Search Results (185)

The opioid epidemic continues to be a major public health crisis in the United States, and nalmefene has recently emerged as an alternative opioid overdose reversal agent. However, little is known about pharmacists’ awareness and beliefs regarding nalmefene use and distribution. Therefore, the purpose of this study was to assess Alabama pharmacists’ knowledge, perceptions, and behavioral intentions related to nalmefene. This study used a cross-sectional survey design. Practicing pharmacists in the state of Alabama were eligible to participate, and were recruited through the Alabama Board of Pharmacy email listserv. An anonymous online survey was distributed via email, and respondents were eligible to enter a lottery for one of five $100 electronic gift cards. The survey instrument was developed by the investigators, adapted from prior overdose reversal literature and informed by the Theory of Planned Behavior. Primary outcome measures included: knowledge of nalmefene (12 items); perceived barriers regarding nalmefene stocking and recommendations (19 items); and Theory of Planned Behavior concepts including attitudes (15 items), subjective norms (perceived social support) (six items), perceived behavioral control (confidence in ability to stock or recommend nalmefene) (11 items), and behavioral intentions surrounding nalmefene stocking and recommendations (13 items). Outcomes were measured via multiple-choice (objective knowledge) and Likert-type scale (1 = strongly disagree, 5 = strongly agree) questions. Differences in mean scale scores across pharmacy setting (pharmacists employed in inpatient versus outpatient settings), community pharmacy type (chain vs. independent), and geographic location (rural vs. urban) were analyzed using two-sided Mann–Whitney U tests for non-parametric data or t-tests for parametric data, as appropriate. Multiple linear regression analyses examined associations between TPB constructs and pharmacists’ intentions to stock or recommend nalmefene over the next six months. All data were analyzed using SPSS statistical software version 29 with an alpha of 0.05. There were 119 pharmacist respondents (n = 25 inpatient, n = 94 outpatient). The majority were female (68.1%), White (94.1%), and worked in community settings (35.3% independent, 10.9% corporate, 10.1% big-box, 5.0% grocery). Median age was 42 years (IQR: 36–51). Awareness of nalmefene was low: only 39.5% had heard of it and 5.9% had seen it in practice. Inpatient versus outpatient pharmacists reported higher subjective norms external to the workplace (median [IQR]: 3.00 [2.33, 3.58] vs. 2.33 [1.67, 3.00]; p = 0.004) as well as subjective knowledge (mean [SD]: 2.96 [0.94] vs. 2.55 [0.74]; p = 0.023), while outpatient versus inpatient pharmacists reported higher perceived barriers related to fiscal/logistical concerns (mean [SD]: 3.45 [0.59] vs. 3.07 [0.66]; p = 0.009). Among community pharmacists, stocking and procurement confidence was higher among independent versus chain pharmacists (3.75 [3.00–4.17] vs. 3.17 [2.67–3.92]; p = 0.026). Furthermore, external workplace norms among urban pharmacists were higher than among rural pharmacists (2.50 [2.00–3.00] vs. 2.33 [1.67, 2.67]; p = 0.027), while stocking and procurement confidence was higher among rural than urban pharmacists (3.83 [2.83–4.50] vs. 3.17 [2.67–4.00]; p = 0.034). In adjusted reduced regression models, perceived behavioral control regarding nalmefene stocking and procurement (B = 0.189, 95% CI: 0.049, 0.329; p = 0.009), subjective norms external to the workplace (B = 0.232, 95% CI: 0.047, 0.418; p = 0.015), and interprofessional recommendation attitudes (B = 0.237, 95% CI: 0.037, 0.437; p = 0.021) positively predicted nalmefene implementation intentions. These findings suggest practice-setting differences that could be further explored for optimal implementation of nalmefene distribution and access, and highlight the need for targeted education, interprofessional collaboration, procurement guidance, and workflow tools to improve pharmacist preparedness for nalmefene services. Full article

