Search Results (2,386)

Background/Objectives: Preoperative risk stratification in renal cell carcinoma (RCC) remains challenging for tumor aggressiveness and for adherent perinephric fat (APF) relevant to surgical planning. Although intratumoral radiomics are established, the peritumoral and perirenal fat microenvironment is biologically active and may encode imaging biomarkers. This systematic review and meta-analysis evaluated CT-based peritumoral and perirenal fat radiomics for preoperative grading, staging, and APF prediction and examined whether fat-derived features add incremental value beyond intratumoral models. Methods: Following PRISMA 2020 and a registered protocol (PROSPERO CRD420251150155), databases were searched through March 2026, with documented verification searches through August 2026. Eligible studies extracted CT radiomics from peritumoral or perirenal fat in adults with RCC and reported discrimination metrics. Random-effects meta-analyses (restricted maximum likelihood with Hartung–Knapp intervals) were performed; incremental value was estimated from nested within-study AUC differences under predefined rules; and methodological quality was assessed with PROBAST, RQS, METRICS, and TRIPOD, and certainty with an adapted GRADE framework. Results: Twenty-five retrospective studies (10,761 patients) were included. Fat radiomics were most consistent for APF prediction (pooled AUC 0.848, 95% CI 0.738–0.917; I² = 0%). Pooled AUCs were 0.772 (0.599–0.884; I² = 93%; 95% prediction interval 0.298–0.964) for grade and 0.813 (0.681–0.899; I² = 72%) for stage. Combined fat-plus-tumor models were numerically higher than tumor-only models in 12 of 15 studies (exploratory p = 0.022), but the formally estimable nested increment (stage family, five studies) was small (delta-AUC +0.017; governing modified Hartung–Knapp 95% CI −0.008 to +0.042) and statistically compatible with no true difference; fat-only models showed no evidence of differing from tumor-only models. PROBAST rated 72% of studies at high risk of bias, and 88% originated from China. Certainty ranged from VERY LOW (grade prediction; grade-family fat-versus-tumor comparison) to LOW (all remaining outcomes). Conclusions: CT-based peritumoral and perirenal fat radiomics show the most consistent signal for APF prediction, while the measurable increment from adding fat features to tumor models is small and of unestablished clinical utility. Standardized fat segmentation, calibration and decision-curve reporting and prospective multicenter validation are required before clinical translation. Full article

Healthy nutrition is pivotal for the prevention of atherosclerotic cardiovascular disease (ASCVD). In addition to traditional risk factors, other components, like low-grade chronic inflammation, play a pathogenetic role in ASCVD. Research efforts aim to identify low-grade chronic inflammation in patients with established ASCVD and in subjects with low ASCVD risk, and to validate effective nutritional strategies. Here, current nutritional approaches to counteract low-grade chronic inflammation related to ASCVD and possibly mitigated ASCVD risk are discussed, along with related molecular pathways and clinical biomarkers. Low-grade chronic inflammation results from a pro-inflammatory response promoted by large multiprotein complexes (inflammasomes). Within the ASCVD context, the nucleotide-binding oligomerization domain (NOD)-like receptor family pyrin domain-containing protein 3 (NLRP3) inflammasome is the most characterized protein complex, whose activation leads to increased release of downstream effectors (interleukin (IL)-1β, IL-18, IL-6). In the current clinical practice, high-sensitivity C-reactive protein (hsCRP) is used as a circulating biomarker for systemic inflammation, although it is not univocally associated with ASCVD. Some nutritional strategies have been shown effective to mitigate low-grade chronic inflammation and to reduce hsCRP, reducing in some cases ASCVD risk. The Mediterranean Diet and related trials showed that their beneficial effects on cardiovascular disorders could also be related to the anti-inflammatory properties of specific active compounds. Contradictory results have also been obtained, due to lack of standardization and to the specific nature of nutritional studies, which often rely on adherence and compliance of participants. Given the relevance of low-grade chronic inflammation for ASCVD risk, future work will need to increase awareness, identify and validate novel biomarkers, and implement novel effective nutrition strategies. Full article

