Search Results (480)

This study compares the Stackelberg game model and the entropy weight method for allocating intercity water rights in Heilongjiang Province (2014–2021). The entropy method objectively determines indicator weights, while the Stackelberg framework simulates leader–follower interactions between the water authority and users to balance efficiency and satisfaction. Under the same total water rights cap, the Stackelberg scheme achieves a comprehensive benefit of CNY 14,966 billion, 4% higher than the entropy method (CNY 14,436 billion). The results and comprehensive benefits of the two schemes are close to each other in the cities of Qiqihaer, Daqing, Hegang, etc., but the allocation method of the game theory is more in line with the practical needs and can meet the water demand of each region, and the entropy right method is more useful for the cities of Jiamusi, Jixi, and Heihe, while for other cities the water rights allocation appeared to be unreasonable. While the entropy approach is transparent and data-driven, it lacks dynamic feedback and may under- or over-allocate in rapidly changing contexts. The Stackelberg model adapts to varying demands, better aligning allocations with actual needs. We discuss parameter justification, sensitivity, governance assumptions, and potential extensions, including hybrid modeling, climate change integration, stakeholder participation, and real-time monitoring. The findings provide methodological insights for adaptive and equitable water allocation in regions with strong regulatory capacity. Full article

The burden of depression is a public health concern, and traditional treatment approaches to mental health alone may be insufficient. The effects of contact with nature on wellbeing have been shown to reduce stress and improve mood, emotional wellbeing and mental health difficulties. Thus, self-guided nature-based interventions (NBIs) present a promising approach to improving mental health and wellbeing. However, there is limited evidence on the development of such interventions. This two-armed pilot randomised controlled trial aimed at determining the feasibility, acceptability and preliminary efficacy of a novel, 4-week, self-help NBI (Roots and Shoots©). Forty-seven participants were randomised (1:1) to either receive the Roots and Shoots intervention or a waitlist control. Participants in both conditions completed measures including wellbeing (primary outcome) and depressive symptoms, rumination, sleep and nature relatedness (secondary outcomes) at three timepoints: baseline (T0), 2 weeks (T1) and 4 weeks (T2). Those who completed the intervention period reported high acceptability and satisfaction with the intervention. The findings from this pilot study indicate potential for improvements in wellbeing following the intervention, which appears reasonably feasible and acceptable. Future research is warranted to further investigate the efficacy of this novel NBI in a larger, powered clinical trial. Full article

The use of long-acting cabotegravir and rilpivirine (LA CAB/RPV) is a novel approach to manage human immunodeficiency virus (HIV). This injectable regimen offers benefits such as an improved quality of life, reduced stigma and enhanced treatment satisfaction by minimising the need for daily medication adherence. This review summarises the findings of clinical trials and real-world studies on the safety, tolerability and metabolic effects of LA CAB/RPV, which are areas that have received less extensive coverage in previous reviews. Clinical trial data suggest that LA CAB/RPV is generally safe and well tolerated. The most common side effects were injection site reactions, affecting 70–97% of participants. However, these were typically mild and short lived, rarely leading to treatment discontinuation in fewer than 2–3% of cases. Systemic side effects were minimal and comparable to those observed with traditional oral antiretroviral therapy. Real-world studies corroborated these findings, reporting low discontinuation rates due to adverse events. Regarding metabolic impact, clinical trials showed minimal weight gain (an average increase of 1–2 kg over 48–96 weeks) with no significant differences or impact on lipid and glucose levels. Although real-world data are still emerging, they suggest similar trends, including a possible improvement in lipid profiles. Overall, LA CAB/RPV appears to be a safe, well-tolerated and effective treatment option, although longer-term follow-up is needed. Full article

Background and Objectives: There is a global rise of public interest in integrative medicine. The principles of integrative medicine combining conventional medicine with evidence-based complementary therapies have been implemented in many medical areas, including plastic surgery, to improve patient’s outcome. The aim of the present study was to systematically analyze the application and use of additional non-pharmacological interventions (NPIs) of patients of a German department of plastic surgery. Materials and Methods: The present real-world data study utilized data from the Network Oncology registry between 2016 and 2021. Patients included in this study were at the age of 18 or above, stayed at the department of plastic surgery and received at least one plastic surgical procedure. Adjusted multivariable logistic regression analyses were performed to detect associations between the acceptance of NPIs and predicting factors such as age, gender, year of admission, or length of hospital stay. Results: In total, 265 patients were enrolled in the study between January 2016 and December 2021 with a median age of 65 years (IQR: 52–80) and a male/female ratio of 0.77. Most of the patients received reconstructive surgery (90.19%), followed by hand surgery (5.68%) and aesthetic surgery (2.64%). In total, 42.5% of the enrolled patients accepted and applied NPIs. Physiotherapy, rhythmical embrocations, and compresses were the most often administered NPIs. Conclusions: This exploratory analysis provides a descriptive overview of the application and acceptance of NPIs in plastic surgery patients within a German integrative care setting. While NPIs appear to be well accepted by a subset of patients, further prospective studies are needed to evaluate their impact on clinical outcomes such as postoperative recovery, pain management, patient-reported quality of life, and overall satisfaction with care. Full article