Background/Objectives: Individual-level data on ultra-processed food (UPF) intake among Polish young adults are limited. This study quantified absolute UPF intake and its weight-based dietary contribution, identified major dietary sources, and examined associations of the UPF weight ratio with sociodemographic and anthropometric factors. Methods: This cross-sectional study included 429 Polish adults aged 18–30 years recruited by convenience sampling through an online questionnaire in March–April 2026, using a non-probabilistic sampling procedure. Habitual dietary intake was assessed using an 82-item semi-quantitative food-frequency questionnaire; body height and weight were self-reported. Foods were classified according to NOVA, supported by a market analysis of 605 retail products. Absolute UPF intake (g/day) and the UPF weight ratio (% of total food and non-water beverage intake) were calculated. Group comparisons used non-parametric tests, and independent associations were examined using multiple linear regression. Results: Median UPF intake was 394.4 g/day, while the mean UPF weight ratio was 23.8 ± 14.67%. Men had significantly higher UPF intake and weight ratio than women (p < 0.001, p = 0.002). The largest contributors to total UPF intake were non-alcoholic beverages (22.7%), animal protein products (19.7%), ready-to-eat/convenience meals (9.2%), and sweets and snacks (7.0%). In multivariable analysis, higher age (B = −1.47) and higher education (B = −3.55) were independently associated with a lower UPF weight ratio, while male sex (B = 2.87) and higher BMI (B = 0.36) were associated with a higher ratio (model R² = 25.0%). Conclusions: UPF intake was substantial in this convenience sample. A higher UPF weight ratio was observed among younger participants, men, and those with lower educational attainment, while beverages were the leading dietary source. These findings may help identify priority groups and dietary sources for public health strategies. Full article

Background/Objectives: Loneliness is a clinically relevant psychosocial factor in later life and has been associated with adverse mental, cognitive, and physical health outcomes. Views on ageing may shape social engagement, coping, and perceived belonging, but evidence from geriatric patient populations remains limited. This study examined whether views on ageing are associated with loneliness in geriatric patients. Secondary analyses explored subjective age, including felt age and the perceived onset of old age. Methods: This cross-sectional analysis used baseline data from two prospective observational studies in geriatric patients (N = 459). Loneliness was assessed with the three-item UCLA Loneliness Scale. Views on ageing were measured using five items from the German Ageing Survey. Associations were examined using Spearman correlations, non-parametric group comparisons, and multiple linear regression. Results: Participants had a mean age of 83.1 years and 65.6% were female. The mean UCLA loneliness score was 1.54 ± 2.07, and the mean views on ageing sum score was 13.21 ± 2.72. More negative views on ageing were associated with higher loneliness (ρ = 0.122, p = 0.009). In the fully adjusted regression model, views on ageing remained independently associated with loneliness after adjustment for chronological age, sex, and depressive symptoms (β = 0.117, p = 0.014; adjusted R² = 0.051). Depressive symptoms were also independently associated with loneliness (β = 0.182, p < 0.001), whereas chronological age and sex were not. At the item level, associations with loneliness were mainly driven by reduced positive ageing-related beliefs. Higher felt age was associated with higher loneliness (ρ = 0.151, p = 0.003), while a later perceived onset of old age was associated with lower loneliness (ρ = −0.136, p = 0.017). Conclusions: In geriatric patients, more negative views on ageing were weakly associated with higher loneliness independent of depressive symptoms. The small effect size suggests that views on ageing should be interpreted as one modest component within a broader biopsychosocial understanding of loneliness in geriatric care. Full article

PA is associated with numerous physical and mental health benefits, while self-efficacy is an important associated factor of health-related behaviors. However, evidence of the relationship between general self-efficacy and PA among healthcare students remains limited. This cross-sectional study included 747 healthcare students who completed an online survey comprising the General Self-Efficacy Scale (GSES), IPAQ-SF, and measures of PA habits. A subsample of 50 participants additionally completed one week of activity monitoring using a Fitbit Versa 4. Associations were examined using non-parametric tests, Spearman’s rank correlation analyses, and multivariable linear regression models. Higher general self-efficacy was associated with greater self-reported PA, more frequent PA habits, and better self-rated physical fitness. Self-efficacy was also weakly associated with lower sitting time during weekends, but not during working days. Bivariate associations between self-efficacy and physical activity-related measures were weak (|ρ| ≤ 0.284). Total self-reported PA remained independently associated with self-efficacy in multivariable models, while the association with exercise frequency was attenuated after accounting for self-rated physical fitness. Model explanatory power was modest (adjusted R² = 0.054–0.073). No clear associations were observed between self-efficacy and objectively measured weekly steps or active zone minutes. The agreement between self-reported and device-based measures was partial. General self-efficacy was associated with self-reported PA and perceived physical fitness, although associations were modest. Findings should be interpreted cautiously given the cross-sectional design, small monitoring subgroup, and multiple exploratory comparisons. Longitudinal studies are needed to clarify temporal relationships. Full article

