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18 pages, 9617 KB  
Article
Estimation of Leaf Water Content in Spring Wheat Based on UAV Multispectral Imagery
by Jiaxin Zhu, Pinyuan Zhao, Xiang Ao, Haochong Chen, Na Li, Yuxiang Zhang and Sien Li
Agronomy 2026, 16(9), 845; https://doi.org/10.3390/agronomy16090845 (registering DOI) - 22 Apr 2026
Abstract
Leaf water content (LWC) is a key physiological indicator for assessing crop water status. However, its spectral response may vary under different irrigation practices, which limits the general applicability of existing models. This study aims to develop irrigation-specific LWC estimation models [...] Read more.
Leaf water content (LWC) is a key physiological indicator for assessing crop water status. However, its spectral response may vary under different irrigation practices, which limits the general applicability of existing models. This study aims to develop irrigation-specific LWC estimation models for spring wheat based on UAV multispectral imagery. Field experiments were conducted during two growing seasons (2023–2024) under three irrigation methods, with five water treatments and three replicates, resulting in a total of 45 experimental plots. Multispectral data and in situ measurements were collected at key growth stages. Irrigation-dependent sensitive vegetation indices were identified through correlation analysis, and machine learning models, including Random Forest (RF), Multiple Linear Regression (MLR), and Backpropagation Neural Network (BPNN), were constructed and evaluated using a five-fold cross-validation framework. The results showed that spectral sensitivity to LWC varied significantly across irrigation methods, with different dominant indicators under FD, ND, and MD. Model performance also exhibited irrigation-dependent differences. Among the three models, RF showed the most stable performance, achieving mean R2 values of 0.70, 0.74, and 0.62 and corresponding RMSE values of 0.04, 0.06, and 0.08 under FD, ND, and MD, respectively. In contrast, MLR showed lower predictive accuracy, while BPNN exhibited limited robustness under the current dataset, particularly under ND. These findings highlight the importance of irrigation-specific modeling strategies for improving LWC estimation reliability. Full article
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17 pages, 675 KB  
Article
Effects of Peru’s National School Feeding Program (Qali Warma) on Overweight and Obesity Among Children Aged 36–59 Months
by Pedro Francke, Gustavo Acosta and Diego Quispe
Obesities 2026, 6(3), 25; https://doi.org/10.3390/obesities6030025 (registering DOI) - 22 Apr 2026
Abstract
Background: School feeding programs aim to improve child nutrition, and they may influence weight outcomes insofar as program modalities and household responses alter children’s total energy intake. This is especially relevant in countries facing the double burden of malnutrition, where undernutrition and micronutrient [...] Read more.
Background: School feeding programs aim to improve child nutrition, and they may influence weight outcomes insofar as program modalities and household responses alter children’s total energy intake. This is especially relevant in countries facing the double burden of malnutrition, where undernutrition and micronutrient deficiencies coexist with rising overweight and obesity. This study estimates the effect of Peru’s former National School Feeding Program on obesity and excess weight among children aged 36 to 59 months under a selection-on-observables identification strategy and assesses whether impacts differ across operational modalities, particularly breakfast-only versus breakfast plus lunch and ready-to-eat rations versus foods delivered for preparation. Methods: We use repeated cross-sectional microdata from the Demographic and Health Survey (ENDES) pooled over 2014 to 2018 and link them to administrative information. The sample includes 18,959 children aged 36 to 59 months. To improve comparability, we estimate propensity score weights targeting the average treatment effect on the treated (ATT) using a machine learning generalized boosted model (GBM), and assess covariate balance using standardized mean differences and Kolmogorov–Smirnov statistics. Identification assumes conditional independence given observed covariates and overlap (common support). Main estimates rely on weighted probit models with fixed effects, progressively adding exposure duration, modality indicators, and controls. Distributional effects are examined using quantile regression on the continuous weight-for-height z-score. Results: Without differentiating modalities, beneficiary status is not associated with a statistically significant change in obesity, while pooled baseline estimates indicate a statistically significant higher probability of excess weight. Modality-specific results show that obesity declines only when Qali Warma is delivered as breakfast plus lunch through products to be prepared (approximately −1.0 percentage point in parsimonious models and −0.4 percentage points after controls). Evidence for excess weight is directionally consistent by modality but less conclusive once controls are included. Conclusions: Qali Warma’s effects on early-childhood weight outcomes depend on implementation modality. Evaluations of school feeding programs should incorporate operational heterogeneity, particularly during program redesign. Full article
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28 pages, 1422 KB  
Article
A Rough Set-Based Decision Process for Evaluating and Promoting Green Community Sustainability
by Chun-Che Huang, Wen-Yau Liang, Yo-Der Huang, Tzu-Liang (Bill) Tseng and Chi-Wen Hsiao
Processes 2026, 14(8), 1318; https://doi.org/10.3390/pr14081318 - 21 Apr 2026
Abstract
Green communities play a critical role in advancing sustainable development; however, evaluating their performance and identifying appropriate improvement strategies remain challenging due to uncertain, incomplete, and multidimensional information. This study formalizes three key processes essential to green community governance—sustainability evaluation, attribute reduction, and [...] Read more.