Background and Objectives: Deciding which pigmented or non-pigmented skin lesions require surgical excision, as opposed to continued observation, is a common challenge in everyday dermatologic practice. Although dermoscopy is well established as a tool that improves melanoma detection accuracy compared with naked-eye examination, real-world evidence on how demographic profile, patient history, and dermoscopic impression jointly influence the surgical decision remains limited. This study examined the clinical and dermoscopic factors associated with a positive surgical decision (PSD) in a large single-centre screening cohort. Materials and Methods: This retrospective cross-sectional analysis included 643 consecutive patients (415 female (64.5%), 228 male (35.5%); mean age 51.3 ± 16.8 years) undergoing dermoscopic skin cancer screening. Data recorded included family history of melanoma (FHM), personal history of skin cancer (HSC), childhood sunburn (CS), clinically atypical lesions (CAL), suspicion of basal/squamous cell carcinoma (BCC/SCC), nevus count (NC, 0–4), and the surgical decision (PSD). Free-text dermoscopic descriptions were grouped into seven diagnostic categories. Group comparisons used the Mann–Whitney U, χ², and Fisher’s exact tests; predictors of PSD were characterised using multivariable logistic regression (with Hosmer–Lemeshow and Nagelkerke R² statistics), multiple correspondence analysis (MCA), Gower-distance k-medoids clustering, and receiver operating characteristic (ROC) analysis, including the area under the curve (AUC). Missing NC data (13.2%) were assessed using Little's test for data missing completely at random (MCAR test). Results: A positive surgical decision was recorded in 133/643 patients (20.7%) and was significantly more common in men than women (25.9% vs. 17.9%; p = 0.017; corresponding to an odds ratio (OR) of 1.61). In multivariable analysis, suspicion of BCC/SCC (OR = 24.7, 95% confidence interval (CI): 9.26–66.0) and clinically atypical lesions (OR = 5.53, 95% CI 3.50–8.74) were the strongest independent predictors of PSD (Nagelkerke R² = 0.31; Hosmer–Lemeshow p = 0.977), far outweighing family or personal history. A significant interaction between childhood sunburn and nevus count (OR = 1.39, 95% CI 1.16–1.66; p < 0.001) predicted clinical atypia. Missing NC data were consistent with a completely random pattern (Little’s χ² = 2.80, df = 2, p = 0.247). Dermoscopic impression showed strong discriminative value for PSD: “no concern” had the highest negative predictive value (NPV = 0.927; AUC = 0.762), while “atypical lesion” combined high specificity (0.916) and positive predictive value (0.632; AUC = 0.736). On average, 4.8 patients were examined for every surgical referral generated (a screening-to-referral ratio, not a number needed to screen for a histologically confirmed cancer). Conclusions: Surgical decision-making in this cohort was driven almost exclusively by the dermoscopic impression—suspected BCC/SCC and clinical atypia—rather than by family or personal oncological history, while male sex was independently associated with a higher surgical rate. These findings support dermoscopy-led triage protocols and highlight the potential value of standardised risk stratification to optimise referral pathways in routine skin cancer screening. Full article

