Search Results (43,211)

Muscle–joint flexibility is defined as the ability of a muscle to stretch in a controlled manner, allowing a wide range of movement at the joints. While numerous methodologies exist for improving flexibility, few studies have investigated the role of athletes’ perceptual processes and awareness related to their own body and movement control during such training. In this pilot study, we explored how two different training protocols—static and dynamic stretching (control group, CON) and multi-joint resistance training (experimental group, EXP)—influence both flexibility and psychophysical awareness, understood as a multidimensional construct involving perceived flexibility improvements, self-assessed control over exercise execution, and cognitive-emotional responses such as engagement, motivation, and satisfaction during physical effort. The study involved 24 male amateur track-and-field athletes (mean age 23 ± 2.5 years), randomized into two equal groups. Over 12 weeks, both groups trained three times per week. Flexibility was assessed using the Sit and Reach Test at three time points (pre-, mid-, and post-intervention). A 2 × 3 mixed ANOVA revealed a significant group × time interaction (F = 20.17, p < 0.001), with the EXP group showing greater improvements than the CON group. In the EXP group, Sit and Reach scores increased from pre = 28.55 cm (SD = 4.91) to mid = 29.39 cm (SD = 4.67) and post = 29.48 cm (SD = 4.91), with a significant difference between pre and post (p = 0.01; d = 0.35). The CON group showed minimal changes, with scores of pre = 28.66 cm (SD = 4.92), mid = 28.76 cm (SD = 5.03), and post = 28.84 cm (SD = 5.10), and no significant difference between pre and post (p = 0.20; d = 0.04). Psychophysical awareness was assessed using a custom questionnaire structured on a 5-point Likert scale, with items addressing perception of flexibility, motor control, and exercise-related bodily sensations. The questionnaire showed excellent internal consistency (Cronbach’s α = 0.92). Within the EXP group, psychophysical awareness increased significantly (from 3.50 to 4.17; p = 0.01; d = 0.38), while no significant change occurred in the CON group (p = 0.16). Post-hoc power analysis confirmed small to moderate effect sizes within the EXP group, although between-group differences lacked sufficient statistical power. These results suggest that resistance training may improve flexibility and concurrently enhance athletes’ psychophysical self-awareness more effectively than traditional stretching. Such findings offer practical implications for coaches seeking to optimize flexibility training by integrating alternative methods that promote both physical and perceptual adaptations. Full article

Background: Skipping breakfast, a prevalent issue among children and adolescents, has been reported to be associated with academic performance and long-term health. However, less attention has been given to the types of breakfast foods consumed. Therefore, our study aims to investigate the association between breakfast variety and dietary knowledge, attitude, and practice (KAP) among preadolescents. Methods: The study included 1449 students in grades 4–6 from Zhongshan city, Guangdong province. Data were collected through face-to-face field investigation using a validated questionnaire. The questionnaire encompassed sociodemographic characteristics, as well as dietary KAP. Results: Among all participants, 1315 reported consuming breakfast daily. Dietary diversity varied significantly: 8.8% consumed only 1 type of food, 52.9% consumed 2–4 types, and 38.3% consumed ≥ 5 types. Students who consumed a greater variety of breakfast foods exhibited more favorable dietary and lifestyle patterns. Specifically, those who consumed ≥ 5 types of food showed statistically significant associations with healthier practices, including reduced intake of sugary beverages and night snacks, stronger adherence to dietary guidelines, more positive attitudes toward improving eating habits, longer sleep durations, increased participation in meal preparation, greater dish variety in meals, and higher engagement in daily physical activity. Conclusions: Breakfast variety was associated with KAP, particularly when breakfast types ≥ 5, providing more sufficient and favorable evidence for breakfast consumption. Full article

