Search Results (1,504)

Background: Chronic stress in childhood and adolescence leads to excessive cortisol secretion, adipokines production and obesity with all the negative mental and physical effects on the health of individuals and adulthood. Objectives: The aim of the present non-randomized controlled trial was to investigate the effect of a stress management protocol with diaphragmatic breathing (DB) and physiotherapy exercise on stress, body composition, cardiorespiratory and metabolic markers of children and adolescents with morbid obesity. Methods: The study included 31 children and adolescents (5–18 years old) with morbid obesity (22 in the intervention arm and 9 controls). All participants completed anxiety questionnaires and a self-perception scale. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), blood pressure (BP) and SpO₂ were measured. Fasting glucose, uric acid, triglycerides, HbA1c, (AST/SGOT), (ALT/SGPT), HDL, LDL, insulin, ACTH, cortisol, HOMA-IR, 17-OH, S-DHEA, SHBG were assessed, and anthropometric measurements were also performed. Results: In the intervention group, 4 months after the treatment, an improvement was noted in the BMI, BMI z-score, waist-to-height ratio, FEV1, SpO₂, pulse and systolic BP. HDL increased, ALT/SGPT and insulin resistance improved. Positive changes were observed in temporary and permanent stress and self-esteem of children in the intervention group, including anxiety, self-perception, physical appearance, etc. Conclusions: A combined exercise and DB protocol has a positive effect on stress, by improving body composition, reducing insulin resistance, and ameliorating physical and mental health and quality of life of pediatric patients with morbid obesity. Full article

This study utilises the Open Source Energy Modelling System (OSeMOSYS) in conjunction with the Climate, Land, Energy, and Water systems (CLEWs) framework to investigate Thailand’s energy transition, which is designed to achieve carbon neutrality by 2050. Two scenarios have been devised to evaluate the long-term trade-offs among energy, water, and land systems. Data were sourced from esteemed international organisations (e.g., the IEA, FAO, and OECD) and national agencies and organised into a tailored OSeMOSYS Starter Data Kit for Thailand, comprising a baseline and a carbon neutral trajectory. The baseline scenario, primarily reliant on fossil fuels, is projected to generate annual CO₂ emissions exceeding 400 million tons and water consumption surpassing 85 billion cubic meters by 2025. By the mid-century, the carbon neutral scenario will have approximately 40% lower water use and a 90% reduction in power sector emissions. Under the carbon neutral path, renewable energy takes the front stage; the share of renewable electricity goes from under 20% in the baseline scenario to almost 80% by 2050. This transition and large reforestation initiatives call for consistent investment in solar energy (solar energy expenditures exceeding 20 billion USD annually by 2025). Still, it provides notable co-benefits, including greater resource sustainability and better alignment with international climate targets. The results provide strategic insights aligned with Thailand’s National Energy Plan (NEP) and offer modelling evidence toward achieving international climate goals under COP29. Full article

Background/Objectives: Obstructive sleep apnea (OSA) is a highly prevalent disorder that significantly impacts quality of life and daily functioning. While continuous positive airway pressure (CPAP) therapy is effective, long-term adherence remains a challenge. This single-arm observational study aimed to evaluate clinical outcomes and adherence patterns during telemedicine-supported CPAP therapy and identify distinct phenotypic response clusters in Romanian patients with OSA. Methods: This prospective observational study included 86 adults diagnosed with OSA, treated with ResMed Auto CPAP devices at “Victor Babeș” University Hospital in Timișoara, Romania. All patients were remotely monitored via the AirView™ platform and received monthly telephone interventions to promote adherence when necessary. Clinical outcomes were assessed through objective telemonitoring data. K-means clustering and t-distributed stochastic neighbor embedding (t-SNE) were employed to explore phenotypic response patterns. Results: During telemedicine-supported CPAP therapy, significant clinical improvements were observed. The apnea–hypopnea index (AHI) decreased from 42.0 ± 21.1 to 1.9 ± 1.3 events/hour. CPAP adherence improved from 75.5% to 90.5% over six months. Average daily usage increased from 348.4 ± 85.8 to 384.2 ± 65.2 min. However, post hoc analysis revealed significant concerns about the validity of self-reported psychological improvements. Self-esteem changes showed negligible correlation with objective clinical measures (r < 0.2, all p > 0.1), with only 3.3% of variance being explained by measurable therapeutic factors (R² = 0.033). Clustering analysis identified four distinct adherence and outcome profiles, yet paradoxically, patients with lower adherence showed greater self-esteem improvements, contradicting therapeutic causation. Conclusions: Telemedicine-supported CPAP therapy with structured monthly interventions was associated with substantial clinical improvements, including excellent AHI reduction (22-fold) and high adherence rates (+15% after 6 months). Data-driven phenotyping successfully identified distinct patient response profiles, supporting personalized management approaches. However, the single-arm design prevents definitive attribution of improvements to telemonitoring versus natural adaptation or placebo effects. Self-reported psychological outcomes showed concerning patterns suggesting predominant placebo responses rather than therapeutic benefits. While the overall findings demonstrate the potential value of structured telemonitoring for objective CPAP outcomes, controlled trials are essential to establishing true therapeutic efficacy and distinguishing intervention effects from measurement bias. Full article

