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Search Results (15,048)

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Keywords = longitudinal studies

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11 pages, 572 KB  
Article
Associations Between Young Adult Emotional Support Derived from Social Media, Personality Structure, and Anxiety
by Renae A. Merrill and Chunhua Cao
Psychiatry Int. 2026, 7(1), 18; https://doi.org/10.3390/psychiatryint7010018 - 13 Jan 2026
Abstract
Background: Longitudinal studies demonstrate an association between social media use and anxiety. However, the mechanism of this association in terms of emotional support is not completely understood. Methods: We used survey data among a national sample of 2403 individuals aged 18–30. [...] Read more.
Background: Longitudinal studies demonstrate an association between social media use and anxiety. However, the mechanism of this association in terms of emotional support is not completely understood. Methods: We used survey data among a national sample of 2403 individuals aged 18–30. Primary measures included the 4-item Patient-Reported Outcome Measurement Information System (PROMIS) scale to assess anxiety, self-reported emotional support derived from social media (SMES), and the 10-item Big Five Inventory (BFI-10) to determine personality structure. We performed factorial analysis of variance (ANOVA) and multiple regression analyses to examine the associations among these variables while controlling for age and sex. Results: SMES was associated with decreased anxiety. These associations were more pronounced among females. Personality traits of high openness to experience, high extraversion, high agreeableness, and low conscientiousness were associated with increased SMES. Limitations: Due to the cross-sectional research design and observation data, causal relationship could not be established. Conclusions: Emotional support derived from social media (SMES) may be linked to reduced anxiety, especially among females. SMES may also be linked with specific personality characteristics. Future research should investigate these associations longitudinally. Full article
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29 pages, 2892 KB  
Article
Physically Interpretable Soft Sensor for Deformation Diagnostics in Extrusion-Based Shaping: A Case Study on Ceramic Roof Tiles
by Milica Vidak Vasić, Zoran Bačkalić and Pedro Muñoz
Processes 2026, 14(2), 279; https://doi.org/10.3390/pr14020279 - 13 Jan 2026
Abstract
This study examines the longitudinal shortening of clay blanks during extrusion and introduces a hybrid soft sensor framework for early prediction of ceramic roof tile performance. Targeted properties include shrinkage, water absorption, and saturation. The models integrate real-time process data collected after vacuum [...] Read more.
This study examines the longitudinal shortening of clay blanks during extrusion and introduces a hybrid soft sensor framework for early prediction of ceramic roof tile performance. Targeted properties include shrinkage, water absorption, and saturation. The models integrate real-time process data collected after vacuum extrusion and pressing with clay-specific descriptors such as carbonate content and granulometry, alongside additional variables including moisture, firing temperature, and length reduction. Partial Least Squares (PLS) regression was adopted as the core method due to robustness against multicollinearity and ease of industrial integration. In contrast to complex machine learning pipelines, PLS-based soft sensors enable lightweight edge deployment without reliance on IoT infrastructure. Complementary regression and machine learning models were used to benchmark predictive accuracy and explore nonlinear effects. The results confirm reliable prediction of key performance indicators and reveal mechanistic links between extrusion-induced deformation and downstream behavior. Although developed for clay systems, the framework is generalizable and can be adapted to other traditional ceramic processes or industries seeking interpretable, locally deployable solutions for process control. Full article
26 pages, 972 KB  
Review
Synergy of SARS-CoV-2 and HIV-1 Infections in the Human Brain
by Rajnish S. Dave and Howard S. Fox
Pathogens 2026, 15(1), 89; https://doi.org/10.3390/pathogens15010089 - 13 Jan 2026
Abstract
This review explores the interplay between SARS-CoV-2 and HIV-1 infections within the human brain, highlighting the significant neurological implications of these viral infections. SARS-CoV-2 can infect the central nervous system (CNS), with evidence of the virus detected in various brain regions, including the [...] Read more.
