Search Results (17,937)

Objective: Although recognition of fibromyalgia (FMS) in men is growing, the mechanisms that contribute to their psychological distress remain poorly understood. This study aims to clarify how FMS alters men’s psychological distress and to identify potential protective and risk factors involved in this process in this often-underrepresented population. Methods: This study comprised a total of 225 men aged 18–75; of these, 102 were men with FMS (based on self-report) and 123 were healthy peers (HPs), all of whom completed questionnaires on demographics, anxiety (GAD-7), depression (PHQ-9), body appreciation (BAS-2), masculine self-esteem (MSES), illness-related shame (CISS), and pain intensity (SF-MPQ). Results: Men with FMS reported significantly higher depression and anxiety, lower body appreciation, and compromised masculine identity. Between-group analysis showed body appreciation mediated the fibromyalgia–distress relationship. However, within the FMS group, compromised masculine identity and illness-related shame were the strongest pathways to distress, while body appreciation showed no effect. Moderation analysis confirmed body appreciation buffered distress in controls but not in men with FMS. Conclusion: Masculine identity threats and illness-related shame constitute central mechanisms of psychological distress in men with FMS. Body appreciation operates differently in this population than in healthy men. Findings underscore the need for gender-sensitive interventions addressing identity disruption and emphasizing functionality over appearance-based acceptance. Full article

The design and optimization of microalgae processes are usually focused on maximizing biomass productivity, neglecting the impact of cell-to-cell heterogeneity. Flow cytometry (FCM) represents a powerful and high-throughput tool for analyzing and examining microalgae intrinsic characteristics, such as their physiology, metabolism and response at the single-cell level. The aim of this work is to develop a novel FCM sensor-based single-cell analysis method to monitor and study the effect of several process conditions, mainly variations of light spectral composition (blue, red and green), nitrogen depletion and moderate osmotic stress conditions (0.2 M NaCl), on the subpopulation structure and dynamics of the green microalgae Chromochloris zofingiensis, a natural source for lipids, proteins and carotenoids. The FCM procedures developed in this study proved to be effective for monitoring the population dynamics of microalgae, demonstrating how the process conditions have a direct and significant impact on population heterogeneity of C. zofingiensis on a single-cell level. Cell division was found to be adversely affected by the moderate osmotic stress (N⁺S⁺), nitrogen depletion (N⁻), and their combined occurrence (N⁻S⁺), independent of the light spectral composition used for culture illumination. In terms of cell-to-cell heterogeneity, a higher proportion of large cells (~20 µm) was observed under green light across all conditions with 21%, 29%, 35% and 52% under N⁻, N⁻S⁺, N⁺S⁺ and N⁺ conditions, respectively, followed by red light combined with osmotic stress (46%), whereas blue light consistently led to a predominance of smaller cells (≤4 µm) with 30%, 47%, 50% and 55% under N⁺S⁺, N⁺, N⁻S⁺ and N⁻ conditions, respectively. Full article

Background/Objectives: Coping with death is an essential yet challenging aspect of nursing. In Ecuador, limited training and cultural factors may influence how nurses face the process of death and dying. This study aimed to explore nurses’ perspectives and highlight the degree of congruence between the numerical and discursive data provided by participants. Methods: A sequential explanatory mixed-methods design (QUAN → qual) using questionnaires and qualitative interviews was employed. The quantitative phase included 497 nurses who completed the Bugen Coping with Death Scale and the qualitative phase involved semi-structured interviews with 18 nurses. Quantitative data were analysed descriptively, while qualitative data underwent thematic analysis. Integration occurred at the methodological level—through the building of the qualitative data collection instrument—and at the levels of analysis and interpretation. Results: Nurses demonstrated moderate coping levels on the Bugen Coping with Death Scale. Although many reported being comfortable discussing death, qualitative data revealed substantial emotional distress and limited preparedness—particularly when facing their own mortality or the death of loved ones. Nurses expressed fear of suffering, sadness, and helplessness, especially when caring for dying children or young mothers. Communication with patients and families at the end of life emerged as a major challenge. Spirituality was identified as a key coping resource. Conclusions: Coping with death remains a complex and emotionally demanding process for nurses in Ecuador. Continuous education, emotional support, and training in spiritual and psychological dimensions of care are essential to strengthen nurses’ resilience and enhance the quality of care. Full article

