Search Results (158,772)

Introduction: Asthma is a chronic inflammatory disease that impairs daily functioning and quality of life. Despite effective therapies, asthma control remains suboptimal and may improve through greater engagement of community pharmacists. This study assessed the knowledge, practices, and perceived barriers of community pharmacists regarding asthma management in the Aseer region, Saudi Arabia. Methods: A cross-sectional study was conducted using a self-administered online questionnaire covering demographics, asthma-related knowledge, practice, and perceived barriers. Results: A total of 290 community pharmacists participated. Overall, 64.8% showed high asthma-related knowledge, while 51.7% reported high asthma counseling practice. Pharmacists showed strong knowledge of asthma symptoms, triggers, determinants of poor control, and counseling on medication-related adverse effects, but moderate knowledge of asthma control assessment, guideline-based management, and treatment-related side effects. Commonly reported services included patient education on asthma and medications, identification of modifiable risk factors, and discussion of treatment side effects, whereas written asthma action plans, symptom control assessment, and follow-up visits were less common. In multivariable logistic regression, high knowledge (p = 0.002), interest in asthma training (p < 0.001), and greater work experience (p = 0.01) were associated with higher counseling practice, while patient volume showed a borderline association (p = 0.051). Conversely, higher practice (p = 0.002), working in independent community pharmacies (p < 0.001), and pharmacy location (p = 0.034) were associated with higher asthma knowledge. Conclusions: Community pharmacists demonstrated moderate-to-high knowledge of asthma management, but gaps remain in guideline-based practice and follow-up. Strengthening guideline-oriented training and pharmacist integration into asthma care may improve outcomes. Full article

Children with Autism Spectrum Disorder (ASD) frequently present impairments in executive functions and motor skills, which can negatively affect academic performance, adaptive behavior, and daily functioning. Exergames have emerged as a potentially engaging cognitive–motor intervention. The objective of this systematic review was to analyze the effects of exergame-based interventions on executive function components (particularly inhibitory control and cognitive flexibility) and motor skills in children with ASD. A systematic review was conducted in accordance with PRISMA guidelines, with the protocol registered in PROSPERO. Electronic searches were performed in PubMed, Scopus, Web of Science, and ERIC. Intervention studies published within the last five years and assessing exergame-based interventions in children with ASD were included. Methodological quality was evaluated using the PEDro scale. Six studies met the inclusion criteria. Exergame-based interventions were associated with improvements in executive functions, particularly inhibitory control (reported in two studies using Stroop- and Flanker-type tasks) and cognitive flexibility (assessed in two studies using the Wisconsin Card Sorting Test), although results varied depending on intervention duration and design. Acute interventions (single-session) primarily influenced inhibitory control, whereas longer-term programs showed broader cognitive and motor adaptations. Improvements in motor outcomes, including gross motor development, coordination, and fundamental motor skills, were reported in four studies. Methodological quality ranged from 4 to 6 points on the PEDro scale, indicating fair to good quality. Considerable heterogeneity was observed in intervention protocols, duration, and outcome measures. Exergame-based interventions may represent a potentially promising approach for targeting executive functions and motor skills in children with ASD; however, the current evidence is limited and heterogeneous. Not all included studies assessed both cognitive and motor outcomes, and findings should therefore be interpreted with caution. Further high-quality randomized controlled trials are needed to confirm these effects and establish optimal intervention parameters. Full article

This paper analyzes the creation and management of a robotics student team, introducing a “flexible project management” approach tailored to educational, voluntary and competitive settings. Drawing on the Beyond Robotics team as a case study, it presents adaptable methodologies addressing challenges such as voluntary participation, limited resources, and member turnover. The framework covers recruitment, skill development, communication, creativity, and continuity planning through mentorship and knowledge transfer. By applying agile and lean methods, it identifies best practices to enhance team resilience, innovation, and sustainability, offering educators and student leaders a practical guide for effective organization and long-term success. Full article

