Search Results (1,451)

Background/Aim: Dental caries is a multifactorial disease influenced by dietary habits, lifestyle factors, and host biochemical processes. Oxidative stress and advanced glycation end products (AGEs) have been implicated in oral and systemic pathophysiology, but their combined association with caries experience remains unclear. This study aimed to evaluate the relationships between caries indices, diet, smoking, oxidative stress markers, and AGEs in adults. Materials and Methods: A cross-sectional study was conducted on adults enrolled in the SALIVAGES project (2018–2020). Dental status was assessed using the DMFT index. Dietary habits and smoking status were recorded using a validated questionnaire. Oxidative stress parameters (TAC, TOS, OSI, NO, MDA, total thiols) and AGEs (FruLys, MG-H1, CML, CEL, Pyr, Arg, Lys) were quantified in saliva and plasma. Associations were analyzed using correlation tests and multivariable regression models (α = 0.05). Results: The mean DMFT was 21.89 ± 7.13, with missing teeth predominating. Caries experience was significantly associated with oxidative stress, AGEs, diet, and lifestyle. Higher decay scores were associated with increased NO and total thiols and reduced antioxidant capacity. Several salivary AGE-related biomarkers (FruLys, MG-H1, CML, and CEL) were negatively associated with the decay index. Sugary beverages, refined carbohydrates, pastries, and donuts were strongly positively associated with the decay index, whereas wholemeal bread showed an inverse association with caries indices. Smoking was independently associated with higher decay and DMFT values, corresponding to an approximately three-unit higher DMFT score. Conclusions: Caries experience in adults is associated with dietary, lifestyle, and biochemical factors. Sugar intake and smoking showed the strongest associations with caries indices, while oxidative stress parameters and selected salivary AGE-related biomarkers showed weaker but significant inverse associations with decay. These findings support preventive strategies targeting diet quality, smoking cessation, and redox balance to reduce oral disease burden. Full article

Objective: The aim of this study was to evaluate serum homocysteine levels in obese children and adolescents and to examine their relationships with insulin resistance, metabolic risk factors, and vitamin B12, folate, and vitamin D status. Methods: A single-center, retrospective cross-sectional observational study included 102 children and adolescents with obesity attending a tertiary pediatric obesity clinic. Clinical, anthropometric, and biochemical data were analyzed. Group comparisons were performed according to obesity severity and presence of hyperhomocysteinemia. Correlation analyses and multivariable linear regression were conducted to identify independent predictors of serum homocysteine levels. Results: The median serum homocysteine level was 9.5 (7.82–11.8) µmol/L, and hyperhomocysteinemia was present in 27.5% of cases. Insulin resistance was significantly more prevalent in children with severe obesity compared to those with obesity (90.6% vs. 64.3%; OR 5.29, 95% CI 1.41–29.8; p = 0.008). Serum homocysteine levels were positively correlated with age, BMI, fasting glucose, insulin, and HOMA-IR, and negatively correlated with vitamin B12 and folate levels (all p < 0.05). Folate deficiency was significantly more common in participants with hyperhomocysteinemia (33.3% vs. 6.7%; OR 6.82, 95% CI 1.80–29.37; p = 0.002). In multivariable regression analysis, age (β = 0.433; p = 0.001) and folate levels (β = −0.235; p = 0.032) were independently associated with serum homocysteine concentrations. Conclusions: Hyperhomocysteinemia is present in approximately one-quarter of children with obesity and may represent a relevant metabolic alteration in this population. Although serum homocysteine levels were correlated with insulin resistance in univariable analyses, multivariable regression analysis identified age and folate levels as independent determinants. These findings highlight the potential clinical importance of evaluating folate status in children with obesity, particularly in those with elevated homocysteine levels. Prospective studies are warranted to determine whether folate supplementation can effectively reduce homocysteine levels and improve long-term cardiometabolic risk in pediatric obesity. Full article