This study examines employees’ readiness for AI-related organizational change by integrating AI perception, work reconfiguration, organizational conditions, and trust within a socio-technical perspective. A cross-sectional survey of 276 employees from six sectors in Croatia combined theory-guided operational composites, reliability assessment, exploratory principal component analysis, nonparametric comparisons, and multiple linear regression. AI perception (β = 0.195, p = 0.003) and AI-related work reconfiguration (β = 0.350, p < 0.001) were positively associated with adaptive capacity and readiness for change. Organizational change culture and trust and organizational relations showed substantial overlap, limiting interpretation of their separate adjusted coefficients. Significant sectoral differences were observed across all five measured domains. Open-ended responses highlighted perceived benefits associated with automation and work processes alongside concerns about accuracy, privacy, ethics, employment, and human oversight. The findings suggest that organizational AI implementation should consider changes in work practices, transparent communication, employee involvement, competence development, and trust. Interpretation is limited by the cross-sectional design, purposive nonprobability sampling, self-reported measures, and the absence of independent confirmatory measurement validation. Full article

Background: Neck pain is a common cause of work-related disability, yet the relationship between serum low-density lipoprotein cholesterol (LDL-C) and neck disability remains uncertain. This study examined whether serum LDL-C was independently associated with neck disability among university employees. Methods: A cross-sectional secondary analysis was conducted using occupational health records from 236 administrative and teaching employees of a private university in Quito, Ecuador. Neck disability was assessed using the Spanish-language Neck Disability Index (NDI). Serum LDL-C was analyzed as a continuous variable (per 10 mg/dL increase). The primary analysis used proportional-odds ordinal logistic regression adjusted for sex, age group, education level, and job position. Model assumptions, multicollinearity, influence, and stability were evaluated. Sensitivity analyses included a three-level ordinal model, multiple linear regression with the continuous NDI score, and nonparametric bootstrap resampling. Results: Mean LDL-C was 112.42 ± 29.09 mg/dL, and 56 participants (23.73%) had LDL-C concentrations ≥ 130 mg/dL. Mild neck disability was the most common category (58.05%), whereas severe disability was uncommon (1.27%). Serum LDL-C was not independently associated with higher neck disability in the adjusted ordinal model (adjusted OR per 10 mg/dL = 0.956; 95% CI, 0.876–1.043; p = 0.309). Sensitivity analyses using alternative-outcome specifications and bootstrap resampling produced consistent findings. Female sex was independently associated with greater disability, whereas no other covariates reached statistical significance. Conclusions: Serum LDL-C was not independently associated with neck disability in this selected occupational population after adjustment for demographic and occupational factors. Prospective multicenter studies incorporating broader cardiometabolic, inflammatory, ergonomic, behavioral, and psychosocial variables are needed to further clarify determinants of neck disability. Full article