In recent years, the biomedical startup industry has flourished, and yet, it still faces challenges in adapting to changing market demands. Meanwhile, the widespread use of single-use medical devices generates significant waste, posing threats to environmental sustainability. Addressing this issue has become a critical challenge for humanity today. The study aimed to delve into the specific difficulties faced by Taiwanese biomedical entrepreneurs during the innovation and development of medical devices from a sustainability perspective and to explore solutions. This study collected first-hand experiences and insights from Taiwanese biomedical entrepreneurs through a literature review and expert questionnaires. It employed Interpretive Structural Modeling to analyze the development stages and interrelationships of biomedical device startups for building sustainable biomedical innovation. The Clinical Needs Assessment is revealed as the most influential factor, shaping Regulatory Feasibility Evaluation, Clinical Trial Execution, and Market Access Compliance. Our findings provide a structured problem-solving framework to assist biomedical startups in overcoming challenges while incorporating energy-saving and carbon reduction processes to achieve environment sustainability goals. The results of this study show that biomedical innovation practitioners should prioritize integrating sustainability considerations directly into the earliest stage of a Clinical Needs Assessment. Full article

The structure and interpersonal interactions of traditional residential communities have also been impacted and recreated as a result of the fast development of urban space and related communities. This study explores the interrelationship between neighborhood social cohesion and the life satisfaction of urban adult residents through the mediating effect of place attachment. A comprehensive theoretical model was constructed to analyze the action mechanism among these variables. Data were collected through an online questionnaire platform (n = 301), and structural equation modeling (PLS-SEM) was employed for analysis. The findings revealed a significant positive relationship between neighborhood social cohesion and residents’ place attachment. Place attachment appeared to play a mediating role between neighborhood social cohesion and life satisfaction, in which place dependence was also a potential effective mediator between the three dimensions of neighborhood social cohesion (neighborliness, sense of community, and neighborhood attractiveness) and life satisfaction. The results suggest that enhancing community cohesion may contribute to urban adult residents’ well-being by strengthening their functional dependence on the community. Full article

Background: Gum chewing is a common habit among young adults, often promoted for its oral health and psychological benefits. However, as a repetitive and non-functional activity, it is also considered a potential risk factor for temporomandibular disorder (TMD), particularly when practiced chronically. The aim of this study was to evaluate whether excessive gum chewing is associated with a higher prevalence of TMD among young adults presumed to be under elevated academic stress based on their demographic characteristics. Methods: Participants were examined in Krakow, Poland, using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol. Participants completed a structured questionnaire assessing gum-chewing frequency, duration, and chronicity. Associations between chewing behaviors and TMD presence were analyzed using univariate logistic regression (α = 0.05). Results: This study included young adults 66 participants aged 19–30. TMD was diagnosed in 55 participants (83.3%), including muscular disorders (n = 9; 16.4%), articular disorders (n = 10; 18.2%), and combined muscular–articular disorders (n = 38; 57.6%). More than 70% of participants reported chewing gum for over five years. No statistically significant associations were found between TMD occurrence and the frequency, duration, or chronicity of gum chewing (p > 0.05). Conclusions: These findings suggest that, in the absence of other contributing factors, gum chewing may not independently contribute to TMD development. The elevated TMD prevalence may reflect confounding variables such as high academic stress, narrow age distribution, or female predominance. However, the limited sample size limits statistical power, particularly for detecting subtle effects potentially distorted by other variables. Additionally, the cross-sectional nature of this study precludes causal interpretation. Further studies in larger and more heterogeneous populations are recommended. Full article

Background/Objectives: The purpose of this study was to clinically characterize the lacrimal functional unit (LFU) of patients with chronic ocular pain associated with dry eye disease (DED). Methods: Ninety-three participants were included in this cross-sectional study: 28 patients with chronic ocular pain associated with DED (pain-DED), 35 patients with DED but no pain (no pain-DED), and 30 subjects without DED or ocular pain (controls). The following examinations were performed: symptom questionnaires, visual function assessment, tear meniscus, ocular surface evaluation, meibography, corneal sensitivity, Schirmer test, and in vivo corneal confocal microscopy. Results: Both DED groups presented increased DED-related symptoms (p < 0.001), corneal staining (p < 0.001), Meibomian gland loss (p < 0.010), and dendritic cell density (p < 0.001) compared with controls. Comparing both DED groups, the pain-DED group showed higher DED-related symptoms (p < 0.002) and increased microneuroma density (p < 0.001). Additionally, significant positive correlations were observed between symptom questionnaires and corneal staining (vs. OSDI: r = 0.514, p < 0.001; vs. m-SIDEQ: r = 0.504, p < 0.001; vs. NRS: r = 0.361, p < 0.001; vs. WBFPRS: r = 0.317, p = 0.002), dendritic cell density (vs. OSDI: r = 0.429, p < 0.001; vs. m-SIDEQ: r = 0.440, p < 0.001), and microneuroma density (vs. NRS: r = 0.405, p < 0.001; vs. WBFPRS: r = 0.416, p < 0.001). Conclusions: Differences in the LFU, especially in the morphology of sub-basal corneal nerves, are related to the presence of DED and chronic ocular pain and, along with ocular clinical questionnaires, can help phenotype these patients. Full article

