Search Results (4,283)

Background/Objectives: The increasing incidence rates of keratinocyte carcinoma (KC), particularly in fair-skinned populations, call for efforts to intensify health education of the general population in addressing this prevalent skin cancer type. As a preparatory step, this systematic review summarizes the published research on the knowledge and risk perception regarding KC among individuals without medical training. Methods: The review was registered in PROSPERO (CRD42024618851) and adheres to PRISMA guidelines. The databases PubMed, Scopus, Web of Science, PsycArticles, and PsycINFO were searched on 30 July 2024. Studies were eligible if knowledge and/or risk perception was assessed in lay people. Risk of bias (ROB) was assessed with the Joanna Briggs Institute checklist for prevalence studies. Comparable outcomes (e.g., awareness of terms for KC) were meta-analyzed. Results: Included reports (n = 17) were published between 1991 and 2024 with 16,728 individuals assessed. Awareness for the most common type of KC, basal cell carcinoma (BCC), was low (20.75% of respondents (95% confidence interval (CI): 15.24–27.61)), while more respondents were familiar with colloquial terms (60.9–72.8%). Meta-analysis indicated an underestimation of the frequency of KC, with only 7.21% (CI: 4.03–12.58) identifying BCC as the most common type of skin cancer. Furthermore, concern about developing KC as assessed in only two overlapping studies was reported by only 25–30% of respondents, indicating a significant gap in risk awareness and a lack of research on risk perception regarding KC. Conclusions: This review highlights the need for targeted health education interventions to improve knowledge and preventive behaviors regarding KC. Given the limitations of the included studies, characterized by high ROB, heterogeneity of results, and a lack of standardized assessment tools, further research is essential to enhance the understanding and awareness of KC in diverse populations. Full article

Background: Access to safe and reliable water and sanitation remains a critical public health and development challenge, with rural and low-income communities being disproportionately affected by inadequate services and heightened exposure to waterborne diseases. Despite global efforts and infrastructure-based progress indicators, significant disparities persist, and these often overlook users’ perceptions of water quality, reliability, and safety. This study explores the determinants of household satisfaction with drinking water in rural areas, comparing subjective user feedback with official access data to reveal gaps in current monitoring approaches and support more equitable, user-centered water governance. Methods: This study was conducted in Kazakhstan’s Atyrau Region, where 1361 residents from 86 rural villages participated in a structured survey assessing household access to drinking water and perceptions of its quality. Data were analyzed using descriptive statistics and multinomial logistic regression to identify key predictors of user satisfaction, with results compared against official records to evaluate discrepancies between reported experiences and administrative data. Results: The field survey results revealed substantial discrepancies between official statistics and residents’ reports, with only 58.1% of respondents having in-house tap water access despite claims of universal coverage. Multinomial logistic regression analysis identified key predictors of user satisfaction, showing that uninterrupted supply and the absence of complaints about turbidity, odor, or taste significantly increased the likelihood of higher satisfaction levels with drinking water quality. Conclusions: This study underscores the critical need to align official water access statistics with household-level experiences, revealing that user satisfaction—strongly influenced by supply reliability and sensory water quality—is essential for achieving equitable and effective rural water governance. Full article

Using waste biomass as a raw material for the combined production of electricity and heat offers corresponding energy, economic, environmental and resource efficiency benefits. The study examines both the performance of a system for combined energy production based on the Organic Rankine Cycle (ORC) utilizing wood biomass and the market interest in its deployment within Bulgaria. Its objective is to propose a technically and economically viable solution for the recovery of waste biomass through the combined production of electricity and heat while simultaneously assessing the readiness of industrial and municipal sectors to adopt such systems. The cogeneration plant incorporates an ORC module enhanced with three additional economizers that capture residual heat from flue gases. Operating on 2 t/h of biomass, the system delivers 1156 kW of electric power and 3660 kW of thermal energy, recovering an additional 2664 kW of heat. The overall energy efficiency reaches 85%, with projected annual revenues exceeding EUR 600,000 and a reduction in carbon dioxide emissions of over 5800 t/yr. These indicators can be achieved through optimal installation and operation. When operating at a reduced load, however, the specific fuel consumption increases and the overall efficiency of the installation decreases. The marketing survey results indicate that 75% of respondents express interest in adopting such technologies, contingent upon the availability of financial incentives. The strongest demand is observed for systems with capacities up to 1000 kW. However, significant barriers remain, including high initial investment costs and uneven access to raw materials. The findings confirm that the developed system offers a technologically robust, environmentally efficient and market-relevant solution, aligned with the goals of energy independence, sustainability and the transition to a low-carbon economy. Full article

