Search Results (13,138)

Background: Bacterial vaginosis and vaginal dysbiosis represent major causes of morbidity among women in sub-Saharan Africa, yet data from Madagascar remain scarce. This study aimed to assess the prevalence and determinants of vaginal bacterial infections among women in northern Madagascar and to explore how vaginal microflora composition reflects broader aspects of reproductive health. Methods: A cross-sectional study was conducted in April 2024 among 159 women (15–80 years) attending a rural second-referral clinic in Manerinerina, Ambatoboeny District. Sociodemographic and hygiene data were obtained through structured questionnaires. Vaginal pH was measured in situ, and Gram-stained smears were evaluated using the Nugent scoring system. The presence of Trichomonas vaginalis, Neisseria gonorrhoeae, and Candida spp. was assessed microscopically. Associations were analyzed using Chi-square or Fisher’s exact tests, with p < 0.05 considered significant. Results: Abnormal vaginal flora was observed in 68.6% of women, including 43.4% with BV (Nugent 7–10) and 25.2% with intermediate flora. Elevated vaginal pH correlated strongly with higher Nugent scores (p < 0.01). T. vaginalis and N. gonorrhoeae were detected in 10.7% and 9.4% of women, respectively, and both were significantly associated with dysbiosis (p = 0.02 and p = 0.04). Poor hygiene practices, vaginal douching (79.1% vs. 64.5%; p = 0.04), and unsafe water sources (p = 0.04) were major behavioral and environmental determinants. Conclusions: Vaginal dysbiosis is highly prevalent among women in northern Madagascar and closely linked to modifiable hygiene behaviors and environmental conditions. In resource-limited settings, Gram-stained microscopy and Nugent scoring remain cost-effective tools for surveillance and patient care. Culturally adapted education, improved water access, and integration of low-cost diagnostics are essential for reducing the burden of vaginal infections in rural Madagascar. Full article

Regarding the problem of the accurate estimation of coherent parameters for the distributed coherent jamming system (DCJS) in active radar applications, this paper first establishes a transmit–receive signal model of the DCJS in the presence of coherent parameter estimation errors. Then, it analyzes and verifies that the generalized cross-correlation function weighting method causes a decrease in the estimation accuracy of coherent parameters due to whitening processing, which in turn impairs the synthesis efficiency of the DCJS. Finally, a coherent parameter estimation method based on frequency-domain feature matching is proposed. The weighting method based on frequency-domain feature matching can effectively preserve the intra-pulse features of signals, thereby improving the estimation accuracy of coherent parameters. The simulation results show that, compared with the existing algorithms, the proposed method improves the time delay estimation accuracy by 27.0% and the phase difference estimation accuracy by 8.3%. Full article

Background: Vaginal infections often present with overlapping symptoms and involve single or multiple pathogens. However, the relationship between clinical symptoms and molecularly defined vaginal pathogen profiles, especially in multi-pathogen infections, remains poorly characterized in a routine care setting. This study exams the connection between vaginal symptoms and pathogen profiles among women with vaginitis in Northern Vietnam. Methods: We conducted a multicenter cross-sectional study of women with vaginitis at Bac Ninh CDC and Hanoi Obstetrics and Gynecology Hospital between December 2023 and December 2024. Baseline demographics and clinical symptoms were assessed by physicians. Vaginal swabs were collected for pH measurement and pathogen detection using multiplex real-time PCR. The correlation was analyzed using logistic regression in GraphPad Prism v10.1.1. Results: Among 289 symptomatic women, abnormal vaginal discharge and itching were the most common symptoms. Gardnerella vaginalis was the most commonly detected pathogen, occurring alone or in combination with Candida albicans, Mycoplasma hominis, and other genital pathogens. Multi-pathogen infection was associated with abnormal vaginal discharge (OR = 5.44), itching (OR = 2.13), and elevated vaginal pH (OR = 4.70). Women at the tertiary hospital showed greater symptom burden (OR = 1.75) and higher prevalence of multi-pathogen infections (OR = 9.75) than those attending the provincial CDC. Conclusions: Multiplex real-time PCR combined with simple clinical indicators (symptom clustering and vaginal pH) provides practical diagnostic value for identifying multi-pathogen infections in symptomatic women. This integrated approach may support more accurate etiologic diagnosis and guide rational testing strategies, particularly in resource-limited settings. Full article

