Search Results (1,439)

Prostate cancer is among the most prevalent malignancies in men worldwide, underscoring the need for early and accurate diagnostic tools. This study presents a proof-of-concept and pilot clinical validation of a novel bioelectric impedance-based biosensor for the detection of prostate-specific antigen (PSA) in human serum. The system integrates Molecular Identification through Membrane Engineering (MIME) with the xCELLigence real-time cell analysis platform, employing Vero cells electroinserted with anti-PSA antibodies. Optimization experiments identified 15,000 cells/well as the optimal configuration for impedance response. The biosensor exhibited specific, concentration-dependent changes in impedance upon exposure to PSA standard solutions and demonstrated significant differentiation between PSA-positive and PSA-negative human serum samples relative to the clinical threshold of 4 ng/mL. The biosensor offered rapid results within one minute, unlike standard immunoradiometric assay (IRMA), while showing strong diagnostic agreement. The system’s specificity, sensitivity, and reproducibility support its potential for integration into point-of-care screening workflows. This bioelectric assay represents one of the fastest PSA detection approaches reported to date and offers a promising solution for reducing overdiagnosis while improving clinical decision-making and patient outcomes. Full article

Introduction: Night shift work (NSW) has been increasingly addressed in the scientific literature, as it is considered a probable carcinogen. In this study, we investigated the association of NSW with health problems, unhealthy behaviors, and occupational carcinogens. Methods: Cross-sectional study with a sample of 47,953 workers from the 2019 National Health Survey. NSW prevalence was estimated according to sociodemographic characteristics. To investigate the associations of NSW with all study variables, gender stratified logistic regression models were used. The odds-ratio and 95% confidence intervals were estimated. Results: Among men, there was a significant association of NSW with sleep disorders (OR = 1.39; 95% CI: 1.17–1.65), tiredness (OR = 1.68; 95% CI: 1.41–2.00), obesity (OR = 1.41; 95% CI: 1.20–1.66), unhealthy food consumption (OR = 1.28; 95% CI: 1.12–1.46), handling of radioactive material (OR = 2.45; 95% CI: 1.61–3.72), and biological material (OR = 3.18; 95% CI: 3.15–4.80). Among females, NSW was associated with the same variables except obesity, but depressive feelings (OR = 1.35 95% CI: 1.09–1.67), frequent alcohol intake (OR = 1.48; 95% CI: 1.23–1.78), handling of chemical substances (OR = 1.54; OR = 1.54; 95% CI: 1.20–1.97), and passive smoking at work (OR = 1.45; 95% CI: 1.12–1.86) were highly significant. Conclusion: Night shift workers are more vulnerable to occupational carcinogen exposure, experience greater impacts on their well-being, and are more likely to engage in unhealthy behaviors. These findings should be considered in managing and organizing night work in the workplace. Actions to promote healthy work environments should be encouraged to protect workers’ health. Full article

Transportation is often cited as a significant barrier to healthcare access by Veterans, particularly those from minority groups, who have disabilities, or live in rural areas. Autonomous shuttles (AS) offer a potential solution, yet limited research has explored Veterans’ experiences with this technology. This study qualitatively investigated Veterans’ lived experiences with AS through focus groups, enrolling participants aged 18+ from Gainesville, The Villages, and Lake Nona, Florida. Via a directed content analysis, six key themes were identified: Perceived Benefits, Safety, Experience with Autonomous Vehicles (AV), AS Experience, AV Adoption, and Perception Change. Among 26 participants (aged 30–85; 77% men; 88% urban residents), prominent themes included Safety (n = 161), Perceived Benefits (n = 153), and AS Experience (n = 118), with predominantly positive counts in all themes except AS Experience. Participants acknowledged safety advantages and multitasking potential of AS over human-operated vehicles while recommending improvements to the shuttle’s slow speed, availability and convenience. While the AS ride was positively received overall, some participants noted issues with comfort and braking, emphasizing the need for further technological enhancements. Real-world exposure to AS appeared to influence acceptance positively, offering insights for policymakers and industry stakeholders aiming to optimize AS deployment for mobility-vulnerable Veterans. Full article

