Search Results (9,494)

Background: The full-scale Russian invasion of Ukraine in 2022 triggered the largest displacement crisis in Europe in recent decades. Displacement may affect both clinical outcomes and mental health among people living with HIV (PLHIV). Evidence comparing displaced PLHIV with host-country patients within the same healthcare system remains limited. This study aimed to compare epidemiological characteristics, clinical staging, and mental health outcomes between war-displaced Ukrainian PLHIV and Slovak PLHIV receiving care in the same clinical setting, with particular attention to sex-specific differences. Methods: This cross-sectional study included 137 PLHIV receiving care at the HIV/AIDS Centre, University Hospital Bratislava, Slovakia (69 from Ukraine and 68 from Slovakia). Anxiety and depressive symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales. Scores were categorized into three severity groups (0–4, 5–9, ≥10). Results: Age distribution was comparable between cohorts (p = 0.2438). Transmission patterns differed substantially: heterosexual transmission predominated among Ukrainian participants, whereas men who have sex with men (MSM) transmission predominated among Slovak men (p < 0.001). Ukrainian patients were more frequently classified in CDC stage C, while Slovak patients more often presented in stage A. The combined antiretroviral therapy coverage was 100% in both cohorts and viral suppression rates were high (HIV RNA < 200 copies/mL: 91.3% in Ukraine vs. 94.1% in Slovakia). Overall anxiety and depressive symptom severity did not differ significantly between cohorts (GAD-7 p = 0.4145; PHQ-9 p = 0.7661). However, within the Ukrainian cohort, women demonstrated higher depressive symptom severity compared with men (p = 0.0478). Conclusions: War-displaced Ukrainian PLHIV achieved comparable biomedical outcomes to host-country patients within a structured healthcare system. However, depressive vulnerability emerged at the intersection of gender and displacement. These findings highlight the importance of integrating gender-sensitive mental health screening and psychosocial support into routine HIV care for displaced populations. Full article

Background and Objectives: Bicuspid aortic valve (BAV) is a common congenital cardiac abnormality frequently associated with aortopathy and progressive aortic dilatation. The 2021 International consensus statement introduced standardized phenotypic definitions for BAV and BAV-associated aortopathy. The aim of this study was to determine the distribution of BAV and BAV-associated aortopathy phenotypes according to the 2021 consensus statement and to assess statistical differences between imaging modalities (magnetic resonance imaging (MRI) and transthoracic echocardiography (TTE)) in aortic diameter measurements. Materials and Methods: This single-center retrospective study included 47 patients with BAV between 2014 and 2018. Aortic root and ascending aorta diameters were measured using MRI white-blood and black-blood sequences and TTE. BAV morphology and aortopathy phenotypes were classified according to the 2021 International consensus recommendations, and agreement between modalities was assessed using correlation and Bland–Altman analysis. Results: The study population had a mean age of 30 ± 11.05 years, with a male-to-female ratio of approximately 3.3:1. The fused BAV phenotype was the most prevalent (53.2%), followed by the partial-fusion (38.3%) and two-sinus (8.5%) phenotypes (p < 0.001). Aortopathy phenotypes assessed by MRI and TTE demonstrated similar distribution patterns, with the extended phenotype being the most frequent, followed by ascending and root phenotypes, with no significant difference between modalities (p = 0.74). Strong correlations were observed across all imaging techniques for both ascending aorta and aortic root measurements; however, small but statistically significant differences were identified between selected modality pairs—a mean difference of 1.59 mm between MRI black-blood and TTE ascending aorta diameters and 1.26 mm between MRI white-blood and TTE aortic root diameters. Conclusions: Multimodality imaging demonstrates strong agreement in the assessment of aortic diameters and yields comparable aortopathy phenotype distributions when applying the 2021 International Consensus Classification. Nevertheless, small systematic measurement differences between MRI and TTE may be clinically relevant in patients approaching diagnostic or therapeutic thresholds, highlighting the importance of consistent imaging methodology in longitudinal follow-up of BAV-associated aortopathy. Full article