Background/Objectives: Periodontitis and low BMD often occur after menopause, but the role of nutritional status in the oral–skeletal link is unclear. This study examined whether nutritional biomarkers relate to periodontitis severity and modify the relationship between low BMD and periodontal destruction in postmenopausal women. Methods: This cross-sectional study included 120 postmenopausal women who underwent comprehensive periodontal measurements at six sites per tooth and were classified according to the 2017 World Workshop staging and grading framework. Areal BMD was measured using dual-energy X-ray absorptiometry (DXA). Objective biomarkers included serum 25(OH)D, plasma vitamin C, RBC omega-3 index, and serum ferritin. Mechanistic measures were serum CTX, P1NP, and urinary 8-OHdG/creatinine. The main periodontal outcome was the mean CAL. Results: Low BMD was associated with greater periodontal destruction (mean CAL 2.06 vs. 1.45 mm; adjusted β = 0.664 mm, 95% CI 0.465–0.863; p < 0.001). Higher 25(OH)D and omega-3 index were independently associated with lower mean CAL (β = −0.024 mm per 1 ng/mL and β = −0.107 mm per 1%, respectively), with false discovery rate control applied across nutritional biomarkers. Across the cohort, serum 25(OH)D showed a weak inverse correlation with CTX (r = −0.14; p = 0.141), and exploratory mediation analyses suggested only small indirect effects via CTX and 8-OHdG. Conclusions: In women after menopause, lower BMD is associated with greater periodontal tissue loss. Objective nutritional biomarkers, especially 25(OH)D and omega-3 levels, correlate with biologically plausible pathways involved in periodontal destruction and remodeling. This supports the idea that nutrition could be a key factor linking oral health and skeletal health. Full article

The peri-implantation window is a tightly regulated temporal phase during which the human endometrium undergoes coordinated molecular remodeling to establish receptivity. MicroRNAs (miRNAs) contribute to implantation-related processes; however, whether dynamic endometrial regulatory signals are functionally reflected in circulation within a defined temporal framework remains unclear. We hypothesized that although individual miRNA identities differ between endometrial tissue and plasma, temporally regulated miRNAs in both compartments may exhibit overlap at the level of enriched biological pathways during the peri-implantation window. To test this hypothesis, we performed time-resolved small RNA sequencing on paired endometrial and plasma samples collected from 62 participants across progesterone exposure days P+3 to P+7 in hormonally controlled cycles. Temporal modeling identified 27 dynamic miRNAs in endometrial tissue and 17 in plasma (FDR < 0.05). Despite limited overlap at the individual miRNA level, functional enrichment analysis revealed recurrent overlap in apoptosis-, cell cycle-, aging-, inflammatory-, and metabolic-related pathways across compartments. Four miRNAs exhibited concordant directional temporal trends between tissue and plasma with moderate correlation coefficients. These findings suggest that dynamic miRNA-associated enrichment patterns during the peri-implantation window may exhibit pathway-level overlap despite divergence in specific molecular identities. This temporally aligned integrative framework provides a pathway-centric perspective for interpreting cross-compartment miRNA-associated temporal patterns and supports a hypothesis-generating systems-level view of human implantation biology. Full article

Background/Objectives: Fetal growth restriction (FGR) represents a model of adverse intrauterine programming associated with an increased risk of cardiometabolic disorders later in life. We examined the relationships between birth weight, catch-up growth, adipokine signaling, and early cardiometabolic risk in adolescents. Methods: This cross-sectional study included 80 term-born adolescents (40 FGR, 40 controls) matched for age and sex. Anthropometry, blood pressure, lipid profile, fasting glucose, adipokines (leptin, adiponectin), and ghrelin levels were assessed. Associations between birth weight, growth rate, adipokines, and cardiometabolic outcomes were analyzed. Results: Birth weight was not associated with adiposity, lipid profile, blood pressure, or glycemic status (p > 0.05). In contrast, catch-up growth in the FGR group was correlated with increased BMI (ρ = 0.680, p < 0.001), central adiposity (ρ = 0.714, p < 0.001), systolic blood pressure (ρ = 0.448, p = 0.0037) and diastolic blood pressure (ρ = 0.325, p = 0.0409). Mediation analyses showed that the current BMI largely explains the associations between catch-up growth and cardiometabolic risk, systolic blood pressure, and waist circumference (β = 2.832 kg/m² per 1-unit increase in ΔZ; p < 0.001). The hypertensive effect of catch-up growth was amplified in overweight/obese adolescents (β = 8.13 mmHg; p = 0.006). Catch-up growth was independently associated with higher leptin (β = 220 ng/L; p = 0.022) and a higher leptin/ghrelin ratio (β = 2.330; p = 0.034). Conclusions: Postnatal growth acceleration, rather than fetal size alone, drives early cardiometabolic susceptibility following FGR through adiposity-mediated and endocrine pathways. Full article