Background: Heritable thoracic aortic disease (HTAD) accounts for approximately 20–25% of thoracic aortic aneurysm and dissection (TAAD) cases and is a major cause of premature death in young adults. Methods: This is a narrative, non-systematic review. We performed a selective synthesis of clinical practice guidelines (ACC/AHA 2022, EACTS/STS 2024), the revised Ghent nosology, large multicenter cohort studies (Montalcino Aortic Consortium), randomized pharmacotherapy trials, and molecular mechanism data published between 2010 and 2025; quantitative figures are reported as published in individual primary sources and were not pooled or re-analyzed. Results: The advent of next-generation sequencing (NGS) has driven a paradigm shift in HTAD management, from risk assessment based purely on phenotype (aortic diameter) to risk stratification based on genotype (molecular mutation). The 2022 ACC/AHA guideline identifies eleven genes with confirmed high-penetrance risk for HTAD; these, together with the established Loeys–Dietz gene TGFB3 (recognized through gene–disease validity assessment rather than the ACC/AHA list), can be grouped into three pathogenic mechanisms: extracellular matrix dysregulation, TGF-β signaling dysregulation, and vascular smooth muscle contractile dysfunction. Gene–disease association should be distinguished from guideline-defined classification and regarded as evolving, since additional candidate genes such as LTBP3 are already emerging in gene-negative families. Multigene panel testing identifies a pathogenic or likely pathogenic variant in roughly 8% of patients referred for suspected HTAD, a yield that rises substantially when applied to syndromic or strongly familial presentations. Prophylactic surgical thresholds are individualized by gene and are generally lower (around 4.0 cm) for high-risk TGFBR1/TGFBR2 and PRKG1 variants and higher (around 5.0 cm) for FBN1 and TGFB3, in contrast with the uniform 5.5 cm threshold historically applied to all patients. Randomized trials over the past decade—including the AIMS irbesartan trial, the Marfan Treatment Trialists’ individual patient data meta-analysis, and the celiprolol and irbesartan trials in vascular Ehlers–Danlos syndrome—now provide direct evidence that angiotensin receptor blockade slows the rate of aortic root dilation in Marfan syndrome, with more limited evidence in vascular Ehlers–Danlos syndrome and uncertain effects on dissection or mortality, while valve-sparing aortic root replacement provides durable long-term outcomes in reported single-center experience. These thresholds and pharmacotherapy recommendations rest predominantly on observational cohort, registry, and randomized trial data of varying maturity and should be interpreted as graded, evolving recommendations rather than fixed cut-points. Conclusions: This review synthesizes the molecular pathogenesis, diagnostic nosology, gene-specific epidemiologic and prognostic data, genetic testing yield, pharmacotherapy evidence, surgical outcomes, and updated prophylactic intervention algorithms per the ACC/AHA (2022) and EACTS/STS (2024) guidelines, providing a practical reference framework for individualizing surveillance and surgical decision-making in patients with HTAD. Full article

Background: Children with Down syndrome often have co-occurring physical conditions affecting well-being, and respiratory issues remain a leading cause of hospitalization and death among people with Down syndrome. Parents of children with Down syndrome experience stressors associated with respiratory illness and challenges navigating healthcare access. No prior qualitative study has examined parental perspectives on respiratory health specifically among children with Down syndrome. Identifying parental concerns can help in the development of strategies to mitigate respiratory ailments in children with Down syndrome. Methods: One-hour, semi-structured interviews were conducted among 24 families of children with Down syndrome to understand respiratory concerns. Findings were identified through codebook thematic analysis. Results: The themes identified included persistent concerns about respiratory health, repeated impact from acute and chronic respiratory issues, a rapid and unexpected decline in health during respiratory illness, insurance coverage concerns, and a lack of confidence in assessing air quality which could impact respiratory health. Conclusions: Insights gained from interviews of parents of children with Down syndrome can help policy makers identify opportunities to prevent and mitigate respiratory health problems. Findings underscore the importance of clinician responsiveness to parental concern about rapid deterioration and suggest that insurance coverage policies for this high-risk population warrant further research and policy consideration. Full article