(1) Background: Physical activity (PA) plays a crucial role in preserving and enhancing mental health, particularly in the aftermath of major health crises such as the COVID-19 pandemic. However, the specific levels and domains of physical activity that have the greatest impact on alleviating symptoms of anxiety, depression, and stress in the post-COVID-19 period remain unclear. The aim of this study was to examine the influence of different levels and domains of PA on mental health parameters, specifically symptoms of anxiety, depression, and stress, in individuals who had recovered from COVID-19. (2) Methods: The study included initial measurements (2–4 weeks post-recovery) and final measurements (14–16 weeks post-recovery). The sample comprised 288 participants aged 20 to 60 years (M = 47.06; SD = 12.41), with 95 men and 193 women. PA was assessed using the long version of the IPAQ questionnaire, while mental health was evaluated using the long version of the DASS scale. (3) Results: Stepwise regression analysis revealed that low- (p = 0.010) and moderate-intensity (p = 0.022) PA was significantly associated with reductions in anxiety symptoms as well as lower stress levels (low PA: p = 0.014; moderate PA: p = 0.042). Total PA (p < 0.001) and vigorous-intensity PA (p = 0.008) emerged as significant predictors of reduced depression levels. Among the domains of PA, home-based activities had a statistically significant impact on all three mental health components: anxiety (p = 0.005), depression (p = 0.002), and stress (p = 0.041). Transport-related PA was significantly associated with anxiety (p = 0.011) and stress (p = 0.022), but not with depression. (4) Conclusions: The results suggest that a combined model incorporating different levels and domains of PA may represent an effective approach to improving mental health in individuals recovering from COVID-19. Further longitudinal studies are needed to establish more precise causal relationships. Full article

Social marketing modifies individual behavior to achieve specific outcomes, mitigating environmental pressures. While proven effective in influencing consumer behavior, empirical studies on its impact on the tourism sector remain limited. This study examines how various social marketing channels influence tourists’ consumption decisions and contributes to achieving SDGs 11 and 12 by reviewing the existing methods of disseminating social marketing content. A conceptual model grounded in theory was developed and empirically tested. In particular, it focuses on the establishment of direct and indirect multi-route effects between social marketing and consumer behavior and introduces different influencing factors. Given the scarcity of research on collective culture, quantitative methods were employed, with data collected through questionnaires in mainland China. Results indicate that social marketing media significantly influence tourist behavior, with three mediators—subjective norms, personal values, and communication channels—playing varying roles across media types (events, public relations, and traditional media). Subjective norms, values, and communication channels act as mediators. This study bridges social marketing, tourist behavior, and SDG attainment, offering novel insights and practical implications for tourism practitioners. Full article

The Gahai wetland in Gansu, China, is a key wetland for nationally and globally threatened bird species. This research aims to quantify the economic value of wetland birds by the method of contingent valuation questionnaire, thereby providing a foundation for conservation of avian species. The result indicated that residents were willing to pay between 208 and 230 CNY (29–32 USD $) annually for bird protection, a total annual value of wetland birds in Luqu County ranging from 7.9 M to 8.8 M CNY (1.1–1.3 M USD $). Men, locals, and older individuals were more inclined to contribute and offered higher payments, albeit non-significant correlation between education level and annual income with the willingness to pay. While the depth of understanding of wetland pressures did not significantly influence the willingness to pay, it did show a positive correlation; those with more profound understanding tended to be more generous in their payments. Tibetan male residents were more likely to prioritize ecological and environmental protection due to their religious beliefs and cultural customs, which emphasize the reverence for and compassion towards birds. This research not only complemented and validated the applicability of the contingent valuation method in China but also underscores the considerations that should be taken into account when employing this method. Full article

