Search Results (1,088)

Background: Running-related injuries are a common issue among recreational runners and may affect training continuity and long-term participation. However, injury-associated factors remain unclear due to methodological heterogeneity and reliance on self-reported data. Objective: This study aims to determine the prevalence and anatomical distribution of running-related injuries and their association with physiological characteristics and weekly running volume in recreational runners. Methods: A cross-sectional study was conducted with 98 recreational runners (57 men and 41 women). Women were aged 41.54 ± 9.14 years, weighed 59.55 ± 5.89 kg, and had a maximal oxygen uptake ($\stackrel{.}{\mathrm{V}}$O₂max) of 43.24 ± 4.86 mL·kg⁻¹·min⁻¹, whereas men were aged 40.16 ± 8.85 years, weighed 80.50 ± 12.89 kg, and had a $\stackrel{.}{\mathrm{V}}$O₂max of 47.73 ± 7.55 mL·kg⁻¹·min⁻¹. Running-related injuries during the previous 12 months were clinically confirmed. Sex, age, body composition, $\stackrel{.}{\mathrm{V}}$O₂max, resting heart rate, and weekly training volume were analyzed using independent t-tests and multivariable logistic regression. Results: Running-related injury prevalence was 43.9% (women: 56.1%; men: 35.1%), with a significant association between sex and injury occurrence (Fisher’s exact test, p = 0.043). The knee was the most frequently affected anatomical region, followed by the leg and ankle/Achilles regions. Iliotibial band syndrome was the most common diagnosis, followed by calf muscle injury, Achilles tendinopathy, plantar fasciopathy, ankle sprain, and hip labral tear. None of the demographic or physiological variables investigated, including weekly running volume, were independently associated with injury occurrence, and the model explained only a small proportion of the variability in injury occurrence. Conclusions: Running-related injuries were frequent among recreational runners, with knee-related injuries representing the most common anatomical pattern and iliotibial band syndrome being the predominant diagnosis. Although female runners presented a higher injury prevalence, the multifactorial nature of running-related injuries was reinforced, as the investigated demographic and physiological characteristics, along with weekly running volume, showed limited explanatory capacity for injury occurrence. Full article

Acanthamoeba keratitis is a severe, sight-threatening corneal infection caused by free-living amoebae widely distributed in soil, natural waters, and domestic or recreational water systems. Following entry into the corneal microenvironment, disease develops within a redox conflict in which host-derived reactive oxygen species (ROS) and reactive nitrogen species (RNS) may contribute to parasite control while simultaneously promoting inflammation and tissue injury. Acanthamoeba responds through an adaptable defense network involving superoxide dismutases, catalase, thioredoxin- and glutathione-dependent systems, peroxiredoxins, and mitochondrial mechanisms. However, most mechanistic evidence derives from in vitro trophozoite studies, whereas the contribution of individual redox pathways to mature cyst survival and persistence in the infected cornea remains poorly defined. This review critically integrates evidence on host oxidative and nitrosative responses, parasite antioxidant adaptation, bidirectional redox crosstalk, and redox-modulating therapeutic strategies. Current data support neither indiscriminate suppression nor uncontrolled amplification of reactive species. Instead, future interventions should achieve spatially, temporally, and stage-specifically controlled redox modulation that weakens parasite defenses while preserving corneal integrity and essential innate immune functions. Progress will require causal validation of redox targets, separate assessment of trophozoites and mature cysts, long-term excystation and regrowth assays, evaluation across clinical isolates and genotypes, and parallel assessment of host-cell toxicity in clinically relevant corneal models. Full article