Background: This study examines balance, flexibility and self-esteem among healthy individuals who engage in surfing compared to those who do not surf. Methods: A cross-sectional study design was conducted with 124 participants divided into the following groups: Group 1: Surfers n = 42; Group 2: individuals performing over 3 h of physical activity per week n = 43; and Group 3: individuals performing fewer than 3 h of physical activity per week n = 39. To assess balance, the Star Excursion Balance Test (SEBT) and the Flamenco Test (FBT) were used, the sit-and-reach test (SRT) was used to measure hamstring extensibility, the Rosenberg Scale was used to measure self-esteem, and the International Physical Activity Questionnaire (IPAQ) was used to measure physical activity levels. Results: Regarding descriptive characteristics, G1 participants were significant older than those of G2 and G3 (p < 0.05 and p < 0.001, respectively). Moreover, there was a higher proportion of females in G3 than in G1 and G2 (p < 0.05). The results revealed significant differences in balance between the surfers and those engaging in fewer than 3 h of activity per week (p < 0.05). G1 obtained significantly higher results in SEBT-left leg than G2 and G3 (p < 0.001) and higher result in SEBT-right leg and FBT than G3 (p < 0.05) but no significant differences in self-esteem were found. Significant differences in flexibility were observed between males and females (p < 0.001). Conclusions: This result suggests that surfing could have a positive effect on balance. Full article

Existing research has predominantly framed defensive silence as an avoidance response to interpersonal mistreatments. Moving beyond this view, this study theorizes defensive silence as a proactive strategy for managing interpersonal relationships through the lens of sociometer theory. We posit that workplace ostracism will reduce employees’ organization-based self-esteem (OBSE), which in turn increases their subsequent defensive silence to avert further damage to relationships. In addition, we also expect a moderating role of the sense of power in mitigating the negative impact of workplace ostracism on OBSE. Based on the multi-wave, multi-source data of 345 employees and their 82 immediate supervisors, we tested all the hypotheses. Results from multilevel modeling indicated that OBSE mediated the indirect effect of workplace ostracism on defensive silence, and also supported the moderation role of sense of power. Our theoretical model provides a novel perspective that deepens the understanding of defensive silence and suggests implications for managerial practices. Full article

Forest fire detection is an essential application in environmental surveillance since wildfires cause devastating damage to ecosystems, human life, and property every year. The effective and accurate detection of fire is necessary to allow for timely response and efficient management of disasters. Traditional techniques for fire detection often experience false alarms and delayed responses in various environmental situations. Therefore, developing robust, intelligent, and real-time detection systems has emerged as a central challenge in remote sensing and computer vision research communities. Despite recent achievements in deep learning, current forest fire detection models still face issues with generalizability, lightweight deployment, and accuracy trade-offs. In order to overcome these limitations, we introduce a novel technique (FireNet-KD) that makes use of knowledge distillation, a method that maps the learning of hard models (teachers) to a light and efficient model (student). We specifically utilize two opposing teacher networks: a Vision Transformer (ViT), which is popular for its global attention and contextual learning ability, and a Convolutional Neural Network (CNN), which is esteemed for its spatial locality and inductive biases. These teacher models instruct the learning of a Swin Transformer-based student model that provides hierarchical feature extraction and computational efficiency through shifted window self-attention, and is thus particularly well suited for scalable forest fire detection. By combining the strengths of ViT and CNN with distillation into the Swin Transformer, the FireNet-KD model outperforms state-of-the-art methods with significant improvements. Experimental results show that the FireNet-KD model obtains a precision of 95.16%, recall of 99.61%, F1-score of 97.34%, and mAP@50 of 97.31%, outperforming the existing models. These results prove the effectiveness of FireNet-KD in improving both detection accuracy and model efficiency for forest fire detection. Full article