Food addiction (FA) is an emerging psychiatric condition that presents behavioral and neurobiological similarities with other addictions, and its early identification is essential to prevent the development of more severe disorders. The aim of the present study was to determine the ability of anthropometric measures, eating habits, symptoms related to eating disorders (ED), and lifestyle features to predict the symptoms of food addiction. Methodology: A cross-sectional study was conducted in a sample of 702 university students (77.3% women; age: 22 ± 6 years). The Food Frequency Questionnaire (FFQ), the Yale Food Addiction Scale 2.0 (YFAS 2.0), the Eating Attitudes Test (EAT-26), anthropometric measurements, and a set of self-report questions on substance use, physical activity level, and other questions were administered. A total of 6.4% of participants presented symptoms compatible with food addiction, and 8.1% were at risk for ED. Additionally, 26.5% reported daily smoking, 70.6% consumed alcohol, 2.9% used illicit drugs, and 29.4% took medication; 35.3% did not engage in physical activity. Individuals with food addiction had higher BMI (p = 0.010), waist circumference (p = 0.001), and body fat (p < 0.001) values, and a higher risk of eating disorders (p = 0.010) compared to those without this condition. In the multivariate logistic model, non-dairy beverage consumption (such as coffee or alcohol), vitamin D deficiency, and waist circumference predicted food addiction symptoms (R²_Nagelkerke = 0.349). Indeed, the machine learning approaches confirmed the influence of these variables. Conclusions: The prediction models allowed an accurate prediction of FA in the university students; moreover, the individualized approach improved the identification of people with FA, involving complex dimensions of eating behavior, body composition, and potential nutritional deficits not previously studied. Full article

Healthcare abuse is a critical human rights and public health issue, particularly impacting medical interns and trainees who are vulnerable to mistreatment during their formative professional years. This cross-sectional study, conducted from February to June 2024, evaluated the prevalence and psychological impact of harassment and discrimination among 463 healthcare interns in Saudi Arabia from various specialties, including medicine, nursing, pharmacy, and dentistry. Using a self-administered online questionnaire, we found that mistreatment was widely reported, with female interns experiencing significantly higher rates of sexual harassment and gender-based discrimination. Common perpetrators included residents, lecturers, professors, nurses, and patients, with incidents most frequently occurring in surgical and internal medicine departments. Despite high prevalence, only 9% of interns reported the abuse due to mistrust in reporting systems or failure to recognize the behavior as abuse. These experiences were associated with significant psychological distress, including frustration, reduced motivation to learn, and higher DASS scores, particularly among female interns. The study underscores the need for institutional reforms, including policy development, cultural change, and effective reporting systems to ensure a safe and supportive learning environment for future healthcare professionals. Addressing abuse in medical training is essential for individual well-being and the sustainability and integrity of healthcare systems. Full article

Extra-pulmonary tuberculosis (EPTB) can affect any organ of the body, producing a wide variety of clinical manifestations that make the diagnosis and treatment of EPTB challenging. The optimum treatment varies depending on the site of EPTB, its severity, and response to treatment. There is often uncertainty about the best management practices, with a significant departure from national guidelines. This study aims to identify gaps and barriers in adhering to the national guidelines for the diagnosis and treatment of EPTB. We included 433 patients having EPTB and followed up at predefined intervals of 2 months, 6 months, 9 months, and 12 months. Questionnaire-based interviews of the treating physician and the patients in different departments were conducted. For confirmatory diagnosis, heavy dependence on clinical-radiological diagnosis without microbiological support was observed, which is a deviation from National Tuberculosis Elimination Programme (NTEP) guidelines and raises concerns about the potential for misdiagnosis and overtreatment. Apart from patient delays, long health system delays in EPTB were observed. The median patient delay, health system delay, and total treatment delay times were 4.2, 4, and 10.1 weeks, respectively. To enhance EPTB diagnosis and management, there is a pressing need for improved access to microbiological testing, enhanced physician training on adherence to NTEP guidelines, and greater utilisation of imaging and histopathological techniques. Full article

