Search Results (8,918)

Background/Objectives: This study examined the association between energy drink consumption and self-reported bruxism behaviors and temporomandibular joint (TMJ) pain among young adults in Jordan. Methods: A cross-sectional, self-administered survey was distributed to young adults aged 18–30. After applying predefined exclusion criteria, the analytic sample for the TMD-related analyses comprised n = 1373 participants. The questionnaire captured demographics, frequency and duration of energy drink consumption, self-reported bruxism behaviours (clenching, grinding, bracing, thrusting), TMJ pain symptoms adapted from DC/TMD screening items, and psychological stress measured by the validated Perceived Stress Scale (PSS-10). Questionnaire reliability was assessed in a pilot (n = 20) using Cohen’s Kappa. Descriptive statistics, chi-square tests and multivariable logistic regression (adjusting for age, sex, smoking and stress) were used to evaluate associations. Results: Among participants, 309 (22.5%) reported daily energy drink use. Self-reported bruxism behaviors were present in 19.4% (n = 60) of consumers, with an additional 26.9% suspecting these behaviors. TMJ pain on awakening was reported by 41.1% (n = 127) of consumers. Energy drink consumption was significantly associated with higher odds of self-reported bruxism behaviors (χ² = 115.6, p < 0.001). In multivariable analyses, daily consumption remained independently associated with bruxism (adjusted OR 1.9; 95% CI 1.3–2.7; p = 0.001). Higher consumption frequency was also linked to an increased number of oral health symptoms. Conclusions: after adjusting for key confounders, energy drink consumption was associated with greater prevalence of self-reported bruxism behaviors and TMJ pain among young Jordanian adults. These findings emphasize the potential oral health risks of habitual energy drink use and underscore the need for targeted education and preventive strategies in this population. Full article

Given the scarcity of specific instruments to assess parental education in pediatric physiotherapy, this study developed the Parental Education in Physiotherapy Scale (Spanish acronym, EPF) and calculated its preliminary psychometric properties, acceptability, and feasibility. A cross-sectional instrumental study was conducted: the EPF was designed based on a specifications matrix and validated by expert judges in two phases. Then it was administered digitally to 63 physiotherapists experienced in treating children under six years of age. They rated it on a 4-point Likert response scale, and qualitative observations on its clarity, usefulness, and acceptability were collected. The validation showed adequate content validity (I-CVI ≥ 0.86; 31/32 items had I-CVI = 1.00) and high inter-judge agreement (global W = 0.659; p < 0.001). In the pilot study, exploratory factor analysis identified three factors (Collaboration, Capacity-Building, and Reflection) that explained 59% of the variance. After refining it, the final version comprised 18 items, showing high internal consistency (ordinal α = 0.944, ω = 0.934). Acceptability was high (100% found it useful; 98.4% said it facilitated reflection; 95.2% found it clear). Overall, the EPF provides preliminary evidence of validity, internal consistency, acceptability, and feasibility, although larger samples and additional analyses are required for its consolidation. Full article

Background/Objectives: Emotional and behavioral difficulties are common during adolescence and have lasting implications for well-being. Although several psychological resources—such as self-efficacy, mindfulness, and reflective functioning—have been individually linked to better adjustment, less is known about how these strengths jointly relate to perceived stress, difficulties, and health-related quality of life (HRQoL). This study aimed to develop and test an integrative structural model capturing the interplay of these factors during early and mid-adolescence. Methods: A cross-sectional online survey was conducted among 395 adolescents (222 girls, 173 boys; aged 10–16 years) who completed self-report questionnaires assessing HRQoL (KIDSCREEN-10), emotional–behavioral difficulties (SDQ), perceived stress (PSS), self-efficacy (GSE), mindfulness (CAMM), and reflective functioning (RFQY-5). After descriptive analyses and correlation testing, the structural path model using observed variables examined how these variables were interrelated. Multi-group analyses assessed whether structural pathways were invariant across gender and age groups. Results: Mindfulness, self-efficacy, and reflective functioning were each indirectly associated with better HRQoL, mainly through lower perceived stress and fewer emotional–behavioral difficulties. Perceived stress showed a strong positive association with difficulties, and both constructs uniquely predicted lower HRQoL. The overall pattern of associations was fully consistent across age and broadly comparable across gender. Conclusions: The findings highlight the interconnected role of psychological resources, stress, and emotional–behavioral difficulties in adolescents’ well-being. However, the cross-sectional design, convenience sampling, reliance on self-report measures, and single-country sample limit the generalizability and causal interpretation of the results. The robustness of these pathways across age and their broad comparability across gender underscore their developmental relevance and suggest that programs aimed at strengthening socio-emotional competences may be meaningfully applied to support adolescents’ well-being already from early adolescence. Full article