Objectives: This study aimed to examine the structure of anthropometric characteristics, motor skills and specific motor skills in young football players. Methods: Study participants (427 male football players) were divided into pre-pioneers (11–13 y), n = 133; pioneers (13–15 y), n = 160; and cadets (15–17 y), n = 134. The entire sample of subjects was evaluated using 13 anthropometric and seven motor variables. The factor structure for each chronological age group was determined using Hotelling’s method. Results: Anthropometric characteristics showed three extracted factors in the pre-pioneers group, four factors in the pioneer group and two factors in the cadet group. Motor skills displayed three factors for the youngest group, two factors for the pioneers and three factors for the cadet group. Four factors were determined for specific motor skills in pre-pioneers, four in pioneers and three in cadet age. Conclusions: This study revealed structural variability and non-uniformity in the latent dimensions across age groups, with the total number of factors fluctuating between two and four. This study revealed two consistent latent dimensions in anthropometric data across all age groups: general morphological parameters and subcutaneous fat tissue. In motor skills, an initial universal factor is separated into central and energetic regulation of movements. Finally, specific motor skills demonstrated a transition from a highly differentiated four-factor structure in younger players toward a more integrated functional system in the oldest cohort, comprising intermuscular coordination, running speed with and without a ball; segmental speed of the lower extremities with a ball; and explosive force in hitting a ball with the foot and head. Full article

Most air pollution research in India has predominantly focused on the Indo-Gangetic Plain (IGP) owing to its high pollution levels and dense populations, leaving peninsular India comparatively undercharacterized. In contrast, South India remains underexplored because of its relatively limited long-term monitoring and more favorable meteorology. This geographical imbalance restricts a comprehensive national understanding of particulate matter (PM) dynamics. Addressing this gap, the present study delivers a multi-scale (hourly to interannual) spatiotemporal assessments of PM_2.5 across eight monitoring stations in Andhra Pradesh, a South Indian State, for the period 2020–2024. The analysis reveals pronounced seasonal variability, with persistent winter and post-monsoon maxima. Although overall concentrations are low compared to northern India, urban–industrial centers such as Visakhapatnam and Rajahmahendravaram frequently exceeded both the National Ambient Air Quality Standards (NAAQS) and World Health Organization (WHO) guidelines. Notably, Amaravati, a non-industrial and low-lying inland site, exhibited anomalously moderate PM_2.5 levels, with ~11.58% of hourly values surpassing 60 µg m⁻³. The COVID-19 lockdown period further offered a natural experiment, revealing substantial reductions (30–65%) in PM_2.5 and PM₁₀ at major urban sites while concurrent ozone enhancements (up to ~50%) at Tirupati and Rajahmundry exposed complex photochemical sensitivity under reduced NO_x conditions. Satellite-based MERRA-2 estimates corroborated inter-annual variability and the short-lived improvement in air quality. This study demonstrates that air quality dynamics in the state of Andhra Pradesh are governed by region-specific meteorological controls, episodic processes, and localized emission characteristics, necessitating expanded long-term monitoring infrastructure and improved satellite–ground calibration frameworks. Full article

The research examines regional disparities in the diffusion of e-commerce among enterprises employing at least 10 people in Italy, using an integrated analytical framework that blends econometric modeling, machine learning, and network analysis. Instrumental Variable (IV) panel models overcome endogeneity arising from digital infrastructure, socioeconomic factors, and online business activity, with geographic slope as a suitable instrument for broadband penetration. Machine learning models—regularized regressions, random forests, and boosting—augment causal inference by registering nonlinear effects and sorting variable salience. The results, in all cases, emphasize internet use, household digital connectivity, and the prevalence of remote work as the most important predictors of the diffusion of e-commerce. Cluster analysis identifies regional digital profiles that distinguish northern-central regions from southern-insular regions, characterizing persistently distinct digital divides. The network analysis, in turn, identifies digital inclusion variables—such as internet penetration and ICT infrastructure—that occupy central positions within the entirety of the economic and technological interdependencies’ regime. Innovation and income levels, while practiced, hold peripheral positions, indicating that digital capacity, rather than economic affluence in the singular, drives online business participation. Italy’s case can particularly illustrate this beyond its national borders. Being a high-income economy with significant regional disparities, it reproduces challenges common elsewhere in the world, among which the cases of Spain, Germany, the USA, the Republic of Korea, and Japan come to mind, where regional disparities inhibit inclusive digital development. The Italian case presents, then, a transferable model for the diffusion of digital tools, the reduction in regional disparities, and the encouragement of economic integration. By synthesizing the causal, predictive, and systemic methodologies, the study offers a theoretical and practical response to digital transformation across diverse terrains. Full article

