Search Results (1,193)

Objectives: The aim of this study was to compare the relationship between psychological factors and the thickness of masticatory muscles in patients with temporomandibular disorders (TMD) and healthy controls. Methods: This cross-sectional study included 106 female participants aged 18–35 years, recruited from students of the Medical University of Lublin. The study group consisted of individuals diagnosed with myalgia based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), while the control group included participants without TMD. Psychological factors were assessed using the PHQ-9, GAD-7, and PHQ-15 questionnaires. The thickness of the temporalis and masseter muscles was measured using an M-Turbo (Sonosite) ultrasound device under relaxed and contracted conditions. Results: Participants with TMD-related myalgia scored significantly higher on the PHQ-9 (mean ± SD: 8.82 ± 5.02 vs. 5.00 ± 3.41; p < 0.001), GAD-7 (8.53 ± 4.48 vs. 4.65 ± 3.58; p < 0.001), and PHQ-15 (9.47 ± 4.07 vs. 6.02 ± 3.89; p < 0.001) compared to controls. No statistically significant differences were observed in temporalis or masseter muscle thickness at rest or during contraction between groups (p > 0.05). Significant differences in correlations were found between depression scores and temporalis muscle thickness in the study group compared to the control group (r = 0.32 vs. −0.13, p = 0.011) as well as between anxiety scores and temporalis muscle thickness (r = 0.25 vs. −0.30, p = 0.002) No significant associations were found for the masseter muscle. Conclusions: Individuals with myalgia did not show increased muscle thickness compared to healthy individuals. Psychological distress, particularly depression and anxiety, was differentially related to temporalis muscle morphology in individuals with myalgia compared to healthy controls. Full article

Background: School feeding programs aim to improve child nutrition, and they may influence weight outcomes insofar as program modalities and household responses alter children’s total energy intake. This is especially relevant in countries facing the double burden of malnutrition, where undernutrition and micronutrient deficiencies coexist with rising overweight and obesity. This study estimates the effect of Peru’s former National School Feeding Program on obesity and excess weight among children aged 36 to 59 months under a selection-on-observables identification strategy and assesses whether impacts differ across operational modalities, particularly breakfast-only versus breakfast plus lunch and ready-to-eat rations versus foods delivered for preparation. Methods: We use repeated cross-sectional microdata from the Demographic and Health Survey (ENDES) pooled over 2014 to 2018 and link them to administrative information. The sample includes 18,959 children aged 36 to 59 months. To improve comparability, we estimate propensity score weights targeting the average treatment effect on the treated (ATT) using a machine learning generalized boosted model (GBM), and assess covariate balance using standardized mean differences and Kolmogorov–Smirnov statistics. Identification assumes conditional independence given observed covariates and overlap (common support). Main estimates rely on weighted probit models with fixed effects, progressively adding exposure duration, modality indicators, and controls. Distributional effects are examined using quantile regression on the continuous weight-for-height z-score. Results: Without differentiating modalities, beneficiary status is not associated with a statistically significant change in obesity, while pooled baseline estimates indicate a statistically significant higher probability of excess weight. Modality-specific results show that obesity declines only when Qali Warma is delivered as breakfast plus lunch through products to be prepared (approximately −1.0 percentage point in parsimonious models and −0.4 percentage points after controls). Evidence for excess weight is directionally consistent by modality but less conclusive once controls are included. Conclusions: Qali Warma’s effects on early-childhood weight outcomes depend on implementation modality. Evaluations of school feeding programs should incorporate operational heterogeneity, particularly during program redesign. Full article

Mathematical abilities are critical for the developmental outcomes of children with autism spectrum disorder (ASD). However, little is known about these abilities and their association with the approximate number system (ANS) in preschoolers with ASD beyond Western samples, including Chinese children. This cross-sectional study examined whether formal and informal mathematical abilities differed between children with and without ASD and assessed the extent to which these abilities were associated with ANS acuity. Participants included 47 children with ASD and 47 typically developing (TD) children aged 3–7 years. All children were assessed on measures of formal and informal mathematical abilities, ANS acuity, and non-verbal IQ. No significant group differences in mathematical abilities were found among children aged 3–5 years. However, among children aged 6–7 years, the ASD group showed significantly lower performance in mathematical abilities compared to their TD peers. ANS acuity was significantly correlated with both formal and informal mathematical abilities in the ASD group, but only with informal mathematical abilities in the TD group. Furthermore, ANS acuity accounted for 5.4% of the unique variance in formal mathematical abilities specifically within the ASD group. The patterns of mathematical abilities and their relationship with ANS acuity differ between preschoolers with and without ASD. These findings suggest a differential association between ANS and formal mathematics learning in children with ASD, highlighting implications for the design of early numeracy interventions. Full article

