Search Results (776)

Background: Patients with head and neck cancer who are undergoing radiotherapy frequently suffer from oral mucositis and oral microecological disorders, which severely impair their quality of life. Oral microbiota transplantation is an emerging oral microecological intervention that offers a novel approach for reconstructing oral microecological balance and relieving mucositis. However, regarding this innovative therapy, there is a paucity of in-depth research into patients’ decision-making cognition, and existing evidence is insufficient to support individualized clinical decision-making guidance. Methods: A descriptive qualitative research design was employed. From July to December 2025, patients diagnosed with head and neck cancer undergoing radiotherapy were recruited from a tertiary hospital in Shanghai via purposive sampling. The data were collected through semi-structured interviews and analyzed using Colaizzi’s seven-step analysis method. The user label system was refined and summarized to construct user portraits. These portraits were visualized in the form of WordArt word clouds and character labels. Results: A total of 21 eligible patients with head and neck cancer undergoing radiotherapy participated in the study. The construct of decision-making cognition encompasses five dimensions: treatment prioritization, information needs, health literacy, psychological status, and decision quality. The patients were categorized into four types: proactive participation, passive dependence, weigh carefully, and symptom-driven. These classifications reflect the cognitive characteristics and group differences regarding the Oral Microbiota Transplantation decision-making process among different patients. Conclusions: Patients exhibit considerable variability in their decision-making cognition regarding the innovative OMT therapy. This phenomenon can be categorized into four distinct persona types, which, respectively, reflect unique information processing styles, risk assessments, and behavioral coping strategies when patients encounter novel therapeutic interventions. This typology provides a theoretical foundation for individualized clinical decision support, delineates targets for the formulation of targeted communication strategies, and ultimately enhances patient decision quality and treatment adherence. Full article

Background/Objectives: Intensified training in adolescent soccer players increases oxidative stress, muscle damage, inflammation, and immune suppression, but direct comparisons of nutritional countermeasures are lacking. This randomised, double-blind, placebo-controlled trial compared the effects of 14-day coenzyme Q10 (CoQ10) versus taurine supplementation on haematological, oxidative, muscle damage, inflammatory, hormonal, and immune biomarkers in under-19 soccer players undergoing three repeated 90 min Soccer Match Simulation (SMS) sessions. Methods: Twenty-four male players (age 17.9 ± 0.7 years) received placebo (n = 8), CoQ10 (300 mg/day, n = 8), or taurine (4 g/day plus 4 g pre-session, n = 8). Blood was collected at baseline (T0), post-first session (T1), post-third session (T2), and 24 h post-third session (T3). Biomarkers included creatine kinase (CK), lactate dehydrogenase (LDH), malondialdehyde (MDA), total antioxidant capacity (TAC), interleukins (IL-6, IL-10, TNF-α), cortisol, testosterone, CD4/CD8 ratio, immunoglobulins (IgA, IgG), and plasma volume (Dill–Costill). Data were analysed by two-way repeated-measures ANOVA. Results: CoQ10 was superior in reducing MDA (T2: 0.83 ± 0.02 vs. 1.24 ± 0.03 μmol/L, p < 0.001), LDH (434 ± 9 vs. 684 ± 12 U/L, p < 0.001), and cortisol (20.2 ± 0.6 vs. 30.4 ± 0.8 μg/dL, p < 0.001), and preserved the testosterone:cortisol ratio (24.5 ± 1.1 vs. 13.6 ± 1.0 × 10⁻³, p < 0.001). CoQ10 was more effective than taurine in lowering IL-6 at T2 (3.5 ± 0.2 vs. 3.9 ± 0.2 pg/mL, p = 0.03), whereas taurine was more effective in increasing IL-10 (7.5 ± 0.2 vs. 5.7 ± 0.2 pg/mL, p = 0.005). Both supplements preserved CD4 counts (CoQ10: 790 ± 13, taurine: 795 ± 14 vs. placebo: 680 ± 15 cells/μL, p < 0.01) and the CD4/CD8 ratio, as well as IgA and IgG levels, with no between-supplement differences for immune outcomes (p > 0.05). No adverse events occurred. Conclusions: For adolescent soccer players undergoing intensified training, CoQ10 may be preferred when the goal is reducing oxidative stress, muscle damage, and catabolic load; taurine may be preferred for targeted anti-inflammatory support (IL-10 elevation). Either supplement effectively attenuated changes in circulating immune biomarkers. These preliminary findings provide evidence-based guidance for targeted sports nutrition, pending confirmation in larger trials. Full article

