Search Results (83,156)

This study investigates the structure of innovation and entrepreneurship competence among university students in China. Based on an analysis of 33 policy texts on innovation and entrepreneurship education from 2010 to 2022, it constructs a structural model of university students’ innovation and entrepreneurship competence comprising the knowledge layer, ability layer, and literacy layer by employing the Onion Model. From the perspective of policy instruments, a two-dimensional competence–policy instrument analytical framework is established. The analysis reveals that the articulation of university students’ innovation and entrepreneurship competence in policy texts exhibits distinct stage-wise evolutionary characteristics. Furthermore, the current policy support system suffers from three structural imbalances: an over-reliance on supply-side policy instruments, with insufficient synergy from environmental and demand-side instruments; weak support from environmental and demand-side instruments for certain key competencies; and an emphasis on explicit knowledge over implicit literacy in the cultivation logic. Consequently, this study proposes a shift in the policy paradigm from factor input to system generation. Recommendations include optimizing the mix of policy instruments, improving the precision of interventions by environmental and demand-side instruments targeting key competencies, and reconstructing the cultivation system based on the different generative logics of explicit and implicit competence. Full article

Background/Objectives: Mental health challenges are increasingly prevalent among higher education students, with significant implications for academic success and personal development. Emerging research suggests that critical thinking dispositions may support psychological well-being by enhancing resilience and adaptive coping. This study aimed to investigate the relationship between critical thinking dispositions and psychological well-being and to identify key sociodemographic predictors in this context. Methods: A cross-sectional design was employed from December 2024 to May 2025, recruiting 429 students from Portuguese higher education institutions via convenience sampling. Participants completed validated self-report measures: the Critical Thinking Dispositions Scale (CTDS) and the Psychological Well-Being Scale (PWBS), assessing seven critical thinking dispositions and six well-being dimensions, respectively. Sociodemographic data were also collected. Descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlations, and hierarchical multiple regression were used for data analysis. Results: Students demonstrated moderate to high levels of critical thinking and psychological well-being, with higher scores associated with increased age and academic progression. Significant positive correlations were identified between critical thinking dispositions and all well-being dimensions; personal growth, purpose in life, and autonomy exhibited the strongest associations. Regression analysis revealed that confidence in reasoning, cognitive maturity, and open-mindedness were significant predictors of psychological well-being, explaining 28.7% of the variance. Conversely, inquisitiveness showed a negative association with psychological well-being in the multivariate model, an unexpected finding that warrants cautious interpretation and further investigation. Conclusions: Critical thinking dispositions reflect affective tendencies and habitual ways of engaging with thinking. These dispositions appear to protect psychological well-being in higher education students. Integrating the development of emotional awareness and reflective thinking into curricula may therefore foster resilience and academic success. Further longitudinal research is needed to explore causal mechanisms and intervention efficacy in broader academic contexts. Full article

Background: Cancer and cardiovascular disease are the two leading causes of death in Canada. Although treatments have improved tremendously across the years, interventions such as radiotherapy and chemotherapies are known to have negative impacts on cardiovascular health and can lead to death if not treated in time. Using a retrospective approach, we determined factors associated with cancer therapy-related cardiac dysfunction (CTRCD). Methods: Patients followed through a dedicated Cardio-Oncology clinic with comprehensive screening for CTRCD were identified. CTRCD was defined as a drop in left ventricular ejection fraction of at least 10% to a value lower than 53%. We performed multivariable logistic regression to determine factors associated with CTRCD. Results: In total, 2460 patients with cancer were identified from clinical records—919 had breast cancer, 758 had hematologic malignancies, and 783 had other cancer types. Patients with breast cancer and hematologic malignancies were more likely to experience CTRCD, with odds ratios (ORs) of 2.10 (p = 0.059) and 1.96 (p = 0.047), respectively. Anthracycline and trastuzumab use were independently associated with CTRCD, with ORs of 1.98 (p = 0.002) and 3.19 (p < 0.001), respectively. In hematologic malignancy patients, hypertension (OR = 2.18, p = 0.047) and diabetes (OR = 2.31, p = 0.036) were also significant predictors of CTRCD. Conclusions: We confirmed the importance of anthracycline, trastuzumab, and radiation in the development of CTRCD. However, among patients with hematologic malignancies, traditional cardiovascular risk factors are also associated with CTRCD. This information could help physicians personalize CTRCD surveillance strategies. Full article