Background: Military police officers are exposed to occupational stressors associated with mental health, coping strategies, and work engagement. This study examined mental health indicators and their associations with coping strategies and work engagement among military police officers in the pre-pandemic period. Methods: A quantitative, cross-sectional, descriptive, and correlational study was conducted in 2018 with 773 Brazilian military police officers from São Paulo (n = 506) and Paraná (n = 267). Participants completed the Work Stress Scale (WSS), Maslach Burnout Inventory (MBI-HSS), Utrecht Work Engagement Scale (UWES), and the Scale of Problem Coping Modes (EMEP). Results: The prevalence of occupational stress was 30.2%, with high proportions of Emotional Exhaustion and Depersonalization. Burnout was interpreted dimensionally (MBI-HSS subscales), with 17.6% (n = 134) joint prevalence of the high Emotional Exhaustion + high Depersonalization + low Personal Accomplishment profile, alongside frequent mixed profiles (e.g., 38.3% with high Depersonalization + low Personal Accomplishment). In the multivariable model, the 6 h shift was associated with higher odds of stress (OR = 7.76; 95% CI: 1.02–58.79), while the absence of self-reported health/quality-of-life issues was associated with lower odds (OR = 0.60; 95% CI: 0.39–0.94), along with Emotional Exhaustion (OR = 1.15; 95% CI: 1.10–1.20) and Depersonalization (OR = 1.12; 95% CI: 1.04–1.20). In sensitivity analysis, work shift was not associated with stress (aOR = 1.20; 95% CI: 0.66–2.21). Stress and burnout dimensions were negatively correlated with work engagement (r = −0.52), problem-focused coping, and social support and positively correlated with emotion-focused coping. São Paulo officers reported higher engagement and greater use of problem-focused coping and social support, whereas those in Paraná reported greater reliance on emotion-focused coping. Conclusions: Stress and burnout dimensions may coexist with high engagement, supporting the need for integrated institutional strategies that address organizational stressors (e.g., workload schedules) and strengthen potentially protective coping repertoires, while accounting for contextual differences between units. The high prevalence of burnout profiles underscores the urgency of preventive interventions to mitigate syndromic manifestations in high-stress occupations. Full article

High-frequency (HF) sensor networks play an irreplaceable role in remote sensing and emergency communications but suffer severely from ionospheric multipath interference, which degrades Time-of-Arrival (TOA) estimation accuracy. Conventional methods, such as the Generalized Cross-Correlation (GCC) and standard Delay-Locked Loops (DLL), often treat multipath components as noise, leading to significant measurement bias in dynamic environments. To address this, we propose a Multipath Separation and Independent Tracking (MSIT) architecture. This framework transforms multipath interference into valuable observables by establishing a closed-loop synergy: a Maximum Likelihood Estimation (MLE)-based module iteratively separates signal components, while parallel tracking loops update phase and delay parameters. Additionally, a super-resolution MUSIC algorithm is employed for initialization to resolve sub-chip multipath components. Simulations demonstrate that under disturbed channel conditions, the MSIT method achieves a mean delay estimation error reduction of about two orders of magnitude relative to the GCC method. Furthermore, field experiments on the Xi’an–Ürümqi link demonstrate its capability to stably resolve and track multiple propagation paths in real-world environments. This approach significantly enhances the measurement precision and reliability of HF sensing systems. Full article

