Search Results (9,844)

Background/Objectives: Identifying consistent patterns across empathy domains can help clinicians understand how empathy relates to burnout, covert narcissism, and other personality traits, thereby enhancing the effectiveness of clinical training. We examined empathy and assessed whether burnout, covert narcissism, and other personality traits show consistent associations across empathy domains. Methods: This cross-sectional study included 213 medical residents from a teaching and public tertiary care facility in Mexico. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, the Hypersensitive Narcissism Scale, and the Zuckerman–Kuhlman Personality Questionnaire were applied. Nonparametric partial correlations were calculated, controlling for sex, age, specialty, year of residency, and psychological well-being. Results: On a 7-point Likert scale, the mean scores for perspective-taking, compassionate care, and the ability to stand in the patient’s shoes were 6.0 ± 0.8, 6.0 ± 1.0, and 4.1 ± 1.2, respectively. Depersonalization was negatively correlated with all empathy domains: perspective-taking (Spearman’s ρ = −0.20, p = 0.04), compassionate care (Spearman’s ρ = −0.30, p < 0.0001), and the ability to stand in the patient’s shoes (Spearman’s ρ = −0.25, p < 0.0001). The associations between other components of burnout, covert narcissism, and the remaining personality traits varied according to the domain of empathy. Conclusions: Depersonalization showed consistent, albeit modest, negative associations with all empathy domains, whereas the remaining psychological factors showed domain-specific relationships. Differentiating between empathy domains is essential, as it allows medical educators and clinicians to tailor interventions to specific components rather than treating empathy as a unitary construct. Full article

Background/Objectives: Major Depressive Disorder (MDD) affects over 280 million people worldwide and is a leading cause of disability. Emotional blunting—characterized by a numbing or flattening of emotions—is a significant yet often underrecognized symptom that impairs daily functioning and interpersonal relationships in patients with MDD. It remains unclear whether emotional blunting results primarily from the disorder itself or from antidepressant treatments, especially selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs). Vortioxetine, a multimodal antidepressant approved for MDD, may help alleviate emotional blunting by modulating neurotransmitters differently than SSRIs. This study investigates the severity of emotional blunting among Hong Kong MDD patients and explores the changes in this symptom with the use of vortioxetine, while also considering anhedonia as a related dimension of reward processing. Methods: This naturalistic, longitudinal observational study in Hong Kong enrolled adults (aged 18 and above) clinically diagnosed with MDD who were initiating vortioxetine treatment for emotional blunting. Patient inclusion was based on independent prescribing decisions by psychiatrists, with informed consent obtained. Data collection comprised one intake interview and the administration of four self-report questionnaires—ODQ, PHQ-9, PDQ-D, SDS, MFI, and SHAPS—at baseline, week 1, week 4, and week 8. Demographic and clinical history data were also recorded. Questionnaires were completed online or via phone, over a study duration of approximately two months. Results: The prevalence of emotional blunting, estimated by the proportion of patients with an ODQ score at or above the clinical cut-off (≥50), was 91.9% at baseline, decreasing to 85.5% at week 1, 77.7% at week 4, and 73.3% at week 8. Significant improvements were also observed in depressive symptoms, cognitive dysfunction, functional impairment, pleasure experience, and fatigue. Conclusions: In this naturalistic observational cohort of patients with MDD who were prescribed vortioxetine, self-reported emotional blunting, depressive symptoms, cognitive dysfunction, functional impairment, and fatigue decreased over eight weeks. Anhedonia scores (SHAPS) decreased to non-significant levels, and clinician-rated Clinical Global Impression scores confirmed a significant reduction in illness severity. Full article