Background/Objective: Pediatric out-of-hospital cardiac arrest (OHCA) carries high morbidity and mortality, placing immense psychosocial and sudden decision-making burdens on families. Subspecialty pediatric palliative care (SPPC) can provide crucial support for these multifaceted needs, but its utilization and timing in this population remain poorly characterized. This study aimed to characterize the current rate, timing, and care domains addressed by SPPC utilization in pediatric patients admitted to the pediatric intensive care unit (PICU) following OHCA. Methods: This was a 13-year retrospective cohort study (2012–2024) conducted at Boston Children’s Hospital, a quaternary academic children’s hospital. This study included 126 patients up to 21 years of age who experienced an OHCA and were admitted to a PICU for at least 24 h. Primary outcomes included the rate of SPPC consultation, timing of the initial consultation, and documented domains of care addressed. Exploratory correlates included patient demographics and clinical factors associated with consultation. Results: Among 126 patients included, 23 (18.3%) received an SPPC consultation. SPPC utilization was significantly higher for Black or African American patients (47% of the SPPC group vs. 9.9% of the non-consult group) and patients with a greater number of pre-existing complex chronic conditions (median: 1 vs. 0). The SPPC cohort had a longer observed median PICU length of stay (22 days vs. 5 days) and hospital length of stay (36 days vs. 6 days) in unadjusted comparisons. The median time from admission to the first SPPC consult was 8 days. When consulted, SPPC addressed goals of care in 96% of cases, medical decision making in 83%, and psychosocial support in 74%. Conclusions: SPPC is not often utilized and is typically introduced later in the illness course during the care of children following OHCA, often associated with patients with prolonged or complex clinical courses. The significant demographic-associated variances in consultation rates highlight the risks of subjective referral practices, underscoring the need for standardized, proactive integration of palliative care to support all families navigating this devastating event. Full article

Ornamental aquaculture represents a high-value segment of global aquaculture and plays an important role in income diversification for small-scale producers. Despite its economic relevance, investment decisions in ornamental fish farming are often supported by limited economic information and rarely incorporate risk and uncertainty into economic assessments. This study developed and applied a stochastic framework to evaluate the economic performance and investment risk of intensive ornamental aquaculture using Betta splendens production as a representative case study. A representative production system was developed from technical and economic surveys conducted on 20 commercial family operated farms located in one of Brazil’s major ornamental fish production clusters. The production system comprised three greenhouse units with an estimated annual output of 162,288 marketable fish. Production costs were estimated using conventional cost-accounting procedures, whereas economic risk was assessed through Monte Carlo simulation incorporating uncertainty in biological, productive, and market variables. The estimated total production cost was US$0.14 fish⁻¹, while the weighted average selling price reached US$0.18 fish⁻¹, resulting in a benefit–cost ratio of 1.33, a profitability of 25.09%, and an annual return on invested capital (ROIC) of 23.90% under the deterministic baseline scenario. Monte Carlo simulation estimated a mean annual ROIC of 22.46%, with a 98.53% probability of positive economic returns. Sensitivity analysis identified labor demand, the selling price of premium males, and reproductive productivity as the principal drivers of economic risk. The results indicate that economic returns in B. splendens farming are primarily influenced by managerial efficiency, labor requirements, and market conditions rather than production volume alone. The proposed framework provides a robust tool for evaluating economic viability and investment risk in ornamental fish farming under uncertainty and may support decision-making in small-scale aquaculture systems. Full article

Background/Objectives: Pediatric palliative care is a highly demanding field requiring nurses to maintain professional competence and emotional resilience. Continuous exposure to suffering, dying, and death may increase the risk of psychological distress among healthcare workers. The objective of this study was to examine compassion satisfaction, burnout, and secondary traumatic stress among nurses working in pediatric palliative and related pediatric care settings in Split-Dalmatia County, Croatia, and to explore organizational and emotional factors associated with their professional quality of life. Methods: A descriptive cross-sectional study was conducted involving 36 female nurses employed in a pediatric hospice, pediatric hemato-oncology department, and neonatology department. Data were collected using the Professional Quality of Life (ProQOL) questionnaire and a custom questionnaire assessing organizational, educational, and emotional challenges. Results: Participants reported high levels of compassion satisfaction (M = 4.55, SD = 0.45), moderate levels of secondary traumatic stress (M = 3.02, SD = 0.68), and relatively low levels of burnout (M = 2.34, SD = 0.65). A significant negative correlation was found between compassion satisfaction and burnout (ρ = −0.542; p < 0.001). Favorable organizational conditions, including sufficient time for rest (ρ = −0.567; p < 0.001) and emotional support from colleagues (ρ = −0.414; p = 0.012), were significantly associated with lower burnout levels. Although 63.9% of nurses lacked formal psychological support in the workplace, communication with families of terminally ill children remained a major emotional burden (M = 4.25, SD = 1.13) and was positively associated with secondary traumatic stress (ρ = 0.460; p = 0.005). Conclusions: Despite the substantial emotional demands of pediatric palliative and terminal care, nurses reported high compassion satisfaction alongside moderate secondary traumatic stress and relatively low burnout. The findings suggest that organizational conditions, collegial support, and access to formal psychological support may represent relevant targets for strategies aimed at sustaining nurses’ professional quality of life. Full article