Background/Objectives: Evidence-Based Nursing is imperative for high-quality care, but its implementation continues to face the know-do gap. While organizational barriers are often cited, the role of individual competencies, specifically Emotional Competence, in facilitating adoption remains underexplored on a large scale. This study aimed to analyze the association between perceived Emotional Competence, Evidence-Based Nursing adoption, and perceived attitudes and barriers in a nationwide sample of nurses registered with the Portuguese Order of Nurses. Methods: A quantitative, cross-sectional, correlational study was conducted using a non-probabilistic sample of 3014 nurses registered with the Portuguese Order of Nurses. The Clinical Effectiveness and Evidence-Based Practice Questionnaire, the Attitudes and Barriers Questionnaire, and the Emotional Competence Questionnaire were administered. Data were analyzed using bivariate correlations and a multivariable linear regression model. Results: Nurses reported high levels of perceived Emotional Competence (M = 204.7; SD = 20.3). In the multivariable regression model, Emotional Competence remained robustly and independently associated with Evidence-Based Nursing adoption (B = 0.315; p < 0.001), even after adjusting for sociodemographic and professional covariates. The perception of organizational barriers (e.g., time, incentives) did not correlate with adoption (r_s = 0.011; p = 0.54). Conclusions: Perceived Emotional Competence is a significant and independent correlate of Evidence-Based Nursing adoption. The results suggest that developing socio-emotional skills, including emotional regulation, may be a relevant training target to support evidence implementation. Full article

Background: Frontotemporal dementia (FTD) is traditionally classified based on the accumulation of either tau or TDP-43 proteins; however, the presence of alpha-synuclein (α-Syn) in these patients is increasingly recognized as a critical factor driving disease progression. Methods: A comprehensive narrative review of recent clinical, neuropathological, and biochemical studies was conducted, focusing on cases of FTLD-synuclein and the occurrence of alpha-syn as a co-pathology in more common FTD variants. Results: Current evidence indicates that α-syn often co-aggregates with tau and TDP-43 via “cross-seeding” mechanisms, significantly accelerating neuronal loss and contributing to clinical heterogeneity. Although FTLD-synuclein is a rare, distinct subtype that mimics atypical multiple system atrophy, secondary α-syn pathology is common and strongly correlates with rapid cognitive decline. Furthermore, existing diagnostic biomarkers typically fail to detect this pathological overlap, which may explain the limited efficacy in protein-specific clinical trials. Conclusions: α-Syn is a major, yet under-recognized, catalyst of neurodegeneration within the FTD spectrum. The findings emphasize the need for future therapeutic and diagnostic strategies to adopt multi-target approaches, addressing the synergistic toxicity of multiple protein aggregates rather than isolating single protein in isolation. Full article

The thermal consequences of industrial land transformation remain underexplored in rapidly urbanizing regions of Bangladesh. This study presents a novel approach of how extensive industrial expansion in Narayanganj, a major manufacturing hub dominated by textile, knitwear and dyeing industries, has altered land surface temperature (LST) dynamics over the past three decades, including its variation across classes, relationships with biophysical indices and future patterns. Landsat 5 TM and Landsat 8 OLI imagery from 1991, 2007, and 2023 were utilized to map LULC using winter-season images through supervised classification, while multi-seasonal thermal bands were used to derive LST. LST variations were further evaluated using cross-sectional profiles across different land cover types, and correlations were examined with indices including the greenness index (NDVI), moisture index (NDMI), built-up index (NDBI), and barrenness index (NDBAI). Additionally, a future LST map for 2039 was generated using the cellular automata–artificial neural network (CA-ANN) model. Results show that between 1991 and 2023, built-up area and bare land expanded by 16.72% and 14.15%, while vegetation area and water bodies decreased by 26.62% and 4.25%. Average LST increased from 25.94 °C in 1991 to 28.68 °C in 2023, with projections indicating an additional 2 °C rise by 2039. Cross-sectional analysis found that built-up areas consistently showed the maximum surface temperatures, followed by bare land, vegetation and water bodies. In addition, correlation analysis revealed that LST showed an inverse relation with NDVI and NDMI, while showing a positive relationship with NDBI and NDBAI. These findings show the necessity of sustainable urban planning and green infrastructure to reduce surface heating in rapidly urbanizing areas. Full article

Background: Ultrasound (US) imaging is widely used in Nephrology for the non-invasive assessment of renal morphology and perfusion. This study investigates correlations between sonographic parameters and renal function measured as estimated glomerular filtration rate (eGFR). Methods: This single-center prospective cross-sectional study enrolled 130 patients undergoing renal ultrasound. Parameters included renal length, parenchymal thickness, cortical–medullary differentiation, renal volume, and intrarenal resistive index (IR). eGFR was calculated using the CKD-EPI formula. Statistical analysis assessed correlations and developed a multivariable predictive model. Results: Renal length and parenchymal thickness correlated positively with eGFR (r = 0.381 and 0.364, p < 0.001), while IR correlated negatively (r = −0.549, p < 0.001). Multivariate regression identified sex, renal length, IR, cortical–medullary differentiation, and solitary/shrunken kidney as significant predictors of eGFR. The final model showed a predictive correlation coefficient of r = 0.6632. Specific ultrasound parameters, particularly renal length and IR, show significant correlation with eGFR. Conclusions: A predictive model incorporating these factors may assist in estimating renal function non-invasively. Full article

