Search Results (662)

Background: Child sexual abuse is a major public health concern, particularly for children from socioeconomically disadvantaged families. This study examined the effect of a body safety training (BST) program on the self-protection skills of preschool children from low-income families. Methods: This one-group pretest–posttest quasi-experimental study was conducted with 32 children aged 4–6 years attending a public kindergarten located in a low-income neighborhood in Türkiye. The children participated in a seven-session BST program. Data were collected via the What If Situations Test (WIST), with assessments conducted before and after the intervention. Differences between the pretest and posttest scores were analyzed via the Wilcoxon signed-rank test, and effect sizes (r) were calculated. Results: Statistically significant improvements were observed in the WIST subscales of appropriate touching recognition, inappropriate touching recognition, Saying skill, Doing skill, Telling skill, and Reporting skill, as well as in the Personal Safety Questionnaire scores (all p < 0.05). A significant increase with a large effect size was observed in the WIST total skill scores following the intervention (Z = −4.756, p < 0.001, r = 0.84; mean change = 6.34, 95% CI: 4.63–8.13). Conclusions: Participation in the BST Program was associated with significant improvements in the self-protection skills of preschool children from low-income families. These findings suggest that structured body safety education may be a promising approach for supporting personal safety skills among socioeconomically disadvantaged preschool children. Full article

Background/Objectives: Digital technologies have created new pathways through which perpetrators can initiate contact with children, yet evidence directly comparing child sexual abuse (CSA) cases according to the mode of first contact between the victim and the perpetrator remains limited. This study compared CSA cases in which the victim first met the perpetrator online with cases in which first contact occurred face-to-face and examined whether online-initiated contact was associated with a higher prevalence of penetrative abuse. Methods: We retrospectively reviewed 1511 CSA cases evaluated at a tertiary-care Child Monitoring Center in Turkey (2017–2018). Cases were classified by mode of first contact as online-initiated (n = 91, 6.0%) or face-to-face (n = 1420, 94.0%); the face-to-face group served as a comparison group defined by mode of contact rather than a non-exposed control group. Groups were compared using chi-square tests with Bonferroni-adjusted post hoc analyses; effect sizes were expressed as Cramér’s V and risk ratios (RRs). Results: Victims in the online-initiated group were predominantly female (89.0% vs. 79.4%; p = 0.027) and aged 12–18 years (79.2%). The perpetrator was most often described by the child as a friend or boyfriend (81.3% vs. 34.2%; p < 0.001), a pattern consistent with grooming dynamics. Penetrative abuse occurred in 54.9% of online-initiated versus 26.9% of face-to-face cases, an approximately twofold difference (RR = 2.04; p < 0.001). Conclusions: In this forensic sample, online-initiated contact was associated with a distinct case profile and more frequent penetrative abuse. Because the data derive from cases referred by judicial authorities for forensic evaluation rather than from adjudicated cases, the findings are associative and cannot be generalized to all CSA; nevertheless, they support the systematic documentation of online contact histories in forensic evaluation and child protection practice. Full article

Carbon nanotube (CNT)-based biosensors have emerged as promising platforms for non-invasive biofluid analysis because of their high electrical conductivity, large surface area, tunable optical properties, and versatile surface chemistry, enabling miniaturized, flexible sensing devices. Sweat, saliva, tears, and urine are increasingly recognized as attractive alternatives to blood for point-of-care diagnostics because they enable repeated, non-invasive sampling while containing clinically relevant metabolites, electrolytes, proteins, hormones, nucleic acids, pathogens, and other biomarkers. However, the low abundance of many analytes, matrix complexity, biofouling, and biofluid-specific variability present significant analytical challenges. This review critically examines the different CNT-based sensor architectures, and their recent advances in non-invasive analysis of sweat, saliva, tears, and urine. It integrates sensor architecture, biofluid-specific analytical challenges, sample-validation level, and translational readiness within a single comparative framework. Representative applications are discussed for metabolic monitoring, renal health assessment, infectious disease testing, and other clinically relevant uses. Beyond clinical diagnostics, emerging non-clinical applications, including drug-of-abuse detection, forensic body-fluid identification, and occupational or environmental exposure assessment, are also highlighted. Finally, we discuss key barriers limiting real-world translation of CNT biosensors, including material reproducibility issues, biofouling, physiological interpretation of biofluid biomarkers, scalable manufacturing, and long-term operational stability, and outline future strategies to advance these platforms toward robust, reliable, and widely deployable biosensing technologies. Full article