Background and Objectives: Oxidative stress and chronic inflammation are closely interconnected processes involved in colorectal cancer (CRC) development and progression. However, the relationships between oxidative stress biomarkers, emerging hematological inflammatory indices, clinicopathological characteristics, and survival outcomes remain insufficiently characterized. This study evaluated circulating levels of 8-epi-prostaglandin F2α (8-epi-PGF2α), malondialdehyde (MDA), and superoxide dismutase 1 (SOD1), together with conventional and novel inflammatory indices, including the mean corpuscular volume-to-lymphocyte ratio (MCVL) and cumulative inflammatory index (IIC), in patients with CRC. Materials and Methods: This prospective observational study included 140 patients with histologically confirmed CRC and 40 healthy controls. Serum concentrations of 8-epi-PGF2α, MDA, and SOD1 were measured by ELISA, and hematological inflammatory indices were calculated from complete blood counts. Associations with clinicopathological characteristics were evaluated using non-parametric analyses with correction for multiple testing where appropriate. Spearman correlations with false discovery rate correction were used to assess oxidative–inflammatory associations. Prognostic analyses included 24-month time-dependent receiver operating characteristic (ROC) analysis accounting for censoring, Kaplan–Meier analysis, and Cox proportional hazards regression for overall survival (OS) and progression-free survival (PFS). Results: CRC patients exhibited significantly higher serum levels of 8-epi-PGF2α (p = 0.016), MDA (p < 0.001), and SOD1 (p < 0.001) than controls. Oxidative stress biomarkers differed significantly across TNM stage, nodal status, and histological grade, although the observed patterns were not uniformly progressive with disease stage. After false discovery rate correction, MDA retained significant correlations with multiple hematological inflammatory parameters, whereas SOD1 showed a more restricted correlation profile and 8-epi-PGF2α showed no significant correlations. At 24 months, MDA demonstrated the highest time-dependent discrimination for OS (AUC = 0.920; bootstrap 95% CI: 0.834–0.978), whereas its discrimination for PFS was modest (AUC = 0.636; bootstrap 95% CI: 0.487–0.773). High MDA, defined by the internally derived 24-month threshold, was associated with shorter PFS after adjustment for age, sex, and TNM stage (HR = 2.49, 95% CI: 1.29–4.80; p = 0.006) and, separately, metastatic status (HR = 2.40, 95% CI: 1.22–4.72; p = 0.011). However, when modeled continuously, MDA was no longer significantly associated with PFS after multivariable adjustment. Conclusions: CRC was associated with increased circulating oxidative stress biomarkers, with MDA showing the most consistent relationships with systemic inflammatory parameters and survival outcomes. Its prognostic association with PFS was dependent on the modeling approach, while its high discrimination for 24-month OS should be interpreted cautiously because of the limited number and metastatic restriction of death events. These findings identify MDA as a promising candidate oxidative–inflammatory marker warranting external validation rather than an independently established prognostic biomarker. Full article

Historic urban regeneration requires not only material conservation but also public understanding of the cultural meanings embedded in buildings, street networks, and local narratives. This study examines how active digital information seeking is associated with visitors’ perceived cultural–cognitive compensation during the interpretation of historic built environments, and how this support relates to cultural heritage experience evaluation and perceived heritage memory quality. An on-site survey of 316 digitally engaged visitors was conducted at Taiping Old Street in Changsha, China. Factor analyses, regression models, bootstrap indirect-association analyses, and non-parametric group comparisons were applied. Active digital information seeking was positively associated with cultural–cognitive compensation, cultural heritage experience evaluation, and perceived heritage memory quality. Cultural–cognitive compensation formed significant indirect associations with memory quality (B = 0.177, 95% CI [0.111, 0.252]) and experience evaluation (B = 0.143, 95% CI [0.084, 0.211]). No robust differences among primary digital tools remained after correction for multiple testing. The findings suggest that digital interpretation can function as a human-centered information layer connecting preserved physical heritage with historical context and visitor understanding. For intelligent heritage regeneration, digital tools should be spatially anchored, complementary, source-traceable, and integrated with physical interpretation and community narratives. Full article

Background/Objectives: Oxidative stress and low-grade chronic inflammation are implicated in the early pathogenesis of non-communicable diseases (NCDs). Malondialdehyde (MDA), a biomarker of lipid peroxidation, may reflect subclinical oxidative stress in apparently healthy young adults. This study aimed to establish a population-specific reference interval for plasma MDA in healthy Thai undergraduate students and evaluate associations with lifestyle risk factors. Methods: This cross-sectional study enrolled 141 Thai college students aged 18–27 years. Plasma MDA was measured using the thiobarbituric acid reactive substances (TBARS) assay. A reference interval was determined non-parametrically (P2.5–P97.5) following IFCC recommendations in a reference subgroup (n = 94). The 75th percentile (P75) was used as an exploratory cutoff for elevated MDA. Associations between MDA and lifestyle risk factors were assessed using logistic regression and multiple linear regression. Results: The plasma MDA reference interval was 1.16–9.23 µmol/L, with P75 = 6.07 µmol/L. Using this cutoff, 25.5% of participants had elevated MDA. High sugar intake was associated with elevated MDA in the P75-based model (adjusted OR = 3.42; 95% CI: 1.08–10.87; p = 0.036). In the linear regression model, BMI emerged as independently associated with MDA (p = 0.004). Conclusions: This study established the first population-specific plasma MDA reference interval for Thai young adults. High sugar intake and BMI emerged as complementary exploratory associations with elevated lipid peroxidation across different models. These findings support plasma MDA as a practical, cost-effective candidate biomarker, providing a basis for further early oxidative stress surveillance and NCD prevention in young populations. Full article