Background: Cardiac involvement is common in Fabry disease (FD) and typically manifests with left ventricular hypertrophy (LVH). Patients with FD are frequently misdiagnosed, and this is mainly related to the lack of disease awareness among clinicians. The aim of this study was to determine whether providing a targeted educational intervention on FD may enhance FD diagnosis. Methods. This research was designed as a single-arm before-and-after intervention study and evaluated the impact of providing a specific training on FD to cardiologists from different Italian centers, without experience in rare diseases. In the 12-month period after the educational intervention, the rate of FD screening and diagnosis was assessed and compared with those conducted in the two years preceding the study initiation. Results: Fifteen cardiologists participated to this study, receiving a theoretical and practical training on FD. In the two previous two years, they conducted 12 FD screening (6/year), and they did not detect any cases of FD. After the training, they performed 45 FD screenings, with an eight-fold rise in the annual screening rate. The screened population (age: 61 ± 11 years, men: 82%) was mainly composed of patients with unexplained LVH (n = 43). There were four new FD diagnoses and, among of them, three had a late-onset GLA variant. After the cascade genetic screening, 11 affected relatives and 8 heterozygous carriers were also detected. Conclusions: A targeted educational intervention for cardiologists allowed the identification of four new families with FD. Enhancing FD awareness is helpful to reduce the diagnostic and therapeutic delay. Full article

Background: Intermediate care units face growing complexity due to aging populations and chronic illnesses. Non-technical skills such as empathy and communication are crucial for quality care. We aimed to examine the relationship between communication skills, self-efficacy, and sense of coherence among intermediate care nurses. Methods: We conducted an observational, cross-sectional study with 60 intermediate care nurses from three units in a Catalan hospital, Spain. Participants engaged in high-fidelity simulation using geriatric end-of-life scenarios with an ultra-realistic manikin representing a geriatric patient at the end of life. NTSs were measured using validated tools: the Health Professionals Communication Skills Scale (HP-CSS), the General Self-Efficacy Scale, and the Sense of Coherence Questionnaire (OLQ-13). Sessions followed INACSL standards, including prebriefing, simulation, and debriefing phases. Results: Post-simulation outcomes revealed significant gains in interpersonal competencies, with men reporting higher assertiveness (p = 0.015) and greater satisfaction with both the simulation experience (p = 0.003) and the instructor (p = 0.008), underscoring gender-related perceptions in immersive training. Conclusions: Ultra-realistic clinical simulation is effective in enhancing NTS among intermediate care nurses, contributing to improved care quality and clearer professional profiles in geriatric nursing. Full article

Modern Western societies are “aging” at a very high rate, and more and more people require assistance and care. Old age has different faces, which is due to genetic conditions, as well as the different contexts and lifestyles of people. To ensure good adaptation of seniors, it is important to determine the conditions for “successful aging”. Therefore, the purpose of the conducted study was to determine the importance of selected predictors, including the level of religiosity, assessment of health, and the intensity of motivational needs of seniors—students of the University of the Third Age—for the level of their well-being. A total of 115 people were surveyed, including 93 women and 21 men who were students in the first year of the Third Age University at the Pontifical University of John Paul II in Krakow. The surveyed seniors represented an autonomous type of religiosity, a high level of realization of the needs of self-determination, namely autonomy and competence, declared an average assessment of the state of their health, and revealed an increased level of eudaimonic well-being. Predictors of the level of well-being of the surveyed seniors turned out to be the variables religious experience, need for autonomy and competence, and health status, as assessed by the seniors. Full article

Background/Objectives: “Ozempic face” is an aesthetic side effect associated with the use of the antidiabetic agent Ozempic (semaglutide), characterized by a prematurely aged and fatigued facial appearance due to rapid weight loss. Currently, treatment options for this condition are limited. In this study, we present our clinical experience with the BodyTite device, provided by InMode Italy S.r.l. (Rome, Italy). Materials and Methods: We report a case series involving 24 patients (19 women and 5 men, aged 27–65 years), treated with subdermal bipolar radiofrequency (Endotissutal Bipolar Radiofrequency) between 2023 and 2024. All patients underwent a minimum follow-up of 12 months. At the end of the follow-up period, patients rated their satisfaction on a from 0 to 10 scale, and an independent expert assessed the stability of clinical outcomes. Results: The majority of patients reported high satisfaction levels (≥8), which correlated with the independent expert’s evaluation of treatment efficacy and result stability. The only observed adverse event was transient cutaneous erythema. Conclusions: “Ozempic face” is an increasingly common side effect associated with newer classes of antidiabetic medications. Although these drugs offer significant metabolic benefits, the accompanying facial volume loss and aging are often poorly tolerated by patients. Our findings suggest that subdermal bipolar radiofrequency represents a safe, low-risk, and cost-effective therapeutic option for the aesthetic management of Ozempic face. Full article