Background: Individuals with intellectual disability face an increased risk of mental health issues compared to the general population. Despite the proven efficacy of physical activity (PA) in improving anxiety and depression in the general population, little is known about this relationship in adults with intellectual disability and the factors that influence it. The purpose of the study was to determine whether a correlation exists between PA and perceived levels of anxiety and depression, and assess gender disparities in PA and mental health. Method: People with intellectual disability were recruited from day centers and sports events. The amount of PA was evaluated through the International Physical Activity Questionnaire. Perceived mental health was assessed through the Zung Self-Rating Anxiety (ZAS) and Depression Scale (ZDS). Results: In total, 99 adults (34 females, aged 33 ± 12) participated in the study. A gender disparity was found in anxiety levels, while depression, PA, and type of sport participation did not differ between males and females. Multiple regression analysis highlights how the depression score was significantly predicted by gender (β = −3.57, p = 0.015), intellectual disability level (β =−3.08, p < 0.008), and PA (β =−0.10, p= 0.001), while anxiety was influenced by gender (β = −4.48, p = 0.003) and intellectual disability level (β = −3.23, p = 0.007). Conclusions: These findings underscore the relevance of physical activity as a factor associated with lower depressive symptoms in adults with intellectual disability, highlighting its potential role in mental health promotion within this population. Full article

Background: Sarcopenic obesity, characterized by reduced skeletal muscle mass and excess adiposity, is strongly associated with chronic pain and functional decline in older adults. Objective: This prospective controlled trial without randomization investigated the effects of a structured, three-phase rehabilitation program on physical performance, pain, and sarcopenia-specific quality of life in elderly patients with sarcopenic obesity and chronic pain. Methods: In this study, 82 participants were enrolled and allocated to a study group (SG, n = 40), receiving supervised rehabilitation, nutritional counseling, and supplementation, or to a control group (CG, n = 42), which did not receive rehabilitation. The final analysis included 35 patients in SG and 36 in CG. Outcomes were assessed at baseline and six months using the Sarcopenia Quality of Life Questionnaire (SarQoL), Short Physical Performance Battery (SPPB), Numeric Rating Scale (NRS), and Pressure Pain Threshold (PPT). Results: The SG showed significant improvements in all outcomes: SarQoL increased from 57.02 to 63.98, SPPB increased from 7.14 to 8.4, PPT increased from 69.31 to 78.05, and NRS decreased from 6.94 to 4.65 (all p < 0.001). The CG showed no significant changes. Conclusions: The implementation of a structured, three-phase rehabilitation program resulted in clinically and statistically significant improvements in physical performance, pain perception, and sarcopenia-related quality of life in older adults with sarcopenic obesity and chronic pain. Full article

Background: The longitudinal RisCoin study investigated risk factors for COVID-19 vaccination failure among healthcare workers (HCWs) and patients with inflammatory bowel disease (IBD) at a University Hospital in Germany. Since the hospital served as the study sponsor and employer of the HCW, we implemented a custom mobile application. We aimed to evaluate the implementation, adherence, benefits, and limitations of this study’s app. Methods: The app allowed secure data collection through questionnaires, disseminated serological results, and managed bidirectional communication. Access was double-pseudonymized and irreversibly anonymized six months after enrollment. Download frequency, login events, and questionnaire submissions between October 2021 and December 2022 were analyzed. Multivariable logistic regression identified factors associated with app adherence. Results: Of the 3979 participants with app access, 3622 (91%) used the app; out of these, 1016 (28%) were “adherent users” (≥12 submitted questionnaires). App adherence significantly increased with age. Among HCW, adherent users were more likely to be non-smokers (p < 0.001), working as administrators or nursing staff vs. physicians (p < 0.001), vaccinated against influenza (p < 0.001), and had not travelled abroad in the past year (p < 0.001). IBD patients exposed to SARS-CoV-2 (p = 0.0133) and those with adverse events following the second COVID-19 vaccination (p = 0.0171) were more likely adherent app users. Despite technical issues causing dropout or non-adherence, the app served as a secure solution for cohort management and longitudinal data collection. Discussion: App-based cohort management enabled continuous data acquisition and individualized care while providing flexibility and anonymity for the study team and participants. App usability, technical issues, and cohort characteristics need to be thoroughly considered prior to implementation to optimize usage and adherence in clinical research. Full article