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Search Results (1,729)

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13 pages, 988 KiB  
Article
Assessing the Applicability of a Partial Alcohol Reduction Method to the Fine Wine Analytical Composition of Pinot Gris
by Diána Ágnes Nyitrainé Sárdy, Péter Bodor-Pesti and Szabina Steckl
Foods 2025, 14(15), 2738; https://doi.org/10.3390/foods14152738 - 5 Aug 2025
Abstract
Climate change has a significant negative impact on agriculture and food production. This trend requires technological development and the adaptation of new technologies in both the grapevine production and winemaking sectors. High temperatures and heat accumulation during the growing season result in faster [...] Read more.
Climate change has a significant negative impact on agriculture and food production. This trend requires technological development and the adaptation of new technologies in both the grapevine production and winemaking sectors. High temperatures and heat accumulation during the growing season result in faster ripening and a higher sugar content, leading to a higher alcohol content during fermentation. The negative consequences are an imbalanced wine character and consumer reluctance, as lower alcoholic beverages are now in high demand. Over the last decade, several methods have been developed to handle this impact and reduce the alcohol content of wines. In this study, we used the MASTERMIND® REMOVE membrane-based dealcoholization system to reduce the alcohol concentration in of Pinot gris wines from 12.02% v/v to 10.69% v/v and to investigate the effect on analytical parameters in three steps (0.5%, 1%, and 1.5% reductions) along the treatment. To evaluate the impact of the partial alcohol reduction and identify correlations between the wine chemical parameters, data were analyzed with ANOVA, PCA, multivariate linear regression and cluster analysis. The results showed that except for the extract, sugar content and proline content, the treatment had a significant effect on the chemical parameters. Both free and total SO2 levels were significantly reduced as well as volatile acid, glycerol and succinic acid levels. It must be highlighted that some parameters were not differing significantly between the untreated and the final wine, while the change was statistically verified in the intermediate steps of the partial alcohol reduction. This was the case for example for n-Propanol, i-Amylalcohol, Acetaldehyde, and Ethyl acetate. The multivariate linear regression model explained 18.84% of the total variance, indicating a modest but meaningful relationship between the alcohol content and the investigated analytical parameters. Our results showed that even if the applied instrument significantly modified some of the wine chemical parameters, those changes would not influence significantly the wine sensory attributes. Full article
(This article belongs to the Special Issue Winemaking: Innovative Technology and Sensory Analysis)
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22 pages, 982 KiB  
Article
Cross-Cultural Adaptation and Validation of the Spanish HLS-COVID-Q22 Questionnaire for Measuring Health Literacy on COVID-19 in Peru
by Manuel Caipa-Ramos, Katarzyna Werner-Masters, Silvia Quispe-Prieto, Alberto Paucar-Cáceres and Regina Nina-Chipana
Healthcare 2025, 13(15), 1903; https://doi.org/10.3390/healthcare13151903 - 5 Aug 2025
Abstract
Background/Objectives: The social importance of health literacy (HL) is widely understood, and its measurement is the subject of various studies. Due to the recent pandemic, several instruments for measuring HL about COVID-19 have been proposed in different countries, including the HLS-COVID-Q22 questionnaire. The [...] Read more.