Background/Objectives: Attention-deficit hyperactivity disorder (ADHD) in adults is often overlooked in refugees, especially those displaced by war and diagnosed with chronic issues such as hypertension and type 2 diabetes mellitus. We sought to provide a preliminary screening to align with ADHD screening and to examine its related demographic and clinical factors. Methods: This cross-sectional study recruited Syrian refugees residing in Jordan. The Adult ADHD Self-Report Scale-V1.1 (ASRS) was employed to provide a preliminary screening of “Consistency with ADHD screening”. Multivariable regression analysis was used to identify the risk factors associated with the “Consistency with ADHD screening”. Results: Data analysis included 345 patients; 179 (51.9%) were females. β-Blockers were used in 151 (43.8%), metformin in 134 (38.8%), and sulfonylurea in 86 (24.9%). In the study, 158 participants (45.8%) reported very consistent results related to ADHD. We used multivariate binary logistic regression, which showed that in our groups that received metformin (OR of 2.08, 95% CI 1.32–3.27, p = 0.001) and insulin (OR of 2.25, 95% CI 1.00–5.04, p = 0.04), we observed a positive association with ADHD symptoms. Also, we noted that high school education was negatively associated with the results of the ADHD screen (OR of 0.58, 95% CI of 0.36–0.94, p = 0.02). Conclusions: This preliminary study guides future steps in addressing ADHD symptoms in war-displaced refugees; proper diabetes management and education seem to be important factors. Full article

Zoological parks increasingly operate as sustainability-oriented institutions that integrate biodiversity conservation, environmental education, animal welfare, and community engagement. In parallel with these evolving roles, digital and interactive technologies have emerged as key instruments for supporting sustainable visitor engagement and conservation communication. This study provides a systematic review and conceptual mapping of the literature by combining a PRISMA-based systematic literature review with bibliometric co-word analysis. The bibliometric results reveal four thematic clusters: (1) mobile and visitor-oriented digital technologies, (2) immersive augmented reality (AR) or virtual reality (VR) based solutions, (3) animal–computer interaction and welfare-focused technologies, and (4) traditional conservation and education research. While digital technologies demonstrate measurable short-term effects on engagement, empathy, and knowledge retention, their long-term sustainability impact and systemic integration remain limited. To address this gap, the study introduces three theoretical contributions: the concept of the zoo-based digital learning ecology, the identification of the digital fragmentation problem, and the Integrated Digital Zoo Ecosystem (IDZE) model. The proposed framework conceptualizes digital visitor experience, animal welfare technologies, and conservation communication as interdependent subsystems within a unified sustainability-oriented ecosystem. This study provides a conceptual foundation for future sustainability-driven digital innovation in zoological parks. Full article

Background: In dual-task (DT) conditions, individuals must walk while simultaneously engaging in cognitive or motor tasks, which impacts gait performance, especially in older adults and individuals with Parkinson’s disease (PD). Gait impairments in PD under DT conditions have implications for intersegmental coordination. Research question: Intersegmental coordination and gait biomechanics during the DTs were compared between people with PD and older adults. Methods: Thirty-two individuals (16 PD, H&Y 1–3; and 16 older adults) participated in this study and were asked to walk under the following self-selected conditions: single task, DT with a math component, and texting on a cell phone. Spatiotemporal, angular, and intersegmental coordination data were collected using a markerless motion analysis system (OpenCap). Results: Dual-task conditions significantly affected spatiotemporal and kinematic variables, as well as intersegmental coordination. A significant task effect was observed for thigh–shank coordination, whereas no significant group effect was found for the main coordination outcomes. Significance: Significant task effects were observed for intersegmental coordination (thigh–shank CRP), with no significant group differences. The concurrent demands of processing visual and motor information for texting and walking lead to significant reductions in gait speed and lower limb movement, as well as altered intersegmental coordination, with task demands rather than disease status being the primary driver of coordination changes. Full article

Background: Migraine is a highly prevalent neurological disorder associated with substantial disability and socioeconomic burden. Although pharmacological therapies remain the mainstay of treatment, their effectiveness may be limited by incomplete response and adverse effects. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a non-invasive neuromodulatory technique that may modulate cortical excitability and pain-processing networks involved in migraine pathophysiology. This systematic review aimed to evaluate the current evidence regarding the efficacy and safety of rTMS compared with sham stimulation in individuals with migraine. Methods: A systematic search was conducted in PubMed (MEDLINE), PsycNet, and Ovid (including MEDLINE and Embase) from database inception to December 2025 in accordance with PRISMA 2020 guidelines. Studies investigating rTMS in adults with migraine and including a sham comparator were eligible for inclusion. Data regarding study design, participant characteristics, rTMS parameters, outcomes, and adverse events were extracted using a predefined template. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Results: Seven studies comprising a total of 301 participants were included. Most trials evaluated high-frequency rTMS targeting the dorsolateral prefrontal cortex. Across studies, rTMS was generally associated with reductions in migraine frequency and severity compared with sham stimulation, although results varied depending on stimulation parameters and study design. Treatment was consistently well tolerated, with only mild and transient adverse effects reported. However, considerable heterogeneity was observed in diagnostic criteria, stimulation protocols, outcome measures, and follow-up duration. Conclusions: Preliminary evidence suggests that rTMS may represent a promising and well-tolerated neuromodulatory approach for migraine management. Nevertheless, methodological variability, limited sample sizes, and concerns regarding risk of bias restrict definitive conclusions. Larger randomized controlled trials with standardized protocols and longer follow-up periods are needed to clarify the clinical role of rTMS in migraine treatment. Full article

