Search Results (6,529)

Background: Subclinical psychological symptoms—such as low mood, perceived stress, and poor sleep—affect a large portion of the population and can impair quality of life despite remaining below clinical thresholds. The gut–brain axis has emerged as a promising target for interventions that support emotional and psychological resilience. Probiotics and postbiotics are gaining attention for their potential to modulate mood and stress via microbiome-related mechanisms, but human evidence remains limited, particularly in non-clinical populations. Objectives: We aimed to assess the effects of a two-strain combination of live microorganisms alongside a two-strain combination of heat-treated inactivated microorganisms on outcomes associated with anxiety, mood, perceived stress, and quality of life in healthy adults experiencing mild stress. Methods: This study was conducted in two parts. In Part I, a randomized, double-blind, placebo-controlled study, 100 participants were randomized to receive either a blend of live microorganisms (Bifidobacterium longum CECT 7347 and Lactobacillus rhamnosus CECT 8361) or an identical placebo once daily for 12 weeks. In Part II, a pilot feasibility study, a subset of eight placebo non-responders from Part I received the heat-inactivated preparation of the same bacterial strains in a 6-week trial extension phase. For Parts I and II, the primary outcome was the change in the Hamilton Anxiety Rating Scale (HAM-A). Secondary outcomes included measures of mood (Beck Depression Inventory (BDI); Patient Health Questionnaire-9 (PHQ-9)), stress (state and trait anxiety inventory (STAI); Perceived Stress Scale (PSS)), sleep (Pittsburgh Sleep Quality Index (PSQI)), quality of life (36-item Short Form Survey (SF-36)), gastrointestinal symptoms (Gastrointestinal Symptom Rating Scale (GSRS)), salivary cortisol and microbiome modulation. Results: In Part I, there were no significant effects of the live blend on the HAM-A, indicating that the primary endpoint was not met. In addition, no significant effects were seen on the STAI or PSS scores when compared to the placebo. However, participants consuming the live blend trended toward a reduction in total PHQ-9 scores compared to placebo (p = 0.089), whilst preliminary exploratory analyses suggested an improvement in anhedonia (p = 0.045). Furthermore, there was a significant improvement in the vitality domain of the SF-36 compared to placebo (p = 0.017). On microbiome analysis, it was noted that consumption of the live blend was linked to the preservation of butyrate-producing bacteria, particularly members of the Pseudoflavonifractor genus and the Clostridium SGB6179 species. Furthermore, the abundance of B. longum species was found to be inversely associated with the total PSS Scores. In Part II, supplementation with the inactivated preparation resulted in significant within-group improvements for the vitality (p = 0.006) and social functioning (p = 0.010) domains of the SF-36 and improvements in PSS scores compared to baseline (p = 0.050). Conclusions: Supplementation with either the dual-strain live or inactivated formulations was associated with significant improvements in the vitality domain of the SF-36, whilst participants receiving the inactivated formulation demonstrated lower perceived stress and improved social functioning compared to baseline. Overall, the findings from this pilot study suggest that these two biotic consortia are well-tolerated and may be associated with improvements in measures of vitality in individuals with subclinical psychological symptoms. The subtle observations detected for stress and anhedonia suggest that further well-powered trials are needed to better characterize these findings, potentially in populations with greater baseline symptomatology. Full article

Desertsand concrete (DSC) is a sustainable alternative to natural river sand; however, its application in cold regions is restricted by inadequate crack resistance and freeze–thaw durability. This study investigates the freeze–thaw performance of steel–polypropylene hybrid fiber-reinforced desert sand concrete (SPHF-DSC), with emphasis on durability enhancement and service life prediction. A three-factor, three-level orthogonal experimental design was employed to evaluate the effects of desert sand replacement ratio (DSR), steel fiber (SF) content, and polypropylene fiber (PPF) content on mass loss, relative dynamic elastic modulus, and compressive strength under 25–100 freeze–thaw cycles. The results demonstrate that hybrid fiber reinforcement significantly improves freeze–thaw resistance due to the synergistic interaction between SF and PPF. After 100 cycles, the mass loss of all specimens remained within a narrow range of 0.65% to 0.73%, and the relative dynamic elastic modulus retention stayed above 90%. The optimal mixture (DSR = 30%, SF = 2%, PPF = 0.05%) exhibited superior frost resistance with the lowest deterioration indices among all groups. A freeze–thaw damage model based on damage mechanics was established and validated ($R^2$ > 0.96), enabling prediction of a service life exceeding 38 years under typical cold-region climatic conditions. These findings provide a durability-oriented design reference for the engineering application of DSC in cold-region infrastructure. Furthermore, the utilization of local desert sand reduces transportation energy consumption and promotes the sustainable development of energy infrastructure. Full article