This review explores the interplay between SARS-CoV-2 and HIV-1 infections within the human brain, highlighting the significant neurological implications of these viral infections. SARS-CoV-2 can infect the central nervous system (CNS), with evidence of the virus detected in various brain regions, including the hypothalamus, cerebellum, and olfactory bulb. This infection is linked to microglial activation and neuroinflammation, which can lead to severe neurological outcomes in affected individuals. Autopsy studies revealed microglial changes, including downregulation of the P2RY12 receptor, indicating a shift from homeostatic to inflammatory phenotype. Similar changes in microglia are found in the brains of people with HIV-1 (PWH) []. In SARS-CoV-2, the correlation between inflammatory cytokines, such as IL-1, IL-6, and MCP-1, found in cerebrospinal fluid and brain tissues, indicates significant neurovascular inflammation. Astrogliosis and microglial nodules were observed, further emphasizing the inflammatory response triggered by the viral infections, again in parallel to those found in the brains of PWH. Epidemiologic data indicate that although SARS-CoV-2 infection rates in PWH mirror those in People without HIV (PWoH) populations, Long-COVID prevalence is markedly higher among PWH. Evidence of overlapping cognitive impairment, mental health burden, and persistent neuroinflammation highlights diagnostic complexity and therapeutic gaps. Despite plausible mechanistic synergy, direct neuropathological confirmation remains scarce, warranting longitudinal, biomarker-driven studies. Understanding these interactions is critical for developing targeted interventions to mitigate CNS injury and improve outcomes. Full article
25 pages, 9880 KB  
Article
Strong Longitudinal and Latitudinal Differences of Ionospheric Responses in North American and European Sectors During the 10–11 October 2024 Geomagnetic Storm
by Xinyue Luo, Ercha Aa, Xin Wang and Bingxian Luo
Remote Sens. 2026, 18(2), 256; https://doi.org/10.3390/rs18020256 - 13 Jan 2026
Abstract
This study examines the spatiotemporal evolution of midlatitude ionospheric disturbances during the intense geomagnetic storm on 10–11 October 2024, focusing on the North American and European sectors. It utilizes multi-instrument datasets from ground-based observations, including Global Navigation Satellite System (GNSS) receivers and ionosondes, [...] Read more.
This study examines the spatiotemporal evolution of midlatitude ionospheric disturbances during the intense geomagnetic storm on 10–11 October 2024, focusing on the North American and European sectors. It utilizes multi-instrument datasets from ground-based observations, including Global Navigation Satellite System (GNSS) receivers and ionosondes, supplemented by the measurements from the Swarm, DMSP and GUVI/TIMED satellites. The results reveal significant longitudinal and latitudinal variations in regional ionospheric responses, specifically related to Storm Enhanced Density (SED) and the midlatitude trough. Key findings include: (a) During the main phase of the storm, the North American midlatitude ionosphere exhibited a pronounced longitudinal contrast: a positive SED-driven phase in the west versus a negative trough-dominated phase in the east. In the early recovery phase, the western sector transitioned to a trough-induced negative phase, while the eastern sector showed a positive phase related to auroral particle precipitation during substorms. (b) The North American SED featured a strong northwest-extending plume with a westward shift velocity of 200–300 m/s at 45°N, and a sharp density gradient of 60–65 TECU on its northeastern side, in contrast to the trough. (c) The European sector displayed a “sandwich-like” latitudinal pattern, with “positive–negative–positive” variations during the storm. (d) The European sector’s storm-time trough expanded rapidly equatorward, reaching a minimum of ~35° magnetic latitude (MLAT), while broadening latitudinally to a width of 18–20°. These density gradient structures, along with the longitudinal/latitudinal differences, highlight the dynamic processes occurring in the magnetosphere–ionosphere–thermosphere system during intense storms and contribute to the understanding of storm-response mechanisms across different sectors. Full article
20 pages, 960 KB  
Article
Long-Term Auditory, Tinnitus, and Psychological Outcomes After Cochlear Implantation in Single-Sided Deafness: A Two-Year Prospective Study
by Jasper Karl Friedrich Schrader, Moritz Gröschel, Agnieszka J. Szczepek and Heidi Olze
J. Clin. Med. 2026, 15(2), 644; https://doi.org/10.3390/jcm15020644 - 13 Jan 2026
Abstract
Background/Objectives: Single-sided deafness (SSD) impairs speech perception, reduces spatial hearing, decreases quality of life, and is frequently accompanied by tinnitus. Cochlear implantation (CI) has become an established treatment option, but long-term prospective evidence across multiple functional and psychological domains remains limited. This [...] Read more.
