Search Results (90)

Background: Mobility limitation is a pivotal but under-documented dimension of disability in Saudi Arabia. Leveraging the 2017 National Disability Survey, this cross-sectional study provides a population-wide profile of mobility-related physical difficulty. Objectives: Five research aims were pursued: (1) estimate national prevalence and severity by sex; (2) map regional differentials; (3) examine educational and marital correlates; (4) characterize cause, duration, and familial context among those with multiple limitations; and (5) describe patterns of assistive-aid and social-service use. Methods: Publicly available aggregate data covering 20,408,362 Saudi citizens were cleaned and analyzed across 14 mobility indicators and three baseline files. Prevalence ratios and χ² tests assessed associations. Results: Overall, 1,445,723 Saudis (7.1%) reported at least one functional difficulty; 833,136 (4.1%) had mobility difficulty, of whom 305,867 (36.7%) had mobility-only impairment. Severity was chiefly mild (35% of cases), with moderate (16%) and severe (7%) forms forming a descending pyramid. Prevalence varied more than threefold across the thirteen regions, peaking in Aseer (9.4%) and bottoming in Najran (2.9%). Mobility difficulty clustered among adults with no schooling (36.1%) and widowed status (18.5%), with sharper female disadvantage in both domains (p < 0.001). Among those with additional limitations, chronic disease dominated etiology (56.3%), and 90.1% had lived with disability for ≥25 years; women were overrepresented in the longest-duration band. Aid utilization was led by crutches (47.7%), personal assistance (25.3%), and wheelchairs (22.6%), while 83.8% accessed Ministry rehabilitation services, yet fewer than 4% used home or daycare support. Conclusions: These findings highlight sizeable, regionally concentrated, and gender-patterned mobility burdens, underscoring the need for education-sensitive prevention, chronic-care management, investment in advanced assistive technology, and distributed community services to achieve Vision 2030 inclusion goals. Full article

Aim: This study aimed to evaluate the potential impact of stone characteristics, patient factors, and upper tract anatomical parameters in the prediction of residual fragments (RFs) following the flexible ureteroscopic (fURS) management of renal stones. Patients and Methods: Between June 2023 and July 2024, a total of 104 cases underwent fURS for the minimally invasive management of medium-sized renal stones (10–25 mm), and 28 cases presenting with RFs 3 months after these procedures were included for further evaluation. In addition to the assessment of patient-related factors, non-contrast computed tomography (NCCT) was performed in all cases in an attempt to assess specific stone characteristics and upper tract anatomical parameters in detail during the 3-month follow-up period. Results: An evaluation of our findings indicated that, among the evaluated parameters, a higher degree of hydronephrosis (>Grade 2), a larger stone size (>15 mm), and the presence of multiple stones were found to affect the presence of RFs significantly (p = 0.020, p = 0.012, and p = 0.040, respectively). On the other hand, although the analysis of other parameters such as patient gender, stone side, stone hardness, and the use of an access sheath with univariate regression demonstrated potential correlations, none of these parameters demonstrated a significant impact when analyzed using backward logistic regression. Logistic regression revealed that Grade 2 hydronephrosis (OR = 18.3, p = 0.020), stone size > 15 mm (OR = 7.0, p = 0.012), and multiple stones (OR = 3.7, p = 0.040) significantly increased the risk of residual fragments following fURS. Conclusions: In light of our findings and published data, we can conclude that endourologists should consider the likelihood of RFs’ presence after successful stone disintegration with fURS. A detailed evaluation of the relevant factors revealed that patients with larger stones, higher degrees of hydronephrosis, and multiple calculi may carry the risk of residual fragments after these procedures. Thus, the utilization of such reliable predictive parameters may aid in selecting optimal stone removal strategies and planning subsequent interventions in the rational management of RFs. Full article