Objectives: Complex regional pain syndrome (CRPS) is a heterogeneous pain disorder with incompletely understood immunoinflammatory features. This study investigated whether autonomic receptor autoantibodies differentiate CRPS from other chronic pain conditions and healthy controls. Methods: We conducted a cross-sectional analysis of serum samples from patients referred with suspected CRPS. Patients were subsequently classified as having either CRPS or another chronic pain condition, based on the Budapest criteria. Healthy controls were included for comparison. Serum levels of autoantibodies targeting the muscarinic M2 receptor (M2R), β1-adrenergic receptor (β1AR), and the β2-adrenergic receptor (β2AR) were assessed using enzyme-linked immunosorbent assay. All analyses were performed blinded to group assignment. Results: Seventy participants were analyzed (CRPS = 22, other chronic pain = 25, healthy controls = 23). M2R autoantibody levels were higher in both CRPS and other chronic pain compared with healthy controls (mean difference [MD] = 0.37, 95%CI 0.22–0.51; and MD = 0.31 95%CI 0.19–0.44, respectively). β2AR levels were higher in other chronic pain compared with healthy controls (MD = 0.29, 95%CI 0.04–0.54), whereas no significant difference was observed in CRPS (MD = 0.21 95%CI −0.01–0.42). No meaningful differences were observed between CRPS and other chronic pain for any receptor. β1AR levels did not differ between groups. Seropositivity for any autoantibody was 55% in CRPS, 44% in other chronic pain, and 22% in healthy controls. Conclusions: Elevated autonomic receptor autoantibody levels were observed across chronic pain conditions but were not specific for CRPS. Full article

The prevalence of Crohn’s disease has increased over the last few decades, even in developing countries, whereas that of intestinal tuberculosis has decreased, which places both diseases at an epidemiological crossroads. Crohn’s disease and intestinal tuberculosis share many clinical, endoscopic, imaging, and pathological features, which sometimes make differential diagnosis very difficult; an accurate diagnosis is, however, very important since an erroneous treatment can worsen the evolution or delay proper therapy. The association between past TB infection and Crohn’s disease can make the diagnosis especially hard. This review summarizes current data on specific features that allow differentiation between Crohn’s disease and intestinal tuberculosis, paying particular attention to the microbiome, clinical signs, endoscopy, cross-sectional imaging, bacteriological, and immunological findings detailed. The importance of computerized models and scores for the differentiation is also detailed, because common features may make the differentiation based on a single criterion difficult. Full article

Zinner syndrome is a rare congenital anomaly of the male genitourinary tract, characterized by the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction. Owing to its low prevalence and nonspecific clinical presentation, diagnosis is often delayed or incidental, with imaging playing a central role in detection and characterization. This study presents a narrative review with an illustrative case report, aiming to summarize the imaging features of Zinner syndrome, outline the main radiologic differential diagnoses of seminal vesicle cysts, and highlight common diagnostic pitfalls, with emphasis on cross-sectional imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI). The narrative review of the literature highlights that CT and MRI are essential for accurate anatomical localization, characterization of cystic content, and identification of associated genitourinary anomalies. MRI, in particular, provides superior soft-tissue contrast and is considered the reference modality for diagnosis and differential evaluation of male pelvic cystic lesions. Key differential diagnoses include Müllerian duct cysts, prostatic utricle cysts, and ejaculatory duct cysts. As an illustrative example, we report the case of a young adult male presenting with pelvic discomfort, infertility, and mild lower urinary tract symptoms. Imaging findings, including ultrasound and cross-sectional studies, demonstrated a seminal vesicle cyst associated with ipsilateral renal agenesis, consistent with Zinner syndrome. Zinner syndrome should be considered in the evaluation of male pelvic cystic lesions, particularly in the presence of unilateral renal agenesis. Awareness of its characteristic imaging features is essential for accurate diagnosis and appropriate management, with MRI playing a pivotal role in confirming the diagnosis and distinguishing it from other pelvic cystic entities. Full article