The Vehicle Routing Problem with Time Windows (VRPTW) takes on a structurally distinct form when the goods being routed undergo first-order quality decay during transport. In this setting, distance minimisation alone underestimates the true economic cost. A per-customer minimum-quality acceptance constraint further introduces a non-linear feasibility condition that does not appear in the classical formulation. This paper addresses such a setting in the context of loose-skin citrus fruit (e.g., mandarins) distribution, where stock has already undergone several days of cold storage at the origin warehouse, and remaining shelf life makes retail time windows binding rather than decorative. We formulate a Maturity-Aware Multi-Echelon Dynamic Reallocation Vehicle Routing Problem with Time Windows (MA-MEDR-VRPTW) on a three-echelon network (origin warehouse → distribution centres → stores) over a seven-day rolling horizon. A first contribution shows that the minimum-quality acceptance constraint admits an analytic transformation into a time-window tightening, which removes per-extension exponential evaluations from the subproblem solver. The algorithmic contribution is a proximal alternating direction method of multipliers (ADMM) with NG-route relaxation (padmm-ma) whose quality-loss weight is updated by a residual-balancing rule and is decoupled from the outer reallocation linear program (LP) through approximate dynamic-programming-style marginal costs. On twelve Solomon-derived mandarin instances (72 feasible algorithm–instance combinations), padmm-ma returns a mean seven-day cost of 12,638 CNY against 11,753 CNY for a subgradient baseline ($+7.5\%$) at statistically indistinguishable arrival quality (paired Wilcoxon $p=0.077$ for ${\overline{q}}_{\mathrm{arr}}$), while cutting mean wall-clock time from 350 to 23 s (about $15\times$). The method, therefore, reads as a fast operational heuristic for daily re-planning. An ablation, an exact-MIP benchmark on tractable subproblems, and a scale extension to $n=100$ customers round out the validation. Full article

This study examined whether adaptive humor styles, affiliative and self-enhancing, predict the five dimensions of post-traumatic growth (PTG) in a sample of South African undergraduate students who had experienced trauma. A cross-sectional SEM design was used with a criterion sample of 194 South African undergraduate students (72.7% female; M = 21.06 years, SD = 1.84) who had experienced a traumatic event between one and five years before participation. Self-enhancing humor was a significant positive predictor of all five PTG dimensions (Relating to Others, New Possibilities, Personal Strength, Spiritual Change, and Appreciation of Life), with standardized path coefficients ranging from β = 0.324 to β = 0.477. The measurement model demonstrated acceptable fit, though CFI (0.870) fell marginally below the conventional 0.90 threshold, likely due to model complexity. Affiliative humor did not independently predict any PTG dimension, with its zero-order correlations accounted for by shared variance with self-enhancing humor. These findings suggest that the emotion regulation and cognitive reappraisal functions of self-enhancing humor may facilitate growth across multiple domains following trauma, and have implications for therapeutic interventions aimed at promoting PTG. Full article