S. Tomé and Principe (STP) islands have been studied in recent years for their wide range of medicinal plants which exhibit several biological activities of great medicinal interest for some diseases. Experimental design for optimization of several parameters was carried out by a full-factorial test of two levels of three factors for secondary metabolite extraction from Rauvolfia caffra leaves. The best conditions for highest extraction of phenolic compounds (i.e., 89.90 μmoles gallic acid equivalent/g leaves) were obtained at 25 °C in H₂O and at 5 days of incubation. Several phytochemical assays were performed for characterization of these plant extracts, and the highest levels of TFC, DPPH and reducing power were obtained with aqueous plant extraction at 25 °C and for 5 days of incubation, whereas leaf extraction with water at 40 °C for 5 days of incubation revealed the highest levels of ABTS scavenging activity. The levels of SOD and superoxide radical scavenging activities were highest in plant extraction, with hexane at 25 and 40 °C for 5 days of incubation, respectively. The present report consists of a novel and intrinsic synchronous fluorescence and phosphorescence characterization of secondary metabolites from this plant extract. Intrinsic and non-destructive synchronous fluorescence was carried out in the range of 250 to 750 nm with a Δλ range of 5–30 nm, which exhibited several fluorescence peaks in hexane and aqueous plant extracts. On the other hand, intrinsic and non-destructive synchronous phosphorescence was also performed which also exhibited several peaks in aqueous and hexane extracts. 3D spectra of secondary metabolites confirmed the fluorescence peaks observed in SFS in plant extracts. FTIR spectroscopy was selected to investigate the structural properties of secondary metabolites in these plant extracts. Therefore, the present work describes a novel characterization of secondary metabolites by a non-destructive and intrinsic synchronous fluorescence technique for plant extracts. Full article

In unmanned aerial vehicle (UAV)-based monocular inspection, cracks typically present as geometrically asymmetric, elongated, low-contrast weak targets, making accurate segmentation and spatial localization challenging. Existing methods are susceptible to missed detections and false positives when handling slender cracks, and monocular 3D reconstruction for localization is often burdened by redundant frames, resulting in limited modeling efficiency. To mitigate these issues, we propose a high-precision framework for crack segmentation and spatial localization from UAV imagery. First, Oriented FAST and Rotated BRIEF–Simultaneous Localization and Mapping, version 3 (ORB-SLAM3) is adopted for keyframe selection to suppress data redundancy and improve reconstruction stability. Second, we develop an enhanced YOLOv11-seg model by integrating the Dilation-wise Residual Segmentation (DWRSeg) module, the Weighted IoU (WIoU) loss, and the Lightweight shared convolutional separator batch-normalization detection head (LSCSBD) to strengthen feature discrimination and segmentation robustness for slender cracks, yielding high-quality crack masks. Finally, the predicted masks are projected onto the reconstructed 3D surface to obtain precise spatial localization. Our experimental results demonstrate that the proposed approach improves the segmentation mAP@50 by 7.2% over the baseline while reducing computational complexity from 10.2 to 9.8 GFLOPs. In addition, keyframe-based processing reduces the 3D modeling time by 59.4% compared to that with full-frame reconstruction. Overall, the proposed framework jointly enhances crack segmentation accuracy and substantially accelerates 3D modeling and localization, providing an effective solution for efficient UAV-based crack inspection. Full article

