Search Results (45)

This study explores the relationship between post-traumatic stress disorder (PTSD) and the two major dimensions of mentalization (self and other-oriented) in asylum seekers resettled in Italy. It is important because it is the first study addressing the role of mentalization in asylum seekers with PTSD. Twenty asylum seekers scoring above the cut-off for the PTSD Checklist for DSM-5 (PCL-5) were contrasted to twenty asylum seekers without PTSD on mentalization and somatization. The Certainty About Mental States Questionnaire (CAMSQ) and the Bradford Somatic Inventory (BSI-21) were used to assess mentalization and somatization, respectively. Pearson correlations and multiple regression analyses were conducted to examine the overall association between variables. Asylum seekers with PTSD had significantly higher scores than those without PTSD on somatization (p = 0.03), and significantly lower scores on self-oriented mentalization (p < 0.05) than those without PTSD. These results show that asylum seekers with PTSD have reduced self-oriented mentalizing abilities, while the other-oriented component of mentalization appears less involved. This study shows that mentalization deserves more research for the possibly crucial role of reduced self-oriented mentalization in asylum seekers’ suffering. If these findings are confirmed by future studies, they could be used to tailor interventions for asylum seekers and refugees with PTSD. Full article

Discrete manufacturing environments face increasing challenges in managing work-in-process (WIP) inventory due to growing product customization and demand volatility. While Value Stream Mapping (VSM) has been widely used for process improvement, traditional approaches lack the ability to dynamically control WIP levels while optimizing multiple performance dimensions simultaneously. This research addresses this gap by developing an integrated framework that synergizes Multi-Dimensional Value Stream Mapping (MD-VSM) with multi-objective optimization, functioning as a specialized digital twin for dynamic WIP control. The framework employs a four-layer architecture that connects real-time data collection, multi-dimensional modeling, dynamic WIP monitoring, and execution control through closed-loop feedback mechanisms. A mixed-integer optimization model is used to balance time, cost, and quality objectives. Validation using a high-fidelity simulation, parameterized with real-world industrial data, demonstrates that the proposed approach yielded up to a 31% reduction in inventory costs while maintaining production throughput and showed a 42% faster recovery from equipment failures compared to traditional methods. Furthermore, a comprehensive sensitivity analysis confirms the framework’s robustness. The system demonstrated stable performance even when key operational parameters, such as WIP upper limits and buffer capacity coefficients, were varied by up to ±30%, underscoring its reliability for real-world deployment. These findings provide manufacturers with a validated methodology for enhancing operational efficiency and production flexibility, advancing the integration of lean principles with data-driven, digital twin-based control systems. Full article

Effective maintenance and management of road infrastructure are essential for community well-being, economic stability, and cost efficiency. Well-maintained roads reduce accident risks, improve safety, shorten travel times, lower vehicle repair costs, and facilitate the flow of goods, all of which positively contribute to GDP and economic development. Accurate intersection mapping forms the foundation of effective road asset management, yet traditional manual digitization methods remain time-consuming and prone to gaps and overlaps. This study presents an automated computational geometry solution for precise road intersection mapping that eliminates common digitization errors. Unlike conventional approaches that only detect intersection positions, our method systematically reconstructs complete intersection geometries while maintaining topological consistency. The technique combines plane surveying principles (including line-bearing analysis and curve detection) with spatial analytics to automatically identify intersections, characterize their connectivity patterns, and assign unique identifiers based on configurable parameters. When evaluated across multiple urban contexts using diverse data sources (manual digitization and OpenStreetMap), the method demonstrated consistent performance with mean Intersection over Union greater than 0.85 and F-scores more than 0.91. The high correctness and completeness metrics (both more than 0.9) confirm its ability to minimize both false positive and omission errors, even in complex roadway configurations. The approach consistently produced gap-free, overlap-free outputs, showing strength in handling interchange geometries. The solution enables transportation agencies to make data-driven maintenance decisions by providing reliable, standardized intersection inventories. Its adaptability to varying input data quality makes it particularly valuable for large-scale infrastructure monitoring and smart city applications. Full article