Background: Behavioral procrastination has been increasingly recognized as a maladaptive self-regulatory pattern associated with unhealthy lifestyle behaviors, psychological stress, and adverse cardiometabolic profiles. However, its relationship with accelerated cardiovascular aging remains poorly understood. This study aimed to evaluate the association between behavioral procrastination and heart age acceleration in a large occupational cohort of Spanish workers. Methods: A multicenter cross-sectional study was conducted including 92,184 actively employed Spanish workers undergoing routine occupational health examinations between 2021 and 2024. Behavioral procrastination was assessed using the Pure Procrastination Scale-9 (PPS-9). Estimated heart age and heart age acceleration were calculated using a cardiovascular risk-factor-based algorithm. Multivariable linear and logistic regression analyses were performed to evaluate associations between procrastination score, continuous heart age acceleration, and accelerated cardiovascular aging phenotypes after adjustment for demographic, lifestyle, anthropometric, and cardiometabolic variables. Restricted cubic spline analyses and sex-stratified analyses were additionally conducted. Results: Higher procrastination levels were associated with progressively worse cardiometabolic and cardiovascular aging profiles. Mean heart age acceleration increased from −3.1 ± 6.0 years in participants with very low procrastination to 14.0 ± 6.4 years in those with very high/chronic procrastination (p < 0.001). The prevalence of accelerated cardiovascular aging (>0 years) increased from 27.2% to 94.2% across increasing procrastination categories, whereas severe accelerated cardiovascular aging (≥10 years) increased from 1.7% to 75.6% (both p < 0.001). In fully adjusted multivariable analyses, each 5-point increase in PPS-9 score was associated with a 0.50-year increase in heart age acceleration (B = 0.50; 95% CI 0.48–0.52; p < 0.001). Participants with very high/chronic procrastination exhibited significantly higher odds of accelerated cardiovascular aging (OR 1.89; 95% CI 1.65–2.18) and severe accelerated cardiovascular aging (OR 2.51; 95% CI 2.16–2.92). Associations were significantly stronger among women (p-interaction < 0.001). Findings remained robust in sensitivity analyses excluding participants with diabetes mellitus. Conclusions: Behavioral procrastination was associated with higher estimated heart age acceleration and less favorable cardiovascular aging profiles in this large occupational cohort. Higher procrastination severity was consistently related to greater estimated heart age acceleration and a higher prevalence of cardiovascular aging phenotypes, even after extensive multivariable adjustment. These findings indicate that higher procrastination levels were associated with less favorable cardiovascular aging profiles beyond traditional biomedical risk factors. However, given the cross-sectional design, no conclusions regarding causality or temporality can be drawn. Full article

Robo-advisors have expanded access to automated investment services, but many platforms continue to rely on relatively static onboarding procedures and limited forms of user interaction. This study examines how participants with investment experience respond to two next-generation robo-advisory design features: financial digital twins, understood as dynamic investor profiles that integrate goals, risk tolerance, cash-flow patterns, and anticipated life events, and conversational artificial intelligence (AI), understood as an interactive interface for explaining recommendations. Using a scenario-based randomized 2 × 2 online experiment, 336 adult respondents with self-reported investment experience, recruited through professional and academic networks, were assigned to one of four robo-advisor scenarios that varied the personalization architecture, standard profile versus digital twin, and the interface style, plain dashboard versus conversational AI, while holding the portfolio recommendation constant. The results show that digital-twin personalization increases perceived personalization and privacy concern, indicating that more adaptive advisory architectures may be viewed as both more relevant and more data-intensive. Conversational AI increases the perceived interactive quality of the advisory experience, while selected willingness-related patterns, especially in the combined digital-twin and conversational-AI condition, are treated as exploratory because several secondary composites displayed limited internal consistency. The strongest confirmatory emphasis is therefore placed on perceived personalization and privacy concern, and the remaining findings are best interpreted as scenario-based investor responses rather than evidence of actual adoption behavior or confirmed psychological mechanisms. The study contributes to behavioral FinTech research by clarifying the personalization–privacy tension in AI-enabled robo-advisory services and by offering design implications for more transparent, interactive, and responsibly personalized digital wealth-management systems. Full article

