Search Results (4,895)

The diffusion and application of advanced and applicable agricultural technologies serve as critical support for realizing the green transition and promoting high-quality agricultural development. This study constructs a two-dimensional analytical framework encompassing external intervention, internal motivation, and behavioral response. Based on micro survey data collected from 675 rice-growing households across Jiangsu Province, China, this study empirically examines the impact of agricultural technology extension services, a representative form of external intervention, on farmers’ adoption of the One-time Fertilization Technology for Mechanized Transplanting Rice (OFT), and its underlying mechanisms. The results demonstrate that external intervention acts as the core exogenous driver of farmers’ adoption of advanced agricultural technologies, with its transmission effect dependent on the mediating and moderating functions of farmers’ internal perceptions. Agricultural technology extension services facilitate technology adoption primarily by improving farmers’ technical cognition and enhancing their value perception. Notably, the effectiveness of extension services is more pronounced among farmers with higher levels of risk perception. The effect of external intervention is jointly shaped by the endowment of regional extension resources and the inherent demand of farmers, with significantly stronger extension effects observed in less developed major agricultural production areas compared to economically developed regions. This study concludes that promoting the adoption of advanced agricultural technologies requires sustained efforts to strengthen the supply of extension services, optimize the design of extension service content, implement differentiated extension strategies, and fully align with the characteristics of farmers’ risk preferences and regional heterogeneity. Full article

Introduction: Individuals aging with HIV face significant challenges that can negatively impact their long-term health, including biomedical complications, premature aging, and the influential role of aging-related stereotypes. Our study aimed to investigate whether a more positive self-perception of aging is associated with better health-related quality of life and less adverse impacts of premature aging on people living with HIV. Methods: We conducted a multicenter study combining a cross-sectional survey with a 2-year retrospective extraction of clinical data from medical records, involving 285 participants aged ≥ 50 years (77.9% male) living with HIV in Spain. Participants reported their health-related quality of life, self-perception of aging, and cultural age-related stereotypes. Additionally, two years of retrospective clinical health data were collected for eight areas: Metabolic, Neurological, Neoplastic, Bone, Hepatic, Renal, Cardiovascular, and Others. Results: As expected, worse physical health over the past two years had a negative impact on the self-perception of aging. Cultural age-related stereotypes of warmth and competence were found to predict their internalization into the self-concept. However, only self-perceived competence mediated the influence of the cultural age-related stereotype of the competence dimension on a more positive self-perception of aging. Furthermore, a positive self-perception of aging positively predicts all dimensions of health-related quality of life. Conclusions: Our data suggest two interrelated pathways that may influence the aging process: a clinical pathway, characterized by the negative impact of pre-existing comorbidities, and a psychosocial pathway, related to the internalization of cultural stereotypes. This study highlights the impact of cultural stereotypes on the self-perception of aging through their internalization in a sample of individuals experiencing premature aging. Full article

This study examines how village spatial institutional capacity (knowledge resources, relational resources, and mobilization capacity) and intra-organizational collaboration jointly shape the governance of agricultural irrigation systems. Using survey data from 840 households in six provinces of China’s Yellow River Basin, we employ OLS regression, bootstrapped quantile regression and moderation analysis. The empirical results indicate that both village spatial institutional capacity and internal collaboration significantly and positively affect comprehensive irrigation governance performance. Specifically, OLS results reveal that knowledge resources ($\mathsf{\beta }$ = 0.0029, p < 0.1), relational resources ($\mathsf{\beta }$ = 0.0711, p < 0.01), and mobilization capacity ($\mathsf{\beta }$ = 0.0236, p < 0.05) significantly enhance comprehensive performance, and internal collaboration exerts a significant positive moderating effect between institutional capacity and governance performance. Furthermore, quantile regression analysis reveals a non-linear distribution of this effect: the safeguarding role of institutional capacity is more prominent in the early stages of governance, whereas the driving role of internal collaboration shows an increasing trend in the middle and later stages. This study theoretically addresses the limitations of past reliance solely on the concept of “social capital” and provides robust empirical evidence for transitioning irrigation management from traditional top-down administrative dominance to a multi-centered, participatory self-governance model. Full article