The physical characteristics of a heated non-Newtonian Eyring–Powell fluid in a conduit with sinusoidally moving ciliated walls are highlighted in this analytical study. The impact of mass transmission is considered in this model. The dimensional form of the governing equations is simplified using the long-wavelength estimation and suitable transformations to produce a set of dimensionless partial differential equations with pertinent boundary conditions. To solve it, the perturbation technique is utilized applying polynomial solutions. The solutions of temperature, concentrations, and velocity profiles are obtained, and then are further analyzed through graphical results. An accurate mathematical solution for the pressure gradient is achieved by integrating the velocity profile over the elliptic cross-section. The non-Newtonian Eyring–Powell fluid flows quicker through this vertical ciliated elliptic duct than the Newtonian fluid. Moreover, the cilia elliptic movement eccentricity and the wave number for metachronal wave have a dual effect on the velocity profile. Increasing the dimensionless flow rate and occlusion leads to an increase in closed contour size, as seen in the streamline description. Full article

Objectives: We aimed to evaluate the reliability and validity of the Arabic version of the Chronic Heart Failure Health-Related Quality of Life Questionnaire (CHFQOLQ-20) among patients with heart failure in Jordan. Methods: A cross-sectional study was conducted among 399 adults with heart failure recruited from a tertiary hospital in Jordan (median age 68 years; 55.9% male). The CHFQOLQ-20 was translated using forward–backward procedures. Construct validity was examined using confirmatory factor analysis (CFA) and a multidimensional Partial Credit Model. Differential item functioning by sex and internal consistency were assessed. Results: CFA supported the original four-domain structure (physical, cognitive, mental, and general health), with all items showing significant factor loadings. Item-level analyses demonstrated acceptable model fit, ordered response thresholds, and minimal sex-related bias. Physical health scores were lower than other domains. Conclusions: The Arabic CHFQOLQ-20 is a valid, reliable, and multidimensional measure of HRQoL in patients with heart failure, supporting its use in clinical practice and research. Full article

Lignin is an abundant aromatic biopolymer, but its conversion into high-performance fibers remains challenging due to intrinsically poor spinnability, structural heterogeneity, and inefficient stress transfer in lignin-rich systems. In this study, a processing and structure strategy is demonstrated to overcome these limitations by transforming industrial black-liquor kraft lignin into a spinnable and load-bearing fiber component. Kraft lignin recovered from black-liquor waste was extracted and subsequently purified using a hot-water treatment to remove inorganic impurities and thermally unstable fractions, increasing lignin purity to 95.9% through extensive deionized water purification using a water-to-lignin ratio of 300:1. The purified lignin was then blended with poly(vinyl alcohol) (PVA), wet-spun into continuous filaments, and subjected to post-spinning hot drawing to induce molecular orientation. This sequential extraction, purification, blending, spinning, and drawing approach enables stable wet spinning and the continuous formation of lignin-rich lignin/PVA filaments without filament breakage, directly addressing the primary processing bottleneck of lignin-based fibers. Molecular-level miscibility between lignin and PVA is confirmed by the presence of a single glass transition temperature at 88.3 °C, indicating the formation of a homogeneous amorphous phase. SEM observations reveal composition-dependent surface roughness and non-circular cross-sectional morphologies arising from differential coagulation and shrinkage, demonstrating that lignin actively participates in the load-bearing fiber network rather than acting as a passive filler. As a result of purification-enabled spinnability, true blend miscibility, and post-spinning hot drawing, fibers with a lignin-to-PVA composition of 40:60 achieve a maximum tensile strength of 2.8 GPa, approaching the performance range of commercial high-strength polymer fibers. This work establishes a clear relationship between material structure, processing strategy, and resulting properties, highlighting the potential of industrial lignin waste as a sustainable precursor for advanced fiber applications. Full article