Psychosocial factors such as diabetes distress, depression, anxiety, social support, stigma, coping styles, and quality of life play a critical role in shaping mental health outcomes among males living with type 2 diabetes. Despite their importance, systematic evidence on how these factors influence mental health remains limited. Objective: This protocol aims to synthesize existing evidence on psychosocial factors associated with mental health outcomes among males living with type 2 diabetes. Eligibility Criteria: Studies will be included if they focus on males aged 18 years and above diagnosed with type 2 diabetes and examine psychosocial factors in relation to mental health outcomes. Qualitative, quantitative, and mixed-methods designs will be considered. Exclusion criteria include studies focused on females, males under 18, or those with type 1 diabetes; studies exclusively evaluating interventions (e.g., CBT trials, self-management programs); non-English publications; and studies published before 2015. Confounders such as co-morbidities and lifestyle factors will be included if reported alongside psychosocial exposures, but studies focusing solely on these without mental health outcomes will be excluded. Information Sources: The search strategy will be guided by the PICO framework, and such searches will be conducted in Scopus, MEDLINE (PubMed), CINAHL, and Web of Science using Medical Subject Headings (MeSH) for articles published in English between January 2016 and December 2026. Risk of Bias: Two independent reviewers will screen studies, with disagreements resolved by a third reviewer. Risk of bias will be assessed using the JBI Critical Appraisal Checklist. Data Synthesis: Eligible studies will undergo narrative thematic synthesis. Confidence in findings will be evaluated using the JBI ConQual approach. Ethics and Dissemination: Ethical approval is not required. This protocol is registered with PROSPERO (CRD420261299482). Results will be disseminated through peer-reviewed journals and conferences. Conclusion: This protocol outlines a transparent plan to review psychosocial factors influencing mental health in men with type 2 diabetes, guiding gender-sensitive strategies that integrate mental health into diabetes care. Full article

Background: Obesity is a major public health concern and shows a clear social gradient, with higher prevalence among individuals with lower socioeconomic position. Educational level is a key indicator of socioeconomic status, but the extent to which lifestyle factors explain its association with obesity remains unclear. Objective: To examine the association between educational level and obesity in a working-age population and to evaluate how adjustment for lifestyle factors influences the magnitude of the association between educational level and obesity. Methods: A cross-sectional study was conducted among 3108 working-age adults undergoing occupational health assessments in Spain. Educational level was categorised into three groups (higher, intermediate, and primary or none). Obesity was defined as a body mass index ≥30 kg/m². Lifestyle variables included smoking status, physical activity assessed using the International Physical Activity Questionnaire (IPAQ-SF), and adherence to the Mediterranean diet evaluated with the MEDAS-14 score. Sequential logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI), with progressive adjustment for demographic, behavioural, and clinical factors. Results: The overall prevalence of obesity was 16.6%, with a clear gradient across educational levels (11.5% in higher education vs. 19.8% in primary or no education). In crude analyses, individuals with the lowest educational level had higher odds of obesity (OR 1.89; 95% CI 1.46–2.45). Adjustment for age and sex attenuated the association (OR 1.72; 95% CI 1.32–2.24), with further reduction after inclusion of lifestyle factors (OR 1.63; 95% CI 1.24–2.13). In the fully adjusted model, the association remained statistically significant (OR 1.61; 95% CI 1.18–2.21), indicating that adjustment for lifestyle factors attenuated the association between educational level and obesity, although the association remained statistically significant. Conclusions: Lower educational level is associated with a higher risk of obesity. Adjustment for lifestyle factors attenuated this association, although a statistically significant relationship remained. These findings support the role of education as a fundamental determinant of health and highlight the need for strategies addressing broader social and structural determinants of obesity. Full article