This study, part of the PRET-study (NCT06579898), investigated changes in body composition, physical fitness, sarcopenia, activities of daily living (ADL), challenging behaviour, and falls in adults with intellectual disabilities (ID) following participation in a 24-week progressive resistance exercise training (PRET) intervention. A repeated-time-series design with one study group was used. We used multilevel linear regression models and non-parametric tests to investigate changes in body composition (bioelectrical impedance), physical fitness (ID-fitscan), sarcopenia, ADL (Barthel Index, Lawton IADL scale), challenging behaviour (Aberrant Behaviour Checklist), and falls. Thirty-six adults with mild to moderate ID (mean age: 55.6 ± 12.9 years; 52.8% male) participated and 26 completed the intervention. Intention-to-treat and per-protocol analyses showed statistically significant improvements in physical fitness and challenging behaviour. As these analyses concerned multiple secondary outcomes from a study powered for cardiovascular risk factors, these findings should be considered exploratory. Intention-to-treat analyses showed improvements in the five-times chair stand (−2.40 s, 95% CI [−4.06; −0.75]), and reductions in irritability (−1.10, 95% CI [−2.21; −0.00]) and inappropriate speech (−0.75, 95% CI [−1.22; −0.28]). No statistically significant changes were observed for body composition, ADL, or falls and no cases of sarcopenia were identified. The findings suggest that participation in PRET may be associated with improvements in lower body functional muscular endurance and challenging behaviour. Full article

Background: The adoption of restrictive diets without medical indication is increasing, but the cognitive factors associated with this dietary behavior remain insufficiently understood. The aim of this study was to examine the proportion of participants following restrictive diets in a self-selected online sample of adults living in Romania and to analyze the associations of nutrition knowledge, beliefs regarding the relationship between diet and health, food vigilance, and social media use with the adoption of restrictive diets without medical indication. Methods: This cross-sectional observational study was conducted online in a self-selected sample of 766 adults living in Romania. Participants were classified into three groups: no restrictive diet, medically indicated restrictive diet, and restrictive diet without medical indication. Three composite scores were constructed: Restrictive Health Beliefs, Food Vigilance, and Nutrition Knowledge. Differences between groups were assessed using non-parametric tests and χ² tests, and factors associated with the adoption of restrictive diets were analyzed using multinomial logistic regression and multiple linear regression. Results: Among the participants, 30.9% reported following a restrictive diet, and 13.1% adopted one without medical indication. Participants who followed restrictive diets scored higher for Restrictive Health Beliefs and Food Vigilance but not Nutrition Knowledge. In the multivariate analysis, Restrictive Health Beliefs showed the strongest independent association with restrictive diets without medical indication. Food Vigilance was only associated with medically indicated restrictive diets (p < 0.001), suggesting an adaptive role in a therapeutic context. Nutrition knowledge and social media use were not independently associated with restrictive diets without medical indication, although social media use was associated with higher levels of Restrictive Health Beliefs. Conclusions: The results suggest that the adoption of restrictive diets without medical indication is more closely associated with beliefs regarding the relationship between diet and health than with the level of nutrition knowledge. These findings support the development of nutrition education interventions that, in addition to conveying evidence-based information, promote the development of critical thinking and the correction of insufficiently scientifically substantiated dietary beliefs. Full article

