Search Results (1,015)

The problem associated with the manifestation of burnout syndrome is the subject of ongoing interest. In recent years, occupational burnout has been actively studied among professionals in the helping professions (teachers, physicians, social workers, psychologists, prison officers, etc.). However, the phenomenon has been poorly studied among freelancers. Therefore, the aim of this study is to fill this gap by determining the level of burnout syndrome among Bulgarian freelancers and investigate the influence of some work environment factors on professional burnout in the sample. A survey of 1138 freelancers was carried out using the Burnout Self-Assessment Questionnaire developed by Maslach and a questionnaire developed in-house to explore the factors of the occupational environment and ask questions related to socio-demographic factors. Hypotheses are tested using correlation analysis and structural equation modelling. The study reveals high levels of emotional exhaustion (40.91%, n = 484). High values on the scale of depersonalization were reported for 26,3% of the respondents (n = 311). Only 3.1% of the respondents (n = 37) had high values on the reduced personal accomplishment scale. The high levels of burnout among freelancers could be influenced by the specific characteristics of their work environment and the nature of their tasks. Full article

Understanding the social drivers of pro-environmental behavior in urban forests and green spaces is critical for addressing sustainability challenges. Subjective norms serve as a key pathway through which social expectations influence individuals’ behavioral intentions. Despite mixed findings in the literature regarding the impact of subjective norms on individuals’ intentions, there is a research gap about the determinants of this construct. This study was conducted to explore how social expectations shape perceived subjective norms among visitors of urban forests. A theoretical model was developed with subjective norms at its center, incorporating their predictors including social identity, media influence, interpersonal influence, and institutional trust, personal norms as a mediator, and behavioral intention as the outcome variable. Using structural equation modeling, data was collected and analyzed from a sample of visitors of urban forests in Tehran, Iran. The results revealed that subjective norms play a central mediating role in linking external social factors to behavioral intention. Social identity emerged as the strongest predictor of subjective norms, followed by media and interpersonal influence, while institutional trust had no significant effect. Subjective norms significantly influenced both personal norms and intentions, and personal norms also directly predicted intention. The model explained 50.9% of the variance in subjective norms and 39.0% in behavioral intention, highlighting its relatively high explanatory power. These findings underscore the importance of social context and internalized norms in shaping sustainable behavior. Policy and managerial implications suggest that strategies should prioritize community-based identity reinforcement, media engagement, and peer influence over top-down institutional messaging. This study contributes to environmental psychology and the behavior change literature by offering an integrated, empirically validated model. It also provides practical guidance for designing interventions that target both social and moral dimensions of environmental action. Full article

E-waste, a form of solid waste, contains many recyclable metals, but improper disposal can make it very harmful. Therefore, the recycling of e-waste is very important, and the willingness of residents to participate is crucial in e-waste recycling. Taking Jiangsu Province, China as an example, we used the theory of reasoned action (TRA) to construct a research model to investigate the factors influencing residents’ willingness to participate in e-waste recycling. The paper introduces impression management motivation and further reveals the application of the Hawthorne effect in e-waste recycling. The paper also introduces the awareness of benefits, which encompasses personal economic benefits, physical health benefits, and environmental benefits, with physical health benefits being ignored by most of the previous literature. In addition, knowledge and convenience are also introduced in this paper. A total of 400 valid responses were used to test the hypotheses of the structural equation model. It was found that all factors positively influenced residents’ willingness to engage in e-waste recycling. Attitude has a mediating role in the effects of convenience, knowledge, and awareness of benefits on willingness, and subjective norms have a mediating role in the effects of impression management motivation on willingness. The model explains 82.9% of the variance in residents’ willingness to recycle e-waste, surpassing the original TRA model’s explanatory power and confirming the strength of the extended framework. The study provides valuable policy implications for the government to promote e-waste recycling. Full article