Background: The use of lower limb prosthesis can impact all aspects of daily life, activities and participation. Various studies have compared the microprocessor-controlled knee (MPK) to the non-microprocessor-controlled knee (NMPK) using a variety of different outcome measures, but results are inconsistent and raise the question of which type of knee is most effective. Therefore, we aimed to assess the effect of MPKs compared to NMPKs across all classified ICF domains in adult prosthesis users. Methods: Participants performed baseline measurements with the NMPK (T0). One week later, they started a four-to-six-week trial period with the MPK. Afterward, measurements were repeated with the MPK (T1). Functional tests (6MWT, TUG-test and activity monitor) and questionnaires (ABC, SQUASH, USER-P and PEQ) were used. For statistical analyses, paired t-tests, Wilcoxon signed-rank tests and Chi² test were applied. The Benjamini–Hochberg procedure was applied to correct for multiple testing. Results: Twenty-five participants were included. Using an MPK compared to an NMPK significantly resulted in improvements in balance and walking confidence, safety, walking distance and self-reported walking ability, as well as a decrease in number of stumbles and falls. Additionally, participants using an MPK were significantly more satisfied with their participation, experienced fewer restrictions, reported greater satisfaction with the appearance and utility of the MPK, experienced less social burden and reported better well-being, compared to using an NMPK. Conclusions: Using an MPK instead of an NMPK can lead to significant improvements in all classified ICF domains, such as improved walking ability, confidence and satisfaction and reduced fall risk. Full article

Background: Emerging evidence indicates that some individuals recovering from COVID-19 develop persistent symptoms, including fatigue, pain, cognitive difficulties, and psychological distress, commonly known as Long COVID. These symptoms often overlap with those seen in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME), underscoring the need for integrative, non-pharmacological interventions. This Phase II controlled trial aimed to evaluate the feasibility and preliminary efficacy of Heart Rate Variability Biofeedback (HRV-BF) in individuals with Long COVID who meet the diagnostic criteria for CFS/ME. Specific objectives included assessing feasibility indicators (drop-out rates, side effects, participant satisfaction) and changes in fatigue, depression, anxiety, pain, and health-related quality of life. Methods: Participants were assigned alternately and consecutively to the HRV-BF intervention or Treatment-as-usual (TAU), in a predefined 1:1 sequence (quasirandom assignment). The intervention consisted of 10 HRV-BF sessions, held twice weekly over 5 weeks, with each session including a 10 min respiratory preparation and 40 min of active training. Results: The overall drop-out rate was low (5.56%), and participants reported a generally high level of satisfaction. Regarding side effects, the mean total Simulator Sickness Questionnaire score was 24.31 (SD = 35.42), decreasing to 12.82 (SD = 15.24) after excluding an outlier. A significantly greater improvement in severe fatigue was observed in the experimental group (H = 4.083, p = 0.043). When considering all outcomes collectively, a tendency toward improvement was detected in the experimental group (binomial test, p < 0.0001). Conclusions: HRV-BF appears feasible and well tolerated. Findings support the need for Phase III trials to confirm its potential in mitigating fatigue in Long COVID. Full article