Background/Objectives: This study examines how seasonality, pollution, and sample type (water and sediment) influence the presence and distribution of antibiotic resistance genes (ARGs), with a focus on antibiotic resistance genes (ARGs) located on plasmids (the complete set of plasmid-derived sequences, including ARGs) in a tropical urban river. Methods: Samples were collected from three sites along a pollution gradient in the Virilla River, Costa Rica, during three seasonal campaigns (wet 2021, dry 2022, and wet 2022). ARGs in water and sediment were quantified by qPCR, and metagenomic sequencing was applied to analyze chromosomal and plasmid-associated resistance profiles in sediments. Tobit and linear regression models, along with multivariate ordination, were used to assess spatial and seasonal trends. Results: During the wet season of 2021, the abundance of antibiotic resistance genes (ARGs) such as sul-1, intI-1, and tetA in water samples decreased significantly, likely due to dilution, while intI-1 and tetQ increased in sediments, suggesting particle-bound accumulation. In the wet season 2022, intI-1 remained low in water, qnrS increased, and sediments showed significant increases in tetQ, tetA, and qnrS, along with decreases in sul-1 and sul-2. Metagenomic analysis revealed spatial differences in plasmid-associated ARGs, with the highest abundance at the most polluted site (Site 3). Bacterial taxa also showed spatial differences, with greater plasmidome diversity and a higher representation of potential pathogens in the most contaminated site. Conclusions: Seasonality and pollution gradients jointly shape ARG dynamics in this tropical river. Plasmid-mediated resistance responds rapidly to environmental change and is enriched at polluted sites, while sediments serve as long-term reservoirs. These findings support the use of plasmid-based monitoring for antimicrobial resistance surveillance in aquatic systems. Full article

Background: Point-of-care ultrasound (POCUS) is gaining recognition as a valuable diagnostic tool in various fields of medicine, including pediatrics. Its application at the point of care enables real-time clinical decision-making, which is particularly advantageous in pediatric settings. Although global interest in POCUS is growing, many European countries—including Poland—still lack formal training programs for POCUS at both the undergraduate and postgraduate levels. Nevertheless, the number of pediatricians incorporating POCUS into their daily clinical practice in Poland is increasing. However, the extent of its use and perceived value among pediatricians remains largely unknown. This study aimed to evaluate the current level of POCUS utilization in pediatric care in Poland, focusing on pediatricians’ self-assessed competencies, perceptions of its clinical utility, and key barriers to its implementation in daily practice. Methods: This cross-sectional study was conducted between July and August 2024 using an anonymous online survey distributed to pediatricians throughout Poland via national professional networks, with a response rate of 7.3%. Categorical variables were analyzed using the chi-square test of independence to assess the associations between key variables. Quantitative data were analyzed using descriptive statistics, and qualitative data from open-ended responses were subjected to a thematic analysis. Results: A total of 210 pediatricians responded. Among them, 149 (71%) reported access to ultrasound equipment at their workplace, and 89 (42.4%) reported having participated in some form of POCUS training. Only 46 respondents (21.9%) reported frequently using POCUS in their clinical routine. The self-assessed POCUS competence was rated as low or very low by 136 respondents (64.8%). While POCUS was generally perceived as a helpful tool in facilitating and accelerating clinical decisions, the main barriers to implementation were a lack of formal training and limited institutional support. Conclusions: Although POCUS is perceived as clinically valuable by the surveyed pediatricians in Poland, its routine use remains limited due to training and systemic barriers. Future efforts should prioritize the development of a validated, competency-based training framework and the implementation of a larger, representative national study to guide the structured integration of POCUS into pediatric care. Full article

Background/Objectives: Pancreatic cancer (PC) is the seventh leading cause of cancer-related deaths worldwide, with its incidence rising each year. Despite its relatively low incidence, the aggressiveness of pancreatic cancer results in high mortality, with only 12% of patients surviving five years post-diagnosis. Surgical resection remains the only potentially curative treatment, but the tumor is often diagnosed at an advanced stage. The goal of this work is to identify vulnerabilities that can affect the efficacy of treatments and improve the efficacy of therapy. Methods: MAP17 overexpression in pancreatic cancer cell lines, RT-qPCR analysis, xenografts, in vitro and in vivo treatments, analysis of data from pancreatic tumors in transcriptomic patient databases. Results: We studied the prognostic and predictive value of MAP17 (PDZK1IP1) expression in pancreatic cancer, and we found that high MAP17 mRNA expression was associated with poor prognosis. In addition, single-cell analysis revealed that high MAP17 expression was present only in tumor cells. We investigated whether the response to various antitumor agents depended on MAP17 expression. In 2D culture, MAP17-expressing pancreatic cancer cells responded better to gemcitabine and 5-fluorouracil. However, in vivo xenograft tumors with MAP17 expression showed resistance to all treatments. Additionally, MAP17-expressing cells had a high NAD pool, which seems to be effectively depleted in vivo by NAMPT inhibitors, the primary enzyme for NAD biosynthesis. Conclusions: Our findings suggest that MAP17 expression could enhance the prognostic stratification of pancreatic cancer patients. Moreover, the coadministration of NAMPT inhibitors with current treatments may sensitize tumors with high MAP17 expression to chemotherapy and improve the efficacy of chemotherapy. Full article

