Search Results (665)

The compelling visualization of Digital Elevation Models (DEMs) constitutes a vital intersection between Geographic Information Science (GIS) and the digital humanities. Nevertheless, traditional Generative Adversarial Networks (GANs) frequently demonstrate a “geography-blind” characteristic, resulting in structural “topographic drift” by dissociating geomorphic complexity from cartographic constraints. To overcome this limitation, we propose Geo-InkGAN, a geo-heuristic framework that integrates geographic principles with generative processes to achieve high-fidelity ink-wash style synthesis. A key component of our approach is an adaptive optimization strategy grounded in the Slope Standard Deviation (SSD). By establishing a quantitative relationship between geomorphological entropy and the cycle-consistency loss weight (${\lambda }_{cyc}$), we effectively address the Pareto trade-off between geomorphic accuracy and esthetic representation. Our results indicate that alluvial plains benefit from low-intensity constraints to facilitate fluid ink diffusion, whereas rugged terrains require high-intensity constraints to maintain the integrity of the topological framework. Additionally, the HCEG-SE mechanism (Hillshade-Contour Edge-Guided Stroke Enhancement) narrows the semantic divide between terrain skeletons and artistic textures by combining multi-directional non-photorealistic rendering with precise edge extraction techniques. Evaluated across five geomorphologically diverse regions—from karst towers to loess plateaus—Geo-InkGAN demonstrably surpasses existing benchmarks in Geomorphological Structure Correlation (GSC). This geomorphology-aware approach advances the scientific rigor of AI-driven cartography and offers a refined methodology for the cultural representation of digital twin landscapes. Full article

Background/Objectives: The current study explored the relationship between cognitive distortions and alexithymia in 214 Saudi adults aged 20 to 45. Methods: Participants completed the Cognitive Distortions Scale and the Toronto Alexithymia Scale (TAS-20). Results: Results showed a significant positive correlation between cognitive distortions and alexithymia. Hierarchical regression analyses indicated that cognitive distortions were independently associated with overall alexithymia and difficulty identifying feelings after controlling for demographics, but not with difficulty describing feelings or externally oriented thinking. Gender moderation was non-significant across all outcomes, suggesting a similar cognitive–emotional pattern for both males and females. However, cognitive distortions partially accounted for the higher alexithymia scores observed in males, though this mediation finding should be interpreted cautiously given the unequal gender subgroup sizes. Culturally, these findings reflect norms in Arab societies, where emotional restraint—particularly among men—is often reinforced by values associated with honor and traditional masculinity. Such norms may inhibit emotional expression and contribute to higher levels of alexithymia. Additionally, collectivist orientations may foster cognitive styles that intersect with maladaptive cognitive distortions. Conclusions: These results highlight the need for culturally adapted cognitive-behavioral interventions that consider local beliefs about emotions and gradually enhance emotional awareness. Future research should examine the interplay of cultural, social, and religious factors with cognitive and emotional processes over time. Full article

Background/Objectives: Routine depression screening is recommended in primary care, yet depression may remain underdetected among Filipino American patients. Provider-level factors, including culturally responsive preparation, communication challenges, workflow constraints, and attitudes toward mental health screening, may influence opportunities for early identification and referral. This exploratory cross-sectional study examined provider perspectives on barriers to depression screening and mental health discussions with Filipino American patients using the Capability, Opportunity, Motivation, and Behavior (COM-B) framework as an implementation-informed organizing lens. Methods: A cross-sectional survey was conducted among healthcare providers (N = 81) with experience caring for Filipino American patients in the United States. Survey items assessed provider confidence, perceived adequacy of mental health training, cultural and communication barriers, perceived stigma-related concerns, comfort discussing mental health, and interest in additional culturally responsive resources. Items from the adapted Attitudes Toward Assisting Filipino American Patients with Mental Health Symptoms (ATFA) scale and one item from the Mental Illness Clinicians’ Attitudes scale were conceptually mapped to the COM-B domains. Descriptive statistics, internal consistency estimates, and nonparametric tests were used to summarize findings and explore differences by provider characteristics. Results: Most providers recognized that Filipino cultural beliefs and customs may influence mental health help-seeking and symptom expression. Although many providers reported confidence identifying mental health symptoms, fewer reported adequate training to assess mental health concerns among Filipino American patients. Communication barriers, stigma-related concerns, and interest in additional culturally tailored resources were commonly reported. COM-B domain scores were not significantly associated with provider role or years of clinical experience. Providers who identified as Filipino reported greater perceived capability and opportunity related to initiating mental health discussions compared with non-Filipino providers. Conclusions: Findings suggest that provider motivation to address mental health concerns may be present, while capability- and opportunity-related barriers, including culturally responsive training, communication support, workflow integration, and referral resources, may remain important targets for future implementation efforts. Because this exploratory study used a modest convenience sample and an adapted measure that requires further psychometric validation, the findings should be interpreted with caution. Larger studies using validated instruments are needed to examine further provider-level determinants of culturally responsive depression screening among Filipino American patients. Full article