Fungal endophytes are symbiotic microorganisms that establish strong relationships inside plant tissues, providing potential advantages, especially in grasses, by enhancing tolerance to both abiotic and biotic stresses. This review investigates the molecular mechanisms through which fungal endophytes mediate stress tolerance, targeting host–pathogen interactions. By modulating pathogen-associated molecular patterns (PAMPs), damage-associated molecular patterns (DAMPs), and effector proteins, fungal endophytes may contribute to priming the plant’s immune system, enhancing its resistance to pathogen invasion. Moreover, endophyte colonization regulates core processes such as osmotic regulation, reactive oxygen species (ROS) detoxification, and secondary metabolite biosynthesis that enable plants to tolerate environmental stresses like drought, heat, and salinity. The review highlights the impact of endophytes on immune priming, systemic acquired resistance (SAR), and the regulation of non-coding RNAs that regulate host gene networks associated with stress tolerance. Furthermore, the integration of advanced multi-omics techniques genomics, transcriptomics, proteomics, metabolomics, and fluxomics has revealed emerging insights into the genetic and metabolic pathways driving these symbiotic associations. However, grass-specific molecular datasets remain limited, and the consistency of endophyte-mediated tolerance across host species and environmental conditions is not yet fully resolved. Fungal endophytes increase grass stress resilience through coordinated pathogen recognition, RNA regulation, and metabolic reprogramming while AI-assisted multi-omics approaches are emerging as tools for identifying candidate regulatory networks, although empirical validation in grass–endophyte systems remains limited. Together, these advances highlight the potential for climate-smart and sustainable crop improvement. Future research integrating functional genomics, field validation, and biosafety assessment will be essential for translating endophyte-based strategies into reliable agricultural applications. Full article

Background: Blood flow restriction (BFR) resistance exercise has emerged as a training methodology capable of inducing muscular adaptations comparable to traditional high-load training despite substantially lower mechanical loads. While low-load BFR protocols (20–50% 1RM) are well-established, emerging evidence supports applications across the full loading spectrum, including moderate-to-high loads (>50–90% 1RM), contralateral training effects, and proximal–distal adaptations. In this second installment of the Blood Flow Restriction in Athletic Populations series, we review current evidence on BFR resistance exercise in athletic populations, with emphasis on morphological, neuromuscular, and functional adaptations across diverse application contexts. Methods: A narrative review of research examining BFR resistance exercise in trained and athletic populations was conducted via a PubMed/MEDLINE search. Search terms: (“blood flow restriction” OR “BFR” OR “occlusion training” OR “KAATSU”) AND (“resistance training” OR “resistance exercise” OR “strength training”) AND (“athletes” OR “athletic” OR “trained” OR “elite” OR “sport”) AND (“cross-education” OR “contralateral” OR “cross transfer” OR “proximal” OR “distal”). Studies investigating low-load (20–50% 1RM) and moderate-to-high load (>50% 1RM) protocols, contralateral cross-education effects, and proximal–distal adaptations were evaluated. Primary outcomes included muscle hypertrophy, strength, power, and sport-specific performance measures. Results: Low-load BFR resistance exercise has been shown to produce significant improvements in muscle hypertrophy and strength gains over 4–12 week interventions compared to low-load control conditions. Moderate-to-high load BFR enhanced barbell velocity and power output, particularly at loads > 80% 1RM with intermittent inflation protocols. Contralateral and cross-transfer effects of BFR training demonstrate variable efficacy across muscle groups, with the most consistent evidence supporting cross-transfer enhancement of training adaptations when BFR is applied to one body region while exercising another. Proximal BFR application induced adaptations in both proximal and distal musculature, suggesting systemic mechanisms beyond local vascular restriction. Conclusions: BFR resistance exercise represents a versatile training modality producing meaningful morphological and neuromuscular adaptations across the loading spectrum. Contralateral and proximal–distal effects expand practical applications for injury rehabilitation and targeted adaptation. These findings support BFR integration within periodized training programs when mechanical load management is prioritized. Full article