Background: Childhood vaccination remains one of the most effective public health interventions. Despite consistently high national coverage, vaccine hesitancy persists among parents and may undermine herd immunity. The Parent Attitudes about Childhood Vaccines (PACV) questionnaire provides a validated framework for identifying parental concerns and patterns of hesitancy. Methods: A cross-sectional online survey was conducted in May 2025 using the Croatian version of the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. The study included 1087 parents aged 18–65 years. PACV scores were transformed to a 0–100 scale, with values ≥50 indicating vaccine hesitancy. Associations between PACV scores and parental age and educational level were analysed using non-parametric statistical tests. Results: Most respondents were mothers (87.7%) and aged between 30 and 45 years (71.8%). Approximately one fifth of parents reported postponing vaccination (22.7%), and 19.2% indicated having refused at least one vaccine dose. While 63.7% expressed full acceptance of recommended childhood vaccines, a substantial proportion either refused vaccination (20.8%) or remained undecided (15.5%). Higher educational attainment was significantly associated with lower PACV scores, whereas no significant association was observed with parental age. Conclusions: Although overall vaccination acceptance in Croatia remains high, vaccine hesitancy continues to affect a considerable proportion of parents. Strengthening tailored communication strategies and reinforcing trust-based counselling—particularly within pediatric and community nursing services—may support informed decision-making and improve vaccine confidence. Full article

Kidney transplantation (KTx) corrects many uremia-related metabolic disturbances; however, dyslipidemia remains common in kidney transplant recipients and contributes to persistent cardiovascular risk. Lipoprotein(a) [Lp(a)] is a largely genetically determined proatherogenic lipoprotein that increases in advanced chronic kidney disease (CKD) and may decrease after restoration of renal function. Autotaxin (ATX), an enzyme involved in proinflammatory lipid signaling through the ATX–lysophosphatidic acid axis, has also been implicated in cardiovascular pathology, but its early post-transplant dynamics remain poorly characterized. In addition to quantitative lipid abnormalities, CKD is associated with high-density lipoprotein (HDL) dysfunction and reduced paraoxonase-1 (PON-1) activity; however, data on early post-transplant changes in PON-1 activity are limited. In this prospective observational study, lipid profile parameters, Lp(a) concentration, ATX activity, and PON-1 activity were assessed in 55 Caucasian patients with CKD stage 5, most of whom were dialysis-dependent, before and 2–3 weeks after KTx. All recipients received tacrolimus-based maintenance immunosuppression with corticosteroids and mycophenolate mofetil. After KTx, Lp(a) levels decreased by a median of 21% and ATX activity by 28% (both p < 0.001). Lp(a) and ATX showed no cross-sectional or longitudinal association either before or after transplantation, and their percentage changes were not correlated. In contrast, conventional lipid fractions increased significantly, including total cholesterol (+22%), LDL cholesterol (+27%), HDL cholesterol (+24%), and triglycerides (+55%) (all p < 0.001). PON-1 activity increased by approximately 13% after KTx (p < 0.001), and its percentage change correlated positively with the increase in HDL cholesterol. In exploratory analyses, the magnitude of Lp(a) reduction was associated with early graft function: patients with eGFR <45 mL/min/1.73 m² exhibited a significantly smaller decline in Lp(a) than those with better graft function (−4.8% vs. −26.7%, p = 0.009). Multivariable analysis showed that demographic characteristics, body mass index, tacrolimus exposure, and post-transplant eGFR did not independently predict the magnitude of Lp(a) reduction. Tacrolimus trough concentrations and cumulative corticosteroid exposure were not associated with lipid parameters or their changes, except for a single subgroup difference in PON-1 activity of uncertain clinical significance. In the early period after KTx under tacrolimus-based immunosuppression, Lp(a) concentration and ATX activity decrease, whereas conventional lipid fractions increase and PON-1 activity improves. These changes were not associated with tacrolimus exposure or cumulative corticosteroid dose. The reduction in Lp(a) was associated with early graft function in exploratory analyses, suggesting that recovery of renal function may contribute to early post-transplant Lp(a) dynamics; however, no independent causal relationship was established, and the findings should be interpreted cautiously given the limited sample size and exploratory design. The clinical significance of these changes for long-term cardiovascular and graft outcomes requires further investigation. Full article