Foreign exchange rate forecasting is difficult, as its time series have complex nonlinear and nonstationary dynamics. To this end, the paper proposes a hybrid forecasting framework based on kernel regression decomposition that combines nonparametric trend extraction with linear and nonlinear forecasting models. In the framework we propose, we decompose each series of exchange rates into a long-run trend component and a short-run fluctuation component, which are modeled separately and then combined to generate forecasts. An empirical study based on five major foreign exchange markets shows that the proposed framework consistently outperforms conventional hybrid and standalone forecasting models in multiple forecasting accuracy measures. The statistical validation of the forecasting improvements is confirmed by the Diebold–Mariano test. Moreover, the decomposition offers an interpretable representation of exchange-rate dynamics by distilling persistent long-run movements from localized short-run nonlinear fluctuations. The results indicate that the proposed framework improves forecasting accuracy and offers insight into the structural behavior of foreign exchange markets. Full article

Corporate net-zero pledges have proliferated across the Middle East, yet whether capital markets distinguish credible decarbonization strategies from symbolic ones remains unexamined in energy-exporting emerging markets, a gap this study addresses. This omission matters because the six Gulf Cooperation Council (GCC) economies in our sample face acute stranded-asset exposure amid national diversification programmes such as Saudi Arabia’s Vision 2030 and the UAE’s Operation 300bn. We test whether net-zero credibility is associated with firm valuation among 167 listed firms across seven Middle Eastern countries (2020–2025, 1002 firm-year observations), constructing a five-dimension Credibility Index (pathway specificity, capex alignment, verification, policy compliance, and track record) and applying event-study, pooled panel regression, mediation, moderation, and firm/year fixed-effects analysis. The index is internally consistent (Cronbach’s α = 0.92) and its estimated valuation association is invariant to equal, alternative and leave-one-out weighting schemes. Credibility is positively associated with all four valuation multiples (p < 0.001, firm-clustered standard errors); a one-standard-deviation increase corresponds to a 0.133 increase in Tobin’s Q (95% CI [0.116, 0.149]). High-credibility announcements earn cumulative abnormal returns 5.95 percentage points above low-credibility announcements over (−5, +5) trading days (95% CI [4.79, 7.11]), a gap robust to nonparametric tests, placebo dates and strictly pre-announcement credibility scoring. The association survives firm and year fixed effects (within-firm β = 0.119 per SD, p < 0.001). No moderator—foreign ESG fund, domestic institutional or sovereign wealth fund ownership, regulatory stringency, carbon intensity or financial health—reaches significance after correction for multiple testing, so we find no evidence of investor-type or jurisdictional heterogeneity in this sample. To the authors’ knowledge, this is the first Middle East-calibrated, capex-verified credibility index and the first evidence on the pricing of transition authenticity across GCC markets and Egypt, informing regulators, boards, and ESG investors. Full article

