Search Results (18,164)

Background/Objectives: Posterior fossa tumors (PFTs) often require radiotherapy which may damage both cortical and subcortical brain tissue. We examined voxel-based and region-based gray matter volume (GMV) alterations and explored their relation to cognitive functioning. Methods: Using T1-weighted MR imaging, intelligence scores from the Wechsler Adult Intelligence Scale-IV (WAIS-IV), and domain scores for language, learning, and memory, complex attention and cognitive flexibility were investigated in 18 of 21 assessed PFT survivors and 21 matched controls. GMV was quantified with voxel-based and region-based volumetry, compared among groups (controls versus survivors, irradiated versus non-irradiated survivors), and correlated with cognitive performance. Results: Survivors showed reduced GMV in two voxel-based clusters, located in the left occipital fusiform area and the left pallidum. Region-based analyses showed lower GMV in survivors located in subcortical areas, while higher GMV was observed in the left inferior temporal region. Survivors who received craniospinal radiation exhibited reductions in GMV in bilateral thalami, right ventral diencephalon, and central corpus callosum, and higher GMV in the bilateral middle temporal regions. Compared to controls, survivors scored lower for all cognitive domains, except for complex attention and cognitive flexibility. Amongst survivors, the GMV of the bilateral thalami and right ventral diencephalon correlated positively with working memory. Conclusions: Overall, PFT survivors demonstrated both alterations in GMV and cognitive functioning, with the most pronounced GMV deviations found in those treated with craniospinal radiation. Reduced GMV was associated with poorer cognitive performance. Full article

The significant impact of greenhouse gases on global warming has drawn widespread attention. This study focuses on the development of the transportation sector and energy consumption across 30 provinces in China from 1997 to 2022, aiming to identify the key drivers of carbon emissions in China’s transportation sector and analyze their causal interactions and spatial heterogeneity. Initially, provincial carbon emissions are estimated based on reallocated energy consumption data. A random forest model is then employed to objectively screen key factors from multidimensional variables. Subsequently, the Decision-Making Trial and Evaluation Laboratory (DEMATEL) approach is utilized to reveal the interaction network among these factors, distinguish their causal attributes, and explore their inter-provincial spatial differentiation. The findings are as follows: (1) Expenditure on research and experimental development, Number of registered scientific and technological achievements, and Total energy consumption are the most crucial factors influencing emissions; (2) Total energy consumption, Green coverage rate of built-up area, and Urbanization level serve as the primary causal drivers within the system; (3) The same factor exhibits significant variations in causal attributes across different provinces, reflecting regional heterogeneity in development stages. This study provides empirical evidence and methodological support for formulating differentiated and precise traffic carbon reduction policies. Full article

Background/Objectives: Male infertility, including primary and secondary infertility, is significantly influenced by oxidative stress, which disrupts sperm function and fertility. Seminal plasma, a protein-rich fluid essential for sperm protection and function, represents a valuable source for identifying biomarkers through proteomic analysis. While previous studies have explored seminal plasma proteins in fertility, the specific proteomic changes associated with oxidative stress in secondary infertility remain unclear. This study aimed to characterize these alterations by analyzing seminal plasma from three groups: men with secondary infertility, fertile donors with high oxidative stress, and fertile donors without oxidative stress. Methods: Pooled semen samples from each group underwent quantitative proteomics analysis using advanced mass spectrometry, with subsequent bioinformatic analysis using tools like DAVID, STRING, and IPA for identifying differentially expressed proteins (DEPs). Results: Quantitative proteomic analysis identified 377 DEPs in secondary infertility and 523 DEPs in fertile donors with high oxidative stress compared to controls. Bioinformatic analysis revealed seven shared pathways, including acute-phase response signaling, organismal injury, cellular movement, cell-to-cell signaling, free radical scavenging, immune cell trafficking, and Hematological system development. Notably, C3 and SERPINA3 exhibited significant alterations, along with proteins involved in sperm motility, capacitation, and fertilization, suggesting their potential roles in impaired fertility. Conclusions: These findings underscore the link between oxidative stress and secondary infertility and highlight specific seminal plasma proteins as potential biomarkers and therapeutic targets for diagnosing and treating male infertility. Full article

