Search Results (14,154)

Background: This study aimed to compare grazing behavior scores between adolescents with essential hypertension (HTN) and controls. It also investigated the associations of grazing behavior with obesity, emotion regulation difficulties (ERD), problematic smartphone use, and screen time. Methods: This cross-sectional case–control study enrolled 60 adolescents with essential HTN and 60 controls selected via frequency matching based on age and sex, all aged 12–18 years. The diagnosis of essential HTN was confirmed using 24-h ambulatory blood pressure monitoring (ABPM). Grazing behavior, ERD, problematic smartphone use, screen time and body mass index (BMI) were assessed in all participants. Group comparisons and associations between grazing behavior and the study variables were analyzed. Results: The essential HTN and control groups were comparable with respect to age and sex distribution (p > 0.05). The mean BMI in the essential HTN group was 31.18 ± 6.81 kg/m², which was significantly higher than that in the control group (23.35 ± 4.47 kg/m²) (p < 0.001). A significant positive correlation was found between total Grazing Questionnaire (GQ) scores and BMI (r = 0.252; p = 0.006), ERD (r = 0.187; p = 0.041), and problematic smartphone use (r = 0.315; p < 0.001). A statistically significant difference was observed between the essential HTN and control groups in total GQ scores [F(1, 117) = 4.85, p = 0.030, η²p = 0.040]. After adjustment for BMI, participants with hepatic steatosis had significantly higher total GQ scores (p = 0.019, η²p = 0.138), Grazing Behaviors subscale scores (p = 0.046, η²p = 0.107), and Uncontrollability subscale scores (p = 0.025, η²p = 0.123) than those without hepatic steatosis. Conclusions: Adolescents with essential HTN had higher grazing behavior scores than controls after adjustment for BMI. Grazing behavior was also associated with ERD and problematic smartphone use across the study sample. The findings regarding grazing behavior and hepatic steatosis warrant cautious interpretation, as the subgroup analysis was exploratory and included a relatively small number of participants. Full article

Background: Diabetes distress is a key mental health dimension of type 2 diabetes (T2D) and a growing concern as populations age, yet its determinants in older adults remain insufficiently characterized. The independent contributions of demographic and metabolic factors to severe distress and their implications for multidisciplinary screening across the lifespan remain unclear. Methods: In this cross-sectional study, we assessed 453 adults with T2D using the 17-item Diabetes Distress Scale (DDS-17). We categorized participants as experiencing low (<2), moderate (2–2.9), or severe (≥3) distress. We compared categories using the Kruskal–Wallis H test and chi-square tests. Logistic regression models were constructed with severe distress (DDS ≥ 3) as the outcome, adjusting for sex, educational level, and HbA1c. Results: Severe distress was identified in 19 participants (4.2%). Age differed significantly across DDS categories (Kruskal–Wallis H test, p = 0.003), with the severe group being significantly older (72.95 ± 4.38 years). Emotional burden was the dominant subscale across all groups. In multivariable logistic regression, increasing age (aOR = 1.163 per year; 95% CI: 1.055–1.282; p = 0.002) and lower educational level (high school vs. basic: aOR = 0.187; p = 0.020) were independently associated with severe distress, whereas metabolic variables were not independently associated with severe distress. ROC analysis identified age ≥ 70 years as an exploratory, sample-derived cut-off (AUC = 0.726, 95% CI 0.602–0.827; sensitivity 84%, specificity 55%). Results were robust in sensitivity analyses that excluded patients with diabetes duration < 5 years. Conclusions: Severe diabetes distress is more strongly associated with demographic vulnerability than with metabolic burden. Age ≥ 70 years and lower educational attainment may help identify older adults at increased risk of diabetes-related distress, supporting targeted psychological screening strategies in this lifespan stage. Full article