The recent literature has increasingly drawn attention to the role of teachers’ personal and relational resources in managing stress and sustaining their well-being. In this study, we examined how self-efficacy and satisfaction in key school relationships contribute to teachers’ psychological health. A sample of 339 Italian teachers (M_age = 49.7, SD = 9.26; 85.5% female) completed measures assessing their self-efficacy, satisfaction in relationships with students, colleagues, and parents, and their overall well-being. We tested a parallel mediation model to explore whether these three forms of relational satisfaction helped explain the link between self-efficacy and well-being. The analyses indicated that higher self-efficacy was associated with greater satisfaction across all relational domains, as well as with better well-being. Moreover, satisfaction with students, colleagues, and parents each emerged as a significant mediator, while the direct effect of self-efficacy remained significant, suggesting a pattern of partial mediation. Taken together, these findings underscore how both individual competencies and everyday relational experiences contribute to teachers’ well-being, pointing to the value of interventions that strengthen self-efficacy and enhance the quality of relationships within the school context. Full article

For 12 isolates of Ilyonectria mors-panacis and 4 isolates of Ilyonectria robusta, the number of genes in the secretome showed a negative correlation with growth rates in culture, especially for small secreted non-cysteine-rich and cysteine-rich proteins, and several proteases and lipases, while it was positively correlated with genes for six CAZyme classes/modules and other proteases and lipases. However, this significant correlation with growth rate was influenced by the I. robusta isolates mostly having faster growth rates than the I. mors-panacis isolates on PDA, indicating a species-level difference. The only significant relationship of gene number to virulence was a positive correlation with genes for secreted glycoside hydrolases in families 18 and 78, and this was related to differences between isolates, even if only I. mors-panacis isolates were examined, indicating a difference within species. Glycoside hydrolase family 18 includes chitinase-like proteins, endo-β-N-acetylglucosaminidases, lectins, and xylanase inhibitors, which could help suppress triggered immunity by the host and regulate fungal xylanase activity. Glycoside hydrolase family 78 contain α-L-rhamnosidases that can cleave flavonoid glycosides, saponins, and ginsenosides, which could degrade antimicrobial compounds produced as a host response during infection. These results indicate that the number of certain classes of secreted enzymes could be a factor in both growth rate in culture and virulence. Full article

Cleisthenes herzensteini is a commercially important demersal fish in the Northwest Pacific. However, the resource stock of this species has undergone a drastic decline due to overfishing and habitat degradation. As a representative taxon for benthic adaptation in the order Pleuronectiformes, the molecular mechanisms underlying its specialized phenotypic traits remain poorly elucidated. Furthermore, population-level studies focusing on the mitochondrial genome of Cleisthenes herzensteini are currently scarce. Given that the mitochondrial genome serves as an ideal genetic tool for deciphering species evolution and population genetics, sequencing of its mitogenome will help fill critical gaps in genetic resources and provide essential support for species conservation and phylogenetic research. In this study, we sequenced, assembled, and annotated its complete mitochondrial genome. The circular mitogenome is 17,171 bp in length and exhibits a typical A + T bias (54.04%). Repeat sequence analysis identified 35 dispersed repeats. Codon usage analysis revealed that leucine was the most frequently encoded amino acid, with CUU being the preferred codon. Several protein-coding genes possessed incomplete stop codons (T--/TA-), and a nucleotide preference for A and C was observed at the third codon position. Phylogenetic reconstruction based on mitogenomes from 23 species supported the monophyly of the order Pleuronectiformes. C. herzensteini showed the closest relationship with Dexistes rikuzenius, forming a distinct clade alongside Hippoglossoides dubius and Limanda aspera. These results provide essential genetic resources for understanding the evolution and population genetics of C. herzensteini and related flatfishes. According to the investigation, this study represents the first report on the sequencing and analysis of the complete mitochondrial genome of the Cleisthenes herzensteini. This not only fills the gap in mitochondrial genetic information for this species but also provides a reference for subsequent investigations into the phylogenetic relationships and evolutionary processes within the family Pleuronectidae. Full article