This study presents a systematic literature review of spatial planning frameworks for coastal hazard mitigation, conducted in accordance with the PRISMA 2020 guidelines. A structured search of two academic databases, Scopus and Web of Science, covering the period 2016 to 2026 identified 368 records, of which 27 peer-reviewed studies were included in the final synthesis. The review pursues four interrelated objectives: analyzing global publication trends in research on spatial planning for coastal hazard mitigation; identifying and describing coastal hazard typologies and their associated mitigation approaches; examining how spatial planning frameworks are integrated with hazard mitigation strategies; and synthesizing cross-cutting constructs that structure an integrative analytical model. Findings reveal a marked intensification of scholarly output over the final third of the review period, with Asia–Pacific and Europe as the most represented regions, while sub-Saharan Africa and small island developing states remain critically underrepresented. Coastal hazards are classified into four categories: slow-onset climate and hydro-geological processes, acute hydro-meteorological events, multi-risk systemic hazard interactions, and ecological and environmental degradation. Three analytically distinct integration families are identified: geospatial and technical modeling, NbS and ecosystem-planning integration, and participatory governance and institutional integration. From these, four cross-cutting constructs emerge inductively across the evidence base, namely spatial risk assessment and geospatial modeling, land-use governance and climate-proof planning, community-based resilience and participatory governance, and ecosystem-based adaptation and nature-based solutions, which together constitute an integrative analytical framework. The discussion demonstrates that governance capacity, rather than technical sophistication, is the primary moderator of implementation effectiveness, and that socio-spatial equity in hazard planning represents a cross-regional challenge irrespective of governance capacity level. Limitations include the geographic concentration of the evidence based in high-capacity planning contexts and the predominantly projected rather than implemented nature of effectiveness evidence. Full article

Background/Objectives: Carotid intima–media thickness (CIMT) is widely recognized as an established biomarker of systemic atherosclerosis and coronary artery disease (CAD). Nevertheless, the connection between circulating miR-29 family members, CIMT and CAD severity has not yet been determined. The aim of this study was to investigate the association of plasma miR-29a and miR-29c with CIMT and CAD severity. Methods: A total of 628 patients scheduled for elective coronary angiography were included in the study. CAD severity was estimated using the Gensini scoring system and was classified into mild, moderate, and severe categories. Additionally, CIMT was evaluated using high-resolution B-mode ultrasonography, while plasma miR-29a and miR-29c levels were detected using qRT-PCR. Results: CIMT increased significantly with CAD severity (0.76 ± 0.15, 0.94 ± 0.18, and 1.12 ± 0.22 mm for mild, moderate, and severe CAD, respectively; p < 0.001). MiR-29a expression progressively increased, whereas miR-29c expression decreased with advancing CAD (both p < 0.001). MiR-29a correlated positively with CIMT (r = 0.612) and Gensini score (r = 0.658), while miR-29c showed negative correlations (r = −0.527 and −0.584, respectively; all p < 0.001). CIMT, miR-29a, and miR-29c were found to be independently associated with CAD severity. Their combined model demonstrated a powerful association with severe CAD (AUC = 0.927; sensitivity 88.6%; specificity 84.1%). Conclusions: Plasma miR-29a and miR-29c are independent biomarkers of CIMT and CAD severity. Their combination with CIMT can improve diagnosis of severe CAD and may enhance cardiovascular risk stratification. Full article