A psoriasis vulgaris flare is characterized by a rapid intensification of symptoms, which is often triggered by various factors that can worsen the condition. The risk factors for these exacerbations are numerous and include obesity, antihypertensive drugs, and psychological stress. Moreover, links have been documented between type II diabetes, hypertension, and psoriasis vulgaris. The present case report describes a 52-year-old female patient who presented at the clinic with disseminated erythematous-squamous plaques and patches covered by thick, white-pearly, easily detachable scales, along with stress, fatigue, anxiety, severe pruritus, irritability, insomnia, and decreased self-esteem. Her past medical regimen included various conventional topical options, including calcipotriol combined with betamethasone, clobetasol, betamethasone combined with salicylic acid, and betamethasone combined with gentamicin, yet the condition remained refractory, with periodic flare-ups. The integrated and personalized therapeutic approach aimed to target both the dermatological issues and the associated systemic and psychological factors contributing to the condition. The therapeutic strategy implemented in this case combined psychological counseling sessions, a very low-calorie ketogenic diet, oral supplementation with anti-inflammatory and antioxidant vitamins and minerals, topical treatments utilizing urea and Dead Sea-mineral-based formulations, and rosemary extract-based scalp care, without requiring additional conventional treatment. This comprehensive approach led to significant improvement, ultimately achieving complete remission of the patient’s psoriasis. The associated comorbidities were well controlled with the specified medication, without any further complications. Thus, the importance of alternative options was emphasized, particularly in the context of an incurable disease, along with the need for continued research to improve the ongoing therapeutic management of psoriasis vulgaris. Such approaches are essential to reducing the risk of flare-ups and to achieving better management of associated risk factors. Full article

Background/Objectives: Cochlear implants (CIs) and hearing aids (HAs) have enhanced auditory rehabilitation in elderly individuals, yet limitations in musical perception and psychosocial integration persist. This systematic review aimed to evaluate the effects of music therapy (MT) on the quality of life (QoL), self-esteem, auditory perception, and cognition in older CI and HA users. Methods: A comprehensive search of PubMed was conducted up to March 2022 following PRISMA guidelines. Studies involving participants aged ≥ 60 years with CIs and/or HAs were included. Ten studies (n = 21,632) met eligibility criteria. Data were extracted and assessed using the Newcastle–Ottawa Scale. Results: MT led to improved sound quality, with HISQUI19 scores rising from 60.0 ± 21.8 to 74.2 ± 27.5. Early MT exposure was associated with significantly better MUMU outcomes (p = 0.02). Bilateral CI users showed enhanced stereo detection (52% to 86%), and CI + HA users achieved CNC scores exceeding 95%. Postlingual CI users outperformed prelingual peers in musical discrimination (9.81 vs. 3.48; p < 0.001). Long-term HA use was linked to better a QoL and reduced loneliness. Conclusions: While music therapy appears to support auditory and psychosocial functioning in hearing-impaired older adults, the absence of randomized controlled trials limits causal inference regarding its effects. These results support its integration into hearing rehabilitation strategies for older adults. Full article