Background: Ménière’s disease (MD) and tinnitus are common otological conditions that substantially impair quality of life. Although their pathophysiology remains incompletely understood, nutritional factors have been proposed to influence inner-ear microcirculation, water–electrolyte balance, oxidative stress and metabolic regulation. The objective of this scoping review was to comprehensively map the extent, nature and characteristics of existing research on nutritional strategies and dietary patterns applied in Ménière’s disease and tinnitus, and to clarify the mechanisms and clinical outcomes reported across studies. Methods: The review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. A comprehensive search of PubMed, Scopus, Web of Science, EBSCO, Cochrane Library and Google Scholar (2–12 March 2026) was conducted using the Population–Concept–Context model. Eligible studies included full-text human research (observational or interventional) and reviews published in English that examined dietary strategies in MD or tinnitus. Results: Of 273 records identified, 13 studies met inclusion criteria (6 on MD, 7 on tinnitus). Reported interventions included sodium reduction, adequate hydration, caffeine and alcohol modification, glycaemic stabilization, weight reduction, anti-inflammatory dietary patterns, and Mediterranean or DASH-style diets. Findings suggest potential symptom improvement in some patients. Conclusions: Available evidence indicates that nutritional interventions may serve as a valuable adjunct in the management of MD and tinnitus; however, their effectiveness has not been conclusively demonstrated. Well-designed, adequately powered randomised trials are still required to establish precise, evidence-based clinical guidelines. Full article

Population aging demands accessible interventions for psychological well-being in later life. This work evaluated the feasibility and acceptability of an 8-week mindful walking program in community-dwelling older adults and generated exploratory estimates of within-person change across emotional, psychosomatic, and psychological outcomes. Thirteen community-dwelling older adults participated in a pilot human trial with assessments at baseline, post-intervention, and one-month follow-up. Measures included depression, anxiety, somatic symptoms, mindfulness, mind wandering, alexithymia, quality of life, and attachment style. Primary feasibility outcomes indicated high acceptability and participant satisfaction, good physiological tolerance and full adherence. Secondary exploratory analyses suggested within-person reductions in depressive symptoms and alexithymia, while somatic symptoms decreased notably by follow-up. Mindfulness increased and was maintained over time, while mind wandering displayed a probable long-term decrease. Psychological quality of life improved and remained elevated, whereas physical, social, and environmental quality-of-life domains showed uncertain trends. Trait anxiety decreased post-intervention but returned toward baseline at follow-up, while state anxiety and attachment styles remained stable. Within pilot design limits, mindful walking may be a feasible intervention for older adults, associated with exploratory within-person patterns suggesting possible improvements in certain psychological outcomes, which should be interpreted as preliminary and descriptive signals pending confirmation in controlled trials. These preliminary findings support further investigation in controlled trials to determine effectiveness and to formally test hypothesized mechanisms. Full article

Background/Objectives: Nocturnal glycemic variability in pediatric type 1 diabetes (T1D) disrupts caregiver sleep and quality of life; advanced hybrid closed-loop (AHCL) systems may be associated with reduced caregiver burden by providing more stable overnight glucose control. We aimed to evaluate changes in caregiver-reported sleep quality and continuous glucose monitoring (CGM) targets three months after transition to an AHCL system. Methods: We conducted a prospective single-center real-world study in a tertiary pediatric diabetes unit that included children aged 6–17 years with T1D who switched from continuous subcutaneous insulin infusion (MiniMed) and intermittently scanned CGM (FreeStyle Libre 2) to an AHCL system (MiniMed 780G) with Guardian 4 sensor. Caregivers completed the Pittsburgh Sleep Quality Index (PSQI) at baseline and after 3 months; CGM metrics (TIR 70–180 mg/dL, TAR1 180–250 mg/dL, TAR2 > 250 mg/dL, TBR1 54–70 mg/dL, TBR2 < 54 mg/dL) were extracted at the same time points. Analyses used Shapiro–Wilk, Wilcoxon signed-rank, Spearman correlations, and McNemar tests (α = 0.05). Results: Twenty-two caregivers completed baseline PSQI; 16 provided PSQI data at three months. The proportion with PSQI > 5 decreased from 56.3% to 18.8% (p = 0.034), and 81.3% showed lower global PSQI at 3 months (p = 0.018). The largest mean improvements were observed in daytime dysfunction (−0.94), subjective sleep quality (−0.81), and sleep duration (−0.63), with slight increases in sleep disturbance (+0.13) and sleep-medication use (+0.13). The proportion of participants meeting international CGM consensus targets improved: the percentage achieving TIR > 70% increased from 26.7% to 80.0% (p = 0.008); those meeting TAR > 180 mg/dL < 30% increased from 26.7% to 80.0% (p = 0.008); and those meeting TAR2 > 250 mg/dL < 5% increased from 20.0% to 53.3% (p = 0.008). Hypoglycemia-related targets showed no significant change, and no episodes of symptomatic or level 3 hypoglycemia were reported. Exploratory analyses suggested that poorer PSQI at 3 months was associated with greater Δ TBR1, and increases in TAR2 with higher sleep disturbance and sleep-medication use. Conclusions: Transition to an AHCL system was associated with improvements in caregiver-reported sleep and attainment of CGM consensus targets within three months. Residual nocturnal hyperglycemia was associated with features of ongoing sleep disturbance, highlighting the potential relevance of individualized alert settings, sleep-focused education, and inclusion of objective sleep measures in future studies. Full article