Background/Objectives: Wilson disease (WD) is an autosomal recessive disorder of copper metabolism caused by pathogenic variants in the ATP7B gene. Early diagnosis and appropriate treatment are essential for preventing irreversible complications. This study demonstrated the clinical utility of integrated high-throughput genomic analysis for molecular diagnosis and genetic counseling in a large Thai family affected by WD. Methods: A 32-year-old woman with clinical features suggestive of WD underwent clinical, biochemical, and molecular genetic evaluations, including sequencing of the entire ATP7B gene and SNP microarray. Fluorescent PCR followed by capillary electrophoresis was used for segregation analysis in available family members. SNP microarray analysis and whole-exome sequencing were performed on the proband’s husband to identify pathogenic variants in the ATP7B gene and other disease-associated genes for reproductive risk assessment. Results: The proband presented with hepatic dysfunction, Kayser–Fleischer rings, low serum ceruloplasmin, and a family history of fatal liver disease. She also developed progressive weakness, with nerve conduction findings consistent with axonal sensorimotor polyneuropathy predominantly affecting the lower limbs. Sequencing identified a novel homozygous 28-bp splice-junction deletion, c.4022-24_4025del, which disrupted the canonical splice acceptor site at the intron 19/exon 20 boundary and was classified as pathogenic variant. Segregation analysis confirmed carrier status in the proband’s father and identified heterozygous carrier or homozygous wild-type status among her living siblings. SNP microarray analysis revealed a 46.7 Mb copy-neutral long contiguous stretch of homozygosity (CN-LCSH) encompassing ATP7B, with CN-LCSH regions accounting for 2.046% of the total autosomal genome. These findings potentially reflected segmental uniparental isodisomy or identity by descent, while the overall homozygosity pattern did not support recent consanguinity. Combined genomic analyses of the proband’s husband revealed no pathogenic or likely pathogenic ATP7B variants. Based on the available testing, all offspring are expected to be heterozygous carriers, and the risk of an affected child is considered very low. Conclusions: This study highlights the value of integrated genomic analysis for molecular diagnosis, cascade testing, and reproductive risk counseling. Further functional studies should be conducted to validate their pathogenicity. Full article

This study examines the feasibility of predicting net repair costs (Estimated Cost, PLN) for multi-family residential buildings from data extracted from technical inspection reports. Rather than merely comparing algorithmic performance, the analysis was designed as a diagnostic sequence aimed at identifying the sources of prediction error. Four machine learning algorithms (Extra Trees, Random Forest, XGBoost, and GBM) were first applied to direct regression of repair cost. We then tested whether the difficulty of estimating exact cost values stems from the high variability of the target variable and whether this limitation can be mitigated by a two-stage approach: assigning observations to one of three cost-risk bands (Low, Moderate, High) and subsequently estimating cost within the assigned band. The empirical cost distribution was strongly right-skewed (median: 4500 PLN; mean: 63,402 PLN; maximum: 3,680,524 PLN). The best direct regression model achieved an R² of 0.452, while the best fully deployable two-stage model, combining an XGBoost classifier with a Random Forest regressor, achieved an R² of 0.392. When it was assumed that the actual cost-risk bands were known, an R² value of 0.839 was obtained, indicating that the main source of error is not regression within the bands, but rather the initial stage of assigning the bands. These results demonstrate that reporting a single global R² for highly skewed, weakly identifiable cost data can be misleading, and that decomposing predictive performance into band-assignment and within-band regression components provides a more informative evaluation. This article also points to concrete directions for improving the underlying database, particularly through the inclusion of variables describing repair quantity, unit of measure, and detailed repair scope. Full article