Background: Family caregivers of children with autism spectrum disorder (ASD) increasingly utilize large language models (LLMs) for health information. This study presents a systematic comparative evaluation of three widely used LLMs as localized ASD health information tools in Saudi Arabia. Methods: Twenty-four clinically validated, caregiver-oriented questions were posed to Google Gemini 1.5 Pro, OpenAI ChatGPT (GPT-4o), and DeepSeek-V3 using a standardized prompt. Three expert raters independently evaluated responses across four dimensions: scientific accuracy, PEMAT-P understandability, PEMAT-P actionability, and neurodiversity (ND)-affirming language. Readability was assessed via Flesch–Kincaid Grade Level (FKGL) and SMOG indices. Non-parametric Kruskal–Wallis tests with post hoc Mann–Whitney U comparisons and one-sample t-tests were applied. Results: Gemini achieved the highest mean accuracy (2.96/3.00), significantly outperforming DeepSeek (p = 0.003, r = −0.37). Accuracy failures across all LLMs clustered on regional epidemiological, genetic risk, and financial inquiries. ChatGPT achieved significantly higher understandability than Gemini (p < 0.001, r = 0.55), while DeepSeek achieved significantly higher actionability than Gemini (p < 0.001, r = 0.59). However, all three LLM scores fell short of the Agency for Healthcare Research and Quality (AHRQ) 80% actionability benchmark (all p < 0.001). All LLMs exceeded patient education readability benchmarks (FKGL ≤ 6, SMOG ≤ 8; all p < 0.001); ChatGPT was the most readable (FKGL = 7.86; SMOG = 9.97) and Gemini the most complex. No model differed significantly on ND-affirming language, defaulting to a mixed medical-affirming register. Conclusions: Evaluated LLMs demonstrated distinct, specialized strengths: Gemini was the most accurate, ChatGPT the most readable, and DeepSeek the most actionable. Importantly, all models failed to meet established consumer education standards for readability and actionability. LLMs require extensive plain-language adaptation and cultural customization. Clinicians must guide families on navigating LLM outputs, particularly concerning country-specific epidemiological, economic, and healthcare service queries. Full article

Background/Objectives: Adolescent pregnancy remains a global public health challenge associated with adverse outcomes for both mothers and newborns. This study aimed to use two instruments and several multivariate techniques to identify a minimal set of variables that reproduces the instrument-based classification of adolescent pregnancy risk, while remaining parsimonious with the original instruments. Methods: A cross-sectional, quantitative methodological study was conducted among Colombian schoolgirls, comprising 160 adolescents in the face-validity phase and 319 in the risk-estimation and modeling phase. The IRENE and REND instruments, originally developed to assess the risk of adolescent pregnancy, underwent cultural adaptation, face validity and content validity. Subsequently, the instruments were administered to estimate the risk. Finally, Factor Analysis and Categorical Principal Component Analysis were applied as exploratory dimensionality reduction techniques to identify the most relevant variables for retention, thereby preserving the parsimony of the original versions. Results: Overall, 80.3% of participants were classified as not at risk, while the remainder were classified as at risk by one or both instruments. The results suggest that variables such as who the adolescent lives with, the age at which the adolescent had their first complete sexual intercourse, and how the adolescent would respond to an unplanned pregnancy are factors associated with the instrument-based risk classification. Subsequently, dimensionality reduction and logistic regression analyses identified a small subset of variables that can be used to reproduce the instrument-based classification of adolescent pregnancy risk. Conclusions: The reduced set of variables reproduced the instrument-based risk classification with high internal accuracy. Because the predictors and the outcome derive from the same instruments, these findings reflect internal reproduction of the instrument classification rather than prediction of an observed pregnancy, and they require external validation. Overall, the reduced and optimized set of variables from the IRENE and REND instruments offers a parsimonious approach that reproduces the instrument-based risk classification and that may support rapid screening once validated in independent adolescent samples. The main limitations are the use of a single institution, the non-probabilistic convenience sample, and the absence of an observed pregnancy outcome. Full article