Background/Objectives: Single-sided deafness (SSD) impairs speech perception, reduces spatial hearing, decreases quality of life, and is frequently accompanied by tinnitus. Cochlear implantation (CI) has become an established treatment option, but long-term prospective evidence across multiple functional and psychological domains remains limited. This study investigated auditory performance, subjective hearing outcomes, tinnitus burden, and psychological well-being over a two-year follow-up in a large SSD cohort. Methods: Seventy adults with SSD underwent unilateral CI. Assessments were conducted preoperatively and at 6 months, 1 year, and 2 years postoperatively. Outcome measures included the Freiburg Monosyllable Test (FS), Oldenburg Inventory (OI), Nijmegen Cochlear Implant Questionnaire (NCIQ), Tinnitus Questionnaire (TQ), Perceived Stress Questionnaire (PSQ), Generalized Anxiety Disorder scale (GAD-7), and General Depression Scale (ADS-L). Longitudinal changes were analyzed using Wilcoxon signed-rank tests with effect sizes; Holm-adjusted p-values were applied for baseline-to-follow-up comparisons. Results: Speech perception improved markedly within the first 6 months and remained stable through 2 years, with large effect sizes. All OI subdomains demonstrated early and sustained improvements in subjective hearing ability. Several hearing-related quality-of-life domains assessed by the NCIQ, particularly social interaction, self-esteem, and activity participation, showed medium-to-large long-term improvements. Tinnitus severity decreased substantially, with marked reductions observed by 6 months and maintained thereafter; the proportion of tinnitus-free patients increased at follow-up, although tinnitus symptoms persisted in a substantial subset of participants. Perceived stress was reduced initially at the early follow-up and remained below baseline thereafter. Anxiety and depressive symptoms mostly stayed within nonclinical ranges, showing no lasting changes after adjusting for multiple comparisons. Conclusions: In this prospective cohort, cochlear implantation was associated with durable improvements in auditory outcomes, tinnitus burden, and selected patient-reported quality-of-life domains over two years. Although significant functional and patient-centered improvements were noted, persistent tinnitus and diverse psychosocial outcomes underscore the need for personalized counseling and comprehensive follow-up that incorporate patient-reported outcomes and psychological assessments. Full article
16 pages, 285 KB  
Article
Relationships Between Hematological Variables and Bone Metabolism in Elite Female Trail Runners
by Marta Carrasco-Marginet, Silvia Puigarnau, Javier Espasa-Labrador, Álex Cebrián-Ponce, Fabrizio Gravina-Cognetti, Nil Piñol-Granadino and Alfredo Irurtia
Healthcare 2026, 14(2), 200; https://doi.org/10.3390/healthcare14020200 - 13 Jan 2026
Abstract
Background: This study investigated the relationships between hematological and bone metabolism variables in 35 elite female trail runners, focusing on identifying key hematological correlates of bone health. Methods: Forty-four hematological variables, including biochemical, hormonal, metabolic, liver enzyme, and iron profiles, as well as [...] Read more.