Background and Objectives: Type 2 diabetes (T2D) is a global health burden with increasing prevalence, necessitating effective management strategies. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as beneficial therapies, promoting both glycemic control and weight loss, yet real-world data on sex differences in response are limited. This study aimed to investigate sex-based differences in glycemic and weight outcomes, as well as adverse effects, in T2D patients treated with GLP-1 RAs at a single diabetes center. Materials and Methods: In this retrospective analysis, 114 patients (58.8% men) with T2D who were initiated on GLP-1 RA therapy between 2015 and 2023 were evaluated. Data on HbA1c, BMI, and adverse events were collected at baseline and 3, 6, and 12 months post-treatment initiation. Results: Our findings indicated a statistically significant HbA1c reduction (from 8.6% at GLP-1 RA initiation to 6.9% at 12 months in men (p < 0.001) and from 8.4% at initiation to 7.0% at 12 months after GLP-1 RA initiation (p < 0.001) in women). By 12 months, a significantly greater proportion of women compared to men achieved ≥ 5% (51.1% vs. 28.4%, p = 0.019) and ≥10% weight loss (29.8% vs. 9.0%, p = 0.006), with both differences reaching statistical significance. A statistically significant difference in weight loss in mean weight change and percent weight change in men vs. women was observed from month 6 of therapy. Conclusions: These findings underscore the effectiveness of GLP-1 RAs in improving glycemic control and weight loss in a real-world setting and suggest that women may experience greater weight reduction. Understanding these differences could inform personalized treatment strategies for optimized outcomes in T2D management. Full article

Access to traditional financial institutions plays a key role in enhancing positive financial outcomes. However, some consumers within the United States experience discrimination from these same institutions. In particular, discrimination based on race and gender has historically been tied to outcomes such as lower service quality and a lack of access to credit. While the previous literature has discussed some of the discriminatory practices that these groups have faced, there is a lack of research on how these groups respond to discrimination from financial institutions. Through a series of logistic regressions, the authors analyzed how race, ethnicity, and gender are related to reporting experiences of discrimination. The authors then explored how consumers react to discrimination by looking at five reported reactions. Primary results show that Black consumers were more likely than most other racial groups to experience financial discrimination. Additionally, women were less likely than men to report financial discrimination. Race was shown to be a significant factor in four of the five reactions to discrimination, while gender was a factor in two of the reactions. The findings further show that after experiencing financial discrimination, most individuals turned to non-traditional financial services as a direct result of the bias or racism. Full article

Background/Objectives: Human immunodeficiency virus (HIV) has evolved from a fatal disease to a manageable chronic condition. However, stigma persists, affecting the lives and sexuality of HIV-positive people, particularly in the gay population. Research on their sexuality is limited, highlighting the need for studies that address their experiences and needs. The aim of the study is to explore the individuals’ experiences of sexuality in serodiscordant gay couples. Methods: A descriptive study was conducted using thematic content analysis. Data collection was carried out through in-depth interviews. Six gay men who have been and/or are in a serodiscordant relationship for at least one year participated in the research. Results: Five sub-themes were identified grouped into two main themes as follows: sexuality: a complex concept accentuated by HIV and the impact of serodiscordance on partners. Conclusions: It is essential to promote accurate information and health services tailored to the needs of people living with HIV while fostering gender equity and combating stigma related to HIV and the gay community. Experiencing sexuality in this context is not only possible but can be full and satisfying when adequate resources are available. Full article

