Search Results (8,384)

Background: With the worldwide resurgence of Mpox in 2022, understanding its regional features is important. This systematic review aimed to provide an overview of the epidemiology, risk factors, clinical features, and outcomes of Mpox in Saudi Arabia to fill the knowledge gaps in this area. Methods: Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic search was performed on PubMed, MEDLINE (via Ovid), Scopus and Wiley Online Library for case reports and series published on Mpox in Saudi Arabia after 2022. Results: Analysis included eight studies comprising a total of 410 patients with confirmatory data. The cohort was predominantly male (91%), with a mean age of 32.8 years. Extramarital sexual contact was the most frequently identified risk factor (28.8%), whereas most patients (63.4%) had unknown or denied exposure routes. The most common clinical manifestations were fever (97.1%) and rash (96.8%). Dermatological findings were usually pleomorphic. These included umbilicated pustules, crusted papules, and vesiculopustular lesions. Although management was primarily supportive, rare complications, such as keratitis and neurological deficits, were observed. Conclusions: In Saudi Arabia, Mpox primarily affects young adult males, particularly individuals with high-risk sexual behaviors. Much of this transmission remains undetermined, and better contact tracing and focused public health efforts are urgently required. Full article

Background/Objectives: Smith–Magenis syndrome (SMS) is a rare neurogenetic disorder caused by a microdeletion in chromosome region 17p11.2 or by pathogenic variants in the RAI1 gene. The syndrome is characterized by a distinctive neurobehavioral profile, including cognitive deficits, sleep disturbances, self-injurious behavior, and typical dysmorphic features. A characteristic diagnostic hallmark is paradoxical melatonin secretion, with increased daytime levels instead of the normal nocturnal peak. This article aims to summarize current knowledge on the etiology, diagnostics, EEG findings, therapy, and prognosis of SMS from a neuropediatric perspective. Methods: A narrative review of the literature on Smith–Magenis syndrome was conducted, focusing on genetic background, clinical features, diagnostic approaches, EEG characteristics, therapeutic strategies, and prognosis. In addition, a detailed clinical case of a 16-year-old female patient with SMS is presented. Results: The reviewed data confirm that SMS is associated with characteristic neurobehavioral abnormalities and sleep–wake rhythm disturbances. EEG findings may include epileptiform activity without overt epilepsy. In the presented case, “Rolandic-type” spike–sharp wave complexes were observed on EEG and are interpreted as an expression of congenital disturbances in brain maturation processes. Therapeutic recommendations addressing behavioral symptoms and sleep regulation are discussed. Conclusions: Smith–Magenis syndrome represents a complex neurodevelopmental disorder with distinctive clinical, neurophysiological, and genetic features. Early recognition of characteristic signs, including sleep disturbances and EEG abnormalities, is essential for appropriate management. A multidisciplinary, individualized therapeutic approach may improve quality of life and long-term outcomes. Full article

Background/Objectives: The dopaminergic system regulates motivation, executive functions, motor learning, and emotional responses—processes that are key in both sport and esports. Although many studies analyse dopaminergic gene polymorphisms, their impact on psychophysical predispositions remains unclear. This narrative review aims to summarise current knowledge about the mechanisms of dopamine action and genetic determinants that may influence athletic and cognitive performance. Methods: The PubMed, Scopus, and Web of Science databases (publications from January 2010 to December 2025) were searched using keywords related to the DRD1–DRD5, COMT, SLC6A3/DAT1, and TH genes, as well as the terms ‘sport’ and ‘esport.’ Studies of athletes were included in which the relationship between dopaminergic polymorphisms and motivational and personality traits was assessed, and the results of neuroimaging and epigenetic studies were also considered. Results: Dopaminergic polymorphisms are associated with differences in reward processing, cognitive flexibility, motivation, and stress resilience. The most essential critical effects concern the DRD2 and DRD4 variants, which are associated with novelty seeking, reward dependence, and coping with stress. The COMT Val158Met polymorphism affects dopamine levels in the prefrontal cortex, modulating executive functions. The effects of individual polymorphisms are moderate, and conclusions regarding esports remain speculative due to limited research in this area. Conclusions: Dopaminergic predispositions involve interactions among genetics, neural activity, and the environment. However, current evidence is limited by small sample sizes, a predominance of European populations, scarce data on esports players, and difficulties in separating genetic effects from training-related adaptations. Full article