Smartphones are now deeply embedded in daily life, but excessive dependence may increase the risk of nomophobia, which is associated with anxiety, sleep disruption, and reduced productivity. Existing screening methods mainly rely on self-reported questionnaires, which are subjective and difficult to scale for continuous monitoring. This study proposes a privacy-preserving federated deep learning framework for three-level nomophobia risk prediction (Normal, Mild, and Severe) using smartphone usage logs while keeping raw user data on local devices. The proposed pipeline uses a publicly available secondary dataset with 1000 original records and expands it to 100,000 records through constraint-aware synthetic augmentation. A continuous risk score is computed from standardized smartphone usage indicators and then converted into three classes using tertile-based thresholds. Several local architectures, including CNN, MLP, ResMLP, Wide & Deep, and a lightweight TabNet-style gated model, are evaluated under FedAvg. In the reported experiments, differential privacy is enabled through DP-SGD with gradient clipping and Gaussian noise. To protect update transmission, the framework applies protected update sharing through encrypted transport of masked updates. Each client masks its local update and encrypts the masked payload before transmission. This mechanism improves communication confidentiality and reduces the direct exposure of client updates. Under a fixed federated setup with five clients and 25 communication rounds, tabular models achieved near-ceiling performance on the constructed test set. The MLP achieved 99.12% accuracy, 99.12% F1-score, 0.9868 MCC, and 0.9997 AUC, while Wide & Deep achieved 98.95% accuracy, 98.95% F1-score, 0.9843 MCC, and 0.9997 AUC. In contrast, sequential models such as RNN and LSTM showed near-random performance, suggesting that the current aggregated feature representation is better suited to tabular learning than temporal modeling. These results indicate that the proposed federated pipeline can effectively learn the constructed nomophobia risk labels while preserving local data ownership. However, because the labels are derived from usage features rather than clinical or psychometric assessment, the findings should be interpreted as proof-of-concept results for constructed risk labels rather than evidence of clinical diagnostic validity. Full article

Background: Health-promoting lifestyle behaviors established during young adulthood play a crucial role in shaping long-term physical and mental health outcomes, including the risk of chronic disease, psychological well-being, and quality of life. Parenting styles represent an important psychosocial factor that may be associated with health-related behaviors; however, evidence regarding their association with multidimensional health-promoting lifestyles among university students remains limited. Methods: A cross-sectional study was conducted among 700 university students. Parenting styles (authoritative, authoritarian, and permissive) were assessed using validated self-report measures. Health-promoting lifestyle behaviors were measured with the Health-Promoting Lifestyle Profile II (HPLP II), including six subscales: Health Responsibility, Physical Activity, Nutrition, Spiritual Growth, Interpersonal Relations, and Stress Management, as well as the overall HPLP II score. Multiple linear regression analyses were performed to examine associations between parenting styles and each HPLP II subscale and the total score. Results: All regression models were statistically significant (p < 0.001), explaining between 5.2% and 13.5% of variance across HPLP II subscales and 11.8% of variance in the total score. Authoritative parenting was significantly positively associated all health-promoting lifestyle domains (β = 0.22–0.33, p < 0.001), including physical activity, interpersonal relations, stress management, and overall health-promoting lifestyle. Permissive parenting was negatively associated with several domains, particularly physical activity, interpersonal relations, stress management, and the total HPLP II score (β = −0.07 to −0.12, p < 0.05). Authoritarian parenting showed weaker and more selective negative associations, most notably with nutrition and stress management. Conclusions: Parenting styles are significantly associated with health-promoting lifestyle behaviors among university students. Authoritative parenting was consistently associated with more favorable health-promoting lifestyle patterns across multiple domains, whereas permissive and authoritarian parenting may be linked to less favorable health behaviors. These findings suggest that perceived parenting styles are associated with health-related behaviors among university students. Full article