Background: Talent identification (TID) programmes aim to detect adolescents with high physical potential, yet the efficiency of finding high-performance talent across different testing environments in an Australian context is unknown. The current study aim was to calculate the likelihood of participants scoring at or above the 90th percentile in anthropometric or physical performance measures across different testing settings. Methods: We analysed retrospective, cross-sectional physical and performance data from 10,134 Australian adolescents aged 12–17 years (4427 girls; 5707 boys) tested in either schools (2992; 3500), advertised come-and-try TID “Select” sessions (1235; 1622), or community-based amateur sports clubs (200; 585). Standardised measures used across all settings included height, body mass, and five physical performance tests of strength, speed, agility, leg power and aerobic fitness. We used a threshold of “higher physical performance” or “physical talent” as an age- and sex-specific ≥90th percentile ranking in any of the performance tests when compared against our international normative database. Anthropometry measures were also compared using the same approach across settings. Results: Chi-square tests showed girls had significantly higher (p < 0.001) prevalence of ≥90th percentile scores in all performance results in Select, and all except speed in Sport settings compared to Schools testing. No differences were found for either height or body mass across settings (p = 0.078 and 0.17, respectively). Boys exhibited smaller differences, with Sport settings yielding significantly higher sprint and agility scores ≥90th percentile (p < 0.05), relative to both Schools and Select testing environments. Differences were found for height and body mass across settings (p < 0.001 for both analyses, respectively). Conclusions: Select environments enhance the identification of physically talented girls, while boys demonstrate broader distribution of performance talent across settings. Findings inform resource allocation for future TID programmes when the primary aim is to maximise the efficiency of finding higher-performance physical talent relative to the number of tests conducted. Full article

Background/Objectives: Cardiovascular disease (CVD) in chronic kidney disease (CKD) arises from a multifaceted interplay of pathophysiological processes, including chronic inflammation, oxidative stress (OS), and accelerated vascular calcification (VC). Red blood cell distribution width (RDW) and the neutrophil-to-lymphocyte ratio (NLR) have emerged as simple, inexpensive, and readily available hematological indices that may capture these underlying disturbances. As such, they hold promise as accessible biomarkers for stratifying cardiovascular risk in patients with CKD. Methods: This cross-sectional study enrolled 497 patients, comprising 477 with CKD across all stages and 20 controls. We evaluated the associations of RDW and NLR with both traditional and non-traditional cardiovascular risk factors, as well as with serum calcification propensity (T50). Spearman’s correlation and multivariable regression analysis were used to assess these relationships. Results: Both RDW and NLR were significantly elevated in patients with established CVD (p < 0.001 for both) and demonstrated a progressive increase across advancing CKD stages (p < 0.001). RDW and NLR showed positive correlations with age, CVD duration, urea, phosphorus, parathormone, CRP, FG23, and mean carotid intima–media thickness (cIMT), while exhibiting inverse correlations with eGFR, serum albumin, hemoglobin, lipids, antioxidants such as superoxide dismutase, fetuin-A, and T50. Additionally, NLR correlated positively with the duration of hypertension and diabetes, as well as with albuminuria. Quartile analysis revealed a stepwise decline in T50 across increasing categories of RDW and NLR, supporting the link with impaired calcification defense. In multivariable analysis, T50 independently predicted NLR (β = −0.013; p = 0.018), whereas total cholesterol (β = −0.011; p = 0.019) and cIMT (β = 0.38; p = 0.018) emerged as independent determinants of RDW. Conclusions: RDW and NLR strongly reflect the burden of inflammation, metabolic disturbance, and vascular dysfunction in patients across the CKD spectrum. The consistent associations with impaired calcification defense and with established cardiovascular risk markers underscore the potential value as accessible indicators of cardiovascular vulnerability in CKD. These findings support incorporating RDW and NLR into routine risk assessment and highlight T50 as a mechanistically relevant determinant of hematologic inflammation profiles. Full article