The objective of the study was to propose curricular guidelines for environmental literacy from a sustainability perspective for the Universidad de la Amazonia distance and virtual programs. The research adopted a mixed-methods approach, with a critical, analytical, and interpretive methodological design structured into three phases: a document review, an exploration of teachers’ and students’ perspectives, and a proposal phase. The results revealed significant weaknesses in the curricular integration of environmental education in virtual and distance learning programs, which limit their effective contribution to achieving the Sustainable Development Goals (SDGs). Likewise, the need to strengthen students’ critical thinking, territorial commitment, and transformative action was identified as a key competency for promoting educational practices oriented toward sustainability, socio-environmental responsibility, and decision-making aligned with national environmental policies and the 2030 Agenda. Based on these findings, guidelines were proposed that articulate pedagogical, didactic, and evaluative components, with recommendations for their practical application in design, implementation, and evaluation, to consolidate contextualized environmental literacy that is relevant and consistent with the socio-environmental challenges of the Amazon region. Full article

Background and Objectives: To evaluate the occurrence of retinal displacement using blue-fundus autofluorescence (BFAF) imaging in eyes treated for primary rhegmatogenous retinal detachment (RRD) and its associations with clinical factors, including macular status, detachment extent, baseline visual acuity, high myopia, postoperative visual recovery, and metamorphopsia. Materials and Methods: This retrospective observational study included 98 patients who underwent surgery for primary RRD at a single center. Surgical approaches included pars plana vitrectomy (PPV), phacovitrectomy, or scleral buckling, with tamponade agents such as SF₆ gas (20%), silicone oil (≈1300 cSt), or air. Postoperative BFAF imaging assessed retinal displacement. Demographic and clinical data were recorded. Results: Macula-off detachments occurred in 56.1% of cases, while 43.9% were macula-on detachments. Phacovitrectomy was performed in 41.8%, simple vitrectomy in 33.7%, and scleral buckling in 24.5%. SF₆ gas was the most used tamponade, while silicone oil was used in 13.3%. Retinal displacement was detected in 16.3% of cases, predominantly downward (81.25%) and less commonly upward (18.75%). Macula-off detachments were significantly associated with displacement (81.2% vs. 51.2%, p = 0.027). No significant associations were found with other parameters. Metamorphopsia was reported in 12.5% of patients with displacement and 4.9% without, though the difference was not statistically significant. Conclusions: Retinal displacement can occur after primary RRD repair, irrespective of tamponade, though it tended to be less frequent with silicone oil and in macula-on detachments. It is significantly more common in macula-off cases, even with immediate postoperative prone positioning. These findings emphasize the need to refine postoperative positioning protocols to reduce displacement and its sequelae. Further studies should explore the impact of retinal displacement on visual function, particularly metamorphopsia, in patients with preserved best-corrected visual acuity. Full article

We present a theoretical framework integrating quantum optimization with DNA-based molecular storage for enhanced image compression, validated via classical simulation in IBM Qiskit. The proposed Quantum-DNA Image Compression (Q-DIC) framework formulates DNA codon selection as a quantum search problem, applying Grover’s algorithm to achieve $\mathrm{O}\left(\sqrt{N}\right)$ speedup in exploring the 4⁸ = 65,536-codon solution space. Key contributions include (1) novel multi-objective cost functions balancing reconstruction fidelity, thermodynamic stability, and synthesis feasibility; (2) quantum-inspired stabilizer codes achieving 10⁸-fold error suppression with 23% overhead reduction versus Reed–Solomon codes; (3) NISQ-compatible implementation achieving 12.3× compression on current quantum hardware. Simulation experiments across diverse image categories demonstrate 8.9× realistic compression ratio (18.3× theoretical maximum). Hardware validation on IBM Quantum systems achieved 10.8–11.2× compression, confirming practical viability. Critical assessment identifies implementation gaps: current hardware supports hundreds of gates versus the required amount of 60,000–800,000, and DNA synthesis costs require 1000× reduction for economic viability. Despite being simulation-based, this work establishes rigorous foundations for quantum–molecular hybrid architectures and provides a validated pathway for experimental confirmation. Full article