Children undergoing cancer treatment face repeated, prolonged hospitalisations carrying substantial risks of psychological distress, social isolation, and impaired development. Volunteers offering structured non-medical activities are widely employed to complement professional psychosocial care in paediatric oncology settings, yet empirical evidence examining their role specifically—as distinct from professionally delivered psychosocial interventions—remains sparse. This narrative review, conducted in accordance with SANRA criteria and drawing on a structured search of PubMed, PsycINFO, and Google Scholar (2000–2025), supplemented by a targeted verification search in July 2026, synthesises the theoretical and preliminary empirical basis for volunteer involvement, critically evaluates associated clinical risks, and proposes evidence-informed recommendations for paediatric oncology clinical practice. Three theoretical frameworks provide the conceptual grounding for volunteer activities: developmental psychological models (Piaget; Erikson), stress and coping theory (Lazarus and Folkman), and the biopsychosocial model (Engel). Indirect empirical evidence—derived predominantly from professionally delivered interventions—supports short-term benefits of structured distraction, play, and social activities on procedural anxiety, pain experience, and sense of social inclusion; the sole study examining volunteer-facilitated activities specifically in paediatric oncology reported meaningful reductions in distress and high family satisfaction. Eight categories of clinical risk are identified, including physical and psychological overload, erosion of child autonomy, suppression of authentic emotional expression, and inadequate coordination with healthcare staff. Six practice recommendations are proposed, centred on a working definition of the volunteer role, mandatory pre-access training, genuine individualisation including cultural adaptation, multidisciplinary-team-led coordination, and structured programme evaluation. Volunteer involvement can meaningfully complement professional psychosocial care when delivered within a structured, supervised, and multidisciplinary-team-coordinated framework. The paediatric oncology team occupies a pivotal role in realising the potential benefits while safeguarding children from associated risks. Prospective research employing standardised volunteer programme definitions and validated child-reported outcome measures is urgently needed to build an evidence base commensurate with the clinical importance of this practice. Full article

Background/Objectives: Colorectal cancer (CRC) disproportionately affects Romania, where mortality exceeds the EU average and screening uptake remains low. Diet is among the most modifiable CRC risk factors, yet no validated instrument for assessing nutritional knowledge, attitudes, and practices (KAP) related to CRC prevention exists for the Romanian population. We developed and pilot-tested the EduNutriCRC questionnaire and characterised the corresponding nutritional KAP profile of Romanian adults. Methods: In a cross-sectional pilot study (April–May 2026), a convenience sample of 301 Romanian adults aged 18–74 years completed the 51-item self-administered questionnaire. The instrument was evaluated for internal consistency and dimensional structure (exploratory factor analysis), with non-parametric tests used for group comparisons. Results: The composite knowledge score (C1–C9; maximum 9) was 6.12 ± 2.25 with wide item-level variation. Internal consistency was acceptable, and the Attitudes subscale resolved into two factors (Motivation & Self-Efficacy and Perceived Barriers). Screening engagement was critically low (92.4% never tested; 81.7% unaware of the national programme). Although 64.1% expressed willingness to change their diet, 46.2% reported consuming processed meat at least weekly. Motivation & Self-Efficacy, but not the knowledge score, was inversely correlated with risk-food consumption (ρ = −0.39, p < 0.001). Conclusions: EduNutriCRC demonstrated acceptable psychometric properties at the pilot stage. The study identified prevalent nutritional misconceptions, a marked knowledge–behaviour gap, low screening awareness, and a structural mismatch between information sources used and those trusted. Attitudes and self-efficacy, rather than factual knowledge, were the more proximal correlates of dietary behaviour, supporting the development of self-efficacy-focused, culturally adapted educational interventions for CRC prevention in Romania, with EduNutriCRC serving as a baseline and monitoring instrument. Full article