This study aimed to uncover how harm is normalised in migrant communities using rationalisations, power imbalances, and emotional distancing. This research counters the dominant discourse that migrant communities are cohesive, altruistic, and protective by critically analysing the psychological and moral mechanisms of intra-community harm. Migration scholarship has long extolled the contribution of migrant networks to settlement, employment, and integration. Using a qualitative ethnographic approach, data were gathered using participant observation and semi-structured interviews with twelve purposively sampled migrants. The aim of applying a primary qualitative study was to capture a detailed, first-hand understanding of participants’ lived experiences and social relations. It permitted the in-depth examination of how people rationalise and navigate intra-community harm in the actual contexts of their lives. Thematic analysis yielded four significant findings: one, injustices in the community are frequently met with silence and inaction due to fear and moral disengagement; two, assistance is extraordinarily situational and gendered, often falling disproportionately on women or being mediated by institutions; three, internal exploitation—like rent gouging and manipulation of aid—is justified through community narratives; and four, people increasingly feel isolation, emotional burnout, and only symbolic unity at communal events. The research suggests that, although migrant networks can offer critical resources, they are not invulnerable to internal hierarchies and moral collapses. To create effectively inclusive and nurturing settings, future interventions must account for more than mere structural barriers, intra-group processes, and psychological rationalisations allowing intra-community injury. Full article

Swearing is a powerful and emotionally charged form of language that has recently gained increased scholarly attention. While commonly used for emotional release, its role in sport and exercise ‘self-talk’ remains understudied. Prior evidence suggests that swearing may aid in pain management, emotion regulation, and performance enhancement, yet research in athletic contexts has largely focused on conventional self-talk. To address this gap, the present study developed and validated the Reasons for Swearing in Sport and Exercise Questionnaire (RSSEQ), a novel tool assessing reasons motivating swearing among competitive athletes, coaches, and recreational exercisers. A total of 513 participants completed the RSSEQ. Exploratory (n = 333) and confirmatory (n = 180) factor analyses supported a three-factor structure: Stress and Emotional Catharsis, Mental Strength Enhancement, and Coping with Physical Discomfort and Pain. Males reported greater use of swearing for mental strength and pain-related coping, while no gender differences were observed for emotional catharsis. Athletes reported more swearing for emotional catharsis than did coaches, but no differences emerged in motivational or pain-related use. No significant differences were found between competitive and recreational athletes or between team and individual sport participants. These findings establish a foundation for future research on the psychological functions of swearing in sport and exercise, encouraging further exploration of its effectiveness and potential integration into mental training strategies, alongside more traditional self-talk approaches. Full article

Objectives: The United States has been greatly impacted by the opioid overdose epidemic, and fentanyl has largely contributed to the rise in overdose deaths in the past decade. We have analyzed trends in fentanyl-related mortality amongst adolescents and young adults (AYAs) to further describe emerging trends by ethnicity, gender, and age. Methods: We used mortality data from the U.S. Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (WONDER) Multiple Cause of Death file from 2009 to 2022. Drug overdose mortalities were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes. Joinpoint regression was used to examine mortality rates involving fentanyl by ethnicity (Hispanic and non-Hispanic), gender, and age category. Results: The Average Annual Percent Change (AAPC) for fentanyl-involved mortality increased for all adolescents and young adults within the United States from 2009 to 2022. The greatest AAPCs for fentanyl-related mortalities occurred amongst, Hispanic AYAs, Male AYAs, and 13–18-year-olds. Conclusions: Significant increases in fentanyl-related mortalities have occurred in AYAs from 2009 to 2022. Disparities by ethnicity and emerging trends in gender and age category highlight the need for targeted approaches to help aid in reducing fentanyl-involved mortality amongst AYAs. There is an urgent need for harm reduction and public health efforts to address this escalating crisis. Full article