Background/Objectives: The social importance of health literacy (HL) is widely understood, and its measurement is the subject of various studies. Due to the recent pandemic, several instruments for measuring HL about COVID-19 have been proposed in different countries, including the HLS-COVID-Q22 questionnaire. The diversity of cultures and languages necessitates the cross-cultural adaptation of this instrument. Thus, the present study translates, adapts, and validates the psychometric properties of the HLS-COVID-Q22 questionnaire to provide its cross-cultural adaptation from English to Spanish (Peru). Methods: As part of ensuring that the final questionnaire accommodates the cultural nuances and idiosyncrasies of the target language, the following activities were carried out: (a) a survey of 40 respondents; and (b) a focus group with 10 participants, followed by expert approval. In addition, the validity and reliability of the health instrument have been ascertained through a further pilot test administered to 490 people in the city of Tacna in southern Peru. Results: The resulting questionnaire helps measure HL in Peru, aiding better-informed decision-making for individual health choices. Conclusions: The presence of such a tool is advantageous in case of similar global health emergencies, when the questionnaire can be made readily available to support a promotion of strategies towards better self-care. Moreover, it encourages other Latin American stakeholders to adjust the instrument to their own cultural, language, and socio-economic contexts, thus invigorating the regional and global expansion of the HL study network. Full article
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26 pages, 1697 KiB  
Review
Integrating Climate Risk in Cultural Heritage: A Critical Review of Assessment Frameworks
by Julius John Dimabayao, Javier L. Lara, Laro González Canoura and Steinar Solheim
Heritage 2025, 8(8), 312; https://doi.org/10.3390/heritage8080312 - 4 Aug 2025
Abstract
Climate change poses an escalating threat to cultural heritage (CH), driven by intensifying climate-related hazards and systemic vulnerabilities. In response, risk assessment frameworks and methodologies (RAFMs) have emerged to evaluate and guide adaptation strategies for safeguarding heritage assets. This study conducts a state-of-the-art [...] Read more.
Climate change poses an escalating threat to cultural heritage (CH), driven by intensifying climate-related hazards and systemic vulnerabilities. In response, risk assessment frameworks and methodologies (RAFMs) have emerged to evaluate and guide adaptation strategies for safeguarding heritage assets. This study conducts a state-of-the-art (SotA) review of 86 unique RAFMs using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic approach to assess their scope, methodological rigor, alignment with global climate and disaster risk reduction (DRR) frameworks, and consistency in conceptual definitions of hazard, exposure, and vulnerability. Results reveal a growing integration of Intergovernmental Panel on Climate Change (IPCC)-based climate projections and alignment with international policy instruments such as the Sendai Framework and United Nations Sustainable Development Goals (UN SDGs). However, notable gaps persist, including definitional inconsistencies, particularly in the misapplication of vulnerability concepts; fragmented and case-specific methodologies that challenge comparability; and limited integration of intangible heritage. Best practices include participatory stakeholder engagement, scenario-based modeling, and incorporation of multi-scale risk typologies. This review advocates for more standardized, interdisciplinary, and policy-aligned frameworks that enable scalable, culturally sensitive, and action-oriented risk assessments, ultimately strengthening the resilience of cultural heritage in a changing climate. Full article
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26 pages, 792 KiB  
Article
From Green to Adaptation: How Does a Green Business Environment Shape Urban Climate Resilience?
by Lei Li, Xi Zhen, Xiaoyu Ma, Shaojun Ma, Jian Zuo and Michael Goodsite
Systems 2025, 13(8), 660; https://doi.org/10.3390/systems13080660 - 4 Aug 2025
Abstract
Strengthening climate resilience constitutes a foundational approach through which cities adapt to climate change and mitigate associated environmental risks. However, research on the influence of economic policy environments on climate resilience remains limited. Guided by institutional theory and dynamic capability theory, this study [...] Read more.