The primary aim of this study is to identify how residents on the Hungarian and Slovak sides of the Lower Ipoly Valley perceive the most considerable material and immaterial local values and unique resources of their settlements. The research was designed to explore and compare the territorial capital of the two sides of the study area based on three major capital types: natural, social, and economic capitals. Data collection included 254 semi-structured interviews, conducted with 136 residents on the Slovak side (14 settlements) and 118 residents on the Hungarian side (12 settlements). Detailed interview summaries were analysed with qualitative content analysis using emergent coding. This resulted in an analytical framework comprising nine value dimensions. Across both sides of the border, we examined the same nine value dimensions: local workforce, local enterprises, civil organisations and cultural groups, local and community events, local gastronomy, natural values, built heritage, holders of local knowledge, and local products. Items mentioned that related to each value dimension were counted for each dimension and normalised to a 0–10 scale. The quantified values were aggregated at the settlement level (90 points being the maximum score). The average score of each dimension was also calculated for both sides of the study area. Our findings show that the Hungarian side achieved a total score of 40.4, while the Slovak side reached 36.6, both reflecting a similarly weak–moderate state of the local capitals with minimal differences. This indicates that the two sides of the study area share comparable developmental challenges but also considerable potential for improvement. The Hungarian side performed slightly better in nearly all dimensions except local gastronomy, where the Slovak side proved stronger. The Hungarian side’s relative advantages include a higher presence of local enterprises, a richer network of civil and cultural groups, and more diverse built heritage; in other dimensions, differences are marginal. One of the most pressing regional challenges is improving employment opportunities and stimulating entrepreneurial activity, which are essential for enhancing population retention. Overall, the results indicate that the settlements possess substantial—yet largely underutilised—value assets, whose conscious and consensus-based development could form a strong foundation for creative and innovative local development. Each settlement’s value matrix includes elements that define its uniqueness, enabling the identification of numerous potential development pathways, whether through nature-based educational and recreational programmes, the utilisation of culturally considerable built heritage, the revitalisation of living traditions, or the promotion of local traditional gastronomy on both sides of the study area. Full article

Urban forest parks (UFPs) are important recreational green spaces within the urban built environment, contributing to urban residents’ subjective vitality and well-being. Understanding how the motivations of visitors to urban forest parks translate into positive psychological experiences is crucial for promoting urban residents’ physical and mental health. This study concentrated on the motives for visiting UFPs in Fuzhou, China, and developed a conceptual framework of “motivation–attitude–visit frequency–experience” to explore the pathways through which two dimensions of motivation influence leisure experience. Data were obtained from the responses of 573 visitors (242 males, 331 females) by using on-site intercept sampling, and online and on-site questionnaire survey at seven UFPs across the city. Serial mediation analysis was used to test the proposed relationships. The results showed that both extrinsic and intrinsic motivation positively predicted visit attitudes (β = 0.297, p < 0.001; β = 0.309, p < 0.001); only intrinsic motivation had a significant positive impact on visit frequency (β = 0.147, p = 0.031), and both visit attitudes and visit frequency positively predicted leisure experiences (β = 0.371, p < 0.001; β = 0.402, p < 0.001). Extrinsic motivation was entirely mediated by attitude, forming an indirect path to leisure experiences, whereas intrinsic motivation influenced experiences through both direct paths and indirect paths. The findings reveal the important role of attitude in linking visitors’ motivations with urban forest park use and experiential outcomes. Decision-makers should consider visitors’ motivational orientations and psychological responses in the planning, design, and management of urban forest parks to promote more meaningful and sustainable engagement with urban nature. With complexities of cities, more attention needs to be given to the use of longitudinal studies in future research to obtain comparable findings and further generalizations. Full article