Groundwater modeling in semi-arid regions presents significant challenges due to complex aquifer dynamics, limited data availability, and heterogeneous hydrogeological conditions. This study presents a comprehensive comparative analysis of three fuzzy expert system strategies for monthly groundwater level forecasting in the Al-Hsain Basin, Syria: localized models based on hydrogeographical grouping, a unified basin-wide approach, and an innovative behavioral clustering methodology. Using synchronized rainfall and temperature data from 35 monitoring wells over four years (2020–2024), we developed and evaluated fuzzy inference systems’ directional classification accuracy as the primary performance metric, categorizing groundwater level changes into rise, stable, and decline states rather than predicting continuous values. This choice reflects the qualitative nature of fuzzy expert systems and their suitability for groundwater management under data-limited conditions. The behavioral clustering approach achieved excellent overall performance with a mean accuracy of 0.74, outperforming localized models (0.71) and unified models (0.67). Behavioral clustering demonstrated effectiveness in 66% of wells, with individual accuracy improvements reaching up to 0.23, while reducing model complexity from five group-specific systems to three behaviorally coherent clusters. Localized models achieved optimal performance in 29% of wells where hydrogeological conditions aligned with spatial assumptions, whereas unified models provided consistent moderate performance across 89% of locations. The incorporation of lagged variables and seasonal indices in behavioral clustering models proved essential for capturing temporal complexity in semi-arid groundwater responses. Statistical analysis revealed lower intra-group variability in behavioral clusters (standard deviation 0.06–0.09) than in geographical groupings (0.08–0.14), confirming improved functional homogeneity through response-based organization. These findings indicate that fuzzy modeling strategy selection should be context-dependent, with behavioral clustering offering an effective balance between accuracy, interpretability, and generalization for regional groundwater management applications. The novelty of this work lies in isolating the effect of fuzzy system organization logic (localized, unified, and behavioral) on forecasting performance, robustness, and transferability, evaluated under an identical inference and time-series validation framework. Full article

Cyanobacteria of the genus Phormidesmis are recognized as a promising source of biologically active secondary metabolites with anticancer and immunomodulatory properties. In the present study, we investigated both the cytotoxic and immunological effects of an extract obtained from Phormidesmis molle PACC (Plovdiv Algal Culture Collection) 8140 as well as its chemical composition. The extract was profiled by LC-ESI-MS/MS (Liquid chromatography—electrospray ionization—tandem mass spectrometry), and selected compounds were evaluated with in silico ADMET (Absorption, distribution, metabolism, excretion and toxicity) modeling. The cytotoxic potential of the extract was evaluated in vitro using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay on human colorectal adenocarcinoma cell lines (Caco-2, HT-29, and LS-180). The immunological impact of the extract was assessed on human peripheral blood mononuclear cells (PBMCs) isolated from healthy donors. PBMCs were treated with 100 µg/mL extract for 48 h, followed by flow cytometric immunophenotyping and ELISA (Enzyme-linked immunosorbent assay)-based cytokine quantification. The extract induced a concentration- and time-dependent decrease in cancer cell viability after 24, 48, and 72 h of exposure. At 72 h, treatment with the highest concentration (200 µg/mL) reduced cell viability to 74% in Caco-2 cells, 69–70% in HT-29 cells, and 59–61% in LS-180 cells. Morphological changes observed after treatment with Phormidesmis extract showed pronounced cytotoxic and apoptosis-related effects in the colorectal cancer cell lines tested. Immunophenotyping revealed a pronounced expansion of natural killer (NK) cells (CD56⁺ and/or CD16⁺). CD3⁻CD56⁻CD16⁺ NK population was markedly increased (from 67.7 ± 0.95% in non-treated PBMCs to 94.66 ± 0.90% in extract-treated PBMCs, p < 0.001). In contrast, the proportions of CD8⁺ T cells, CD19⁺ B cells, and CD11b⁺ monocytes were significantly reduced (from 21.5 ± 4.50% to 7.22 ± 0.41%, from 11.9 ± 1.70% to 6.06 ± 0.42%, and from 66.4 ± 0.60% to 34.4 ± 0.87%, respectively). Cytokine analysis demonstrated strong suppression of Th1-associated cytokines, with significantly reduced interferon gamma (IFN-γ, 461 ng/mL in controls vs. 84 ng/mL in extract-treated cultures) and tumor necrosis factor alpha (TNF-α) levels (169 ng/mL in controls vs. 32 ng/mL in extract-treated cultures), whereas nterleukin-6 (IL-6) was moderately elevated (from 158 ng/mL in controls to 234 ng/mL in extract-treated cultures) and IL-10 remained low. These findings demonstrate that P. molle extract combines cytotoxic activity against cancer cells with potent immunomodulatory effects, highlighting its potential as a source of bioactive compounds for immune-based therapeutic strategies. Full article