Punch velocity is a key performance indicator in boxing and reflects effective coordination along the kinetic chain. This study aimed to investigate the relationship between punch acceleration and plantar pressure distribution using wearable sensing technologies. Twenty-four collegiate boxers (12 professional-level and 12 amateur-level athletes) performed jab and cross punches under controlled conditions. Punch acceleration was measured using a glove-mounted inertial measurement unit (IMU), while plantar pressure distribution was recorded using pressure-sensing insoles. Professional boxers demonstrated significantly higher punch acceleration (22–31%, p < 0.05) and greater forefoot plantar pressure (18–27%, p < 0.05) compared to amateur athletes. Correlation analysis revealed significant positive associations between forefoot pressure and punch acceleration (r = 0.62–0.71, p < 0.01), indicating that increased lower-limb force contributes to higher upper-limb striking performance. These findings demonstrate that combined wearable sensing provides a practical approach for quantifying punching biomechanics and identifying level-dependent kinetic-chain characteristics in boxing. Full article

A novel urea complexation technology was developed based on the agglomeration phenomenon induced by ambient-temperature agitation of a ternary system consisting of urea, water and fatty acid ethyl esters (EEs). The agglomeration phenomenon can be regarded as an intuitive indicator to judge the occurrence of urea complexation. Using docosahexaenoic acid (DHA) containing EE (DHA-EE) from Crypthecodinium cohnii oil as the substrate, key variables including agglomeration time, urea/DHA-EE ratio, water/DHA-EE ratio, and temperature were investigated. The urea complexation predominantly occurred within 15 min following agglomerate formation. Temperature in the range of 0–40°C exerted no significant effect on the yield of the non-urea-complexed fraction or its DHA content, enabling the operation to be conducted at room temperature without heating or cooling. Under unoptimized conditions, the proposed method effectively increased the DHA content of EE from Crypthecodinium cohnii oil from 40.73% to 89.87%. For EE from Schizochytrium sp. oil, the contents of DHA and docosapentaenoic acid were improved from 47.17% and 13.93% to 69.30% and 20.29%, respectively. Meanwhile, the contents of eicosapentaenoic acid and DHA in two EE form fish oils were enhanced from 18.26% and 11.76% to 34.86% and 22.96%, and from 13.30% and 57.24% to 15.66% and 68.68%, respectively. The present study provided a novel technical pathway for the efficient enrichment of polyunsaturated fatty acids. Full article

Background: Advanced glycation end products (AGEs) accumulate in tissues with age and are associated with the risk of chronic diseases. However, evidence regarding lifestyle factors related to AGE accumulation in healthy adolescents is limited. The aim of this study was to explore dietary and lifestyle factors that may attenuate tissue AGE accumulation, using skin autofluorescence (SAF) as a noninvasive proxy marker, in healthy Japanese early adolescent girls. Methods: This cross-sectional study included 315 first-year junior high school girls aged 12–13 years from a private school in Japan. SAF was measured on the volar forearm using an AGE Reader MU. Dietary intake was assessed using a validated brief diet history questionnaire (BDHQ-15y). Lifestyle factors, including weekday sleep duration, were assessed using a self-administered questionnaire. Health-related variables (including weight-loss dieting) were also collected. Associations between SAF and each factor were analyzed using generalized linear models and nonparametric tests, with multivariable adjustment for potential confounders. Results: The mean SAF was 1.06 ± 0.13 arbitrary units. No significant associations were observed between SAF and health-related characteristics, nutrient intakes, or major food-group intakes. Longer weekday sleep duration was significantly associated with lower SAF (p for trend = 0.019) and remained significant after multivariable adjustment (p for trend = 0.018). A similar association was observed for better perceived restorative sleep (p for trend = 0.033; adjusted p for trend = 0.048). Conclusions: In healthy early adolescent girls, longer weekday sleep duration and better perceived restorative sleep were associated with lower SAF, whereas dietary intake was not. Given the largely irreversible age-related accumulation of AGEs, promoting healthy sleep during adolescence may help attenuate AGE accumulation early in life and reduce long-term AGE-related disease risk. Prospective studies with more detailed dietary assessments are needed to clarify dietary influences and confirm temporality. Full article