Objective: To comprehensively evaluate the interaction between diet quality and multivitamin intake during pregnancy on offspring neurodevelopment. Methods: This analysis was grounded in mother-child dyads from the 3D Cohort Study in Quebec, Canada. Among the 2366 participants initially enrolled in the 3D study, 1535 women successfully completed the 3-day food record during 20–24 weeks of gestation. A Canadian adaptation of the Healthy Eating Index (HEI-C) 2010 was used to quantify diet quality. The total HEI-C score was dichotomized into low and high diet quality by median split. Cognitive and motor development in childhood were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Language abilities were measured using the toddler short-form version of the MacArthur–Bates Communicative Development Inventories (MCDI) questionnaire, administered in either English or French. After excluding participants with missing covariate data, cognitive, motor, and language development scores at 2 years of age were available for 1066, 1040, and 981 children, respectively. Multiple linear regression models were employed to calculate adjusted effect estimates. The interaction on an additive scale was assessed by incorporating a product term into the linear regression model. Results: Statistically significant interactions were detected between diet quality and multivitamin intake in relation to the cognitive and language development outcomes of the offspring (interaction p-values were 0.018 and 0.023, respectively). The lowest cognitive and language scores were observed in the group of women who neither took multivitamins nor maintained a high-quality diet. Among women not taking multivitamins, a high-quality diet was associated with improved offspring cognitive and language scores (mean difference [95% CI] = 4.2 [0.1, 8.2], p = 0.04; and 11.3 [3.1, 19.5], p = 0.01, respectively). However, among women taking multivitamins, no such associations were identified. Conversely, in participants with a low-quality diet, multivitamin intake was associated with a 3.0-point increase in cognitive composite scores (95% CI: 0.3, 5.8, p = 0.03), but this was not the case for those with a high-quality diet. No statistically significant interactions were observed between maternal diet quality and multivitamin intake for motor development outcomes. Conclusions: Adequate nutritional supply during pregnancy, achieved either through a high-quality diet or multivitamin supplementation, is fundamental for the neurodevelopment of children. Full article

Pre-trip anxiety is a critical yet understudied factor influencing participation and engagement in Outdoor Experiential Education (OEE) programs. Anxiety can serve as both a motivator and a barrier, shaping participants’ willingness to engage in challenging activities. This study examines the sources, predictors, and temporal progression of pre-trip anxiety among OEE participants, with a focus on experience level, gender differences, and activity type. Using a cross-sectional design, data were collected from students and staff at two Midwestern universities across three time points leading to an OEE program. Measures included the State–Trait Anxiety Inventory (STAI) and a course-specific worry scale assessing concerns such as physical ability, social dynamics, and environmental risks. Results indicate that experience level can predict anxiety, with less experienced participants reporting higher levels of concern. Gender differences were also observed, with female participants exhibiting greater pre-trip anxiety, particularly in water-based activities. However, anxiety remained relatively stable across time intervals, suggesting that interventions may be effective at multiple stages before a program begins. These findings have practical implications for OEE design, including targeted pre-trip interventions, adjusted program marketing, and tailored support strategies to reduce barriers to participation and enhance student preparedness. Full article

Background/Objectives: Instrumental Activities of Daily Living (IADL) are the key indicators of the autonomy and functional ability in older adults with neurocognitive disorders (NCDs). However, the specific predictors of IADL performance across the NCD spectrum remains insufficiently characterized. This study aimed to identify the cognitive, motor, and caregiver-related determinants of the IADL in individuals with minor and major NCDs. Methods: A cross-sectional study was conducted involving 117 participants referred from a university-based dementia clinic. Standardized tools were administered to evaluate their IADL performance (Lawton IADL Scale), cognition [Addenbrooke’s Cognitive Examination III (ACE-III)], Functional Cognitive Assessment Scale (FUCAS)], motor functions, balance, and mobility [Tinetti Test, Timed Up and Go (TUG)], emotional status [Geriatric Depression Scale (GDS)], neuropsychiatric symptoms [Neuropsychiatric Inventory (NPI)], and caregiver burden [Zarit Burden Interview (ZBI)]. Multiple regression analyses were performed to identify the significant predictors of IADL performance. Results: In the total sample (n = 117), the IADL performance was significantly predicted via ACE-III, FUCAS, and Tinetti-balance (adjusted R² = 0.729). In the minor NCD group (n = 41), the significant predictors included sex, FUCAS, GDS, Tinetti-balance, and TUG (adjusted R² = 0.725). In the major NCD group (n = 76), ACE-III, FUCAS, and Tinetti-balance remained the significant predictors (adjusted R² = 0.634). Female sex and a worse profile on the other variables were associated with lower IADL scores. Conclusions: Global cognitive decline, executive dysfunction in everyday problem-solving situations, and balance impairment are the key determinants of IADL performance across both minor and major NCDs. Female sex and depressive symptoms further predicted the IADL performance in the minor NCD group. These findings highlight the need for multidisciplinary assessment and intervention strategies to promote health and autonomy and preserve the functional independence in older adults with NCDs. Full article