Green communities play a critical role in advancing sustainable development; however, evaluating their performance and identifying appropriate improvement strategies remain challenging due to uncertain, incomplete, and multidimensional information. This study formalizes three key processes essential to green community governance—sustainability evaluation, attribute reduction, and decision-rule generation—and proposes a rough set-based decision framework that integrates quantitative indicators, expert knowledge, and rule-based reasoning. Using empirical assessment data from Nantou County, the framework identifies the most influential determinants of community performance, including accessibility-related facilities, remote-area status, and socioeconomic conditions. The results reveal clear drivers of sustainable community performance. Remote villages lacking community hubs face structural barriers to participation. Communities without facilities supporting vulnerable groups tend to stall at the registration stage, while bronze-level villages require equity-focused engagement despite possessing stronger resource endowments. Notably, silver-level performance is consistently associated with moderate income levels and moderate income disparity, underscoring socioeconomic balance—rather than economic extremes—as a key precondition for stable sustainability advancement. Together, these findings provide interpretable, evidence-based guidance for policymakers and community managers to identify performance gaps and allocate resources more effectively. Full article
(This article belongs to the Section AI-Enabled Process Engineering)
23 pages, 2143 KB  
Review
Application of Suitable Bioactive Probiotic Strains Sustaining Gut Microflora for Healthcare and Disease Prevention
by Divakar Dahiya and Poonam Singh Nigam
Appl. Sci. 2026, 16(8), 4023; https://doi.org/10.3390/app16084023 - 21 Apr 2026
Abstract
Background/Objectives: The human gastrointestinal tract is a dynamic and interactive micro-ecosystem, with its distinct microbial population residing in the gut. The healthy condition of the gut is integrated into the normal functioning of all physiological activities. The gut microbiome is critical for [...] Read more.
Background/Objectives: The human gastrointestinal tract is a dynamic and interactive micro-ecosystem, with its distinct microbial population residing in the gut. The healthy condition of the gut is integrated into the normal functioning of all physiological activities. The gut microbiome is critical for the functioning of metabolism via several gut-axis connections with different systems in the human body; thus, it affects the status of health and general well-being. The fundamental physiology and homeostatic shifts are associated with specific diseases caused by a disrupted balance in the diversity of the gut microbiome, which could be due to a condition of dysbiosis in a host, instigated by several reasons. Some studies have been conducted on the selective isolation of probiotic species from dairy and other food sources to obtain effective probiotic strains, which have been studied and used by dietary intake strategies to restore gut microbial diversity, which is disturbed by some disease/s. Methods: Our search strategy included specific keywords—gut, microbiota, microbiome, disease, dysbiosis, probiotic bacteria and yeast—and was based on a timeframe of 15 years in the web-based electronic databases of PubMed, Scopus, and Web of Science. Among the few hundred results, a secondary screening was conducted to select references on probiotics studied for disease management with preclinical evidence and some reports on clinically validated outcomes; we excluded the search results for screening fermented foods for taxonomy studies of isolated probiotics. Results: The summarised information using two figures and two tables has been presented in this article from the review of 137 selected references: >75% have been published in the last 10 years. Conclusions: Further advances in modelling and analysis of the gut microbiota are required to understand their influence on the occurrence of certain diseases; this approach will allow us to establish research strategies for filling knowledge gaps, inconsistencies in clinical evidence, or limitations in translating probiotic effects from experimental models to humans. Full article
(This article belongs to the Special Issue Advancements in Food Nutrition and Bioactive Compounds)
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19 pages, 2897 KB  
Article
Oral Function, Frailty and Mortality in Older Adults: Evidence from the Chilean National Health Survey 2016–2017
by Gustavo Sáenz-Ravello, Mauricio Baeza, Laura Sáenz-Ravello, Carol Guarnizo-Herreño and Jorge Gamonal
Int. J. Environ. Res. Public Health 2026, 23(4), 538; https://doi.org/10.3390/ijerph23040538 - 21 Apr 2026
Abstract
Background: Oral health is an often-overlooked component of healthy ageing, as a sign of cumulative functional decline. This study explored the association between oral functional status and all-cause mortality. Methods: This was a secondary analysis of the 2016–2017 Chilean National Health Survey linked [...] Read more.