Animal abuse and substandard animal care may be difficult to report when members of the public are uncertain about the seriousness of their observations, the competent authority, or the information needed for further assessment. This study aimed to develop and preliminarily evaluate a structured online reporting interface for suspected animal abuse and animal welfare concerns in Hungary. Two public online questionnaires assessed reporting-related knowledge, experiences, and preferences, and a separate professional questionnaire examined the experiences of actors involved in animal protection procedures. Based on these findings, the Hungarian legal context, and international reporting models, a browser-based prototype was developed and professionally tested by staff members of the National Food Chain Safety Office. Public respondents significantly differentiated between suspected criminal animal cruelty and substandard animal keeping: the police were selected more often for animal cruelty cases, whereas the notary was selected more often for substandard keeping cases (p < 0.001). Substandard keeping conditions were observed significantly more frequently than direct animal abuse (p < 0.001). Professional testing indicated that the prototype was understandable, transparent, and potentially useful, although further refinement, institutional integration, and field validation are required. Full article

Subgaleal hemorrhage is uncommon in infants beyond the newborn period and, when disproportionate to the reported causal trauma, raises suspicion for child abuse. We describe a 9-month-old girl who developed a large right subgaleal and small epidural hematoma after a 50 cm fall. Initial abuse evaluation was negative, and standard coagulation tests were normal, although von Willebrand factor (vWF) activity was elevated. However, repeat testing 2 months later revealed markedly reduced vWF antigen and activity, suggestive of type 1 von Willebrand disease (vWD). This case highlights that disproportionate bleeding after minor head trauma should prompt evaluation for both non-accidental injury and occult bleeding disorders, and that variability in vWF levels necessitates repeat testing for accurate interpretation. Full article

Anabolic-androgenic steroids (AAS), such as ND, are commonly used to enhance physical performance and muscle mass. However, its abuse has been associated with numerous adverse health effects, particularly on the hippocampus, affecting learning, working memory, and cognitive functions. The current study aims to investigate the potential effects of ND, aerobic exercise, resistance exercise, and the combination of ND with aerobic or resistance exercise on memory and cognitive functions. Moreover, the study aims to explore the possible underlying mechanisms of changes in memory and cognitive function. Adult male rats were divided into four groups: control (GI), only ND-treated (GII), only exercise (GIIIa & GIIIb), and combined exercise + ND-treated (GIVa & GIVb). Exercise included aerobic treadmill training and ladder-climbing modalities for 8 weeks, either alone or with ND. Cognitive function was evaluated using the Modified Barnes Maze and T-maze tests. Hippocampal integrity was assessed through oxidative stress markers, hippocampal brain-derived neurotrophic factor (BDNF) levels, hippocampal nerve growth factor (NGF) expression, and histological examination. ND significantly impaired spatial learning and memory, increased oxidative stress, lowered hippocampal BDNF levels, and reduced NGF expression in the hippocampus. Exercise markedly attenuated these harmful effects. Aerobic exercise gave the most pronounced improvements. It restored cognitive function, enhanced antioxidant defenses, increased hippocampal BDNF levels, increased hippocampal NGF expression, and preserved hippocampal structure. Resistance training also had neuroprotective effects, but to a lesser extent than aerobic exercise. In brief, both aerobic and resistance exercise have been shown to exert protective effects against ND-induced neurotoxicity by enhancing antioxidant defenses and promoting neuronal integrity. The monitored neuroprotective benefits suggest that physical exercise could serve as a possible non-pharmacological approach to prevent or decrease cognitive impairments associated with anabolic steroid abuse. Full article

