Search Results (831)

Accurate and accessible motor function quantification is important for monitoring the movement disorders’ progression. Manual muscle testing models and wearable sensors can be costly or reduce degrees of freedom. Artificial intelligence, especially human pose estimation (PE), offers promising alternatives. This work aims to compare the accuracy of a 2D PE tool for the Finger Tapping Test (FTT) with a 3D infrared motion capture system (MoCap). PE tracked three anatomical landmarks (wrist, thumb, index finger), while reflective markers were placed at corresponding locations on both tools to measure wrist-centered angles. Different trials of slow and rapid FTT sessions were statistically analyzed by rank correlation analysis, Friedman, Bland–Altman, and Kruskal–Wallis to assess agreement and repeatability. PE and MoCap measurements showed no significant differences (p > 0.05), with high reliability (ICC 0.87–0.91), low variability (CV 6–8.6%), and negligible effect size. Bland–Altman slopes indicated minor amplitude-dependent bias, while RMSE (2.92–4.48°) and MAPE (6.38–8.22%) errors occurred in slow and rapid conditions. These results demonstrate that 2D PE provides a reliable, accessible, and low-cost alternative for quantifying finger movement. The findings suggest that PE can serve as an assistive method for monitoring motor function. Future studies can be population-level studies with patients with neurological disorders. Full article

Bio-based fertilisers (BBFs), produced from various types of biological waste using different processing methods, have demonstrated encouraging levels of agronomic efficiency and environmental benefits, consistent with the principles of sustainable development (SD). Nevertheless, bringing these newly developed products to market remains difficult due to limited farmer awareness, perceived risks, and regulatory uncertainties. In this paper, we examine the attitudes, opinions, and awareness of farmers regarding the use of various BBFs in their fertilisation practices. We applied a survey research method, using the Paper and Pen Personal Interview (PAPI), and answers were collected by agricultural advisors. A questionnaire, consisting of open, closed, and Likert scale questions, focusing on general information about farmers, current practices regarding fertiliser use, and the determinants of fertiliser choice, was used. Descriptive statistics, cross-tabulations, chi-square tests, Cramer’s V coefficients, 95% confidence intervals, and McNemar’s test were used to analyse the data. This study was conducted in all 16 voivodeships in Poland, collecting a total of 800 responses. Factors influencing the negative or positive attitude of farmers toward this practice were identified. Currently, mineral fertilisers remain the dominant choice among Polish farmers due to their accessibility, cost-effectiveness, and agronomic performance. There is observed growing, albeit cautious, interest in alternative fertilisation strategies and the correct understanding of sustainable agriculture practices. About half of farmers expressed willingness to partially replace mineral fertilisers with organic options, but only a minority showed interest in adopting BBFs. The findings indicate that concerns about contaminants, heterogeneous quality, limited availability, and regulatory uncertainty continue to constrain interest in BBFs. Although respondents recognised potential environmental benefits, economic and agronomic considerations remained the primary drivers of decision-making. As the survey was conducted in late 2021, the results reflect pre-2022 market conditions and should be interpreted as a baseline rather than a direct indication of current attitudes. Overall, this study provides insights into behavioural and structural factors influencing fertiliser use in Poland and highlights areas where further policy, advisory, and market developments may help support more sustainable nutrient management. Full article

Multiple sclerosis (MS) affects approximately 2.9 million people in the world, exerting a significant economic and societal burden. The disease is increasingly identified among populations considered as uncommonly affected. MS is reported in all regions of the World Health Organization (WHO) member states in Africa, the Americas, South-East Asia, Europe, the Eastern Mediterranean and the Western Pacific, affecting all ethnicities while exhibiting substantially variable prevalences. Countries with high MS prevalence and some with moderate frequencies generally have economically better structured healthcare systems. Nevertheless, health disparities in these countries are accentuated by suboptimal accessibility of care for their minorities, immigrants and other underserved populations. Social Determinants of Health (SDOH) might have an impact on morbidity and higher rates of disability. Large segments of the world population (i.e., African, Latin American, people from the Middle East and Southeast Asia) do not have access to adequate MS diagnostic procedures, compounded by reduced availability of neurologists. Healthcare disparities exist practically in every country of the world. Active wars and a large number of refugees resulting from conflict augments the challenges to healthcare systems. These global factors constitute obstacles to the adequate management of MS. A collective international path is required to facilitate access to highly effective, albeit onerous treatments, some already approved and being utilized, i.e., monoclonal antibodies and B-lymphocyte depletory agents, and others foreseen in the future as advanced therapeutic molecules continue to develop. Full article