This study aimed to evaluate the intra-model repeatability of three artificial intelligence-based chatbots (ChatGPT-4.0, Microsoft Copilot, and Claude 3.5) in composite shade selection and their agreement with a dental specialist. Ten acrylic resin maxillary central incisor teeth representing different VITA Classical shades (n = 10) were photographed together with A1, A2, and A3 composite shade tabs under standardized illumination. Shade selections were performed by each artificial intelligence model based on the photographs and repeated on five different days using identical images and prompts. Visual shade selection by the dental specialist was determined by consensus between two calibrated evaluators. CIE L*, a*, and b* values of the acrylic teeth and composite shade tabs were obtained by photometric analysis, and color differences were calculated using the CIEDE2000 formula. Intra-model repeatability was assessed using Fleiss’ kappa coefficient, and agreement with the dental specialist was evaluated using Cohen’s kappa statistic. Intra-model repeatability differed among the models, with ChatGPT-4.0 demonstrating fair repeatability (κ = 0.33), Claude 3.5 showing moderate repeatability (κ = 0.45), and Microsoft Copilot exhibiting poor repeatability (κ = −0.12). Trial-level agreement with the dental specialist varied across repeated assessments, with ChatGPT-4.0 generally demonstrating higher agreement than the other models, whereas Microsoft Copilot showed consistently low agreement. Artificial intelligence chatbots showed variable repeatability and limited agreement with expert evaluation in composite shade selection under standardized conditions. Full article

Alveolar macrophages orchestrate phagocytosis and inflammatory programs during respiratory infection. CD2-associated protein (CD2AP) and BTB and CNC homology 2 (BACH2) are immune-related genes involved in cytoskeletal organization/vesicular trafficking and transcriptional regulation, respectively, but the coding-level constraints shaping their synonymous-site architecture remain unclear. Here, we profiled codon usage bias (CUB) of CD2AP and BACH2 across 49 vertebrate species using nucleotide composition, relative synonymous codon usage, and complementary codon bias diagnostics. Across species, BACH2 preferentially used G/C-ending codons with higher GC3s, whereas CD2AP was enriched for A/T-ending codons with lower GC3s. Both genes showed weak-to-moderate CUB (high ENC and modest CAI). ENC–GC3s and PR2 analyses indicated a strong compositional background at third codon positions, while neutrality analysis yielded shallow GC12–GC3 slopes, suggesting overall coding constraints, with compositional effects acting as a background influence and selective constraints possibly contributing to GC1/GC2 patterns. CD2AP deviated more from composition-only expectations than BACH2, suggesting greater gene-specific modulation. Phylogenetic reconstruction placed Sus scrofa within mammalian clades for both genes. In conclusion, CD2AP and BACH2 display opposite third-base codon-ending preferences across vertebrates, with CD2AP favoring A/T-ending codons and BACH2 favoring G/C-ending codons. This provides a comparative baseline for codon usage analyses of macrophage-relevant immune genes. Full article