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes an immune-mediated neurological syndrome, which persists long after infection. Mechanisms for SARS-CoV-2-associated neurological complications are multifactorial, with an increased risk of drug abuse such as methamphetamine (meth). SARS-CoV-2 infection and its viral proteins play pivotal roles in coronavirus disease 2019 (COVID-19)-associated neuroinflammation, which can lead to long COVID. We hypothesize that meth augments activation of the microglial NOD-, leucine-rich repeat, and pyrin domain-containing protein 3 (NLRP3) inflammasome by the SARS-CoV-2 nucleocapsid (N) protein, resulting in neuroinflammation. To test this hypothesis, we investigated the effect of N-protein and meth on NLRP3 inflammasome activation in primary rat microglial cultures using enzyme-linked immunosorbent assay (ELISA), Reverse Transcription quantitative Polymerase Chain reaction (RT-qPCR), western blot (WB), and immunofluorescence assay (IFA). Our results showed that meth augmented N-protein-induced microglial activation, as evidenced by increased ionized calcium-binding adapter 1 (Iba-1) expression. The addition of meth to the microglial cultures treated with N-protein increased proinflammatory cytokine production. Meth augmentation of N-protein-induced neuroinflammation was further supported by increased inducible nitric oxide synthase (iNOS)-mediated nitric oxide (NO) production. The effects of meth on N-protein-associated inflammatory responses were significantly attenuated by MCC950, a specific NLRP3 inhibitor. Moreover, meth-associated NLRP3 activation was either blocked by the opioid sigma1-receptor (σ1_-R) inhibitor BD1047 or by σ1R siRNA knockdown. Taken together, these results demonstrated that meth augmented SARS-CoV-2 N-protein-induced neuroinflammation via microglial σ1_-R and the NLRP3 inflammasome, which may underlie the pathogenesis of neurological manifestations in COVID-19, such as long COVID with meth abuse. These results may also underscore the impact of drug abuse on long COVID and provide targets for the development of therapeutic strategies to control the neurological outcomes of long COVID. Full article

Background/Objectives: Time perspective and resilience are both relevant to adolescent mental health, yet their association has rarely been examined in clinical adolescent populations. This study investigated associations between resilience and time perspective and tested their independent associations with depressive, anxiety, and PTSD symptoms beyond trauma-related variables. Methods: A total of 105 adolescents aged 14 to 20 years were recruited from a child and adolescent psychiatric outpatient department. Participants completed self-report measures of resilience, time perspective, trauma exposure, and PTSD, depressive, and anxiety symptoms. Discrepancy from the optimal balanced time-perspective profile was quantified using the revised Deviation from a Balanced Time Perspective coefficient (DBTP-r). Spearman correlations and linear regression models were computed using DBTP-r alone, DBTP-r plus resilience, and extended models including trauma-related variables. Results: Higher DBTP-r was associated with lower resilience. Higher resilience was associated with higher Future and Past Positive scores and lower Past Negative scores. DBTP-r accounted for substantial variance in symptom severity. When resilience was added, both DBTP-r and resilience were independently associated with depressive, anxiety, and PTSD symptoms. In the extended models, DBTP-r and resilience remained significant for all three outcomes. Of the trauma-related predictors, physical sexual abuse was associated with PTSD symptoms in the extended model, but this association was no longer significant after controlling for biological sex. The cumulative number of other potentially traumatic experiences was not independently associated with symptom severity in the extended models. Conclusions: Time perspective and resilience appear to be related but distinguishable constructs. Both were independently associated with symptom levels of depression, anxiety, and PTSD in adolescents. Full article