Infertility affects 10–30% of couples globally, with significant psychological and social impacts in sub-Saharan Africa, where fertility is closely tied to identity and social status. To explore how couples’ understanding of infertility causes influences their treatment-seeking behaviours and healthcare decision-making processes in Ghana, this cross-sectional qualitative study used in-depth interviews with 24 married participants (nine dyads and six individuals) experiencing current or past infertility in Greater Accra, Ghana, from August to October 2023. Data were analysed using thematic analysis with NVivo version 15. Couples demonstrated comprehensive knowledge of infertility causes spanning medical, spiritual, cultural, and lifestyle factors, although they lacked knowledge of clinical diagnostic criteria. Three main treatment pathways emerged: medical/orthodox, herbal, and spiritual interventions, pursued either sequentially or concurrently. Decision-making was influenced by internal factors (treatment effectiveness, financial constraints, and safety concerns) and external factors (family influence and peer testimonials). Four distinct navigation strategies were identified: informed notification, trial periods and evaluation, parallel relationship management, and strategic sequencing. Couples experiencing infertility are sophisticated healthcare consumers who skilfully navigate pluralistic healthcare systems through strategic decision-making. Rather than representing non-compliance, their multimodal approaches reflect rational responses to structural constraints and cultural values. Healthcare systems should recognise and accommodate these navigation strategies to improve therapeutic relationships and outcomes. Full article

Food waste is a persistent global concern, requiring behavioral and systemic responses from consumers. The current study investigated the effect of sociodemographic factors and digital activism on food waste prevention behavior. Data from 390 respondents living in Italy (65% females, from 18 to 75 years old, grouped into four generations) were collected through an online survey covering these sections: sociodemographic variables, digital activism, knowledge, attitudes, and food waste behaviors. A Food Waste Prevention Index (FWPI) was computed to assess self-reported adherence to waste-reducing practices, and differences across three groups identified through tertiles were tested. Women displayed higher levels of digital activism; Gen Z was the most engaged generation in seeking information about food, while interest in food issues declined with age. Gender, geographical area, and dietary orientation significantly influenced food waste prevention, with women, rural residents, and individuals adopting flexitarian or vegetarian diets tending towards more virtuous behavior (higher FWPI). According to digital activism, less virtuous waste behavior (lower FWPI) was associated with a lower social media and apps usage frequency. Furthermore, higher FWPI individuals self-reported stronger sensitivity to sustainability-related topics such as circular economy, short food chains, and ethical or environmental motivations for vegetarianism. Overall, awareness and digital activism may synergistically foster more responsible food consumption, and targeted communication and digital tools can effectively support household food waste reduction strategies. Full article

Trait-based approaches, particularly those focusing on behavioral traits, have become increasingly important in ecology. However, empirical studies addressing behavioral trait variation in insects remain comparatively scarce. To address this knowledge gap, we investigated the behavior of six wild-living ground beetle species for which no behavioral data have previously been reported. Using standardized behavioral measures, we found that in species occurring in their preferred forest habitats, behavioral traits related to activity, exploration, boldness, and risk-taking showed weak or limited temporal consistency. In contrast, in species inhabiting modified forest habitats, behavioral traits exhibited pronounced and repeatable individual differences, were intercorrelated, and formed behavioral syndromes. Moreover, half of the studied species showed sex-specific differences in personality, reflecting drivers related to reproductive roles and investment. Overall, our findings emphasize that animal personality and behavioral syndromes in ground beetles are not universal species-level properties but emerge from the interaction between intrinsic traits, and sex-specific strategies, underscoring the importance of considering ecological context when interpreting individual-level behavioral variation. Full article