Resilience is critical for construction projects to cope with diverse risks and uncertainties. Inter-organizational relationship governance has been widely recognized as an important means of strengthening project resilience. However, existing research has paid limited attention to how different governance mechanisms interact and combine to enhance resilience in construction projects. Drawing on a configurational perspective, this study examines how contractual, hierarchical, and network governance jointly contribute to construction project resilience. Based on survey data from 289 practitioners, fuzzy-set qualitative comparative analysis (fsQCA) is employed to identify the governance configurations associated with high project resilience. The results reveal three configurational pathways leading to high resilience: (1) relational–structural network governance coupled with contractual governance; (2) a combination of contractual, hierarchical, and network governance; (3) relational–cognitive network governance coupled with contractual governance. These findings offer important theoretical and practical implications for understanding the role of hybrid governance in the resilience of construction projects. Theoretically, this study extends resilience research by demonstrating that contractual, hierarchical, and network governance do not operate in isolation but jointly enhance project resilience through distinct configurations. Practically, these findings offer guidance for project stakeholders to optimize and integrate governance mechanisms, thereby improving their capacity to anticipate, respond to, and manage internal and external crises. Full article

Background: Post-stroke spasticity is a frequent and disabling consequence of stroke, including when affecting the lower limbs, where it may impair stance, gait, balance, postural control, functional independence and quality of life. Botulinum toxin type A (BoNT-A) is widely used as a focal neuromodulatory treatment for post-stroke spasticity. However, the relationship between BoNT-A-induced reduction in muscle hypertonia, objective changes in spastic muscle’s biomechanical properties, and functional outcomes such as mobility and balance remains insufficiently clarified. This systematic review aimed to synthesize recent evidence regarding the non-invasive assessment of spastic muscle properties following BoNT-A administration in post-stroke patients, with emphasis on mobility and balance outcomes. Methods: A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was performed in international electronic databases and included studies published between 1 January 2023 and 31 December 2025. The search strategy used specific keywords and keyword combinations/syntaxes, contextually, related to the topic of interest. Results: A total of 32 studies met the eligibility criteria and were included in the final data analysis and synthesis, comprising 13 primary clinical studies—6 randomized or controlled interventional studies and 7 observational studies—together with 12 reviews or evidence syntheses, 3 technical or clinical framework papers, and 4 survey, epidemiological, health-services or health-economic studies. Overall, the included articles addressed BoNT-A treatment in post-stroke spasticity, with partial focus on muscle properties, gait, mobility, and functional outcomes. However, only a limited number of studies investigated objective non-invasive assessment methods, and few directly related muscle-property changes in balance and mobility outcomes. Formal risk-of-bias assessment and quantitative synthesis were not performed because of the substantial heterogeneity of the included evidence, with only two studies being potentially suitable for pooling and these addressing different muscle groups, interventions, and outcome domains. Discussion and Conclusions: The reviewed literature confirms the clinical relevance of BoNT-A in the management of post-stroke spasticity. However, most studies assess treatment effects mainly through clinical scales, while objective evaluation of muscle stiffness, elasticity, viscoelastic properties, and their relationship with mobility and balance remains limited. Although some studies address gait, functional recovery, or muscle-related changes, the combined use of BoNT-A treatment, myotonometric assessment, and proprioceptive–stabilometric evaluation is largely absent. Therefore, current evidence highlights an important research gap and supports the need for future longitudinal studies integrating non-invasive biomechanical and balance assessment tools to better monitor treatment response and guide individualized neurorehabilitation in post-stroke patients. Full article