Rehabilitation devices such as actuated lower-limb exoskeletons can provide essential mobility assistance for pediatric patients with gait impairments. Enhancing their control systems under conditions of user variability and dynamic disturbances remains a significant challenge, particularly in active-assist modes. This study presents a human-in-the-loop control architecture for a pediatric lower-limb exoskeleton, combining outer-loop admittance control with robust inner-loop trajectory tracking via a non-singular terminal sliding-mode (NSTSM) controller. Designed for active-assist gait rehabilitation in children aged 8–12 years, the exoskeleton dynamically responds to user interaction forces while ensuring finite-time convergence under system uncertainties. To enhance adaptability, we augment the inner-loop control with a twin delayed deep deterministic policy gradient (TD3) reinforcement learning framework. The actor–critic RL agent tunes NSTSM gains in real-time, enabling personalized model-free adaptation to subject-specific gait dynamics and external disturbances. The numerical simulations show improved trajectory tracking, with RMSE reductions of 27.82% (hip) and 5.43% (knee), and IAE improvements of 40.85% and 10.20%, respectively, over the baseline NSTSM controller. The proposed approach also reduced the peak interaction torques across all the joints, suggesting more compliant and comfortable assistance for users. While minor degradation is observed at the ankle joint, the TD3-NSTSM controller demonstrates improved responsiveness and stability, particularly in high-load joints. This research contributes to advancing pediatric gait rehabilitation using RL-enhanced control, offering improved mobility support and adaptive rehabilitation outcomes. Full article

Familial dysbetalipoproteinemia (FD) is a prevalent and highly atherogenic hyperlipoproteinemia associated with the ε2/ε2 APOE genotype or rare APOE variants. The contributions of additional genetic and clinical factors to the FD phenotype remain unclear. We investigated these factors in both autosomal recessive and autosomal dominant forms of FD. Targeted (n = 4666) and exome (n = 194) sequencing were used to identify the ε2/ε2 APOE genotype or rare FD-causative APOE variants. Twenty-four lipid-related genes and forty variants included in a polygenic risk score for hypertriglyceridemia (HTG) were analyzed. FD was defined by the presence of FD variants and triglycerides (TG) ≥ 1.5 mmol/L (main study group). The comparison group consisted of patients with FD variants but TG < 1.5 mmol/L. Univariable and multivariable regression analyses were performed. A total of 71 unrelated subjects were identified (45.1% male, median age 50 years). FD was diagnosed in 52 patients, while 19 had FD variants only. Age (p = 0.019), elevated polygenic risk for HTG (p = 0.001), and the presence of metabolic syndrome components (p = 0.014) were independently associated with the FD phenotype. TG levels were significantly associated with polygenic burden (0.05 mmol/L per percentile), the presence of additional rare lipid-related variants (7.0 mmol/L), and glucose metabolism disorders (3.62 mmol/L), together explaining 30% of TG variance in cross-validated model. These results highlight the interplay of genetic and metabolic factors in FD development and support the integration of HTG genetic risk scores and metabolic control into personalized FD management. Full article

This study is concerned with the formal and functional development of the pragmatic marker not gonna lie. It comprises a detailed investigation into the usage and development of not gonna lie in American English. This study shows that not gonna lie develops from the clause NP BE not going to lie to NP. From its earliest attestations onward, the marker occurs in contexts carrying face threats, which points towards face-threat mitigation as its main function. This discourse function can only be observed for variants with first-person subjects and you in the prepositional phrase (if present). The later omission of elements through the course of the development indicates an increase in syntactic autonomy. The remaining chunk, not gonna lie, leaves little room for variability and is dominated by its discursive function. The findings are interpreted through the lens of usualization as described in the Entrenchment-and-Conventionalization Model. This dynamic, usage-based and cognitive model of language use and change lends itself to providing a fine-grained description and explanation of the grammaticalization-like processes observed in this case study. Full article

Entrepreneurial intention research requires further examination of systemic relationships between constructs of comprehensive models that will more closely approximate the ontological realities of individuals. This research jointly examines relationships among basic individual values and constructs from the theory of planned behavior, entrepreneurial orientation, and entrepreneurial intention while accounting for multiple contextual factors. Situational factors are accounted for by random determination of mediators, examination of 23 model configurations, and use of quasi-random samples (e.g., respondents with different demographic factors from different organizations, industries, and regions) from two culturally and economically contrasting countries, the United States and India. Models were analyzed using PLS-SEM. Contrary to the “common view”—the idea that Western countries are individualistic and Asian and Latin American countries are collectivistic—individual personal focus values and passion relationships were stronger for India’s sample than for the United States. Contrary results were found for basic individual social focus values and subjective norms relationships. Results show a lack of stark disparities between the two country samples. Hence, it seems that between-country differences have been overemphasized, while more attention to context and to within-country variability is required. This study expands the entrepreneurial orientation nomological network by jointly considering basic individual values and TPB’s and EO’s constructs anteceding entrepreneurial intention and examining a large set of model configurations while accounting for multiple situational factors in two culturally and economically contrasting countries. Full article