Background/Objectives: Resilience, defined as the ability to adapt and cope effectively with stress, plays a crucial role in preparing candidates for the paramedic profession. This study aimed to assess the resilience intensity as a personality trait and identify stress-coping styles among paramedic candidates. Methods: A cross-sectional cohort study was conducted across multiple Polish universities offering bachelor’s degree programs in emergency medical services. The study included 138 participants (56 females, 82 males, aged 18–51). Data collection involved demographic surveys and standardized tools, including the Polish version of the Resilience Scale (SPP-25), the Satisfaction with Life Scale (SWLS), and the Coping Inventory for Stressful Situations (CISS). Results: The study revealed a positive correlation between resilience and age (p = 0.002). Males exhibited significantly higher resilience compared to females (p = 0.0004). While both genders demonstrated average life satisfaction (SWLS), men scored significantly higher (p = 0.0082). Task-oriented coping strategies were predominant among all participants, but females scored higher in emotion-oriented coping (p = 0.0003). Resilience was positively correlated with task-oriented coping (0.4872) and negatively correlated with emotion-oriented coping (−0.4727). Conclusions: These findings emphasize the importance of resilience in paramedic training and selection, as it significantly influences stress management and professional performance in high-pressure situations. Full article

Objective. To investigate the relationships among neuropathic pain (NP), pain catastrophizing (PC), and central sensitization (CS) in relation to functional status and radiological damage in patients with knee osteoarthritis (OA). Methods. This cross-sectional study included knee OA patients derived from an observational cohort. The Spearman correlation test was used to analyze the relationship between the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the PainDetect Questionnaire (PDQ), Central Sensitization Inventory (CSI), and Pain Catastrophizing Scale (PCS). The Kruskal–Wallis test was employed to compare WOMAC scores according to CSI categories. A multivariate analysis was conducted to identify predictors of functional ability, with the WOMAC score as the dependent variable and the independent variables including pain-related indices such as PCS, PDQ, and CSI, along with Kellgren–Lawrence (K-L) grading and demographic characteristics. Results. This study included 149 patients (76.5% female; mean age 71.5 years; mean duration of pain 8.1 years). In total, 23.5% exhibited NP, 30.9% showed PC, and 33.6% had CS. Higher mean values of WOMAC were correlated with CSI categories (p < 0.0001). WOMAC showed a significant relationship with CSI (rho = 0.791; p < 0.0001), PDQ (rho = 0.766; p < 0.0001), and PCS (rho = 0.536; p < 0.0001). In the multiple regression analysis, WOMAC was independently associated with CSI (p < 0.0001), PDQ (p < 0.0001), and PC (p = 0.0001). No association was observed between the K-L grading and the other variables. Conclusions. A reduced functional capacity in patients with knee OA is correlated with the presence of NP, PC and CS, without being significantly associated with radiological damage. Full article

Today, businesses are adopting digital transformation strategies to make their production processes more agile, efficient, and sustainable. At the same time, lean manufacturing principles aim to create value by reducing waste in production processes. In this context, it is important that the machine to be selected for inventory tracking can meet both the technological features suitable for digital transformation goals and the operational efficiency criteria required by lean manufacturing. In this study, multi-criteria decision-making methods were used to select the most suitable machine for inventory tracking based on digital transformation and lean manufacturing perspectives. This study applies a framework that integrates the Continuous Intuitionistic Fuzzy Analytic Hierarchy Process (CINFU AHP) and the Continuous Intuitionistic Fuzzy Combinative Distance-Based Assessment (CINFU CODAS) methods to select the most suitable machine for inventory tracking. The framework contributes to lean manufacturing by providing actionable insights and robust sensitivity analyses, ensuring decision-making reliability under fluctuating conditions. The CINFU AHP method determines the relative importance of each criterion by incorporating expert opinions. Six criteria, Speed (C1), Setup Time (C2), Ease to Operate and Move (C3), Ability to Handle Multiple Operations (C4), Maintenance and Energy Cost (C5), and Lifetime (C6), were considered in the study. The most important criteria were C1 and C4, with scores of 0.25 and 0.23, respectively. Following the criteria weighting, the CINFU CODAS method ranks the alternative machines based on their performance across the weighted criteria. Four alternative machines (High-Speed Automated Scanner (A1), Multi-Functional Robotic Arm (A2), Mobile Inventory Tracker (A3), and Cost-Efficient Fixed Inventory Counter (A4)) are evaluated based on the criteria selected. The results indicate that Alternative A1 ranked first because of its superior speed and operational efficiency, while Alternative A3 ranked last due to its high initial cost despite being cost-effective. Finally, a sensitivity analysis further examines the impact of varying criteria weights on the alternative rankings. Quantitative findings demonstrate how the applied CINFU AHP&CODAS methodology influenced the rankings of alternatives and their sensitivity to criteria weights. The results revealed that C1 and C4 were the most essential criteria, and Machine A2 outperformed others under varying weights. Sensitivity results indicate that the changes in criterion weights may affect the alternative ranking. Full article

