Search Results (328)

Background/Objectives: Accumulating evidence suggests that cognitive training can induce functional reorganization of intrinsic connectivity networks involved in higher-order cognitive processes. However, few interventions have specifically targeted language, an essential domain tightly interwoven with memory, attention, and executive functions. Given their foundational role in communication, reasoning, and knowledge acquisition, enhancing language-related abilities may yield widespread cognitive benefits. This study investigated the neural impact of a new structured, language-based cognitive training program on neurotypical older adults. Methods: Twenty Brazilian Portuguese-speaking women (aged 63–77 years; schooling 9–20 years; low-to-medium socioeconomic status) participated in linguistic activities designed to engage language and general cognitive processing. Behavioral testing and resting-state functional Magnetic Resonance Imaging (fMRI) were conducted before and after the intervention. Results: Functional connectivity analyses revealed significant post-intervention increases in connectivity within the frontoparietal network, critical for language processing, and the ventral attentional network, associated with attentional control. Conclusions: The observed neural enhancements indicate substantial plasticity in cognitive networks among older adults, highlighting the effectiveness of linguistic interventions in modulating critical cognitive functions. These findings provide a foundation for future research on targeted cognitive interventions to promote healthy aging and sustain cognitive vitality. Full article

Background: Psychophysical well-being, understood as the integrated balance between physical and psychological health, is essential for both personal quality of life and academic performance. Among emerging strategies to support emotional balance and cognitive functioning, active breaks, brief physical activity sessions during study or work, are gaining recognition for their effectiveness. This pilot study explored the impact of active breaks on psychological, cognitive, and physiological variables in a sample of business students, aiming to evaluate their role in enhancing resilience, decision-making, well-being, and autonomic regulation. Methods: An experimental design was used, with students divided into two groups: the experimental group engaged in daily active breaks for 12 weeks, while the control group maintained their regular routines. Psychometric assessments (CD-RISC, DMC Test, PSS, and Stroop Test) and physiological measures (HRV and HRR) were administered before and after the intervention. Results: The findings showed significant improvements in psychological resilience, decision-making ability, and psychophysical well-being in the experimental group. Cognitive performance also improved, as indicated by better Stroop Test scores. Physiologically, increases in heart rate variability (HRV) and heart rate recovery (HRR) suggested enhanced autonomic balance and stress regulation. Conclusions: Active breaks offer a simple and effective strategy to promote students’ holistic well-being—encompassing both psychological and cognitive dimensions—thereby preparing future professionals to manage stress and maintain performance in high-demand environments. Full article

Background: Persistency of patent ductus arteriosus is the main cardiac condition in the preterm population born before 32 completed weeks of gestation with possible short- and long-term hemodynamic disturbances leading to vast morbidity. Jaundice is present in the majority of very preterms needing phototherapy, that also may have an influence on immature hemodynamics. The objectives of this review and meta-analysis were to find relevant evidence of whether chest shielding during phototherapy does or does not have an impact on the ductus arteriosus patency and hemodynamics. Methods: we reviewed the literature and performed a meta-analysis of five randomized controlled trials regarding chest shielding effect on the ductus arteriosus closure. Results: A total of 452 infants, with a mean gestational age of 28.04 weeks and mean birth weight of 1004.8 g were included in our meta-analysis, where we found an RR of 0.6 for developing PDA during phototherapy and chest shielding (95% CI: 0.37; 0.96. prediction interval: 0.18; 1.99) while development of hemodynamically significant PDA had RR = 0.57, within 95% CI: 0.3; 1.06, and a predictive interval between: 0.11; 2.93. Conclusions: Although the estimated RR may suggest a possible moderate protective role of the chest shield regarding development of PDA during phototherapy, the wideness of the predictive intervals, that include no effect, as well as the small number of eligible trials with heterogeneity between them, make the available data insufficient to evaluate the effectiveness of chest shielding during phototherapy. For more conclusive evidence there is a need for well-designed, blinded, multicenter randomized controlled trials with standardized assessment addressing to a more compact target population, knowing the large physiological differences among preterm infants of different gestational ages. Full article