Background/Objectives: Preoperative anxiety is a common issue among patients undergoing third-molar surgery, significantly impacting physiological stability, surgical outcomes, and recovery, highlighting the need for effective non-pharmacological interventions. This systematic review was performed to delineate the current literature regarding non-pharmacological interventions aimed at alleviating preoperative anxiety in patients undergoing an odontectomy. Methods: A comprehensive search was performed across major databases, including Cochrane, EMBASE, MEDLINE, PubMed, Scopus, and Web of Science, for studies published between 2011 and 2026. The inclusion criteria comprised original research, reviews, and clinical trials focused on non-pharmacological approaches to alleviating anxiety in patients undergoing an odontectomy. Results: A total of 28 studies were found via an electronic search. After screening, 11 studies were eligible for systematic review. This study demonstrates that preoperative anxiety is common in odontectomies, impacting both psychological and physiological stability. Instruments such as VAS, STAI, and MDAS demonstrate elevated anxiety levels prior to surgical procedures. This anxiety induces physiological responses that affect stability. Music therapy effectively lowers anxiety, as indicated by reduced VAS scores (F = 4.226, p < 0.05) and improved emotional well-being and parasympathetic activity. Conclusions: This review highlights both subjective and objective instruments for measuring anxiety as well as non-pharmacological approaches to mitigating preoperative anxiety in patients undergoing an odontectomy. While non-pharmacological interventions show potential, there is a lack of protocols and specific evidence, highlighting the need for integrated, culturally adapted strategies and regular anxiety screening. Full article

Background/Objectives: Chronic kidney disease (CKD) requires complex Medical Nutrition Therapy, yet dietary non-adherence remains high (20–70%) due to a gap between theoretical knowledge and practical application. This scoping review aims to map the literature exploring the intersection between nutritional requirements, dietary knowledge (food literacy), and culinary skills in adults with CKD (stages 3–5 and dialysis). Methods: Following JBI methodology and PRISMA-ScR guidelines, a systematic search was conducted across PubMed, Web of Science, Scopus, and EBSCO. Studies were screened using the PCC (Population, Concept, Context) framework and mapped according to the WHO International Classification of Functioning, Disability and Health (ICF). Results: Out of 617 identified records, 49 studies from 24 countries were included. Findings reveal that while high-income regions focus on e-Health and precision technology, developing regions prioritize visual literacy and culturally adapted analog tools. Culinary skills, such as leaching and moist-heat cooking, represent practical strategies for reducing mineral bioavailability; however, the evidence directly linking these skills to clinical outcomes remains fragmented. However, culinary skills remain the least represented component in the current literature, despite being a critical facilitator for adherence. Conclusions: Current literature has not yet established a robust empirical link between food literacy and culinary skills in CKD. This review maps a precise research agenda: future large-scale, validated studies must characterise this relationship before scalable culinary medicine interventions can be designed and evaluated. Full article

The anion exchanger 1 (AE1), traditionally known for its role in erythrocyte anion transport and acid–base homeostasis, has recently been identified in non-erythroid tissues, suggesting broader physiological functions. In the present study, we investigated for the first time the expression and potential role of AE1 in human ovarian granulosa cells (GCs) obtained from women with endometriosis (ENDO-GCs) or male factor infertility controls (MF-GCs). Cells were cultured in the presence of follicular fluid derived from control (FF-MF) or endometriosis patients (FF-ENDO), and DIDS-sensitive anion exchange activity was pharmacologically inhibited using 4,4′-diisothiocyanatostilbene-2,2′-disulfonic acid (DIDS). AE1 expression was evaluated at both protein and transcript levels together with markers of proliferation, inflammation, and steroidogenesis. The results demonstrate that AE1 is constitutively expressed in GCs and may contribute to granulosa cell homeostasis. Inhibition of DIDS-sensitive anion exchange activity inhibited cell proliferation, shifted cell morphology toward a fibroblast-like phenotype, and reduced estradiol and progesterone secretion and inflammatory (IL-6) gene transcription. Notably, MF-GCs cultured in FF-MF exhibited compensatory upregulation of AE1, whereas ENDO-GCs and cells exposed to FF-ENDO showed impaired adaptive responses and generalized transcriptional suppression. These findings provide preliminary evidence supporting a role for DIDS-sensitive anion exchange activity in granulosa cell physiology and warrant further studies to clarify the specific contribution of AE1 to follicular dysfunction associated with endometriosis. However, the specific mechanistic contribution of AE1 could not be established and will require further functional and genetic investigations. Full article