Strengthening climate resilience constitutes a foundational approach through which cities adapt to climate change and mitigate associated environmental risks. However, research on the influence of economic policy environments on climate resilience remains limited. Guided by institutional theory and dynamic capability theory, this study employs a panel dataset comprising 272 Chinese cities at the prefecture level and above, covering the period from 2009 to 2023. It constructs a composite index framework for evaluating the green business environment (GBE) and urban climate resilience (UCR) using the entropy weight method. Employing a two-way fixed-effect regression model, it examined the impact of GBE optimization on UCR empirically and also explored the underlying mechanisms. The results show that improvements in the GBE significantly enhance UCR, with green innovation (GI) in technology functioning as an intermediary mechanism within this relationship. Moreover, climate policy uncertainty (CPU) exerts a moderating effect along this transmission pathway: on the one hand, it amplifies the beneficial effect of the GBE on GI; on the other hand, it hampers the transformation of GI into improved GBEs. The former effect dominates, indicating that optimizing the GBE becomes particularly critical for enhancing UCR under high CPU. To eliminate potential endogenous issues, this paper adopts a two-stage regression model based on the instrumental variable method (2SLS). The above conclusion still holds after undergoing a series of robustness tests. This study reveals the mechanism by which a GBE enhances its growth through GI. By incorporating CPU as a heterogeneous factor, the findings suggest that governments should balance policy incentives with environmental regulations in climate resilience governance. Furthermore, maintaining awareness of the risks stemming from climate policy volatility is of critical importance. By providing a stable and supportive institutional environment, governments can foster steady progress in green innovation and comprehensively improve urban adaptive capacity to climate change. Full article
(This article belongs to the Section Systems Practice in Social Science)
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12 pages, 432 KiB  
Article
Impact of Lumbar Arthrodesis on Activities of Daily Living in Japanese Patients with Adult Spinal Deformity Using a Novel Questionnaire Focused on Oriental Lifestyle
by Naobumi Hosogane, Takumi Takeuchi, Kazumasa Konishi, Yosuke Kawano, Masahito Takahashi, Azusa Miyamoto, Atsuko Tachibana and Hitoshi Kono
J. Clin. Med. 2025, 14(15), 5482; https://doi.org/10.3390/jcm14155482 - 4 Aug 2025
Abstract
Background/Objectives: Correction surgery for adult spinal deformity (ASD) reduces disability but may lead to spinal stiffness. Cultural diversity may also influence how this stiffness affects daily life. We aimed to evaluate the impact of correction surgery on Japanese patients with ASD using a [...] Read more.
Background/Objectives: Correction surgery for adult spinal deformity (ASD) reduces disability but may lead to spinal stiffness. Cultural diversity may also influence how this stiffness affects daily life. We aimed to evaluate the impact of correction surgery on Japanese patients with ASD using a newly developed questionnaire and to clarify how these patients adapt to their living environment postoperatively in response to spinal stiffness. Methods: This retrospective study included 74 Japanese patients with operative ASD (mean age: 68.2 ± 7.5 years; fusion involving >5 levels) with a minimum follow-up of 1 year. Difficulties in performing various activities of daily living (ADLs) were assessed using a novel 20-item questionnaire tailored to the Oriental lifestyle. The questionnaire also evaluated lifestyle and environmental changes after surgery. Sagittal and coronal spinal parameters were measured using whole-spine radiographs, and clinical outcomes were assessed using the ODI and SRS-22 scores. Results: Coronal and sagittal alignment significantly improved postoperatively. Although the total ADL score remained unchanged, four trunk-bending activities showed significant deterioration. The lower instrumented vertebrae level and pelvic fusion were associated with lower scores in 11 items closely related to trunk bending or the Oriental lifestyle. After surgery, 61% of patients switched from a Japanese-style mattress to a bed, and 72% swapped their low dining table for one with chairs. Both the ODI and SRS-22 scores showed significant postoperative improvements. Conclusions: Trunk-bending activities worsened postoperatively in Japanese patients with ASD, especially those who underwent pelvic fusion. Additionally, patients often modified their living environment after surgery to accommodate spinal stiffness. Full article
(This article belongs to the Special Issue Clinical Advancements in Spine Surgery: Best Practices and Outcomes)
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18 pages, 4799 KiB  
Article
An Adaptive CNN-Based Approach for Improving SWOT-Derived Sea-Level Observations Using Drifter Velocities
by Sarah Asdar and Bruno Buongiorno Nardelli
Remote Sens. 2025, 17(15), 2681; https://doi.org/10.3390/rs17152681 - 3 Aug 2025
Viewed by 86
Abstract
The Surface Water and Ocean Topography (SWOT) mission provides unprecedented high-resolution observations of sea-surface height. However, their direct use in ocean circulation studies is complicated by the presence of small-scale unbalanced motion signals and instrumental noise, which hinder accurate estimation of geostrophic velocities. [...] Read more.