Based on extensive ethnographic fieldwork conducted in Mianning County, Liangshan Yi Autonomous Prefecture between 2023 and 2024, this paper analyzes the “xiō bū” (ꑭꁮ) ritual of the Liangshan Yi people. Framed within contemporary approaches to religious anthropology and social memory theory, the study explores how this ritual constructs Yi ecological ethics, social integration, and cultural identity through nature worship, ancestral spirit beliefs, and ritual practices. The ethnographic evidence reveals that the “xiō bū” ritual, by designating wooded mountains as sacred space and performing sacrifices to nature deities and ancestral spirits, integrates “humans—nature—ancestors” into a symbiotic system of the “community of life.” This reflects the Yi people’s relational ontology and embedded ecological knowledge. The sacrificial offerings, shared meals, and purification practices in the ritual not only reinforce reverence for nature through symbolic acts but also unify the community through Durkheimian “collective effervescence,” thereby restoring the community’s spiritual order. As a carrier of social memory, the “xiō bū” ritual, through epic chanting, symbolic performances (such as clothing, ritual implements), and bodily practices (like the ritual specialist’s movements), embeds individual memories into the collective historical narrative of the group, dynamically constructing the cultural boundaries of the “Yi” people. The ritual specialists (Bimo or Suni), as intermediaries of knowledge and power, maintain religious authority through bricolage-like symbolic reorganization and foster the creative transformation of tradition in response to the challenges of modernity. The study further reveals that while the ritual faces challenges in the contemporary context, such as secularization and population mobility, it continues to activate ethnic identity by simplifying rituals, preserving core symbols, and coupling with ecological discourses, offering a model for the modern adaptation of traditional religions. This paper argues that ritual studies should engage with contemporary theoretical approaches like the ontological turn, focus on the agency of individuals, and reflect on the insights traditional knowledge systems offer in the face of globalization and ecological crises. Full article

Background/Objectives: Across geographical and cultural contexts, how individuals identify, communicate and help-seek for distress is often shaped by how mental health itself is understood. Insight into how adolescents and adults in their routine environment, such as teachers, understand mental health is crucial for developing context-specific mental health promotion strategies to young people. Sri Lanka, a country that navigates the dual legacies of pre-and-post-colonial mental health frameworks, has this need. The aim was to explore Sri Lankan school-going adolescents’ and their teachers’ perspectives of mental health and its determinants. Methods: Semi-structured interviews were conducted with 28 school-going adolescents in grades 10–12/13 and 14 of their school teachers, from seven secondary schools in Gampaha District, Sri Lanka. Interviews were transcribed, translated, coded inductively and analysed thematically. Results: All participants drew on culturally meaningful language that is rooted in Buddhist perspectives to conceptualise mental health. Causes and risk factors of poor mental health were attributed to individual, immediate environmental and structural factors. School environment played a central role in exacerbating other risk factors. Adolescents exhibited more knowledge of informal care avenues for mental health-related concerns. Conclusions: Findings highlight several implications including opportunities to leverage culturally contextualised language/frameworks when promoting mental health to Sri Lankan adolescents, diversifying mental health research and initiating school-based mental health programmes that integrate mental health promotion into routine educational practice to transform learning institutions across Sri Lanka to become mental health-promoting schools. Full article

Cultural ecosystem services (CESs) are the non-material benefits people derive from ecosystems and are important for human well-being. Most research has focused on individual CES supply–demand relationships, with little systematic study of the overall CES structure, interactions, and mechanisms in metropolitan areas. This study takes the Nanjing Metropolitan Area as a case study, integrating multi-source geospatial data and employing the MaxEnt model, self-organizing maps (SOMs), Spearman correlation analysis, and the Optimal Parameters-based Geographical Detector (OPGD). It analyzes supply–demand matching, trade-offs, synergies, and drivers for four CES categories: aesthetic (AE), recreational entertainment (RE), knowledge education (KE), and cultural diversity (CD). The main findings are as follows: (1) CES supply and demand are spatially zoned: the core area has surplus supply, secondary centers are balanced, and the periphery has both weak supply and demand. (2) Three supply–demand bundles have distinct synergy and trade-off patterns: Bundle 1 primarily exhibits strong synergy between AE and CD; Bundle 2 shows a weak trade-off relationship; and Bundle 3 forms a synergy centered on AE. (3) The explanatory power of driving factors exhibits pronounced spatial heterogeneity: Bundle 1 is dominated by non-quantifiable social factors; Bundle 2 features dual synergistic drivers of population and transportation; and Bundle 3 demonstrates synergistic effects driven by facilities and economic factors. Overall, this study contributes an integrated metropolitan-scale framework that connects CES supply–demand mismatch patterns with bundle typologies, interaction structures, and bundle-specific drivers. The results provide an operational basis for targeted planning and coordinated ecological–cultural governance in the Nanjing Metropolitan Area and offer a transferable reference for other metropolitan regions. Full article