Background: Catechol-O-methyltransferase (COMT) catalyzes catecholamine O-methylation and contributes to dopamine turnover, potentially influencing levodopa requirements in Parkinson’s disease (PD). We evaluated whether the Gothelf COMT haplotype—and its constituent variants rs2075507, rs4680 (Val158Met), and rs165599—differ in frequency between PD cases and controls. We then tested associations between these variants and clinical phenotypes, with a prespecified focus on levodopa equivalent daily dose (LEDD). Finally, we examined whether haplotype structure and allele-specific context (e.g., background-dependent effects) help explain observed genotype–phenotype relationships in the PD cohort. Aim: Analysis of the rs2075507, rs4680 and rs165599 at individual and haplotype level between control and diseased groups. Furthermore, analysis of association of individual SNPs or haplotype level with clinical outcomes. Subjects and methods: Fifty-five individuals with Parkinson’s disease (PD) and fifty-three neurologically healthy controls were enrolled at a single center. Genomic DNA was isolated from peripheral blood, and three COMT variants—rs2075507 (promoter), rs4680/Val158Met (coding), and rs165599 (3′UTR)—were genotyped by Sanger sequencing. Allele, genotype, and tri-marker haplotype frequencies were estimated, and case–control differences were evaluated. Within the PD cohort, associations with clinical outcomes—primarily levodopa equivalent daily dose (LEDD)—were analyzed using multivariable linear models. Statistical tests were two-sided, with multiplicity control as specified in the corresponding tables. Results: The rs2075507 polymorphism showed a robust additive association with LEDD; each A allele predicted higher dose (LEDD ≈ +1331 mg/day, p = 0.001) after adjusting for age and sex. The tri-haplotype test did not show significant association with LEDD. Nevertheless, rs2075507 SNP strongly marked downstream backgrounds: in AA carriers, rs4680–rs165599 haplotypes were enriched for Val (G) and rs165599-G; in GG carriers, for rs165599-A with mixed Val/Met; and GA was A-loaded at both loci. Exact tests confirmed that AA and GG differed in rs4680–rs165599 composition, whereas GA vs. GG was not significant. Conclusions: The promoter variation at rs2075507 may represent the genetic contributor to levodopa dose requirements when modeled with SNP–SNP interactions, with its effect is modified mostly by rs165599 polymorphism. Tri-haplotypes do not independently predict LEDD. The rs4680 (coding) and rs165599 (3′UTR) context appears to fine-tune rather than determine dosing needs, mainly via interaction with rs2075507 SNP. Full article

Megacity clusters are the key battlegrounds for carbon emission reduction in China, and the polycentric spatial structure of these clusters has a profound impact on their carbon emission intensity. This paper focuses on five major megacity clusters: the Beijing–Tianjin–Hebei (BTH), Yangtze River Delta (YRD), Pearl River Delta (PRD), the middle reaches of the Yangtze River (MRYR), and the Chengdu–Chongqing (CY) City Clusters. We construct an inter-period panel dataset spanning from 2002 to 2023 and utilize an index of polycentric spatial structure, which equally considers both morphology and functionality. A fixed-effects model is employed, and the Lind–Mehlum U-shape test is applied to identify the nonlinear relationship. Additionally, a two-step approach is used to examine the mediating effect of industrial agglomeration, while interaction terms help identify the moderating effects of technological innovation and transport infrastructure. The results indicate a significant U-shaped relationship between the polycentric structure of megacity clusters and carbon emission intensity. When the polycentric spatial structure index reaches a specific threshold, carbon emission intensity is minimized, suggesting that a moderate degree of polycentricity is most conducive to carbon reduction. Mechanism analysis reveals that industrial agglomeration functions as a significant mediator, whereas technological innovation and transport infrastructure serve as critical moderators in this relationship. Based on these findings, we propose several policy recommendations: to guide the moderate adjustment of the polycentric structure of city clusters with stage-specific targets, optimize the mechanism of industrial synergy and transfer, differentiate the allocation of innovation resources, and achieve a fine-tuned alignment between the transport system and spatial structure. These measures will support the high-quality, low-carbon transformation of city clusters. Full article