Background/Objectives: Mental health conditions such as anxiety, depression, and stress remain among the leading global causes of disability. Mindfulness-Based Interventions (MBIs) have gained increasing attention as effective non-pharmacological strategies for reducing psychological distress. Methods: This systematic review examined 30 randomized controlled trials and quasi-experimental studies involving over 24,000 participants to evaluate the impact of MBIs on mental health outcomes, with a specific focus on the contribution of gratitude-based components. Results: Studies varied in terms of population, duration, and format, with most demonstrating moderate to strong effects on symptom reduction, particularly in programs lasting 8 to 12 weeks. A random-effects meta-analysis was conducted, yielding a pooled effect size of Hedges’ g = −0.45, indicating a moderate improvement in psychological outcomes. Subgroup analyses revealed slightly stronger effects for anxiety (g = −0.56) than depression (g = −0.45). Gratitude-integrated MBIs demonstrated modestly enhanced emotional benefits, suggesting a synergistic role in improving well-being. Conclusions: The review found low evidence of publication bias and acceptable risk of bias, supporting the moderate results. The findings underscore the value of MBIs, particularly those integrating gratitude, as scalable, cost-effective interventions in clinical and educational settings. Full article

Marine-derived filamentous fungi are a rich source of structurally diverse and biologically active natural products. However, many biosynthetic gene clusters (BGCs) in fungi remain silent under standard conditions. In this study, we employed a metabolic shunting strategy to disrupt azaphilone biosynthesis in the marine-derived fungus Penicillium sclerotiorum E23Y-1A by deleting the pathway-specific regulator gene A00667. HPLC analysis revealed the emergence of new metabolite peaks in the mutant strain Δ667 compared to the wild type. Subsequent purification yielded seven compounds: the mutant produced two novel meroterpenoids sclerotilins A and B (1 and 2) along with the known steroids ergosta-5,7,22-trien-3β-ol (3) and cerevisterol (4), while the wild type yielded the known steroid (22E)-5α,8α-epidioxyergosta-6,22-dien-3β-ol (5) and two azaphilones geumsanol G (6) and 5-chloro-3-[(1E,3R,4R,5S)-3,4-dihydroxy-3,5-dimethyl-1-hepten-1-yl]-1,7,8,8a-tetrahydro-7,8-dihydroxy-7-methyl-(7R,8R,8aS)-6H-2-benzopyran-6-one (7). Bioactivity assays showed that compound 6 exhibited moderate antimicrobial activity against Staphylococcus aureus, and compound 3 displayed moderate cytotoxicity against five human cancer cell lines. These results demonstrate that A00667 is essential for azaphilone biosynthesis and that its disruption leads to the production of structurally distinct natural products, highlighting the potential of pathway engineering to redirect fungal metabolism to yield novel natural products. Full article

Background and Objectives: Coronary computed tomography angiography (CCTA) is widely used in the diagnostic evaluation of suspected stable coronary artery disease; however, its agreement with invasive coronary angiography (ICA) remains inconsistent across different levels of analysis. The aim of this study was to evaluate the agreement between CCTA and ICA and to identify the factors associated with discrepancies. Materials and Methods: A single-centre retrospective analysis of 500 patients was performed. All patients underwent CCTA within one year prior to ICA. Coronary stenoses were evaluated at the 11-segment coronary artery, vessel, and patient levels using a ≥50% cut-off. Diagnostic agreement was assessed using the kappa coefficient, while diagnostic performance was evaluated in terms of sensitivity, specificity, positive predictive value, and negative predictive value. Factors associated with discrepancies were evaluated using a logistic regression model. Results: At the segment level, agreement between CCTA and ICA was low to moderate across 11 coronary segments (κ = 0.108–0.461). At the patient level, CCTA identified ≥50% coronary stenosis more frequently than ICA (86.2% vs. 59.4%, p < 0.001), demonstrating high sensitivity (91.3%) but low specificity (21.2%). Diagnostic discrepancies were associated with higher coronary calcium burden, and in multivariable analysis, body mass index > 25 kg/m², age < 68 years, and multiple comorbidities were independently associated with discordant findings. Conclusions: At the patient level, CCTA demonstrates high sensitivity and represents an appropriate non-invasive method for patient selection for further diagnostic evaluation. However, agreement between CCTA and invasive coronary angiography remains limited at the segment and vessel levels. Diagnostic discrepancies were significantly associated with coronary artery calcification and higher body mass index (BMI), which should be taken into consideration when interpreting CCTA findings. Full article