Coronavirus disease 2019 (COVID-19) is associated with systemic inflammation and immune dysregulation, potentially affecting hypothalamic–pituitary–adrenal (HPA) axis function and glucocorticoid signaling. However, the dynamics and clinical relevance of these alterations across different disease phases remain insufficiently defined. In this cross-sectional observational study, 101 participants were divided into three groups: patients with active COVID-19 (n = 33), individuals ≥ 6 months post-COVID-19 (n = 35), and a reference group of healthy individuals (n = 33). Serum cortisol, circulating glucocorticoid receptor alpha (GRα), and selected cytokines were measured. Statistical analysis included parametric and non-parametric tests, multivariable generalized linear models adjusted for age and sex, correlation analysis, and receiver operating characteristic (ROC) analysis. Lower serum cortisol levels were observed in approximately two-thirds of patients during the acute phase. Circulating GRα concentrations demonstrated a significant gradient across groups, with the lowest levels in active infection and partial restoration post-COVID. Active COVID-19 status remained independently associated with reduced GRα levels after adjustment for age and sex. The cytokine profile, including interleukin-17A (IL-17A), tumor necrosis factor-alpha (TNF-α), and interleukin-10 (IL-10), provided a mechanistic context for inflammation-associated modulation of glucocorticoid signaling, most evident during acute infection. Significant correlations between cortisol, GRα, and inflammatory mediators were observed only in this phase. ROC analysis demonstrated a high degree of statistical separation between active COVID-19 and healthy individuals (AUC 0.942; 95% CI: 0.878–1.000). Given the predefined group structure and modest sample size, these findings should be considered exploratory. Overall, the results support the presence of dynamic and potentially reversible immune–endocrine dysregulation during and after SARS-CoV-2 infection. Further validation in larger prospective cohorts is required. Full article

In this study, the comparative residual performance of fire-exposed reinforced concrete (RC) beams with rectangular and T-shaped cross-sections is investigated. Two concrete beams, one with a T-section and the other with a rectangular section, were tested under the combined effects of fire exposure and structural loading. Data generated in the tests during and following fire exposure is utilized to compare the thermal and structural response of the beams. The results indicate a notable difference in the temperature evolution, mid-span deflection, and the residual capacity of the beams. The T-beam experienced greater deflection and stiffness degradation due to its larger exposed surface area (approximately 17% higher than the rectangular beam) and flange geometry, despite comparable peak rebar temperatures. A simplified approach, based on the maximum concrete and rebar temperatures and corresponding strength reductions, is proposed to evaluate the residual capacity of fire-exposed RC beams. For equal cover depth to reinforcement, peak rebar temperature is unaffected by cross-section shape as long as the web of the T-beam is not slender. T-shaped beams with similar overall depth exhibit greater post-fire strength retention than rectangular beams when the neutral axis lies within the flange. A 20% reduction in the web thickness and a combined reduction of 20% in web and 37% in flange thickness result in a comparable decrease in the flexural capacity to that of the rectangular beams of similar depth, indicating that the flange plays a key role in maintaining post-fire performance. Full article

Precarious and informal employment has been increasingly recognized as a key social determinant of health, particularly in countries of the Global South. In Chile, despite relatively strong labor institutions, informal employment remains widespread, yet contemporary evidence on its health implications is limited. This study examines the association between the absence of a written employment contract, used as an indicator of labor informality, and multiple health and well-being outcomes among employed adults in Chile. A cross-sectional analysis was conducted using data from the nationally representative 2022–2023 National Health and Sexuality Survey (ENSEX), restricted to the urban employed population (n = 5193). Informal employment was defined by self-reported absence of a written contract. Health outcomes included perceived general health, quality of life, physician-diagnosed conditions, and recent anxiety–depressive symptoms assessed with the PHQ-4. Weighted descriptive analyses and logistic regression models were estimated, accounting for the complex survey design and adjusting for sex, age, and educational level. Approximately 12.8% of employed individuals reported not having a written contract. Contract absence was associated with higher odds of anxiety–depressive symptoms and lower odds of reporting good quality of life after adjustment. Associations with general health and chronic physical conditions were weaker and not statistically significant. These findings suggest that contractual informality is particularly linked to reduced psychological well-being and quality of life, highlighting the relevance of informal employment as a public health concern beyond traditional disease outcomes. Full article

