Search Results (19,836)

Introduction: Colonization by Staphylococcus aureus—including methicillin-resistant strains (MRSA)—represents a growing public health concern, particularly in community and rural settings. In Portugal, limited data are available regarding its prevalence in populations with agricultural or animal-related exposures. Objectives: To determine the prevalence of S. aureus and MRSA nasal colonization among adults residing in the municipality of Sertã, Portugal, and to explore potential sociodemographic and behavioral factors associated with colonization. Methods: A cross-sectional study was conducted with 292 adult participants from multiple parishes of Sertã. Nasal swabs were collected for microbiological identification of S. aureus and MRSA. Data on sociodemographic characteristics, occupational exposure, animal contact, and recent antibiotic use were collected via structured questionnaires. Descriptive statistics and inferential analyses (chi-square and Fisher’s exact tests) were performed, and odds ratios were estimated. Results: The overall prevalence of S. aureus colonization was 19.9% (58/292), with MRSA detected in 4.8% (14/292) of participants, representing 24.1% of all S. aureus carriers. Colonization by S. aureus was slightly more frequent among females (51.7%) and predominantly observed in individuals aged 35–59 years. MRSA was more frequent in participants aged ≥ 60 years and was equally distributed between sexes. 57% of MRSA cases reported recent antibiotic use and all MRSA cases reported daily contact with animals—primarily domestic species. No statistically significant associations were identified between colonization and the analyzed variables, although trends suggested increased risk among individuals with animal contact and moderate to high-risk occupations. Conclusions: This study revealed a notable prevalence of S. aureus and MRSA colonization in a rural Portuguese population. Although no statistically significant associations were found, with animal contact, occupational exposure, and recent antibiotic use emerged as relevant epidemiological factors. These findings highlight the need for strengthened surveillance and further investigation into zoonotic transmission and occupational risk in rural environments. Full article

The rapid growth of digital communication has intensified spam-related threats, including phishing and malware, which employ advanced evasion tactics. Traditional filtering methods struggle to keep pace, driving the need for sophisticated machine learning (ML) solutions. The effectiveness of ML models hinges on selecting high-quality input features, especially in high-dimensional datasets where irrelevant or redundant attributes impair performance and computational efficiency. Guided by principles of symmetry to achieve an optimal balance between model accuracy, complexity, and interpretability, this study proposes an Enhanced Hybrid Quantum-Inspired Firefly and Artificial Bee Colony (EHQ-FABC) algorithm for feature selection in spam detection. EHQ-FABC leverages the Firefly Algorithm’s local exploitation and the Artificial Bee Colony’s global exploration, augmented with quantum-inspired principles to maintain search space diversity and a symmetrical balance between exploration and exploitation. It eliminates redundant attributes while preserving predictive power. For interpretability, Shapley Additive Explanations (SHAPs) are employed to ensure symmetry in explanation, meaning features with equal contributions are assigned equal importance, providing a fair and consistent interpretation of the model’s decisions. Evaluated on the ISCX-URL2016 dataset, EHQ-FABC reduces features by over 76%, retaining only 17 of 72 features, while matching or outperforming filter, wrapper, embedded, and metaheuristic methods. Tested across ML classifiers like CatBoost, XGBoost, Random Forest, Extra Trees, Decision Tree, K-Nearest Neighbors, Logistic Regression, and Multi-Layer Perceptron, EHQ-FABC achieves a peak accuracy of 99.97% with CatBoost and robust results across tree ensembles, neural, and linear models. SHAP analysis highlights features like domain_token_count and NumberOfDotsinURL as key for spam detection, offering actionable insights for practitioners. EHQ-FABC provides a reliable, transparent, and efficient symmetry-aware solution, advancing both accuracy and explainability in spam detection. Full article

Legionella is an environmental bacterium capable of causing severe respiratory infections, with outbreaks posing significant public health challenges in developed countries. Understanding public awareness of Legionella transmission, risk perception, and preventive behaviors is crucial for reducing exposure and guiding health education strategies. This study aimed to evaluate the Portuguese population’s knowledge of Legionella infections and their readiness to adopt preventive measures. A structured questionnaire was developed and administered to 239 participants aged 18–76 years across Portugal, collecting socio-demographic data and assessing literacy through statements organized into domains related to Legionella risk, control measures, and public health impact. The results indicate that participants possess moderate to high awareness of Legionella severity, transmission routes, and preventive strategies, yet gaps remain in understanding key risk factors, optimal water system maintenance, and the influence of temperature on bacterial growth. Age, educational attainment, and occupational status were associated with differences in self-assessed literacy levels. Artificial neural network models were applied to classify literacy levels, achieving a near 90% accuracy and demonstrating higher confidence in low and moderate categories. These findings provide insights for designing tailored educational programs, improving public health communication, and enhancing preventive behaviors to reduce Legionella infection risks. Full article