Background/Objectives: Injuries to spinal ventral roots induce complex retrograde reactions that compromise motoneuron survival, synaptic organization, and glial responses, ultimately limiting the potential for regeneration. The endocannabinoid system (ECS) has emerged as a crucial modulator of neuroprotective processes, primarily through the activation of CB1 and CB2. However, the individual and combined contributions of these receptors to post-injury spinal responses remain poorly understood. Here, we examined the effects of selective blockade of CB1 and CB2 receptors in a murine model of ventral root crush (VRC). Methods: Female C57BL/6JUnib mice received daily intraperitoneal injections of the CB1 antagonist AM-251 and/or the CB2 antagonist AM-630 (1 mg/kg) for 14 days post-lesion. At 28 days after injury, spinal cords were analyzed for motoneuron survival (Nissl staining), glial responses (immunohistochemistry for GFAP and Iba-1), and synaptic coverage (immunohistochemistry for synaptophysin). Results: Selective blockade of CB2 receptors led to a marked reduction in motoneuron survival, enhanced microglial activation-associated morphology (morphological classification and Sholl analysis), and decreased synaptic coverage. CB1 blockade produced milder, context-dependent effects. Dual blockade exacerbated all outcomes, indicating complementary CB1/CB2 functions in the spinal microenvironment. Conclusions: Under the conditions tested, CB2 signaling is necessary for motoneuron preservation, limiting microglial activation-associated morphology, and maintaining synaptic coverage after VRC. The knowledge of specific actions of CB1 and CB2 provides mechanistic insight into the neuroprotective potential of endocannabinoid signaling and reinforces its therapeutic relevance for motoneuron preservation and functional recovery after axotomy. Full article

This manuscript examines how distinct epistemic attitudes toward singularity and generality have been articulated in medical writing across different historical contexts, offering a conceptual and meta-historical analysis of two enduring genres in biomedical literature: the individualized case report and the systematically aggregated clinical trial. Hippocratic case narratives are considered as a particularly lucid articulation of a mode of inquiry that privileges detailed observation of individual patients, while medieval Aristotelian natural philosophy exemplifies a contrasting emphasis on regularity, intelligibility, and general explanation. Renaissance medical and philosophical traditions are treated as a mediating moment in which attention to anomaly, wonder, and singularity was explicitly re-legitimized within learned medicine. These historically situated articulations are not presented as stages in a progressive narrative, but as recurrent epistemic orientations that are repeatedly reconfigured under different theoretical, institutional, and technological conditions. The paper argues that the tension between attention to exceptional cases and the pursuit of generalizable knowledge continues to structure modern biomedical writing, where case reports remain essential for identifying rare, novel, or anomalous phenomena, while clinical trials formalize strategies for producing reproducible, population-level evidence. Full article

Background/Objectives: In England, gay, bisexual, and other men who have sex with men (GBMSM) are eligible for vaccination at NHS sexual health services, including human papillomavirus (HPV), hepatitis A virus (HAV), and hepatitis B virus (HBV) vaccines. However, current research shows limited understanding of the factors influencing vaccination uptake among GBMSM. This study aimed to examine the barriers and facilitators affecting the offer and uptake of these vaccination programmes. Methods: A qualitative interview study following the Person-Based Approach (a systematic method for developing and optimising health interventions) involving GBMSM and sexual health service staff from two regions of England. Purposive sampling aimed to include GBMSM with diverse backgrounds and engagement with sexual health services. Patient and public involvement shaped the study design and interview topic guides. The interviews were recorded, transcribed, and thematically analysed to identify barriers and facilitators which were interpreted using the COM-B model of behaviour change. Results: Twenty GBMSM and eleven staff took part. The findings showed that opportunistic delivery of HPV, HAV, and HBV vaccination within sexual health services is mostly acceptable and feasible for GBMSM and staff, while also highlighting areas for optimization. Despite low knowledge of these viruses and their associated risks, willingness to be vaccinated was high, with healthcare provider recommendations and the convenience of vaccine delivery during routine clinic visits acting as important facilitators. However, the reach of opportunistic models was limited, particularly for individuals underserved by sexual health services or disengaged from GBMSM social networks. System-level barriers such as complex vaccine schedules (particularly when multiple schedules are combined), inconsistent access to vaccination histories, and limited system-level follow-up processes (e.g., automated invites and reminders) were also found to act as obstacles to vaccination uptake and delivery. Conclusions: To improve equitable uptake, sexual health services should explore the feasibility of addressing both individual and structural barriers through additional strategies, including targeted and persuasive communication to increase knowledge, leveraging regular contact with GBMSM to promote uptake, and implementing enhanced approaches to support vaccination completion (e.g., automated prompts or reminders). Full article