Investigating the cycling characteristics of dissolved inorganic carbon (DIC) in karst groundwater within arid and semi-arid regions is crucial for understanding its role in the global carbon cycle and its contribution to atmospheric carbon sinks. This study is centered on the Liulin Spring area of North China, based on sampling data from April 2019. We employed hydrogeochemical analysis and environmental isotopic tracing methods to (1) characterize the spatial distribution of DIC along the groundwater flow path; (2) elucidate the sources of HCO₃⁻; (3) calibrate groundwater ¹⁴C ages. Results indicate that the HCO₃⁻ concentration initially increases and then decreases along the flow path, peaking in the spring discharge zone. Conversely, δ¹³C values initially decrease and then increase, reaching a minimum in the discharge zone, exhibiting a negative correlation with the HCO₃⁻ concentration. The contribution of soil/biogenic CO₂ dissolution to HCO₃⁻ ranges from 26% to 62%, with the highest values (56–62%) observed in recharge, runoff, and discharge zones and lower values (26–49%) observed in stagnant zones; this contribution generally decreases towards the western boundary. Calibrated ¹⁴C ages are significantly reduced and align better with expected groundwater dynamics. Full article

Objective: To characterize the distribution of FCR severity across survivorship time intervals in bladder cancer survivors. Methods: A cross-sectional study of 79 patients utilized the validated 9-item FCR Inventory-Short Form (FCRI-SF) to assess overall FCR severity. Primary analysis employed Spearman’s correlation coefficient to evaluate the relationship between time elapsed since the first procedure and total FCR scores. Patients were stratified into four temporal groups (<1, 1–2, 2–5, and >5 years). Inter-group variability in FCR scores was assessed using Levene’s test for equality of variances. Subgroup analyses compared FCR scores across clinical subgroups, including tumor grade and smoking history, using the Mann–Whitney U test. Multivariate logistic regression identified independent predictors of clinically significant FCR (total score ≥13). Results: Median patient age was 72.0 years (IQR 66.0–78.0), with a median of 24.0 months post-diagnosis. Clinically significant FCR (score ≥13) was prevalent in 55.7% of the cohort. Spearman correlation analysis revealed no significant relationship between months elapsed and FCR severity (rho = 0.068, p = 0.552). Patients in the 12–24 month window exhibited the highest variability (Levene’s test, p = 0.058), representing a period of clinical divergence. High-Grade disease and smoking cessation motivated by diagnosis were associated with higher FCR scores. In the multivariate logistic regression model, history of tumor recurrence was the sole independent predictor of clinically significant FCR (aOR 3.28, 95% CI 1.11–9.68, p = 0.031), whereas age and gender were not significantly associated. Conclusions: FCR severity did not demonstrate a significant association with time elapsed since diagnosis in this cross-sectional sample. The 1–2 year interval demonstrated greater inter-individual variability in FCR scores. Findings highlight the need for long-term, structured survivorship support, particularly targeting the 12–24 month post-diagnosis window. Full article

This study presents the results of chemical and morphological analyses of conductive layers, indium tin oxide (ITO) and silver, deposited on lead zirconium titanate (PZT) substrates, in the form of ITO/PZT, Ag/PZT, and PZT buffer samples. The buffer layer was also examined to assess any potential impacts on the interface and was obtained by etching silver-coated PZT discs in an acid sonification bath. The ITO/PZT discs were obtained by DC sputtering. Chemical and morphological analyses were conducted using Raman spectroscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS). XRD analysis revealed distinct diffraction peaks corresponding to the composition and crystalline structure of the various discs. This established the presence of the expected face-centered cubic (FCC) structure of silver, the perovskite phase of PZT, and the cubic bixbyite structure of the conductive ITO layer. SEM/EDS illustrated the particle distribution and elemental composition of the samples. Raman spectroscopy further corroborated the presence and identity of the surface layers of the samples. The results demonstrate that ITO/PZT structures have the expected compositions and identified impurities. SEM results give insight into possible effects on piezoelectric effects and integration into opto-electronic devices. Full article