The association between patterns of internet use for older adults’ well-being is unclear. We examined the association between the frequency and purpose of internet use and subjective well-being in older Japanese adults. We analyzed cross-sectional data from 2343 community-dwelling older adults (aged 65–84 years). Subjective well-being was measured using the World Health Organization Well-Being Index as a continuous score, and internet use was categorized by frequency and purpose. Hierarchical linear regression analysis was controlled for sociodemographic and health-related covariates. After full adjustment, only daily (B = 1.04, 95% CI [0.53, 1.56]) and dual-purpose use (i.e., for both practical and social communication purposes; B = 0.80, 95% CI [0.28, 1.31]) were independently associated with higher well-being. The analysis of the combined patterns further suggested that daily use was the primary factor. For older adults, regularity of internet use was more strongly associated with well-being than diversity of purpose. Daily integration appears to be a key factor for realizing benefits, suggesting that sustained practice is the foundational step in building the digital capital necessary for a flourishing later life. Longitudinal studies are needed to confirm these findings and untangle the causal relationship between sustained internet use and improved well-being among older adults. Full article

Background/Objectives: Diabetes mellitus is a major global health concern requiring both preventive strategies and patient-centered clinical management. This study evaluated knowledge, lifestyle behaviors, treatment adherence and the use of digital tools among Romanian patients with diabetes in a real-world setting. Methods: A cross-sectional observational study was conducted on 100 patients recruited from community pharmacies in Iași, Romania. Data were collected using a structured 27-item questionnaire addressing demographics, disease management, adherence, lifestyle factors, and complications. Results: Most participants had type 2 diabetes. Engagement in healthy behaviors was suboptimal, with low levels of daily physical activity and limited routine glucose monitoring. Complications and treatment-related side effects were frequent, reflecting a high disease burden. Treatment adherence was significantly higher among younger patients, those with type 1 diabetes and individuals who had set long-term health goals. The use of digital technologies was low overall but more common in younger participants. Conclusions: This study identifies critical gaps in lifestyle practices, adherence and technology uptake among Romanian patients with diabetes. These findings carry important clinical implications, as poor adherence and limited self-management are closely linked to complications and higher healthcare spending. The findings suggest that patient education, integrating validated digital tools and enhancing the role of community healthcare providers could support better adherence and reduce long-term complications. Full article

Air pollutants pose a growing public health concern in Puerto Rico (PR), particularly from rapid industrialization, military activities, environmental changes and natural disasters. A total of 193 pollutants, comprising the 187 hazardous air pollutants and the 6 criteria air pollutants—including particulate matter (PM), carbon monoxide (CO), volatile organic compounds (VOC), and heavy metals—coincide with rising respiratory disease rates (e.g., lung cancer) documented in national and regional health registries. This study aimed to review major air pollutants in PR, their molecular carcinogenic mechanisms (mostly focused on respiratory-related cancers), and the geographic areas impacted significantly. We conducted an extensive literature search utilizing peer-reviewed scientific articles (PubMed and Web of Science), governmental reports (EPA, WHO, State of Global Air), public health registries, (Puerto Rico Central Cancer Registry and International Agency for Research on Cancer) and local reports. Data on pollutant type, source, molecular pathways, and carcinogenic properties were extracted and synthesized. Our analysis identified ethylene oxide (EtO), polycyclic aromatic hydrocarbons, and PM from industrial sites as key pollutants. The municipalities of Salinas and Vieques, hubs of industrial activity and military exercises, respectively, emerged as critical hotspots where high concentrations of monitored pollutants (e.g., EtO, formaldehyde, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and diesel PM) are associated with a significant prevalence of cancer and respiratory diseases. These agents, known to induce genomic instability and chromosomal aberrations, were correlated with elevated local cancer incidence. Our findings underscore the urgent need for targeted public health interventions and support a multi-pronged strategy that includes: (1) enhanced regulatory oversight of EtO and other hazardous air pollutant emissions; (2) community-based biomonitoring of high-risk populations; and (3) investment in public health infrastructure and a transition to cleaner energy sources. Integrating rigorous environmental science with public health advocacy is essential to strengthen PR’s cancer-control continuum and foster resilience in its most vulnerable communities. Full article