Background/Objectives: Dietary habits are important modifiable factors influencing survival among cancer patients. The dietary quality among cancer survivors may differ from those of the general population and may vary according to age at cancer diagnosis. This study aimed to compare dietary quality between cancer survivors and the general population and to examine whether age at diagnosis is associated with dietary quality. Methods: This retrospective cross-sectional study used data from 8706 adults aged ≥ 30 years (641 cancer survivors and 8065 controls) from the 2019–2021 Korea National Health and Nutrition Examination Survey. Dietary quality was assessed using the Diet Quality Index-International (DQI-I; range 0–100). Survey-weighted multiple linear regression models were used to compare DQI-I scores between cancer survivors and controls. Subgroup analyses were stratified by age at diagnosis, and quadratic age terms were included to assess nonlinear associations. All analyses accounted for the complex survey design. Results: Cancer survivors had significantly higher mean DQI-I scores than controls (69.1 ± 0.4 vs. 66.1 ± 0.2; p < 0.001). Among survivors diagnosed before age 50, dietary quality was significantly higher in those currently under 65 years than in controls (mean difference +3.02, 95% CI 1.44–4.60), but notably lower in those aged ≥ 65 years (−3.18, 95% CI −6.16 to −0.20). In contrast, survivors diagnosed at age ≥ 50 consistently showed higher dietary quality than controls across all age groups (+3.76, 95% CI 2.83–4.68). Conclusions: While cancer survivors generally exhibit better dietary quality than the general population, this positive trend was not observed among younger-onset survivors in older age groups. These findings suggest that age at cancer diagnosis may be associated with dietary quality and highlight the need for sustained, age-specific nutritional support strategies in cancer survivorship. Full article

The rapid evolution of Padel in Saudi Arabia (SA) has positioned the sport as a popular recreational and social activity, mainly among young adults. However, limited research has examined how different forms of sport motivation are associated with mental health outcomes in this emerging context. Drawing on Self-Determination Theory (SDT), this study investigated the associations between intrinsic and extrinsic motivation and depression, stress, and anxiety among Padel players in SA. A quantitative, cross-sectional online survey was conducted with a sample of 475 players, the majority of whom were aged 17–35 and held at least a bachelor’s degree. Data were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM) to evaluate the relationships between multidimensional motivation factors and mental health symptoms. The findings revealed a nuanced, at times paradoxical, pattern of relationships. Intrinsic motivation to experience stimulation (engaging in an activity because of the positive sensations, excitement, enjoyment, or stimulation that the activity itself provides, rather than for external rewards or pressures) was consistently associated with lower levels of depression, stress, and anxiety, suggesting that enjoyment-driven involvement is associated with better mental health outcomes. In contrast, intrinsic motivation to accomplish was positively correlated with all three mental health indicators, indicating that achievement-oriented engagement might intensify emotional pressure. Among extrinsic motivations, external regulation was significantly associated with poorer mental health outcomes. In contrast, introjected regulation unexpectedly displayed a negative association with psychological distress, demonstrating a potentially adaptive role in this setting. Identified regulation, however, was not significantly associated with any mental health symptoms. These results underscore the “double-edged” nature of sport motivation, showing that not all internal or external motives yield uniformly positive consequences. The study contributed to the growing literature by providing a context-specific understanding of how motivational dynamics function within a rapidly growing sport in Saudi Arabia. In practice, the findings suggested that enjoyment-based involvement was associated with more favourable mental health outcomes, whereas performance-related pressures might be associated with less favourable outcomes. Full article

This paper presents the design, implementation, and assessment approach of the Blended Intensive Program (BIP) “Towards Enhanced Pedestrian Safety”, developed under the Erasmus+ framework at the University of Beira Interior in collaboration with four partner universities from Slovenia, Poland, and Croatia. The study applies the EPIC framework (Embedded, Pluralistic, Internationalized, and Connected) to the design and evaluation of a short-term, hybrid, and international learning format in Civil Engineering, addressing a gap in the literature regarding the limited availability of structured and empirically grounded approaches for the design and assessment of Blended Intensive Programs in engineering education. The research presents an applied case study design in higher education supported by a mixed-methods approach, combining quantitative and qualitative data from a cohort of 25 participants across different academic levels. Data collection includes performance-based assessment (tests and project evaluation), structured surveys, and qualitative feedback. The program combined digital technologies, including GIS, machine learning, and video image analysis, with problem-based and collaborative learning in a hybrid format comprising 7 h online and 35 h in person. The BIP fostered both technical competences, such as road safety diagnosis and data-driven modelling, and transversal skills, including teamwork, communication, leadership, and intercultural competence. Results from student assessment and satisfaction surveys indicate high levels of engagement, motivation, and learning achievement. The findings provide empirical support for the applicability of the EPIC framework in the design and implementation of BIPs, demonstrating its adaptability to short-term, hybrid, and international learning contexts. The study highlights the pedagogical value of integrating international collaboration, digital tools, and active learning strategies, while aligning with SDG 3 (Good Health and Well-being) and SDG 11 (Sustainable Cities and Communities). Full article