Introduction: This study aimed to assess, through health metrics and bibliometric analysis, the global research on attitudes and social stigma of people living with HIV/AIDS and to identify research findings, gaps, and future directions. Methods: A cross-sectional bibliometric study was conducted through a structured search in different databases. Fifteen thousand four hundred and ninety-six documents were found between 1981 and 2024. Results: 83.5% were original articles, and international co-authorship was 30.66%. Since 2000, there has been an increase in research on HIV/AIDS attitudes and social stigma. The United States is the most prolific country worldwide (n = 7837 publications; 50.5%), with the highest number of prolific institutions (n = 4/5), as well as the greatest influence and relevance in research (h-index 170). The most studied topics worldwide are social support and social psychology concerning homosexuality, middle age, and youth in people living with HIV/AIDS. There was no significant correlation between the volume of publications, countries’ income levels, and the most prolific geographic regions with adult HIV prevalence, overall HIV incidence and prevalence, or antiretroviral therapy coverage in people living with HIV (p > 0.05 for all cases). Conclusions: Over the past two decades, research has shifted from human rights, legal rights, and ethics to attitudes toward healthcare, with the recent interest in pre-exposure prophylaxis, gender minorities, and intersectional stigma. The absence of strong correlations between publications volume and global health HIV-related indicators underscores the necessity of translating evidence into actionable strategies to reduce stigma and improve health outcomes. Full article

Background and Objective: Active aging is influenced by various factors, including chronic diseases, multimorbidity, functional limitations, and disabilities. The presence of these factors might lead to greater dependence on caregivers and could present potential barriers to community engagement. Physical functioning might be considered as one of the vital components for healthier aging experience promotion and support in elderly people. This study aimed to assess self-perceived general health and related health characteristics among the elderly population in Serbia, with a focus on varying degrees of functional limitations, as well as to analyze the predictors of physical functioning limitations in relation to gender. Materials and Methods: This population-based modeling study included a representative sample of 3540 elderly individuals aged above 65 years from Serbia. We employed a dual approach to model the four distinct difficulty levels related to the two groups of limitations of physical functioning (PF1 and PF2) for both genders. The PF1 focused on walking half a kilometer on level ground without the assistance of any mobility aids, and the PF2 navigated a set of 12 steps of ascent and descent: Model 1: inability to execute PF1, Model 2: some/a lot of difficulty in PF1, Model 3: inability to execute PF2, and Model 4: some/a lot of difficulty in PF2. Further variables were evaluated: self-perceived general health, long-lasting health problems, and chronic diseases/chronic conditions. Logistic regression analysis was performed to assess predictors of physical functioning. The models’ performance was presented. Results: Significant predictors were as follows: self-perceived general health (Model 1 (male OR: 8.639; female OR: 3.569); Model 2 (male OR: 2.759; female OR: 2.277); Model 3 (male OR: 24.290; female OR: 5.090); Model 4 (male OR: 3.256; female OR: 2.152)); long-lasting general health (Model 1 (female OR: 2.867); Model 3 (female OR: 3.602)); pulmonary diseases (Model 2 (male OR: 2.036); Model 4 (male OR: 1.976; female OR: 1.756)); musculoskeletal diseases (Model 1 (female OR: 1.537); Model 2 (male OR: 1.397; female OR: 1.410); Model 3 (male OR: 1.954; female OR: 1.739); Model 4 (male OR: 1.531; female OR: 1.483)); and other chronic diseases (Model 3 (male OR: 2.215)). Conclusions: Bad self-perceived general health and pulmonary and musculoskeletal diseases were predictors of functional disability in both genders of elderly individuals, while long-lasting health problems were predictors of functional disability in females and other chronic diseases were predictors in elderly males. Full article