Recent studies have indicated that territorial cohesion represents a fundamental variable for the viable functioning of a state. Territorial cohesion is the result of the interaction between two categories of forces: centripetal, which tends to maintain its cohesion, and centrifugal, which tends to break it up. These forces are the combined result of several categories of factors (ethnic, historical and geopolitical, demographic, and social–economic) which characterize each state and territory. The degree of accessibility is a composite indicator that accumulates the influence of natural and economic–social factors through the degree of development of the communications infrastructure on territorial cohesion. Accessibility is of crucial importance, especially in the case of relatively ethnically homogeneous states. Our study analyzes these aspects of territorial cohesion and administrative organization in the case of Romania, a state located in a European region of geopolitical interference and instability. By using a methodology on the critical analysis of data, documents, and bibliographic sources in Romania, the results of our study indicate changes in the relations between cities and subordinate human settlements that occurred in the last five decades, as well as the lack of financial viability of many administrative–territorial units. The conclusions of our research propose a broad rethinking of the administrative–territorial organization in this country, based mainly on better functionality and territorial cohesion. Full article

Background and Objectives: The attachment-diathesis model of chronic pain, which associates insecure attachment with pain catastrophizing and worse pain-related outcomes, is well-supported in adults. Although Functional Abdominal Pain Disorders (FAPDs) are common in youth, with symptoms influenced by the parent–child dynamic, an attachment-diathesis model of FAPDs is unexplored. The aim of this study was to investigate if insecure parental attachment is associated with pain catastrophizing and pain-related variables in youth with FAPDs. Methods: Baseline questionnaire data from an RCT of cognitive behavioral therapy for children with FAPDs (n = 200, 73% girls, 93% White, and a mean age of 11.2 years old) were used to examine relationships between parental attachment (subscales include Alienation, Trust, and Communication), catastrophizing, and pain-related variables (depression, disability, and gastrointestinal (GI) symptom severity). Results: Alienation was significantly correlated with depression (r = 0.39), GI symptom severity (r = 0.30), and disability (r = 0.22; ps < 0.05). Trust was also correlated with depression (r = −0.39), GI symptom severity (r = −0.19), and disability (r = −0.19; ps < 0.05). Communication was associated with depression (r = −0.30, p < 0.01). Catastrophizing mediated these associations, accounting for 22–89% of the relationship between attachment and pain-related variables. Conclusions: Children who report a less secure attachment to their parents report more physical and psychological symptomatology than children who describe their attachment as more secure. This association is partly explained by child catastrophizing. Results suggest that parent–child attachment and catastrophizing may be important treatment targets in children with FAPDs. Full article

This study intends to identify and quantify the individual, perceptual, and contextual factors associated with odor-related perception and to assess the perception of odor sources according to meteorological conditions. Two face-to-face seasonal community surveys were conducted using stratified random sampling with proportional allocation, yielding representative samples of residents in a southern Brazilian city, where mild constant temperatures throughout the year and shifting prevailing wind directions expose residents to different odor sources. Chi-Square tests were applied to assess associations between odor perception and qualitative variables, while logistic regression was used to identify predictors of higher annoyance. Results showed that prevailing wind direction influenced source attribution, with steel industry and sewage-related sites most frequently cited. Proximity to the steel plant increased both source recognition and annoyance levels. Reported impacts included closing windows and reducing outdoor activities. Self-reported respiratory problems consistently predicted higher annoyance levels in both surveys. The statistical methods were effective in analyzing the likelihood of odor-related perception and its relationship with explanatory variables. These findings highlight the value of a data-driven approach—specifically, integrating wind direction, source proximity, and community-based perception—to support urban environmental management and guide odor mitigation strategies. Full article