Background: Oral health is an often-overlooked component of healthy ageing, as a sign of cumulative functional decline. This study explored the association between oral functional status and all-cause mortality. Methods: This was a secondary analysis of the 2016–2017 Chilean National Health Survey linked to mortality records through December 31, 2022. In total, 223 participants aged ≥ 60 years were included (N = 1,016,557). Minimum dentition (MD) was defined as ≥10 teeth, prosthesis use was self-reported, and frailty was assessed using a modified Fried phenotype. Survey-weighted Cox models estimated associations with all-cause mortality, adjusting for age, sex, area, education, frailty, diabetes, and hypertension. Results: In the survey-weighted Cox model, each category representing MD and/or prosthesis use was associated with lower mortality hazards compared with the reference group (<10 teeth and no prostheses): prostheses only (HR 0.17, 95% CI 0.05–0.61), MD only (HR 0.16, 95% CI 0.04–0.74), and MD with prostheses (HR 0.08, 95% CI 0.01–0.46). Increasing age and rural residence were associated with higher mortality hazards, whereas estimates for sex, education, frailty, diabetes and hypertension were imprecise and generally compatible with no clear association. Conclusions: These findings are hypothesis-generating and support further evaluation of oral functional status as a marker of broader health vulnerability in aged Chileans. Full article
(This article belongs to the Special Issue Improving Oral Health for Older Adults)
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21 pages, 4359 KB  
Article
Oxidative Status as an Indicator of Gonadal Maturation in Three Species of Mediterranean Sea Urchin
by Pedro A. Álvarez, Alberto Coll, María Elena Díaz-Casado, Félix Hidalgo, Eva E. Rufino-Palomares, Amalia Pérez-Jiménez and Cristina E. Trenzado
Antioxidants 2026, 15(4), 516; https://doi.org/10.3390/antiox15040516 - 21 Apr 2026
Abstract
Sea urchins are invertebrates that play a crucial role in marine ecosystems by controlling benthic algal communities and whose natural populations are being affected by different biotic and abiotic factors. Triggering physiological processes promotes the activation of certain metabolic pathways, so oxidative status [...] Read more.