As an artificial–natural composite ecosystem, polders face increasingly prominent internal and surrounding water environment problems under sustained strong human activities. To systematically assess the water ecological health status of polders around Dongting Lake, this study took four typical polders around Dongting Lake as research subjects, and two seasonal surveys of benthic macroinvertebrates were carried out in July and December 2024. Through analyses of community structure characteristics and correlations with key environmental factors, the Trophic Level Index (TLI), Water Quality index (WQI), Shannon–Wiener index of benthic macroinvertebrates, and Benthic Macroinvertebrates Index of biotic integrity (B-IBI) were selected to establish an entropy-weighted Bayesian model for comprehensive evaluation of the current ecological health of Dongting Lake polders. In 2024, a total of 47 benthic macroinvertebrate species were found in Dongting Lake polders, including 25 species in the summer and 36 species in the winter. The main groups were Gastropoda, Insecta, and Bivalvia, and the community composition did not show significant seasonal or spatial differences. The benthic macroinvertebrate community structure in the summer was mainly influenced by TN/TP, NO₃⁻-N, WD, Tur, and Chl.a, suggesting eutrophication as a critical concern, while in the winter it was mainly regulated by WSW, WT, Tur, and DO, highlighting hydrological conditions as pivotal. The entropy-weighted Bayesian assessment indicated an overall aquatic ecological health status of “moderate” in 2024, with summer conditions superior to those in the winter and notable spatial heterogeneity observed in winter sampling sites within ditches, among which Polder Chengxi exhibited the best condition, while Polder Junshan and Polder Xiangbin Nanhu showed degraded states. Notably, Polder Junshan (JS2 and JS3) displayed clear signs of ecological degradation during the winter, warranting immediate initiation of targeted restoration measures. This study provides a systematic diagnosis and scientifically grounded evaluation of aquatic ecological health in Dongting Lake polders, offering a robust theoretical framework and empirical data for future water environmental protection strategies and ecological restoration practices. Full article

Sleep is a multidimensional health domain influenced by behavioural, psychological, and lifestyle factors. However, multinational evidence integrating insomnia severity and multiple sleep outcomes within the Mediterranean lifestyle framework remains limited. This study examined correlates of insomnia severity and key sleep outcomes in adults from Mediterranean and neighbouring countries participating in the MEDIET4ALL survey. Data were collected from 4010 adults (59.5% female) across 10 countries using a standardized multilingual e-survey. Insomnia severity was assessed as primary outcome using the Insomnia Severity Index (ISI), while sleep characteristics were assessed using sleep duration, sleep latency, sleep efficiency, and subjective sleep quality. Regression analyses examined sociodemographic, health-related, Mediterranean dietary, movement-related, psychological, and social correlates. Exploratory statistical indirect association analyses involving life satisfaction were also conducted. Insomnia severity showed the highest explained variance among sleep outcomes (adjusted R² ≈ 0.29). Higher insomnia severity was associated with female sex, higher body mass index, and greater depression, anxiety, and stress (β ≈ 0.15–0.17), whereas lower insomnia severity was associated with older age, better self-reported health status, higher life satisfaction, and greater adherence to Mediterranean dietary consumption patterns (β ≈ −0.04 to −0.11). Models for secondary sleep outcomes explained more modest variance and should be interpreted as exploratory. Across these outcomes, psychological well-being and distress showed the most consistent associations, while Mediterranean dietary dimensions and social participation showed smaller and outcome-specific associations. Exploratory indirect association analyses showed small but statistically significant indirect associations involving life satisfaction between Mediterranean dietary dimensions, social participation, and selected sleep outcomes, particularly sleep quality and insomnia severity. The findings confirm and contextualize established associations between sleep, psychological well-being, distress, Mediterranean lifestyle-related behaviours, and regional context within a large multinational sample. Psychological well-being and distress emerged as the most consistent correlates. Insomnia severity was the most robustly explained sleep outcome, whereas secondary sleep dimensions reflected more modest exploratory correlational profiles. Full article