Background: Motor as well as attentional skills are deficient in children with attention deficit hyperactivity disorder (ADHD). The aim of the present study was to explore whether a short immersive rehabilitation therapy could improve motor and visuo-attentional capabilities in children with ADHD. Methods: Forty children with ADHD participated in this study; IQ-, sex- and age-matched children were splitted in two groups (G1 and G2) of twenty. An unpredictable random sequence was used to allocate a child to group G1 (trained group) or G2 (control group). Oculomotor and postural performance for both groups of children were objectively assessed twice (before and after 16 min) by using an eye tracker and platform. Group G1 only underwent 16 min of immersive rehabilitation therapy, while the control group (G2) had 16 min of resting. The immersive therapy consisted of performing physical movement while training visual discrimination, attention and spatial orientation skills. Results: After 16 min, significant improvements in the fixation area (p = 0.008) and in the number of catch-up saccades during pursuit eye movements (p < 0.001), as well as a smaller postural instability index (PII) (p < 0.001), were observed for the trained group (G1) only. Conclusions: These findings suggest that children with ADHD could benefit from a short immersive therapy to improve both visual–attention and motor performances. This new immersive therapy is a useful tool allowing a better integration of both visual and motor sensory inputs via the cortico/cerebellar network. Follow-up studies on a larger number of children with ADHD will be necessary to explore the eventual possible persistence of such a training effect and imaging works will help to understand where such adaptive mechanisms take place. Full article

Background: Health literacy and eHealth literacy are core competencies for nursing students, yet their distribution across training pathways remains insufficiently explored. Objective: This study aimed to examine HL and eHL levels among nursing students across different years of the educational programme and identify distinct subgroups of students. Methods: A cross-sectional study was conducted among undergraduate nursing students enrolled in all years of a single Italian university programme. Literacy profiles were assessed using validated questionnaires. A Two-Step Cluster Analysis was applied to identify homogeneous literacy profiles. Group differences were examined using appropriate statistical tests. Results: Four distinct clusters were identified, showing heterogeneous patterns of literacy profiles across the training course. Significant differences emerged in demographic and educational variables across clusters. Conclusions: The findings highlight the coexistence of diverse literacy profiles among nursing students and suggest the need for tailored educational strategies. Due to the cross-sectional design, causal inferences cannot be drawn. Full article

There is considerable interest in the connection between alcohol-induced oxidative stress, DNA methylation, antioxidants, and accelerated aging across diverse populations. Nevertheless, self-reported alcohol consumption is prone to bias, and objective biomarkers of alcohol intake are needed. Our aims were to investigate the performance of an epigenomic biomarker of alcohol consumption in a Mediterranean population using self-reported data and the biomarker gamma-glutamyl transferase (GGT); to examine the effects of alcohol (self-reported and biomarker-assessed) on epigenome-wide methylation; to analyze the association between alcohol (self-reported and biomarker-assessed) and telomere length and other aging biomarkers; and to explore the modulating effect of the Mediterranean diet (MedDiet). We performed blood epigenome-wide methylation studies (EWAS) in a Mediterranean cohort (aged 55–75 years). Self-reported alcohol consumption and MedDiet were assessed by questionnaires. A replication cohort (cohort 2) from the same area was also analyzed. For both cohorts, the DNA methylation-based biomarker (450-CpGs) was computed alongside epigenetic clocks for the following biological age acceleration metrics: DNAm telomere length, GrimAgeAcceleration, PhenoAgeAcceleration, and CausalityAgeYing (cohort 1). The association between the epigenomic biomarker and self-reported alcohol consumption was significant (p < 0.001) in both cohorts, but modest. However, the association was stronger when predicting high alcohol intake (AUC: 0.76; 95%CI: 0.65–0.86; p < 0.0001). In the EWAS, the hit (cg06690548-SLC7A11, in a cystine transporter that enhances glutathione production for antioxidant defense) was shared among the self-reported alcohol consumption, GGT, and the epigenomic biomarker, with alcohol linked to hypomethylation. We detected differential methylation in pre-selected oxidative stress-related genes. Enrichment analysis revealed “Rap1 signaling pathway” as the hit (p < 0.00001). High self-reported alcohol consumption and the epigenomic biomarker were associated with shorter telomere length (p < 0.05) in cohort 1. Additionally, a modulation by Mediterranean diet adherence was hypothesized. No significant associations were found between self-reported alcohol intake and the other aging biomarkers; however, the epigenomic score was directly associated with GrimAge, PhenoAge and CausAgeYing biomarkers in cohort 1 (p < 0.001), and two were replicated in cohort 2. In conclusion, alcohol intake has an impact on DNA methylation at the epigenome-wide level in this Mediterranean population, replicating the main hits from other populations and validating the epigenomic biomarker for intake, although improvement is needed. Moreover, several associations with aging biomarkers were observed. Full article