Aiming at the challenges of complex spatial-temporal correlation and strong nonlinearity in the power prediction of large-scale wind farm clusters, this study proposes a short-term wind power prediction method that combines a dynamic graph structure and a Kolmogorov–Arnold Network (KAN) enhanced neural network. Firstly, a spectral embedding fuzzy C-means (FCM) cluster partition method combining geographic location and numerical weather prediction (NWP) is proposed to solve the problem of insufficient spatio-temporal representation ability of traditional methods. Secondly, a dynamic directed graph construction mechanism based on a stacked wind direction matrix and wind speed mutual information is designed to describe the directional correlation between stations with the evolution of meteorological conditions. Finally, a prediction model of dynamic graph convolution and Transformer based on KAN enhancement (DGTK-Net) is constructed to improve the fitting ability of complex nonlinear relationships. Based on the cluster data of 31 wind farms in Gansu Province of China and the cluster data of 70 wind farms in Inner Mongolia, a case study is carried out. The results show that the proposed model is significantly better than the comparison methods in terms of key evaluation indicators, and the root mean square error is reduced by about 1.16% on average. This method provides a prediction tool that can adapt to time and space changes for engineering practice, which is helpful to improve the wind power consumption capacity and operation economy of the power grid. Full article

Background/Objectives: This study investigates whether psychological well-being moderates the relationship between burnout and depressive symptoms among mental health professionals, who are frequently exposed to high emotional labor. Methods: A sample of 607 professionals—including psychologists, guidance counselors, social workers, and psychiatrists—working in public and private institutions in Turkey participated in the study. Data were collected online using the Maslach Burnout Inventory, the Psychological Well-Being Scale, and the Beck Depression Inventory–II. A latent interaction term between burnout and psychological well-being was tested using Structural Equation Modeling (SEM). Results: Burnout was positively associated with depressive symptoms (β = 0.37, p < 0.001), and psychological well-being showed a significant main effect on depressive symptoms (β = 0.26, p < 0.001). Importantly, the interaction between burnout and psychological well-being was significant (β = 0.20, p < 0.001), indicating that psychological well-being significantly moderates the relationship between burnout and depressive symptoms. Specifically, the positive interaction suggests that the association between burnout and depressive symptoms becomes stronger at higher levels of psychological well-being. The model explained 27% of the variance in depressive symptoms. Conclusions: These findings highlight the protective role of psychological well-being and suggest that interventions aimed at enhancing well-being may help reduce depressive symptoms among mental health professionals in high-stress environments. Full article

Background/Objectives: SA001, a mofetil-ester prodrug of rebamipide, was developed to enhance gastrointestinal absorption and systemic exposure, which was confirmed in a prior Phase 1 study. Given the limited efficacy of current symptomatic therapies for primary Sjögren’s syndrome (pSS), this trial aimed to assess whether the improved bioavailability of SA001 could translate into clinical benefits. Methods: This multicenter, randomized, double-blind, placebo-controlled Phase 2a study enrolled adults who met the 2016 ACR–EULAR criteria for pSS. The participants were randomly assigned to one of four groups: SA001 at 360, 720, or 1080 mg/day (administered twice daily for 8 weeks) or placebo. Exploratory ocular assessments included tear break-up time, ocular surface staining, the Schirmer test, and the Standard Patient Evaluation of Eye Dryness. Oral endpoints included unstimulated whole salivary flow and the Xerostomia Inventory. Anti-SSA(Ro) antibodies were assessed both quantitatively and qualitatively. Safety evaluations comprised adverse events (AEs), ophthalmic examinations, laboratory tests, and vital signs. The efficacy outcomes were exploratory, and this study was not powered to formally test efficacy hypotheses. Results: Twenty-eight women (mean age 58.54 ± 9.29 years; range 41–75 years) were enrolled in this study and randomly assigned to one of the study groups. SA001 showed no statistically significant improvements versus placebo in ocular or oral endpoints, and no consistent dose–response relationship was observed. The anti-SSA(Ro) findings did not differ meaningfully across the groups. SA001 was generally well-tolerated, with infrequent, mostly mild-to-moderate AEs; however, one serious AE occurred in the placebo group. No clinically relevant ophthalmic or laboratory safety signals were detected. Conclusions: Despite the fact that markedly increased systemic exposure has been demonstrated previously, SA001 did not improve the dryness outcomes in pSS. These findings suggest that systemic exposure alone may be insufficient in established glandular disease and highlight the need for tissue-exposure-driven strategies and biomarker-informed patient selection in future studies. Predefined primary efficacy endpoints and objective, gland-proximal measures of target engagement (e.g., standardized salivary gland ultrasonography and salivary or tear fluid biomarker assessments) may help to better interpret local pharmacodynamic activity and the likelihood of a clinically meaningful benefit. Full article