Background/Objectives: Muscle dysmorphia (MD), a subtype of body dysmorphic disorder, is prevalent among males who engage in the non-medical use of anabolic–androgenic steroids (AASs) and performance-enhancing drugs (PEDs). These individuals often experience severe psychopathology, including mood instability, compulsivity, and a distorted body image. Despite its clinical severity, no randomized controlled trials (RCTs) have evaluated structured psychological treatments in this subgroup. This study aimed to assess the efficacy of a manualized cognitive behavioral therapy (CBT) protocol in reducing MD symptoms and associated psychological distress among male steroid users. Results: Participants in the CBT group showed significant reductions in MD symptoms from the baseline to post-treatment (MDDI: p < 0.001, d = 1.12), with gains sustained at follow-up. Large effect sizes were also observed in secondary outcomes including depressive symptoms (PHQ-9: d = 0.98), psychological distress (K10: d = 0.93), disordered eating (EDE-Q: d = 0.74), and exercise addiction (EAI: d = 1.07). No significant changes were observed in the control group. Significant group × time interactions were found for all outcomes (all p < 0.01), indicating CBT’s specific efficacy. Discussion: This study provides the first RCT evidence that CBT significantly reduces both core MD symptoms and steroid-related psychopathology in men engaged in AAS/PED misuse. Improvements extended to mood, body image perception, and compulsive exercise behaviors. These findings support CBT’s transdiagnostic applicability in addressing both the cognitive–behavioral and affective dimensions of MD. Materials and Methods: In this parallel-group, open-label RCT, 59 male gym-goers with DSM-5-TR diagnoses of MD and a history of AAS/PED use were randomized to either a 12-week CBT intervention (n = 30) or a waitlist control group (n = 29). CBT sessions were delivered weekly online and targeted distorted muscularity beliefs, compulsive behaviors, and emotional dysregulation. Primary and secondary outcomes—Muscle Dysmorphic Disorder Inventory (MDDI), PHQ-9, K10, EDE-Q, EAI, and BIG—were assessed at the baseline, post-treatment, and 3-month follow-up. A repeated-measures ANOVA and paired t-tests were used to analyze time × group interactions. Conclusions: CBT offers an effective, scalable intervention for individuals with muscle dysmorphia complicated by anabolic steroid use. It promotes broad psychological improvement and may serve as a first-line treatment option in high-risk male fitness populations. Future studies should examine long-term outcomes and investigate implementation in diverse clinical and cultural contexts. Full article

Nursing students often face emotional challenges related to death and dying, affecting their psychological well-being, emotional intelligence, and academic success. Cultural and educational factors may influence how they experience and manage these stressors. This study aimed to compare fear of death, emotional intelligence, coping with death, and academic burnout among second-year nursing students in Spain and Portugal to identify cross-cultural differences. A cross-sectional study was conducted among 174 second-year nursing students from the University of Extremadura (Spain) and the University of Évora (Portugal) during the 2023/2024 academic year. The instruments used included the Collett–Lester Brief Fear of Death Scale, the Trait Meta-Mood Scale—24 ítems, the Bugen’s Coping with Death Scale, and the Maslach Burnout Inventory—Student Survey. Descriptive statistics were calculated, and group comparisons were performed using independent samples t-tests and Welch’s t-tests, depending on variance homogeneity. A two-way ANOVA was also conducted to explore interactions between gender and nationality. The Spanish sample comprised 86 women and 21 men, and the Portuguese sample included 58 women and 9 men. The mean age across the sample was 21.5 years (SD = 4.15). No significant differences were observed in fear of death or emotional intelligence between the two groups. However, Portuguese students showed significantly better coping with death, but also higher academic burnout and cynicism. Spanish students reported greater perceived efficacy. Although emotional intelligence and death anxiety were similar, Portuguese students demonstrated stronger coping skills but experienced more burnout. This suggests that coping alone may not buffer academic stress, emphasizing the need for culturally tailored interventions to enhance emotional readiness and reduce burnout. Full article

The Vâlcea Subcarpathians, known for their wealth of natural resources and their spa tradition, are distinguished by renowned spa resorts such as Băile Olănești, Călimănești, Ocnele Mari and Băile Govora. These destinations provide tourists with a variety of treatment, relaxation, and recreational options. This research aims to explore the factors influencing tourist behavior at spa resorts in the Vâlcea Subcarpathians, Romania. Specifically, the relationships between tourists’ residential environment and frequency of visits, the influence of participation in cultural activities on the average duration of trips, and the impact of information sources and vacation planning methods on why tourists choose to visit spa resorts in the Vâlcea Subcarpathians, Romania, will be examined. As part of this study, a questionnaire was developed to collect relevant data on the perceptions and behaviors of visitors to spa resorts in the Vâlcea Subcarpathians, Romania. To analyze the collected data and test the research hypotheses, the following statistical methods were used: Chi-Square Test, Independent Samples t-Test and Analysis of Variance (ANOVA). The results obtained from the statistical tests largely confirmed the proposed hypotheses. There is a significant relationship between the age range of tourists and the frequency of visits, suggesting that different age groups have distinct visiting behaviors. Also, the perception of service quality varies by the gender of tourists, indicating that men and women have different experiences and expectations. Full article