Against the backdrop of pursuing technological self-reliance and strength, examining how participation in technical standard setting influences corporate patient capital investment holds significant importance. This study constructs a complex mediation model based on the Technology-Organization-Environment (TOE) framework. It employs a sample of 211 listed enterprises involved in China’s Information and Communication Technology (ICT) standardization. Utilizing both their cross-sectional data from 2023 and panel data spanning 2003 to 2024, it empirically tests the impact of participation in technical standard setting on corporate patient capital investment and its underlying mechanisms. Findings reveal: First, participation in technical standard setting exerts a significant and robust direct positive effect on corporate patient capital investment. Second, this influence operates primarily through multiple heterogeneous configurational pathways. Configurational analysis identifies four pathways leading to higher patient capital investment, categorized into “innovation-driven” and “sustainable development-driven” types. Further mediation tests reveal that three of these pathways mediate the relationship between participation in technical standard setting and patient capital investment. Third, comparative analysis of linear and complex mediation mechanisms reveals that participation in technical standard setting primarily exerts direct effects through independent pathways influencing innovation levels, innovation information disclosure, and ESG responsibility fulfillment. Variables such as long-term corporate investment and financing constraints—which are insignificant in linear models—emerge as critical components within specific configuration scenarios. These findings enrich the literature on the economic consequences of participating in technical standard setting and the determinants of patient capital investment, providing theoretical foundations and practical references for optimizing corporate strategic allocation and formulating relevant government policies. Full article

Global demand for adaptable and rapidly deployable construction solutions in offshore, coastal, and fluvial environments continues to rise, driven by pressing needs to develop energy platforms, improve coastal resilience, and support emergency response in the face of natural disasters. Increased investment in human-made coastal infrastructure, such as piers, support structures for power lines, offshore wind farms, and seawall protection systems, further underscores this trend. This study investigates the development of printable concrete mixtures for underwater environments using seawater as a replacement for freshwater, using a 3D printing syringe-based extrusion system. The effect of seawater addition and the printing medium (in air vs. underwater) was assessed via rheological and mechanical performance characterization. The results indicate rheological properties are favorable for seawater adoption by producing mixtures with higher yield stress and viscosity with the same levels of admixtures used for freshwater. Seawater-based mixtures demonstrated superior dimensional stability compared to freshwater counterparts, maintaining cross-sectional geometry, while compressive strength results showed no statistical differences between in-air and underwater samples. However, flexural strength was significantly influenced by geometry and printing medium. These findings establish critical rheological parameters for printable underwater mixtures and highlight the need for optimized curing strategies and layer bonding techniques to improve interfacial strength in underwater 3D printing applications. Full article