Background: Preliminary evidence supports high-intensity functional training (HIFT) for improving various health outcomes in non-disabled adults with overweight/obesity. It remains unknown whether HIFT produces similar benefits in individuals who are overweight/obese and also have a mobility disability (e.g., spinal cord injury, multiple sclerosis)—a population disproportionately affected by obesity-related health conditions and systemic barriers to exercise. This pilot study aimed to evaluate the feasibility and preliminary effects of a 24-week HIFT intervention, delivered at community sites by certified trainers, for adults with mobility disabilities (MDs) who were overweight/obese. Methods: Twenty adults with MD and overweight/obesity (self-reported BMI 25–46 kg/m²) enrolled in a 24-week HIFT intervention (3 days/wk, 60 min sessions) delivered at four community-based facilities by certified trainers. Feasibility indicators included recruitment, retention, and attendance; adverse events were tracked. Effect sizes (Cohen’s d) were calculated for changes in obesity-related measures, physical function, work capacity, and psychological measures from baseline to post-intervention. Results: Feasibility targets were met, with a recruitment rate of 72.2%, 76.9% retention, and 80.7% attendance. Thirteen adverse events occurred. Effects on obesity-related measures ranged from negligible to moderate, with stable weight/BMI, reduced waist circumference (45% ≥ 3 cm decrease), decreased body fat, and increased lean mass. Functional outcome effects ranged from small to large and included grip strength, balance, and walking speed. Large improvements were observed for the endurance, speed, work capacity, and self-reported physical function. Conclusions: A community-based HIFT program is feasible and may improve health outcomes in adults with MD and overweight/obesity. Full article

Looking into early Christian–Muslim relations seems to be the outcome of greater interest in Islam transcultural encounters due to current issues of mass migration. Sicily presents an informative example of the interaction between different ethnic and religious groups over centuries. Several scholars, including Jeremy Johns, Alex Metcalfe and Julie Taylor, have explored the social and administrative position of Christians and Muslims within the complex society of Sicily, although their contributions were largely from the umbrella of Norman Sicily from the eleventh to the thirteenth centuries. Thus, there is a need to shift away from the Normans’ experience to exploring Christian–Muslim relations in Sicily during the ninth through eleventh centuries, especially the expansion, society and activities during the rule of the Fāṭimids of Ifrīqiya (909–965) and their Kalbid allies (948–1053). These forms of relationships are not only important for Sicily but for the whole region of the central Mediterranean. This paper will build on the works of Umberto Rizzitano and other scholars to explore the relations between the Arabs and Muslims and the Christians in Sicily during the Muslim rule of the Island. Using Arabic and Islamic sources, including travel accounts by the Muslim geographer Ibn Ḥawqal (d. 988), this paper aims to discuss the lives of Christians and their dynamic exchanges with Muslims within the social and political complexities of Aghlabid and Fāṭimid Sicily as well as Sicily’s link to North Africa (Ifrīqiya). Sicily’s proximity to North Africa and to Europe has been an essential aspect of its history, which facilitated movement of communities between these regions. The paper will also compare the policies of the Fāṭimids towards Christians in Sicily with their relations towards their Christian subjects in Cairo, Egypt. It will show the pragmatic aspects of this relationship concerning marriage, legal status, the movement of people, and cultural and intellectual exchange. Christians and Muslims practised cultural hybridisation that brought changes in Sicily with respect to language, religion, and social habits, resulting in a distinctive Sicilian multicultural identity. Full article

Areas characterised by high ecological and cultural value are increasingly exposed to overtourism and intensifying land-use pressures, often exacerbated by mobility policies aimed at enhancing regional accessibility and promoting tourism. These dynamics create spatial tensions, particularly in environmentally sensitive areas such as those within the Natura 2000 network and Sites of Community Importance (SCIs), where intensified visitor flows, and infrastructure expansion can disrupt the balance between conservation and development. This study offers a geospatial analysis of the current state (2024) of such dynamics in the Lazio Region (Italy), evaluating the effects of mobility strategies on ecological vulnerability and tourism pressure. By applying isochrone-based accessibility modelling, GIS buffer analysis, and spatial overlays, the research maps the intersection of accessibility, heritage value, and environmental sensitivity. The methodology enables the identification of critical zones where accessibility improvements coincide with heightened ecological risk and tourism-related stress. The original contribution of this work lies in its integrated spatial framework, which combines accessibility metrics with indicators of ecological and heritage significance to visualise and assess emerging risk areas. The Lazio Region, distinguished by its heterogeneous landscapes and ambitious mobility planning initiatives, constitutes a significant case study for examining how policy-driven improvements in transport infrastructure may inadvertently exacerbate spatial disparities and intensify ecological vulnerabilities in peripheral and sensitive territorial contexts. The findings support the formulation of adaptive, place-based policy recommendations aimed at mitigating the unintended consequences of accessibility-led tourism strategies. These include prioritising soft mobility, enhancing regulatory protection in high-risk zones, and fostering coordinated governance across sectors. Ultimately, the study advances a replicable methodology to inform sustainable territorial governance and balance tourism development with environmental preservation. Full article