Current research lacks systematic understanding of cross-scale correlations between micro-texture geometry and macro-lubrication behavior. This study presents a multi-scale collaborative optimization methodology for gear Micro-Textured Meshing Interface (MTMI). An objective function targeting macroscopic interfacial performance is formulated, and a topology optimization strategy is employed to achieve optimal MET configuration. The homogenization analysis captures the modulating effects of MET on local flow and stress fields, while topology optimization transcends conventional parametric geometric constraints, enabling the generation of non-regular MET topological patterns tailored to complex operating conditions, thereby ensuring optimal macroscopic ASLBC. The proposed scheme is validated through numerical simulations of two representative problems capturing distinct lubrication regimes: (1) IEL, characterizing transient load-bearing dynamics governed by temporally evolving MET configurations; and (2) ASLBC, elucidating steady-state load-bearing capacity modulation via spatially heterogeneous MET distributions. A Taylor expansion-based surrogate model is developed to efficiently explore the MET configuration design space, significantly enhancing computational efficiency and solution accuracy for multi-scale optimization. While the gradient-based algorithm cannot guarantee global optimality, extensive numerical simulations and cross-validation studies demonstrate consistent convergence toward high-performance MET configurations, with sensitivity analyses of design parameters further confirming the engineering applicability of the optimized solutions. Full article

Background/Objectives: Patients with rheumatoid arthritis (RA) have an increased risk of chronic kidney disease (CKD) and cardiovascular disease, largely driven by persistent systemic inflammation. This study aimed to assess the risk of CKD in RA patients and to evaluate its association with structural joint damage and cardiovascular risk (CVR). Methods: In this cross-sectional study, 70 patients fulfilling the 2010 ACR/EULAR criteria for RA were evaluated. Structural joint damage was assessed using the Sharp/van der Heijde score (SHS). Renal involvement was evaluated by estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (ACR), and intrarenal resistive index (RRI). CVR was assessed using the SCORE system, adjusted according to EULAR recommendations, and carotid ultrasonography was performed to assess intima–media thickness (IMT) and atherosclerotic plaques. Results: SHS was significantly correlated with renal and vascular parameters, showing positive associations with ACR, RRI, and carotid IMT, and a negative correlation with eGFR (all p < 0.0001). CVR correlated positively with SHS, ACR, RRI, and IMT. Patients with elevated RRI (≥0.70) had longer disease duration, more severe joint damage, impaired renal function, and higher CVR. Conclusions: In RA patients, cumulative articular damage is closely associated with renal dysfunction and increased CVR, highlighting the central role of sustained inflammation in multiorgan involvement. Full article

Background: Hydatid disease poses unique management challenges in pediatric populations due to developing anatomy and growth considerations. This systematic review evaluates the efficacy and safety of medical, surgical, and combination therapies for pediatric hydatid liver disease. Methods: A comprehensive search of PubMed, Scopus, Web of Science, and Cochrane Library from inception to January 2025 identified studies investigating treatment outcomes in pediatric hydatid liver disease. Data was synthesized through qualitative analysis of treatment effectiveness, complications, and patient outcomes. Results: Fifteen studies were included, comprising controlled trials, cohort studies, and cross-sectional studies. Treatment efficacy correlated significantly with cyst size: small cysts (<5 cm) responded well to albendazole monotherapy (88.3–97.6% success at 6–12 months); medium-sized cysts (5–6 cm) benefited from percutaneous interventions (PAIR) with 97.1% technical success; large cysts (>6 cm) required surgical management. Laparoscopic approaches demonstrated advantages over open surgery, including shorter hospitalization (5.6 ± 2.2 vs. 12.1 ± 1.5 days) and reduced analgesic requirements. Omentoplasty emerged as superior for residual cavity management with fewer complications than tube drainage approaches. Conclusions: This review supports personalized treatment algorithms based primarily on cyst characteristics. The findings recommend standardized protocols incorporating cyst size, location, and complexity as key decision points, with expanded access to minimally invasive techniques. Future research should focus on prospective comparative studies with standardized outcome measures. Full article