Introduction: The gut microbiota is vital for human health, and its modulation through dietary and pharmaceutical compounds has gained increasing attention. Among gut microbes, Akkermansia muciniphila has been extensively researched due to its role in maintaining intestinal barrier integrity, regulating energy metabolism, and influencing inflammatory responses. Subject: To analyze and synthesize the available scientific evidence on the influence of various bioactive compounds, including prebiotics, polyphenols, antioxidants, and pharmaceutical agents, on the abundance and activity of A. muciniphila, considering underlying mechanisms, microbial context, and its therapeutic potential for improving metabolic and intestinal health. Methods: A systematic literature review was conducted in accordance with the PRISMA 2020 guidelines. Databases such as PubMed, ScienceDirect, Scopus, Web of Science, SciFinder-n, and Google Scholar were searched for publications from 2004 to 2025. Experimental studies in animal models or humans that evaluated the impact of bioactive compounds on the abundance or activity of A. muciniphila were prioritized. The selection process was managed using the Covidence platform. Results: A total of 78 studies were included in the qualitative synthesis. This review compiles and analyzes experimental evidence on the interaction between A. muciniphila and various bioactive compounds, including prebiotics, antioxidants, flavonoids, and selected pharmaceutical agents. Factors such as the chemical structure of the compounds, microbial environment, underlying mechanisms, production of short-chain fatty acids (SCFAs), and mucin interactions were considered. Compounds such as resistant starch type 2, GOS, 2′-fucosyllactose, quercetin, resveratrol, metformin, and dapagliflozin showed beneficial effects on A. muciniphila through direct or indirect pathways. Discussion: Variability across studies reflects the influence of multiple variables, including compound type, dose, intervention duration, experimental models, and analytical methods. These differences emphasize the need for a contextualized approach when designing microbiota-based interventions. Conclusions: A. muciniphila emerges as a promising therapeutic target for managing metabolic and inflammatory diseases. Further mechanistic and clinical studies are necessary to validate its role and to support the development of personalized microbiota-based treatment interventions. Full article

Social marketing modifies individual behavior to achieve specific outcomes, mitigating environmental pressures. While proven effective in influencing consumer behavior, empirical studies on its impact on the tourism sector remain limited. This study examines how various social marketing channels influence tourists’ consumption decisions and contributes to achieving SDGs 11 and 12 by reviewing the existing methods of disseminating social marketing content. A conceptual model grounded in theory was developed and empirically tested. In particular, it focuses on the establishment of direct and indirect multi-route effects between social marketing and consumer behavior and introduces different influencing factors. Given the scarcity of research on collective culture, quantitative methods were employed, with data collected through questionnaires in mainland China. Results indicate that social marketing media significantly influence tourist behavior, with three mediators—subjective norms, personal values, and communication channels—playing varying roles across media types (events, public relations, and traditional media). Subjective norms, values, and communication channels act as mediators. This study bridges social marketing, tourist behavior, and SDG attainment, offering novel insights and practical implications for tourism practitioners. Full article

Obstructive sleep apnea (OSA) is a prevalent and heterogeneous sleep disorder associated with significant health and societal burdens. While continuous positive airway pressure (CPAP) remains the gold standard treatment, its limitations in adherence and patient tolerance have highlighted the need for alternative therapies. Positional therapy (PT), which targets apneas that occur predominantly in the supine position, has emerged as a promising option for individuals with positional OSA (POSA). This narrative review synthesizes the current literature on PT, examining its clinical indications, typologies, comparative efficacy with CPAP, oral appliances, and hypoglossal nerve stimulation, as well as data on adherence and barriers to long-term use. Traditional methods such as the tennis ball technique have largely been replaced by modern vibrotactile devices, which demonstrate improved comfort, adherence, and comparable short-term outcomes in selected POSA subjects. While PT remains inferior to CPAP in reducing overall AHI and oxygen desaturation, it performs favorably in terms of mean disease alleviation (MDA) and sleep continuity. Importantly, treatment effectiveness is influenced by both anatomical and non-anatomical traits, underscoring the need for accurate phenotyping and individualized care. PT should be considered within a broader patient-centered model that incorporates preferences, lifestyle, and motivational factors. Further research is needed to validate long-term efficacy, optimize selection criteria, and integrate PT into personalized OSA management strategies. Full article

