Search Results (29,288)

The southeastern coastal region of China is extensively influenced by the circum-Pacific geothermal activity, particularly during the excavation of deep-buried tunnels, where the confined space leads to the accumulation of heat flow, resulting in high-temperature and high-humidity environments. These conditions are detrimental to both the physical and mental health of workers and the safe operation of equipment. Based on this, the Lijiashan deep-buried high-temperature tunnel along the Wen-Yu High-Speed Railway (Wenling-Yuhuan) was selected as a case study. Field monitoring was conducted to assess the surrounding rock stress, temperature distribution characteristics of the surrounding rock and structure, and the humid and high-temperature environment within the tunnel during construction. A comprehensive evaluation index considering both temperature and humidity was employed to evaluate the tunnel construction environment. The results indicate the following: (1) During tunnel excavation, the maximum surrounding rock pressure occurs at the arched shoulder, and the fractures induced by blasting effectively relieve stress, mitigating the risk of rockburst. (2) The seepage paths of the surrounding rock are redistributed during excavation, converging towards the invert, with the osmotic pressure being approximately 10 times that of the upper structure. (3) The temperature at the tunnel face, secondary lining, and surrounding rock is significantly influenced by the heat released from concrete hydration. The closer the surrounding rock is to the support structure, the higher the temperature, with the secondary lining reaching up to 58.6 °C and the working area up to 35.2 °C. (4) Water spraying can reduce the temperature in the construction area by approximately 0.65% at the Kelvin temperature conditions, but it increases humidity by about 16%. The average humidity levels within the tunnel are 75.3% during the day and 87.5% at night. (5) Evaluation of workers’ physiological parameters reveals that the humid and high-temperature environment during tunnel construction is consistently unfavorable for workers’ health. Full article

Background/Objectives: Artificial intelligence (AI) is increasingly used in clinical decision-support systems, yet its adoption in low- and middle-income countries, including Jordan, remains limited and underexplored. Understanding how healthcare professionals perceive AI-assisted clinical decision-making is essential for safe and contextually appropriate implementation. This study explored healthcare professionals’ perceptions of AI-assisted clinical decision-making in Jordan, with particular attention to trust, accuracy, accountability, professional judgement, digital literacy, and health-system readiness. Medication-related safety and prescribing concerns were examined as secondary cross-cutting issues where they emerged from participants’ accounts. Methods: A qualitative study was conducted using semi-structured, in-depth interviews with 22 purposively sampled healthcare professionals from public, private, and university-affiliated healthcare institutions in Amman, Irbid, and Zarqa. Participants included physicians, nurses, pharmacists, and allied health professionals with varied specialties and levels of seniority. Data were analysed using Braun and Clarke’s reflexive thematic analysis. Member checking, peer debriefing, reflexive memos, and audit trails were used to enhance trustworthiness, and reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). Results: Eight overarching themes were identified: conditional trust in AI-assisted clinical decision-making; concerns regarding accuracy and confident algorithmic errors; accountability and professional responsibility; AI as an adjunct rather than a substitute for clinical judgement; the influence of experience, specialty, and digital literacy on AI acceptance; Jordanian health-system readiness; privacy, confidentiality, and algorithmic bias; and training requirements for safe AI use. Medication-related safety emerged as a cross-cutting concern, particularly in relation to dosing, polypharmacy, drug–drug and drug–herb interactions, and the risk of over-reliance on AI-generated recommendations. Conclusions: Healthcare professionals in Jordan expressed cautious but constructive views toward AI-assisted clinical decision-making. AI was perceived as potentially useful when used to support, rather than replace, professional judgement. Participants’ accounts suggest that safe implementation depends on local validation, clear accountability frameworks, ethical data governance, interprofessional training, and careful consideration of medication-safety expertise where AI tools influence prescribing or therapeutic decisions. These findings highlight the importance of context-sensitive AI governance strategies that support trustworthy, accountable, and professionally supervised AI adoption in healthcare. Full article