Background/Objectives: Impaired masticatory function may compromise nutritional status in older adults wearing removable dentures, but its associations with nutritional risk indices remain unclear. This study aimed to examine associations between masticatory performance and risk defined by the Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score. Methods: This cross-sectional study included 179 outpatients aged ≥60 years wearing removable dentures. Masticatory performance was quantified by glucose concentration after chewing a gummy jelly. GNRI-defined risk was the prespecified primary outcome; PNI- and CONUT-defined risk were secondary. Logistic regression used Model 1 adjusted for age, sex, and comorbidity and an exploratory Model 2 with additional oral, dietary, and socioeconomic covariates. Results: Mean age was 74.1 ± 6.9 years, and 60.9% were female. Nutritional risk was identified in 21.8%, 48.6%, and 31.3% using the GNRI, PNI, and CONUT, respectively. Higher masticatory performance, indicated by higher glucose concentration, was associated with lower odds of GNRI-defined nutritional risk in both the primary parsimonious model (OR per 10 mg/dL increase, 0.89; 95% CI, 0.82–0.95; p = 0.001) and the exploratory additionally adjusted model (OR, 0.89; 95% CI, 0.82–0.96; p = 0.002). Associations with PNI- and CONUT-defined risk were not consistent across models. Conclusions: Lower masticatory performance was consistently associated with higher GNRI-defined risk, whereas comparable associations were not consistently observed for PNI- or CONUT-defined risk. Objective assessment of masticatory performance may provide clinically relevant information regarding GNRI-defined nutritional risk in older removable denture wearers. Full article

Background/Objectives: Osteoarthritis (OA) is strongly associated with mitochondrial dysfunction, oxidative stress, and the accumulation of mitochondrial DNA (mtDNA) alterations in several joint-associated cell types, including chondrocytes, synoviocytes, and mesenchymal stromal cells (MSCs). These alterations contribute to impaired cellular homeostasis and reduced regenerative potential. In this study, we systematically characterized mtDNA heteroplasmy and variant distribution across bone marrow MSCs, induced pluripotent stem cells (iPSCs) and induced MSCs (iMSCs) derived from OA patients and healthy donors. Methods: Ultra-deep mitochondrial genome sequencing was integrated with transcriptomic and miRNome analyses to investigate mitochondrial remodeling during cellular reprogramming, encompassing changes in mtDNA heteroplasmy, variant distribution, mtDNA copy number and associated transcriptomic adaptations of nuclear-encoded mitochondrial pathways. Results: OA-derived MSCs exhibited a markedly increased heteroplasmic burden, followed by decrease in mtDNA copy number and accumulation of non-synonymous variants, particularly within OXPHOS-related genes, including MT-ND1-5, MT-ATP8, MT-CO1, and MT-RNR1/2. Reprogramming into iPSCs and subsequent differentiation into iMSCs were associated with an increase in mtDNA copy number and a progressive reduction in heteroplasmic variants predicted to have pathogenic potential, including m.7913C>T and m.7821G>A, as well as substantial reduction in heteroplasmic variant burden within several mitochondrial genes, suggesting mitochondrial genome remodeling during cellular reprogramming. Multiomic analysis further revealed coordinated deregulation of mitochondrial-associated nuclear genes and ceRNA regulatory networks involving lncRNAs MEG3 and SNHG14, along with multiple mitochondria-related miRNAs. These findings suggest post-transcriptional regulations associated with mitochondrial adaptation in iMSCs Conclusion: Collectively, our findings suggest that cellular reprogramming is associated with mitochondrial genomic reorganization in the donor-matched cell populations examined. These exploratory observations support the utility of iMSCs as a relevant model for studying OA-associated mitochondrial alterations and as a potential tool for regenerative approaches in OA. Full article