Indentation and crush tests are widely used as crash-relevant surrogates for mechanical intrusion in Lithium-Ion Batteries (LIBs), yet their interpretation still relies on macroscopic, binary pass/fail criteria established at the Beginning of Life (BoL). This neglects how calendar and cyclic degradation alter a cell’s mechanical, thermal, and structural state before abuse, leaving the literature on aged cells apparently contradictory. This review establishes an aging-aware interpretive framework that separates three levels commonly conflated: the boundary conditions governing deformation, the study-specific criteria and evidence strength behind a declared electrical event, and the post-trigger hazard progression captured within the available monitoring window. A descriptive synthesis of 22 normalized fresh-to-aged comparisons from 13 primary studies shows no universal aging-driven shift of the reported comparison event toward earlier or later force–displacement states, with force and displacement changing in the same direction in only about half of the cases. An apparent format-associated displacement pattern is substantially attenuated when the pouch-cell displacement ratios are normalized by the respective initial cell thicknesses: the pouch-cell median displacement ratio decreases from 1.07 to approximately 1.00, and the remaining variation differs across aging routes and states of charge, although their individual contributions cannot be separated in the available dataset. Many apparent contradictions likewise stem from non-equivalent mechanical boundary conditions and trigger definitions, and continuity of confinement—especially for pouch cells aged under stack pressure and tested in a relaxed state—is identified as a frequently overlooked interpretive variable, although no controlled aged-cell study has yet isolated its contribution. An earlier-reported trigger does not necessarily imply a more severe outcome. We distill these requirements into a tier-resolved reporting checklist, providing a more rigorous and reusable basis for abuse-test interpretation, model development, and safety qualification of batteries intended for long service life and second-life deployment. Full article

Background. Bipolar disorder (BD) is characterized by circadian rhythm disruptions, contributing to mood instability and recurrence. These rhythms are regulated by clock genes in the suprachiasmatic nucleus, including the CLOCK 3111T/C (rs1801260) polymorphism that has been linked to delayed sleep phase, insomnia, and altered circadian expression. Both circadian disruption and adverse childhood experiences (ACEs) correlate with white matter (WM) abnormalities. We hypothesized that rs1801260 moderates ACE effects on WM microstructure in BD. Methods. We enrolled 137 BD patients in depressive episodes. Participants underwent 3T MRI, rs1801260 genotyping and completed the Childhood Trauma Questionnaire. Moderation (PROCESS) tested genotype–ACE interactions on whole-brain fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) values; voxel-wise TBSS (FSL Randomize) localized effects, with sex-stratified and GLZ analyses for genotype–sex interactions. Results. Significant rs1801260 × ACE interactions emerged for FA and RD across physical abuse, physical neglect, and emotional neglect. Higher ACEs were associated with lower FA/higher RD only in CLOCK rs1801260*C carriers, mainly females. TBSS showed physical abuse × rs1801260 interaction in the corpus callosum, internal capsule and corona radiata. A GLZ model with separate slopes confirmed physical abuse × sex × rs1801260 interactions on FA/RD, with effects specific to female CLOCK rs1801260*C carriers but genotype-independent in males. Conclusions. rs1801260 moderates the impact of early-life stress on WM integrity in BD, particularly in emotion-regulation tracts, with CLOCK rs1801260*C carriers showing greater vulnerability. Effects are genotype-specific in females but genotype-independent in males, possibly reflecting sex-dimorphic neurodevelopment driven by estrogen–androgen modulation of clock genes, HPA axis, and myelination. Full article

Background: Perinatal deaths remain a major public health concern and present unique medico-legal challenges. Forensic autopsy plays a crucial role in determining the cause of death, distinguishing live birth from stillbirth, assessing fetal viability, and identifying traumatic or non-natural causes of death. Methods: This retrospective study included all perinatal cases referred to the Gaziantep Forensic Medicine Group Presidency between 2021 and 2024. Demographic characteristics, gestational age, autopsy findings, histopathological and toxicological examinations, hydrostatic lung test results, and final forensic diagnoses were evaluated. Results: Seventeen of 339 infant forensic cases met the inclusion criteria. Fourteen underwent complete forensic autopsy, whereas three were evaluated by external postmortem examination and medical records. Despite a multidisciplinary forensic investigation that included external examination, complete forensic autopsy, systematic macroscopic organ evaluation, routine histopathological examination, hydrostatic lung flotation testing, toxicological analysis when indicated, review of maternal medical and obstetric records, judicial investigation records, and placental and umbilical cord histopathology whenever available, no definitive cause of death could be established in six cases. Advanced decomposition prevented determination in two cases. One case was classified as an undiagnosed natural death, whereas no specific cause of death could be assigned in the remaining three cases. Placental examination was available in only a minority of cases, whereas umbilical cord histopathology was performed in nearly all autopsied cases. Causes of death included traumatic injury, pulmonary immaturity, intrauterine infection, congenital anomalies, maternal drug exposure, placental abruption, maternal disease, and umbilical cord pathology. Conclusions: Perinatal death investigations require a multidisciplinary forensic approach integrating autopsy, histopathology, toxicology, placental examination, and clinical information. Beyond determining the cause of death, forensic evaluation is essential for assessing live birth, fetal viability, suspected abuse, maternal violence, medical malpractice, and criminal investigations. Full article