Background: This study investigated the relationships between hematological and bone metabolism variables in 35 elite female trail runners, focusing on identifying key hematological correlates of bone health. Methods: Forty-four hematological variables, including biochemical, hormonal, metabolic, liver enzyme, and iron profiles, as well as complete blood count and platelet indices, were analyzed. Bone mineral density (BMD) and bone mineral content (BMC) were assessed at multiple skeletal regions via dual-energy X-ray absorptiometry (DXA). A cross-sectional design was employed, utilizing descriptive statistics, correlation analyses, and multiple linear regression to analyze the associations between hematological markers and BMC and BMD. Results: Significant but moderate associations were identified: magnesium consistently emerged as a negatively associated factor, particularly associated with BMC and BMD in the lumbar spine (L1–L4) and whole-body, potentially reflecting hypothesized mineral mobilization during chronic physical stress. Follicle-stimulating hormone showed positive associations with BMD, suggesting a potential protective association in bone turnover regulation. Additionally, calcium and thyroid hormones were linked to regional bone properties, highlighting site-specific skeletal vulnerabilities. Conclusions: These findings suggest a complex interplay between mineral homeostasis and hormonal balance that may be related to skeletal integrity in elite female trail runners. This work provides a foundation for developing evidence-based guidelines to support the health and performance of female endurance athletes. Further research is warranted to confirm these results through longitudinal evaluations. Full article
(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)
11 pages, 505 KB  
Article
Behavioral and Cognitive Assessment in a Cohort of Term Small-for-Gestational-Age Children
by Rossella Vitale, Annachiara Libraro, Francesca Cocciolo, Mariangela Chiarito, Emilia Matera and Maria Felicia Faienza
Children 2026, 13(1), 120; https://doi.org/10.3390/children13010120 - 13 Jan 2026
Abstract
Background/Objectives: Children born small for gestational age (SGA) are at increased risk for impaired growth, metabolic disturbances, and neurodevelopmental difficulties. Although previous research has examined cognitive and behavioral outcomes in this population, findings remain inconsistent. Moreover, limited evidence is available regarding the potential [...] Read more.
Background/Objectives: Children born small for gestational age (SGA) are at increased risk for impaired growth, metabolic disturbances, and neurodevelopmental difficulties. Although previous research has examined cognitive and behavioral outcomes in this population, findings remain inconsistent. Moreover, limited evidence is available regarding the potential effects of recombinant human growth hormone (rhGH) therapy on cognitive development. We aimed to assess cognitive performance, emotional–behavioral functioning, and neonatal predictors of neurocognitive outcomes in term SGA children compared with age- and sex-matched peers born appropriate for gestational age (AGA). We also explored potential differences in cognitive outcomes between rhGH-treated and untreated SGA children. Methods: A total of 18 term SGA children and 23 AGA controls underwent anthropometric measurements, biochemical evaluation, cognitive testing using the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV), and behavioral assessment through the Child Behavior Checklist (CBCL). Birth weight, length, and head circumference were analyzed as potential predictors of cognitive performance. Results: SGA children demonstrated significantly lower Intelligence Quotient (IQ) scores than AGA peers, with marked weaknesses in Perceptual Reasoning index (PRI) and Processing Speed index (PSI), while Verbal Comprehension and Working Memory were preserved. They also exhibited higher internalizing behavioral symptoms, whereas externalizing behaviors did not differ between groups. Birth head circumference emerged as a strong predictor of PRI and a modest predictor of PSI. No associations were found between rhGH treatment parameters and cognitive outcomes. Larger longitudinal studies are needed to clarify how early growth restriction affects brain development and cognition and whether GH therapy influences these processes. Full article
(This article belongs to the Section Pediatric Neonatology)
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14 pages, 276 KB  
Article
Associations Between Perceived Physical Literacy and DXA-Measured Body Composition in Spanish Adolescents: The ENERGYCO Study
by Emilio Villa-González, Pablo Campos-Garzón, Manuel Ávila-García, Ana Ramírez-Osuna, David Rodriguez-Sanchez, José Manuel Segura-Díaz and Víctor Manuel Valle-Muñoz
Appl. Sci. 2026, 16(2), 807; https://doi.org/10.3390/app16020807 - 13 Jan 2026
Abstract
Background: Physical literacy is a multidimensional construct that may be relevant for promoting active lifestyles and healthy development during adolescence. However, the association between perceived physical literacy (PPL) and body composition assessed by dual-energy X-ray absorptiometry (DXA) remains underexplored. Objective: To examine the [...] Read more.