Introduction: Intensive chemotherapy protocols and hematopoietic stem cell transplantation (HSCT) in children with cancer frequently lead to severe complications, such as mucositis and immune dysfunction. A growing body of evidence indicates that these complications are closely associated with the patient’s nutritional status and the composition of the gut microbiome, which becomes profoundly destabilized as a result of cytotoxic therapy and antibiotic use. Background: The aim of this review is to critically evaluate the current state of knowledge on the interplay between gut dysbiosis, metabolomic profiles—with particular emphasis on short-chain fatty acids (SCFAs)—and treatment-related toxicity in pediatric patients, as well as to delineate pathways toward personalized nutritional therapy. Methods: A narrative review was conducted, including clinical and preclinical studies published between January 2015 and October 2025. PubMed/MEDLINE, Embase, Cochrane Library, and other databases were searched, focusing on changes in microbiome composition, correlations between gut-derived metabolites and the severity of complications (sepsis, graft-versus-host disease [GvHD], mucositis), and the effects of targeted nutritional interventions (probiotics, prebiotics, postbiotics, and fecal microbiota transplantation [FMT]) on microbiome modulation during anticancer therapy. Results: The analysis demonstrates that pediatric oncologic treatment leads to a marked reduction in microbial diversity, including the loss of protective Clostridiales taxa (e.g., Faecalibacterium), accompanied by an overgrowth of Proteobacteria pathobionts. Metabolomic profiling indicates that low SCFA levels (e.g., butyrate < 20–50 µmol/g) are a strong predictor of severe mucositis, prolonged neutropenia, and an increased risk of sepsis. Interventions aimed at restoring eubiosis and enhancing SCFA production show potential in strengthening the intestinal barrier, modulating immune responses, and enabling maintenance of the planned relative dose intensity (RDI) of chemotherapy by reducing treatment-related toxicity. Conclusions: Gut microbiome profiling and fecal metabolomics represent promising prognostic tools in pediatric oncology. There is an urgent need for further research employing “omics”-based approaches to develop precise, individually tailored nutritional protocols. Such strategies, including postbiotics and FMT, may minimize treatment-related adverse effects and improve long-term clinical outcomes in pediatric patients. Full article

Musculoskeletal disorders, particularly in the neck and back, are prevalent across various professions, stemming from prolonged static postures and awkward neck flexions. This study investigated the efficacy of a passive exoskeleton, designed to alleviate musculoskeletal neck and back strain, in a simulated neck flexion task. Ten participants performed tasks involving neck flexion at angles of 15°, 30°, 45°, and 60°, both with and without the exoskeleton. Additionally, the impact of using a headlight was evaluated at a 45° neck flexion angle. Wearable electromyography sensors were used to quantify muscle activity as an indicator of neuromuscular loading, while subjective discomfort was assessed using the Rate of Perceived Exertion scale, and endurance times were recorded. The results demonstrated significant reductions in neck and lower back muscle activity (median values up to 31.0%) and perceived discomfort (median values up to 50.0%), with the most improvements at 30° and 45° neck flexion angles. Participants reported 50% higher endurance time when using the exoskeleton. Minimal benefits were observed at 15° flexion, likely due to reduced musculoskeletal demand at this angle. These findings highlight the potential of exoskeletons as an ergonomic intervention to mitigate neck and back strain in occupations where high degrees of neck flexion are prevalent. Full article

Interleukin-37 (IL-37) is an anti-inflammatory cytokine with an undefined role in chronic endometritis (CE). This study aims to explore its therapeutic mechanism in CE, focusing on epithelial-mesenchymal transition (EMT) and macrophage polarization. A CE model was induced in Sprague-Dawley rats using lipopolysaccharide (LPS), followed by intervention with TAT-fused recombinant IL-37. Histological damage and fibrosis were evaluated through H&E and Masson staining. Immunofluorescence staining was performed to assess the expression of IL-37 and EMT markers (E-cadherin and vimentin) and macrophage phenotypes (M1: CD86⁺; M2: CD206⁺). In vitro, transwell, qPCR, Western blot, and flow cytometry analyses were performed to determine the effects of IL-37 on EMT and macrophage polarization. The activity of the STAT6 and Smad3 pathways was evaluated using Western blotting, dual-luciferase assays, and immunofluorescence staining. The results revealed that IL-37 accumulated in the injured uterus, alleviating inflammation, tissue damage, and collagen deposition. IL-37 reduced epithelial migration and reversed abnormal EMT by upregulating E-cadherin expression and downregulating vimentin expression. It also suppressed M1 macrophage infiltration and promoted M2 polarization. Mechanistically, IL-37 coactivated the STAT6 and Smad3 pathways, thereby increasing their phosphorylation and nuclear translocation and elevating ARG1 expression. In conclusion, IL-37 mitigates CE by suppressing EMT and promoting M2 macrophage polarization via coordinated STAT6/Smad3 activation, highlighting its therapeutic potential for CE. Full article