The Surface Water and Ocean Topography (SWOT) mission provides unprecedented high-resolution observations of sea-surface height. However, their direct use in ocean circulation studies is complicated by the presence of small-scale unbalanced motion signals and instrumental noise, which hinder accurate estimation of geostrophic velocities. To address these limitations, we developed an adaptive convolutional neural network (CNN)-based filtering technique that refines SWOT-derived sea-level observations. The network includes multi-head attention layers to exploit information on concurrent wind fields and standard altimetry interpolation errors. We train the model with a custom loss function that accounts for the differences between geostrophic velocities computed from SWOT sea-surface topography and simultaneous in-situ drifter velocities. We compare our method to existing filtering techniques, including a U-Net-based model and a variational noise-reduction filter. Our adaptive-filtering CNN produces accurate velocity estimates while preserving small-scale features and achieving a substantial noise reduction in the spectral domain. By combining satellite and in-situ data with machine learning, this work demonstrates the potential of an adaptive CNN-based filtering approach to enhance the accuracy and reliability of SWOT-derived sea-level and velocity estimates, providing a valuable tool for global oceanographic applications. Full article
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16 pages, 1690 KiB  
Article
Effect of Photobiomodulation on Post-Endodontic Pain Following Single-Visit Treatment: A Randomized Double-Blind Clinical Trial
by Glaucia Gonçales Abud Machado, Giovanna Fontgalland Ferreira, Erika da Silva Mello, Ellen Sayuri Ando-Suguimoto, Vinicius Leão Roncolato, Marcia Regina Cabral Oliveira, Janainy Altrão Tognini, Adriana Fernandes Paisano, Cleber Pinto Camacho, Sandra Kalil Bussadori, Lara Jansiski Motta, Cinthya Cosme Gutierrez Duran, Raquel Agnelli Mesquita-Ferrari, Kristianne Porta Santos Fernandes and Anna Carolina Ratto Tempestini Horliana
J. Pers. Med. 2025, 15(8), 347; https://doi.org/10.3390/jpm15080347 - 2 Aug 2025
Viewed by 145
Abstract
The evidence for photobiomodulation in reducing postoperative pain after endodontic instrumentation is classified as low or very low certainty, indicating a need for further research. Longitudinal pain assessments over 24 h are crucial, and studies should explore these pain periods. Background/Objectives: This [...] Read more.
The evidence for photobiomodulation in reducing postoperative pain after endodontic instrumentation is classified as low or very low certainty, indicating a need for further research. Longitudinal pain assessments over 24 h are crucial, and studies should explore these pain periods. Background/Objectives: This double-blind, randomized controlled clinical trial evaluated the effect of PBM on pain following single-visit endodontic treatment of maxillary molars at 4, 8, 12, and 24 h. Primary outcomes included pain at 24 h; secondary outcomes included pain at 4, 8, and 12 h, pain during palpation/percussion, OHIP-14 analysis, and frequencies of pain. Methods: Approved by the Research Ethics Committee (5.598.290) and registered in Clinical Trials (NCT06253767), the study recruited adults (21–70 years) requiring endodontic treatment in maxillary molars. Fifty-eight molars were randomly assigned to two groups: the PBM Group (n = 29), receiving conventional endodontic treatment with PBM (100 mW, 333 mW/cm2, 9 J distributed at 3 points near root apices), and the control group (n = 29), receiving conventional treatment with PBM simulation. Pain was assessed using the Visual Analog Scale. Results: Statistical analyses used chi-square and Mann–Whitney tests, with explained variance (η2). Ten participants were excluded, leaving 48 patients for analysis. No significant differences were observed in postoperative pain at 24, 4, 8, or 12 h, or in palpation/percussion or OHIP-14 scores. Pain frequencies ranged from 12.5% to 25%. Conclusions: PBM does not influence post-treatment pain in maxillary molars under these conditions. These results emphasize the importance of relying on well-designed clinical trials to guide treatment decisions, and future research should focus on personalized dosimetry adapted to the anatomical characteristics of the treated dental region to enhance the accuracy and efficacy of therapeutic protocols. Full article
(This article belongs to the Special Issue Towards Precision Anesthesia and Pain Management)
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16 pages, 1919 KiB  
Article
CampyTube: Seamless Integration of a Molecular Test and Lateral Flow Detection of Campylobacter in a Single Vial
by Natalia Sandetskaya, Andreas Kölsch, Kai Mattern, Vanessa Vater, Dirk Kuhlmeier and Florian Priller
Biosensors 2025, 15(8), 497; https://doi.org/10.3390/bios15080497 - 1 Aug 2025
Viewed by 107
Abstract
Background: The efficient control of hygiene and Campylobacter’s contamination status at various steps of poultry meat production is essential for the prevention of Campylobacter transmission to humans. Microbiological methods are laborious and time-consuming, and molecular methods of detection are often too skill- [...] Read more.