Background: The mortality and morbidity rates of cardiovascular disease (CVD) are rising sharply in many developed and developing countries. CVD is a fatal disease that requires early and timely diagnosis to prevent further damage and ultimately save patients’ lives. In recent years, numerous studies have explored the automated identification of different categories of CVDs using various deep learning classifiers. However, they often rely on a substantial amount of data. The lack of representative training samples in real-world scenarios, especially in developing countries, poses a significant challenge that hinders the successful training of accurate predictive models. In this study, we introduce a framework to address this gap. Methods: The core novelty of our framework is the combination of Multi-Resolution Wavelet Features with Scale-Invariant Feature Transform (SIFT) keypoint density maps and a lightweight residual attention neural network (ResAttNet). Our hybrid approach transforms one-dimensional ECG signals into a three-channel image representation. Specifically, the CWT is used to extract hidden features in the time-frequency domain to create the first two image channels. Subsequently, the SIFT algorithm is implemented to capture additional significant features to generate the third channel. These three-channel images are then fed to our custom residual attention neural network to enhance classification performance. To tackle the challenge of class imbalance present in our dataset, we employed a hybrid strategy combining the Synthetic Minority Over-sampling Technique (SMOTE) with Edited Nearest Neighbors (ENN) to balance class samples and integrated Focal Loss into the training process to help the model focus on hard-to-classify instances. Results: The performance metrics achieved using five-fold cross-validation are 99.60% accuracy, 97.38% precision, 98.53% recall, and 97.37% F1-score. Conclusions: The experimental results showed that our proposed method outperforms current state-of-the-art methods. The primary practical implication of this work is that by combining a novel, information-rich feature representation with a lightweight classifier, our framework offers a highly accurate and computationally efficient solution, making it a significant step towards developing accessible and scalable computer-aided screening tools. Full article

Spinach (Spinacia oleracea L.) is a commonly consumed crop with a diverse array of unique flavonoids. These molecules likely contribute to the health benefits associated with spinach consumption. However, little is known about the genetic diversity of these molecules, their bioaccessibility, and the heritability of these traits. We assembled a diversity panel of 30 F₁ and open-pollinated spinach accessions and cultivated them under controlled conditions over two periods. Quantification of 39 flavonoids revealed that their concentration is largely influenced by environmental factors, and at least two divergent branches in the spinach flavonoid biosynthesis pathway may exist. Despite generally similar trends in the amounts of major flavonoids, open-pollinated and F₁ varieties of spinach could be distinguished based on the concentrations of minor flavonoid species. Broad-sense heritability estimates for absolute bioaccessibility accounted for more genetic variation than raw material content, suggesting that this trait is preferable for breeders seeking to alter the phytochemical profile of spinach. Lastly, we found that several spinach flavonoids are unstable under digestive conditions, which was made evident by the proportion of aglycones rising from 0.1% to approximately 15% of total flavonoids after digestion. Together, these data suggest that spinach flavonoid biosynthesis and bioaccessibility are complex and contextualize how these molecules may behave in vivo. Full article

The article discusses the challenges faced by primary and secondary school students in North Macedonia, focusing on the availability of textbooks for those receiving instruction in minority languages. Although some materials are available for download on the E-učebnici platform operated by the Ministry of Education and Science, this does not encompass all didactic resources required for instruction. Cataloging of the materials on the platform reveals that while electronic versions of many textbooks in Macedonian are freely accessible, students studying in Albanian (a co-official language) and minority languages such as Turkish, Bosnian, and Serbian have considerably fewer digital resources. The data indicate that disparities begin from the fifth grade and widen in higher grades, with Bosnian- and Serbian-speaking students particularly disadvantaged. In vocational education, Macedonian-speaking students have the broadest access to electronic materials, while Albanian and especially Turkish speakers have far fewer options, and no digital textbooks are available in Serbian. The analysis demonstrates that a semi-official hierarchy of languages persists within North Macedonia’s educational system, privileging Macedonian and, to a lesser extent, Albanian, while marginalizing other minority languages both institutionally and technologically. The article concludes by outlining the challenges and implications of implementing digital resources as a means to address linguistic inequality in education. Full article