Background/Objectives: To evaluate whether peripheral pulmonary artery and vein morphology improves image-based diagnosis of pulmonary hypertension (PH), in accordance with the recently updated hemodynamic definition. Methods: 229 patients underwent CT pulmonary angiography (CTPA) within 30 days of RHC. Pulmonary vessels ranging between 2 and 10 mm in diameter were extracted and labeled as either arteries or veins by an independently validated fully automated algorithm. Segmentation labels were validated by a radiologist. Results: The segmentation algorithm reached a median accuracy of 90%, aligning with the radiologist’s assessments. Vessel density of pulmonary arteries with diameters between 6 and 10 mm was higher in patients with versus those without PH (median [inter-quartile range]: 8.9 [6.1–10.8] 1/L vs. 6.2 [3.1–7.0] 1/L; p = 0.007). Artery-to-vein ratio was higher in PH (1.32 [0.93–2.06] vs. 0.88 [0.48–1.17], p = 0.004). The artery-to-vein ratio for vessels with diameters between 6 and 10 mm identified PH with an AUC of 0.73 (95% CI: 0.60–0.87). Combining this readout with the DMPA resulted in a numerically higher AUC (sole DMPA AUC: 0.79 (95% CI: 0.68–0.90)) vs. DMPA + artery-to-vein ratio for vessels with diameters of 6–10 mm: 0.81 (95% CI: 0.71–0.92); however, this improvement was not statistically significant (p = 0.4). Conclusions: PH is associated with an increased ratio of peripheral pulmonary arteries to veins within the 6–10 mm diameter range. Pulmonary vascular morphology may complement the established morphological criterion of MPA diameter and improve the diagnostic accuracy of PH on CT. Full article

Obesity is recognized as a causal risk factor for the development of multiple cancers, with risk magnitude varying by tumor site, sex, life stage, and adipose tissue distribution. This narrative review synthesizes recent epidemiological evidence linking excess body fatness with cancer incidence and mortality and integrates the biological mechanisms that explain this association. Chronic low-grade inflammation, insulin resistance with compensatory hyperinsulinemia, dysregulation of adipose-derived hormones and sex steroids, impairment of anti-tumor immune responses, alterations in the gut microbiota, and remodeling of the tumor microenvironment collectively create conditions that favor tumor initiation and progression. Bariatric surgery is the most effective clinical intervention for achieving substantial and sustained weight loss in individuals with severe obesity, and growing evidence indicates that it is associated with a reduction in overall cancer risk and cancer-related mortality, particularly for malignancies strongly linked to obesity. However, the extent of this benefit differs by surgical technique and remains less consistent for colorectal cancer. Beyond metabolic improvements, bariatric surgery produces long-term changes in nutritional physiology that may also influence oncologic outcomes. Persistent deficiencies of micronutrients such as iron, folate, vitamin B12, vitamin D, and calcium can affect DNA synthesis, methylation, oxidative balance, and cellular repair. Altered protein and energy intake may contribute to loss of lean mass and reduced metabolic resilience, while changes in alcohol absorption and metabolism can increase systemic exposure to ethanol and its carcinogenic metabolites. In addition, bariatric surgery induces sustained remodeling of the gut microbiome and bile acid metabolism, which may further modulate tumorigenic signaling. Overall, the oncological impact of bariatric surgery reflects a balance between metabolic improvement and long-term nutritional management, underscoring the need for structured follow-up and targeted nutritional strategies to optimize cancer risk reduction. Full article