Emerging evidence implicates the gut–brain axis in the pathophysiology of schizophrenia, yet literature regarding specific microbiome alterations remains inconsistent. This study aims to synthesize evidence on gut microbiota diversity and taxonomic composition in individuals with schizophrenia compared to healthy controls. Unlike prior meta-analyses, this study integrates quantitative alpha diversity synthesis with cross-taxonomic qualitative analysis and contextualizes findings within functional frameworks of the gut–brain axis, highlighting the methodological heterogeneity that limits biological interpretation. A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Electronic databases (Web of Science, PubMed, MDPI) were searched for observational studies published between 2017 and 2025. Forty-eight studies met inclusion criteria for qualitative synthesis, with 14 providing sufficient data for random-effects meta-analyses of alpha diversity. Meta-analyses revealed no statistically significant differences in alpha diversity indices (Shannon, Simpson, Chao1, ACE, Observed) between patients and controls, despite high heterogeneity. Conversely, beta diversity analyses generally demonstrated significant differences in microbial community composition. Taxonomic synthesis identified recurrent but heterogeneous dysbiotic patterns characterized by the depletion of short-chain fatty acid-producing taxa (e.g., Faecalibacterium, Roseburia, Lachnospiraceae) and enrichment of pro-inflammatory taxa (e.g., Proteobacteria, Fusobacterium). Schizophrenia is associated with evidence of compositional alterations and functional shifts rather than a global loss of microbial richness. These findings highlight candidate taxa that may warrant further investigation in biomarker-focused studies and microbiome-based therapeutics. However, these findings should be interpreted cautiously due to substantial heterogeneity and limited control for key confounders such as antipsychotic medication, diet, and life-style factors. Full article

This paper focuses on the early Qing monk-painter Hongren 弘仁, systematically exploring the pathways through which the Chan Buddhist “emptiness contemplation” is manifested in his landscape paintings. As a representative monk-painter, Hongren produced works that profoundly embody the Chan contemplation of emptiness, yielding a singular style defined by austere coldness, minimalist simplicity, and profound quietude. Transcending conventional stylistic descriptions in art history and essentialist philosophical deductions, this study adopts a comprehensive empirical approach that integrates poetry, calligraphy, painting, and seals (shi-shu-hua-yin 诗书画印). By adopting an interdisciplinary perspective of philosophy, religion, and art history, this study argues that Hongren’s landscapes are not merely subjective emotional expressions or aesthetic pursuits; rather, they constitute a visual extension and a spiritual externalization of his emptiness contemplation. Through a multi-layered analysis of his form, brushwork, composition, and artistic conception, combined with the mutual corroboration of poetic inscriptions on paintings and textual inscriptions on seals, this paper reveals how the Chan philosophy of “emptiness contemplation” is reflected within his artistic language. While Hongren’s style is the cumulative result of various factors such as the Ming-Qing dynasty transition, his personal life, the inheritance of painting techniques, and the regional culture of Mount Huang, this paper specifically takes Chan thought as its analytical starting point, focusing on its unique expression in his work. Hongren’s path of “Painting-Chan” (hua chan 画禅) not only infused early Qing painting with a sublime spiritual power but also provides a vital religious exegesis of the deep-seated Chinese tradition of “Technique Ascending to the Dao” (ji jin yu dao 技进于道). Full article