This study examined sarcopenia severity effects on body composition, physical performance, and mechanical properties of gait-related muscles in older women. Forty-one women aged ≥70 years participated and were classified by the following criteria: non-sarcopenia (NS, n = 15), functional sarcopenia (FS, n = 10), sarcopenia (SP, n = 9), and severe sarcopenia (SS, n = 7). Assessments included body composition, physical performance, and muscle tone, stiffness, and elasticity of the tibialis anterior (TA) and gastrocnemius medialis (GM). Group differences were analyzed using one-way ANOVA with Bonferroni post hoc tests (α = 0.05). SP and SS groups had lower body weight, BMI, appendicular skeletal muscle mass, and calf circumference compared with NS. FS demonstrated poorer physical performance than SP across all variables, with six-meter gait speed lower than SS (p < 0.05). SP exhibited significantly higher TA muscle tone, GM muscle tone and GM stiffness than NS (p < 0.05, p < 0.01, p < 0.05, respectively), while TA elasticity was significantly lower in SP (p < 0.01). These findings indicate that sarcopenia severity negatively influences body composition, muscle function, and mechanical properties, with functional sarcopenia showing the greatest impairment in performance. Early detection and targeted interventions are therefore critical to mitigate functional decline in older women. Full article

Background/objectives: Maternal adiposity is a known risk factor for adverse pregnancy outcomes, yet routine antenatal care primarily relies on body mass index (BMI), which has limitations. This study aimed to explore the acceptability of incorporating a broader range of adiposity measurements into early pregnancy antenatal care, assessing pregnant women’s perceptions to inform implementation strategies. Methods: A qualitative study using semi-structured interviews was conducted with 14 pregnant women purposively sampled to capture variation in BMI, age, and parity. Interviews occurred approximately 4–5 months post-measurement experience. The Theoretical Framework of Acceptability (TFA) guided thematic analysis of transcribed data, with independent coding to ensure rigour. Results: Participants generally viewed the current reliance on BMI as outdated and expressed neutral to positive attitudes toward the use of more detailed adiposity measurements. Most reported little emotional discomfort with the process. However, some reflected likelihood of more body self-consciousness had it been their first pregnancy. Time involved in measurements was not seen as burdensome, however waiting between procedures was a minor inconvenience. Self-assessing body shape was described as difficult. Women emphasised the importance of choice, autonomy, and informed consent, especially in relation to partner involvement, the gender of the anthropometrist, and the nature of the procedures. Clear, advance communication and supportive explanations during appointments were seen as essential to ensuring a positive experience. Conclusions: Expanding adiposity assessments in early pregnancy is acceptable to women if implemented ethically, prioritising consent, privacy, emotional safety, and effective communication. Integration into routine care requires staff training and pre-appointment guidance. Full article

Austrian loess cliffs represent unique habitats supporting a rich bryophyte flora, including numerous rare and endangered species. We conducted a comprehensive survey of 86 loess cliff sites in the Pannonian area of Lower Austria, Burgenland, and Vienna, recording 79 bryophyte species. The results highlight that Austrian loess cliffs, despite their small spatial extent, are key refugia for light-demanding, desiccation-tolerant bryophytes. Hilpertia velenovskyi, a critically endangered species, was recorded at six new sites, expanding its known Austrian distribution. Our study also documents the first Austrian occurrences of several Pterygoneurum species. Seven bryophyte communities were distinguished: Aloinetum rigidae, Hilpertio velenovskyi–Pterygoneuretum compacti, and the newly described subassociations Didymodontetum glauci didymodontetosum cordati and Eurhynchietum schleicheri didymodontetosum cordati, as well as Pterygoneuro–Acaulonetum triquetri ass. nov. Multivariate analyses suggest carbonate content as the most consistent environmental driver. Despite their ecological significance, loess cliffs are increasingly threatened by habitat loss, overgrowth by vascular plants, and shading from invasive trees. Our study provides a detailed syntaxonomic and ecological framework for bryophyte communities on loess cliffs, underlining their role as refugia for rare species and the urgent need to protect remaining sites in the Pannonian region. Full article