Background: Previous research has confirmed that dietary diversity is positively linked to mental health outcomes in older populations. Nevertheless, relevant evidence focusing specifically on Chinese older adults remains limited, and the internal mechanisms underlying this association I confirm. are not fully understood. Against this background, this study intended to investigate the association between dietary diversity and mental health among Chinese older individuals, explore the chain mediating roles of sleep quality and self-perceived quality of life, and further test whether gender moderates the above direct and mediating pathways. Methods: Using 2018 CLHLS data, 10,089 older adults aged 60 and above were selected as valid samples. Pearson correlation analysis was employed to determine the relationships between key variables. Hayes’ PROCESS macro Model 6 was used for baseline serial mediation analysis, and Model 85 was used for moderated serial mediation with gender as the moderator, adopting 5000 bootstrap samples. Results: The results revealed significant positive correlations (p < 0.01) between key variables, including dietary diversity, sleep quality, self-rated quality of life, and mental health. Model 6 showed that dietary diversity serves as a positive and significant predictor of mental health (B = 0.130, p < 0.001). Three significant mediating pathways were identified through which dietary diversity affects mental health: (1) sleep quality (B = 0.076, 95% CI: 0.062, 0.092), (2) self-rated quality of life (B = 0.100, 95% CI: 0.083, 0.118), and (3) sleep quality and self-rated quality of life (B = 0.020, 95% CI: 0.016, 0.025). The total mediating effect of the three pathways reached 59.94%. Model 85 found that the interaction term of dietary diversity x gender was non-significant (p > 0.05), demonstrating no statistically significant gender moderation of any pathway. Gender-stratified conditional effects revealed numerical differences across subgroups. Conclusions: Higher dietary diversity is significantly correlated with better mental health among Chinese older adults. Sleep quality and self-rated quality of life play significant roles as serial mediators in this association. Although gender does not statistically moderate the whole association mechanism, subtle gender heterogeneity exists in the pathway effect magnitude. The above findings offer novel insights into the underlying mechanisms. Strategies aimed at improving dietary diversity, combined with targeted interventions to enhance sleep quality and self-rated quality of life, with slight gender-differentiated auxiliary suggestions, may effectively promote mental health and contribute to active aging in later life. Full article

Introduction: Population aging is a growing and challenging phenomenon, primarily due to its association with functional decline and sarcopenia, which increase the risk of falls. These events have significant impacts on public health and the quality of life of older adults. Regular physical activity has shown benefits in reducing falls and their consequences, with systemic vibratory therapy (SVT) emerging as a promising strategy to mitigate these adverse outcomes. However, evidence on the actual effectiveness of this therapeutic approach remains limited, as does clarity regarding optimal body position, protocol parameters, and equipment when combined with physical activity programs. Objectives: To compare the effect of systemic vibratory therapy (SVT) associated with a physical activity program on the perception of fear of falling in older adults (M01.060.116.100). As secondary outcomes, the study will assess functional physical conditioning, electromyographic activity, muscular synergy, and center of pressure oscillation in this population. Methods: A randomized controlled clinical trial with blinded outcome assessors and blinded statistical analysis will be conducted with 192 older adults participating in the UNATI/UNISUAM program. Participants will be allocated into three groups: (A) usual physical activity; (B) usual physical activity + SVT in a semi-squat position; and (C) usual physical activity + SVT in a seated position. Assessments will include sociodemographic data, concern about falling assessed using the Falls Efficacy Scale-International (FES-I), physical performance (2 min stationary march test), surface electromyography of the tibialis anterior and medial gastrocnemius muscles, along with posturography using a force platform. Results: This study will provide information on outcomes related to fall risk, balance, physical fitness, and neuromuscular variables in older adults undergoing two distinct SVT protocols. Clinical Trials Registration: Brazilian Registry of Clinical Trials RBR-68pry5j. Registered on 8 December 2025. Full article