Sea urchins are invertebrates that play a crucial role in marine ecosystems by controlling benthic algal communities and whose natural populations are being affected by different biotic and abiotic factors. Triggering physiological processes promotes the activation of certain metabolic pathways, so oxidative status markers could be a suitable tool to asses maturation stage in which natural populations are. Antioxidant status of three species of Mediterranean Sea urchins, A. lixula, P. lividus and S. granularis, was evaluated in gonadal and digestive tissue. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione s-transferase (GST), glucose 6-phosphate dehydrogenase (G6PDH), NAD(P)H: quinone oxidoreductase (NQO1) and lipid peroxidation were assayed. Significant differences were found among species, displaying in general higher antioxidant activity in A. lixula and S. granularis compared to P. lividus. A significant effect of sex was observed with females exhibiting a higher gonadosomatic index and higher levels of lipid peroxidation mainly in A. lixula. These results seem to be related to metabolic fluctuations associated with the gonadal maturation stage. Changes in digestive tissue were less evident, but some differences among species could be related to triggered digestive processes for replenishment of energy reserves in gonads. Oxidative status can be a useful complementary tool to evaluate gonadal condition in species of sea urchin from the same habitat. Integrative physiological and biochemical studies will contribute to the knowledge of invertebrate physiology. Full article
(This article belongs to the Section Health Outcomes of Antioxidants and Oxidative Stress)
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21 pages, 428 KB  
Article
Winning or Losing? Intergroup Competition and Racially Diverse Groups
by Chantrey Joelle Murphy and Jane Sell
Soc. Sci. 2026, 15(4), 269; https://doi.org/10.3390/socsci15040269 - 20 Apr 2026
Abstract
Status characteristics and expectation states theory (SC-EST) describes how general beliefs about capability contribute to disproportionate rates of power, prestige, and resource outcomes between group members. Similarly, endorsements for competition stem from a general belief that it is useful for identifying which people [...] Read more.
Status characteristics and expectation states theory (SC-EST) describes how general beliefs about capability contribute to disproportionate rates of power, prestige, and resource outcomes between group members. Similarly, endorsements for competition stem from a general belief that it is useful for identifying which people are more capable and therefore more deserving of limited or highly valued resources. This paper investigates the relationship between both contexts simultaneously by considering whether introducing intergroup competition into an otherwise collectively oriented task situation essentially promotes inequality between diverse group members. Using a two-condition experiment, we demonstrate how interaction dynamics change in racially diverse task groups when their task involves intergroup competition compared to no competition. The findings support our predictions that intergroup competition promotes inequality by reproducing and exacerbating macro-level inequalities in micro-level interpersonal interactions. Specifically, white group members were significantly less likely to defer (i.e., accept others’ suggestions) when the group task involved intergroup competition. Overall, these results offer insight into the diverging effects of unequal group processes in group settings and the detrimental effects of competition. Full article
(This article belongs to the Special Issue Group Processes Using Quantitative Research Methods)
18 pages, 9235 KB  
Article
Critical Role for Malic Enzymes in MYC-Mediated Cellular Adaptation to Glutamine Depletion
by Yufan Si, Wei Li, Yang Chen, Jiayang Yuan, Chenrui Hu, Yanan Liu and Li Li
Metabolites 2026, 16(4), 282; https://doi.org/10.3390/metabo16040282 - 20 Apr 2026
Abstract
Background/Objectives: MYC-driven tumors exhibit significant glutamine addiction, but the metabolic adaptation mechanisms enabling their survival under glutamine deprivation remain incompletely understood. Malic enzymes catalyze the oxidative decarboxylation of malate to pyruvate while generating NADPH, linking central carbon metabolism to redox homeostasis. This study [...] Read more.