Background/Objectives: “Ozempic face” is an aesthetic side effect associated with the use of the antidiabetic agent Ozempic (semaglutide), characterized by a prematurely aged and fatigued facial appearance due to rapid weight loss. Currently, treatment options for this condition are limited. In this study, we present our clinical experience with the BodyTite device, provided by InMode Italy S.r.l. (Rome, Italy). Materials and Methods: We report a case series involving 24 patients (19 women and 5 men, aged 27–65 years), treated with subdermal bipolar radiofrequency (Endotissutal Bipolar Radiofrequency) between 2023 and 2024. All patients underwent a minimum follow-up of 12 months. At the end of the follow-up period, patients rated their satisfaction on a from 0 to 10 scale, and an independent expert assessed the stability of clinical outcomes. Results: The majority of patients reported high satisfaction levels (≥8), which correlated with the independent expert’s evaluation of treatment efficacy and result stability. The only observed adverse event was transient cutaneous erythema. Conclusions: “Ozempic face” is an increasingly common side effect associated with newer classes of antidiabetic medications. Although these drugs offer significant metabolic benefits, the accompanying facial volume loss and aging are often poorly tolerated by patients. Our findings suggest that subdermal bipolar radiofrequency represents a safe, low-risk, and cost-effective therapeutic option for the aesthetic management of Ozempic face. 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: In Canada, despite universal healthcare coverage, dental care remains predominantly privately financed, creating financial barriers that prevent many from accessing essential services. This case study is part of a larger initiative, the One Smile Research program, which evaluates the impact of cost-free dental care on the oral health and overall well-being of individuals who have been unable to access dental services in the past two years due to financial constraints. Participants in the program receive necessary dental care and attend follow-up appointments to assess the long-term effects of continuous cost-free care. Clinical Case: This mixed-methods case report focuses on a 26-year-old male participant and integrates a qualitative semi-structured interview with clinical and self-reported data, providing an in-depth understanding of his experiences. Results: Clinical outcomes demonstrated the effectiveness of the provided dental treatments, while self-reported measures indicated improved oral health, satisfaction with dental appearance, enhanced psychosocial well-being, increased self-esteem, reduced dental anxiety, and better oral hygiene habits. The qualitative interview identified three key themes reflecting positive experiences with the program: ease of admission, staff kindness, and overall well-being improvement. The integration of both quantitative and qualitative analyses revealed significant advancements in both objective and subjective measures, particularly regarding overall well-being. Conclusions: The continuity of cost-free dental care effectively addressed the participant’s oral health and overall well-being, with most benefits sustained even at the two-year follow-up. These individual-level outcomes offer preliminary insight into the potential advantages of universal dental coverage within the Canadian healthcare system. Full article

In novels, readers encounter a variety of characters with distinct personalities, and their satisfaction tends to increase when each character’s utterances consistently reflect their unique traits. Recent advances in large language model (LLM) technology have made it possible to perform complex tasks such as generating long-form narratives and adapting writing styles. However, research on generating character utterances that reflect individual personalities remains limited. In this paper, we identify a key challenge in this task, namely the unconscious influence of the author’s writing style, and propose a novel clustering-based method to mitigate this problem by tuning large language models. We manually annotated Big Five personality trait scores for characters appearing in selected novels and designed prompts to generate examples for instruction-tuning. Experimental results demonstrate that language models trained using our proposed method produce utterances that more consistently reflect character personalities compared to untuned models. Full article

Thermal comfort is the condition of mind that expresses satisfaction with the thermal environment, and it is assessed through subjective evaluation, according to the American Society of Heating, Refrigerating, and Air-Conditioning Engineers. While research has traditionally emphasised physical factors, growing evidence highlights the role of the state of mind in shaping thermal perception. In a prior Monte Carlo sensitivity analysis, six mood subscales—Anger, Confusion, Vigour, Tension, Depression, and Fatigue—were examined for how they affect the absolute difference between actual and predicted thermal sensation. Depression and vigour were found to be the most influential, while confusion appeared least impactful. However, to accurately assess the role of confusion, it is necessary to consider its potential interactions with other mood subscales. To this end, a mediation analysis was conducted using Hayes’ PROCESS tool. The mediation analyses revealed that confusion partially mediated depression’s effect in males and vigour’s effect in females. These results suggest that, despite a weak direct impact, confusion critically influences thermal perception by altering the effects of key mood states. Accounting for the indirect effects of mood states may lead to more accurate predictions of human sensory experiences and improve the design of occupant-centred environments. Full article

Evaluating the implant site immediately after implant removal is crucial for assessing its condition and ensuring morphological stability. Immediate reconstruction at the time of implant removal has been proposed as a strategy to preserve alveolar ridge width. This study aims to evaluate whether immediate alveolar bone reconstruction at the time of implant removal provides comparable or superior dimensional stability of the alveolar ridge compared to staged reconstruction approaches. The null hypothesis of this study is that there is no significant difference in alveolar bone dimensions between immediate and staged reconstructions following implant removal. This retrospective study included seven participants, consisting of six males and one female. The participants were categorized into three groups based on the treatment approach following implant removal. In Group 1, no bone grafting was performed after implant removal. In Group 2, bone grafting was conducted following implant removal, with an adequate healing period before implant placement. In Group 3, bone grafting was performed simultaneously with implant removal. Cone-beam computed tomography (CBCT) imaging was conducted before implant removal (T0), after implant removal or bone grafting (T1), and after implant placement (T2). All removed implants were successfully replaced with new ones, regardless of bone grafting. In terms of alveolar ridge width at 1 mm below the crest, Group 1 exhibited the greatest reduction (ΔT1 − T0 = −5.1 ± 3.7 mm), while Group 2 showed a mild increase (+1.1 ± 2.6 mm), and Group 3 had a moderate decrease (−1.3 ± 1.0 mm). This suggests that delayed bone grafting can better preserve or enhance bone volume during healing. A reduction in buccal ridge height between T1 and T0 (ΔT1 − T0) was observed, particularly in Group 1. In contrast, an increase in buccal ridge height was most pronounced in Group 2. Although immediate reconstruction (Group 3) did not result in statistically significant gains, it achieved successful implant placement without complications and reduced the total treatment duration, which might be beneficial from a clinical efficiency and patient satisfaction standpoint. Therefore, staged bone grafting (Group 2) appears to offer greater dimensional stability, particularly in maintaining ridge height, whereas immediate reconstruction (Group 3) remains a clinically viable alternative for stable healing in select cases, especially when shorter treatment timelines are prioritized. Full article