Background: Early childhood caries is defined as a carious disease affecting primary teeth in children under 6 years of age. It may lead to pain, infections, and difficulties with eating. Despite its burden, evidence on simple, non-invasive preventive approaches which can be implemented both in dental clinics and outreach services is fragmented. The aim of this review was to identify and map such methods for the secondary and tertiary prevention of ECC and to define priorities for future research. Material and Methods: The scoping review followed the PCC framework (Population–Concept–Context). Two databases were searched: PubMed and Scopus. A systematic search was conducted in PubMed and Scopus between 1 August and 30 September 2025. Eligible studies included children under 6 years of age with existing carious lesions, evaluated non-invasive methods for secondary and tertiary ECC prevention (such as sodium fluoride (NaF), silver diamine fluoride (SDF), nano-silver fluoride (NSF), and motivational techniques), requiring simple armamentarium, and reported data on the effectiveness in the context of ECC. Only publications from the past 5 years, available in English, and in open access, were considered. The results of the analysis were summarized narratively, outlining intervention types based on their characteristics, impact, and usage context. Results: Fifteen studies were included. Most were randomized controlled trials (eight studies), focusing primarily on silver diamine fluoride (SDF), often compared with other non-invasive methods, followed by systematic reviews (two studies), reviews (two studies), cross-sectional studies (two articles), and one qualitative study. Only one publication examined the use of motivational interviewing within the context of ECC. While the evidence on non-invasive approaches is growing, significant gaps remain. Small sample sizes, short follow-up periods, and heterogenous interventions and outcomes limit comparability. To strengthen the evidence base, future studies should recruit larger cohorts, adhere to standardized procedures, and use consistent reporting. Conclusions: The majority of studies focused on SDF, reflecting the increasing interest in its use. Research on motivational interviewing in ECC is particularly scarce. Further research under standardized conditions is needed to enable reliable comparisons across treatment protocols. Full article

Objective: This study aimed to assess the psychosocial impact of stainless steel crowns (SSCs) among primary school children in Dammam, Saudi Arabia, focusing on bullying experiences, child satisfaction, and parental perception. Methods: A cross-sectional survey was conducted in June 2025 among 123 children (mean age 7.8 years; 52% male) from two randomly selected schools. Schools were chosen using simple random sampling from a Ministry of Education-approved list. All children aged 6–10 years with at least one SSC placed for six months or more were eligible. A validated, self-administered questionnaire completed by children and their parents assessed bullying related to SSCs, satisfaction with the crown’s appearance, and perceived impact. Statistical analyses included descriptive statistics, Chi-square tests, and logistic regression to evaluate associations between variables (p < 0.05). Results: Bullying was reported by 39.0% of children, primarily verbal (58.1%), followed by social exclusion (29.1%). Although gender differences in bullying were not statistically significant (p = 0.829), boys more often reported nickname-based teasing (p < 0.001). Only 35.0% of children were satisfied with the crown’s shape and 29.3% with its color. Nearly half (48.8%) felt uncomfortable when asked about it. In contrast, parental satisfaction was higher (69.1%), though only 42.3% believed their child had fully accepted the crown. Conclusions: While SSCs are clinically effective and accepted by most parents, a notable proportion of children experience bullying and aesthetic dissatisfaction. These findings highlight the need for child-centered care and consideration of esthetic alternatives. Full article

There is a global documented rise in depressive symptoms among adolescents. The cross-sectional assessments in representative samples of adolescents would help explore their correlates, which may serve as resources for intervention. Our cross-sectional survey entitled “Békés County Youth Study 2024” involved a representative sample of grade-9 high school students (N = 1590, aged 15–17 years, 56.4% females) from public high schools in the region, Hungary. Besides depressive symptoms (measured by a validated, shortened version of the Children’s Depression Inventory, CDI), a set of psychosocial variables (psychosomatic symptoms, internet addiction, future orientation, social support from family and friends, marks, gender, school satisfaction, and religiosity) was included in the survey. Gender differences in the summary score for CDI were significant: t(1588) = −12.062, p < 0.001, showing a higher rate of females. A total of 22.6% (males: 13% and females: 30%) belonged to the group at risk of depression. All potential predictors proved significant, with the strongest contribution of psychosomatic symptoms (Beta = 0.306, p < 0.001), and the most relevant protective role of family support (Beta = −0.265, p < 0.001). Other than further exploring contextual factors that increase risk for and protect against adolescent depression, mental health promotion in schools should include well-being training. Full article