Background: Physical literacy is a multidimensional construct that may be relevant for promoting active lifestyles and healthy development during adolescence. However, the association between perceived physical literacy (PPL) and body composition assessed by dual-energy X-ray absorptiometry (DXA) remains underexplored. Objective: To examine the association between PPL and DXA-derived body composition parameters in Spanish adolescents. Methods: This cross-sectional study included 56 adolescents (13.2 ± 1.27 years, 28.6% girls). PPL was assessed using the validated Spanish version of the Perceived Physical Literacy Instrument (S-PPLI). Body composition was measured by DXA. Associations between PPL and body composition outcomes were examined using general linear models, adjusting for sex, age, and device-measured moderate-to-vigorous physical activity (MVPA) and sedentary time. Results: Higher PPL was significantly associated with greater lean body mass (β = 0.81; p = 0.02), lean mass index (β = 0.22; p = 0.01), and fat-free mass (β = 0.85; p = 0.01), as well as with higher body mass index (BMI) (β = 0.24; p = 0.03). Conclusions: Higher PPL is associated with more favorable lean-related body composition outcomes in Spanish adolescents, whereas no associations were found with adiposity or bone parameters. These findings highlight PPL as a relevant correlation of lean body composition during adolescence. Given the cross-sectional design, causal inferences cannot be drawn, and future longitudinal and interventional studies are warranted. Full article
(This article belongs to the Special Issue Health Promotion Through Physical Activity and Diet)
17 pages, 2288 KB  
Article
The Role of Matrix Shielding in the In Situ Fiber Strength and Progressive Failure of Unidirectional Composites
by Mostafa Barzegar, Jose M. Guerrero, Zahra Tanha, Carlos Gonzalez, Abrar Baluch and Josep Costa
J. Compos. Sci. 2026, 10(1), 47; https://doi.org/10.3390/jcs10010047 - 13 Jan 2026
Abstract
While carbon fiber strength is typically characterized through single-fiber tensile tests, these isolated measurements do not account for the local mechanical constraints present within a composite architecture. This study employs a synergistic computational micromechanics approach combining finite element analysis (FEA) and analytical modeling [...] Read more.
While carbon fiber strength is typically characterized through single-fiber tensile tests, these isolated measurements do not account for the local mechanical constraints present within a composite architecture. This study employs a synergistic computational micromechanics approach combining finite element analysis (FEA) and analytical modeling to investigate how the surrounding matrix influences the Stress Intensity Factor (SIF) and the apparent ultimate strength of embedded fibers. By calculating the J-integral, we demonstrate that the matrix provides a significant shielding effect, constraining crack opening displacements and substantially reducing the SIF. This mechanism results in a marked increase in in situ fiber tensile strength relative to dry fibers. Incorporating this matrix-adjusted Weibull distribution into a longitudinal failure model significantly improves the prediction of fiber-break density accumulation, showing closer correlation with experimental benchmarks than traditional models. Full article
(This article belongs to the Section Composites Modelling and Characterization)
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28 pages, 8060 KB  
Article
A Five-Stage Closed-Loop Lean Routine for Daily Factory Management: A Field Intervention in a UK Pharmaceutical Plant
by Marcelo José de Albuquerque Fonseca and Denise Dumke de Medeiros
Systems 2026, 14(1), 86; https://doi.org/10.3390/systems14010086 - 13 Jan 2026
Abstract
Lean implementations often deploy tools in isolation, leaving gaps in how abnormalities are exposed, resolved at the root cause, escalated when needed, and converted into organisational learning. This study proposes a five-stage closed-loop routine for daily factory management that integrates problem visibility, standardised [...] Read more.