Infection with oncogenic human papillomavirus (HPV) remains a leading cause of cervical cancer and other HPV-related diseases. This situation persists despite the availability of effective prophylactic vaccines. While global vaccination programs have significantly reduced the incidence of HPV in adolescents and young adults, many women presenting with HPV infection or squamous intraepithelial lesions (SIL) were not covered by primary prevention. This review was performed with the aim of evaluating the impact of administering the 9-valent HPV vaccine in adult women who are HPV-positive or have histologically confirmed cervical precancerous lesions. Following the PRISMA 2020 guidelines, a search was performed in the MEDLINE, Scopus, and Cochrane Library databases. A total of 653 studies were retrieved, of which 7 studies, including 19,414 women, met the inclusion criteria. According to the literature, vaccination was linked to significant reductions in persistent HPV infection, progression of SIL, and recurrence of high-grade lesions after surgical removal. Complete HPV remission was achieved in up to 72.4% of vaccinated women, compared to 45.7% among unvaccinated controls. Vaccination after conization lowered the recurrence risk of CIN2+ lesions by 87%, with benefits seen regardless of timing. The most significant effect was observed when vaccine administration was performed before the surgical procedure. Furthermore, HPV vaccination notably enhanced viral clearance and decreased the likelihood of repeated surgical interventions. Despite differences in study design and follow-up definitions, the overall evidence supports additional vaccination in HPV-positive adult women as an effective measure to reduce recurrence and promote viral remission. These findings emphasize the need for clear guidelines and wider access to HPV vaccination for adult populations. Full article

The rising prevalence of dementia has raised significant public concern globally. However, the level of understanding and assistance concerning people with dementia remains limited. This study investigates the impact of virtual reality (VR) on enhancing public awareness and empathy toward dementia. We developed a Virtual Dementia Tour (VDT) designed to simulate the cognitive and sensory impairments associated with dementia while incorporating interactive decision-making elements. A total of 80 adults aged 18 years or older, residing in Hong Kong and with no personal or close family history of dementia or caregiving experience, were recruited for the study. Quantitative data were analyzed using paired and independent samples t-tests to assess the changes in the Dementia Attitudes Scale (DAS) scores before and after the intervention. The results indicate that the baseline awareness and understanding of dementia were low in both groups. However, participants who experienced the VDT showed significantly greater improvements in knowledge and empathy compared to the control group. The findings suggest that VR interventions can effectively promote dementia awareness, reduce stigma, and contribute to the development of dementia-friendly societies. This study contributes to the growing body of evidence supporting the use of VR as an innovative tool for advancing social awareness and empathy in public health education. Full article

Fire has had a profound impact on Australia’s landscapes and biodiversity since the late Tertiary. Indigenous (Aboriginal) people have lived in Australia for at least 65,000 years and fire is an integral part of their culture and cosmology. In 2015, an Indigenous cultural burn was undertaken by Banbai rangers at Wattleridge Indigenous Protected Area, New England Tablelands, NSW. We compared the impact of this burn on the composition, cover, abundance, and species richness of dry sclerophyll vegetation and fuel hazard, with a hazard reduction burn at nearby Warra National Park, using a Before-After-Control-Impact experimental design. Our study found that the low-severity cultural burn and moderate-severity hazard reduction burn reduced fuel loads but did not have a significant impact on the composition of the vegetation overall or the herb layer. The hazard reduction burn had a significant impact on shrub and juvenile tree (woody species) cover, while the abundance of woody species was significantly affected by both fires, with a mass germination of ‘seeder’ species, particularly after the cultural burn. The long unburnt fire regime at Wattleridge may have made the vegetation more responsive to fire than the more frequently burnt vegetation at Warra, through accumulation of seed in the seed bank, so that the patchy cultural burn had a greater impact on woody species abundance. In terms of ecological and bushfire management outcomes, this study provides evidence to support claims that Indigenous cultural burning decreases fuel loads, stimulates regeneration of shrubs and trees, and manages at a local, place-based scale. We recommend cultural burning as a key management tool across Indigenous Protected Areas and other land tenures, with its implementation monitored and adaptively managed through two-way science, to foster fire regimes that are both culturally and ecologically beneficial. This is a vital element of our resilience in the Pyrocene and a significant step toward decolonizing science and land management. Full article

Many athletes consume caffeine before late afternoon/evening training sessions or competition, yet the impact on subsequent sleep remains unclear. This systematic review with meta-analysis examined the effects of late afternoon/evening caffeine consumption on sleep in athletes. Ten studies (n = 128 athletes) involving randomized controlled trials and quasi-experimental designs were included if caffeine was consumed prior to late afternoon/evening training and subsequent sleep was measured. Meta-analysis followed PRISMA guidelines with risk of bias assessed using RoB-2 and ROBINS-I tools. Meta-analysis of randomized controlled trials revealed a small reduction in sleep efficiency with evening caffeine consumption: mean difference −4.87%, 95% CI −7.45 to −2.29, p = 0.04, though this effect was not robust in leave-one-out sensitivity analyses. Total sleep time showed a non-significant trend toward reduction: mean difference −32.47 min, 95% CI −69.93 to 4.99, p = 0.08, I² = 0%. Athletes consistently reported substantial subjective sleep impairment following evening caffeine intake (3–6 mg/kg BM), creating a pronounced objective–subjective disconnect. The most notable finding is that athletes consistently perceive substantial sleep disruption despite inconsistent objective changes, highlighting the importance of subjective sleep experience in athletic populations. These findings should be interpreted cautiously given the small number of studies and predominance of male participants, limiting generalisability. Full article