A rapid quasi-one-dimensional (quasi-1D) reacting-flow analysis code was developed for the preliminary assessment of rocket-based combined cycle engines over a broad flight envelope. The internal flow was modeled as steady and quasi-1D in a variable-area duct by solving the coupled conservation equations together with species transport, and finite-rate chemical kinetics were included to represent combustion-induced heat release and composition change. To incorporate configuration-dependent mixing effects that affect RBCC heat release evolution and thermal choking tendencies, a streamwise mixing efficiency distribution was extracted from non-reacting 3D CFD and prescribed as an input to the quasi-1D formulation to represent the progressive availability of reactable fuel along the flowpath. A mode-dependent solution strategy was established by separating the computation into scramjet mode and ramjet mode procedures with a switching criterion based on whether a sonic condition occurs within the combustor, allowing thermal choking and mode transition behavior to be addressed within a single framework. The numerical solver was implemented in Python 3.12.2 and integrated using a stiff ordinary differential equation (ODE) scheme to ensure robust convergence in the presence of reaction-induced stiffness. Verification against previously published hydrogen-fueled scramjet results reproduced the overall streamwise trends of key quantities including Mach number, pressure, temperature, and density. The developed code was then applied to an RBCC configuration under operating conditions representative of ERJ and ESJ regimes, and the quasi-1D predictions were compared with cross-section-averaged 3D RANS CFD results, showing consistent mode identification and comparable axial behavior at a level suitable for preliminary analysis with substantially reduced computational cost. Full article

Skeletal muscle activity, such as exercise, enhances mitochondrial function, a process critical for ATP production through oxidative phosphorylation. Mitochondrial dysfunction, often linked to mutations in the chchd10 gene, contributes to the pathogenesis of neurodegenerative and neuromuscular diseases. Although exercise is known to improve mitochondrial performance, its regulatory influence on chchd10 remains poorly defined. In this study, zebrafish (Danio rerio) at three different ages (4, 9, and 15 months) were divided into control and exercise groups, with the latter subjected to a swimming intervention. We observed that exercised male zebrafish exhibited improved muscle morphology across all age groups, marked by increased muscle fiber cross-sectional area and reduced inter-fiber spacing. Transcriptome sequencing via RNA-seq further identified chchd10 as a differentially expressed gene in three age group comparisons. Exercise may be associated with downward regulation of expression of chchd10, which was correlated with increased methylation levels in its promoter region. These results illuminate the epigenetic mechanisms induced by exercise, revealing a novel pathway through which physical activity, potentially via modulation of chchd10, promotes muscle and mitochondrial health. Full article

Technical and vocational education and training (TVET) colleges in South Africa continue to experience challenges related to staff commitment, organisational performance, and institutional effectiveness. These challenges highlight the need to better understand leadership approaches that sustain academic engagement and stability. This study examines the relationship between transformational leadership and organisational commitment among academic staff at a selected TVET college in Gauteng, South Africa. Grounded in the transformational leadership theory of Bass and Avolio, the study adopted a quantitative, cross-sectional survey design. Data were collected from 203 academic staff across six campuses using a structured self-administered questionnaire. Descriptive statistics and multiple regression analysis were performed using SPSS. The findings revealed low levels of organisational commitment among academic staff. While transformational leadership, as a composite construct, did not significantly predict organisational commitment, specific components—namely intellectual stimulation, inspirational motivation, and individualised consideration—showed significant positive relationships with organisational commitment. Theoretically, the study refines the application of transformational leadership theory within the TVET context by demonstrating that its components may operate differentially rather than as a unified construct in predicting organisational commitment. These findings challenge assumptions regarding the holistic predictive power of transformational leadership and extend leadership scholarship within under-researched TVET settings in developing-country contexts. Practically, the results provide evidence-based guidance for TVET management to design targeted leadership development interventions that emphasise specific transformational leadership behaviours to enhance academic staff commitment. Full article