Geranium robertianum L. is used in traditional medicine to treat different systemic disorders and holds great therapeutic potential but remains understudied. To this aim, an ethanolic extract obtained from the aerial parts of G. robertianum L. (GR) was investigated in terms of phytochemical composition and biological activity. GR extract exhibited high levels of phenolic compounds and flavonoids. The antioxidant activity was determined by means of three different colorimetric assays (DPPH, ABTS, and FRAP), and the results obtained indicate that the ABTS assay showed the highest antioxidant capacity. Metal analysis was also performed. Fe was found to be the most abundant element in the analyzed extract, with a concentration of 363.65 ± 4.18 μg/g, followed by Zn, Mn, Ni, and Cr. Four potentially hazardous heavy metals, As, Co, Pb, and Cd, were found to be under the detection limit. The GR extract exhibited moderate antibacterial activity against both Gram-positive and Gram-negative bacteria, with inhibition zones generally comparable to those of levofloxacin. However, the extract was significantly less effective against the P. aeruginosa strain. On A253 human salivary gland carcinoma cells, GR extract elicited a dose-dependent antiproliferative effect, produced morphological changes, and increased ROS and both caspase-3/7 and caspase-9 levels. Full article

Performance differences between female youth handball players selected for national teams and non-selected peers are often linked to strength, speed, and power. This study aimed to compare the conditioning capacities and body composition of national and non-national youth handball players. The sample included 36 female players (17.13 ± 1.75 years), 18 national and 18 position-matched non-national players. Anthropometry, sprint and change in direction ability, vertical jump, upper- and lower-body strength, aerobic capacity, and body composition were assessed using standard tests and bioimpedance analysis. For normally distributed variables, an independent-samples t-test was applied, while for variables that did not meet the normality assumptions, the Mann–Whitney U test was used. Cohen’s d was used to assess effect size. National team players showed significantly greater jump height (p < 0.001, d = 1.408), higher relative peak power (p < 0.001, d = 1.644), and faster 20 m sprint times (p = 0.004, d = −1.037). No significant differences were found in body composition or the other measured parameters, although a moderate Yo-Yo IRL1 effect size suggests a potential practical advantage in aerobic capacity for national team players. These results indicate that explosive power and linear speed are key discriminators for youth national-team selection. Full article

Background/Objectives: Volatile anesthetic dosing during cardiopulmonary bypass (CPB) is poorly standardized. We estimated the end-tidal sevoflurane (ETsevo) concentration required to maintain adequate anesthesia during CPB and investigated the effects of age and body temperature. Methods: This study is a PRISMA-compliant, PROSPERO-registered meta-analysis. PubMed, Embase, and the Cochrane Library were searched. Prospective studies of adults who underwent cardiac surgery with CPB and receiving sevoflurane were included. Primary outcome was mean ETsevo concentration when bispectral index (BIS) was 40–60. Three-level random-effects meta-analytic models with robust variance estimation were used to pool repeated measurements within studies. Age and body temperature were then examined as study-level moderators. Risk of bias was determined using ROBINS-I. Results: Five studies (n = 129) fulfilled the criteria. Pooled ETsevo during CPB was 0.88 vol% (95% confidence interval [CI] 0.29 to 1.46; p = 0.02) with substantial heterogeneity (I² = 87.6%). Body temperature was not a significant moderator (difference 0.26 vol%; 95% CI −1.12 to 1.64; p = 0.27). Higher mean age was associated with lower ETsevo, evidenced by the finding that patients with a mean age of >62.0 years required 0.45 vol% less ETsevo (95% CI −0.78 to −0.13; p = 0.01), and sensitivity analysis revealed a 0.05 vol% decrease per additional year. Conclusions: To maintain BIS at 40–60 during CPB, the estimated ETsevo requirement is 0.88 vol% (minimum alveolar concentration 0.53–0.58 in patients in their 60s). Requirements decreased with age, and body temperature exerted no detectable effect. Full article