This study aimed to assess the physical, chemical, and combustion properties of pellets made from corncob and rice husk residues sourced in Sucre, Colombia, and to evaluate the performance of different blending ratios. Before pelletization, the residues were ground and processed using a small-scale flat die pellet mill equipped with a 6 mm die. Physical properties were evaluated according to ISO standards for particle density, bulk density, and impact resistance assessment. Proximate and ultimate analyses, as well as heating values, were determined and compared against the ISO 17225-6:2021 classification for herbaceous biomass. The 70:30 corncob-to-rice husk blend (CC70:RH30) showed good quality, with 7.23% ash, 9.18% moisture, and an LHV of 15.19 MJ/kg, meeting the criteria for Class B pellets. Combustion performance was assessed using a custom-designed macro-TGA, revealing that co-pelletized blends exhibited improved ignition temperatures and comprehensive combustion indices compared to the individual feedstocks. Additionally, calorific values were proportional to the blending ratios. In summary, controlling the blending ratio of corncob and rice husk residues during pellet production allows modulation of both the total ash content and the lower heating value of the resulting solid biofuels, making them more suitable for thermochemical conversion routes such as combustion and/or gasification. Full article

Background/Objectives: Glaucoma is the primary cause of irreversible blindness worldwide, with enormous impact on quality of life and activities of daily living. Since one pathogenic mechanism of glaucoma is mitochondrial dysfunction at the retinal ganglion cell level, niacin has been proposed as an adjuvant treatment, with encouraging results. The objective of this prospective, non-randomized, single-arm clinical trial was to investigate the effect of oral supplementation with niacin on the quality of life of a cohort of glaucoma patients in Romania. Methods: Fifty-eight patients diagnosed with primary open angle glaucoma, under topical hypotensive treatment, were evaluated before and after a 6-month period of daily administration of 500 mg of oral niacinamide. Evaluation involved a complete ophthalmological exam and QoL quantification using the Glaucoma Quality of Life-15 (GQL-15) Questionnaire. Results: We found strong evidence that niacin supplementation for 6 months led to a statistically significant improvement in QoL scores among glaucoma patients (mean difference = −2.10, 95% CI: [−2.89, −1.32], p < 0.0001), including central and near vision (mean difference = −2.16, 95% CI: [−3.91, −0.4], p = 0.017), peripheral vision (mean difference = −2.66, 95% CI: [−0.23, −0.08], p < 0.001), and the glare and dark adaptation (mean difference = −5.24, 95% CI: [−0.33, −0.14], p < 0.001). In addition, B3 treatment resulted in a significant reduction in intraocular pressure in both eyes over 6 months (mean difference = 0.53, 95% CI: [0.21, 0.86] in the left eye and mean difference = 0.36, 95% CI: [0.04, 0.68] in the right eye), indicating potential clinical benefits. Conclusions: The observed GQL-15 score reductions suggest that B3 may be of benefit in glaucoma management. Further research with larger sample sizes and placebo-controlled designs is needed to confirm B3 potential impact on disease progression and quality of life. Trial Registration at clinicaltrials.gov: NCT07007260. Full article