Background: In Spain, the number of patients anticoagulated with vitamin K antagonists (VKAs) is high. Among them, poor adherence is common, which may be justified by a low level of knowledge, and could affect their quality of life. We analyzed treatment adherence, health-related quality of life, and knowledge level about treatment, and evaluated the possible influence of these factors on patients’ time in the therapeutic range while also studying potential differences between patients under routine monitoring or self-monitoring. Methodology: A cross-sectional descriptive study was conducted using three validated and cross-culturally adapted questionnaires to study therapeutic adherence, health-related quality of life, and knowledge level about VKA treatment in a sample of anticoagulated patients. Additionally, it was assessed whether they were self-monitoring or not; the Rosendaal Time in Therapeutic Range (TTRr) was also administered for each patient at the time of recruitment. Descriptive analysis of all variables was performed, and a logistic regression model was constructed to evaluate the possible interaction of variables. Results: Ninety-eight patients participated and were selected sequentially from those attending the oral anticoagulation clinic at Hospital Universitario Virgen de la Victoria in Malaga. Of these, 39 were men and 59 were women. The mean age of these participants was 60.62 years (SD 11.67). Sixty-six were under conventional monitoring and thirty-two followed the self-monitoring program. The DecaMIRT had a mean score of 39.22 (SD 8.57), the SF-12 mean score was 31.73 (SD 6.21), and the knowledge questionnaire’s was 14.2 (SD 2.6). The mean TTRr value was 63.88 (SD 22.99). Self-monitored patients showed better results in DECAMirt and knowledge. Discussion: Overall, patients included in the sample presented satisfactory values in these three questionnaires, which seems to indicate that this was a treatment-compliant group with a correct quality of life, and adequately informed about their treatment. Conclusions: The work of nurses responsible for these aspects appears crucial in achieving these results. We aim to extend this study by focusing on groups with poorer results to design specific activities that allow for improvement in care and, as much as possible, homogenize outcomes. For this purpose, we intend to use all available tools, including those derived from the use of health-oriented artificial intelligence. Full article

Background: Health and social outcomes of previous opiate users (POUs) are not well-documented. We characterize the life situation, health status, and health-related quality of life (HRQoL) of POUs entering antiviral hepatitis C (HCV) treatment, compared with HCV patients without past illicit opiate use (NOU), and with HCV patients currently in opiate agonist treatment (OAT). Methods: Data are taken from the German Hepatitis C-Registry (“Deutsches Hepatitis C-Register”, DHCR), a multi-centre registry study focussing on the course and outcome of HCV treatment with directly acting antivirals. At treatment entry, patients underwent a standardized clinical assessment, including the Short Form 36 (SF-36) for self-reported HRQoL. Results: POUs (n = 734) and OAT patients (n = 554) were similar with regard to age, sex, migrant background, and psychiatric comorbidity. Employment rate and cannabis, alcohol, and smoking abstinence rates were higher for POUs than for OAT patients, but still lower than for NOU (n = 4147) patients. Mental and physical HRQoL was better for POUs than for OAT patients, but worse than for NOU patients. Compared with SF-36 normative data, POUs showed decreased HRQoL, especially regarding mental health. Conclusions: Compared with opiate-dependent patients in OAT, POUs showed less psychotropic substance use and better HRQoL. Compared with NOU patients and the general population, mental health problems were especially increased. Challenges persist for POUs even during abstinence from opiates, highlighting the need for targeted interventions tailored to the specific needs of this population. Full article

Background: Displaced intra-articular calcaneal fractures are difficult to treat due to their complex anatomy and the high risk of soft-tissue complications. Although open reduction and internal fixation (ORIF) enables accurate anatomical reconstruction, it can be associated with substantial wound morbidity. Minimally invasive techniques have been developed to mitigate these risks. This study aims to describe a modified external fixation technique and report its clinical and radiographic outcomes in consecutive cases of patients with displaced intra-articular calcaneal fractures, with a minimum follow-up period of one year. Methods: The surgical technique is described in detail. The technique was evaluated by analyzing the treatment results in a case series of 17 patients. The time from injury to surgery, radiographic parameters (Böhler’s angle and time to union) and clinical outcomes were recorded and analyzed, as were complication rates. The minimum follow-up period was 12 months. Results: Surgical reconstruction was performed at a mean of three days (range 1–6 days; SD 1.5) after injury. Preoperative radiographic parameters showed significant deformity, with calcaneal morphology restored at follow-up. At 12 months, the mean Böhler angle had increased to 27.8°, and all fractures had achieved radiographic union. Functional outcomes improved progressively over time, with increases in both the AOFAS and SF-12 P scores. One complication was observed: K-wire displacement requiring conversion to ORIF in a psychiatric patient. Conclusions: The proposed technique facilitates early surgical treatment and the satisfactory restoration of calcaneal morphology with no soft-tissue complications. It appears to be safe and effective in selected patients. A longer follow-up will provide further insight into long-term outcomes, such as subtalar osteoarthritis. Full article