The aim of this study was to determine the association between matrix metalloproteinase (MMP1, MMP2, and MMP3) gene variations and susceptibility to Peyronie’s disease, and to investigate their effects on disease progression. This cross-sectional case–control study included a total of 182 individuals—91 patients with Peyronie’s disease and 91 healthy controls. Peripheral venous blood samples (5 mL) were collected, and genomic DNA was isolated using standard spin-column extraction kits. The promoter regions of MMP1, MMP2, and MMP3 were amplified via polymerase chain reaction (PCR), and genotyping was performed using restriction fragment length polymorphism (RFLP) assays with specific restriction endonucleases. All genotyping procedures were conducted in a blinded fashion. Hardy–Weinberg equilibrium analysis (HWE), binary logistic regression with rigorous multiplicity adjustments (Bonferroni-adjusted p-values), and non-parametric Kruskal–Wallis/Mann–Whitney tests with Dunn–Bonferroni post hoc comparisons were utilized. The frequency of the 2G allele for MMP1 (−1607 1G/2G) was significantly higher in the patient group (0.4830) compared to the control group (0.2360; p < 0.05). Similarly, significant differences in allele frequencies were observed for MMP2 (−735 C/T) and MMP3 (−1171 5A/6A) between the cohorts (p < 0.05). HWE analysis confirmed that all investigated variations were in equilibrium in both groups (all p > 0.05). Logistic regression analysis showed that the MMP1 1G/1G genotype was associated with lower odds of Peyronie’s disease (OR: 0.250, p < 0.001), while the 1G/2G (OR: 2.032, p = 0.023) and 2G/2G (OR: 3.509, p = 0.005) genotypes were significantly associated with increased odds. Temporally, carriers of the MMP1 2G/2G genotype presented predominantly in the acute phase, exhibiting a significantly shorter median symptom duration (6.00 months, IQR: 3.00–9.00) compared to 1G/1G carriers (12.00 months, IQR: 5.25–36.00; p = 0.016, adj p = 0.048). For MMP2 (−735 C/T), the CC genotype was associated with higher odds of Peyronie’s disease (OR: 3.049, p < 0.001), while the TT genotype was associated with lower odds (OR: 0.278, p = 0.002). Furthermore, penile plaques were detected in 90% of patients with the CC genotype (p < 0.001). Patients with the CC genotype presented with a median symptom duration of 6.00 months (IQR: 3.00–12.00), whereas TT carriers exhibited a significantly longer duration (24.00 months, IQR: 4.00–48.00; p = 0.002, adj p = 0.006). Regarding MMP3 (−1171 5A/6A), the 5A/5A (OR: 3.930, p = 0.002) and 5A/6A (OR: 2.050, p = 0.022) genotypes were significantly associated with increased odds of the disease, while the 6A/6A genotype showed an inverse association (OR: 0.226, p < 0.001). Patients carrying the 5A allele presented characteristically in the acute phase, with a median symptom duration of 6.00 months (5A/5A) or 4.00 months (5A/6A), which was significantly extended to a median of 24.00 months (IQR: 7.50–54.00) in the 6A/6A genotype (p < 0.001, adj p < 0.001). The findings indicate robust statistical associations between the MMP1 2G, MMP2 C, and MMP3 5A alleles and increased susceptibility to Peyronie’s disease, as well as distinct correlations with compressed symptom durations, acute-phase characteristics, and plaque presence. Because this study relied on peripheral blood DNA genotyping without direct tissue expression quantification in a cross-sectional design, these genetic variations reflect strong exploratory associations rather than direct causal evidence. These markers highlight significant prognostic potential that warrants validation in larger, prospective, longitudinal cohorts. Full article

Background: Inflammatory bowel disease (IBD) involves chronic immune activation, yet alterations in the cortisol awakening response (CAR) remain poorly defined. We compared cortisol dynamics in patients with IBD and healthy controls and explored associations with phenotype, endoscopic activity, and inflammation. Methods: This single-centre, cross-sectional case–control study enrolled 100 patients with IBD (51 with ulcerative colitis [UC] and 49 with Crohn’s disease [CD]) and 78 frequency-matched controls. Salivary cortisol was measured at awakening (C0), 30–45 min later (C1), and bedtime (C2); 97 patients and 78 controls met timing criteria. The absolute post-awakening increment (ΔCAR) and area under the curve with respect to increase (AUCi) were calculated. Analyses included non-parametric tests, adjusted regression, mixed models, and multiplicity-corrected within-IBD comparisons and correlations. Results: Patients with IBD had lower C0 (median 0.478 vs. 1.067 µg/dL) and C1 (0.850 vs. 1.950 µg/dL; both p < 0.001), whereas C2 was comparable (p = 0.819). ΔCAR (0.130 vs. 0.461 µg/dL) and AUCi (2.080 vs. 7.770 min·µg/dL) were lower in IBD (both p < 0.001); adjusted analyses confirmed this pattern. Cortisol metrics did not differ consistently by IBD subtype or endoscopic activity. Higher high-sensitivity C-reactive protein (hs-CRP) correlated positively with C0 (ρ = 0.325; q = 0.041) and inversely with ΔCAR (ρ = −0.402; q = 0.002), AUCi (ρ = −0.408; q = 0.002), and relative CAR (ρ = −0.517; q < 0.001). Conclusions: IBD was associated with attenuated CAR and lower morning cortisol output, with preserved bedtime concentrations. These cross-sectional findings support a relationship between systemic inflammation and altered early-morning HPA-axis dynamics but do not establish causality. Full article