Background/Objectives: The aim of this study is to describe sex- and age-specific patterns of HbA1c in adults with type 2 diabetes (T2D) mellitus across three temporal cohorts from Southern Italy (2012, 2017, and 2024), and to assess whether glycemic differences between men and women persist, narrow, or evolve over time. Methods: We analyzed three independent cohorts of adults with T2D, including 1249 patients in 2012 and 1125 patients in both 2017 and 2024. HbA1c values were summarized as medians and interquartile ranges within sex- and age-stratified groups. Temporal variation in cohort-specific median HbA1c was examined across timepoints within each sex and age category, and sex differences were assessed within each cohort year. Results: At the population level, median HbA1c values remained within a narrow range across all three cohorts, indicating overall temporal stability of glycemic control. No significant sex differences were observed in 2012 or 2024, and only one age stratum (≥80 years) showed a significant sex difference in 2017, with men exhibiting slightly higher median HbA1c. Age-stratified analyses revealed heterogeneous temporal patterns. In older adults (≥70 years), HbA1c medians were remarkably stable in both sexes (approximately 7.2–7.4% in women and 7.2–7.6% in men). In midlife (40–59 years), women tended to show modest increases or partial reversals in HbA1c, whereas men displayed worsening between 2012 and 2017 followed by stabilization thereafter. The youngest adults (18–29 and 30–39 years) showed the highest HbA1c levels in 2017 and the largest subsequent improvements between 2017 and 2024 in both sexes, with median values decreasing toward approximately 7.1–7.6%. Conclusions: Despite well-described biological and social sex differences in T2D, median HbA1c values in this real-world setting were broadly comparable between men and women and largely stable over a 12-year period. Sex differences were small, inconsistent, and age-dependent, with age, and not sex, emerging as the primary determinant of HbA1c over time. These findings suggest that sex-related disparities in glycemic control may be better understood through a dynamic, life-course perspective rather than static cross-sectional comparisons. Full article

Electrochemical discharge machining (ECDM) with low machining reaction forces is useful for machining hard and brittle materials, which are required in precision equipment. Lathe-type ECD machines have been proposed to machine axisymmetric shapes while reducing cracks caused by thermal expansion, and they are suitable for thin workpiece machining due to the small reaction force. This paper demonstrates the micromachining of non-circular cross-sections using a lathe-type ECD machine equipped with an improved force-controlled tool electrode holder. The tool electrode holder combining a voice coil motor (VCM) with leaf springs arranged in parallel was built. This holder achieves both flexibility in the longitudinal direction of the tool electrode and high rigidity in the lateral direction. The relationship between the VCM current, tool electrode shift within the tool electrode holder, and thrust force was approximated using a polynomial. Consequently, this device allows for the stable, small contact force required in micromachining. An on-machine shape measurement method was also carried out by combining the tool electrode shift with the motion of an XZ stage. As a demonstration for non-circular cross-section machining, a square cross-section was grooved from a cylindrical glass rod. The removal and measurement processes were alternately repeated to achieve precision. During ECDM, the on/off of the DC power supply for ECDM was synchronized with the rotation of the workpiece. The measurement results indicated some dimensional errors, including bulging at the middle of sides and excessive removal at corners. The bulging was mainly caused by drift due to thermal expansion of the stage, as well as tool electrode wear. Since the tool electrode comes into close proximity to with the machined surface, the discharge from the side surface of the tool electrode caused excessive removal at the corners. Full article

Background/Objectives: Internalized weight bias has been linked to adverse mental health outcomes and maladaptive eating-related behaviors. However, its relationship with habitual dietary intake and overall diet quality remains insufficiently explored. The objective of this study was to examine associations between internalized weight bias and habitual energy intake, macronutrient composition, and adherence to the Mediterranean diet among adults with a history of overweight or obesity. Methods: In this web-based cross-sectional study, 484 adults with a history of excess body mass index completed validated assessments of internalized weight bias (Weight Bias Internalization Scale–Modified; WBIS-M) and usual dietary intake (69-item Food Frequency Questionnaire). Adherence to the Mediterranean diet (MeDi) was assessed via the MedDietScore. Multivariable analyses adjusted for several covariates were performed. Results: Higher levels of internalized weight bias were associated with lower adherence to the MeDi (B_adj = −0.670, p = 0.025). Higher adherence to the MeDi was associated with reduced odds of being classified in the medium or the highest WBIS-M tertile, corresponding to an approximately 5% reduction per 1-unit increment in the MedDietScore. No associations were observed between internalized weight bias and total energy intake. At the macronutrient level, higher internalized weight bias was associated with higher saturated fat intake, independent of total energy intake. Conclusions: Internalized weight bias was associated with poorer habitual diet quality and unfavorable macronutrient profiles, independent of total energy intake. These findings suggest that internalized weight bias relates to qualitative differences in habitual food choices, highlighting the potential importance of addressing weight bias in efforts to improve diet quality among adults with overweight or obesity. Full article

