centered care; however, its implementation in primary healthcare settings, particularly in low-resource systems, remains inconsistent due to limited training and institutional support. Objectives: This study aimed to evaluate the effectiveness of a structured educational intervention in improving nurses’ knowledge and practical competencies in applying the nursing process in primary healthcare centers in Vlora, Albania. Methods: A quasi-experimental study was conducted with 32 nurses from five public primary healthcare centers. Sixteen nurses received a structured training program consisting of theoretical instruction and case-based practice, while sixteen nurses served as a control group. Pre- and post-intervention assessments were performed using standardized questionnaires and skill evaluation tools, and differences were analyzed using nonparametric statistical tests. Results: The results showed clear improvements in the intervention group across all domains, after the training. The reported use of the nursing process increased from 62.5% to 100%, while the use of Gordon’s Functional Health Patterns increased from 6.3% to 93.7%. The use of NANDA nursing diagnosis increased from 62.5% to 100%. The proportion of nurses reporting written nursing care plans increased from 62.5% to 93.7%, and the implementation and evaluation of care plans increased from 62.5% to 100%. The control group showed no comparable progress. Nurses who participated in the training also reported increased confidence and consistency in applying the nursing process in daily practice. Conclusions: These findings suggest that structured, competency-based training programs may improve immediate nurses’ theoretical knowledge and practical skills. Such training may contribute to improving the quality of nursing care, but further studies and longer follow-up and patient-related results are needed. Full article

Background/Objectives: Oral squamous cell carcinoma (OSCC) remains clinically heterogeneous, and prognosis is not always fully explained by conventional clinicopathological parameters. Systemic inflammation and tumor metabolic alterations may provide complementary information on tumor biology. This study aimed to assess associations between preoperative inflammatory markers, isotope ratio mass spectrometry (IRMS)-derived tumor signatures, clinicopathological features, and survival outcomes in OSCC. Methods: This exploratory retrospective secondary analysis included 50 consecutive patients with surgically treated, histologically confirmed OSCC. Preoperative blood-based markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), white blood cell count, lymphocyte count, and C-reactive protein, were retrieved from routine laboratory tests. Matched tumor, surgical margin, and healthy oral mucosa samples were analyzed by IRMS for δ¹³C, δ¹⁵N, carbon and nitrogen content, and [N]/[C] ratio. Associations with clinicopathological variables, nodal status, overall survival (OS), and disease-free survival (DFS) were evaluated using non-parametric tests, Spearman correlations, and Cox regression models. Results: Tumor tissue showed a consistent isotope and elemental phenotype compared with healthy mucosa, including higher nitrogen content, lower carbon content, increased [N]/[C] ratio, lower δ¹⁵N, and less negative δ¹³C values. NLR, PLR, SII, and CRP were not robustly associated with standard clinicopathological features after correction for multiple testing. Correlations between inflammatory and isotope-derived parameters were modest. Higher NLR was associated with worse OS and DFS and remained significant after adjustment for pathologic nodal status. Less negative tumor δ¹³C showed a potential adverse prognostic signal. Conclusions: Systemic inflammatory markers and IRMS-derived tumor signatures appear to reflect partly distinct biological domains in OSCC. NLR may provide accessible prognostic information, while tumor δ¹³C warrants further validation as a metabolic biomarker. Full article

Background/Objectives: This study aimed to apply morphometric and multivariate analytical techniques to footprint evidence for forensic identity determination, focusing on sex estimation and the reconstruction of body proportions as components of the biological profile. By integrating detailed footprint metrics with body measurements, the research sought to develop discriminant and regression models to evaluate the predictive value of footprint metrics for sex estimation and selected somatic dimensions. Methods: Static bilateral footprints were obtained using charcoal powder impressions and digitized using ImageJ. Eleven footprint parameters (F1–F11) and eleven body measurements (B1–B11) were recorded. Sex-based differences were examined using appropriate parametric or non-parametric tests with effect sizes. Sex estimation was evaluated using discriminant function analysis and internally validated using leave-one-out and stratified 10-fold cross-validation. Regression models for stature and body dimension estimation were assessed with multicollinearity diagnostics and repeated 10-fold cross-validation, including RMSE, MAE, and cross-validated R². Results: The apparent discriminant classification accuracies were 74.0% for the right foot and 71.0% for the left foot. After internal validation, classification performance decreased to approximately 64–67%, indicating moderate discriminative ability. Reduced regression models showed the most stable validated performance for stature and arm span, although cross-validated R² values remained weak. Conclusions: Static footprint morphometry may provide supportive information for sex estimation and selected somatic dimensions in this Turkish adult sample. However, the validated performance indicates that these models should be interpreted as ancillary and exploratory tools rather than standalone forensic identification methods. Full article