Background: COVID-19 increased psychological distress among healthcare workers. Italian studies have suggested lower distress levels among mental health professionals compared to hospital-based colleagues. Methods: In May 2025, we conducted a cross-sectional observational study in community mental health centers and non-psychiatric hospital outpatient departments in Sardinia, Italy, involving 101 professionals from three community mental health centers and 97 staff members from four non-psychiatric hospital outpatient departments. The SF-12 was used to assess health-related quality of life (HRQoL) and the PHQ-9 was used to assess depressive symptoms. Results were also compared with pre-pandemic community samples. Results: Mental health professionals reported fewer depressive symptoms and better quality of life than hospital-based colleagues: PHQ-9 ≥ 10: 10.9% vs. 35.0% (11/101 vs. 34/97) (OR = 0.23; 95%CI 0.11–0.47; p < 0.001); PHQ-9 ≥ 9: 14.8% vs. 38.1% (OR = 0.31; 95%CI 0.16–0.60; p < 0.001). Mean PHQ-9 score: 4.45 ± 3.51 vs. 8.35 ± 3.95 (p < 0.001). Low HRQoL (SF-12 ≤ 36): 34.6% vs. 62.9% (35/101 vs. 61/97) (OR = 0.31; 95%CI 0.19–0.52; p < 0.001). No significant within-group differences were found by sex, age, or professional role. Compared with pre-pandemic community data, the well-being of mental health professionals remained stable. Limitations: Cross-sectional design and convenience sampling limit causal inference and generalizability. Conclusions: The organizational structure, operational flexibility, and peer collaboration typical of community-based services may contribute to the sustained psychological well-being of mental health professionals. The community-based model deserves consideration for future reforms aimed at improving staff well-being. Full article

Lentinula edodes (Berk.) Pegler, also known as Shiitake, is one of the most popular edible mushroom species containing high contents of polysaccharides, proteins and unique aroma, widely cultivated in China, Japan and Korea. A series of studies has been carried out on the extraction and active effect of the L. edodes polysaccharides, but the molecular mechanisms involved in the protein expression profiles during the whole life cycle are relatively unclear. This study employed an iTRAQ-MS/MS proteomic approach, combined with real-time quantitative PCR (qRT-PCR) and enzyme activity assays, to systematically analyze the protein expression profiles and their relationship with lignocellulose degradation in L. edodes across four key developmental stages: mycelia (SF), brown film formation (BF), primordia (YF), and fruiting bodies (MF). A total of 2043 proteins were identified, with 1188 being differentially expressed proteins (DEPs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses revealed that metabolic processes, carbohydrate metabolism, and related pathways were significantly active during development. The study specifically focused on carbohydrate-active enzymes (CAZymes), identifying 197 CAZyme proteins classified into 78 families. Key families such as glycoside hydrolases (GHs) and carbohydrate esterases (CEs) played crucial roles in lignocellulose degradation. The enzymatic activities of major lignin-degrading enzymes (laccase, manganese peroxidase, and lignin peroxidase) were dynamically regulated across the developmental stages. qRT-PCR results largely corroborated the proteomic data, confirming the reliability of the protein expression profiles. This study provides a comprehensive, stage-resolved proteomic landscape of lignocellulose degradation during L. edodes development, revealing species-specific temporal dynamics, offering a valuable basis for understanding its growth and development, with implications for edible fungus cultivation and biomass conversion applications. Full article

The integration of service function chains (SFCs) and unmanned aerial vehicles (UAVs) lays a crucial technological foundation for achieving efficient, reliable, and adaptive future airborne service networks. Service functions (SFs) in the SFC will be deployed on UAVs; this type of SFC is called unmanned aerial vehicle-based service function chains (USFCs). However, due to the combined effects of open hardware and software architectures, exposed communication links, and complex mission environments, UAVs have become ideal targets for attackers. Once a vulnerability is successfully injected into a UAV, data from the SFs running on it will be stolen, seriously threatening the dependability of the USFC. Therefore, it is necessary to conduct a quantitative evaluation of the USFC dependability to provide insights for further improving its dependability. This paper develops a USFC dependability evaluation model based on a semi-Markov process (SMP) to capture the dynamic interaction between attacker behavior and USFC system recovery behavior. The dependability of the USFC is comprehensively evaluated from two perspectives: availability and security. Extensive numerical analysis experiments are conducted, and the results not only demonstrate the changing trends of various dependability metrics under different parameters but also show parameter combinations for synergistic optimization among metrics. Full article