This paper examines a previously unknown anonymous Hebrew letter inserted into a postwar edition of Shem HaGedolim, found in the library of the Jewish University in Budapest. The letter, composed in Győr in 1947, consists almost entirely of passages copied from Tiferet Chayim, a hagiographic genealogy of the Sanz Hasidic dynasty. Although derivative in content, the letter’s form and placement suggest it was not meant for transmission but instead served as a private act of mourning and historiographical preservation. By situating the letter within the broader context of post-Holocaust Jewish and Hasidic memory practices, including yizkor books, rabbinic memoirs, and grassroots commemorative writing, this study proposes that the document constitutes a “micro-yizkor”: a bibliographic ritual that aimed to re-inscribe lost tzaddikim into sacred memory. Drawing on theories of trauma, religious coping, and bereavement psychology, particularly the Two-Track Model of Bereavement, the paper examines the letter as both a therapeutic and historiographical gesture. The author’s meticulous copying, selective omissions, and personalized touches (such as modified honorifics and emotive phrases) reflect an attempt to maintain spiritual continuity in the wake of communal devastation. Engaging scholarship by Michal Shaul, Lior Becker, Gershon Greenberg, and others, the analysis demonstrates how citation, far from being a passive act, functions here as an instrument of resistance, memory, and redemptive reconstruction. The existence of such a document can also be examined through the lens of Maurice Rickards’ insights, particularly his characterization of the “compulsive note” as a salient form of ephemera, materials often inserted between the pages of books, which pose unique challenges for interpreting the time capsule their authors sought to construct. Ultimately, the paper argues that this modest and anonymous document offers a rare window into postwar Ultra-orthodox religious subjectivity. It challenges prevailing assumptions about Hasidic silence after the Holocaust and demonstarates how even derivative texts can serve as potent sites of historical testimony, spiritual resilience, and bibliographic mourning. The letter thus sheds light on a neglected form of Hasidic historiography, one authored not by professional historians, but by the broken-hearted, writing in the margins of sacred books. Full article

Background: Post-concussion syndrome (PCS) and Functional Neurological Disorder (FND), including Functional Cognitive Disorder (FCD), are two frequently encountered but diagnostically complex conditions. While PCS is conceptualized as a sequela of mild traumatic brain injury (mTBI), FND/FCD encompasses symptoms incompatible with recognized neurological disease, often arising in the absence of structural brain damage. Yet, both conditions exhibit considerable clinical overlap—particularly in the domains of cognitive dysfunction, emotional dysregulation, and symptom persistence despite negative investigations. Objective: This review critically examines the shared and divergent features of PCS and FND/FCD. We explore their respective epidemiology, diagnostic criteria, and risk factors—including personality traits and trauma exposure—as well as emerging insights from neuroimaging and biomarkers. We propose the “Functional Overlay Model” as a clinical tool for navigating diagnostic ambiguity in patients with persistent post-injury symptoms. Results: PCS and FND/FCD frequently share features such as subjective cognitive complaints, fatigue, anxiety, and heightened somatic vigilance. High neuroticism, maladaptive coping, prior psychiatric history, and trauma exposure emerge as common risk factors. Neuroimaging studies show persistent network dysfunction in both PCS and FND, with overlapping disruption in fronto-limbic and default mode systems. The Functional Overlay Model helps to identify cases where functional symptomatology coexists with or replaces an initial organic insult—particularly in patients with incongruent symptoms and normal objective testing. Conclusions: PCS and FND/FCD should be conceptualized along a continuum of brain dysfunction, shaped by injury, psychology, and contextual factors. Early recognition of functional overlays and stratified psychological interventions may improve outcomes for patients with persistent, medically unexplained symptoms after head trauma. This review introduces the Functional Overlay Model as a novel framework to enhance diagnostic clarity and therapeutic planning in patients presenting with persistent post-injury symptoms. Full article

Introduction: Adolescent well-being is influenced by emotional regulation and clarity, particularly in contexts of depression, stress, and anxiety. Objective: This study explores how depression mediates the relationship between emotional regulation and well-being and whether emotional clarity moderates this interaction, providing a comprehensive model to understand adolescent mental health. Methodology: A cross-sectional study was conducted with 636 Chilean adolescents aged 10–18. Emotional clarity and regulation were assessed using the TMMS-24 scale, depression with the DASS-21 scale, and subjective well-being with the Personal Well-Being Index (PWI). Statistical analyses included descriptive statistics, Pearson correlations, and moderated mediation models (PROCESS Macro, Models 4 and 7). Results: Emotional regulation positively correlated with subjective well-being (r = 0.373, p < 0.01) and negatively with depression (r = −0.251, p < 0.01). Depression partially mediated the relationship between emotional regulation and well-being (B = 0.149, 95% CI [0.082, 0.225]), with regulation explaining 86.41% of the effect. Emotional clarity moderated the regulation-depression link, with higher clarity amplifying the protective impact of regulation (index = 0.008, 95% CI [0.0017, 0.0149]). Conclusions: Emotional regulation and clarity are vital for adolescent well-being and enhance the protective role of regulation against depression. Interventions targeting both constructs could improve mental health outcomes in vulnerable populations. Full article