Environmental damage assessment has become an important institutional component of regional sustainability transitions, especially in resource-dependent northern territories where industrial risks, fragile ecosystems, sparse monitoring networks, and limited institutional capacity intersect. Existing oil-spill valuation approaches provide well-developed legal, economic, and ecosystem-service tools; however, their use as decision-support instruments for compensation governance, prevention investment, monitoring design, and regional resilience policy remains insufficiently operationalized. This article addresses this gap by developing a modular institutional framework for selecting and combining established environmental damage valuation methods under the ecological, legal, data-related, and socio-cultural constraints of the Russian North. The study applies a transparent narrative methodological review and framework-building design based on international and Russian literature, official regulatory sources, natural-resource damage assessment practice, ecosystem-service valuation studies, and publicly available evidence on the 2020 Norilsk diesel fuel spill. The analysis organizes six established valuation approaches into three complementary modules: direct harm, indirect and opportunity-related losses, and non-market ecosystem-service losses. The Norilsk case is used as an illustrative plausibility check rather than a full empirical recalculation. It shows that legally recognized compensation can provide a liability signal, but indirect losses and ecosystem-service components require separate evidence, sensitivity analysis, and double-counting control. The contribution of the article is to adapt established valuation methods into a transparent decision-support protocol that links environmental liability, compensation governance, prevention, monitoring, institutional resilience and regional sustainability transitions in Arctic and sub-Arctic resource regions. Full article

Rusty root rot of ginseng (Panax ginseng) caused by Ilyonectria spp. infection is a devastating soil-borne disease restricting the sustainable production of garden-cultivated ginseng (GCG) in Northeast China and causes severe yield and economic losses; GCG is far more susceptible to this pathogen than forest-cultivated ginseng (Lin-Xia-Shan-Shen, LXSS). Ginsenosides, the signature triterpenoid saponin defensive metabolites of ginseng, are characteristic dammarane-type triterpenoid defensive saponins represented by Re, Rg₂, Rb₁, Rd, and Rg₁. These compounds are continuously secreted into the rhizosphere and widely participate in plant–microbe interactions, yet their functional roles in mediating Ilyonectria infection remain poorly clarified. This study aimed to clarify how rhizospheric ginsenosides regulate the infection process of pathogenic Ilyonectria strains. Two pathogenic strains, Ilyonectria sp. SYM-1 and Ilyonectria sp. SYM-2, were found isolated from diseased GCG roots and verified as causal agents via morphological observation, molecular ITS identification and artificial inoculation infection experiments. Interestingly, the concentrations of five ginsenosides, Re, Rg₂, Rb₁, Rd, and Rg₁, in the rhizospheric soil of GCG with rusty root rot were significantly higher than those in the rhizospheric soil of healthy LXSS plants. In addition, the concentrations of ginsenosides in the LXSS rhizospheric soils decreased with increasing age of plants. Non-nutritive suspension co-culture assays showed that high concentrations of the ginsenosides Rg₁ and Rd significantly promoted spore germination of the strains SYM-1 and SYM-2. However, Rb₁ had a certain inhibitory effect on the growth of Ilyonectria sp. SYM-2. Host inoculation experiments further indicated that infection with either fungus significantly reduced the concentrations of ginsenosides produced in ginseng roots. These results demonstrate that the pathogenic fungi SYM-1 and SYM-2 of Ilyonectria can adapt to and utilize ginsenosides. Collectively, these findings prove that the two pathogenic Ilyonectria strains have evolved the capacity to adapt to and exploit rhizospheric ginsenosides to facilitate their infectivity. From an application perspective, reducing rhizospheric ginsenoside release may represent a promising theoretical strategy for ginseng cultivation and germplasm improvement, which warrants further verification by field or greenhouse experiments for validation. Full article