Background: The coronavirus disease 2019 (COVID-19) pandemic altered nasal fracture epidemiology, with fewer outdoor injuries and more domestic accidents. This study compared intra-pandemic and post-pandemic nasal fracture patterns and their prevention implications. Materials and Methods: This retrospective study included patients treated for nasal fractures during February 2020–January 2021 (intra-pandemic) and February 2023–January 2024 (post-pandemic). The post-pandemic cohort was identified using the same eligibility criteria, variable definitions, coding framework, and electronic-record retrieval procedure as the previously published intra-pandemic cohort. The predefined objective was a direct comparison of these two matched periods; no pre-pandemic control group was included. Results: A total of 290 patients were analyzed (184 post-pandemic and 106 intra-pandemic). In exploratory unadjusted comparisons, sports accidents occurred in 29/184 (15.8%) post-pandemic versus 7/106 (6.6%) intra-pandemic cases (p = 0.023), road traffic incidents in 31/184 (16.8%) versus 7/106 (6.6%) (p = 0.041), interpersonal violence in 60/184 (32.6%) versus 20/106 (18.9%) (p = 0.009), and alcohol-related events in 37/184 (20.1%) versus 7/106 (6.6%) (p = 0.009). Falls, virus- or flu-associated syncope, and accidents at home were more frequent intra-pandemic. Because multiple comparisons were performed, findings with p-values near 0.05 should be regarded as nominal and hypothesis-generating. The unadjusted mean hospital stay was shorter post-pandemic; however, the study period was not independently associated with length of stay after adjustment. The post-pandemic period showed a borderline, non-significant association with violence-related fractures (odds ratio 1.76, 95% confidence interval 0.99–3.12; p = 0.051). Conclusion: The observed changes are compatible with a return of social, recreational, and traffic-related trauma patterns, although the absence of a pre-pandemic control group and the exploratory nature of subgroup analyses limit causal interpretation. Differences in hospital stay appear to be more closely related to patient-level characteristics than to the study period itself. Full article

Background/Objectives: Opiates comprise naturally occurring opium alkaloids and their semisynthetic derivatives. Routine urine drug screening relies on enzyme immunoassays (EIAs) to rapidly detect opiate exposure; however, EIAs provide limited insight into opiate-associated metabolic patterns. Methods: We retrospectively analyzed liquid chromatography–quadrupole time-of-flight mass spectrometry (LC-qToF-MS) datasets from comprehensive urine drug screening of 363 patients at the University of Pittsburgh Medical Center Clinical Toxicology Laboratory. Multiple statistical analyses were applied to identify the features associated with opiate (OPIA)-EIA-positive, oxycodone (OXY)-EIA-positive, and 6-monoacetylmorphine (6MAM)-EIA-positive specimens (42, 34, and seven specimens, respectively) designated as EIA-associated discovery feature sets. The feature sets selected by ≥2 statistical analyses were defined as EIA-associated consensus feature set and further evaluated using MS-FINDER for feature annotation. Results: Among 14,883 features, 138, 121, and 104 features were assigned to the OPIA-, OXY-, and 6MAM-EIA discovery feature sets, respectively. Consensus feature sets included oxycodone/opiate metabolites, acetaminophen metabolites, and norfentanyl for OPIA-EIA; oxycodone metabolites, α-phenylalanylaspartic acid, and 4-pyridoxic acid for OXY-EIA; and norfentanyl, 6-monoacetylmorphine, and 3-hydroxycotinine artifact for 6MAM-EIA. Conclusions: These metabolomic patterns indicate a dominant exposure gradient model, in which OXY-EIA-positive specimens primarily reflect prescribed oxycodone exposure, 6-MAM-EIA-positive specimens reflect illicit heroin/fentanyl exposure with polysubstance/recreational use signature, and OPIA-EIA-positive specimens occupy an intermediate, mixed profile shaped by immunoassay cross-reactivity and real-world co-exposures. Associations involving α-phenylalanylaspartic acid and 4-pyridoxic acid are hypothesis-generating and require further validation. These findings illustrate the value of archived clinical toxicology datasets for metabolomic discovery and as a foundation for sentinel laboratory-based surveillance of evolving drug and chemical exposures. Full article

In an increasingly urbanized world, green spaces provide Cultural Ecosystem Services (CES) that support human well-being and are often perceived as the most valued benefits in cities. Yet, their perception and co-occurrence remain underrepresented in Latin American regions. In this study, we assess the diversity and bundling of CES perceived by visitors across five urban parks in the Mexican city of Xalapa, Veracruz, and examine how park identity (synthesizing park-specific ecological and structural characteristics) and sociodemographic factors influence these perceptions. Using a mixed-methods approach, we analyzed 373 surveys using general linear models. We identified 13 CES, with an average of three services per park. ‘Recreation’, ‘Mental health’, ‘Physical health’, and ‘Contact with nature’, the most frequently mentioned services, together with ‘Social relations’, consistently formed a dominant CES bundle, suggesting patterns in how cultural benefits are co-experienced. Park identity, visitor Age, and Gender were key predictors of CES perception variation, highlighting joint spatial and social influences. By integrating CES bundles with park-specific characteristics and sociodemographic drivers, this study advances current understanding of CES perception comprehensively and demonstrates that CES are not uniformly experienced across urban green spaces, underscoring the need for context-sensitive planning and management that account for both place identity and user diversity. Full article