Deep learning models for tabular data often behave unpredictably during training, and these internal dynamics directly influence the reliability of post hoc interpretability methods. Static techniques such as SHapley Additive exPlanations (SHAP) and Integrated Gradients offer useful but incomplete snapshots of model behaviour, while tabular models frequently undergo noise-driven fluctuations, structural reorganisations, and collapse phases that these methods cannot detect. This study introduces a temporally aligned, multimodal diagnostic framework that observes and interprets model behaviour as it evolves. The framework integrates fractal complexity, spectral energy, persistent homology, gradient-noise statistics, reflex responsiveness, attribution instability, and exploratory sonification into a single phase-aligned system. The framework is evaluated on Multilayer Perceptron (MLP) and Gated Recurrent Unit (GRU) models across benchmark and real-world datasets using a reproducible protocol with consistent configurations and autocorrelation-robust analysis. An ablation study confirms the distinct diagnostic value of each modality, with reflex-aware metrics validated against optimiser behaviour and sonification assessed through event detection. The multimodal diagnostics reveal instability regimes, fragmentation events, attribution drift, and optimiser–noise coupling failures that static Explainable Artificial Intelligence (XAI) methods cannot detect. GRU models show repeated structural transitions, whereas MLPs exhibit simpler but noisier optimisation dynamics. These behaviour-aware, temporally aligned diagnostics provide a more reliable foundation for interpreting tabular deep learning models. Full article

In this study, we use gratifications (U&G) theory to explore how social media shapes Millennials’ gastronomic destination choices. Rather than treating social media influence as uniform, we identify three key gratifications obtained from gastronomy-related content: experiential–inspirational, utilitarian decision-making, and information search and assurance. The study investigates how these gratifications directly and indirectly affect destination choice through pre-visit destination impressions. Data were collected from 418 Chinese Millennials. Validity of measurements was confirmed through exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability tests, with hypotheses tested using Hayes’ PROCESS Model 4. Findings indicate that pre-visit destination impression significantly predicts destination choice and mediates the influence of all three gratifications. Experiential–inspirational gratification has the greatest overall impact; experiential–inspirational and information search and assurance gratifications operate through both directly and indirectly, while utilitarian decision-making gratification operates primarily through pre-visit impressions. By integrating U&G theory with pre-visit impressions, this study offers a novel pathway-specific explanation of social media’s role in gastronomic destination choice, suggesting that different gratifications activate distinct psychological mechanisms rather than a uniform process. It also advances destination-choice research by highlighting pre-visit impression as a rapid evaluative mechanism linking digital gratification and behavioral decision. Full article

The war in Ukraine, beginning in February 2022, disrupted continuous medical care for Ukrainian childhood and adolescent cancer patients (UCC), many of whom were relocated to pediatric cancer centers worldwide, including Switzerland. In this Brief Report, we describe their health-related quality of life (HRQoL) after arrival. In a multicenter, cross-sectional survey across five Swiss pediatric oncology centers, we included patients ≤18 years at diagnosis who arrived after 24 February 2022 and were undergoing active treatment. HRQoL was assessed by the PedsQL™ 4.0 Generic Core Scales (self- and parent-reports). Fourteen of 23 eligible families (61%) participated. HRQoL declined with age, particularly in physical functioning, while psychosocial functioning remained relatively stable but lower among adolescents; parent scores closely matched self-reports. Scores were referenced against a published cohort of healthy Ukrainian children and previously reported pediatric cancer populations. Given the small sample and lack of a matched control group, the findings cannot separate the effects of displacement, cancer, and treatment and are hypothesis-generating. They suggest a potential role for age-tailored supportive care in displaced children with cancer and call for larger, controlled studies. Full article