Grape (Vitis vinifera spp.) accessions exhibit rich diversity, and understanding their genetic variation and evolutionary relationships is crucial for cultivar selection and utilization. A highly representative SNP marker set was developed in this study based on re-sequencing data analysis, to clarify the phylogenetic relationships among 96 grape accessions and to evaluate the genetic resolution of core markers. Using PN40024 as the reference genome, high-quality SNP loci were screened from resequencing data of the 96 accessions. A phylogenetic tree was constructed, and genetic diversity was analyzed using PCA and population structure analysis. The results showed that the 96 accessions were mainly divided into four groups: European (‘Merlot’, ‘Chardonnay’), American (‘Beta’, ‘Concord’), Euro-American hybrids (‘Vidal’, ‘Miguang’), and wild populations along with their hybrid progeny (‘Zuoyouhong’, ‘Huajia 8’). PCA and ADMIXTURE validated population differentiation, revealing clear separation between wild and cultivated accessions. Through screening of core SNP markers, 384,304 candidate SNPs suitable for probe design were identified. Further refinement yielded 2000 and 10,000 SNP markers. Detailed analysis of core marker characteristics showed that their minor allele frequency (MAF) was predominantly between 0.1 and 0.3, with the majority distributed in CDS (38.65%), intronic (30.2%), and intergenic regions. The most common mutation types were [A/G] (35%) and [C/T] (34%) transitions. The 2000 core SNPs were associated with 1220 functional genes and were significantly enriched in pathways such as protein binding, RNA transport, and plant–pathogen interaction. These findings provide an efficient tool for grape genetic diversity analysis, cultivar identification, and molecular breeding, laying the groundwork for the precise utilization of grape germplasm resources. Full article

Background: Individuals with severe disability require intensive and long-term healthcare, rehabilitation and social support. Updated population data are essential to inform planning and resource allocation. This study aimed to quantify—with a cross-sectional analysis conducted in 2025—the demographic, clinical, socioeconomic, and geographic characteristics of individuals with severe disability within the Provincial Health Authority (ASP) of Catania (Sicily) in Italy, and to identify statistically significant differences across subgroups. Methods: A cross-sectional analysis was conducted on 3277 individuals officially certified as having severe disability under the Italian Ministerial Decree of 26 September 2016. Data were extracted from administrative records and stratified by age, sex, clinical classification, income level, and healthcare district. Associations were tested using chi-square statistics. Results: Participants had a mean age of 39.14 ± 28.64 years; Minors represented 33% of the disability cohort (vs. 19.4% minors in the general provincial population) with a mean age 10.28 ± 3.55. Adults accounted for 67% of the cohort (vs. 81% adults in the general population), with a mean age of 69.94 ± 24.61 years. Females constituted 43% of the sample (compared with 51% females in the provincial population), whereas males represented 57% (vs. 49% males in the general population). Most individuals (95.9% of the cohort) had an income level below €25,000/year. Conclusions: The study reveals substantial demographic, socioeconomic, and clinical heterogeneity among individuals with severe disability and highlights significant district-level disparities. Notably, minors appear markedly over-represented in the disability cohort compared with the general population, while females are under-represented, indicating potential age- and sex-related differences in disability burden, access to assessment, or underlying diagnostic patterns. These findings indicate the need for stratified, district-sensitive planning approaches, ensuring equitable access to services and optimizing allocation of healthcare and social resources. Full article

Background: Colorectal cancer (CRC) incidence and mortality have declined in the United States over the past two decades, yet disparities persist by age, sex, race/ethnicity, and geography. To characterize population-level survival signals, we examined trends in age-adjusted incidence rates (AAIR), mortality rates (AAMR), and the mortality-to-incidence ratio (AAMIR) from 1999 to 2021, stratified by key subgroups. Methods: This retrospective analysis utilized de-identified data from the CDC WONDER United States Cancer Statistics database, encompassing incident CRC cases (SEER codes 21041–21052) and deaths (ICD-10 codes C18–C20) in adults aged 20 years and older. Age-adjusted rates (per 100,000, 2000 U.S. standard population) and AAMIR were calculated using Stata 17.0. Joinpoint regression identified trends (annual or average annual percent change [APC/AAPC], p < 0.05). Results: Among 3,489,881 cases and 1,225,986 deaths, AAIR decreased from 78.24 (1999) to 50.79 (2021; AAPC: −2.20%, 95% CI: −2.52 to −1.89), AAMR decreased from 29.34 to 17.92 (AAPC: −2.33%, −2.46 to −2.20), and AAMIR from 0.375 to 0.353 (AAPC: −0.08%, −0.47 to 0.30; p = 0.669). Women showed a significant AAMIR decline (AAPC: −0.29%), unlike men (AAPC: 0.07%). Young adults (20–39 years) had rising AAIR (AAPC: 2.42%) and AAMR (0.87%) but improving AAMIR (AAPC: −1.71%). Non-Hispanic Black individuals had the highest AAMIR (0.400 in 2021; AAPC: −0.54%). The Northeast had the most favorable AAMIR trend (AAPC: −0.40%), while the Midwest, South, and West were stable. States like New Jersey and Massachusetts achieved low AAMIR (0.292 and 0.304 in 2021), contrasting with Nebraska and Arizona (0.402 in both). Conclusions: Although colorectal cancer incidence and mortality have declined substantially in the United States from 1999 to 2021, the mortality-to-incidence ratio improved only marginally and remained markedly uneven across subgroups. Targeted interventions—enhancing screening and treatment access for men, racial/ethnic minorities, younger adults, and high-burden regions and states—can promote equitable outcomes. Full article