Background: Children often present to primary and specialty care clinics with multiple somatic symptoms of nonspecific origin that can be highly distressing and prompt significant health service use. We evaluated the psychometric properties of the eight-item Children’s Somatic Symptoms Inventory (CSSI-8) as a brief measure of somatic distress that could be easily integrated into clinical systems. Method: Eight items from the 24-item CSSI were selected based on their representation of multiple bodily systems, association with high base rates, and ability to maximize the separation of the items’ Rasch measure scores. The psychometric quality of the eight-item scale was evaluated in 876 pediatric patients with chronic abdominal pain and a nonclinical sample of 954 school children using methods from three psychometric models (the classical test theory, Rasch modeling, and confirmatory factor analysis). Results: The CSSI-8 showed good measurement properties on an extensive array of psychometric criteria, had adequate Rasch person separation reliability for a brief instrument (r_sep = 0.74–0.75), and distinguished between clinical and nonclinical youth. Girls in both groups had significantly higher CSSI-8 scores than boys. Norms for the clinical sample are presented. Conclusions: The CSSI-8 is a psychometrically sound measure suitable for use as a brief dimensional assessment of pediatric somatic distress. Full article

Multiple sclerosis (MS) is a chronic, debilitating neurological condition for which current treatments often focus on managing symptoms without curing the underlying disease. Recent studies have suggested that dietary supplements could potentially modify disease progression and enhance quality of life. This systematic review aims to evaluate the efficacy and safety of epigallocatechin-3-gallate (EGCG) as a dietary supplement in patients with MS, with a specific focus on its impact on disease progression, symptom management, and overall quality of life. We conducted a comprehensive systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, utilizing an exhaustive search across the databases PubMed, Scopus, and Web of Science up to 23 February 2024. Eligible studies were randomized controlled trials. Nine clinical trials involving 318 participants were analyzed, with dosages ranging from 600 mg to 1200 mg of EGCG daily, although most studies had only a 4-month follow-up period. Results indicated that EGCG supplementation, particularly when combined with coconut oil, led to significant improvements in metabolic health markers and functional abilities such as gait speed and balance. One trial observed significant improvements in the Berg balance scale score from an average of 49 to 52 after four months of treatment with 800 mg of EGCG daily. Additionally, interleukin-6 levels significantly decreased, suggesting anti-inflammatory effects. Measures of quality of life such as the Beck Depression Inventory (BDI) scale showed significant improvements after EGCG supplementation. However, primary outcomes like disease progression measured by the Expanded Disability Status Scale (EDSS) and Magnetic Resonance Imaging (MRI) of lesion activities showed minimal or no significant changes across most studies. EGCG supplementation appears to provide certain symptomatic and functional benefits in MS patients, particularly in terms of metabolic health and physical functionality. However, it does not significantly impact the primary disease progression markers such as EDSS scores and MRI lesions. These findings underscore the potential of EGCG as a supportive treatment in MS management, though its role in altering disease progression remains unclear. Future research should focus on long-term effects and optimal dosing to further elucidate its therapeutic potential. Full article

Background: the objective of this longitudinal study (from pregnancy to the end of the sixth month postpartum) is to elucidate the association between maternal self-efficacy, defined as a mother’s confidence in her ability to breastfeed, and breastfeeding outcomes. Methods: This prospective cohort study was conducted among high-risk pregnant women (including those with conditions such as gestational diabetes, hypertension, pre-eclampsia, and other pathological medical conditions) and normal-risk pregnant women in Greece. The high-risk group included 164 women, while the normal-risk group comprised 154 women. Data were collected using validated psychometric scales, including the Breastfeeding Self-Efficacy Scale-Short Form, State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, Maternal Antenatal Attachment Scale, and Iowa Infant Feeding Attitude Scale. Results: Higher maternal self-efficacy was significantly associated with a longer duration and greater exclusivity of breastfeeding. A statistically significant relationship between the type of breastfeeding and the degree of breastfeeding self-efficacy was observed at multiple postpartum milestones: in the first and third 24 h postpartum, and at the end of the sixth week, third month, and sixth month postpartum. Conclusion: The findings underscore the critical role of maternal self-efficacy in breastfeeding success, influenced by individual psychological factors and broader socio-cultural contexts. Strengthening maternal self-efficacy is essential for improving breastfeeding outcomes. Full article