Background and objectives: Cardiac surgery with cardiopulmonary bypass (CPB) is associated with endothelial glycocalyx injury and perioperative endothelial dysfunction. Syndecan-1 is commonly used as a biomarker of glycocalyx shedding, but data on its perioperative changes and their relationship with operative and patient-related factors remain limited. The aim of this study was to evaluate perioperative Syndecan-1 dynamics during coronary artery bypass grafting (CABG) with CPB and to assess associations with ischemia–reperfusion exposure and patient characteristics. Materials and methods: This prospective observational study included 147 patients undergoing elective CABG with CPB. Syndecan-1 concentrations were measured at five time points: before induction of anaesthesia, immediately after aortic cross-clamp application, immediately after aortic declamping, on arrival at the ICU and 24 h after surgery. Perioperative changes were analysed using non-parametric tests, Spearman’s rank correlation analysis and mixed-effects modelling. The study was registered at ClinicalTrials.gov (NCT03491163; registered on 29 March 2018). Results: Syndecan-1 concentrations changed significantly over time (p < 0.001), increasing from a baseline median of 49.74 ng/mL to a peak of 147.78 ng/mL at ICU admission, followed by a partial decline to 65.26 ng/mL at 24 h. Aortic cross-clamp duration was weakly but significantly associated with Syndecan-1 concentration at ICU admission (r_s = 0.243, p = 0.003) and with perioperative increases from baseline to ICU admission (ΔS4-1: r_s = 0.196, p = 0.017) and from aortic clamping to ICU admission (ΔS4-2: r_s = 0.207, p = 0.012). No significant associations were observed between CPB duration and Syndecan-1 concentrations in univariable analyses. In the mixed-effects model, a significant non-linear temporal pattern of Syndecan-1 concentrations was observed (both linear and quadratic time terms, p < 0.001). Male sex (β = 0.247, p = 0.009) and aortic cross-clamp duration (β = 0.016, p = 0.005) were independently associated with higher Syndecan-1 concentrations, whereas smoking status, age, BMI, diabetes status, EuroSCORE II, and CPB duration were not independently associated. Conclusions: Syndecan-1 concentrations increase significantly during cardiac surgery with cardiopulmonary bypass, peaking at ICU admission and partially declining within 24 h. Aortic cross-clamping duration, but not total CPB duration, showed weak associations with glycocalyx shedding. Male sex was independently associated with higher Syndecan-1 concentrations. These findings support ischemia–reperfusion injury as an important contributor to endothelial glycocalyx shedding during cardiac surgery. Full article