Background: In Canada, despite universal healthcare coverage, dental care remains predominantly privately financed, creating financial barriers that prevent many from accessing essential services. This case study is part of a larger initiative, the One Smile Research program, which evaluates the impact of cost-free dental care on the oral health and overall well-being of individuals who have been unable to access dental services in the past two years due to financial constraints. Participants in the program receive necessary dental care and attend follow-up appointments to assess the long-term effects of continuous cost-free care. Clinical Case: This mixed-methods case report focuses on a 26-year-old male participant and integrates a qualitative semi-structured interview with clinical and self-reported data, providing an in-depth understanding of his experiences. Results: Clinical outcomes demonstrated the effectiveness of the provided dental treatments, while self-reported measures indicated improved oral health, satisfaction with dental appearance, enhanced psychosocial well-being, increased self-esteem, reduced dental anxiety, and better oral hygiene habits. The qualitative interview identified three key themes reflecting positive experiences with the program: ease of admission, staff kindness, and overall well-being improvement. The integration of both quantitative and qualitative analyses revealed significant advancements in both objective and subjective measures, particularly regarding overall well-being. Conclusions: The continuity of cost-free dental care effectively addressed the participant’s oral health and overall well-being, with most benefits sustained even at the two-year follow-up. These individual-level outcomes offer preliminary insight into the potential advantages of universal dental coverage within the Canadian healthcare system. Full article

Tomatoes are globally esteemed not only for their nutritional value but also for their complex and appealing aroma, a key determinant of consumer preference. The present study aimed to comprehensively characterise the volatilomic fingerprints of three tomato species—Solanum lycopersicum L., S. lycopersicum var. cerasiforme, and S. betaceum—encompassing six distinct varieties, through the application of headspace solid-phase microextraction coupled with gas chromatography–mass spectrometry (HS-SPME/GC-MS). A total of 55 volatile organic compounds (VOCs) spanning multiple chemical classes were identified, of which only 28 were ubiquitously present across all varieties examined. Carbonyl compounds constituted the predominant chemical family, with hexanal and (E)-2-hexenal emerging as putative key contributors to the characteristic green and fresh olfactory notes. Notably, esters were found to dominate the unique volatile fingerprint of cherry tomatoes, particularly methyl 2-hydroxybenzoate, while Kumato and Roma varieties exhibited elevated levels of furanic compounds. Multivariate statistical analyses, including principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA), demonstrated clear varietal discrimination and identified potential aroma-associated biomarkers such as phenylethyl alcohol, 3-methyl-1-butanol, hexanal, (E)-2-octenal, (E)-2-nonenal, and heptanal. Collectively, these findings underscore the utility of volatilomic fingerprint as a robust tool for varietal identification and quality control within the food industry. Full article

Background and Objectives: Polycystic ovary syndrome (PCOS) is associated with an elevated risk of impaired mental health and psychiatric disorders, such as depression and anxiety. Physical factors like weight and hirsutism, as well as psychological factors, such as self-esteem and coping strategies, are all known to have an influence on mental health status. Aim: To assess psychological symptoms in women with and without PCOS, by use of the well-established, validated self-report questionnaire: Symptom Checklist-90-Revised (SCL-90); to determine the reliability of the SCL-90 for assessment of PCOS patients. Design: Prospective case-control study. Methods: Psychological symptoms were assessed using the German version of the SCL-90 in 31 PCOS women and 31 healthy controls. To test the impact of various parameters on numerical outcome parameters, correlation analyses were conducted. Results: PCOS women revealed significantly increased SCL-90 scores in seven out of the nine subscales (hostility subscale, anxiety subscale, depression subscale, paranoid ideation subscale, psychoticism subscale, somatization subscale, interpersonal sensitivity subscale, obsessive compulsive subscale), as well as in all three global indices (p < 0.05). SCL-90 scores were significantly positively correlated with perceived total stress and perceived helplessness and significantly negatively correlated with perceived self-efficacy (p < 0.05). Conclusions: PCOS women experienced higher levels of psychological symptoms including depressive and anxiety symptoms. Higher perceived stress, higher perceived helplessness and lower self-efficacy were associated with more psychological symptoms. Hence, there is a need to support PCOS women with their emotional regulation and coping strategies. Full article