The intensification of the urban heat island effect poses a critical threat to the preservation and habitability of compact historic districts. The Alameda de Hércules in Seville exemplifies this vulnerability, where the intersection of heritage protection and extreme Mediterranean summers limits conventional climate adaptation. This study conducts a multi-temporal evaluation of the square’s climate resilience, spanning from its configuration prior to major 21st-century renovations to its current state and future projections, proposing future interventions. By integrating advanced microclimatic simulation and high-fidelity energy modeling, the research assesses a dual-function strategy: the improvement of the thermal environment while implementing non-intrusive photovoltaic pavements (PVPs) for energy generation. Environmental parameters, including air temperature, mean radiant temperature (MRT), and the universal thermal climate index (UTCI), were analyzed alongside the renewable energy potential of the site’s mobility infrastructure. Four heritage-sensitive interventions were tested: PV-integrated bicycle lanes, shading canopies, reflective pavement, and permeable paved grass. The results demonstrate that the canopies and paved grass zones can lower surface temperature up to 3.7–4.3 °C, reduce UTCI stress up to 2.3–3.0 °C, and decline MRT up to 10.6 °C. These values correspond to the maximum reductions achieved in specific zones. However, the PVP can locally increase surface temperature by about 4.7 °C and the reflective pavements increase MRT by around 10.4 °C, while generating an estimated annual energy yield of 174.19 MWh. The analysis under future climate projections suggests that these strategies remain equally effective under future scenarios. These findings confirm that PV-integrated urban surfaces offer a viable, reversible, and replicable approach to retrofitting historic public spaces, harmonizing climate-adaptive cooling with decentralized energy production without compromising the site’s cultural significance. Full article

Registered dietitian nutritionists (RDNs) have an opportunity to play a central role in improving nutritional outcomes among Mexican American young adult college students by helping them make culturally relevant adaptations to their eating patterns. Previous research has suggested limited representation of Mexican Americans among RDNs; therefore, the cultural competence of RDNs as perceived by Mexican Americans is uncertain. The purpose of this study was to evaluate how young adult college-age Mexican Americans (defined as 18–30 years old) perceive the cultural competence of RDNs. A sample of Mexican American (n = 93) and non-Mexican American (n = 120) young adult college students completed a 19-item online survey, with researchers using a subset of 4 survey items related to perceived cultural competence of RDNs in the present study. Descriptive statistics, Fisher’s exact tests with adjusted standardized residuals, and ordinal regression models were used. Fisher’s exact tests indicated that Mexican American young adult college students, compared to non-Mexican American young adult college students, reported less agreement that RDNs were knowledgeable about a traditional Mexican diet, that RDNs would take time to know students’ food preferences, and that RDNs would take personal preferences into account during nutrition counseling (p < 0.05). These associations, however, became insignificant in adjusted regression models. Rather, results indicated that other variables, such as age and lack of prior experience with an RDN, were associated with poorer perceptions. Full article

As digital beauty filters have become widespread among young people, their links with self-image cognition and behavioral responses have attracted growing attention. However, existing studies largely focus on Western samples or linear approaches, leaving Chinese youth underexplored in their cultural context. Using mixed methods combining grounded theory and fsQCA, this study examines the mechanisms shaping self-image cognition and behavioral responses among Chinese youth in the context of digital beauty filter use. Semi-structured interviews and three-stage coding identified four core categories: Beauty Filter Use Habits, Beauty Filter Use Motivations, Beauty Filter Use Preferences, and Psychological Responses to Beauty Filter Use. Building on this, fsQCA identified five configurational pathways. The psychological-response–motivation and psychological-response–preference core coexistence configurations were linked to high Self-Image Cognition; the three non-high Self-Image Cognition pathways formed two patterns: dual absence of psychological responses and motivations, and motivational-core absence with coexisting habits and preferences. Different self-image cognition outcomes may relate to adaptive behaviors, such as moderate retouching and naturalized self-presentation, or risk-related behaviors, such as avoidance of original images and overdependence on beauty filters. This study offers a new perspective on youth authentic self-construction and technological adaptation in the digital visual era, with implications for media literacy education, platform design, and mental health intervention. Full article