Background/Objectives: MYC-driven tumors exhibit significant glutamine addiction, but the metabolic adaptation mechanisms enabling their survival under glutamine deprivation remain incompletely understood. Malic enzymes catalyze the oxidative decarboxylation of malate to pyruvate while generating NADPH, linking central carbon metabolism to redox homeostasis. This study investigates whether and how ME1 and ME2 mediate cell adaptation to glutamine starvation and explores their functional division in relation to p53 status. Methods: Using MYC-amplified, p53-mutant (G266E) SF188 glioblastoma cells, we performed siRNA-mediated knockdown, overexpression, and rescue experiments. Cell survival was assessed by trypan blue exclusion and Annexin V/PI staining. ROS levels and NADP+/NADPH ratios were measured by DCFH-DA fluorescence and enzymatic assays. Metabolite tracing was conducted using [U-13C5] glutamine followed by LC-MS. Key findings were validated in additional cell lines including HCT116, U2OS and MDA-MB-231. Results: ME1 and ME2 promote SF188 cell survival under glutamine deprivation, an effect that depends on their catalytic activity but is independent of TCA cycle anaplerosis. ME1 maintains redox balance by generating NADPH, and antioxidant treatment rescues the survival defect caused by ME1 knockdown. In contrast, ME2 does not contribute to redox regulation but stabilizes mutant p53 (G266E) via proteasome inhibition. Both of these pro-survival functions are attenuated upon MYC knockdown, suggesting a dependency on MYC expression. Across all cell lines tested, ME1 and ME2 also promote survival through redox maintenance, although the isoform responsible for antioxidant function differs. Conclusions: ME1 and ME2 support metabolic adaptation to glutamine starvation through distinct, isoform-specific mechanisms that depend on MYC expression and p53 mutation status. These findings suggest malic enzymes as potential therapeutic targets in MYC-driven, p53-mutant tumors. Full article
(This article belongs to the Section Cell Metabolism)
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10 pages, 756 KB  
Article
Assessment of Foot Health and Toe Strength in Older Adults Undergoing Heart Valve Surgery: A Pilot Study
by Hiromi Moriwaki and Mihoko Ishizawa
Healthcare 2026, 14(8), 1090; https://doi.org/10.3390/healthcare14081090 - 20 Apr 2026
Abstract
Objectives: We aimed to explore foot condition and toe strength in older adults undergoing heart valve surgery. Materials and Methods: This exploratory pilot study included nine older adults undergoing heart valve surgery. Subjective data on foot-related symptoms, self-care status, nail care, [...] Read more.
Objectives: We aimed to explore foot condition and toe strength in older adults undergoing heart valve surgery. Materials and Methods: This exploratory pilot study included nine older adults undergoing heart valve surgery. Subjective data on foot-related symptoms, self-care status, nail care, footwear, exercise habits, and fall history were collected. Preoperative foot and nail conditions were assessed using observation and photography. Toe strength was measured preoperatively in all participants and postoperatively in a subset of participants when feasible. Descriptive analyses were primarily conducted, with exploratory group comparisons. Results: Participants frequently reported foot-related symptoms and difficulties with foot self-care prior to hospitalization. Lower toe strength appeared to be related to greater difficulties in foot self-care, whereas higher toe strength was more commonly observed in those reporting regular exercise habits. Postoperative toe strength was reassessed in six participants. In a participant with prolonged intensive care unit (ICU) stay, delayed recovery of toe strength was observed. Conclusions: These preliminary findings suggest that foot condition and toe strength may be relevant to physical function and fall prevention-related factors in older a dults undergoing cardiac surgery. Reduced toe strength may be related to self-care difficulties, and prolonged ICU stay may influence the recovery of toe strength. However, due to the small sample size, these findings should be interpreted as exploratory and hypothesis-generating. Full article
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21 pages, 1349 KB  
Systematic Review
Effects of Vitamin D3 Supplementation on Physiological and Performance Outcomes in Swimming Athletes: A Systematic Review
by Xundian Liu, Jinxuan Bao, Yaxuan Huang and Xiuying Jiang
Physiologia 2026, 6(2), 29; https://doi.org/10.3390/physiologia6020029 - 20 Apr 2026
Abstract
Background/Objectives: This systematic review examined whether oral vitamin D supplementation improves vitamin D status, health, and exercise outcomes in indoor-training aquatic athletes. Methods: We systematically reviewed randomized, placebo-controlled trials (>2 weeks) investigating vitamin D supplementation in competitive swimmers and divers. Six eligible [...] Read more.