Muscle weakness is a key contributor to functional limitation in individuals with hip (HOA) or knee osteoarthritis (KOA). Identifying accessible and objective tools to estimate muscle strength could improve clinical assessment and rehabilitation monitoring. This exploratory cross-sectional study investigated the relationship between parameters derived from the instrumented Timed Up and Go test (iTUG), and isokinetic quadriceps and hamstring strength in individuals with KOA or HOA. Thirty-six participants with KOA and 21 with HOA were assessed. Quadriceps and hamstring peak torques were measured at 60°/s using an isokinetic dynamometer. The iTUG was performed with a sacrum-mounted inertial measurement unit. Correlations between iTUG parameters and lower-limb muscle strength were weak-to-moderate in KOA (r = −0.398 to −0.516, p < 0.05) and moderate-to-strong in HOA (r= −0.537 to −0.843, p < 0.05). Total iTUG duration strongly correlated with the traditional stopwatch TUG (r = 0.91, p < 0.01), suggesting that the classic stopwatch-based TUG may offer comparable clinical insights to certain iTUG-derived temporal metrics. The iTUG test reflects lower-limb muscle weakness, especially in HOA, with vertical push-off power and temporal metrics showing the strongest relationships. These results support the use of iTUG as an accessible tool for estimating muscle weakness when isokinetic testing is unavailable. However, these findings should be interpreted with caution given the small sample size. Full article

Background: Smartphones and social media (SPSM) use has become an integral part of life around the globe, including the United Arab Emirates (UAE). This study investigated the association and strength of association between SPSM screen time and dietary and physical activity behaviours among adults in the UAE. Methods: A cross-sectional household-based study was conducted in the Emirate of Abu Dhabi, UAE, between June 2024 and March 2025. A total of 5152 adults aged 18 years and above were selected through a multistage stratified random sampling method. Data were obtained from structured interviews that collected information about demographics, SPSM use time, dietary habits and physical activity levels. The statistical analyses conducted using SPSS software. Results: The mean SPSM usage time was 277.6 ± 165.6 and 234.6 ± 170.8 min per day for smartphone and social media, respectively. Social networking was the main purpose for smartphone (71.7%) and social media (74.8%) usage. Higher SPSM use was significantly associated with more frequent consumption of unhealthy foods, including sugar-sweetened beverages, fast food, and energy drinks (p < 0.001). The associations between SPSM and dietary behaviour and physical activity were generally weak. Only social media usage time was significantly associated with physical activity (p = 0.012). Conclusion: SPSM use time is associated with dietary patterns and physical activity among adults in the UAE. Higher smartphone and social media screen time was associated with increased consumption of unhealthy foods and lower physical activity; however, the relationships were weak to moderate. Full article

Background: Exclusive breastfeeding (EBF) is crucial for infant health, and maternal mental health significantly influences breastfeeding practices. This study investigates the relationships among postpartum depression (PPD), maternal dietary diversity, and exclusive breastfeeding in Kinshasa, Democratic Republic of Congo. Methods: A cross-sectional study was conducted involving 793 mother–child pairs. Data were collected through structured interviews using a validated questionnaire administered by trained enumerators. Statistical analyses included descriptive statistics, chi-square tests, and structural equation modeling (SEM) to evaluate the relationships between maternal and child characteristics and EBF. Results: The proportion of infants in the study sample who were exclusively breastfed was 29.1% (95% CI: 26.0–32.3%). Breastfeeding self-efficacy is positively associated by nutritional advice during pregnancy, with a coefficient of 2.17 (p = 0.003). The husband’s support in exclusive breastfeeding positively correlates with breastfeeding self-efficacy (coefficient = 0.23, p < 0.001). A significant negative relationship exists between child age and EBF (coefficient = −0.095, p < 0.001). EBF is positively associated by nutritional advice during pregnancy, with a coefficient of 0.12 (p = 0.016). Child morbidity in the last 2 weeks showed a negative association with EBF practice (coefficient = −0.09, p = 0.014). Conclusions: This study highlights the multifaceted challenges faced by mothers in Kinshasa regarding exclusive breastfeeding. By prioritizing husband involvement, nutritional counseling, and robust health-system engagement, we can create a more supportive framework for breastfeeding practices. Future research should focus on longitudinal approaches to understand the long-term impacts of these factors on breastfeeding and infant health. Additionally, exploring the potential benefits of integrated maternal health programs that address nutritional needs will be crucial in developing comprehensive support systems for new mothers. Full article