Etomidate is an ultrashort-acting imidazole-derived intravenous anesthetic. The non-medical abuse of etomidate as a new psychoactive substance has emerged as a critical public health challenge globally, particularly among adolescents, necessitating sensitive, rapid detection methods for forensic analysis. This study developed a quantum dot-based immunochromatographic test strip and a corresponding rapid detection method for the sensitive detection of etomidate acid in urine. CdSe/ZnS fluorescent quantum dot microspheres were used as labeling probes combined with specific monoclonal antibodies, and the detection protocol utilized a portable fluorescence reader. The method’s validation demonstrated a linear range of 10–2000 ng/mL (y = −0.231lnx + 0.5241, r = −0.991), with intra-batch and inter-batch coefficients of variation below 12%. The spike recovery rates ranged from 88.24% to 95.69%. Cross-reactivity testing against 12 common drugs and structural analogs showed no interference. The detection limit of 10 ng/mL represents a substantial improvement over conventional colloidal gold strips and approaches LC-MS/MS sensitivity. Assays of real urine specimens confirmed that the immunochromatographic test strip and detection method possess favorable accuracy and reliability. This fluorescent quantum dot-based immunochromatographic assay provides rapid, quantitative, and highly specific etomidate screening suitable for on-site forensic applications, effectively bridging front-end rapid testing with confirmatory laboratory analysis. Full article

Background: Mental health nurses work in high-pressure environments where leadership styles strongly influence well-being and job performance. Toxic leadership, including abusive and authoritarian behaviors, can contribute to psychological distress, somatic symptoms, reduced job satisfaction, and lower organizational effectiveness. It may also decrease Organizational Citizenship Behavior (OCB), which reflects voluntary positive workplace behaviors. Intrinsic motivation may help buffer these negative effects by enhancing employees’ internal drive and resilience. Therefore, this study examines the associations between toxic leadership, psychological distress, somatic symptoms, and organizational citizenship behavior among mental health nurses while exploring the potential role of intrinsic motivation. Methods: This descriptive-correlational study, based on Structural Equation Modeling (SEM), was conducted at the Psychiatric Inpatient Department of Mansoura University Hospital. A total of 117 mental health nurses were recruited through simple random samplings. Data were collected using four standardized tools: the Toxic Leadership Scale, the Brief Symptom Inventory (BSI), the Intrinsic Motivation Inventory (IMI), and the Organizational Citizenship Behavior (OCB) Scale, starting from the end of May and completed by the end of June 2024. Data analysis was conducted using IBM SPSS 22 and AMOS 22, employing descriptive statistics, Pearson’s correlations, independent t-tests, and Structural Equation Modeling (SEM). Results: Toxic leadership was positively associated with psychological distress (β = 0.46, p < 0.001). Psychological distress was strongly associated with somatic symptoms (β = 0.99, p < 0.001). Intrinsic motivation was positively associated with organizational citizenship behavior (β = 0.31, p < 0.001). However, intrinsic motivation was not significantly associated with psychological distress or somatic symptoms, and no significant direct association was observed between toxic leadership and organizational citizenship behavior. Conclusions: Toxic leadership was significantly associated with higher levels of psychological distress among mental health nurses, while psychological distress was strongly associated with somatic symptoms. Intrinsic motivation was positively associated with organizational citizenship behavior. However, the hypothesized mediating role of intrinsic motivation was not supported by the structural model. These findings highlight the importance of addressing toxic leadership and promoting supportive workplace environments to enhance nurses’ well-being and organizational outcomes. Relevance for Clinical Practice: Addressing toxic leadership is essential for enhancing nurses’ well-being and organizational outcomes. Interventions targeting leadership behaviors and promoting supportive workplace environments may help reduce psychological distress and its associated somatic symptoms among mental health nurses. In addition, creating workplace conditions that support intrinsic motivation may encourage organizational citizenship behavior and professional engagement, ultimately benefiting clinical practice and patient care quality. Full article