Background/Objectives: Vitamin D plays an important role in glucose metabolism, lipid regulation, and inflammatory processes, and has been implicated in cardiometabolic health. However, its associations with specific metabolic biomarkers remain inconsistent, particularly in older adults. This study aimed to examine whether vitamin D deficiency is differentially associated with multiple metabolic biomarkers in a nationally representative sample of older adults. Methods: This cross-sectional study used data from the 2024 Korea National Health and Nutrition Examination Survey, including 1806 adults aged ≥65 years. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D levels < 20 ng/mL. Metabolic biomarkers included fasting glucose, glycated hemoglobin (HbA1c), triglycerides, C-reactive protein (CRP), high-density lipoprotein cholesterol (HDL-C), waist circumference, and body mass index (BMI). Complex sample linear regression analyses were performed with sequential adjustment for sociodemographic factors, health behaviors, and comorbidities. Results: In unadjusted analyses, vitamin D deficiency was associated with adverse metabolic profiles, including higher fasting glucose, HbA1c, triglycerides, waist circumference, and CRP levels, and lower HDL-C levels. After adjustment for sociodemographic factors, health behaviors, and comorbidities, significant associations remained for HbA1c (β = 0.10, p = 0.034), triglycerides (β = 0.10, p = 0.003), and waist circumference (β = 1.21, p = 0.040). No significant associations were observed for fasting glucose, HDL-C, CRP, or BMI. Conclusions: Vitamin D deficiency was independently associated with poorer long-term glycemic status, hypertriglyceridemia, and central adiposity in older adults, but not with other metabolic markers after adjustment. These findings suggest that the metabolic correlates of vitamin D deficiency may be domain-specific rather than generalized. Longitudinal and interventional studies are needed to clarify causality and underlying mechanisms. Full article

Precise, spatially explicit sub-provincial GDP estimates are essential for regional planning, especially in mountainous areas where official economic data remain spatially coarse and unevenly distributed. This study develops a multisource county-level GDP spatialization framework for Sichuan Province, China, integrating corrected NPP/VIIRS nighttime-light (NTL) data with Points of Interest (POIs), land-use structure indicators (proportion of farmland (PFL); proportion of construction land (PCL)), elevation, precipitation, accessibility and population density within a unified indicator system. Two regression approaches—Ordinary Least Squares (OLS) as a global benchmark and Geographically Weighted Regression (GWR) as the spatially adaptive primary model—are calibrated on county-level cross-sectional data for 2020 (n = 183) and evaluated using R², adjusted R², AICc and residual spatial diagnostics. The multisource GWR model achieves R² = 0.882 (adjusted R² = 0.872, AICc = 5712.26), substantially outperforming both the global OLS benchmark (R² = 0.801) and NTL-only GWR baseline (R² = 0.662), confirming that spatial nonstationarity is an intrinsic feature of the GDP–proxy relationship and that integrating complementary geospatial proxies is the primary pathway to improved estimation accuracy in topographically heterogeneous regions. The GWR-based GDP surface exhibits a pronounced basin–plateau contrast: high-value clusters concentrate along the Chengdu Plain and adjacent city corridors, while extensive low-value zones prevail across the western highlands (global Moran’s I = 0.33, Z = 14.26, p < 0.001). Spatially varying GWR coefficients reveal that elevation and precipitation constrain GDP most strongly in high-altitude counties, construction land exerts a consistently positive but spatially graded effect, and the influences of accessibility and population density are context-dependent and locally differentiated. These findings support differentiated territorial development policies: plateau counties require accessibility-first strategies; hill counties benefit from targeted small-city industrialization; and basin cores need managed growth to balance agglomeration advantages against congestion pressures. The framework relies exclusively on globally or nationally available data and is portable to other mountainous regions, though cross-regional validation and extension to multi-year panels using geographically weighted panel regression remain important directions for future work. Full article

Social media environments and meme-based communication are increasingly incorporated into nursing education, yet it remains unclear whether students respond uniformly to digitally embedded instructional strategies. This study examined whether alignment between meme-based instruction and perceived social media learning utility differentiates motivation, perceived academic impact, and demand for educator presence among undergraduate nursing students. A cross-sectional study was conducted with 458 nursing students from Spanish universities who completed a structured questionnaire assessing perceptions of meme-based instruction, social media learning utility, motivation, perceived academic impact, and expectations of educator presence. Hierarchical regression models examined interaction effects, quadrant comparisons were analysed using Kruskal–Wallis tests, and a sequential mediation model evaluated indirect pathways. Students reported high endorsement of meme-based instruction (M = 4.44, SD = 0.80) and social media learning utility (M = 4.15, SD = 0.80). However, substantial divergence emerged across alignment profiles. Students showing high alignment between meme endorsement and perceived social media utility tended to report higher motivation and different expectations of educator presence, whereas perceived academic impact was primarily explained by additive effects. These findings suggest that digital instructional innovations may not generate entirely homogeneous responses across students and that alignment between instructional format and perceived learning utility is associated with differences in motivational activation and instructional expectations in undergraduate nursing education. Full article