Background/Objectives: Physical activity is a cornerstone of diabetes mellitus (DM) management and is strongly recommended in the American Diabetes Association (ADA)’s guidelines. This study aims to investigate the self-reported physical activity levels of individuals with DM in Germany, as well as the barriers and facilitators they encounter. Methods: Individuals with type 1 DM (T1DM) and type 2 DM (T2DM) were asked to fill out an online questionnaire that was partly based on the International Physical Activity Questionnaire (IPAQ). Results: The questionnaire was completed by 338 persons with either T1DM (57.1%) or T2DM (42.9%) (females: 56.2%, males: 42.0%, gender diverse persons: 1.8%) of all age groups (at least 18 years). In total, 80.5% of respondents were aware of the current physical activity recommendations. Among the respondents, 58% reported meeting the recommendations for endurance-type physical activity, while only 30.5% reported meeting those for strength training. The three most frequently cited barriers to physical activity were lack of time, lack of motivation and current state of health. Supporting factors included coverage of costs, availability of exercise programs in close proximity to the patient’s home and target group specific exercise programs. Conclusions: The results imply that many individuals with DM in Germany do not meet ADA’s physical activity recommendations, especially considering that self-reports often overestimate actual behavior. In particular, the actual number of individuals who regularly engage in strength training may be too low. There is a clear need to better communicate the benefits of different forms of physical training and to provide physical activity programs aligned with patients’ individual needs. Full article

Background: Angiosarcomas (ASs) represent a heterogeneous and highly aggressive subset of tumors that respond poorly to systemic treatments and are associated with short progression-free survival (PFS) and overall survival (OS). The aim of this study was to develop and validate an immune-related prognostic model—termed the AS score—using data from two independent sarcoma cohorts. Methods: A prognostic model was developed using a previously characterized cohort of 25 angiosarcoma samples. Candidate genes were identified via the Maxstat algorithm (Maxstat v0.7-25 for R), combined with log-rank testing. The AS score was then computed by weighing normalized gene expression levels according to Cox regression coefficients. For external validation, transcriptomic data from TCGA Sarcoma cohort (n = 253) were analyzed. The Immunoscore—which reflects the tumor immune microenvironment—was inferred using the ESTIMATE package (v1.0.13) in R. All statistical analyses were performed in RStudio (v 4.0.3). Results: Four genes—IGF1R, MAP2K1, SERPINE1, and TCF12—were ultimately selected to construct the prognostic model. The resulting AS score enabled the classification of angiosarcoma cases into two prognostically distinct groups (p = 0.00012). Cases with high AS score values, which included both cutaneous and non-cutaneous forms, exhibited significantly poorer outcomes, whereas cases with low AS scores were predominantly cutaneous. A significant association was observed between the AS score and the Immunoscore (p = 0.025), with higher Immunoscore values found in high-AS score tumors. Validation using TCGA sarcoma cohort confirmed the prognostic value of both the AS score (p = 0.0066) and the Immunoscore (p = 0.0029), with a strong correlation between their continuous values (p = 2.9 × 10⁻⁸). Further survival analysis, integrating categorized scores into four groups, demonstrated robust prognostic significance (p = 0.00021). Notably, in tumors with a low Immunoscore, AS score stratification was not prognostic. In contrast, among cases with a high Immunoscore, the AS score effectively distinguished outcomes (p < 0.0001), identifying a subgroup with poor prognosis but potential sensitivity to immunotherapy. Conclusions: This combined classification using the AS score and Immunoscore has prognostic relevance in sarcoma, suggesting that angiosarcomas with an immunologically active microenvironment (high Immunoscore) and poor prognosis (high AS score) may be prime candidates for immunotherapy and this approach warrants prospective validation. Full article