The composition, distribution, and growth of native natural forests are important references for the restoration, structural adjustment, and close-to-nature transformation of artificial forests. The joint species distribution model is a powerful tool for analyzing community structure and interspecific relationships. It has been widely used in biogeography, community ecology, and animal ecology, but it has not been extended to natural forest conservation and restoration in China. Therefore, based on the 9th National Forest Inventory data in Jilin Province, combined with environmental factors and functional traits of tree species, this study adopted the joint species distribution model—including a model with all variables (model FULL), a model with environmental factors (model ENV), and a model with spatial factors (model SPACE)—to examine the distribution of multiple tree species. The results show that, in models FULL and ENV, the environmental factors explaining the model variation were ranked as follows, climate > site > soil. The explanatory power was as follows: model FULL (AUC = 0.8325, Tjur R² = 0.2326) > model ENV (AUC = 0.7664, Tjur R² = 0.1454) > model SPACE (AUC = 0.7297, Tjur R² = 0.1346). Tree species niches in model ENV were similar to those in model FULL. Compared to predictive power, we found that the information transmitted by environmental and spatial predictors overlaps, so the choice between model FULL and ENV should be based on the purpose of the model, rather than the difference in predictive ability. Both models can be used to study the adaptive distribution of multiple tree species in northeast China. Full article

Background: Business continuity entails the potential negative consequences of uncertainty on a firm’s ability to achieve strategic objectives. The COVID-19 pandemic significantly impacted business continuity due to lockdowns, travel restrictions, and social distancing measures. Consequently, firms adopted specific supply chain (SC) practices to effectively navigate this global crisis. Methods: This research adopted a stochastic approach based on Bayesian Networks to evaluate the implications of business continuity on firms’ decisions to embrace SC practices, focusing on omnichannel strategies, SC coordination, and technologies such as artificial intelligence systems, big data and machine learning, and mobile applications. Results: Our findings revealed that firms facing disruption in a single performance area can apply specific strategies to maintain resilience. However, multiple areas of underperformance necessitate a varied approach. Conclusions: According to our empirical analysis, omnichannel strategies are critical when disruptions simultaneously impact quality, inventory, sales, and ROI, particularly during major disruptions such as the COVID-19 pandemic. AI and big data become vital when multiple risks coalesce, enhancing areas such as customer service and supply chain visibility. Moreover, supply chain coordination and mobile app adoption are effective against individual performance risks, proving crucial in mitigating disruption impacts across various business aspects. These findings help policy-makers and business owners to have a better understanding of how business continuity based on performance resistance to disruptions pushes companies to adopt different practices including new technologies and supply chain coordination. Accordingly, they can use the outputs of this study to devise strategies for improving resilience considering their supply chain vulnerabilities. Full article

In organisational contexts, professionals are required to decide dynamically and prioritise unexpected external inputs deriving from multiple sources. In the present study, we applied a multimethodological neuroscientific approach to investigate the ability to resist and control ecological distractors during decision-making and to explore whether a specific behavioural, neurophysiological (i.e., delta, theta, alpha and beta EEG band), or autonomic (i.e., heart rate—HR, and skin conductance response—SCR) pattern is correlated with specific personality profiles, collected with the 10-item Big Five Inventory. Twenty-four participants performed a novel Resistance to Ecological Distractors (RED) task aimed at exploring the ability to resist and control distractors and the level of coherence and awareness of behaviour (metacognition ability), while neurophysiological and autonomic measures were collected. The behavioural results highlighted that effectiveness in performance did not require self-control and metacognition behaviour and that being proficient in metacognition can have an impact on performance. Moreover, it was shown that the ability to resist ecological distractors is related to a specific autonomic profile (HR and SCR decrease) and that the neurophysiological and autonomic activations during task execution correlate with specific personality profiles. The agreeableness profile was negatively correlated with the EEG theta band and positively with the EEG beta band, the conscientiousness profile was negatively correlated with the EEG alpha band, and the extroversion profile was positively correlated with the EEG beta band. Taken together, these findings describe and disentangle the hidden relationship that lies beneath individuals’ decision to inhibit or activate intentionally a specific behaviour, such as responding, or not, to an external stimulus, in ecological conditions. Full article