This study presents an integrated framework for agricultural drought monitoring in data-scarce regions, utilizing the Google Earth Engine (GEE) platform to analyze multisource Earth observation data over the South Wollo highlands, Ethiopia, from 2001 to 2024. The analysis was complemented by Mann–Kendall trend testing, Sen’s slope estimation, and Pettitt change-point detection to identify and quantify long-term trends and abrupt shifts in drought dynamics. The methodology integrates climatic and satellite-derived indicators within a hybrid analytical framework. It incorporates the standardized precipitation evapotranspiration index (SPEI), vegetation condition index (VCI), vegetation health index (VHI), temperature condition index (TCI), and land surface temperature (LST), which are derived from MODIS (NDVI, LST, PET) and CHIRPS precipitation datasets. The analysis focused on the main growing season (June–September) to capture critical crop growth and moisture-sensitive periods for agricultural production in the study area. The findings reveal pronounced interannual variability in drought occurrence and intensity across the study period. Severe agricultural drought conditions were most extensive in 2009 and 2014, with VHIs indicating 15% and 4% of the area under severe and extreme drought in 2009, respectively, and 2.6% and 2% in 2014, respectively. In contrast, 2001, 2005, 2020, and particularly 2024 were characterized by predominantly no-drought to mild-drought conditions, with no-drought coverage increasing from 86.7% (2009) to 98.0% (2024). Vegetation-based indices demonstrate that drought impacts are episodic rather than persistent and strongly controlled by rainfall timing and early-season moisture availability. The LST exhibited marked year-to-year variability (28.8 °C to 33.8 °C), with elevated temperatures coinciding with drought periods and suppressed evaporative cooling. Correlation analysis confirmed a strong positive relationship between the SPEI and VHI (r = 0.77), with moderate correlations for the VCI (r = 0.40) and TCI (r = 0.36), underscoring the sensitivity of integrated vegetation health to the climatic water balance. The study concludes that combining the SPEI with satellite-derived vegetation and thermal indices provides a robust, scalable approach for agricultural drought assessment in regions with limited ground-based observations. The integrated framework effectively captures both moisture deficits and thermal stress components, offering a scientific basis for improving drought early warning systems and climate-resilient agricultural planning in Ethiopia and similar environments. Full article

Sustainable urban air quality in tropical cities is threatened by interactions between climate change, extreme drought, and long-range wildfire smoke transport. This study investigated the causes of PM_2.5 pollution in Manaus, Brazil, under El Niño conditions during the 2023 drought, focusing on long-range wildfire smoke transport. The links among hydroclimatic drying, wildfire activity, and urban air quality were examined using hourly PM_2.5 observations, meteorological data, long-term climate records, MODIS hotspot and fire radiative power (FRP) data, and air-mass trajectory analyses. Significant long-term warming, decreasing precipitation, and a declining standardized precipitation evapotranspiration index were observed around Manaus during 1981–2024, indicating persistent drying. In 2023, severe drought and increased wildfire activity caused an annual mean PM_2.5 concentration of 15.09 µg m⁻³. Directional analyses, upwind FRP, potential source contribution function, and backward trajectories consistently highlighted the eastern and southeastern source regions approximately 500–2200 km from Manaus. These results indicated that PM_2.5 levels were more sensitive to spatial alignment between upwind fires and prevailing winds than to total fire activity alone. In conclusion, the 2023 PM_2.5 surge was driven by long-range wildfire smoke transport under intensified drying and drought, with implications for urban sustainability, public health, and climate-resilient early warning systems. Full article

The Mediterranean diet (MedDiet) has emerged as a promising dietary strategy for the prevention and management of type 2 diabetes mellitus (T2DM). This narrative review provides a comprehensive synthesis linking the biological pathways of the MedDiet with established clinical evidence. Adherence to this traditional dietary pattern—characterized by a high intake of fiber, complex carbohydrates, antioxidants, and healthy fats—has demonstrated significant benefits in terms of glycemic control, enhanced insulin sensitivity, and overall metabolic health. Mechanistically, the review explains how the MedDiet improves health by modulating key physiological processes, including anti-inflammatory and antioxidant pathways, the regulation of branched-chain amino acid metabolism, the enhancement of short-chain fatty acid production via gut microbiota modulation, and upregulated incretin effects. Importantly, this review explains how the MedDiet complements modern medications, including glucagon-like peptide-1 (GLP-1) receptor agonists and sodium–glucose cotransporter-2 (SGLT-2) inhibitors. By integrating molecular mechanisms with human clinical outcomes, this narrative review addresses multiple aspects of the MedDiet in both the prevention and management of T2DM including glycemic control, weight management, and cardiovascular risk reduction, rendering it a valuable dietary strategy for both the prevention and treatment of this chronic condition. Full article