Climate change adaptation in cities increasingly requires not only technical and spatial solutions, but also a better understanding of residents’ beliefs and expectations towards green infrastructure. This study aimed to identify the relationship between climate change knowledge and preferences for urban green infrastructure among Warsaw residents. The research was based on a CAWI survey conducted at the end of 2024 among 780 adult residents of Warsaw. Respondent segmentation was performed using hierarchical cluster analysis and k-means clustering, while differences between groups were assessed using the Kruskal–Wallis and chi-square tests. Four resident segments were identified: Climate Aware, Natural-Factor Oriented, Sceptics, and Uncertain. These groups were found to differ significantly in their climate change knowledge and beliefs, socio-demographic characteristics, motivations for using green areas, and preferences for specific green infrastructure elements. Climate-aware residents attached particular importance to multifunctional green and blue infrastructure, including large parks, trees, water elements, and proximity to natural areas. More sceptical residents tended to perceive green areas mainly through their recreational and sport-related functions. The findings indicate that climate-adaptive green infrastructure should be planned in a socially differentiated way, combining environmental, recreational, and tourism-related functions to strengthen both urban resilience and the attractiveness of Warsaw. Full article

Although recreational experience segmentation is widely used in coastal tourism research, existing motivational frameworks have been developed primarily in island and protected-area destinations, leaving urban, open-access, developing-country contexts theoretically underexplored. This study addresses that gap by identifying the dimensions of recreational experience and market segments for the city of Salinas, Ecuador—an accessible, family-oriented, urban coastal destination—to advance sustainable tourism management. Using a quantitative, cross-sectional design, data were collected through a structured questionnaire administered to 385 tourists; 374 cases with complete scale responses were retained for analysis. An exploratory factor analysis (EFA) identified seven motivational dimensions: environment and sustainable recreational resources, learning and knowledge, affective well-being and creative harmony, interest and enjoyment in the experience, aquatic natural resources and wildlife, cognitive stimulation and emotional connection, and hedonic well-being. A K-means cluster analysis, validated through the elbow method (inflection at k = 3) and silhouette coefficient (0.25), revealed three distinct tourist segments: intensive recreational tourists (n = 183; 48.9%), moderate recreational tourists (n = 136; 36.4%), and passive recreational tourists (n = 55; 14.7%). Chi-square tests confirmed significant associations between clusters and sociodemographic variables including gender, marital status, and number of visits. This study offers four theoretical contributions: it reports a more detailed motivational factor structure than previously documented three- and four-factor models for coastal destinations; it proposes recreational amotivation—grounded in self-determination theory—as a candidate visitor profile that merits further theoretical and empirical validation; it advances a destination-type-sensitive motivational framework; and it provides boundary condition evidence clarifying the contextual scope of recreational experience theory. These findings offer actionable segmentation tools for destination managers seeking to differentiate and sustain coastal tourism markets. Full article

Urban forest walkways provide accessible forest recreation opportunities within cities, but little is known about how different walkway landscape environments are associated with older adults’ perceived psychological restoration. This study examined three representative urban forest walkways in Fuzhou, China, by integrating image-based landscape classification with photo-elicitation questionnaires. A total of 1188 field photographs were collected, of which 963 valid images were used for landscape analysis. A SegNet-based semantic segmentation model was used to extract major landscape elements, and the images were subsequently classified into four landscape environment types. Questionnaire data were obtained from 415 older walkway users, generating 4980 respondent–image evaluation records. The SegNet model achieved a mean IoU of 79.4%. The high-naturalness canopy-immersive type received the highest scores for tranquillity, refuge, naturalness, landscape preference, and perceived psychological restoration, whereas the semi-open viewing-platform type showed the highest spaciousness and prospect scores. Landscape preference was positively associated with perceived psychological restoration in the mixed-effects model and partially mediated the associations between selected perceived landscape attributes and perceived psychological restoration. These findings suggest that age-friendly urban forest walkway design should maintain canopy immersion, provide semi-open viewing nodes, improve resting and interaction spaces, and refine forest-edge urban-interface sections. Full article