Lean implementations often deploy tools in isolation, leaving gaps in how abnormalities are exposed, resolved at the root cause, escalated when needed, and converted into organisational learning. This study proposes a five-stage closed-loop routine for daily factory management that integrates problem visibility, standardised shop-floor cadence, disciplined problem-solving, and tiered escalation within a single operating logic. The novelty lies not in the individual Lean tools, but in the specification of cadence, triggers, accountable roles, and verification steps that connect them into a replicable end-to-end routine. The model was evaluated through a 19-month longitudinal, single-site field intervention (quasi-experimental before–and–after) on the bottleneck production line of a pharmaceutical plant in Hengoed, Wales (UK). Line OEE increased by over 50% in relative terms. At factory level, total output increased by 20% year-on-year in 2024 (context indicator), alongside qualitative field observations of shorter time-to-resolution and improved cross-functional coordination. As a single-site study, external validity is context-dependent; nevertheless, the paper provides a specified closed-loop routine and field evidence on the operational effects of embedding an integrated Lean cycle into daily management. Practically, the study provides a specified routine that practitioners can replicate and adapt; academically, it contributes to Lean implementation research by showing how tool bundles can be operationalised as an end-to-end daily management routine with observable performance effects. Full article
(This article belongs to the Section Systems Engineering)
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14 pages, 788 KB  
Article
Trunk Kinematics in Writhing and Fidgety Movements: A Pilot Study on Early Postural Control in Infants Using Computer Vision
by Lucía Fernanda Flores-Santy, Karina Elizabeth Flores Santy and Juan Pablo Hervás-Pérez
Bioengineering 2026, 13(1), 91; https://doi.org/10.3390/bioengineering13010091 - 13 Jan 2026
Abstract
Background: General Movement Assessment is a strong early predictor of adverse neurodevelopmental outcomes but remains qualitative and examiner-dependent. Quantitative, video-based kinematic analysis may complement General Movement Assessment by providing objective, scalable metrics. Methods: In this pilot study, a computer–vision-based pipeline was [...] Read more.
Background: General Movement Assessment is a strong early predictor of adverse neurodevelopmental outcomes but remains qualitative and examiner-dependent. Quantitative, video-based kinematic analysis may complement General Movement Assessment by providing objective, scalable metrics. Methods: In this pilot study, a computer–vision-based pipeline was used to extract trunk center-of-mass kinematics from video recordings of spontaneous General Movements in infants under three months corrected age during the Writhing and Fidgety stage. Two measures were derived: trunk quantity of motion and movement duration. Group differences were examined using t-tests and effect sizes, and associations with corrected age and sex were explored with correlation analyses. Results: Writhing Movements were substantially longer than Fidgety Movements, with a large effect size, whereas trunk quantity of motion did not differ meaningfully between movement types. Correlations between corrected age and both the quantity of motion and duration were small and imprecise. Sex did not moderate duration changes, but trunk motion showed a significant age–sex interaction effect. Conclusions: Video-based extraction of trunk kinematics is feasible in early infancy and reveals robust differences in GMs type duration between Writhing and Fidgety Movements. Larger longitudinal studies are needed to clarify the value of these measures as early quantitative markers of postural control and neuromotor development. Full article
(This article belongs to the Special Issue Intelligent Systems for Human Action Recognition)
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13 pages, 4348 KB  
Proceeding Paper
Investigation of the Influence of Distributor Valve Position on Longitudinal Train Dynamics During Braking
by Stefan Krastev, Svetoslav Slavchev, Vladislav Maznichki, Petko Sinapov and Magdalen Velev
Eng. Proc. 2026, 121(1), 13; https://doi.org/10.3390/engproc2025121013 - 13 Jan 2026
Abstract
The distributor valve is one of the most important components in the pneumatic braking system of trains. It performs the functions of filling and releasing the brake cylinder. The distributor valve most widely used on Bulgarian railways operates in two positions, respectively, in [...] Read more.