Reproductive efficiency is a critical determinant of productivity and profitability in both dairy and beef cattle systems. Progesterone-based estrus synchronization protocols have emerged as essential tools to control the timing of ovulation, enhance artificial insemination efficiency, and optimize herd reproductive performance. These protocols exploit the physiological regulation of the hypothalamic–pituitary–ovarian axis, maintaining elevated progesterone levels to suppress ovulation and coordinating luteolysis and follicular wave emergence through prostaglandins, GnRH analogues, and, in some cases, equine chorionic gonadotropin. In beef cattle, progesterone supplementation facilitates fixed-time artificial insemination, shortens calving intervals, and improves calf crop uniformity, whereas in dairy cows it mitigates poor estrus detection, enhances service rates, and reduces days open. Fertility outcomes are influenced by cow physiological status, metabolic condition, and protocol adherence, with pregnancy per AI typically ranging from moderate to high in beef cattle and lower in lactating dairy cows. Economic evaluation indicates that these protocols are cost-effective in herds with moderate to large size, low estrus detection efficiency, and intensive management, although labor, drug costs, and handling requirements must be considered. Critical analysis suggests that synchronization cannot compensate for underlying nutritional, health, or metabolic deficiencies, and future research should focus on precision application, individualized protocols, and integration with automated reproductive monitoring to improve both biological and economic efficiency. This review summarizes physiological principles, protocol designs, practical applications, fertility outcomes, and economic considerations of progesterone-based estrus synchronization in cows, highlighting current challenges and perspectives for enhanced reproductive management. Full article

Reproductive emergencies in male dromedary camels (Camelus dromedarius) threaten fertility, health, and welfare but remain poorly documented. This review consolidates knowledge on the diagnosis, management, and prognosis of acute reproductive pathologies, including traumatic injuries (testicular trauma, penile hematoma, and preputial laceration), obstructive conditions (urethral obstruction, phimosis, and paraphimosis), vascular emergencies (spermatic cord torsion, priapism), inflammatory diseases (orchitis, epididymitis, pizzle rot), congenital anomalies (persistent frenulum), iatrogenic complications, and pharmacologic-induced dysfunction. Systematic breeding soundness examination and ultrasonography are indispensable for assessing testicular perfusion and guiding intervention. Given the scarcity of camel-specific literature, this narrative clinical review integrates evidence from published camelid studies, relevant reports from other domestic species, and representative clinical observations documented by the authors to provide a practical framework for diagnosis and management. Field constraints, the stoic nature of camels, and harmful ethnoveterinary practices often delay diagnosis and compromise outcomes. Prognosis varies considerably depending on the condition and timeliness of intervention; early aggressive management can preserve reproductive function, while delayed treatment frequently results in permanent infertility or death. Given the economic and cultural importance of camels in arid regions, improving outcomes for reproductive emergencies is essential for sustaining breeding programs and enhancing animal welfare. This narrative clinical review integrates published literature with representative clinical observations and retrospective field cases to summarize the diagnosis, management, and prognosis of reproductive emergencies in male dromedary camels. It also provides a structured clinical framework to support veterinarians in managing these acute conditions and highlights critical gaps requiring further research. Full article

Background: Multiple sclerosis (MS) is a condition that requires long-term, multidisciplinary management. The growing digital transformation in healthcare has highlighted the central role of nurses in supporting key aspects such as patient self-management, continuity of (at home) care, and patient empowerment. However, evidence on nurse-led digital interventions in MS remains fragmented. Objective: To map the available literature on nurse-led digital interventions in MS, focusing on the role of nurses, clinical outcomes, and research gaps. Methods: The review was conducted using the methodological framework of the Joanna Briggs Institute (JBI) and the PRISMA-ScR checklist. A systematic search was performed in PubMed, Scopus, Web of Science, and CINAHL. Studies were included if they described digital or telehealth interventions led or coordinated by nurses in patients with MS. Results: A total of 12 studies published between 2015 and 2025 met the inclusion criteria. Four main thematic areas were identified: (1) telenursing and empowerment-based interventions; (2) mobile and web-based patient self-management programs; (3) digital systems for monitoring and integrated care pathways; and (4) digital interventions targeting symptom management and psychosocial outcomes. Across the studies, nurse-led digital interventions were associated with improvements in self-management, treatment adherence, self-efficacy, and health-promoting behaviors. Positive effects were also reported on clinical outcomes such as fatigue, sleep quality, and balance, as well as on psychosocial variables including quality of life, coping strategies, and emotional well-being. Furthermore, the identified systems, in general, contributed to enhanced continuity of care, patient engagement, and organizational efficiency. Conclusions: Nurse-led digital interventions represent a promising approach in the management of patients with multiple sclerosis, supporting both clinical and psychosocial outcomes while enhancing continuity of care. However, the current evidence base remains limited by small sample sizes, heterogeneity of interventions, and short follow-up periods. Future research should prioritize multicenter randomized studies with larger samples and long-term follow-up to strengthen the evidence. Additionally, the integration of digital interventions into routine clinical practice, along with targeted training for nurses, is essential to ensure sustainability, accessibility, and equitable implementation. Further studies should also explore cost-effectiveness and the impact on caregivers and long-term quality of life. Full article