Urban greenery represents a crucial component of green infrastructure, influencing ecological stability, aesthetic quality, and the quality of life of urban residents. The aim of this study was to characterise the functional–spatial structure of urban greenery in the city of Nitra and to quantify the effects of selected urban, vegetation, and management factors on its aesthetic appearance and health status using an integrated statistical approach. The analysis was conducted on green spaces covering a total area of 1116.5 hectares, classified into 20 functional categories. The most dominant categories were residential greenery (31.47%), greenery at healthcare facilities (19.25%), and greenery at recreational facilities (15.72%). To identify the factors influencing greenery quality, statistical models were applied to assess the determinants of vegetation aesthetics and health status. The result demonstrated that maintenance intensity is one of the most significant determinants of greenery quality. An increase in maintenance level by one unit increased the probability of achieving a higher aesthetic rating by 112% and improved health status by 161%. The strongest positive effect on aesthetic evaluation was observed for the proportion of coniferous trees. Conifers species increased the likelihood of achieving a higher aesthetic rating by 3.7 times, while a positive effect was also observed for greater woody vegetation coverage. In contrast, the total area of green spaces did not represent a significant predictor of their quality. These findings confirm that the quality of urban greenery is determined primarily by vegetation structure and management intensity rather than by total green space area. They also highlight the need to move toward more targeted and scientifically based maintenance strategies consistent with nature-based solutions principles, integrating the ecological, aesthetic, and social functions of urban greenery. This study provides an empirical basis for more effective planning and management of urban greenery aimed at enhancing ecological functionality, aesthetic value, and climate change adaptability. Full article

Guided forest bathing is increasingly incorporated into resort wellness portfolios, yet tourism evaluations often report average programme outcomes without examining how guests differ at entry or what the findings imply for product and service design. This prospective one-group pre–post field study examined a three-day guided forest bathing programme delivered as part of the organised wellness offer of a forest-rich Northern Adriatic resort. Of 150 enrolled adults, 132 provided matched questionnaires. Six study-specific experiential and relational dimensions were assessed before and after the programme: nature connectedness, restorative perception, sensory awareness, environmental-ethical sensitivity, planetary health orientation, and intention to continue nature-based self-care. All six post-programme scores were higher after Holm adjustment. The largest standardised differences were observed for sensory awareness (mean difference = 0.91, Cohen’s dz = 1.42), restorative perception (mean difference = 0.61, Cohen’s dz = 1.17), and future nature-based self-care (mean difference = 0.59, Cohen’s dz = 1.04). Change in sensory awareness correlated with change in restorative perception (r = 0.62) and nature connectedness (r = 0.58). Previous nature contact, nature-related hobbies, and spiritual-existential orientation predicted baseline nature connectedness, whereas integrative health orientation, wellness self-care, spirituality, and expectations predicted baseline future self-care. In baseline-adjusted models, lower previous forest contact was associated with higher post-programme sensory awareness. Because the study had no control group, these differences cannot be attributed specifically to guided forest bathing rather than to the wider resort stay, time away from routine, recreation, social interaction, expectancy, or repeated measurement. Co-created restorative value is proposed only as an interpretive framework and was not measured as a construct. For tourism and hospitality management, the findings generate testable decisions concerning guest onboarding, adaptive facilitation, guide training, expectation management, and the development of low-infrastructure nature-based wellness products. Full article