The introduction of respiratory multiplex PCR in the post-pandemic world has improved the detection of viral infections, whose clinical relevance is still being characterized. Patients with diabetes mellitus (DM) exhibit altered innate immune responses, yet the effect of concurrent viral infection on their inflammatory trajectory and clinical outcomes remains poorly characterized. This study examined whether diabetes is associated with a more pronounced inflammatory response, delayed resolution, and worse multi-organ outcomes during viral respiratory infections. A prospective, longitudinal cohort of 430 hospitalized adults (DM: n = 211; non-DM: n = 219) with PCR-confirmed viral respiratory infections was stratified into four groups by diabetes and co-infection status using a respiratory multiplex PCR panel. Serum IL-6, CRP, NLR, procalcitonin, and urea were measured at admission (Day 1) and at clinical stabilization (Day 6). All variables failed normality testing (Shapiro–Wilk p < 0.0001); non-parametric methods were applied. Receiver operating characteristic (ROC) analysis was used to identify candidate biomarker cutoffs for mortality prediction. SARS-CoV-2 was the predominant pathogen (29.1%). In an exploratory comparison limited by small subgroup sizes (n = 8 vs. n = 14), co-infected diabetic patients had higher baseline inflammatory markers than co-infected non-diabetic patients: median IL-6 32.87 vs. 6.20 pg/mL (Mann–Whitney p = 0.0006) and median CRP 103.83 vs. 23.03 mg/L (p = 0.0012). At the Day 6 checkpoint, co-infected diabetic survivors had higher IL-6 (12.01 vs. 6.13 pg/mL, p = 0.0183) and showed little within-group NLR change (Wilcoxon p = 0.2367); these Day 6 estimates are subject to survivor selection and should be interpreted accordingly. In-hospital mortality was 25.6% in diabetic vs. 3.7% in non-diabetic patients (p < 0.0001). Diabetic patients more frequently required orotracheal intubation (6.4% vs. 1.0%, p = 0.0207) and high-flow nasal oxygen (HFNO) support (7.9% vs. 1.8%, p = 0.0166). In an internal ROC analysis, baseline IL-6 showed the highest discriminatory performance for in-hospital mortality (AUC 0.812, 95% CI 0.772–0.848), with a candidate cutoff of > 55.78 pg/mL (sensitivity 71.0%, specificity 79.1%); IL-6 outperformed CRP (AUC 0.706, DeLong p = 0.0029) and NLR (AUC 0.656, DeLong p = 0.0001). As this cutoff was derived and evaluated in the same cohort, it is reported as exploratory and requires external validation. In this single-center cohort, diabetes was associated with a more pronounced baseline inflammatory profile, slower resolution of the neutrophil-to-lymphocyte ratio, and greater multi-organ involvement during viral respiratory infection, including in the small co-infected subgroup. In the full cohort, diabetes remained associated with higher mortality, IL-6, and CRP after adjustment for age, sex, and BMI; however, the small co-infected subgroups could not be adjusted, so those specific comparisons should be regarded as hypothesis-generating and need confirmation in larger, adequately powered multi-center cohorts. Full article

Background/Objectives: This study aimed to assess oral health values, oral hygiene habits, preventive dental attendance, and lifestyle-related risk factors among students at the University of Osijek and to compare findings between students enrolled in health-related and non-health-related study programs. Methods: A cross-sectional survey was conducted among 331 students (186 health-related and 145 non-health-related). Participants were recruited using a convenience sampling approach. Data were collected using an anonymous questionnaire comprising demographic information, oral health–related behaviors, and the Croatian version of the Oral Health Values Scale (OHVS-CRO). Group differences were analyzed using nonparametric statistical tests. Results: Students enrolled in health-related study programs reported significantly more favorable oral hygiene behaviors, including more frequent toothbrushing, greater use of dental floss, interdental brushes, and mouthwash, as well as more regular preventive dental attendance (all p < 0.05). They also achieved significantly higher OHVS-CRO scores across all domains and on the total scale (median total score: 42 vs. 40; p < 0.001). No significant differences were observed regarding smoking, alcohol consumption, or refined sugar intake. Conclusions: Students enrolled in health-related study programs demonstrated higher oral health values and more favorable oral health-related behaviors than students enrolled in non-health-related study programs. These findings suggest an association between educational orientation and oral health values and behaviors and may inform future oral health promotion initiatives targeting university students. Full article

Background. Children’s health-related quality of life (HRQoL) has been associated with both individual and family-related factors, including internalizing symptoms and parental psychological well-being. Although previous research has highlighted the role of parental mental health, evidence from non-clinical community samples remains limited, particularly when parent-proxy reports are used. Methods. A cross-sectional study was conducted among 242 parents of children aged 8–12 years in Northern Greece. Parents completed proxy measures of children’s HRQoL and internalizing symptoms, as well as self-reported measures of their own HRQoL and anxiety. Nonparametric tests were used for bivariate analyses, and multiple linear regression was applied to identify independent predictors of children’s HRQoL. Results. Higher parental mental HRQoL was positively associated with children’s HRQoL (ρ = 0.213, p = 0.031), while parental anxiety (trait anxiety: ρ = −0.204, p = 0.004; state anxiety: ρ = −0.314, p < 0.001) and parent-reported child internalizing symptoms (depression: ρ = −0.369, p < 0.001; anxiety: ρ = −0.322, p < 0.001) were negatively associated with HRQoL; however, in the multivariable model, only parental mental HRQoL (B = 0.344, p = 0.020) and parental education (B = −2.944, p = 0.044) remained significantly associated with parent-proxy child HRQoL, explaining 29.2% of the variance in children’s HRQoL (R² = 0.292). Conclusions. The findings suggest that parent-proxy child HRQoL is associated with parental psychosocial functioning in this community-based sample. Parental mental HRQoL was the strongest independent correlate of parent-proxy child HRQoL. However, given the exclusive use of parent-proxy reports and the convenience-based sample, these findings should be interpreted cautiously, as shared method variance, rater-related effects, and limited generalizability may have contributed to the observed associations. Further multi-informant and longitudinal studies conducted in more diverse populations are warranted. Full article