Kid health problems are important welfare and productivity concerns in goat farming, yet herd-level patterns and management responses remain poorly described in many production systems. This cross-sectional study investigated farmer-reported kid health problems in Swedish goat herds and their associations with herd size and management practices. An online questionnaire distributed through national goat networks during 2024 yielded 684 completed responses, representing approximately one-third of Swedish goat keepers. Overall, 27.63% of farms (189/684) reported at least one kid health problem during the preceding three years, most commonly gastrointestinal disorders (22.8%), followed by joint-related (15.1%) and neurological conditions (9.0%). A subset of farms (6.0%) reported multiple concurrent types of kid health problems, indicating more complex herd health profiles. The proportion of farms reporting at least one kid health problem increased with herd size; large herds (>50 animals) were more likely to report health problems compared with small herds (RR = 1.51; 95% CI: 1.08–2.10), while medium-sized herds showed modest, non-significant increases. This herd-level outcome is inherently influenced by herd size, as larger herds have a higher probability of observing at least one case. Farms reporting multiple concurrent kid health problems more frequently implemented management measures such as isolation during kidding, early colostrum provision, and selenium supplementation, likely reflecting reactive adoption following previous health challenges rather than proactive prevention. Longitudinal studies using animal-level data are needed to clarify causal relationships. Full article

Introduction: Eating disorders and disordered eating behaviours are crucial mental health concerns, yet evidence linking social media use to eating-related outcomes in adult populations, particularly in Saudi Arabia, remains limited and primarily focused on female or student samples. This study examined the prevalence of disordered eating risk among Saudi adults and its association with social media engagement, body mass index (BMI), and sociodemographic factors. Method: A cross-sectional survey was conducted among adults residing in Saudi Arabia. Disordered eating risk was assessed using the Eating Attitudes Test (EAT-26), and social media engagement was measured as frequency of use across multiple daily routines using the Social Media Engagement Questionnaire (SMEQ). BMI and sociodemographic variables were self-reported. Descriptive statistics, bivariate analyses, and multivariable linear regression were performed to examine associations between study variables. Results: Approximately 43% of respondents were at high risk of disordered eating behaviors. Social media engagement was prevalent; however, its association with disordered eating risk was weak and inverse (Spearman’s Rho = −0.1243, p < 0.01). BMI showed domain-specific associations across eating-related domains, while most sociodemographic factors were not strongly associated with disordered eating outcomes. Conclusions: Disordered eating behaviors were present among adults in Saudi Arabia and extend beyond traditionally studied high-risk groups. The weak inverse association indicates that frequency of social media use alone may not be a reliable indicator of eating-related risk in adults and likely does not capture content- and comparison-specific mechanisms. Findings highlight the need for broader screening and prevention efforts, as well as for longitudinal research using content- and behavior-specific measures of social media exposure to clarify mechanisms in adult populations. Full article

In this paper, we present a deep neural network–based approach for computing radar cross section (RCS) over a wide frequency band and a broad range of incident angles. The proposed network, termed WBRCS-Net, is designed to converge to the solution of the method of moments (MoM) formulation by minimizing a mean-squared residual loss without explicitly solving the MoM linear system, thereby avoiding the numerical instabilities commonly encountered in conventional iterative solvers. Moreover, by using only the frequency and incident angle as inputs, WBRCS-Net enables wideband RCS prediction over a broad range of incident angles while substantially simplifying the network architecture. The performance of WBRCS-Net is evaluated on perfectly electrically conducting (PEC) spheres and cubes and is compared with the Maehly approximation based on Chebyshev polynomials, using monostatic RCS over a frequency range of 2–12 GHz and an incident-angle range of 0°∼90°. Experimental results demonstrate that, once trained, WBRCS-Net enables stable wideband RCS computation over a wide range of incident angles with instantaneous inference speed, achieving a minimum mean-squared error (MSE) on the order of ${10}^{-14}$ relative to reference MoM solutions. Full article