Background/Objectives: A multivariable prediction model was developed and externally validated to estimate an individual’s current need to visit a dentist among young to middle-aged adults. The objective was to provide an accessible, non-invasive screening tool for independent home self-assessment or integration within routine healthcare workflows. Methods: A cross-sectional study utilised data from two National Health and Nutrition Examination Survey (NHANES) cycles (2011–2014). Logistic regression was applied to develop the prediction model among 1870 dentate adults aged 30–50, a critical onset period for oral diseases. The primary outcome was derived from objective oral examinations conducted by licensed dentists. The resulting questionnaire-based tool provides two recommendations: a visit to a dentist or continuation of routine oral care. Results: External validation using the independent NHANES 2013–2014 cohort (n = 2024) demonstrated robust and clinically relevant predictive capacity, with an AUC of 0.822 (95% CI 0.803–0.842). The model exhibited acceptable calibration (slope 0.85; intercept 0.04) and stable operation. Decision-curve analysis showed net benefit across thresholds; at Pt = 0.33, 14/100 unnecessary screenings were avoided compared with treat-all. Internal validation using a 10% hold-out partition (n = 184) supported these findings, indicating similarly strong discrimination (AUC 0.817, 95% CI 0.751–0.884). Conclusions: Early midlife is a consistent and informative period for oral health intervention. A scalable 14-predictor architecture using accessible indicators established high clinical utility, supporting integration into digital health and primary care. This approach enables efficient population-level prevention. Large-scale, nationally representative NHANES data allowed for the investigation of less-studied factors, including intermittent smoking, metabolic dysregulation, and elevated cholesterol levels. Full article

This study examined perceived inequalities in access to healthcare in Hungary using data from the 2021 International Social Survey Programme Health and Health Care II module (ISSP; N = 1008). The aim was to identify sociodemographic, behavioral, health-related, and attitudinal factors associated with perceived healthcare-access disparities and expectations of receiving the best available treatment if seriously ill. Cross-sectional analyses were performed using chi-squared tests, Fisher’s exact tests, multivariable ordinal logistic regression, and binary logistic regression. In adjusted ordinal models, urban residence was associated with the rich–poor healthcare-access comparison (OR = 1.72, 95% CI: 1.04–2.83, p = 0.033), while daily fruit and vegetable consumption showed an inverse association in the same model (OR = 0.40, 95% CI: 0.22–0.75, p = 0.004). Neutral trust in doctors was associated with the citizens–non-citizens access comparison (OR = 1.86, 95% CI: 1.26–2.77, p = 0.002). Expectation of receiving This study examined perceived inequalities in access to healthcare in Hungary using data from the 2021 International Social Survey Programme Health and Health Care II module (ISSP; N = 1008). The aim was to identify sociodemographic, behavioral, health-related, and attitudinal factors associated with perceived healthcare-access disparities and expectations of receiving the best available treatment if seriously ill. Cross-sectional analyses were performed using chi-squared tests, Fisher’s exact tests, multivariable ordinal logistic regression, and binary logistic regression. In adjusted ordinal models, urban residence was associated with the rich–poor healthcare-access comparison (OR = 1.72, 95% CI: 1.04–2.83, p = 0.033), while daily fruit and vegetable consumption showed an inverse association in the same model (OR = 0.40, 95% CI: 0.22–0.75, p = 0.004). Neutral trust in doctors was associated with the citizens–non-citizens access comparison (OR = 1.86, 95% CI: 1.26–2.77, p = 0.002). Expectation of receiving the best available treatment was positively associated with secondary education compared with primary education (OR = 2.47, 95% CI: 1.44–4.24, p = 0.001) and daily fruit and vegetable consumption (OR = 2.18, 95% CI: 1.10–4.31, p = 0.025), and negatively associated with low confidence in the healthcare system (OR = 0.11, 95% CI: 0.04–0.27, p < 0.001) and disagreement that doctors can be trusted (OR = 0.17, 95% CI: 0.04–0.66, p = 0.010). These findings suggest that perceived healthcare-access inequalities in Hungary are shaped not only by structural socioeconomic position but also by institutional trust and health-related behaviors. Full article