Background: The efficient control of hygiene and Campylobacter’s contamination status at various steps of poultry meat production is essential for the prevention of Campylobacter transmission to humans. Microbiological methods are laborious and time-consuming, and molecular methods of detection are often too skill- and infrastructure-demanding. Methods: We have developed CampyTube, a simple and user-friendly format for the integration of isothermal DNA amplification with embedded instrument-free detection on a miniaturized lateral flow test in a single vial. All test components, from the dry amplification reagents to the mini lateral flow tests, are incorporated into a standard single vial, which is closed after the addition of the liquid sample and never has to be opened again. This ensures the absolute prevention of carry-over contamination and makes the system very safe and simple to use in point-of-need settings. Results: As few as 60 Campylobacter genome copies per reaction could be successfully detected with CampyTube. We have primarily developed and evaluated CampyTube for the detection of Campylobacter in chicken neck skin samples and could reach 100% sensitivity and 100% specificity in the samples exceeding the regulatory limit of 1000 CFU/g confirmed microbiologically, while the sensitivity in all samples that tested positive using qPCR (1.4 × 102–2.5 × 106 genome copies/g) was 71.1%. We discuss the impact of sample preparation on CampyTube performance and suggest further options for test optimization. Conclusions: CampyTube is a highly versatile and efficient, yet simple, affordable, and material-saving system that can be adapted for other targets and sample types. Full article
(This article belongs to the Special Issue Biosensors for Monitoring and Diagnostics)
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19 pages, 440 KiB  
Article
Contextual Study of Technostress in Higher Education: Psychometric Evidence for the TS4US Scale from Lima, Peru
by Guillermo Araya-Ugarte, Miguel Armesto-Céspedes, Nicolás Contreras-Barraza, Alejandro Vega-Muñoz, Guido Salazar-Sepúlveda and Nelson Lay
Sustainability 2025, 17(15), 6974; https://doi.org/10.3390/su17156974 - 31 Jul 2025
Viewed by 277
Abstract
Sustainable education requires addressing the challenges posed by digital transformation, including technostress among university students. This study evaluates technostress levels in higher education through the validation of the TS4US scale and its implications for sustainable learning environments. A cross-sectional study was conducted with [...] Read more.
Sustainable education requires addressing the challenges posed by digital transformation, including technostress among university students. This study evaluates technostress levels in higher education through the validation of the TS4US scale and its implications for sustainable learning environments. A cross-sectional study was conducted with 328 university students from four districts in Lima, Peru, using an online survey to measure technostress. Confirmatory factor analysis (CFA) was performed to assess the psychometric properties of the TS4US scale, resulting in a refined model with two latent factors and thirteen validated items. Findings indicate that 28% of students experience high technostress levels, while 5% report very high levels, though no significant associations were found between technostress and sociodemographic variables such as campus location, employment status, gender, and academic level. The TS4US instrument had been previously validated in Chile; this study confirms its structure in a new sociocultural context, reinforcing its cross-cultural applicability. These results highlight the need for sustainable strategies to mitigate technostress in higher education, including institutional support, digital literacy programs, and policies fostering a balanced technological environment. Addressing technostress is essential for promoting sustainable education (SDG4) and enhancing student well-being (SDG3). This study directly contributes to the achievement of Sustainable Development Goals 3 (Good Health and Well-being) and 4 (Quality Education) by providing validated tools and evidence-based recommendations to promote mental health and equitable access to digital education in Latin America. Future research should explore cross-country comparisons and targeted interventions, including digital well-being initiatives and adaptive learning strategies, to ensure a resilient and sustainable academic ecosystem. Full article
(This article belongs to the Section Sustainable Education and Approaches)
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11 pages, 1521 KiB  
Article
Thermal Treatment Prevents Effects of Downward Loads on the Screw-In Force Generation and Canal-Centering Ability of Nickel–Titanium Rotary Instruments
by Keiichiro Maki, Arata Ebihara, Yanshan Luo, Yuka Kasuga, Hayate Unno, Satoshi Omori, Shunsuke Kimura and Takashi Okiji
Materials 2025, 18(15), 3610; https://doi.org/10.3390/ma18153610 - 31 Jul 2025
Viewed by 206
Abstract
This study aimed to examine how downward load applied during instrumentation affects the stress generation and shaping properties in thermally treated and non-treated NiTi rotary instruments. ProTaper Universal (PTU; non-thermally treated) and ProTaper Gold (PTG; thermally treated) were used to prepare J-shaped canals [...] Read more.