Background/Objectives: Workplace violence (WPV) is a major occupational health hazard and psychosocial safety concern in psychiatric nursing, yet evidence integrating exposure, worker well-being, and workforce stability within a single theory-informed model remains limited in Saudi Arabia. This study examined associations between WPV and proximal occupational outcomes (burnout, job satisfaction, and absenteeism) and distal outcomes (quality of life [QoL] and turnover intentions) among psychiatric nurses and tested burnout as a statistical mediator of the WPV–turnover intentions association. Methods: A multicentre cross-sectional census survey was conducted across three psychiatric facilities in northern Saudi Arabia between June and August 2025 (N = 171). Participants reported WPV exposure over the preceding 12 months using Arabic versions of standardised instruments, including validated Arabic versions where available and a forward–backward-translated WVSQ. Linear, negative binomial, and logistic regression models examined outcome associations and factors associated with WPV exposure; the PROCESS macro (Model 4, 5000 bootstrap resamples) tested statistical mediation. Results: Most nurses reported at least one WPV incident in the preceding 12 months, most commonly verbal abuse. Younger age, male sex, shorter psychiatric nursing experience, lower perceived staffing adequacy, and inadequate security were associated with higher WPV exposure. WPV exposure was associated with lower QoL across all WHOQOL-BREF domains, higher burnout, lower job satisfaction, higher absenteeism, and stronger turnover intentions. Burnout showed a partial statistical mediation pattern in the WPV–turnover intentions association. Because the study was not specifically powered for the indirect effect, the mediation result should be interpreted with caution. Conclusions: In this cross-sectional study, WPV was a pervasive occupational exposure among Saudi psychiatric nurses and was associated with poorer QoL and higher turnover intentions, with burnout showing a partial statistical mediation pattern. Multilevel prevention, safer staffing, and structured post-incident psychological support are needed to support psychiatric nurses’ well-being and workforce retention. Full article

Household food safety refers to consumer practices that reduce microbial contamination, cross-contamination, temperature abuse, and foodborne disease risks during food storage, preparation, cooking, and leftover handling. Rural households may be particularly vulnerable because of limited access to standardized food safety education and the persistence of experience-based practices. This study examined progressive changes in household food safety handling knowledge and behaviors associated with cumulative exposure to a continuous tracing intervention among rural residents in China. A two-month quasi-experimental repeated-measures study without a non-intervention control group was conducted in rural households in Liaoning, Jilin, and Heilongjiang provinces. A total of 139 households completed all intervention activities and four assessment waves, yielding 556 valid questionnaires. The intervention consisted of 10 rounds of paper-based and video-based materials targeting food safety knowledge, risk awareness, and self-efficacy. Outcomes were measured at baseline, after four intervention rounds, after eight rounds, and after ten rounds. Food safety behavior scores increased from 9.76 at baseline to 11.66, 13.33, and 14.72 after successive intervention stages. Knowledge scores increased from 13.71 to 17.35, 19.34, and 21.43, respectively. Pairwise comparisons showed significant differences between all assessment waves for both outcomes. Analyses accounting for the repeated-measures structure showed a positive association between food safety knowledge and self-reported handling behavior. Both online and offline delivery channels were associated with improvements in knowledge and behavior, while between-channel differences did not appear to be the primary driver of the observed changes. However, causal interpretation should be cautious because the study lacked a non-intervention control group, and testing effects, maturation, seasonal influences, and social desirability cannot be ruled out. Full article