Background: Synaptic plasticity in neurodegenerative disorders (NDs), cognitive impairment, and mental health conditions is regulated by brain-derived neurotrophic factor (BDNF). Even healthy individuals have different levels, which are affected by complex epigenetic, inflammatory, and metabolic regulation. BDNF expression changes are associated with both typical and abnormal aging, as well as mental health conditions. These changes affect brain areas that are crucial for memory, such as the hippocampus and the parahippocampal cortex. Neurotrophins (NTs), including nerve growth factor (NGF) and BDNF, are essential for neuronal differentiation via tropomyosin receptor kinase B (TrkB) and the p75 neurotrophin receptor (p75NTR). Dysregulated NTs signaling contributes to synaptic dysfunction and neuroinflammation. Objective: This systematic review synthesizes preclinical evidence of the potential of naturally derived compounds to modulate NTs for neuroprotection and their incorporation into novel foods. Methodology: A review of major databases found studies that examined the impact of dietary polyphenols and other bioactive substances on NT signaling oxidative stress, inflammation, and neuronal plasticity. Results: Compounds such as epigallocatechin gallate, resveratrol, curcumin, quercetin, and flavanols, can positively impact NTs, reducing reactive oxygen species/reactive nitrogen species, enhancing cell survival, and increasing the expression of trophic factors such as nuclear factor erythroid 2-related factor 2 (Nrf2), NGF, and vascular endothelial growth factor in neural stem cells. However, their bioavailability, optimal dosage, and dietary interactions require further research. Conclusions: The consumption of BDNF-promoting foods can potentially stimulate BDNF synthesis, support optimal neurotransmission, and fortify neural plasticity. Evidence supports a polyphenol-rich diet for preventing NDs and promoting brain health. Observational studies consistently support the protective effects of polyphenols on brain health through their impact on the gut–brain axis. Full article

Soil biological activity integrates microbial processes involved in organic matter decomposition and nutrient cycling, yet its long-term response under agricultural systems in Paraguay remains poorly documented. This study evaluated soil biological activity in a 32-year field experiment in the Eastern Region of Paraguay, comparing cropping systems differing in tillage intensity and crop rotation diversification. Soil samples from the 0–20 cm layer were analyzed for microbial biomass carbon (MBC), β-glucosidase (BG), urease (URE), acid phosphatase (AP), arylsulfatase (ARS), soil organic carbon (SOC), total nitrogen (TN), available phosphorus (P), sulfur (S), and pH. Our results revealed that BG, URE, and AP increased under no-tillage, particularly in the most diversified no-tillage rotation, with 71%, 90%, and 51% higher activities, respectively, than conventional tillage. MBC and ARS were not significantly affected by cropping systems. Principal component analysis, Spearman correlations, and Mantel analysis indicated that enzymatic responses were associated with SOC, TN, P, S, and pH, linking soil biological activity with chemical attributes related to nutrient cycling. These findings show that diversified no-tillage strengthens soil biological functioning under representative Paraguayan grain-production conditions, providing long-term local evidence to guide soil-health management, crop diversification strategies, and more sustainable agricultural systems in the region. Full article