This study investigates the effects of vehicle air-conditioning parameters on cabin thermal environment and occupant comfort. Computational fluid dynamics and discrete particle simulations involving different inlet-vent angles, inlet relative humidity (RH) levels, and occupant counts were conducted to analyze airflow, temperature, and RH. Thermal comfort was assessed using predicted mean vote (PMV), predicted percentage of dissatisfied (PPD), equivalent homogeneous temperature, and mean age of air (MAA). As a result, the uniform airflow at a 30° inlet angle provided the best global thermal comfort based on PMV (0.49) and PPD (10.02), whereas a 0° inlet angle improved local comfort around the chest area. Maintaining an inlet RH of 40–50% enhanced overall thermal comfort. Increasing the occupant counts raised the average cabin temperature to 301.76 K (Case 9), while also affecting local airflow patterns and MAA distributions; the addition of rear-seat occupants increased the local temperature around the driver’s left hand. These findings provide practical guidance for vehicle heating, ventilation, and air-conditioning system design, indicating that ventilation strategies should consider global comfort indices, localized airflow, thermal patterns, and particle removal performance. Overall, this parametric study highlights the association between vehicle cabin conditions and thermal comfort, providing baseline data for digital twin–based adaptive ventilation systems. Full article

Purpose: The primary aim of the present study was to examine the extent to which participation in organized youth basketball training contributes to physical activity across intensity zones during training sessions in relation to biological maturation status. Methods: Participants were classified into three maturity groups based on predicted age at peak height velocity (PHV): −2.5 to −1.5, −1.5 to −0.5, and ≥−0.5 to 0.83 years from PHV. Data from two training sessions per participant were averaged to obtain representative individual values. One-way analyses of variance (ANOVAs) were used to examine differences in anthropometric, physical performance, and field performance variables between PHV groups. Physical activity patterns were analyzed using two-way mixed-design ANOVAs with PHV stage as the between-subject factor and intensity zone (MET- and HRR-based) as the within-subject factor. Results: Across all maturity groups, approximately 10–17% of total training time was spent in light-intensity activity, while the majority of time was accumulated in moderate-to-vigorous intensity zones (approximately 35–50%, depending on the classification method). Significant maturity-related differences were observed in anthropometric variables and physical performance measures, with more mature players demonstrating superior sprint performance, jumping ability, and grip strength. Field performance indicators also differed between PHV groups, with more mature athletes exhibiting higher external and internal training loads. In contrast, no significant interactions or main effects of PHV stage were observed for physical activity intensity distribution. Conclusions: Organized basketball training contributes substantially to moderate-to-vigorous physical activity accumulated during training sessions. However, these findings reflect training-specific activity and should not be interpreted as representing total daily physical activity. No differences in activity intensity distribution were observed between maturation groups, although this finding should be interpreted with caution, given methodological limitations. These results highlight the need to consider biological maturation when designing youth training programs. Full article