This study aimed to examine how downward load applied during instrumentation affects the stress generation and shaping properties in thermally treated and non-treated NiTi rotary instruments. ProTaper Universal (PTU; non-thermally treated) and ProTaper Gold (PTG; thermally treated) were used to prepare J-shaped canals in resin blocks. Load-controlled automated instrumentation and torque/force sensing devices were employed with preset downward loads of 1, 2, or 3 N (n = 10 each). The torque/force, instrumentation time, and canal-centering ratio were measured and analyzed using two-way or one-way analysis of variance with Tukey’s test (α = 0.05). In the PTU-1N group, instrumentation was not completed because a ledge was formed in all canals. The PTU-3N group showed significantly greater upward force (screw-in force) and clockwise torque, along with a significantly smaller canal-centering ratio (less deviation) at the apical 0 mm level, than the PTU-2N group (p < 0.05). The downward load did not influence the instrumentation time (p > 0.05). In the PTG groups, these effects of downward load on the force generation and canal-centering ratio were not significant (p > 0.05). In the non-thermally treated PTU instruments, greater downward loads enhanced screw-in force while decreasing apical canal deviation; however, these effects were abolished in the thermally treated PTG instruments. This study highlights the importance of adapting the instrumentation technique with instrument characteristics: thermally treated flexible instruments facilitate smoother use, while stiffer, non-thermally treated ones may require precise control of downward loads. Full article
(This article belongs to the Topic Advances in Dental Materials)
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16 pages, 489 KiB  
Review
A Scoping Review of Psychometric Instruments Measuring Teachers’ Resilience
by Athena Daniilidou and Christos Pezirkianidis
Encyclopedia 2025, 5(3), 109; https://doi.org/10.3390/encyclopedia5030109 - 31 Jul 2025
Viewed by 181
Abstract
Over the past two decades, rising concerns about teacher stress and professional sustainability have fueled the development of instruments assessing teacher resilience. This review aims to map the existing resilience assessment tools specifically designed for educators, evaluating their theoretical frameworks, psychometric soundness, and [...] Read more.
Over the past two decades, rising concerns about teacher stress and professional sustainability have fueled the development of instruments assessing teacher resilience. This review aims to map the existing resilience assessment tools specifically designed for educators, evaluating their theoretical frameworks, psychometric soundness, and contextual relevance. Twelve instruments were analyzed through an extensive literature review of peer-reviewed studies published over the past twenty years, including general, preservice, EFL, and teacher-specific scales for special education. Findings reveal a progression from early instruments emphasizing intrapersonal traits to current tools incorporating ecological and contextual dimensions. While several scales demonstrate satisfactory reliability and cross-cultural applicability, many still suffer from conceptual limitations, insufficient cultural adaptation, or marginal psychometric robustness. This review concludes that despite significant advances, future research must prioritize culturally grounded frameworks, broader subgroup validation, and advanced psychometric methodologies to ensure accurate, inclusive, and practical assessments of teacher resilience across diverse educational settings. Full article
(This article belongs to the Section Social Sciences)
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14 pages, 357 KiB  
Article
Reliability and Validation Study of the Spanish Translation of the Nociception Coma Scale-Revised—Adapted for Intubated Patients (NCS-R-I)
by Candelas López-López, Gemma Robleda-Font, María del Mar Sánchez-Sánchez, Carmen María Sarabia-Cobo, Ignacio Latorre-Marco, Montserrat Solís-Muñoz, Teresa Pérez-Pérez, Cristina Martín-Arriscado Arroba, Caroline Schnakers and Juan Roldan-Merino
Nurs. Rep. 2025, 15(8), 278; https://doi.org/10.3390/nursrep15080278 - 30 Jul 2025
Viewed by 268
Abstract
Background/Objectives: Pain assessment scales provide a clear clinical benefit in patients who are unable to self-report. The Nociception Coma Scale-Revised—adapted for Intubated patients (NCS-R-I) was developed to assess pain in patients with acquired brain injury who are unable to self-report. However, this [...] Read more.