Background/Objectives: Inflammatory bowel disease (IBD), including Crohn’s Disease and Ulcerative Colitis, requires complex treatment and active patient participation. Health literacy (HL), defined as the ability to access, understand, and apply health information, is a key factor influencing adherence, self-management, and quality of life in chronic illness. However, evidence regarding HL in IBD remains limited and fragmented. This systematic review aimed to synthesize existing literature on HL in IBD, exploring its impact on outcomes, as well as its predictors and barriers. Methods: A systematic search of PubMed, Scopus, CINAHL, and Cochrane Library identified studies published between January 2000 and August 2025 in English or Italian. Eligible studies examined HL among adults with IBD and its associations with clinical, behavioral, or psychosocial outcomes. Methodological quality was assessed using the QuADS tool. Due to heterogeneity across studies, a narrative synthesis was conducted. Results: Seventy studies were included, comprising observational, qualitative, mixed-methods, and interventional designs. Higher HL was consistently associated with better treatment adherence, self-management, communication with healthcare providers, and quality of life. Conversely, low HL was linked to poor adherence, greater disease activity, and lower psychological well-being. Predictors of low HL included older age, lower education, minority status, and socioeconomic disadvantage. Barriers included inadequate communication, lack of tailored information, cultural and linguistic challenges, and the digital divide. Interventions such as structured education, telemedicine, and digital tools showed potential to improve HL and patient engagement. Conclusions: HL is a crucial determinant in IBD management. Enhancing HL through integrated clinical, educational, and digital strategies is essential to improve outcomes and reduce health disparities. Full article

A course was created at a large private R1 university in the northeast U.S. to explore Diversity, Equity, Inclusion, and Accessibility (DEIA) in STEM in response to and to fulfill a university-wide DEIA requirement for undergraduates. To assess the effectiveness of the course, open-response pre- and post-tests were designed that measured students’ understanding of barriers to learning and participation across four underutilized groups in STEM: (1) women, (2) racial minorities, (3) people with disabilities, and (4) people raised in lower socioeconomic households. Written responses on the first and last day of class were analyzed for 69 unique students in three successive cohorts (Fall 2022, 2023, and 2024) and disaggregated by student-reported demographic data. A common codebook was developed that could be broadly applied to all four underutilized groups with overarching categories of individual/self; cultural/societal; and institutional/educational/career, with codes and subcodes specific to each category. Additionally, codes distinct to each underutilized group also emerged. As intended, students on average cited more total and unique barrier codes in the post-test than in the pre-test, confirming that the course had deepened their understanding of the multifaceted challenges and opportunities within educational systems and the broader culture that impact STEM inclusivity. When exploring STEM barriers for women, women reported more unique codes in the pre-test than men, but men showed higher gains from pre- to post-test. Similarly, White and Asian students showed greater gains than racial minority students when identifying STEM barriers for racial minorities. Students without disabilities reported a doubling in unique STEM barrier codes in the post-test. In these three groups, codes related to academic and workplace discrimination were commonly cited. Students who reported being from a low socioeconomic household were limited in this study, though these individuals included more unique codes in their pre-test responses on average. Students in this group commonly cited barriers related to access to opportunity. In general, we found that STEM students acquired significant understanding of barriers to STEM participation in the four underutilized groups of focus after completing a dedicated DEIA course. Additionally, learning gains were often greater in the majority (or privileged) demographic. Full article