Graduate STEM education in the U.S. has experienced continued growth in enrollment, due to its strong international reputation. Yet, attrition rates among students remain high. Mentoring is frequently identified as a critical factor for supporting graduate student success; however, there is limited empirical evidence regarding the most effective mentoring practices for graduate STEM students. The Mentoring Experiences of Graduate Students Survey (MEGSS) was developed and validated with data from 280 graduate STEM students enrolled in a large, public, research-intensive university in the Eastern U.S. Exploratory factor analysis was performed to examine the survey’s reliability and construct validity. A five-factor, 38-item model was developed, consisting of the following subscales: psychosocial support, program completion, research and writing support, career expectations, and career support. The findings show statistically significant differences in students’ perceptions of mentoring experiences and anticipated outcomes based on gender, citizenship, and stage in the program. Recommendations are offered for faculty mentors and institutions to strengthen mentoring practices, particularly in psychosocial areas, research and writing, and career support. Extending the distribution of MEGSS to other graduate research programs (including non-STEM) could identify mentoring gaps and inform evidence-based strategies to strengthen graduate student development. Full article

Internalized weight bias—the self-directed endorsement of weight-related stereotypes—has emerged as a psychologically potent correlate of health outcomes in individuals with overweight and obesity, yet its relationship with sleep remains largely unexplored. In a cross-sectional manner, 495 Greek adults with a history of overweight/obesity were assessed regarding sleep quality and duration, internalized weight bias (Modified Weight Bias Internalization Scale; WBIS-M), and expressed anti-fat attitudes (Anti-Fat Attitudes Questionnaire, AFA: Dislike, Fear of Fat, Willpower). Insomnia prevalence, assessed with the Athens Insomnia Scale (AIS), was high at 57.6%—nearly doubling across ascending WBIS-M tertiles (39.9% to 73.1%). In hierarchical linear regression models, AIS score remained independently associated with WBIS-M after adjustment for depression, anxiety, BMI, and a comprehensive range of sociodemographic and clinical covariates (B = 0.058; 95% CI: 0.036–0.079; p < 0.001), with the fully adjusted model explaining 58.5% of total variance in WBIS-M. AFA subscales did not remain significant in the model post-full adjustment, and sleep duration failed to show independent association with either bias dimensions. The sleep–weight bias association was therefore specific to the internalized dimension and to sleep quality, rather than quantity. These findings highlight a clinically relevant and dimension-specific link between insomnia symptoms and internalized weight stigma, and suggest that routine sleep assessment may be warranted in individuals with a history of overweight or obesity presenting with elevated internalized weight bias—and vice versa. Full article

Background: The increasing prevalence of diabetes mellitus and metabolic risk factors among young adults has become a major public health concern. University students are particularly vulnerable to unhealthy lifestyle changes, including sedentary behavior, insufficient physical activity, and academic stress, all of which may be associated with an elevated risk of metabolic disorders. Objective: This study aimed to examine the associations of academic stress, physical activity, and sedentary behavior with diabetes risk among university students. Methods: A cross-sectional analytical study was conducted among 264 university students recruited through an online survey. Academic stress was assessed using a six-item Likert-scale instrument, while diabetes risk was evaluated using a composite score derived from indicators adapted from the modified Finnish Diabetes Risk Score (modified FINDRISC). Statistical analyses included descriptive statistics, Cronbach’s alpha reliability testing, exploratory factor analysis (EFA), Spearman’s correlation analysis, and multivariable logistic regression. Results: The academic stress instrument demonstrated good internal consistency (Cronbach’s alpha = 0.85). Exploratory factor analysis supported the construct validity of the instrument, with all six items loading substantially on a common academic stress factor. Correlation analysis revealed that academic stress was positively associated with sedentary behavior and diabetes risk, whereas physical activity was negatively associated with diabetes risk. Multivariable logistic regression showed that academic stress was significantly associated with an increased risk of diabetes (adjusted odds ratio [aOR] = 1.18, 95% confidence interval [CI]: 1.02–1.36; p = 0.028). Moderate-to-vigorous physical activity was associated with a lower risk of diabetes (aOR = 0.74, 95% CI: 0.60–0.92; p = 0.011), while longer sitting duration was associated with an increased risk of diabetes. Conclusions: Academic stress, sedentary behavior, and physical activity were significantly associated with diabetes risk among university students. These findings highlight the importance of developing university-based health promotion programs that integrate stress management, physical activity promotion, and sedentary behavior reduction to support the prevention of metabolic risk factors in young adults. Full article