Hospital-acquired infections (HAIs) remain a major clinical and economic burden, with pathogens such as Escherichia coli contributing to high rates of morbidity and mortality. Traditional manual disinfection methods are often insufficient, particularly in high-risk hospital environments. In this study, we investigated innovative strategies to enhance surface decontamination and reduce infection risk. First, we assessed the efficacy of the SMEG BPW1260 bedpan washer-disinfector, a thermal disinfection system for human waste containers. Our results demonstrated a reduction in Clostridium difficile and Escherichia coli contamination by >99.9% (>3 log reduction), as measured by colony-forming units (CFU) before and after treatment. Molecular techniques, including spectrophotometry, cell counting, and quantitative PCR (qPCR) for DNA quantification, confirmed reduction in bacterial contamination. Specifically, Clostridium difficile showed a reduction of approximately 89% in both optical density (OD) and cell count (cells/mL). In the case of Escherichia coli, a reduction of around 82% in OD was observed, with an even more pronounced decrease in cell count, reaching approximately 99.3%. For both bacteria, DNA quantification by qPCR was below detectable limits. Furthermore, we optimized the energy efficiency of the disinfection cycle, achieving a 45% reduction in power consumption compared to standard protocols without compromising antimicrobial efficacy. Secondly, we developed a sustainable cleaning solution based on methyl ester sulfonate surfactants derived from waste cooking oil. The detergent’s antibacterial activity was tested on contaminated surfaces and further enhanced through the incorporation of nanoassemblies composed of silver, electrostatically bound either to biomimetic magnetic nanoparticles or to conventional magnetic nanoparticles. Washing with the detergent alone effectively eliminated detectable contamination, while the addition of nanoparticles inhibited bacterial regrowth. Antimicrobial testing against E. coli revealed that the nanoparticle-enriched formulations reduced the average MIC values by approximately 50%, with MIC₅₀ values around 0.03–0.06 mg/mL and MIC₉₀ values between 0.06 and 0.12 mg/mL, indicating improved inhibitory efficacy. Finally, recognizing the infection risks associated with intra-hospital transport, we tested the SAFE-HUG Wheelchair Cover, a disposable non-woven barrier designed to reduce patient exposure to contaminated wheelchair surfaces. Use of the cover resulted in a 3.3 log reduction in surface contamination, based on viable cell counts. Optical density and bacterial DNA were undetectable in all covered samples at both 1 and 24 h, confirming the strong barrier effect. Together, these approaches—thermal no-touch disinfection, eco-friendly detergent boosted with nanoparticles, and protective transport barriers—respond to the urgent need for effective, sustainable infection control methods in healthcare settings. Our findings demonstrate the potential of these systems to counteract microbial contamination while minimizing environmental impact, offering promising solutions for the future of infection prevention in healthcare settings. Full article

The built environment, technology, human health and well-being, and sustainable development are closely related, and human-centered therapeutic design in environmental, architectural, spatial, and landscape domains demonstrates human health promotion potential. This study examines health promotion design measurement indices and develops a scale for sub-healthy tourists in a hot spring tourism destination. Recent research mainly emphasized the development and utilization of hot spring resources and their economic benefits. It rarely provided a systematic discussion on the health-promoting impact of environmental design and evaluation criteria. Thus, this study employs the literature review method and the Delphi expert method to construct an index system and measurement scale that comprises 20 evaluation indices of physical, mental, and social health. Moreover, this study conducts a questionnaire survey to measure the physical, mental, and social health of sub-healthy tourists and non-sub-healthy tourists (observation and control groups) and the sub-healthy tourists before and after their visit to the hot spring tourism destination (pre-test group and post-test group). The scale demonstrates satisfactory reliability and validity, and the health–healing design measurement indices for the sub-healthy tourists consist of three subscales: physical, mental, and social health. The evaluation index system and measurement scale can comprehensively and effectively measure the effects of healing and therapeutic design (HTD) and can be used as reliable tools for sub-healthy tourists in hot spring tourism. Full article

Background and Objectives: Patent ductus arteriosus (PDA) is one of the most common cardiovascular conditions affecting preterm infants, with incidence rates reaching 60% in neonates born before 28 weeks gestation. Traditional clinical assessment alone often proves inadequate for accurate diagnosis, potentially leading to both overtreatment and undertreatment. Targeted neonatal echocardiography (TnECHO) has emerged as a powerful bedside tool that enables neonatologists to perform focused cardiac evaluations, providing real-time assessment of ductal significance and systemic hemodynamics. This systematic review aimed to comprehensively evaluate the clinical utility of TnECHO in the management of PDA in preterm infants, with specific focus on its diagnostic accuracy, impact on treatment decisions, and influence on clinical outcomes. Materials and Methods: Following PRISMA guidelines, we conducted a systematic search of PubMed, Web of Science, and Scopus from inception (earliest available date of each database) through February 2025. The search strategy combined terms for “Targeted Neonatal Echocardiography” and “Patent Ductus Arteriosus.” We included observational studies and randomized controlled trials (RCTs) evaluating TnECHO in PDA management, while excluding reviews and case reports. Data extraction focused on study design, population characteristics, TnECHO protocols, and clinical outcomes. Results: From 173 initial records, 11 studies met inclusion criteria. Eight studies were rated as high-quality (NOS score ≥ 7). TnECHO implementation was associated with a 49% reduction in PDA ligation rates and decreased need for multiple treatment courses. Studies demonstrated improved diagnostic precision in assessing shunt significance and myocardial function, leading to more tailored therapeutic approaches. The establishment of dedicated TnECHO services enhanced interdisciplinary collaboration between neonatologists and cardiologists. However, limitations included operator dependence, variable institutional protocols, and occasional missed minor cardiac anomalies. Conclusions: TnECHO represents a transformative approach to PDA management in preterm infants, enabling physiology-guided decision-making that reduces unnecessary interventions while maintaining patient safety. Current evidence supports its role in improving diagnostic accuracy and optimizing treatment timing. Future research should prioritize multicenter RCTs to establish standardized protocols and evaluate long-term neurodevelopmental outcomes. The integration of TnECHO into routine neonatal practice requires investment in training programs and quality assurance measures to maximize its clinical potential. Full article