Unsafe behaviors remain a major contributor to workplace accidents within broader safety-management systems. Acknowledging the essential influence of organizational and leadership factors, this study focuses on systematically identifying and prioritizing individual-level determinants of unsafe behavior through an integrated qualitative–quantitative methodology to clarify their specific role within the wider safety framework. Grounded Theory analysis of semi-structured interviews with 40 industry professionals yielded a conceptual model encompassing demographic characteristics, general health, individual competencies, personality traits, and psychological factors. Subsequently, the Fuzzy Delphi Method, applied with 20 domain experts, validated and ranked these determinants. The analysis highlighted risk perception as the most influential factor, followed by work experience, skill level, knowledge, and risk-taking propensity, whereas variables such as family welfare, substance use, and self-display exhibited relatively minor effects. These findings reveal the multidimensional nature of unsafe behavior and underscore the importance of focusing on high-impact personal attributes to enhance workplace safety. By recognizing that many individual factors are shaped by organizational and psychosocial conditions, the study provides evidence-based insights for developing integrated safety management and targeted intervention strategies in industrial settings. Full article

The article presents the current state of knowledge on genetic modifiers of ovarian cancer risk in women carrying pathogenic variants (PVs) in the BRCA1 and BRCA2 genes, which are major contributors to hereditary susceptibility to this malignancy. Although PV carriers have high disease penetrance (BRCA1: ~40% and BRCA2: 11–27%), substantial variability in individual risk is observed, suggesting the influence of additional genetic variants. Background: Ovarian cancer is characterized by late detection and high mortality, and a significant portion of risk among BRCA1/2 carriers is shaped by reproductive and environmental factors as well as genetic modifiers. The article emphasizes that carriers of the same BRCA PV can exhibit markedly different risk levels depending on additional variants that modulate key biological processes, such as DNA repair, cell cycle regulation, and apoptosis. Methods: A systematic literature search covering the years 1996–2025 was conducted in the PubMed database. Initially, 734 publications were identified; after removing duplicates, thematically irrelevant articles, non-full-text papers, and studies not meeting the inclusion criteria, 47 articles were included in the review. These studies covered candidate gene analyses, GWAS, and data from the CIMBA consortium, which enables the examination of large cohorts of PV carriers. Results: The review identified numerous variants associated with increased or decreased ovarian cancer risk in BRCA1 carriers, including the following: OGG1, DR4, MDM2, CYP2A7, CASP8, ITGB3, HRAS1, TRIM61, and MTHFR. The reviewed studies also identified both protective and risk-increasing variants among BRCA2 PV carriers: UNG, TDG, and PARP2, and haplotypes in ATM, BRIP1, BARD1, MRE11, RAD51, and 9p22.2. The analysis identified 11 variants affecting both BRCA1 and BRCA2 carriers, most of which increase risk, including the following: IRS1, RSPO1, SYNPO2, BABAM1, MRPL34, PLEKHM1, and TIPARP. Protective variants include BNC2 and LINC00824. The only SNP reaching genome-wide significance (p < 5 × 10⁻⁸) was in BNC2. Conclusions: The article summarizes the growing number of genetic modifiers of ovarian cancer risk among BRCA1/2 carriers and highlights their potential to improve individualized risk assessment, enhance patient stratification, support personalized prevention and surveillance strategies, deepen the understanding of disease biology, and identify potential therapeutic targets. Full article

Data fluency—the ability and confidence to actively make sense of and use data—is increasingly recognized as essential for students’ civic participation and scientific literacy, yet questions remain about implementing data-rich instruction effectively. This exploratory mixed-methods study examined current practices and professional learning needs through surveys with 155 secondary Earth science educators across the United States and focus groups with 21 participants. Educators reported comprehensive engagement with data practices (91% using 5+ practice categories) but showed critical gaps: only 39% used pre-existing datasets despite their importance for investigating large-scale phenomena, 45% employed dynamic visualization tools that could democratize data exploration, and 18% did not foster dispositions for student data agency. Teachers recognized diverse student assets for data work, including community-based knowledge and problem-solving approaches, with 42% seeking support for community-connected pedagogy. Barriers included accessing relevant datasets (53%), time constraints (42%), and integrating data into lessons (47%)—challenges that reflect systemic rather than individual limitations. These findings reveal that while educators serving diverse communities envision data science as an opportunity to value different strengths and ways of knowing, realizing this transformative potential requires systematic support including accessible tools, relevant datasets, and professional learning that bridges recognition of student assets with classroom implementation. Full article