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder frequently associated with impairments in executive functions (EF). These deficits have been linked to difficulties across various cognitive domains, including metaphonological skills (MS), essential for phonological awareness and processing abilities. Background/Objectives: This pilot study examines the correlations between EF and MS in ADHD children. Methods: A total of 84 children aged 6–14 years, diagnosed with ADHD and an IQ ≥ 70, were assessed using the NEPSY-II test to evaluate executive functions and the Assessment of Metaphonological Skills Test to assess phonological processing abilities. Results: Correlational analyses and multiple regression models were employed to explore the relationships between EF and MS, focusing on attention, cognitive flexibility, and response inhibition. Rhyme was positively correlated with processing speed and negatively correlated with response inhibition. Phonemic segmentation was significantly related to auditory attention and response inhibition. Age emerged as a significant predictor of phonemic synthesis and final syllable deletion, consistent with the developmental maturation of executive and phonological abilities. Conclusions: The findings suggest that deficits in executive functioning in ADHD children are closely linked to metaphonological abilities, which play a crucial role in the acquisition of reading and writing skills. Integrating EF training into phonological interventions can help reduce learning difficulties and improve cognitive and language outcomes. Full article

Aggressive corporate tax avoidance represents a significant fiscal and governance challenge in developing economies, where public revenues are critical for sustainable development and enforcement capacity is often uneven. This study examines whether environmental, social, and governance (ESG) performance constrains corporate tax avoidance and whether this relationship is conditioned by national institutional quality. Using a multi-country panel of 2464 publicly listed non-financial firms from 14 developing economies over the period 2015–2023, the analysis employs fixed-effects estimation, dynamic System GMM, and instrumental-variable (2SLS) techniques to address unobserved heterogeneity and endogeneity concerns. The results indicate that stronger ESG performance is associated with significantly lower levels of tax avoidance; however, this effect is highly contingent on institutional quality. ESG exerts a substantive disciplining role primarily in governance-strong environments characterized by effective regulation and credible enforcement. Heterogeneity analyses further reveal that the ESG–tax avoidance relationship is driven mainly by the governance and environmental pillars, is more pronounced among large firms, varies across regions, and strengthens over time as ESG frameworks mature. In contrast, the social ESG dimension and smaller firms exhibit weaker or insignificant effects, consistent with symbolic compliance in low-enforcement settings. By integrating stakeholder, legitimacy, agency, and institutional theories, this study advances a context-sensitive understanding of ESG effectiveness and helps reconcile mixed findings in the existing literature. The findings offer policy-relevant insights for regulators and tax authorities seeking to strengthen fiscal discipline and development financing in developing economies. Full article

Background/Objectives: This study aimed to investigate the relationship between carotid artery anatomy and geometry and white matter hyperintensities (WMH) and to determine whether it is a risk factor for the disease. Methods: The geometry and anatomy of both carotid arteries were evaluated with the three-dimensional vessel model obtained from the computed tomography angiography (CTA) data, and the segmentation software calculated the geometrical features of the arteries. In this model, vascular diameter, vascular cross-sectional area, carotid bifurcation and internal carotid artery (ICA) angles, as well as ICA tortuosity index (TI) measurements of the common carotid artery (CCA) and ICA were determined. Results: Compared with the non-WMH group, increased carotid bifurcation and ICA angle and higher ICA TI values were found in the WMH group (p < 0.001). In multivariate regression analysis, increased carotid bifurcation angle, higher ICA TI values, age, hypertension, and stroke history were identified as independent risk factors for the development of WMH (p < 0.05). In addition, age, carotid bifurcation angles and ICA angles were found to be associated with the severity of WMH (p < 0.05). Conclusions: Considering the vascular pathologies involved in the pathogenesis of WMH, identifying these risk factors may help determine individuals who are at an increased risk. Full article