Background/Objectives: The nutrition transition in low- and middle-income countries has produced a double burden of malnutrition (coexistence of excess weight, undernutrition, and micronutrient deficiencies), with scarce evidence in schoolchildren from vulnerable peri-urban areas of Paraguay. The objective was to characterize, in a multidimensional way, the nutritional status of children and adolescents from Limpio and to explore its associations with anemia and clinical, dietary, and environmental variables, in particular, reported intestinal parasitosis. Methods: Cross-sectional observational study in 90 participants aged 6 to 16 years recruited by convenience at six community settings. Anthropometry, body composition, capillary hemoglobin, dietary patterns, and environment were assessed. Weight status was classified using the WHO 2007 references (z-scores), anemia was described using WHO thresholds, and central obesity was assessed using a waist-to-height ratio > 0.5. Non-parametric tests, Fisher’s exact test, Spearman correlations, and multivariable logistic regression were used. Results: Overweight or obesity affected 39.3% (obesity, 16.7%) and central obesity 22.4%, with no cases of thinness, coexisting with anemia (27.0%), stunting (8.2%), and reported intestinal parasitosis (24.1%). Anemia was more frequent in children with reported intestinal parasitosis (45% versus 20%; adjusted OR 5.44; 95% CI 1.44–20.51). Height-for-age was inversely associated with the number of siblings (ρ = −0.25). Conclusions: This population showed a double burden of malnutrition. The association between reported, non-laboratory-confirmed intestinal parasitosis and capillary-hemoglobin-defined anemia was exploratory and non-causal, given the cross-sectional design. Together with the high burden of anemia, these findings raise the hypothesis of a possible triple burden of malnutrition, which would require confirmation through stool parasitological testing and biomarkers of iron status, inflammation, and other micronutrients. These findings are compatible with integrated community strategies addressing dietary quality, sanitation, and access to safe water; decisions on deworming and micronutrient supplementation should be guided by local parasitological surveillance and biomarker-based assessment rather than by these data alone. Because the study used a convenience sample from a single peri-urban community during one fieldwork period, the findings should not be generalized beyond similar vulnerable settings without further confirmation. Full article

Aims: This study aimed to evaluate the agreement of a frequency sampling method (FR) as a tool for species identification while measuring undisturbed sward height. Methods: The botanical composition of both grazing systems was evaluated during the pre-grazing and post-grazing periods using two methods: the Dry Weight Rank (DWR) and FR. A non-parametric Friedman test was applied to compare evaluation methods and grazing moments. Differences in detection frequencies between methods were assessed using McNemar’s test for paired binary data. Results: The evaluation method did not influence the relative abundance of the three most abundant plant species identified: U. decumbens, Paspalum genus, and Commelinaceae weeds. A high positive Lin’s concordance correlation coefficient (CCC) was observed between the two methods in U. decumbens, Paspalum genus, U. brizantha cv. Marandú, U. plantaginea, U. arrecta, and U. humidicola (CCC ≥ 0.70). We observed lower agreement for some functional groups, particularly Commelinaceae weeds (CCC = 0.38), narrow-leaf weeds (CCC = 0.46), and Cyperaceae weeds (CCC = 0.17). Canonical correlation analysis (CCA) between the chemical composition of leaves and the botanical composition estimated by the DWR revealed two significant canonical functions (p < 0.01), with canonical correlations of 0.692 and 0.478 for the first and second functions, respectively. When botanical composition estimated by the FR was used as a regressor for leaf chemical composition, three significant canonical functions (p < 0.01) were identified, with canonical correlations of 0.632, 0.529, and 0.425 for the first, second, and third functions, respectively. Conclusions: FR represents a practical and complementary approach for assessing botanical composition and plant diversity in heterogeneous tropical grasslands, particularly for the rapid monitoring of dominant species. However, lower agreement was observed for some low-abundance functional groups, indicating reduced FR sensitivity for certain plant types. Full article