Urban parks provide critical benefits for public health, mental well-being, and social connection. However, inequities in park access and use persist, particularly among socially and economically vulnerable populations. While previous studies have established that segregation and social vulnerability each contribute to uneven park access, little is known about how these two forces interact to shape real visitation patterns. This study addresses this research gap and answers the research question: How does highway segregation relate to differences in the different aspects of social vulnerability in influencing park access across Austin’s east–west divide? SafeGraph mobility data from 2019 and the Social Vulnerability Index (SVI), which included four themes (i.e., socioeconomic status, household composition, minority status and language, and housing and transportation characteristics), were analyzed through fixed-effects regression models for Austin, Texas. Results show that household composition and minority vulnerabilities have negative associations with park visitation, indicating that areas with more elderly, single-parent, or minority residents visit parks less frequently. Interaction terms reveal that highway segregation functions as a structural barrier that conditions the influence of social vulnerability on park use. Those associated with socioeconomic resources diminish, while the disadvantages linked to household composition and minority status intensify on the east side of I-35, reflecting the cumulative effects of segregation and infrastructural division. These findings confirm that inequities in park access are more pronounced on the east side of the I-35, consistent with the highway’s role in reinforcing segregation. Efforts to strengthen connectivity represent key strategies for advancing equitable park visitation across Austin. Full article

Background/Objectives: Iran carries a significant burden of mental health disorders. This study aimed to describe the status of mental health and mental health care in Iran between 2012 and 2023, addressing inequalities and mapping existing challenges in the mental health care system. Methods: A systematic literature review was conducted. Databases including Medline, CINAHL, APA PsycINFO, Scopus, Web of Science, and the Cochrane Library, as well as local databases such as SID, Magiran, and Noormags, were searched to identify studies related to mental health care in Iran. A total of 59 studies met the inclusion criteria. An inductive approach and thematic analysis were used to synthesize themes from the data. Results: Lower socioeconomic status (SES) was associated with higher rates of mental disorders due to poverty-related stressors and limited access to quality care. Gender disparities revealed that women are more vulnerable to mental health problems, exacerbated by perceived gender inequality. Ethnic minorities and undocumented migrant populations faced inadequate healthcare services, resulting in poorer mental health outcomes. Children and older adults also experienced mental health challenges influenced by sociodemographic factors. The main challenge for mental health care is establishing mechanisms to ensure more equitable access for all citizens. Additional challenges include limited awareness among policymakers, insufficient budget allocation, weak prevention programs, and poor intra- and inter-sectoral coordination and collaboration. A shortage of mental health care providers, as well as deficiencies in structure, system processes, and resources, further hinder progress. Conclusions: Socioeconomic factors exacerbate the challenges of Iran’s under-resourced mental health system. To address these issues, equity considerations must be integrated into mental health policies. Key interventions include the routine monitoring of mental health indicators, expanding insurance coverage for mental health services, and establishing dedicated services for children. Full article

The lack of research on Asian and Asian American students attending Hispanic-Serving Institutions (HSIs) in the Southwest U.S. leaves this population vulnerable to marginalization by educational leaders who are not adequately prepared to support their unique needs. Considered both a numerical and racialized community in HSIs in addition to their position as the model minority, this study aimed to examine how navigating a predominantly Hispanic context shaped participants’ understanding and construction of the Asian/Asian American identity. Using a constructivist grounded theory approach, the study developed a model suggesting that Asian and Asian American students construct their identities through three interconnected spaces: expressions of Asian culture, relationships with other Asians, and physical features associated with Asian identities. Key findings include: participants’ navigation and negotiation of externally created narratives; personal interpretations of what it means to be Asian; the role of interactions within the HSI environment in shaping participants’ Asian identity construction; the consideration of access to identity spaces in participants’ personal interest, investment, and salience; and the contributions of cultural, relational, and racial spaces to identity construction. Full article

Urban parks improve the overall quality of life (QoL) by reducing CO₂ emissions, depression, anxiety, and fatigue. Urban green spaces shape our lives by influencing our mental and physical well-being. High-income dwellers of low-density urban areas enjoy a wide range of health benefits because they have better access to sustainable logistics urban parks (SLUPs), while the economically disadvantaged sometimes have fewer chances to access parks in their high-density suburbs in Middle Eastern Countries (MECs). The disparity in accessibility to urban parks raises questions about the inclusivity of civic facilities. Therefore, this study seeks to answer the following question: What challenges do MECs face in the successful implementation of SLUPs? This study aimed to analyze and understand the challenges of establishing SLUPs in MECs. To achieve this aim, this study adopted a mixed-method approach, whereby in-depth interviews and questionnaire surveys were utilized to collect and validate the data. The study outcome shows that the gap in stakeholder collaboration and high land prices are the major challenges, whereas sociability issues, lack of awareness, and interest are the minor challenges in establishing SLUPs in MECs. Full article