Background: The transapical off-pump NeoChord procedure is a recognized minimally invasive surgical approach for the treatment of severe degenerative mitral regurgitation. This study aims to report the initial Greek experience with the NeoChord procedure, presenting mid-term clinical and echocardiographic outcomes from a single cardiothoracic surgical center, with a median follow-up duration of 20 months. Methods: In this study, 42 symptomatic patients with moderate to severe and severe primary mitral regurgitation underwent mitral valve repair with the Neochord procedure between March 2018 and December 2024. All patients were evaluated clinically and echocardiographically by the Heart team preoperatively, after 1 month, and at the last follow-up (end of 2024). The primary endpoint was established as the presence of a major clinical event (all-cause mortality, reintervention due to deterioration of MR, and cardiac-related rehospitalization). Results: The median age of patients was 69 [61.75–79.25] years, and 69% of patients were men. The median EuroScore II was 1.79 [1.32–2.48], and the STS-PROM MV repair score was 3.18 [2.28–4.66]. Regarding the preprocedural mitral valve anatomical evaluation, 35 patients had type A (83.3%),4 had type B(9.5%), whereas only two patients had type C and 1 with type D anatomy. The median of LAI was 1.2 [1.15–1.25], whereas the CI was 4 [2.15–5]. More than two neochordae were implanted in 34 patients (81%). MR severity improved at 1-month (<moderate:92.85%) and at the last follow-up (<moderate:92.1%). NYHA class decreased within 1 month (I + II: 95.23%) after the procedure and was maintained at the last follow-up (I + II: 94.73%). The median left ventricular ejection fraction (LVEF) before the procedure was 63 [58–67]%, which significantly decreased to 57 [53–61]% at the 1-month follow-up (2-sided p < 0.001). At the final follow-up, LVEF increased to 65 [60–68]%, however, this change was not statistically significant compared to the preprocedural value. During the follow-up period, four deaths were documented—three due to non-cardiac and one attributable to a cardiac cause. Two cases proceeded to reoperation for surgical valve implantation due to recurrent mitral valve regurgitation 6 months and 8 months after the NeoChord procedure. Conclusions: Transapical off-pump NeoChord implantation offers a minimally invasive alternative to conventional surgery for symptomatic patients with moderate-to-severe or severe primary mitral regurgitation. Among patients with suitable mitral valve anatomy, the procedure has demonstrated a favorable safety profile and promising mid-term outcomes, in terms of cardiac mortality, as well as freedom from reoperation and rehospitalization. Full article

Background: The prevalence of mental health problems among young adults has increased exponentially worldwide, with significant implications for public health. This study explores the structural and intermediate social determinants of health associated with emotional well-being and distress in Colombian young adults. Methods: A cross-sectional study was conducted with 1232 university students aged 18–28 years residing in Cali, Colombia. The Social Determinants of Mental Health Questionnaire for Young Adults (SDMH) was administered to assess structural and intermediate determinants. Participants were categorized into two groups: those with mental health diagnoses (n = 252) and those without (n = 980). Descriptive, comparative association and predictive analyses were conducted. Results: Significant differences were found between groups, with diagnosed participants showing higher exposure to violence and suicidal ideation. Women with diagnoses predominantly presented anxiety and depression, while men showed more externalizing symptoms. Violence experiences emerged as the strongest predictors of emotional distress in both groups. Psychosocial life skills and perceived social support were the most robust protective factors for emotional well-being, regardless of diagnostic status. Conclusions: This study reveals that multiple risk factors accumulate rather than single extreme factors characterizing mental health vulnerability. Violence prevention, life skills development, and social support enhancement should be prioritized in public health interventions for young adults. The findings emphasize the need for multisectoral approaches addressing social determinants to promote youth mental health. Full article