Background/Objectives: Suicidal behaviors (SBs) and non-suicidal self-injury (NSSI) are significant mental health concerns in children and adolescents. The hypothalamic–pituitary–adrenal (HPA) axis, of which cortisol is a key hormone, has been implicated in these behaviors. This narrative review aims to explore whether cortisol levels play a role in SBs and NSSI in youth and to synthesize current evidence on this topic. Methods: A comprehensive literature search was conducted on studies published through November 2024, using PubMed, Web of Science, and Google Scholar databases. Studies were screened for eligibility, including only human studies published in English, with no animal models or studies excluding cortisol levels. A narrative synthesis approach was used due to the methodological diversity across studies. Due to limited adolescent-focused research, studies involving adults were also considered. Results: Findings indicate inconsistent cortisol patterns in relation to SBs and NSSI. Elevated cortisol levels are linked to SBs, with some studies suggesting they may predict future suicide attempts, though no definitive cause-and-effect relationship is established. Conversely, cortisol levels in relation to NSSI show mixed results, with some studies reporting no differences. Cortisol responses to stress, measured by saliva, blood, and hair, reveal complex interactions with psychological factors such as depression and impulsivity, influencing cortisol secretion. Discussion: Despite some evidence pointing to a role of cortisol dysregulation in SBs and NSSI, the relationship remains unclear due to study heterogeneity, including small sample sizes and methodological variations. Gender and the type of stressor used in studies also complicate the findings. Future research should prioritize longitudinal studies, better control for confounding factors, and utilize more diverse cortisol assessment methods to clarify these links. Conclusions: While cortisol may play a role in the pathophysiology of SBs and NSSI, further research is needed to establish clearer, more reliable patterns. Identifying alterations in cortisol levels may aid in early detection and targeted interventions for at-risk adolescents. Full article

Background: Several studies have suggested that the serum albumin–creatinine ratio (sACR) is a useful marker for the early risk stratification of patients with cardiomyocyte injury. This study aims to evaluate the relationship between sACR and anthracycline-related cardiotoxicity. Methods: This study included patients who had received anthracycline-based chemotherapy between 2014 and 2023 and had undergone baseline and follow-up echocardiography after the treatment. The level of sACR was calculated using serum albumin and creatinine values obtained before the chemotherapy. The definition of cardiotoxicity was based on the criteria of the European Society of Cardiology (ESC) for ejection fraction and the American Society of Echocardiography (ASE) for diastolic dysfunction. The patients were categorized into either the high or low sACR group based on the cut-off value obtained from the receiver operating characteristic (ROC) curve analysis. Results: In total, 525 patients (159 males, 366 females) were included. Multivariate analysis after adjustment for age, body mass index (BMI), cardiovascular disease, hemoglobin, anthracycline dose, and gender showed that sACR (HR = 1.85% 95 CI 1.12 to 3.06 p = 0.016), cardiovascular disease (HR = 1.97% 95 CI 1.08 to 3.61 p = 0.027), BMI (HR = 1.86% 95 CI 1.12 to 3.10 p = 0.017), and age (HR = 1.02% 95 CI 1.001 to 1.04 p = 0.036) were significantly associated with an increased risk of cardiotoxicity. Conclusions: This study is the first to show a significant relationship between sACR and cardiotoxicity related to anthracycline use. Routine laboratory tests that are conducted before anthracycline therapy can aid clinicians in identifying high-risk patients who may require closer follow-up or cardioprotective measures. Full article

Background/Objectives: Wine neophobia identifies segments of consumers who are reluctant to consume new or unfamiliar wines. This study examined the wine neophobia levels of a cohort of 376 Spanish wine consumers and the differences in demographics, wine consumption, and food neophobia according to their degree of wine neophobia. To that end, a specific survey with demographic data, wine consumption habits, and neophobia levels was designed and administered to Spanish consumers. Methods: The Wine Neophobia Scale (WNS) and Food Neophobia Scale (FNS) were used, and data collected were statistically analyzed (chi-square test, Pearson correlation analyses, and principal component analysis (PCA)). Two different clusters were identified: high- and low-wine-neophobic groups (HWN and LWN, respectively). Results: Results indicated significant differences in gender, marital status, and employment between groups. The HWN group was generally formed by women and singles, whereas participants with a partner (not married) and employed individuals were mostly in the LWN group. Overall, HWN consumers were characterized by consuming wine less frequently, preferring fruity and “softer” wines (e.g., whites and sparkling wines) or wine mixed with soda, and being willing to pay less money (“less than 5 €”) to buy wine on a daily basis than low-neophobics, who preferred red reserve wines with higher sourness and astringency and were willing to pay for more expensive wines. Finally, a direct relation has been observed between wine and food neophobia, as the LNW group reported lower scores on items relative to greater openness to the consumption of new foods. Conclusions: The present study provides for the first time insights into the relationship between wine neophobia, demographics, and wine consumption behavior in Spanish consumers, which can be useful to the wine industry for the development of personalized wines. This approach can aid wine market segmentation as well as product innovation. Full article