Freeze–thaw damage significantly reduces the performance and durability of airport pavements in cold regions. Traditional assessment methods, such as the F300 freeze–thaw test, are time-consuming and hinder rapid optimisation of mix design. In addition, previous studies have mostly relied on long-term laboratory testing and have evaluated phase-change concrete (PCC) independently, without considering synergistic effects. These approaches lack fast, synergy-aware predictive capability and interpretable tools for mix proportion design, resulting in a gap between laboratory research and practical engineering applications. To address this issue, this study proposes an intelligent and explainable framework for predicting freeze–thaw damage and guiding mix design of steel fibre-reinforced phase-change concrete (SF–PCC). A boundary-controlled experimental programme was first conducted, varying steel fibre (SF) content from 0 to 1.2% and phase-change material (PCM) content from 0 to 12% under fixed mixture conditions. The freeze–thaw test results were recorded sequentially and used to construct a supervised learning dataset. Then, an XGBoost model was developed to predict two key durability indicators: relative dynamic modulus of elasticity (RDEM) and mass loss. SHAP (SHapley Additive exPlanations) analysis was further applied to quantify feature importance and interaction effects. The model achieved high predictive accuracy (R² = 0.9938 for mass loss and R² = 0.9935 for RDEM) under controlled experimental conditions. After 300 freeze–thaw cycles, the reference mix exhibited an RDEM of 61.2%, while optimised configurations showed improved performance. The economical design (9% PCM + 0.9% SF) achieved an RDEM of 66.8%, and the high-performance design (12% PCM + 1.2% SF) reached 72.6%. These results demonstrate that the proposed framework can effectively enhance durability and support rapid preliminary decision-making. The framework significantly accelerates freeze–thaw performance evaluation by enabling near-instant prediction and serves as an efficient supplementary tool for mix design optimisation alongside conventional laboratory testing. It also provides interpretable, data-driven insights for the design of freeze–thaw-resistant airport pavement concrete in cold regions. Full article

Suspended sediment concentration (SSC) and sediment flux (SF) are critical indicators of sediment delivery in the Lower Mekong and underpin deltaic geomorphic stability and ecosystem services. With recent evidence of declining sediment supply caused by upstream regulation and intensive in-channel extraction, there is a pressing need for data-efficient tools to reproduce non-linear sediment dynamics and assist management in the Vietnamese Mekong Delta (VMD). This study evaluates three machine-learning algorithms—Random Forest (RF), Support Vector Machine (SVM), and Extreme Gradient Boosting (XGBoost)—for data-driven prediction of SSC (2009–2023) and SF (2009–2021) at Tan Chau (Viet Nam). The predictive models were developed using daily discharge inputs from Kratie (Cambodia) and local hydrological data, including water levels and discharge, from the Tan Chau station. Across the held-out testing dataset, all models captured substantial variability in both targets, with consistently higher performance for SF than for SSC. RF achieved the highest skill (SSC: R² = 0.783; SF: R² = 0.867), followed by XGBoost and then SVM. Variable-importance analysis indicates that upstream discharge at Kratie is the most influential predictor for both SSC and SF, consistent with basin-scale hydrological forcing governing downstream sediment transport capacity. The observed record at Tan Chau further suggests an attenuation of wet-season SSC peaks during 2018–2022 relative to earlier years, signalling potential sediment-starvation dynamics that warrant continued monitoring. Overall, the results demonstrate the utility of ML-based sediment prediction models as a complement to conventional monitoring and as an evidence base to inform sediment-aware river–delta management and risk mitigation in the Lower Mekong. Full article

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that is often associated with cutaneous pain. The objective of this study was to evaluate the impact of cutaneous pain on the prevalence of anxiety, depression, quality of life (QoL) and stigmatization in patients with AD. Methods: A cross-sectional study was conducted on a group of 113 adults with AD (61% females; mean age 34.48 ± 13.20 years). The severity of AD was evaluated using the Eczema Area and Severity Index (EASI). The intensity of cutaneous pain in the past week was measured using a Numerical Rating Scale (NRS), a Short Form McGill Pain Questionnaire (SF-MPQ) and a Visual Analogue Scale (VAS). Psychosocial burden was evaluated using the Hospital Anxiety and Depression Scale (HADS), the Anxiety Generalized Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Dermatology Life Quality Index (DLQI) and the 6-Item Stigmatization Scale (6-ISS). Results: Individuals with AD who reported cutaneous pain in the past week scored significantly higher in HADS (p < 0.001), HADS-A (p < 0.001), HADS-D (p = 0.002), GAD-7 (p < 0.001), PHQ-9 (p < 0.001), DLQI (p < 0.001) and 6-ISS (p < 0.001) than the rest of the cohort. More individuals with cutaneous pain had anxiety (36 (48.0%) vs. 7 (18.4%), p = 0.002), depression (21 (28.0%) vs. 2 (5.3%), p = 0.006) and abnormal HADS scores (46 (61.3%) vs. 9 (23.7%), p < 0.001) compared to the rest of participants. Significant correlations were observed between all studied pain assessment tools and all studied psychometric assessments. Conclusions: The prevalence and severity of anxiety, depression, stigmatization, and impaired QoL are higher in adults with AD suffering from cutaneous pain compared to those without pain. This symptom is significantly associated with disease burden. Full article