The HEROn magazine was created as an innovation project by the S-TEAM team for the 2024/2025 SUBMERGED season of the FIRST^® LEGO^® League Challenge category. The primary aim of the HEROn project was to implement game-based learning methods to enhance environmental awareness, particularly concerning the protection of our water resources. This initiative is designed to engage individuals from ages 9 to 99 in a creative and enjoyable manner. At the core of the HEROn project is a well-known game that challenges players to find the differences between two photos. This activity not only provides entertainment but also educates participants about the importance of protecting and preserving the aquatic environment. By discovering subtle differences between images, players become more attuned to environmental issues, which promotes a deeper understanding and appreciation of water conservation. The chapters of the HEROn magazine are thoughtfully organised into themes, each focusing on various aspects of water’s importance, its protection, and sustainable usage. Additionally, a random sample of participants was surveyed to gather opinions and feedback on HEROn magazine as part of the project and this research. This feedback is invaluable for assessing the magazine’s impact and for improving future editions to better serve the goals of raising environmental consciousness. The online HEROn questionnaire consisted of 10 items and employed a 5-point Likert scale for responses. Data were collected over a three-month period (28 January–28 April 2025), with 630 Hungarian respondents participating in the survey. The HEROn magazine was generally well received, with mean scores ranging from 4.2 to 4.6. Age-group differences were examined using nonparametric Kruskal–Wallis tests, with Dunn–Bonferroni post hoc comparisons. These analyses show statistically significant differences between adults (30–89) and the younger cohorts for aggregated awareness, design/engagement, and branding measures, while teenagers (9–15) and young adults (16–29) did not differ significantly from each other. The Find-the-Difference game showed the greatest variability across groups, with young adults giving the lowest mean. Full article

Background/Objectives: Uterine fibroids are one of the most prevalent forms of benign tumors in women and may substantially impair quality of life due to heavy menstrual bleeding, pelvic pain, and pressure-related symptoms. Transvaginal radiofrequency ablation (TV-RFA) has emerged as a promising minimally invasive, uterus-sparing treatment approach. However, there exists a paucity of data regarding the early vascular response evaluated through quantitative Doppler parameters. This study aimed to assess the short-term clinical outcomes and ultrasound effectiveness of TV-RFA in treating symptomatic uterine fibroids, with particular emphasis on early vascular and morphological response. Methods: This retrospective study included 38 women who presented with symptomatic uterine fibroids and underwent TV-RFA between July 2024 and December 2025. Inclusion criteria were as follows: (1) presence of up to three intramural fibroids (FIGO types 3–6) and (2) maximum diameter of fibroids: ≤6 cm. Patients were assessed at baseline and at 1- and 3-month follow-up visits. Ultrasound evaluation included the measurement of fibroid dimensions and volume as well as quantitative Doppler parameters (Pixels Power, Ratio, and CM² Power Index). Clinical outcomes were assessed based on the intensity and duration of menstrual bleeding. Statistical analysis was performed using nonparametric tests with significance set at p < 0.05. Results: Significant reductions in fibroid dimensions and volume were observed at both follow-up time points, with the greatest effect at 3 months (p < 0.001). Doppler analysis demonstrated a marked decrease in vascularization parameters, particularly CM² Power Index and Pixels Power (p < 0.001), suggesting an early vascular response to treatment. Clinically, the proportion of patients experiencing heavy menstrual bleeding considerably reduced, accompanied by a significant shortening of bleeding duration (p < 0.001). No major complications requiring surgical intervention were reported. Conclusions: TV-RFA was associated with significant short-term reductions in fibroid vascularization, fibroid volume, and bleeding-related symptoms in this cohort of women with symptomatic uterine fibroids. Quantitative Doppler parameters may serve as valuable early markers of treatment response; however, further studies with larger cohorts and a longer follow-up duration are warranted. Full article