The HIV epidemic remains a major public health issue globally and in Vietnam. This study assesses changes in HIV/AIDS-related mortality rates over time in Lang Son Province, Vietnam, from 2005–2018. We performed a descriptive epidemiological study using a population-based mortality registration system to examine HIV/AIDS-related mortality. HIV/AIDS-related mortality was converted to a crude and adjusted rate per 100,000 person-years using the World Health Organization’s standard population for 2000–2025. The mortality rate ratio and 95% confidence interval were estimated to examine the province’s time trend from 2005 to 2018. The adjusted mortality rate for HIV/AIDS in Lang Son Province was 12.3 and 2.4 per 100,000 for men and women, respectively, with a male-to-female ratio of 5.1. The province experienced a 94% reduction in HIV/AIDS-related deaths between 2005 and 2018. The mortality rate ratio for 2018 compared to 2005 was lower for men (0.056, 95% CI: 0.029, 0.110) than for women (0.080, 95% CI: 0.019, 0.338). The findings show a gradual decline in HIV/AIDS-related mortality rates in Lang Son Province, Vietnam. However, significant gender disparities in mortality remain a major concern, and HIV remains a significant burden. This highlights the urgency for major efforts to prevent HIV transmission and address these disparities to effectively end the HIV epidemic in Lang Son and throughout Vietnam. Full article

This study examines the relationship between gender-related aid and legal frameworks governing women’s economic opportunities. Using data from 116 countries (2009–2022), we analyze how significant (SGRA) and principal (PGRA) gender-related aid influence the Women, Business, and Law (WBL) Index, which measures women’s access to employment, credit, and entrepreneurship. Results from fixed-effects models show that SGRA consistently improves WBL Index components, while PGRA significantly impacts marriage, parenthood, and mobility regulations, with modest effects on workplace and entrepreneurship measures. PGRA substantially affects marriage, parenthood, and mobility regulations while demonstrating more modest impacts on workplace conditions and entrepreneurship measures. These observations underscore the complexity of addressing gender inequality and the necessity of targeted, multifaceted approaches to overcome legal restrictions, entrenched social norms, and economic barriers. The research offers valuable insights for policymakers and donors on the transformative potential of gender-mainstreamed aid initiatives in fostering a more equitable world. Full article

Chronic non-cancer pain, defined by the Center for Disease Control and Prevention (CDC) as lasting beyond three months, significantly affects individuals’ quality of life and is often linked to various medical conditions or injuries. Its management is complex. Cannabis, containing the key compounds Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), has garnered interest for its potential in pain management, though it remains controversial due to its psychoactive effects and illegal status in many countries. THC provides pain relief by blocking nociceptive stimuli but has psychoactive effects and may potentially induce dependency. CBD has calming and antipsychotic properties. The inhalation of cannabis offers quick relief but poses respiratory risks, while its oral administrations are safer but act more slowly. Short-term cannabis use can impair cognition and motor skills, while long-term use may lead to dependency and cognitive decline, especially if used from an early age. Adverse effects vary by gender and prior use, with addiction mainly linked to THC and influenced by genetics. Despite these risks, patients often report more benefits, such as improved quality of life and reduced opioid use, although the evidence remains inconclusive. The legal landscape for medical cannabis varies globally, with some positive public health outcomes like reduced opioid-related issues in areas where it is legalized. Cannabis shows promise in managing chronic pain, but its psychoactive effects and dependency risks necessitate cautious use. Future research should prioritize long-term clinical trials to establish optimal dosing, efficacy, and safety, aiding in the development of informed guidelines for safe cannabis use in chronic pain management. This review examines the use of cannabis in managing chronic non-cancer pain, focusing on its benefits, drawbacks, mechanisms, delivery methods, and impact on quality of life. Full article