Background/Objectives: High-quality diets are increasingly recognized as a promising strategy for alleviating mental health problems. This study aimed to evaluate the association between adherence to the EAT-Lancet diet (ELD) and depression and anxiety using a systematic review and meta-analysis of observational studies. Methods: A comprehensive literature search of PubMed, Web of Science, and Embase was conducted. Two independent reviewers screened titles, abstracts, and full texts and extracted data, with any discrepancies resolved by consensus. Results: Ultimately, eight unique studies (10 comparisons) met the predefined inclusion criteria. Adjusted effect estimates (odds ratios (ORs) or hazard ratios (HRs)) and corresponding 95% confidence (95%CI) intervals were extracted and pooled using random-effects meta-analysis. Between-study heterogeneity was quantified with the I² statistic. Compared with the lowest ELD adherence, the highest adherence was associated with a lower risk of depression (OR = 0.78, 95% CI 0.73–0.85; I² = 85.0%); a similar inverse association was observed for anxiety (OR = 0.83, 95% CI 0.79–0.86; I² = 0%) and the co-occurrence of depression and anxiety (HR = 0.76, 95% CI 0.68–0.85; I² = 0%). Conclusions: Our findings indicate that, compared with low adherence, high adherence to the ELD is associated with beneficial effects on mental health and may inform dietary recommendations for the early prevention and intervention of depression, anxiety, and their co-occurrence. Full article

Objectives: While Pilates exercise is commonly prescribed for chronic low back pain (CLBP), its effect on normalizing the lumbar flexion–relaxation ratio (FRR) remains unclear. This trial examined whether an 8-week Pilates exercise program (PEP) modifies FRR magnitude and side-to-side asymmetry in women with CLBP and explored associations with trunk kinematics, pain, and functional capacity. Methods: In a randomized controlled pre-test–post-test training design, ninety-six women with CLBP (55.8 ± 5.4 y) were allocated to a PEP group (n = 49) or a usual-care control group (n = 47). The PEP included two supervised 60-minute mat sessions per week over eight weeks. Surface electromyography of the right and left erector spinae and trunk flexion range of motion (TFRoM), measured via inertial sensors, were recorded during the standardized flexion–extension task pre- and post-intervention. Pain intensity (Visual Analog Scale) and functional capacity (Low Back Outcome Score, LBOS) were assessed concurrently. Results: Two-way repeated-measures ANOVA revealed no group × time interaction for global FRR (p = 0.454) or TFRoM (p = 0.745). FRR asymmetry increased by 11% in the PEP group (p = 0.033), with no change observed in the controls (p = 0.143). Compared to the controls, the PEP group exhibited a 30% reduction in pain (p = 0.003) and a 13.4% improvement in LBOS (p < 0.001) compared to the control group (all ps > 0.228). Conclusions: An 8-week Pilates intervention reduces pain and improves functional capacity in women with CLBP but does not restore lumbar extensor relaxation. The observed increase in FRR asymmetry may reflect compensatory or maladaptive redistribution. Full article

Maladaptive family interaction is one of the mechanisms through which trauma is transmitted across generations. The current intervention approach for trauma-affected families focuses on traumatized parents and child–parent dyads during childhood. This leaves a gap in how adult children, who might no longer live with their parents, can overcome the negative impacts of maladaptive childhood interactions with parents as a legacy of parental trauma history. This study focuses on the children of Vietnamese boat refugees in their 30s and 40s in two cities in Norway, applying narrative interviews to elicit long narratives about their lifespan experiences. A hybrid analytic approach utilizes Thematic Network Analysis, informed by a conceptual framework integrating salutogenesis theory and Bowen family systems theory. The findings reveal that maladaptive parent–child interactions in Vietnamese boat refugee families include parents’ high expectations, harsh parenting, children’s obligation to please parents, and adultification, which are trauma-shaped and mediated by Vietnamese culture. Developing a strong sense of coherence (SOC), characterized by enhancing one’s understanding of the self in relation to family, making meaning regarding the past, and playing an active role in reframing relationships with one’s parents, serves as a pathway to outgrow the impacts of maladaptive patterns in one’s family of origin. Overall, this paper contributes a salutogenic, lifespan-oriented framework for understanding recovery beyond childhood impacts of intergenerational trauma. Full article

Smart healthcare is rapidly emerging as a transformative paradigm, enabling simultaneous health monitoring, therapeutic intervention, and early prediction of disease onset. In this context, electrochemical monitoring systems have attracted growing interest due to their cost-effectiveness, ease of operation, miniaturization and compatibility with wearable platforms. Accordingly, conductive hydrogel-based electrochemical (bio)sensors have gained significant attention for health monitoring owing to their soft mechanical properties, high water content, excellent biocompatibility, and ability to form intimate, conformal interfaces with biological tissues. Their three-dimensional polymeric networks facilitate efficient ion transport and mechanical flexibility, making them particularly suitable for wearable and noninvasive sensing and monitoring applications. However, the intrinsically limited conductivity and catalytic activity of pristine hydrogels often constrain their electrochemical performance. To overcome these limitations, functional nanomaterials such as metal–organic frameworks (MOFs) and MXene (MX) nanosheets have been increasingly integrated into hydrogel matrices to enhance conductivity and electrochemical activity. This review provides a comprehensive and critical comparison of recent advances in MOF- and MX-integrated conductive hydrogels for electrochemical health monitoring. In addition to material design strategies and sensing performance, emerging trends in data-driven sensing aimed at improving signal interpretation and multi-analyte discrimination are systematically discussed. Key challenges related to long-term stability, biocompatibility, scalability, and intelligent system integration are critically assessed, and the future potential of these platforms within closed-loop architectures is highlighted, paving the way for next-generation conductive hydrogel-based electrochemical sensors in smart healthcare applications. Full article