Urban expansion and spatial restructuring significantly influence the urban thermal environment. This study investigates the central urban area of Jinan, developing a multi-dimensional spatial structure index system that integrates terrain, 2D/3D morphology, and layout based on multi-source data. Land surface temperature (LST) was derived from remote sensing imagery. Using road networks and triangulated irregular networks (TINs) generated from a digital elevation model (DEM), hybrid analysis units were created. Pearson correlation and bivariate global/local spatial autocorrelation analyses were applied to examine the mechanisms and spatial heterogeneity of how urban spatial structure affects LST. The results showed that (1) LST was strongly associated with urban spatial structure. Among the 12 significantly correlated indicators, building density showed the strongest positive correlation with LST (r = 0.5883), while DEM mean had the strongest negative correlation (r = −0.7444), indicating that compact built-up areas intensified heating, whereas terrain most strongly moderated surface temperature. (2) LST and indicator correlations varied with elevation. LST showed a negative correlation with the standard deviation of DEM, suggesting that greater terrain variability enhances cooling effects. This spatial variation in the dominant drivers of the thermal environment reflects a clear divergence of influencing factors across different elevational zones. The thermal environment exhibits a pronounced north–south split: cooling effects prevail in the south due to terrain, while warming effects dominate in the north due to building forms. (3) Bivariate spatial autocorrelation revealed clear spatial heterogeneity. High–high clustering of LST and spatial structure indicators in the northern plain denoted heat-aggregated zones. Low–low clustering in the topographically complex, sparsely built south formed cold-source zones, and transitional areas showed mixed high–low and low–high clustering. (4) Based on these findings, a zonal governance framework was advocated, prioritizing terrain assessment followed by spatial structure optimization. This promoted a shift from uniform to precise, zone-based thermal environment management, laying a scientific foundation for sustainable spatial planning. Full article

In recent decades, profound transformations in work organization, employment conditions, and organizational change processes have intensified workers’ exposure to psychosocial risks, with significant consequences for occupational health and well-being. Despite the growing relevance of these risks, organizations often lack psychometrically robust instruments capable of capturing psychosocial stressors associated with change, Conflicts, and working conditions in an integrated manner. The purpose of this study was to develop and psychometrically evaluate a questionnaire designed to measure psychosocial factors related to organizational changes, interpersonal Conflicts, and occupational well-being. An instrumental study design was employed, following international standards for the construction and validation of psychological instruments. The sample consisted of 350 workers with a mean age of 33.19 years (SD = 9.18; range: 18–66) and an average organizational tenure of 6.71 years (SD = 8.61). The initial 48-item questionnaire was refined to a final version comprising 24 items distributed across 7 scales: Organizational Changes, Work Program, Job Security, Promotion, Training, Interpersonal Conflicts, and Lack of Participation. Preliminary analyses indicated that the data adequately met the assumptions for factor analysis (KMO = 0.81; Bartlett’s test χ² = 4376.98, p < 0.001). The results supported a seven-factor structure explaining 72% of the total variance, with clear and interpretable factor loadings consistent with the theoretical model. Internal consistency was acceptable to excellent across scales (α = 0.72–0.91; ω = 0.84–0.95), including short scales with three items. Inter-scale correlations were low to moderate, supporting discriminant validity and indicating that the dimensions, while related, represent distinct constructs. Overall, the findings provide strong evidence for the instrument’s reliability and validity based on its internal structure, supporting its use for psychosocial risk assessment and research on organizational changes, interpersonal Conflicts, and occupational well-being. Full article