Background/Objectives: Pain assessment scales provide a clear clinical benefit in patients who are unable to self-report. The Nociception Coma Scale-Revised—adapted for Intubated patients (NCS-R-I) was developed to assess pain in patients with acquired brain injury who are unable to self-report. However, this instrument has not yet been translated and validated for use in Spain. The objective was to translate the Nociception Coma Scale-Revised—adapted for Intubated patients (NCS-R-I) into Spanish and to assess the reliability and validity of the Spanish version in patients with brain injury. Methods: This study was carried out in two phases. First, the scale was translated into Spanish. Next, a psychometric analysis was performed to determine the reliability and validity of the Spanish version of the NCS-R-I in 207 critically ill patients with acquired brain injury and disorders of consciousness. Two blinded observers administered the scale at three time points: 5 min before, during, and 15 min after a series of nociceptive and non-nociceptive procedures. Results: The internal consistency of the NCS-R-I was acceptable (ordinal alpha = 0.60–0.90). Interobserver agreement was good (kappa = 0.80; intraclass correlation coefficient = 0.90). In terms of discriminant validity, the AUC was 0.952 (95% CI: 0.931–0.973). NCS-R-I scores increased significantly during performance of nociceptive procedures compared to scores obtained before and after these procedures, confirming the scale’s sensitivity to change. Similarly, during the performance of nociceptive procedures, scores on the NCS-R-I were significantly higher (p < 0.001) than those observed during non-nociceptive procedures. Conclusions: The results of this study demonstrate that the NCS-R-I is a valid, reliable tool for the assessment of pain in patients with acquired brain injury who are unable to self-report. Full article
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10 pages, 390 KiB  
Article
Art Therapy and Its Impact on Mood and Emotional States in Pediatric Hematology Oncology Units: Translation and Validation of the Italian Version of the Arts Observational Scale (ArtsObS)
by Marianna Avola, Enrica Garibaldi, Milena La Spina, Andrea Di Cataldo, Giovanna Russo, Luca Lo Nigro, Maria Montanaro, Dorella Scarponi, Angela Militello, Clara Raciti, Federica Maio, Antonella Agodi, Martina Barchitta, Paola Adamo, Soani Duca, Davide Massidda, Momcilo Jankovic, Giulia Zucchetti and Cinzia Favara Scacco
Healthcare 2025, 13(15), 1851; https://doi.org/10.3390/healthcare13151851 - 29 Jul 2025
Viewed by 262
Abstract
Background/Objectives: Art therapy is a psychotherapeutic technique that involves the creation of tangible visual arts and represents a coping strategy to support children with cancer. Evaluating the effects of such activities on children with cancer is essential for providing evidence of the [...] Read more.