Obesity is a widespread condition strongly linked to increased cardiovascular risk, and heart rate (HR) responses to physical activity are widely used physiological indicators of this relationship. Although the role of fat mass- and obesity-associated (FTO) gene variants in obesity risk is well established, their potential associations with HR changes during and after physical activity (independent of adiposity) have not yet been fully elucidated. This study examined whether common FTO polymorphisms (rs9939609, rs1121980, rs1558902, and rs9941349) and an exploratory FTO multi-variant score (MVS_FTO), representing regional variation across the high-LD FTO locus, are associated with HR responses to a brief submaximal exercise stimulus. A population-based cohort of Hungarian adults (n = 660) completed the YMCA 3-min step test, with HR measured at rest, at first-minute post-exercise (HR_aft), and at 5- (HR_5min) and 10-min recovery (HR_10min). Acute HR response (ΔHR) and percent of predicted maximal HR (HR_max%) were calculated. Linear regression analyses showed no association between any FTO variant and resting HR (all p > 0.05). In contrast, all four candidate SNPs demonstrated significant negative associations with HR_aft (β ≈ −3.6 to −4.2, all p ≤ 0.005), ΔHR (β ≈ −3.7 to −3.9, p ≤ 0.005), and HR_max% (β ≈ −2.5, p = 0.001). The MVS_FTO revealed even more pronounced and consistent associations: higher MVS_FTO burden was associated with lower HR_aft (β = −4.19, p = 0.001), HR_5min (β = −2.06, p = 0.004), HR_10min (β = −1.15, p = 0.009), ΔHR (β = −4.04, p = 0.001), and HR_max% (β = −2.47, p = 0.001). Exploratory four-way mediation decompositions and saturated structural equation models indicated that these inverse associations remained statistically robust after multivariable adjustment for measured BMI and leisure-time physical activity (all direct paths p ≤ 0.001). Furthermore, multi-trait latent cluster analysis identified distinct phenotypic profiles consistent with these findings, showing that individuals with high MVS_FTO burden and moderate physical activity exhibit blunted exercise HR reactivity across recovery phases. Rather than establishing biological causality or clinical cardiovascular benefit, these observational findings demonstrate that regional FTO locus variation captured by the multi-variant score is statistically associated with inter-individual variability in short-term post-exercise HR reactivity, providing hypothesis-generating insights that warrant validation in prospective cohorts and interventional exercise trials. Full article

Introduction: Altered lipid metabolism is implicated in atrial fibrillation, but longitudinal lipidomic changes during anticoagulation remain poorly characterized. Objectives: To characterize plasma lipidomic changes during 12 weeks of edoxaban treatment and explore associated metabolic pathways in Chinese patients with nonvalvular atrial fibrillation (NVAF). Methods: This prespecified substudy of a prospective multicenter study analyzed fasting predose plasma collected at baseline and week 12 from 74 patients receiving protocol-assigned edoxaban doses (15 mg, n = 3; 30 mg, n = 23; 60 mg, n = 48). Widely targeted UPLC-MS/MS lipid profiling, with laboratory quality control (QC CV < 30%), yielded 1099 lipid features retained for statistical analysis. Differential lipids were defined by paired testing with Benjamini–Hochberg correction (|log₂FC| > 0.58 and q < 0.05). Results: The overall, 30 mg, and 60 mg analyses identified 25, 15, and 35 FDR-significant features, respectively; none was significant in the exploratory 15 mg group. Twelve features were shared across the primary analyses and increased at week 12; they comprised mainly acylcarnitines, together with docosadienoic acid and DG (21:0/16:0/0:0), and four lacked HMDB identifiers. The corresponding FDR panels yielded participant-grouped out-of-fold AUCs of 0.918 (95% CI 0.890–0.963), 0.786 (0.701–0.890), and 0.891 (0.835–0.950) for discriminating baseline from week 12, respectively. Pathway mapping identified no multi-compound enriched pathways (q < 0.05). Observed annotations represented single-metabolite signals—most notably DG (21:0/16:0/0:0) (HMDB0094301) and octanoylcarnitine (HMDB0000791)—rather than coordinated, pathway-level alterations. Conclusions: Paired analyses identified consistent longitudinal plasma lipidomic changes in patients receiving edoxaban. The 12 shared features provide focused candidates for targeted validation. Controlled studies are needed to determine whether these changes are specific to edoxaban and to establish their biological and clinical relevance. Full article