Background/Objectives: Results from a well-designed trial provide evidence to support approval of truly effective treatments or discontinuation of ineffective treatments. However, the information available at the time of trial design may be limited which may lead to underpowered trials. This work aims to evaluate the impact of design assumption misspecifications on the statistical power of randomized trials with survival outcomes. Methods: The impact of the design assumption misspecifications on statistical power of four different statistical methods was investigated in a simulation study. The methods include the log-rank test, MaxCombo test, the test of difference in survival probability, and test of difference in restricted mean survival time (RMST). The deviations considered include the survival rate in the control arm, the expected treatment effect in terms of magnitude and pattern, accrual rate, and drop-out rate. Results: Deviations in the control arm’s survival distribution have no impact on the power of the log-rank and MaxCombo tests but it affects the trial duration since trials designed with these tests require the total number of events to be met before the final analysis can be conducted. Misspecified treatment effect has similar effect on the statistical power of all four methods. When the proportional hazards assumption is misspecified, the RMST is more robust with a larger early treatment effect, while the survival probability and the MaxCombo tests are more robust with a larger late treatment effect and crossing hazards. Conclusions: Selecting the appropriate statistical tests to design a trial depends on the goal of the trial, the mechanism of action of the experimental treatment, the survival quantity of clinical interest, and the pattern of the expected treatment effect. The final design should be based on assumptions that are as accurate as possible, and the potential impacts of deviations from these assumptions on the trial’s statistical power should be carefully considered. Full article

Contemporary muralism has gained increasing cultural and social relevance in recent years, becoming a prominent form of urban artistic expression. However, its outdoor exposure makes it highly vulnerable to environmental degradation, raising significant challenges for long-term preservation. While solar radiation is widely recognized as a main agent of deterioration, the impact of rainfall has received comparatively little attention. This study addresses this gap by evaluating the durability of commercial protective coatings applied to modern paints (alkyd, acrylic, and styrene-acrylic) under simulated rain exposure. The ageing protocol replicates approximately 10 years of cumulative rainfall in Central-Southern Europe. A key innovation of this research is the use of a custom-built rain chamber, uniquely designed to expose a large number of samples simultaneously under highly uniform and controlled rain conditions. The system ensures reproducible exposure through a precision-controlled moving platform and programmable rain delivery. A comprehensive set of analytical techniques was employed to assess morphological, chemical, and functional changes in the coatings and paints before and after ageing. Results highlight the limited performance of current protective materials and the need for more effective solutions for the conservation of contemporary outdoor artworks. Full article

This study examined the impact of entrepreneurship education in sustainability on entrepreneurial intention using the theory of planned behavior (TPB). The MEMORE macro was used to analyze within-subject mediation and enabled us to examine how entrepreneurial intention is affected by changes in the factors of the theory of planned behavior (attitude, subjective norms, perceived behavioral control). The survey follows a questionnaire-based, pre-test-post-test design (the research involved 271 business administration students in Athens). A paired sample t-test was used to analyze changes in attitude, subjective norms, perceived behavioral control, and entrepreneurial intention before and after education. The results indicated that after the entrepreneurship course in sustainability, students indicated a significant positive change in entrepreneurial intention, attitude, and perceived behavioral control. MEMORE macro indicated that only the change in perceived behavioral control positively influenced the increase in entrepreneurial intention levels. Based on these findings, entrepreneurship education in sustainability enhances students’ entrepreneurial intentions by increasing their perceived behavioral control. As a result, students’ confidence and knowledge regarding sustainable entrepreneurship are fundamental to the development of sustainable entrepreneurial mindsets. This study emphasizes the importance of integrating targeted pedagogical approaches that enhance perceived behavioral control in sustainable entrepreneurship education by equipping students with practical knowledge and skills to overcome psychological barriers. The use of the MEMORE macro highlights this study’s innovation, uncovering new relationships between the examined variables. Full article