Dengue (DENV), Chikungunya (CHIKV), and Zika (ZIKV) are emerging arboviral threats in Bangladesh, transmitted by Aedes mosquitoes thriving in urban Dhaka. Overlapping symptoms complicate diagnosis, and Bangladesh-specific data on arboviral antibody reactivity are limited. In four hospitals of Dhaka, we conducted a cross-sectional study on 438 febrile patients aged ≥10 years, collecting samples between September and December 2023 to describe arboviral antibody reactivity and their distribution across selected demographic and environmental characteristics. Rapid diagnostic tests (RDTs) for DENV and CHIKV were performed, followed by enzyme-linked immunosorbent assay (ELISA) on RDT-reactive samples. Participants had a mean age of 30 years (±13.5); two-thirds were male, and most lived in crowded, low-income households. RDTs indicated DENV/CHIKV antibody reactivity in 40% of participants; 170 samples underwent ELISA, suggesting DENV IgG reactivity in 33.5% and IgM reactivity in 15.5%. CHIKV IgG reactivity (0.7%) was low and ZIKV IgG was reactive in 21% of total samples, and IgM was reactive in one (0.2%); most ZIKV IgG-reactive samples also showed DENV IgG reactivity, suggesting cross-reactivity. DENV IgG and IgM reactivity were associated with lower education, while ZIKV IgM reactivity was associated with older age. Awareness of Aedes mosquitoes was low, and environmental risk factors were common. This study provides cross-sectional data on serological reactivity against DENV, CHIKV, and ZIKV among febrile patients attending four hospitals of Dhaka, without aiming to establish etiologic causes of illness. ZIKV IgG antibody reactivity requires confirmatory testing to distinguish true infections from other arboviral cross-reactivity. Strengthened community-based surveys, better public awareness, and sustained vector control are critical for reducing arboviral disease risks in urbanizing settings like Dhaka, Bangladesh. Full article

Background: Viticulture in Southern Brazil heavily relies on fungicides, such as Mancozeb, to manage fungal diseases. Increasing concern has emerged regarding the chronic health effects of Mancozeb exposure among vineyard workers, particularly its potential to induce oxidative stress and genotoxicity. Methods: A cross-sectional study was conducted between July and November 2023 involving 94 participants: 50 vineyard workers occupationally exposed to Mancozeb and 44 organic farmers with no history of pesticide exposure, who served as the control group. Eligible participants were aged 18 years or older, and exposed individuals had at least 5 years of documented Mancozeb use. Data on demographics, health status, occupational history, and use of personal protective equipment (PPE) were collected through structured interviews. Blood and urine samples were analyzed to determine hematological and biochemical parameters, oxidative stress biomarkers, genotoxicity (via comet assay and micronucleus test), and urinary ethylene thiourea (ETU), the primary metabolite of Mancozeb. Results: Workers exposed to Mancozeb exhibited significantly elevated levels of oxidative stress markers (p < 0.001) and DNA damage in both genotoxicity assays (p < 0.001). Urinary ETU concentrations were also markedly elevated, and a threshold of 69.3 ng/mL was identified as a discriminative marker of exposure. Conclusions: This study offers a novel contribution by proposing a specific biological exposure limit for ETU concentrations, derived from ROC curve analysis, representing a significant advancement in occupational health. The findings underscore the urgent need for regulatory biological exposure limits and the implementation of effective preventive strategies. Full article