The distributor valve is one of the most important components in the pneumatic braking system of trains. It performs the functions of filling and releasing the brake cylinder. The distributor valve most widely used on Bulgarian railways operates in two positions, respectively, in “freight train” mode (G) and in “passenger train mode” (P). The difference between them is determined by the different times for filling and emptying the brake cylinder. These times affect the moment of engagement of the braking system of each wagon in the train composition. This has a significant impact on the longitudinal forces obtained in the couplers. This paper is dedicated to the analysis of the influence of the distributor valve position on the longitudinal forces. A simulation study of the longitudinal behavior of a train set was carried out in Simulink®, which consists of a locomotive and 43 freight wagons attached to it, with 80 t gross mass of each wagon. The railway cars are linked by elastic elements with nonlinear characteristics. The results represent the distribution of longitudinal forces in time. They are used for the investigation of the longitudinal dynamics of the train, with the aim of improving the running-dynamic qualities of the train during braking. Full article
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16 pages, 499 KB  
Review
Mindfulness Components and Their Clinical Efficacy: A Critical Review of an Ongoing Debate
by Andrea Lizama-Lefno, Krystel Mojica, Mayte Serrat, Carla Olivari, Ángel Roco-Videla and Sergio V. Flores
Healthcare 2026, 14(2), 196; https://doi.org/10.3390/healthcare14020196 - 13 Jan 2026
Abstract
The rapid expansion of mindfulness research has generated both enthusiasm and controversy regarding its actual clinical value. While meditation is often regarded as the central mechanism of mindfulness-based interventions, other components such as psychoeducation and informal practice may play an equally significant role [...] Read more.
The rapid expansion of mindfulness research has generated both enthusiasm and controversy regarding its actual clinical value. While meditation is often regarded as the central mechanism of mindfulness-based interventions, other components such as psychoeducation and informal practice may play an equally significant role in improving mental health outcomes. This critical review examines the relative contributions of these elements to the therapeutic impact of mindfulness and clarifies the extent to which its effects are comparable to established treatments, particularly Cognitive Behavioral Therapy (CBT). Evidence from meta-analyses and high-quality trials indicates that mindfulness programs achieve moderate efficacy in reducing symptoms of anxiety, depression, and stress, but effect sizes are frequently inflated by methodological limitations. Importantly, cognitive and emotional regulation skills, especially acceptance and non-judgment, appear to sustain long-term benefits more consistently than meditation alone. These findings highlight the need for rigorous longitudinal studies and component-focused designs to identify the mechanisms that drive clinical change. By distinguishing between evidence-based applications and overstated claims, this review contributes to a more balanced understanding of mindfulness and its appropriate integration into healthcare. Full article
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12 pages, 2455 KB  
Article
Fontan Route Remodeling over Time: A Longitudinal Quantitative 3D Case Series
by Raquel dos Santos, Amartya Dave, Mohammed Usmaan Siddiqi, Aashi Dharia, Deqa Muse, Junsung Kim, Kameel Khabaz, Nhung Nguyen, Luka Pocivavsek and Narutoshi Hibino
J. Cardiovasc. Dev. Dis. 2026, 13(1), 45; https://doi.org/10.3390/jcdd13010045 - 13 Jan 2026
Abstract
Fontan patients experience anatomical remodeling over time, yet the mechanisms driving these changes remain unclear. This study aimed to characterize full-route Fontan remodeling and evaluate whether observed morphological changes arise from somatic growth alone or from the combined influence of conduit properties, surgical [...] Read more.