About 8% of Ghanaians, including adolescents, have various types of disabilities. Although many legal and constitutional protections for people with disabilities, including adolescents, exist in Ghana, it is widely known that these persons face a variety of psychosocial issues. Several factors have been identified as contributing to the unremitting marginalisation of people with disabilities in general, but the extent to which these can be generalised to adolescents with disabilities is unknown. This study, therefore, sought to document the determinants, manifestations, and consequences of disability-related stigma among differently abled adolescents in three special schools in northern, middle, and southern Ghana. An exploratory descriptive qualitative design was used. Overall, 54 participants were purposively selected for a semi-structured interview and focus group discussions. Braun and Clarke’s procedure for thematic analysis was followed. The findings showed a variety of stigmatising experiences by adolescents with disabilities in their sociocultural context. More broadly, the cause of disability was linked to the ramifications of parental sins against the gods, being a descendant of river gods, and the consequences of bewitchment/curses by family members. Others included the perceived transmissibility of the disability and disability as a visible condition. Stigma manifested in the form of pejorative labelling, ableism, and social exclusion. The consequences of this stigma included negative psychological and emotional effects (i.e., depression, low self-esteem, and a lack of confidence) and suicidal ideation. There is an urgent need for stigma reduction interventions for adolescents with disabilities in Ghana as part of an effort to improve their wellbeing. Full article

This study investigates the relationship between social media use and subjective well-being among South Korean women in their 20s, with a particular emphasis on the moderating role of self-esteem. Cross-sectional data from 611 women in their 20s who had experience using social media platforms was drawn from the Korean Media Panel Survey 2021. A regression analysis revealed that increased social media use was associated with lower subjective well-being. Self-esteem acted as a moderator in the relationship between social media use and subjective well-being. Among individuals with low or medium levels of self-esteem, higher social media use was linked to decreased subjective well-being; however, for those with high self-esteem, social media use did not significantly impact subjective well-being. These findings underscore the significance of self-esteem as a protective factor in the context of social media use and its influence on the subjective well-being among women in their 20s. Full article

Background/Objectives: Anorexia nervosa (AN) is a severe disorder with limited treatment efficacy. This interim analysis aimed to assess the preliminary efficacy and safety of transcranial direct current stimulation (tDCS) in reducing core AN symptoms, stress, depression, low self-esteem, and BMI in adolescent females, to determine the rationale for continuing the study. Methods: A single-center, randomized, double-blind, placebo-controlled trial included 20 adolescent females with AN assigned to an active tDCS group (n = 10) or a sham group (n = 10). The intervention involved 30 sessions over three weeks, targeting the dorsolateral prefrontal cortex. Outcomes were assessed at baseline, post-treatment, and follow-up using the Eating Attitudes Test (EAT-26) for eating disorder symptoms, the Perceived Stress Scale (PSS-10) for stress, the Beck Depression Inventory (BDI) for depression, the Rosenberg Self-Esteem Scale (SES) for self-esteem, and body mass index (BMI) measurements. Safety and tolerability were assessed using the tDCS Side Effects Questionnaire. Results: Eating disorder symptoms significantly decreased in the active tDCS group at study end (p = 0.003) and follow-up (p = 0.02), while no significant changes were observed in the sham group. Although BMI increased more in the active group (13.78%) than in the sham group (7.31%), this difference was not statistically significant (p = 0.10). Conclusions: Adverse effects were mild and transient, with no serious safety concerns reported. Based on the results of this interim analysis, the study will proceed due to promising efficacy outcomes and good treatment tolerability. Full article

Studies commonly measure the effects of media narratives on the self immediately following exposure. We explored whether these effects on viewers’ self-esteem, self-efficacy and motivation are confined to the immediate post-exposure period and examined how they are related to the audience’s identification with the protagonist. In Study 1, participants watched movie clips that included inspiring narratives depicting protagonists who succeeded in accomplishing their goals. Implicit self-esteem was significantly higher immediately after watching than after a short break. Unexpectedly, identification was positively correlated only with delayed self-esteem. In Study 2 we changed the control condition and added explicit measures. The reduction in implicit self-esteem between the two measurement times was replicated in the no-treatment control group. Moreover, self-efficacy and motivation were higher than in the control group and were stable over time, and identification was positively related only to delayed implicit self-esteem and motivation. We conclude that the effect of inspiring narratives on the self extends beyond the immediate time of exposure, and identification with the characters contributes to this persistent effect. The findings are explained by theories of contrast and assimilation, identification and inspiring narratives. Full article