Background/Objectives: Galleria mellonella (G. mellonella) larvae have emerged as a valuable in vivo model for antifungal drug screening. This study aimed to determine the optimal inoculum concentrations of Candida albicans (C. albicans) in G. mellonella, as well as the appropriate fluconazole concentrations, in order to standardize a preliminary screening method for compounds with antifungal activity. Methods: Larvae were infected with four C. albicans strains, including two reference strains (ATCC^® 10231 and ATCC^® 90028) and two oral isolates (A1 and A2). Fluconazole toxicity was evaluated at doses of 20, 40, and 80 mg/kg over a 72 h period. In the treatment assays, larvae were infected via the left pro-leg and treated with fluconazole, administered as a single or two doses, one hour after infection. Larval viability was monitored over five days based on movement, cocoon formation, and melanization, and survival data were analyzed using Kaplan–Meier curves and the log-rank test. Results: Fluconazole showed no toxicity at the tested concentrations. Infection with up to 2 × 10⁷ cells/mL was non-lethal for most strains, except for A2, which exhibited 50% mortality within 48 h but it was effectively controlled with a single 20 mg/kg dose of fluconazole. Infection with 2 × 10⁸ cells/mL resulted in complete mortality within 48 h; however, a single 80 mg/kg dose significantly improved survival. Conclusions: The G. mellonella model proved to be a suitable and reproducible in vivo system for the preliminary screening of antifungal compounds. The standardized experimental conditions established in this study support its applicability for evaluating antifungal activity in early research stages. Future studies should expand this approach to different fungal species and antifungal agents, as well as explore its applicability in combination therapies. Full article

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterised by motor and non-motor symptoms. Several studies have reported varying prevalence of Carpal Tunnel Syndrome (CTS) among individuals with PD. Objective: This study aimed to estimate the pooled prevalence of CTS in people with PD and explore any potential association between the two conditions. Methods: This systematic review and meta-analysis was conducted and reported in accordance with the PRISMA 2020 guidelines. A systematic search was performed across PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (WoS), Scopus, and EMBASE from inception to April 2024. Studies reporting CTS prevalence data in individuals with PD were included. Methodological quality was assessed using the National Institutes of Health (NIH) quality assessment tool. Pooled prevalence estimates were calculated using a random-effects model. Risk difference (RD) and risk ratio (RR) were calculated to assess the association between PD and CTS compared with control groups. Results: A total of 7 studies involving 411 participants (343 with PD and 68 controls) met the inclusion criteria, with 679 wrists assessed. The pooled prevalence of CTS in PD was estimated at 15% (95% CI: 0.07–0.28) with significant heterogeneity (p < 0.001, I² = 91%). The RD was 10% (95% CI: 0.04–0.16, p = 0.002), with low heterogeneity (p = 0.29, I² = 19%). The RR of CTS in PD compared with controls was 3.31 (95% CI: 0.60–18.42, p = 0.17), with moderate heterogeneity (p = 0.13, I² = 52%). Conclusions: This meta-analysis provides preliminary pooled estimates indicating a potentially increased prevalence of carpal tunnel syndrome in individuals with PD. Although the findings suggest a possible association, clinicians should maintain increased vigilance for CTS symptoms in patients with PD presenting with upper-limb sensory or motor complaints. From a biomechanical and functional perspective, these findings highlight the importance of routine upper-limb screening and the implementation of rehabilitation strategies targeting hand use, dexterity, and sensorimotor control within physiotherapy practice. Further high-quality studies with larger, well-characterised samples are required to confirm this relationship and clarify its clinical and functional implications. Full article