Fontan patients experience anatomical remodeling over time, yet the mechanisms driving these changes remain unclear. This study aimed to characterize full-route Fontan remodeling and evaluate whether observed morphological changes arise from somatic growth alone or from the combined influence of conduit properties, surgical design, thoracic anatomy, and mechanical forces. Five Fontan patients (four extracardiac, one lateral tunnel) underwent analysis using two MRI-derived 3D models obtained between 1 and 4 years apart. Directional displacement was assessed using 3D shape overlays, surface geometry was quantified using the Koenderink Shape Index (KSI), and patient-specific growth mapping estimated localized tissue dynamics. Statistical analyses included a one-sample t-test for mean anterior displacement, the Grubbs’ test for outlier detection, and the Wilcoxon signed-rank test for KSI comparisons across time points. All patients exhibited anterior displacement of the Fontan route, with a mean shift of 0.29″ ± 0.33″ and one significant outlier (lateral tunnel, 0.87″). Four of five patients showed increased convexity over time. Growth mapping revealed minimal, heterogeneous native-tissue expansion, with localized growth up to 0.2 mm/year. Individual remodeling trajectories varied and did not consistently align with localized anterior growth, indicating that Fontan route remodeling is highly individualized and cannot be explained by somatic growth alone. This retrospective longitudinal case series study highlights the value of quantitative 3D geometric tools for assessing subtle Fontan route remodeling and supports the feasibility of growth-aware, patient-specific modeling frameworks in single-ventricle physiology. Full article
(This article belongs to the Section Pediatric Cardiology and Congenital Heart Disease)
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13 pages, 541 KB  
Review
Occupational Radiation Risk Stratification and Protection in Fluoroscopy-Guided Surgeons and Interventionalists: A Multispecialty Structured Narrative Review
by Nana Kwadwo Okraku-Yirenkyi, Sri Snehita Reddy Bonthu, Hanisha Bhakta, Oluwatoyin O. Duyile and Michael Bernas
J. Pers. Med. 2026, 16(1), 50; https://doi.org/10.3390/jpm16010050 - 13 Jan 2026
Abstract
Background/Objectives: Fluoroscopy-guided procedures are widely used across surgical and interventional specialties but expose operators to ionizing radiation with associated stochastic and deterministic effects. The aim is to characterize occupational radiation exposure, evaluate the effectiveness of shielding strategies, assess long-term cancer risks, and identify [...] Read more.
Background/Objectives: Fluoroscopy-guided procedures are widely used across surgical and interventional specialties but expose operators to ionizing radiation with associated stochastic and deterministic effects. The aim is to characterize occupational radiation exposure, evaluate the effectiveness of shielding strategies, assess long-term cancer risks, and identify compliance patterns. Methods: This structured narrative review summarizes evidence on operator dose, shielding effectiveness, compliance with protective practices, and long-term cancer risk. A search of PubMed, Scopus, Embase, and Web of Science (limited to January 2000–March 2024) identified 62 records; 27 full texts were reviewed, and 16 studies met the inclusion criteria. Results: Across studies, unshielded chest exposure averaged 0.08–0.11 mSv per procedure, and eye exposure averaged 0.04–0.05 mSv. Lead aprons reduced exposure by about 90% at 0.25 mm and 99% at 0.5 mm, thyroid collars reduced neck dose by 60–70%, and lead glasses reduced ocular dose 2.5–4.5-fold. Compliance with aprons and thyroid collars was high, whereas lead glasses and lower-body shielding were inconsistently used. Limited epidemiologic data suggested a higher cancer burden in exposed surgeons, and Biologic Effects of Ionizing Radiation (BEIR) VII–based modeling projected increased lifetime risks of solid cancers in chronically exposed operators. Conclusions: Protective equipment substantially reduces operator dose, but exposure variability and inconsistent shielding practices persist and justify standardized monitoring, stronger enforcement of radiation safety protocols, and longitudinal studies. Full article
(This article belongs to the Special Issue Review Special Issue: Recent Advances in Personalized Medicine)
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