Background and Aim: Low back pain (LBP) represents an important public health issue, with approximately 20% of acute cases progressing to chronic low back pain (CLBP). In addition to pain, patients with CLBP also suffer from reduced cognitive performance, depressive symptoms and catastrophic thoughts. Central sensitization (CS) is considered a key point in pain persistence. This study examines CS and its impact on cognitive, emotional, and behavioral functioning in patients with CLBP. Methods: In this cross-sectional study, 67 patients with CLBP were classified using the Central Sensitization Inventory (CSI) into groups with (WCS, n = 32) and without central sensitization (WoCS, n = 35). Cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA), emotional functioning using the Center for Epidemiologic Studies Depression Scale (CES-D), and behavioral functioning using the Pain Catastrophizing Scale (PCS), including helplessness, rumination, and magnification domains. Normality was assessed using the Shapiro–Wilk test. Between-group comparisons were performed using Mann–Whitney U, chi-square, or Welch’s t-tests. Multivariable linear regression analyses adjusted for age and gender were conducted. Results: Compared with the WoCS group, patients with central sensitization were older (median 58 vs. 50 years, p = 0.001) and more frequently female (71.9% vs. 40.0%, p = 0.018). The WCS group showed higher PCS total scores (31.8 ± 14.2 vs. 16.0 ± 11.9), higher helplessness (14.3 ± 6.1 vs. 6.9 ± 5.5), rumination (12.7 ± 6.2 vs. 7.0 ± 4.8), and magnification scores (4.8 ± 2.4 vs. 2.1 ± 2.1), higher CES-D scores (26.3 ± 10.4 vs. 11.7 ± 7.2), and lower MoCA scores (23.6 ± 3.0 vs. 26.1 ± 2.1) (all p < 0.001). All associations remained significant after adjustment for age and gender. Conclusions: Central sensitization in CLBP is independently associated with greater pain catastrophizing across all domains, increased depressive symptoms, and reduced cognitive performance, supporting its role as a multidimensional clinical phenotype. Full article

The renewable energy transition has become one of the vital pathways for approaching climate change and promoting sustainability. The success of this transition, however, does not depend only on technical and economic considerations, but is mainly influenced by social and institutional factors that form acceptance and support. This study aims at measuring the contribution of social capital, the awareness of the energy transition, and the institutional context in increasing the level of public support for the energy transition among Sultan Qaboos University students. It adopts a cross-sectional quantitative approach, and data are collected through a multi-section questionnaire from a sample of 437 male and female students from different colleges, majors, and academic years at Sultan Qaboos University. These tools of the study measure the dimensions of social capital: trust, social networks, bridging, institutional linking, and student participation. They also evaluate objective knowledge and self-perceived awareness of the renewable energy transition, in addition to components of the institutional context within the university: the sustainability climate on campus, opportunities for participation, and trust in governance/procedural justice. The indicators of internal consistency (reliability) also show significant values: the Cronbach’s Alpha coefficients range approximately between 0.715 and 0.893 for the independent variables and reach 0.864 for the dependent variable. The results of this study show that most of the students fall within the high level of support (77.3%), with no statistically significant differences based on gender, college type, academic year, or previous volunteering experience. The ordinal logistic regression results indicate that the campus sustainability climate is the strongest factor influencing higher levels of support followed by trust in governance/procedural justice and general trust (TR). The bridging dimension (BB) does not have a significant independent influence after accounting for the other variables. This study emphasizes that increasing support for the renewable energy transition in the university environment requires strengthening an institutional climate which supports sustainability, promoting fair and transparent governance, expanding participation opportunities, and investing in building trust and strengthening institutional connections to encourage pro-sustainability behaviors. Full article