According to the literature, the advancement of information and communication technology (ICT) has increased individual exposure to scams, turning fraud victimization into a significant concern. While prior research has primarily focused on socio-demographic predictors of fraud victimization, this study adopts a behavioral perspective that is grounded in the Signal Detection Theory (SDT) to investigate the likelihood determinants of individuals becoming fraud victims. Using survey data of 671 Indonesian respondents analyzed with the Partial Least Squares Structural Equation Modeling (PLS-SEM), we explored the roles of vigilance and financial literacy in moderating the relationship between fraud exposure and victimization. Our findings substantiate the notion that higher exposure to fraudulent activity significantly increases the likelihood of victimization. The results also show that vigilance negatively moderates the relationship between fraud exposure and fraud victimization, suggesting that individuals with higher vigilance are better at identifying scams, thereby decreasing their likelihood of becoming fraud victims. Furthermore, financial literacy is positively related to vigilance, indicating that financially literate individuals are more aware of potential scams. However, the predictive power of financial literacy on vigilance is relatively low. Hence, while literacy helps a person sharpen their indicators for detecting fraud, psychological, behavioral, and contextual factors may also affect their vigilance and decision-making. Full article

Grounded in health behavior theory, this study examined patterns of preventive health behavior in a culturally diverse, multilingual region of northern Italy using data from a representative population survey (n = 2090). Preventive behaviors were assessed using the 16-item Good Health Practices (GHP-16) scale. Latent profile analysis (LPA) identified five behavioral profiles, ranging from ‘Globally Low Engagers’ to ‘Comprehensive High Engagers’. Binary logistic regression compared ‘Globally Low Engagers’ to ‘Broadly Moderate Preventers’, examining predictors including gender, age, education, language, chronic disease status, health literacy (HLS-EU-Q16), patient activation (PAM-10), mistrust of health information, living situation, and healthcare employment. The results showed that men, younger adults, individuals with low patient activation, those living alone, and respondents with high mistrust of health information had higher odds of belonging to the low engagement group. Health literacy and language group membership were not significantly associated with the profile membership. Item-level comparisons revealed gender differences in information-seeking, oral hygiene, and dietary behaviors, with men reporting lower engagement. These findings support a segmentation-based understanding of preventive health behavior and highlight the need to address personal capacities and contextual barriers in interventions while challenging assumptions of uniformly higher female health vigilance. Full article

This study empirically investigates the use of artificial intelligence (AI) tools within Hungarian religious communities, with a focus on Catholic respondents, to assess their awareness, application, and acceptance of AI in religious contexts. By religious communities, we do not mean monastic or priestly communities, but rather communities of lay religious people. Conducted between 10 February and 11 March 2025, the questionnaire-based research (N = 133) employs Campbell’s Religious Social Shaping of Technology (RSST) framework to analyze attitudes toward AI across 15 religious functions. Six hypotheses explore gender differences, religiosity types (church-based vs. self-defined), and the acceptability, authenticity, and ethicality of AI applications. Findings reveal high acceptance for administrative tasks (e.g., email list updates: 64.7%) and technical functions (e.g., live translation: 65.4%), but low acceptance for spiritual roles (e.g., spiritual leadership: 12.8%). Self-defined religious individuals are significantly more accepting, perceiving AI as more authentic and ethical compared to those adhering to church teachings. No significant gender differences were found. The study contributes to digital religion studies, highlighting the influence of religiosity on AI adoption, though its non-representative sample limits generalizability. Full article

Genetic transformation is an essential tool for investigating gene function and editing genomes. Kiwifruit, recognized as a significant global fresh fruit crop, holds considerable economic and nutritional importance. However, current genetic transformation techniques for kiwifruit are impeded by low efficiency, lengthy culture durations (a minimum of six months), and substantial labor requirements. In this research, we established an efficient system for shoot regeneration and the stable genetic transformation of the ‘Hayward’ cultivar, utilizing leaf explants in conjunction with two strains of Agrobacterium that harbor the expression vector pBI121-35S::GFP, which contains the green fluorescent protein (GFP) gene as a visible marker within the T-DNA region. Our results show that 93.3% of leaf explants responded positively to the regeneration medium, producing multiple independent adventitious shoots around the explants within a six-week period. Furthermore, over 71% of kanamycin-resistant plantlets exhibited robust GFP expression, and the entire transformation process was completed within four months of culture. Southern blot analysis confirmed the stable integration of GFP into the genome, while RT-PCR and fluorescence microscopy validated the sustained expression of GFP in mature plants. This efficient protocol for regeneration and transformation provides a solid foundation for micropropagation and the enhancement of desirable traits in kiwifruit through overexpression and gene silencing techniques. Full article