Body image and mental health outcomes are influenced by both sex and body weight. This study investigated how sex and BMI category (participants classified with healthy weight, overweight, or with obesity) relate to body image, disordered eating, weight bias, global self-esteem and depression. Participants (N = 642; 278 (43.3%) males; 364 females (56,7%)) provided self-report measures of appearance satisfaction, body appreciation, overweight preoccupation, disordered eating scores, weight bias, depression, and self-esteem. The results indicated that women and participants classified with overweight and obesity based on BMI categories reported lower appearance satisfaction and body appreciation and a higher preoccupation with overweight and depression. Interaction effects showed that women participants with overweight and obesity reported particularly low appearance satisfaction and body appreciation. Individuals classified with healthy BMI category reported higher disordered eating scores than those classified with overweight. No significant effects were found for global self-esteem. These findings suggest that sex and BMI contribute to the study’s variables of interest, with some effects more pronounced in women with a higher BMI. The results align with sociocultural theories of appearance pressure but indicate complexity in disordered eating patterns. The findings underscore the importance of adopting intersectional, weight-inclusive, and sex-responsive approaches in both research and clinical practice. Full article

Objective: This study aimed to examine whether perceived social support, appearance satisfaction, and self-esteem mediate the relationship between the type of dermatological condition and psychological distress among dermatological patients. Methods: A cross-sectional quantitative study utilizing self-report measures. The sample consisted of 108 dermatological patients aged 18 to 35 years. Participants were divided into two groups based on their diagnosis: Group A included 54 individuals with visible facial cystic acne, and Group B included 54 individuals with non-visible psoriasis or eczema. Assessments were conducted following their initial dermatological consultation and prior to the commencement of pharmacological treatment. Participants completed a battery of questionnaires including the Symptom Checklist-90-Revised (SCL-90-R), the Multidimensional Body–Self Relations Questionnaire-Appearance Scale (MBSRQ–AS), the Interpersonal Support Evaluation List (ISEL-40), and the Rosenberg Self-Esteem Scale. Results: Mediation analyses indicated that perceived social support and appearance satisfaction significantly mediated the relationship between dermatological group and psychological distress. Self-esteem did not emerge as a significant mediator. Conclusions: The findings suggest that differences in psychological distress among dermatological patients can be partially explained by their perceived social support and satisfaction with physical appearance. These psychosocial factors should be considered in the psychological assessment and treatment planning for individuals with dermatological conditions. Full article

Background and Objectives: The associations between body appreciation, weight status, and weight management practices are influenced by societal, cultural, and psychological factors. Studies indicated that a higher level of body appreciation is linked to lower engagement in unhealthy weight management practices. The transition from high school to university is a significant life event, often accompanied by substantial lifestyle changes that can affect students’ body image and weight-related behaviours. This study aimed to assess the associations between body appreciation, weight status, and weight management behaviours among first-year students at four universities of applied sciences in Lithuania. Materials and Methods: A cross-sectional online survey was conducted in 2022 among 709 first-year students (216 males and 493 females) at the four largest universities of applied sciences in Vilnius, Kaunas, Klaipėda, and Šiauliai. Body appreciation was assessed using the Body Appreciation Scale-2 (BAS-2), whilst BMI was calculated from self-reported height and weight. Students were asked about their weight management practices. Logistic regression analysis was applied to evaluate associations between weight management behaviours, body appreciation, and weight status. Results: Female students had a significantly lower median BMI (21.1 kg/m²) than males (23.3 kg/m²) but were more likely to perceive themselves as overweight (34.5% vs. 17.1%), worry about gaining weight (40.6% vs. 11.6%), and attempt weight loss (52.5% vs. 23.6%) (all p < 0.001). Higher BAS scores were associated with greater accuracy in weight perception, higher satisfaction with body weight, and fewer concerns about weight gain. Students with lower BAS scores were more likely to engage in harmful weight-control behaviours such as smoking (OR = 0.07; 95% CI: 0.02–0.25 for high vs. low BAS) and were more strongly influenced by media beauty standards and dissatisfaction with appearance. Conclusions: Body appreciation is linked to healthier weight perceptions and behaviours. Interventions that enhance body appreciation may help reduce body dissatisfaction and prevent unhealthy weight control practices, especially among female students. Full article