Smoking is a well known risk factor for coronary artery disease (CAD). However, the effects of smoking on gene expression in the blood of CAD subjects in Hungary have not been extensively studied. This study aimed to identify differentially expressed genes (DEGs) associated with smoking in CAD subjects. Eleven matched samples based on age and gender were selected for analysis in this study. All subjects were non-obese, non-alcoholic, non-diabetic, and non-hypertensive and had moderate to severe stenosis of one or more coronary arteries, confirmed by coronary angiography. Whole blood samples were collected using PAXgene tubes. Next-generation sequencing was employed using the NextSeq 500 system to generate high-throughput sequencing data for transcriptome profiling. The differentially expressed genes were analyzed using the R programming language. Results: The study revealed that smokers exhibited non-significant higher levels of total cholesterol, low-density lipoprotein-cholesterol, and triglycerides compared to non-smokers (p > 0.05), although high-density lipoprotein-cholesterol was also elevated. Despite this, the overall lipid profile of smokers remained less favorable. Non-smokers had a higher BMI (p = 0.02). Differential gene expression analysis identified 58 DEGs, with 38 upregulated in smokers. The key upregulated genes included LILRB5 (log₂FC = 2.88, p = 1.05 × 10⁻⁵) and RELN (log₂FC = 3.31, p = 0.024), while RNF5_2 (log₂FC = −5.29, p = 0.028) and IGHV7-4-1_1 (log₂FC = −2.86, p = 0.020) were notably downregulated. Heatmap analysis showed a distinct clustering of gene expression profiles between smokers and non-smokers. However, GO analysis did not identify significant biological pathways associated with the DEGs. Conclusions: This research illuminates smoking’s biological effects, aiding personalized medicine for predicting and treating smoking-related diseases. Full article

Introduction: Acceptable Noise Level (ANL) is defined as the most comfortable level (MCL) intensity for speech and is calculated by subtracting the maximum noise tolerable by an individual. The ANL test has been used over time to predict hearing aid use and the impact of digital noise reduction. This study analyzes this impact by using different masker babble spectra when performing the ANL test in both hearing-impaired and healthy subjects in three different languages (Dutch, French, and Italian). Materials and Methods: A total of 198 patients underwent the ANL test in their native language using a standardized protocol. The babble file was speech-weighted to match the long-term spectrum of the specific ANL language version. ANL was proposed in three different masking conditions: with multitalker Matched babble speech noise, with the same masking signal with the spectrum reduced from 2 kHz onwards (High Cut), and with the spectrum increased from 2 kHz onwards (High Boost). Results: In all of the comparisons among the three languages, ANL with High Boost noise gave significantly higher (worse) scores than ANL with Matched noise (p-value S1: <0.0001, S2: <0.0001, S3: 0.0003) and ANL with High Cut noise (p-value S1: 0.0002, S2: <0.0001, S3: <0.0001). The ANL values did not show any significant correlation with age and gender. In French, a weak correlation was found between ANL with High Cut noise and the Fletcher index of the worst ear. In Italian, a weak correlation was found between both ANL with Matched and High Boost noise and the Fletcher index of the best ear. Conclusions: ANL with High Boost added to noise stimuli was less acceptable for all patients in all of the languages. The ANL results did not vary in relation to the patients’ characteristics. This study confirms that the ANL test has potential application for clinical use regardless of the native language spoken. Full article