Compensatory Health Beliefs (CHBs) are cognitions that the negative effects of unhealthy behaviors can be offset by healthy ones. While their role in single behaviors is established, their mechanisms in regulating multiple health behaviors remain empirically unclear, particularly whether CHBs facilitate or inhibit actual cross-behavior compensation between physical activity (PA) and healthy eating (HE). This study tested a dual-path model proposing that CHBs are associated with immediate intention compensation via moral licensing and with long-term cross-behavior inhibition through reduced self-efficacy. A cross-sectional online survey of 366 university students assessed general CHBs, domain-specific social cognitive variables (self-efficacy, intention, planning), and self-reported PA (IPAQ-SF) and HE (calculated from reported food consumption as a dietary guideline adherence score). Data were analyzed using Structural Equation Modeling. We found that CHBs were positively associated with PA intention but negatively linked to HE intention, planning, and behavior. CHBs were also negatively related to HE self-efficacy, which was subsequently associated with lower PA planning, indicating a cross-behavior inhibition pathway. In conclusion, CHBs are linked to lower health behavior engagement through two pathways: short-term intention-based licensing across domains and self-efficacy erosion that inhibits integrated planning. This integrated model highlights the importance of addressing both CHBs and self-efficacy in health interventions. Full article

The involvement of the immune system in pulmonary fibrosis is established, the precise contributions of tissue-resident memory T (T_RM) cells are still poorly defined. This study sought to define the contribution of CD4⁺ T_RM cells to pulmonary fibrosis, their origin, and regulatory mechanisms. We combined bioinformatic analysis of human fibrotic lung single-cell RNA-sequencing data with experiments in a bleomycin-induced C57BL/6 mouse model. Flow cytometry, targeted in vivo depletion, lymphocyte trafficking blockade, cell co-culture, and pharmacological inhibition were employed. CD4⁺ T_RM cells were observed at higher frequencies within fibrotic lung tissue. Their presence correlated with disease severity, and they were found to exhibit a pro-inflammatory and pro-fibrotic phenotype. Their specific depletion alleviated fibrosis. These cells primarily originated from recruited circulating lymphocytes, as blocking this recruitment reduced T_RM accumulation and attenuated disease. Furthermore, the Notch signaling pathway was activated in fibrotic lung CD4⁺ T_RM cells, and its inhibition suppressed their differentiation and impaired their pro-fibrotic function. We conclude that CD4⁺ T_RM cells are pathogenic drivers in pulmonary fibrosis, originating from circulating precursors and being regulated by Notch signaling, underscoring their relevance for therapeutic intervention. Full article

Background/Objectives: This cross-sectional study examined factors associated with diabetic foot complications and identified areas for targeted interventions. Methods: Participants were selected from Dubai Health Authority (DHA) primary health care centers (PHCCs) and divided into two groups: those with diabetic foot complications (DFC) and those without (non-DFC). Data were collected through demographic surveys and a structured questionnaire assessing knowledge, attitudes, and practices (KAP) related to foot care. Results: A significant age disparity was observed within the study population, with 70.6% of individuals in the DFC group being over 60 years. In contrast, only 41.8% of the non-DFC group fell within the same age range, underscoring the potential role of age as a critical risk factor. Analysis of KAP towards diabetic foot care did not reveal any notable differences when stratified by sex, employment status, or overall educational attainment. However, a higher proportion of individuals within the DFC group reported having received no formal education. Furthermore, participation in foot care education programmes was significantly correlated with enhanced knowledge (p < 0.001) and improved practices (p = 0.013). Overall, individuals within the DFC group exhibited significantly poorer self-care practices regarding foot health (p < 0.001). Conclusions: This finding indicates a pressing need for targeted educational interventions aimed at improving outcomes and reducing complications among patients with diabetes. Full article