This review provides a comprehensive analysis of recent advancements in lower limb exoskeleton systems, focusing on applications, control strategies, hardware architecture, sensing modalities, human-robot interaction, evaluation methods, and technical innovations. The study spans systems developed for gait rehabilitation, mobility assistance, terrain adaptation, pediatric use, and industrial support. Applications range from sit-to-stand transitions and post-stroke therapy to balance support and real-world navigation. Control approaches vary from traditional impedance and fuzzy logic models to advanced data-driven frameworks, including reinforcement learning, recurrent neural networks, and digital twin-based optimization. These controllers support personalized and adaptive interaction, enabling real-time intent recognition, torque modulation, and gait phase synchronization across different users and tasks. Hardware platforms include powered multi-degree-of-freedom exoskeletons, passive assistive devices, compliant joint systems, and pediatric-specific configurations. Innovations in actuator design, modular architecture, and lightweight materials support increased usability and energy efficiency. Sensor systems integrate EMG, EEG, IMU, vision, and force feedback, supporting multimodal perception for motion prediction, terrain classification, and user monitoring. Human–robot interaction strategies emphasize safe, intuitive, and cooperative engagement. Controllers are increasingly user-specific, leveraging biosignals and gait metrics to tailor assistance. Evaluation methodologies include simulation, phantom testing, and human–subject trials across clinical and real-world environments, with performance measured through joint tracking accuracy, stability indices, and functional mobility scores. Overall, the review highlights the field’s evolution toward intelligent, adaptable, and user-centered systems, offering promising solutions for rehabilitation, mobility enhancement, and assistive autonomy in diverse populations. Following a detailed review of current developments, strategic recommendations are made to enhance and evolve existing exoskeleton technologies. Full article

Nitric oxide (NO) predominantly regulates endometrial receptivity, angiogenesis, immunological tolerance, and trophoblast invasion throughout the implantation period. Both insufficient and excessive nitric oxide production have been linked to suboptimal embryo implantation and infertility. The primary enzymatic source of uterine nitric oxide, along with hormonal, metabolic, and immunological variables and genetic variations in the endothelial nitric oxide synthase gene (NOS3), affects endothelial nitric oxide synthase (eNOS). Despite its considerable importance, there is limited knowledge regarding the practical implementation of nitric oxide-related diagnoses and therapies in reproductive medicine. A comprehensive assessment was performed in accordance with the PRISMA principles. Electronic searches were carried out in PubMed, Scopus, and Embase, and we analyzed the literature published from 2000 to 2024 regarding the association between NO, its metabolites (NO₂⁻ and NO₃⁻), eNOS expression, NOS3 gene variants, and reproductive outcomes. Relevant studies encompassed clinical trials, observational studies, and experimental research using either human or animal subjects. We collected data about therapeutic interventions, hormonal and immunological associations, nitric oxide measurement techniques, and in vitro fertilization success rates. A total of thirty-four studies were included. Dysregulated nitric oxide signaling, characterized by modified eNOS expression, oxidative stress, or NOS3 polymorphisms (e.g., Glu298Asp and intron 4 VNTR), was linked to diminished endometrial receptivity and an elevated risk of implantation failure and miscarriage. The dynamics of local uterine NO are essential as elevated and diminished systemic levels of NO₂⁻/NO₃⁻ corresponded with enhanced and decreased implantation rates, respectively. Among many therapeutic approaches, targeted hormone treatments, antioxidant therapy, and dietary nitrate supplements have demonstrated potential in restoring nitric oxide balance and enhancing reproductive outcomes. In animal models, the modification of nitric oxide significantly impacted decidualization, angiogenesis, and embryo viability. Nitric oxide is a multifaceted molecular mediator with considerable ramifications for successful implantation. Its therapeutic and diagnostic efficacy increases with its sensitivity to environmental, hormonal, and genetic alterations. Integrating targeted nitric oxide modulation, oxidative stress assessment, and NOS3 genotyping with personalized reproductive therapy will enhance endometrial receptivity and improve IVF outcomes. Future translational research should incorporate nitric oxide signaling into personalized treatment protocols for patients with unexplained infertility or recurrent implantation failure. Full article