Financial reporting oversight evolves through repeated feedback among managerial incentives, audit detection, board oversight, regulatory intervention, and market trust. I develop a transparent recursive simulation model to examine whether specified mechanism combinations can generate distinguishable governance trajectories within its rules. Monte Carlo simulations compare institutional scenarios, supported by analyses of uncertainty, alternative model designs, heterogeneous conditions, and a learning-agent extension. Within the simulations, high-transparency coordination generally produces the strongest governance outcomes, whereas weak governance remains consistently least favorable across the uncertainty analyses. In the model, governance improvement depends on interactions among disclosure, audit, regulation, and market feedback. In the learning-agent extension, learned policies yield less favorable governance and reporting outcomes than the fixed-policy benchmark. Chinese A-share evidence is broadly consistent with the main simulated patterns in direction, risk location, and broad ordering. These findings provide mechanism-sufficiency evidence within the declared rule family and explain how oversight signals become institutional outcomes and subsequent feedback. Full article

Background: Coronary artery disease (CAD) remains a leading global health burden largely driven by modifiable risk factors, and public awareness plays a critical role in its prevention and early risk reduction. However, gaps in knowledge and behavioral practice persist. Objective: This study aims to assess awareness of CAD risk factors and examine its relationship with the socio-demographic characteristics, lifestyle behaviors, personal medical history, and family history among residents of the Jazan Region, Saudi Arabia. Methods: A cross-sectional study was conducted among 559 participants between April and May of 2026. Data were collected using a structured questionnaire assessing awareness of behavioral, clinical, and non-modifiable risk factors. Awareness was scored out of 12 and categorized as poor (<50%), moderate (50–75%), or high (>75%). Chi-square tests were applied to analyze associations, and binary logistic regression analysis was performed to determine independent factors associated with high awareness. The results are expressed as adjusted odds ratios (aORs) with 95% confidence intervals. Statistical significance was set at p < 0.05, and data were analyzed using IBM SPSS Statistics v.29. Results: Among the 559 participants, 67.3% demonstrated high awareness, 29.9% moderate awareness, and 2.9% poor awareness of CAD risk factors. Awareness of modifiable factors was high, including smoking (96.8%), obesity (95.5%), hypertension (94.6%), and high cholesterol (93.4%), while non-modifiable factors such as family history (54.6%) and sex (60.3%) were less recognized. In the bivariate analysis, significant associations with awareness were found for age, body mass index (BMI), education, marital status, and employment status. Exercise was significantly associated with awareness (p = 0.020), with higher awareness levels observed in individuals with greater activity. High awareness was independently linked to a higher educational level (aOR = 1.76, p = 0.009) and a previous diagnosis of CAD (aOR = 6.28, p = 0.014). Conclusions: This study found moderate to high CAD risk factor knowledge among adult residents in the Jazan Region. Self-reported preventative practices differed among health behaviors, demonstrating that awareness alone may not always lead to healthy lifestyles. As the cross-sectional nature of the study precludes causal conclusions, more longitudinal, qualitative, or theory-informed research is needed to understand the drivers of healthy behavior adoption. Full article

Data-driven urban governance increasingly seeks to incorporate the needs of different population groups, yet child-sensitive evidence for public street-space renewal remains limited in older urban districts. Most studies still evaluate environmental conditions through population averages, with insufficient attention to heterogeneous child groups that may require differentiated planning responses. Based on an analytic sample of 314 children retained from 343 usable questionnaire responses collected from children aged 6–12 in the older urban districts of Xi’an, China, this study integrates street-activity characteristics and age- and sex-standardized body mass index (zBMI) using an established person-centered analytical approach. Latent Class Analysis (LCA) was used to identify children’s activity–health profiles, and multinomial logistic regression was used to examine associations between individual, family, and perceived street-environment factors and profile membership. Three profiles were identified: high-activity–healthy, high-intensity active, and low-activity–high-risk. The model-estimated low-activity–high-risk profile represented 35.7% of the analytic sample, and children assigned to this profile reported the lowest perceived safety and convenience. The findings suggest that profile-based analysis may inform child-sensitive street-renewal prioritization. Perceived safety and convenience showed the strongest and most consistent associations with membership in either the high-activity–healthy or high-intensity active profile relative to the low-activity–high-risk profile. These findings are associative and do not establish the effects of street interventions. The study therefore represents a context-specific extension and planning application of established analytical methods. Full article