Commercial sesame paste exhibits substantial variations in color and aroma, reflecting differences in raw materials and commercial processing conditions, including roasting. This study investigated 15 commercial sesame paste products to characterize associations among color/browning characteristics, sensory attributes, and aroma-active chemical profiles. Across the commercial samples, darker color and higher browning index ($BI$) values were generally associated with stronger roasted nutty and burnt attributes and weaker grassy notes. Higher pyrazine levels were also observed in samples exhibiting more pronounced apparent roasting-related aroma characteristics and were positively associated with roasted nutty and burnt attributes. GC-O and OAV screening, together with exploratory PLSR further analysis, indicated that Strecker aldehydes, pyrazines, and phenolic compounds were candidate contributors to the observed sensory differences. In aroma addition experiments, under the tested addition conditions, the R mixture containing 2-methylbutanal and selected pyrazines enhanced roasted nutty intensity, whereas the B mixture containing guaiacol and 4-vinyl-2-methoxyphenol enhanced burnt/smoky intensity under the tested addition conditions. These findings demonstrate that color/browning characteristics and aroma-active compound profiles provide complementary information for characterizing apparent roasting-related differences and aroma quality in commercial sesame paste, without representing direct measures of controlled roasting degree. Full article

This article examines the “Boomers vs. Millennials” generational conflict as it is constructed within digital meme cultures on Instagram. Drawing on generational theory, media-generation research, and platform studies, it treats generational identities as socially and culturally produced rather than as purely demographic categories. The study adopts a qualitative and exploratory design based on a multilingual corpus of 60 static Instagram memes collected between May and June 2026 through purposive sampling. Memes are analysed as visual–textual artefacts through a four-stage interpretive procedure addressing visual composition and templates, thematic coding, framing strategies, and discursive registers. Five first-order thematic categories are organised into four higher-order analytical dimensions: digital literacy gaps; economic precarity and material inequality; intergenerational responsibility for structural crises; and identity, recognition, and generational boundary-work. The findings show that memes condense structural inequalities into simplified oppositional narratives and use irony, satire, and expectation reversal to redistribute responsibility between generations. Rather than empirically measuring recommendation systems or algorithmic amplification, the article interprets these patterns within the broader platform environments in which memetic communication circulates. The study concludes that memes contribute to generational othering by reinforcing symbolic boundaries while simultaneously providing a space in which dominant narratives of merit, responsibility, and intergenerational justice can be contested. Full article

Waste prevention begins upstream, in decisions made long before a product becomes waste. This article examines product lifetime management as an upstream environmental strategy and asks when longer product use can reduce waste generation, resource consumption and environmental impacts across the life cycle. An integrative literature review combined exploratory searches in Google Scholar and citation tracking with a structured search of Scopus. Records were screened by title, abstract and keywords. Publications in English were considered without a date limit and selected according to their relevance to product lifetime, premature replacement, repair and lifetime extension, consumer and business decisions, regulation, waste prevention and life cycle assessment. The selected studies were supplemented with relevant legal, regulatory, institutional and standardisation documents, producing a final reference base of 240 sources. The review shows that actual product lifetime is shaped not only by technical durability, but also by repairability, access to spare parts and information, continued software and service support, opportunities for upgrading and reuse, business incentives and consumer behaviour. Extending product use can reduce waste and resource demand, but environmental benefits are not automatic. They depend on product characteristics, energy consumption, technological progress and, above all, whether prolonged use genuinely replaces the production and purchase of new products. Product lifetime management should therefore be understood as a coordinated upstream strategy linking design, repair, reuse, business models, regulation and consumption with environmental assessment across the life cycle. Full article

Geopolitical conflict, tariff shocks, and rapidly evolving environmental, social, and governance (ESG) regulation have made global supply chains markedly less predictable. This study examined how manufacturing supply chain decision-makers perceive six regulatory-volatility risks, including labor, environmental, customs, ownership, military-logistics, and distribution, and whether those perceptions predict recorded engagement outcomes. Adopting an information systems perspective, we retrospectively analyzed 1988 fully anonymized decision-maker records from the digital lessons-learned repository of a multinational supply chain logistics firm, applying descriptive statistics, exploratory factor analysis with parallel analysis, and binary logistic regression with classification diagnostics. The perceived risks did not converge on a unified regulatory-volatility construct: sampling adequacy was weak (KMO = 0.470), and parallel analysis retained three single-indicator factors (distribution, environmental, and ownership risk) that were close to orthogonal apart from one moderate environment-distribution association. Critically, the sustainability-motivated risks were rated lowest, with a median labor severity of 0 and an environmental severity of 1 on 0–5 scales, during a period of record forced-labor enforcement; this perception gap invites sustainability leakage, whereby surprise enforcement provokes supplier exit and sourcing flight rather than remediation within scrutinized regions. The logistic regression separated success from failure perfectly in-sample (accuracy = AUC = 1.000), driven jointly by the near-collinear distribution and supply items—a complete-separation pattern warning of label leakage when digitized organizational records are mined for artificial intelligence-based decision support. The two items are near-duplicate measures (r = 0.915), so no individual predictor effect is identified. The findings favor multidimensional rather than composite digital risk dashboards, provenance-aware data governance for supply chain analytics pipelines, and digitally enabled ESG compliance under volatile regulation, contributing an empirically grounded information systems lens to sustainable supply chain management. Full article