Background/Objectives: Workplace violence (WV) against healthcare workers (HCWs) is a major hazard all over the world. Prevention requires a reliable risk assessment. The rate of HCWs reporting a violent event varies considerably across multi-year retrospective studies compared to periodic surveys. We conducted a rapid observational study to demonstrate that data collection methods are more important than socio-cultural and healthcare organizational differences in determining the frequency of reported violence. Methods: In June 2025, in a cross-sectional observational comparison, we examined a total of 236 nurses divided into three groups: the first two were recruited online from Brescia (Italy) and Trollhättan (Sweden), while the third group was composed of Latium (Italy) nurses participating in a sleep health promotion program who answered the same questions on WV online. All the workers reported the frequency of violent incidents experienced in the previous 12 months using the Violent Incident Form (VIF), occupational stress using the Effort/Reward Imbalance questionnaire (ERI), and work ability via the Work Ability Score (WAS). Results: In the three samples, WV was correlated positively with stress and inversely with work ability (p < 0.01), while no significant difference was found between Italian and Swedish nurses in relation to the spot surveys. The nurses questioned directly about WV were significantly younger and reported significantly higher rates of physical aggression (28% vs. 5%, p < 0.001) and all forms of violence (73% vs. 20%, p < 0.001) than those questioned indirectly during the census of all the HCWs. In a multivariate linear regression model, the WV experienced and poor work ability were highly significant predictors of work-related stress (p < 0.001). Nurses who had experienced WV in the previous year had an increased odds ratio (OR = 8.94; Confidence Interval 95% = 4.43; 18.01) of reporting a state of distress. Conclusions: Experience has shown that specific questioning about violence—the commonest method used—encourages respondents to report violent events and may induce overreporting. This method also tends to involve younger workers who are more exposed to WV. On the other hand, prospective studies based on official reports may be influenced by underreporting. Monitoring WV during health promotion interventions included in occupational health surveillance could minimize both phenomena. Systematic studies and meta-analyses which rely mainly on “ad hoc” studies may be biased. Full article

Psychological distress impacts a large portion of the general population. While effective treatments are available, few seek them out. This lack of treatment seeking may be due to several factors, particularly low mental health literacy (MHL). MHL is the knowledge an individual has regarding psychological disorders and their symptoms, treatments, and where to seek appropriate help when identified. The capacity to pay attention to present-moment experiences in MHL translates to the qualities of dispositional mindfulness (DM), the capacity to pay non-judgmental attention to present-moment experiences. The purpose of the present study was to evaluate the reliability and preliminary convergent validity of a newly developed, vignette-based assessment of psychological disorder recognition. A total of N = 299 participants were recruited via TurkPrime and completed measures of DM (FFMQ), MHL (MHLS), depression (PHQ-9), anxiety (GAD-7), and treatment-seeking attitudes (MHSAS). Participants were subsequently asked to read newly created vignettes based on ICD-11 criteria of major depressive, generalized anxiety, social anxiety, bipolar disorders, post-traumatic stress disorder, and schizophrenia. Participants then responded to questions assessing the recognition of disorder presence and identification. The vignettes with accompanying questions were titled the Psychological Disorder Recognition—Vignette (PDR-V) task. The PDR-V evidenced a Kuder–Richardson Formula 20 (KR-20) of 0.83, indicating excellent internal consistency. Independent sample t-tests indicated that participants with prior psychotherapy exposure, a history of mental health diagnosis, and, unexpectedly, those reporting lower education levels and no current mindfulness practice, scored significantly higher on the PDR-V. Spearman correlations revealed that higher scores on a validated MHL scale and specific facets of DM (describe, act with awareness) were positively correlated with PDR-V scores. Bipolar disorder evidenced the highest recognition as a psychological problem broadly, while social anxiety had the highest specific disorder identification accuracy rates. Generalized anxiety disorder had the lowest recognition and identification accuracy. While the PDR-V demonstrated promising preliminary psychometric properties, it also observed anomalies that warrant further investigation, as findings are limited by its cross-sectional nature. These findings suggest that the PDR-V is a versatile tool for differentiating the presence of a problem and accurately identifying the condition, supporting its potential as a reliable and sound measure. Full article