This article documents the widespread absence of sessile species in bedrock intertidal habitats at the head of the St. Lawrence Estuary, a large macrotidal estuary located in eastern Canada. Extensive observations revealed that no seaweeds or sessile invertebrates occurred anywhere (including cracks and crevices) on substrate areas that become exposed to the air during low tides. Only one sessile species, a green filamentous alga, was found submerged in tidepools. The lack of truly marine sessile species is likely explained by the very low water salinity of this coast, while the absence of sessile freshwater species on intertidal substrates outside of tidepools likely responds to a combination of oligohaline conditions during high tides and daily exposures to the air during low tides, which freshwater species are typically not adapted to. Influences of winter ice scour and coastal suspended sediments are likely secondary. Experimental research could unravel the interactive effects of these abiotic stressors. Overall, this “intertidal desert” could be a useful model system to further explore the boundaries of life on our planet. Full article

Background/Objectives: This study aimed to evaluate myocardial scar burden and distribution, as well as other nuclear imaging parameters, in predicting cardiac resynchronization therapy (CRT) responses and long-term outcomes in patients selected for CRT with ischemic HF etiology. Methods: Seventy-one patients were prospectively included. They all had NYHA class II/III despite optimal medical therapy, LVEF ≤ 35%, wide QRS complexes, and ischemic HF etiology. All were indicated for de novo CRT implantation and underwent a SPECT MPI viability test prior to CRT implantation. Two-dimensional echocardiography was performed one day before CRT implantation and 6 months after the intervention. The follow-up examination was conducted six months after the CRT implantation and, after 5 years, patients underwent a telephone follow-up to assess survival. Results: Most patients (85%) were male, with an average age of 66.26 ± 9.25 yrs. SPECT MPI revealed large myocardial scars (44.53 ± 20.94%) with high summed rest scores (SRSs) of 25.02 ± 11.29 and low EFs of 26.67 ± 7.71%. At the 6-month follow-up, after the CRT implantation, the NYHA class significantly changed and 35% of the patients were classified as CRT responders. The only difference between responders and non-responders was in the SRS and myocardial scar size (p < 0.001). A scar size of 19.5% was an optimal cutoff for the prediction of CRT response (AUC 0.853, Sn 85% and 1-sp 94%). Conclusions: SPECT MPI parameters are valuable in predicting responses and long-term survival in patients with CRT. Patients with myocardial scars of less than 19.5% may be suited to CRT and experience better cardiovascular survival. Full article

Phosphorus (P) availability is a major constraint on plant growth in many forest ecosystems, yet the strategies by which different tree species acquire and utilize various forms of soil phosphorus remain poorly understood. This study investigated how coexisting tree species with contrasting mycorrhizal types, specifically arbuscular mycorrhizal (AM) and ectomycorrhizal (ECM) associations, respond to different phosphorus forms under field conditions. An in situ root bag experiment was conducted using four phosphorus treatments (control, inorganic, organic, and mixed phosphorus) across four subtropical tree species. A comprehensive set of fine root traits, including morphological, physiological, and mycorrhizal characteristics, was measured to evaluate species-specific phosphorus foraging strategies. The results showed that AM species were more responsive to phosphorus form variation than ECM species, particularly under inorganic and mixed phosphorus treatments. Significant changes in root diameter (RD), root tissue density (RTD), and acid phosphatase activity (RAP) were observed in AM species, often accompanied by higher phosphorus accumulation in fine roots. For example, RD in AM species significantly decreased under the Na₃PO₄ treatment (0.94 mm) compared to the control (1.18 mm), while ECM species showed no significant changes in RD across treatments (1.12–1.18 mm, p > 0.05). RTD in AM species significantly increased under Na₃PO₄ (0.030 g/cm³) and Mixture (0.021 g/cm³) compared to the control (0.012 g/cm³, p < 0.05), whereas ECM species exhibited consistently low RTD values across treatments (0.017–0.020 g/cm³, p > 0.05). RAP in AM species increased significantly under Na₃PO₄ (1812 nmol/g/h) and Mixture (1596 nmol/g/h) relative to the control (1348 nmol/g/h), while ECM species showed limited variation (1286–1550 nmol/g/h, p > 0.05). In contrast, ECM species displayed limited trait variation across treatments, reflecting a more conservative acquisition strategy. In addition, trait correlation analysis revealed stronger coordination among root traits in AM species. And AM species exhibited high variability across treatments, while ECM species maintained consistent trait distributions with limited plasticity. These findings suggest that AM and ECM species adopt fundamentally different phosphorus acquisition strategies. AM species rely on integrated morphological and physiological responses to variable phosphorus conditions, while ECM species maintain stable trait configurations, potentially supported by fungal symbiosis. Such divergence may contribute to functional complementarity and species coexistence in phosphorus-limited subtropical forests. Full article