Background/Objectives: This systematic review examined whether oral vitamin D supplementation improves vitamin D status, health, and exercise outcomes in indoor-training aquatic athletes. Methods: We systematically reviewed randomized, placebo-controlled trials (>2 weeks) investigating vitamin D supplementation in competitive swimmers and divers. Six eligible trials (n = 246) were included and summarized descriptively. Results: Supplementation (2000–5000 IU/day for 12 weeks to 6 months) consistently increased serum 25(OH)D compared with placebo, with average increases up to 9.3 ng/mL. While higher doses occasionally improved muscle strength and lean mass, evidence showed no consistent benefits for swimming performance, immune function, or bone turnover. Additionally, higher body mass index (BMI) correlated with smaller 25(OH)D increases. Conclusions: Vitamin D effectively corrects deficiencies in aquatic athletes but lacks consistent ergogenic benefits. Therefore, in practice, supplementation should serve primarily as a targeted corrective measure for deficiency to support fundamental musculoskeletal health, rather than a generalized strategy for performance enhancement. Full article
(This article belongs to the Special Issue Exercise Physiology and Biochemistry: 3rd Edition)
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30 pages, 2389 KB  
Review
Applications of Deep Learning to Metal Surface Defect Detection: Status and Challenges
by Yizhe Wang, Mengchu Zhou, Chenyang Zhang and Khaled Sedraoui
Processes 2026, 14(8), 1305; https://doi.org/10.3390/pr14081305 - 19 Apr 2026
Viewed by 111
Abstract
The detection technology for metal surface defects plays a crucial role in improving metal product quality and production efficiency in various manufacturing and 3-D printing factories. Metal defect detection faces scale variation and irregular shapes, which limit the adaptability of general object detection [...] Read more.
The detection technology for metal surface defects plays a crucial role in improving metal product quality and production efficiency in various manufacturing and 3-D printing factories. Metal defect detection faces scale variation and irregular shapes, which limit the adaptability of general object detection models in industrial scenarios. Deep learning-based methods are widely used for metal surface defect detection due to their strong adaptability and high automation. Yet, their existing studies pay limited attention to adaptability, evaluation, and recommendations across different detection methods for metal surface defects. This work mainly discusses YOLO, R-CNN, and transformers, as well as FPN, and analyzes their applications in metal surface defect detection according to their respective characteristics, to provide guidance for future research. YOLO has advantages in real-time industrial online detection, while R-CNN and transformer models show potential advantages in handling complex defect cases. Additionally, this work summarizes commonly used datasets and evaluation metrics for metal surface defect detection and analyzes the benchmark performance of different types of detection methods. It also discusses future research directions, including the current status and improvement paths of different models in terms of accuracy, real-time performance, and adaptability. Future models should focus on balancing accuracy and real-time performance, exploring new hybrid architectures, and improving adaptability to different metal surface defects to support further development in this field. Full article
24 pages, 545 KB  
Article
Does Support Meet the Need? A Focus Group Study on Parental Support and Students’ Psychological Need Satisfaction in a Minority School Context
by Aikaterini Vasiou, Servet Altan, Eleni Vasilaki, Aristea Mavrogianni, Georgios Vleioras, Marinos Anastasakis and Konstantinos Mastrothanasis
Healthcare 2026, 14(8), 1082; https://doi.org/10.3390/healthcare14081082 - 18 Apr 2026
Viewed by 314
Abstract
Background: Parental practices that support autonomy, provide structure, and foster warm relationships are associated with greater satisfaction of students’ basic psychological needs for autonomy, competence, and relatedness. In minority educational contexts, however, students’ psychological need satisfaction is also shaped by broader sociocultural conditions [...] Read more.