Restoration of the osteochondral unit remains a major challenge in regenerative orthopaedics, largely due to the limited intrinsic healing capacity of articular cartilage and the complex, multilayered nature of the cartilage–bone interface. Osteochondral regeneration must accommodate differences in cellular composition, vascularization, metabolic demand, and mechanical properties between cartilage and bone, while simultaneously recreating a stable, functional interface. While exogenous mesenchymal stem cell (MSC) therapies have dominated the field, their clinical translation has been hindered by donor variability, phenotypic instability, logistical complexity, and inconsistent long-term outcomes. Resident stem cells from sources such as articular cartilage, bone marrow, periosteum, synovium, synovial fluid, and adipose tissue (infrapatellar fat pad) can act as potential targets for in situ osteochondral regenerative therapies. Joint-resident MSCs are adapted to the biomechanical and biochemical environment of the joint and may therefore represent a promising cell source for osteochondral regeneration; however, much of the supporting evidence remains preclinical. Effective osteochondral repair depends on the precise orchestration of stem cell recruitment, maintenance of chondrogenic phenotypes, induction of osteogenic differentiation in the subchondral compartment, and modulation of local immune responses. Patient-specific factors, including age, inflammatory status, and the severity of osteoarthritis, can significantly influence the regenerative potential of resident MSC populations and should therefore guide biomaterial design strategies. The proposed niche-by-design framework integrates stem cell biology with advanced biomaterial engineering, offering a rational roadmap for developing next-generation therapies that promote endogenous osteochondral regeneration through targeted activation of joint-resident progenitor cells. Full article

The rapid expansion of outdoor hiking activities has increased pressure on natural ecosystems, and environmentally irresponsible behaviors by hikers have become an important source of environmental degradation. However, limited attention has been paid to the mechanisms driving pro-environmental behavior among outdoor hiking participants. To overcome this limitation, an integrated framework combining TPB and PMT was established to investigate both pro-environmental intentions and subsequent environmental behaviors among outdoor hiking participants. A questionnaire survey was conducted among 1092 outdoor hiking participants in Hubei Province, China, and the data were analyzed using structural equation modeling. Empirical findings revealed that constructs from both TPB and PMT significantly influence pro-environmental intentions, with positive effects from most variables and a negative effect from response cost. Behavioral intention and self-efficacy significantly promote actual pro-environmental behavior among outdoor hiking participants. Furthermore, the integrated TPB–PMT model demonstrated greater explanatory power than either theory applied independently. These findings suggest that pro-environmental behavior among outdoor hiking participants is jointly shaped by social-psychological and protection motivation factors. The integrated framework provides a more comprehensive understanding of the mechanisms underlying environmental responsibility in outdoor recreation and offers practical implications for environmental management and sustainable outdoor hiking development. Full article

Ornamental flora is often appreciated for its aesthetic and recreational value, overlooking its ecological functions. This study provides the first comprehensive assessment of ecosystem services and disservices delivered by cultivated ornamental plants across all the islands of the circum-Sicilian archipelago. We surveyed the vascular flora characterizing each island, compiling a checklist of 402 taxa. For each taxon, we recorded biological traits, beneficial services (e.g., wildlife food, human food, habitat provision, beekeeping, erosion control, green fencing, and medicinal interest), and disservices (naturalization, toxicity to humans, pets, or livestock, and allergenicity). The island of Ustica hosts the highest number of taxa (217), followed by the island of Lipari (213), while the islands of Marettimo (95) and Alicudi (96) are the poorest. Remarkably, 329 taxa are potential sources of medicine, 326 provide wildlife habitats, 299 are of beekeeping interest, 218 are suitable for living fences, 212 contribute to erosion control, 192 supply fruits for wild birds, 130 human food, and 86 livestock forage. Spatial analysis of ornamental flora reveals that the island of Favignana has the highest proportional cover (11%) with moderate clustering, the islands of Ustica and Panarea display more dispersed, larger patches, and the islands of Lipari and Salina show strongly aggregated small patches. These results demonstrate that ornamental plants perform substantial regulatory and provisioning services, and their spatial arrangement further modulates ecological outcomes. Full article