Background/Objectives: Older patients with fractures often present with a complex interplay of factors associated with frailty and functional decline. The emerging concept of Orthogeriatric Fracture Syndrome (OFS) aims to characterize these distinct relationships of pathologies and outcomes. Despite increasing recognition of OFS in clinical practice, due to the distributed nature of fragility factors across medical disciplines, it remains poorly defined in the literature. Methods: We used large-scale text mining of 26 million PubMed abstracts to quantify the occurrence and interrelationship of OFS-related concepts across all disciplines in biomedical research. Results: OFS terms were more prevalent in fragility fractures than in other fracture types, particularly osteoporosis (0.52 vs. 0.09, p < 0.05). In pairwise keyword correlation (Pearson φ), the correlations presented between OFS keywords are comparable to the ones in the more established metabolic syndrome (e.g., φ = 0.07 between stroke and hypertension, p < 0.05). For OFS, osteoporosis emerged as the central node linking OFS outcomes and pathologies, correlating with fragility fracture (φ = 0.176, p < 0.05) and sarcopenia (φ = 0.03, p < 0.05). Sarcopenia in turn correlated with gait (φ = 0.04, p < 0.05), malnutrition (φ = 0.05, p < 0.05), and frailty (φ = 0.032, p < 0.05). Old age keywords showed substantially higher association with OFS keywords (e.g., φ = 0.06 for elderl* and hip fracture, p < 0.05) than with metabolic syndrome terms (elderl* and insulin resistance, p > 0.05). Conclusions: Overall, the analysis showed statistically significant associations between keywords representing OFS outcomes, pathologies and old age. The combined occurrence of osteoporosis, sarcopenia, frailty and risk of falls may help conceptually identify older adults at risk and inform preventive measures. This large-scale bibliometric analysis supports OFS as a conceptually coherent, proposed theoretical framework for cross-disciplinary awareness and coordinated care, with a literature-level organizational pattern comparable to metabolic syndrome, however, pending prospective clinical validation. This study reframes fragility fractures as the endpoint of a broader, potentially modifiable risk constellation and underscores the need for further clinical and epidemiological validation. Full article

Accurate rainfall information is essential for rainfall–runoff modeling in monsoon-influenced basins, where pronounced spatial variability and limited gauge coverage introduce significant uncertainty. Satellite precipitation products provide spatially continuous estimates but are affected by systematic biases, and improvements in statistical rainfall accuracy do not necessarily translate into hydrologically consistent model forcing. This study interpreted satellite rainfall bias correction through a rainfall–runoff framework in the Phetchaburi River Basin, Thailand, using the DWCM-AgWU hydrological model. Simulations were driven by gauge observations and multiple satellite-based rainfall products (GSMaP, CMORPH, CHIRPS, and PERSIANN-CCS), with bias correction applied using Linear Scaling and Quantile Mapping under rainfall-specific calibration. Results showed that bias correction significantly modified rainfall characteristics in distinct ways. Linear Scaling primarily preserved temporal and spatial structure while adjusting rainfall magnitude, whereas Quantile Mapping improved the distributional representation of rainfall intensities. These differences propagated through hydrological processes, leading to systematic variations in runoff responses across multiple metrics, including water balance consistency, peak magnitude, and timing errors. This suggests that each method performs differently depending on the aspect of system response. Rather than identifying a universally optimal method, the findings highlight trade-offs in how rainfall correction strategies influence hydrological system response. Runoff behavior is interpreted as a process-level indicator of rainfall representation, emphasizing that hydrological consistency depends not only on rainfall accuracy but also on its interaction with model structure. These results suggest a process-oriented perspective for interpreting the role of satellite rainfall products in regulated and monsoon-affected basins. Full article