Background/Objectives: Art therapy is a psychotherapeutic technique that involves the creation of tangible visual arts and represents a coping strategy to support children with cancer. Evaluating the effects of such activities on children with cancer is essential for providing evidence of the value that creativity holds within healthcare systems. A dedicated tool for assessing the creative process is the Arts Observational Scale (ArtsObS), focusing on mood and emotional states as key indicators of psychosocial well-being. This study aims to validate a translated version of the ArtsObS in the Italian language. Methods: The translation process followed recommendations for translation and cultural adaptation. The distribution properties of the scores, internal consistency, sensitivity to change, reliability, and convergent validity were assessed through observations conducted by two different evaluators. Results: The ArtsObS in its Italian adaptation is proven to be an adequate tool for capturing changes following an intervention, with good internal consistency and low sensitivity to differences between operators. The analysis supports the reliability of the ArtsObS across different observers. Conclusions: The Italian ArtsObS is a valid and reliable instrument for evaluating the impact of art therapy on pediatric patients’ mood and emotional states. It provides a standardized tool for clinical and research settings to assess creative interventions in pediatric oncology. Full article
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19 pages, 717 KiB  
Article
Advancing Nuclear Energy Governance Through Strategic Pathways for Q-NPT Adoption
by Hassan Qudrat-Ullah
Energies 2025, 18(15), 4040; https://doi.org/10.3390/en18154040 - 29 Jul 2025
Viewed by 190
Abstract
This paper proposes a strategic framework to enhance nuclear energy governance by advancing the Qudrat-Ullah Nuclear Peace and Trust (Q-NPT) framework. Designed to complement existing treaties such as the Nuclear Non-Proliferation Treaty (NPT) and International Atomic Energy Agency (IAEA) safeguards, Q-NPT integrates principles [...] Read more.
This paper proposes a strategic framework to enhance nuclear energy governance by advancing the Qudrat-Ullah Nuclear Peace and Trust (Q-NPT) framework. Designed to complement existing treaties such as the Nuclear Non-Proliferation Treaty (NPT) and International Atomic Energy Agency (IAEA) safeguards, Q-NPT integrates principles of equity, transparency, and trust to address persistent governance challenges. The framework emphasizes sustainable nuclear technology access, multilateral cooperation, and integration with global energy transition goals. Through an analysis of institutional, economic, technological, and geopolitical barriers, the study outlines actionable pathways for adoption, including legal harmonization, differentiated financial instruments, and deployment of advanced verification technologies such as blockchain, artificial intelligence (AI), and remote monitoring. A phased implementation timeline is presented, enabling adaptive learning and stakeholder engagement over short-, medium-, and long-term horizons. Regional case studies, including Serbia and Latin America, demonstrate the framework’s applicability in diverse contexts. By linking nuclear policy to broader climate, energy equity, and global security objectives, Q-NPT offers an operational and inclusive roadmap for future-ready governance. This approach contributes to the literature on energy systems transformation by situating nuclear governance within a sustainability-oriented, trust-centered paradigm. Full article
(This article belongs to the Section C: Energy Economics and Policy)
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14 pages, 4714 KiB  
Review
Dermatopathological Challenges in Objectively Characterizing Immunotherapy Response in Mycosis Fungoides
by Amy Xiao, Arivarasan Karunamurthy and Oleg Akilov
Dermatopathology 2025, 12(3), 22; https://doi.org/10.3390/dermatopathology12030022 - 29 Jul 2025
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Abstract
In this review, we explore the complexities of objectively assessing the response to immunotherapy in mycosis fungoides (MF), a prevalent form of cutaneous T-cell lymphoma. The core challenge lies in distinguishing between reactive and malignant lymphocytes amidst treatment, particularly given the absence of [...] Read more.
In this review, we explore the complexities of objectively assessing the response to immunotherapy in mycosis fungoides (MF), a prevalent form of cutaneous T-cell lymphoma. The core challenge lies in distinguishing between reactive and malignant lymphocytes amidst treatment, particularly given the absence of uniform pathological biomarkers for MF. We highlight the vital role of emerging histological technologies, such as multispectral imaging and spatial transcriptomics, in offering a more profound insight into the tumor microenvironment (TME) and its dynamic response to immunomodulatory therapies. Drawing on parallels with melanoma—another immunogenic skin cancer—our review suggests that methodologies and insights from melanoma could be instrumental in refining the approach to MF. We specifically focus on the prognostic implications of various TME cell types, including CD8+ tumor-infiltrating lymphocytes, natural killer (NK) cells, and histiocytes, in predicting therapy responses. The review culminates in a discussion about adapting and evolving treatment response quantification strategies from melanoma research to the distinct context of MF, advocating for the implementation of novel techniques like high-throughput T-cell receptor gene rearrangement analysis. This exploration underscores the urgent need for continued innovation and standardization in evaluating responses to immunotherapies in MF, a field rapidly evolving with new therapeutic strategies. Full article
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