Background: Over the years, it has become increasingly clear that neurological conditions, such as multiple sclerosis (MS), commonly exhibit other health problems. Therefore, this is the first study aimed at investigating the prevalence of and factors associated with three binary outcomes: depression, anxiety, and an overactive bladder (OAB) among MS patients in the Qassim region, Saudi Arabia. Methods: This cross-sectional study was conducted in the neurological department of King Fahad Specialist Hospital in the Qassim region, Saudi Arabia, from January to December 2024. Data on age, sex, marital status, occupation, body mass index (BMI), MS duration, comorbidities, anxiety, depression, and OAB symptoms (frequency, nocturia, urgency, and urge incontinence) were obtained. Results: Of the 262 MS patients in this study, 184 (70.2%) were females, and 78 (29.8%) were males. The median values [IQR] of age and MS duration were 34 [26–40] and 5 [2–9] years, respectively. The prevalence of depression, anxiety, and OAB were 53.4%, 43.9%, and 50%, respectively. Nocturia was the most frequent urinary symptom, and urge incontinence was significantly higher among females. Multiple logistic regression analyses were conducted to assess factors associated with three binary outcomes: depression, anxiety, and OAB. For depression, being single and anxiety were associated with increased risk. Regarding anxiety, being a student was related to decreased risk, while being female and having depression were associated with increased risk. For OAB, only anxiety was associated with increased risk. Conclusions: Approximately one in two MS patients experience either depression or OAB, while anxiety was reported by fewer than half of the patients. This high prevalence of the three outcomes has critical implications for healthcare policy and resource allocation. Thus, screening, early diagnosis, and intervention, as well as integrated care, should be prioritized by healthcare institutions and practitioners to address these conditions and improve MS patients’ quality of life. Full article

Against the backdrop of rapid urbanization, urban sewer networks face increasing challenges, including infrastructure deterioration and imbalanced resource allocation. Conventional single-dimensional risk assessment methods fail to capture the coordinated development of such complex systems. This study proposes a comprehensive HFM framework integrating Health (H), Failure (F), and Management (M), coupled with a Coupling Coordination Degree (CCD) model and an obstacle degree model to evaluate system interactions and identify key constraints. A game theory-based weighting approach combining AHP and CRITIC is applied to integrate subjective and objective weights, while fuzzy mathematics is used for multidimensional evaluation. CCD spatial analysis is conducted at the drainage unit scale. Results show that: (1) The system is in a transitional stage from disorder to coordination, with CCD values mainly ranging from 0.4 to 0.8 and exhibiting significant spatial heterogeneity. (2) High-risk areas tend to have better health conditions and stronger management inputs, whereas low-risk areas may still face latent risks due to insufficient management. (3) Key obstacles are concentrated in Failure and Management systems, particularly pipeline functionality and management capacity. Overall, system risk arises from mismatches between risk sources and management allocation rather than purely structural deficiencies. The proposed framework effectively identifies imbalance areas and priority interventions, supporting the transition toward proactive risk regulation. Full article

Digital isolation represents a contemporary paradox in which increased connectivity through social media and digital technologies does not necessarily translate into improved social integration or psychological well-being. This review synthesizes current evidence on the relationship between digital environments and mental health, with a focus on mechanisms underlying loneliness, anxiety, depression, and related outcomes. The findings indicate that problematic and passive use of social media—particularly when associated with social comparison processes and Fear of Missing Out (FoMO)—is consistently linked to increased levels of depressive symptoms, anxiety, sleep disturbances, and reduced well-being. At the same time, the evidence highlights substantial heterogeneity, suggesting that the impact of digital technologies is moderated by user characteristics, age, patterns of engagement, and psychosocial context. Importantly, digital technologies may also serve compensatory and protective functions by facilitating social support, especially in conditions of objective isolation. Key mediating mechanisms include cyberbullying, social exclusion, emotional contagion, and internalization of body image standards. The concept of “digital loneliness” emerges as a useful framework for understanding the discrepancy between constant connectivity and perceived relational insufficiency. Practical implications emphasize the need for targeted interventions focusing on digital literacy, healthy usage patterns, and psychosocial support rather than simplistic reduction in screen time. Overall, digital isolation should be conceptualized as a qualitative dysfunction of mediated social interaction rather than a purely quantitative effect of technology exposure. Full article