Background: Parental practices that support autonomy, provide structure, and foster warm relationships are associated with greater satisfaction of students’ basic psychological needs for autonomy, competence, and relatedness. In minority educational contexts, however, students’ psychological need satisfaction is also shaped by broader sociocultural conditions that may create additional pressures and sources of chronic stress. Within such environments, parental support may function as a protective factor that helps students cope with educational and cultural demands. Objective: The aim of this study was to explore how parental support contributes to the satisfaction of students’ basic psychological needs within a minority educational context where students from the Greek minority attend a bilingual school operating within a Turkish educational framework. Methods: A qualitative design was employed using three focus groups conducted in a minority school located in Gökçeada, Türkiye: one with parents (N = 5), one with lower secondary school students (N = 6), and one with upper secondary school students (N = 6). Interview questions were developed on the basis of Basic Psychological Needs Theory. Data were analyzed thematically by five members of the research team. Results: Findings indicated that parental support influenced students’ need satisfaction through practices related to autonomy (e.g., trust, space for mistakes), competence (e.g., encouragement, comparison), and relatedness (e.g., emotional presence, empathy). However, these practices were not experienced in a uniform way. Rather, their meaning and impact were shaped by contextual conditions associated with minority status, including bilingual educational demands, limited resources, and close-knit community dynamics. Conclusions: The study suggests that in minority school settings, parental support operates not simply as a general interpersonal resource but as a contextually mediated protective process. By showing how sociocultural and institutional conditions shape the enactment and experience of autonomy, competence, and relatedness, the findings extend existing BPNT research beyond majority settings and offer a more context-sensitive understanding of students’ psychological need satisfaction. Full article
11 pages, 3065 KB  
Article
Dose-Dependent Efficacy of Nefopam for Preventing Catheter-Related Bladder Discomfort in Patients Undergoing Transurethral Ureteroscopic Lithotripsy: A Retrospective Case–Control Observational Study
by Jae Hun Hwang, Hyung Rae Cho, Ju-Yeun Lee, Seo Yeon Lee and Jiyoung Kim
J. Clin. Med. 2026, 15(8), 3099; https://doi.org/10.3390/jcm15083099 - 18 Apr 2026
Viewed by 130
Abstract
Background/Objectives: Catheter-related bladder discomfort (CRBD) is a common complication that patients with Foley catheters may experience following surgery. Previous studies have suggested that nefopam can reduce the incidence and severity of CRBD; however, dose-dependent effects (20 mg vs. 40 mg) have not [...] Read more.
Background/Objectives: Catheter-related bladder discomfort (CRBD) is a common complication that patients with Foley catheters may experience following surgery. Previous studies have suggested that nefopam can reduce the incidence and severity of CRBD; however, dose-dependent effects (20 mg vs. 40 mg) have not been directly compared. Therefore, this study aimed to evaluate the dose-dependent effects of nefopam on CRBD, determine its effective dose, and assess the incidence of associated side effects. Methods: Electronic medical records of patients aged 18–70 years with American Society of Anesthesiologists physical status I–III who underwent elective transurethral ureteroscopic lithotripsy under general anesthesia from August 2016 to December 2022 were reviewed. Patients were categorized into three groups: premedication with intravenous nefopam 20 mg (group N20), premedication with nefopam 40 mg (group N40), or no premedication (control, group C). Results: The incidence rates of CRBD were 85.7% in group C, 81.3% in group N20, and 51.4% in group N40, showing a significant difference among the groups (p = 0.003, Pearson’s chi-squared test). Postoperative NRS was significantly different among the groups (p < 0.001, one-way ANOVA). In post hoc analysis, both group N20 and group N40 showed significantly lower scores compared to group C (p = 0.002, p = 0.001 respectively). The severity of CRBD also decreased in a dose-dependent manner, which was considered significant. No significant differences were observed among the groups in terms of intraoperative hemodynamic stability or postoperative nausea and vomiting. Conclusions: The administration of nefopam 40 mg significantly reduced the incidence and severity of CRBD compared with no premedication. Full article
(This article belongs to the Section Anesthesiology)
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18 pages, 1854 KB  
Article
Heterogeneity of PD-L1 Expression Between the Primary Tumor and Matched Lymph Node Metastases in Head and Neck Squamous Cell Carcinomas
by Moritz Knebel, Gilbert Georg Klamminger, Jan Philipp Kühn, Sandrina Körner, Silke Wemmert, Lukas Alexander Brust, Felix Braun, Sigrun Smola, Mathias Wagner, Martin Ertz, Luc G. T. Morris, Bernhard Schick and Maximilian Linxweiler
Cancers 2026, 18(8), 1286; https://doi.org/10.3390/cancers18081286 - 18 Apr 2026
Viewed by 204
Abstract
Background: The role of immune checkpoint inhibition in treating head and neck squamous cell carcinoma (HNSCC) is expanding, yet response rates to PD-L1 therapy remain inconsistent and generally poor. Although several studies have examined heterogeneous intratumoral PD-L1 expression, the disparity in response [...] Read more.