Background/Objectives: Human papillomavirus (HPV) infection is a major concern in public health, given its role as a persistent sexually transmitted infection and a causative agent of non-cancerous and cancerous lesions (neoplasms). The increasing infection rates observed in recent years underscore the need for effective public health measures to address this issue. The objective of this study is to describe the challenges and the results of conducting vaccination campaigns within a university setting and its impact on the HPV vaccination rate. Methods: A multifaceted approach was adopted, entailing the implementation of two distinct interventions. Following the promotional and educational online campaign (described elsewhere), vaccination delivery took place from November 2024 to July 2025 in the university campus and in three university hospitals in Milan. Overall and covariate-specific drop-out rate is calculated; significance is tested through a chi-square test of homogeneity between the population that completed less than three doses vs. those who completed the full cycle. Overall and vaccine-specific vaccination proportion is reported. Results: The vaccination rate for first doses reached 92% of available appointments, with a slight female majority (50.9%) and the 23–26 age as the most represented group (47%). The most represented nationality was Italian (58.4%), followed by Iranian (26.5%). Regarding the vaccination sites, the university venue recorded the highest rates in terms of both vaccines booked (56.4%) and vaccines administered (64.7%). With a net loss in follow up, consistent with WHO data, the three-dose HPV vaccination campaign was completed by 82.5% of participants. A chi-squared test of homogeneity revealed significant differences in age distribution between vaccination groups, χ² (3) = 347.78, p < 0.001, Cramér’s V = 0.457. Participants who received only one dose were predominantly younger (17–22 years: 71.1% vs. 19.0%, difference = 52.1 percentage points, 95% CI [46.6, 57.7]). Meanwhile, a catch-up strategy raised interest on other crucial vaccinations. Conclusions: The findings pertaining to the vaccination rate underscore the heightened awareness among young adults concerning the HPV vaccine. They further substantiate the efficacy of the integrated strategy encompassing advisory and educational site-based campaigns as an initial measure to attain the WHO-endorsed vaccination rates. Full article

Aim: The aim of this study was to explore the distribution and driving factors influencing the disparity of health professionals (HPs) at the Centers for Disease Control and Prevention (CDC) in China and to provide a reference for regional health planning and rational allocation of public health resources. Methods: The Gini coefficient was used to measure the equity of HP distribution at CDC sites at the provincial level during 2012–2023 in China. Moran’s I was used to analyze the spatial agglomeration effect, and the geographic detector model was used to explore the factors driving the allocation of HPs at CDC sites in different provinces. Results: The number of HPs at the CDC showed an increasing trend from 2012 to 2023 in China. The average Gini coefficients at the population and geographical areas were 0.16 and 0.58, respectively. The global Moran’s I statistic indicated a notable decline in spatial clustering for the population dimension, decreasing from 0.503 to 0.238; in contrast, spatial clustering for the geographical dimension remained relatively stable, ranging between 0.13 and 0.16. The local Moran’s I statistic revealed that provinces such as Qinghai in the western China consistently exhibited a “low–low” spatial clustering pattern. Six factors were found to explain the variability in the CDC HP distribution based on the 2020 data. In the context of factor interactions, the synergistic effects between education level and health expenditure share (q = 0.9781), and between population aging and per capita GDP (q = 0.9699), substantially exceed the explanatory power attributable to any single factor alone. Conclusions: A significant regional disparity was observed in the distribution of HPs among 31 provinces, with the distribution based on service area being less equitable than that based on population. The shortage of healthcare professionals in the western region is characterized by notably inadequate geographical distribution. Future policy initiatives should prioritize targeted spatial interventions and integrated, multi-factor collaborative strategies. Full article

The transformation of religious authority in the digital age is shaped by the interactions between human actors, digital media and algorithmic systems. This study uses digital ethnography to examine how religious authority is constructed and negotiated on digital platforms used by Muslims in Indonesia and globally. This study focuses on seven authoritative figures in the digital Islamic landscape, representing different spectra of authority, from traditional pesantren in Indonesia to transnational apologetics and urban liberalism. The findings reveal patterns of authority delegation in which digital platforms replace human roles in da’wah and Islamic institutions. Religious authority is formed through articulative work that connects the Sunnah, intermediaries (religious scholars), and congregations. Public search data show that digital spaces function as a medium of distribution, where religious authority is shaped by audience responses, message repetition, symbolic affiliation, and the dynamics of debate. This study highlights the role of algorithmic culture and authority representation aesthetics in mediating religious authority in the digital age. Algorithms shape exposure and reach audiences, and representational aesthetics are crucial for disseminating religious content. The study concludes that clerical authority in the digital era results from technocultural mediation, in which the cleric becomes both a figure and representation calculated by machines and validated by the audience’s participation. Full article