High-density urban renewal requires blue–green infrastructure (BGI) strategies that address surface warming and stormwater runoff under land constraints. This study examined how BGI area and interface configuration regulate water–thermal performance across three purposively selected 100 ha urban fabrics in Beijing. Multi-year Landsat observations and matched 30 m land-cover data quantified radiometric land-surface-temperature (LST) contrasts and distance gradients, while a transparent Python event-runoff model evaluated relative hydrological scenarios using wet-day rainfall-depth quantiles, storage, impervious-area capture, and terrain-informed connectivity. The evidence streams were compared using the scenario cooling–storage index (SCSI), descriptive half-response area (A50), and interface–area substitution ratio (SAR). Stable surface-cooling contrasts occurred in Xicheng and Daxing; Chaoyang supported only exploratory thermal comparison because mapped BGI was sparse. Hydrological outputs represented configuration-dependent simulated runoff-volume responses, not calibrated predictions. In equal-weight 100 ha analyses, bootstrap intervals supported SAR above one across 1–10 ha in Xicheng and 1–3 ha in Daxing, while nested 50 ha windows and thermal weights of 0.2–0.8 shifted transition ranges. Corridor A50 was not identifiable within the tested 1–10 ha range in Daxing, so corridor saturation remains unresolved. Interface compensation was therefore morphology-, scale-, and weighting-dependent. The framework enables conditional comparison of BGI configurations while preserving the distinction between observed thermal and scenario-based hydrological evidence. Full article

Background: Cellular heterogeneity limits causal inference in complex diseases. We applied an established cell-type-stratified Mendelian randomization (csMR) framework, originally developed by Hao et al. (2024), to investigate whether lipid phenotypes affect kidney disease through distinct brain cell populations, extended by a proteome-wide mediation component. Methods: Using Bayesian colocalization (posterior probability of hypothesis 4 [PPH4], ≥0.8) and multidimensional instrumental variable selection, we evaluated cell-type-stratified MR-supported associations of five lipid traits across ten brain cell or tissue strata with kidney disease risk. Instrumental variables were derived from published genome-wide association studies and human brain single-cell expression quantitative trait locus (eQTL) maps. An exploratory proteomic mediation analysis using the Difference Method was performed with UKB-PPP as the discovery resource and deCODE as the external validation resource, with mediation signals interpreted as hypothesis-generating. For the primary csMR analysis, multiple testing was corrected separately within each lipid trait using a Bonferroni threshold of 3.33 × 10⁻⁴, corresponding to 150 cell/tissue-by-outcome tests per lipid trait. Results: In csMR analyses, cholesterol-related lipids showed cell-type-stratified associations with kidney disease, most prominently in oligodendrocyte-related analyses (max β on the log-odds scale = 1.025). LDL-related associations with broad chronic glomerular disease were most evident in excitatory neuron-related analyses. Dual-cohort proteomic analysis prioritized plasma proteins, including SNAP29 and ICAM4, as candidate protein-associated signals for exploratory mediation analysis. These findings represent genetic colocalization and Mendelian randomization-supported associations, not experimentally established mechanisms, and should be interpreted as hypothesis-generating. Conclusions: This study provides a cell-type-resolved genetic and proteomic association map linking lipid traits, brain cell strata, and kidney disease outcomes, offering hypotheses for future experimental validation. Full article