Background: The role of immune checkpoint inhibition in treating head and neck squamous cell carcinoma (HNSCC) is expanding, yet response rates to PD-L1 therapy remain inconsistent and generally poor. Although several studies have examined heterogeneous intratumoral PD-L1 expression, the disparity in response to PD-L1 therapy between primary tumors and their associated lymph node metastases remains unclear. Methods: Primary tumor samples and two matching lymph node metastases were obtained from a cohort of 50 patients and immunohistochemically stained with a PD-L1 antibody. PD-L1 expression, assessed using the combined positive score (CPS) and tumor proportion score (TPS), and immune infiltration, measured with an immunoreactive score (IRS), were compared between the primary tumor and lymph node metastases. These measures were then correlated with other histopathological and clinical features. Results: PD-L1 expression, evaluated by CPS and TPS, showed no significant differences between the primary tumor and matched lymph node metastases. Discordance relative to established regulatory cut-offs was observed in a subset of patients, affecting 18% (CPS; 95% CI, 8.0–30.0%) and 4% (TPS; 95% CI, 0.0–10.0%) of cases. CPS and TPS values were not influenced by primary tumor subsite or HPV status. Conversely, immune infiltration measured by IRS was significantly affected by primary tumor subsite location. Both HPV tumor status and primary tumor subsite were statistically significantly associated with overall survival. Conclusions: Our findings highlight variability in PD-L1 expression in HNSCC and may offer context for differential responses of primary tumors and lymph node metastases to immune checkpoint therapy reported in recent clinical studies. These observations support the need for a more comprehensive characterization of PD-L1 expression across tumor sites in head and neck cancer. Further investigation is required to determine whether, and in which settings, reassessment of PD-L1 status in metastatic lesions—including lymph node metastases—may provide additional clinically relevant information when initial testing does not meet established therapeutic cut-offs. Full article
(This article belongs to the Special Issue Senescence and Cell Plasticity in Cancer Development)
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14 pages, 518 KB  
Article
Beyond Psychological Trauma: Associations of Nutritional Status with Depression in Child and Adolescent Victims of Crime
by Ahmet Depreli, Emre Adıgüzel, Burcu Çavdar and Fatma Coşkun
Healthcare 2026, 14(8), 1075; https://doi.org/10.3390/healthcare14081075 - 17 Apr 2026
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Abstract
Background/Objectives: Children and adolescents exposed to criminal victimization are at increased risk for depression; however, the contribution of nutritional status to depressive symptom severity in this vulnerable population remains poorly understood. Therefore, we aimed to examine the associations between depression severity and nutritional [...] Read more.
Background/Objectives: Children and adolescents exposed to criminal victimization are at increased risk for depression; however, the contribution of nutritional status to depressive symptom severity in this vulnerable population remains poorly understood. Therefore, we aimed to examine the associations between depression severity and nutritional parameters in child and adolescent victims of crime. Methods: This cross-sectional study included 72 children and adolescents (aged 10–16 years) referred to a forensic medicine department in Türkiye. Nutritional status was assessed using anthropometric measurements (body weight, body mass index [BMI], BMI-Z score, and body fat percentage), three-day dietary records, and the Mediterranean Diet Quality Index (KIDMED). Depression severity was evaluated using the Kutcher Adolescent Depression Scale (KADS). The associations were analyzed using Pearson’s rho correlation and forward stepwise linear regression. Potential confounding variables, including age, gender, socioeconomic status, and trauma-related characteristics, were recorded and considered during the analysis; however, due to the limited sample size and to avoid model overparameterization, they were not fully adjusted for in the final model. Results: Depression severity was positively correlated with the body weight, BMI, BMI-Z score, body fat percentage, and dietary energy, carbohydrate, protein, and fat intakes (all p < 0.05). In contrast, the vitamin C and dietary fiber intakes, breastfeeding duration, and KIDMED scores were negatively correlated with the KADS scores (p < 0.05). Regression analysis revealed that the lower KIDMED scores, higher body fat percentage, and greater body weight were significantly associated with depression severity, collectively explaining 82.2% of the variance in the KADS scores. Conclusions: Poor diet quality and adverse body composition are strongly associated with depression severity in child and adolescent victims of crime. These findings suggest that nutritional factors may be associated with depression severity in child and adolescent victims of crime; however, the results should be interpreted as preliminary and hypothesis-generating. Full article
(This article belongs to the Section Mental Health and Psychosocial Well-being)
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