The development of all-concrete liquefied natural gas (LNG) storage tanks is hindered by the susceptibility of conventional concrete to ultra-low temperature (ULT) cycling down to −70 °C. While redispersible polymer powder (RPP) and polypropylene (PP) fibers individually enhance performance, their combined effect in various mineral admixture systems remains unclear. This study investigates the synergy and selective compatibility in hybrid-modified concrete containing fly ash (FA), silica fume (SF), or slag (SG). Comprehensive assessments after 50 ULT cycles reveal that the efficacy of hybrid modification is intrinsically governed by the mineral admixture. Among all systems, the silica fume-based hybrid system (EPSF) exhibits the highest residual compressive strength (57.5 MPa), the lowest strength loss (6.7%), and the most balanced durability. Microstructural analysis reveals that this synergy arises from a dense matrix, continuous polymer network, and effective fiber bridging—achieved only when the mineral admixture enables uniform RPP distribution. In contrast, the FA system exhibits a strength–durability trade-off, with RPP localized at interfaces, while the SG system shows a polymer-activated hydration mechanism. Microstructural and nano-mechanical analyses confirm that RPP acts as a pore filler in cement, an interfacial modifier in FA, a cohesive network former in SF, and a hydration activator in SG. This work establishes that superior ULT resilience requires not merely additive modifications but a matrix-enabled synergy, providing a scientific basis for the rational design of cryogenic concrete. Full article

Objective: Clinical remission is a major therapeutic goal in systemic lupus erythematosus (SLE) because of its association with improved long-term outcomes. However, its relationship with patient-reported burden, quality of life, and disease perception remains incompletely understood. This study aimed to evaluate patient-reported outcomes (PROs) in patients with SLE in clinical remission, identify factors associated with impaired health-related quality of life (HRQoL), and assess physician–patient discordance in disease activity perception. Methods: A total of 106 adult patients with SLE in clinical remission according to the definition proposed by Zen et al. were enrolled at a single rheumatology center. Patients were classified into complete remission, clinical remission off corticosteroids, or clinical remission on corticosteroids. Demographic, clinical, and treatment-related data were collected, including organ damage (SLICC-SDI) and disease activity (SLEDAI-2K). Patients completed PRO measures including SF-36, Global Health (GH), pain VAS, STAI-Y1 and STAI-Y2, Zung Depression Scale, Insomnia Severity Index, and HAQ. Disease activity was assessed by both the patient (PGA) and the physician (PhGA); a PGA–PhGA difference >25 mm was considered clinically relevant discordance. Results: Among patients in clinical remission, mild anxiety was observed in 17.1% according to STAI-Y1 and in 27.9% according to STAI-Y2, mild-to-moderate depressive symptoms in 47.1%, and mild insomnia in 25.5%. Of the 106 patients, 24 (22.6%) were in complete remission, 27 (25.5%) in clinical remission off corticosteroids, and 55 (51.9%) in clinical remission on corticosteroids. Patients in clinical remission on corticosteroids showed worse patient-reported outcomes than those in complete remission or clinical remission off corticosteroids. In multivariable analyses, poorer physical HRQoL was independently associated with functional disability, pain intensity, and depressive symptoms, whereas poorer mental HRQoL was independently associated with trait and state anxiety. Clinically relevant physician–patient discordance was observed in 22.6% of the cohort and was almost exclusively driven by higher patient than physician scores. Pain intensity emerged as the most robust independent correlate of discordance. Conclusions: A substantial patient-reported burden may persist in patients with SLE despite clinical remission. Pain, psychological distress, insomnia, and functional disability contribute to impaired HRQoL, while physician–patient discordance appears to reflect a broader mismatch between inflammatory disease control and the patient’s lived experience of illness. These findings support a more comprehensive and patient-centered approach to remission assessment in SLE. Full article