(1) Background: The purpose of this study was to investigate the associations between perceived stress and anxiety in high school senior students, taking into account the possible influence from lifestyle (physical activity, nicotine dependence, and alcohol use) and social support. (2) Methods: A representative sample of high school senior students (N = 405; mean age: 18.2 ± 0.4), reflecting the overall geographic distribution of Lithuania’s student population, was investigated using anonymous questionnaires on perceived stress (Perceived Stress Scale, PSS-10), anxiety (Generalized Anxiety Disorder Scale, GAD-7), perceived social support (Multidimensional Scale of Perceived Social Support, MSPSS), lifestyle (Fagerström Test for Nicotine Dependence), alcohol use (Alcohol Use Disorders Identification Test, AUDIT), and physical activity (International Physical Activity Questionnaire, IPAQ). Hierarchical multiple regression analysis was employed, investigating mediating and moderating effects. (3) Results: The direct effect of perceived stress on anxiety was significant (B = 0.364; SE = 0.0486; 95% CI [0.268, 0.459]; p < 0.001). Furthermore, the analysis revealed a significant indirect effect via social support (B = 0.387; SE = 0.0525; 95% CI [0.284, 0.490]), indicating that a portion of the relationship between perceived stress and anxiety was mediated by social support. Physical inactivity, alcohol use, and nicotine dependence served as moderators. Our findings confirmed that all three moderators showed significant interaction effects, with standardized β = −0.124, p = 0.002, for physical inactivity, β = 0.073, p = 0.016, for alcohol dependence, and β = 0.119, p = 0.001, for nicotine dependence, in the relationship between perceived stress and anxiety among high school senior students. (4) Conclusions: These findings have practical insights for educators who implement physical activity and alcohol and nicotine usage programs for high school senior students to help reduce their stress and anxiety. Full article

Background: Large positive responses to placebo are common in clinical trials and pose a major challenge when evaluating different treatments, including new foods. Standard between-group comparisons may fail to detect true effects when placebo improvements are significant. We aimed to demonstrate how a simple dose–response correlation method can help differentiate genuine positive responses from those experienced with placebo through secondary analysis of a randomized controlled clinical trial of powdered Rosa-canina fruits. Methods: Data were reanalyzed from a multicenter, double-blind, randomized, placebo-controlled trial (N = 120; ClinicalTrials.gov NCT01459939) evaluating the effects of standardized Rosa-canina powder in hip and knee osteoarthritis (OA). Participants received fixed doses, leading to variability in mg/kg exposure due to different body weights. Pearson correlations between dose/kg and changes in WOMAC pain and function at 6 and 12 weeks were calculated separately for the active and placebo groups. Standard between-group comparisons were also performed. Results: Both groups showed significant improvement, over 50%, with no statistically significant differences between them in WOMAC pain or function. However, only the active group, which received a food supplement, exhibited a consistent negative correlation between body weight and symptom improvement at 6 and 12 weeks, suggesting greater benefit with higher dose per kilogram of body weight. No dose–response relationship was observed in the placebo recipients. Therefore, weight-stratified plots revealed an exposure–response gradient in the active group. Conclusions: Dose–response correlation analysis uncovered positive effects of Rosa-canina as a nutrient that were not detectable through standard between-group comparisons. This is consistent with findings from earlier rose-hip research. This low-cost, easy-to-implement method may help distinguish active effects from placebo responses in trials with large nonspecific improvements. Incorporating such analyses could improve the identification of nutrients containing biologically active preparations and support dose selection in future clinical research. Full article