Background and Objectives: Medication adherence is a key determinant of treatment effectiveness in early-stage breast cancer, particularly during long-term systemic therapies. As breast cancer is increasingly diagnosed at younger ages, a growing number of women continue to carry active parenting responsibilities during treatment. However, the associations between parenting-related psychosocial factors and medication adherence remain insufficiently explored. This study aimed to examine the associations between parenting stress, spiritual well-being, and medication adherence in women with early-stage breast cancer who maintain active parenting roles. Materials and Methods: This multicenter, cross-sectional study included 432 women with early-stage (I–III) breast cancer receiving active systemic therapy across nine oncology centers. Parenting stress was assessed using the Parenting Stress Scale (PSS), spiritual well-being using the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale (FACIT-Sp-12), and medication adherence using the 6-item Modified Morisky Adherence Scale (MMAS-6). Spearman correlation analyses and multivariable linear regression models were used to evaluate associations between variables. Mediation analysis was performed using Hayes’ PROCESS macro (Model 4) with 5000 bootstrap samples to assess statistical mediation. Results: Parenting stress was positively associated with poorer medication adherence (ρ = 0.248, p < 0.01), whereas spiritual well-being was negatively associated with non-adherence (ρ = −0.225, p < 0.01). Parenting stress showed a strong inverse association with spiritual well-being (ρ = −0.597, p < 0.01). In multivariable regression analyses, both parenting stress and spiritual well-being were independently associated with medication adherence (β = 0.180, p = 0.002 and β = −0.199, p = 0.001, respectively). Mediation analysis demonstrated a significant indirect statistical association between parenting stress and medication adherence through spiritual well-being (indirect effect = 0.0155), consistent with partial statistical mediation. Conclusions: Medication adherence among women with early-stage breast cancer and active parenting responsibilities is associated with psychosocial context in addition to clinical factors. Parenting stress is associated with poorer adherence, whereas greater spiritual well-being is associated with better adherence within a statistical mediation framework. These findings generate hypotheses for future longitudinal and interventional studies. Full article

The rapid digital transformation of higher education institutions (HEIs) has created new opportunities to promote sustainability-focused teaching, learning, and assessment. At the same time, traditional assessment methods often fail to accurately measure complex skills needed for sustainability, such as systems thinking, critical reflection, and real-world problem-solving. This study examines the integration of adaptive learning platforms with performance-based assessment (PBA) as an innovative way to support inclusive, sustainability-oriented learning in higher education. Based on principles of Education for Sustainable Development (ESD), Universal Design for Learning (UDL), and constructivist learning theory, the study investigates how adaptive learning technologies tailor instruction for diverse learners while PBAs offer genuine measures of sustainability skills. Using a mixed-methods approach, data were gathered from forty-eight undergraduate students enrolled in an inclusive education course that used an adaptive learning module and PBA tasks. Learning analytics, rubric-based performance scores, and student perception surveys were analyzed to explore effects on engagement, accessibility, and skill development. The results show that this combined method enhances student inclusion, supports differentiated learning pathways, boosts engagement in sustainability tasks, and yields more complete evidence of sustainability competencies than traditional assessments. The study provides a framework for HEIs aiming to align digital transformation initiatives with sustainability objectives. It emphasizes the potential of integrating adaptive learning and PBA to promote innovative, inclusive, and sustainability-focused assessment practices. Implications for policy, curriculum design, and future digital sustainability efforts are also discussed. Full article

Background/Objectives: Safe delivery and correct identification of newborns are critical aspects of healthcare systems globally. The accreditation of healthcare and standards regulation significantly promotes the adoption of modern technologies to address risks related to infant abduction and misidentification. The effectiveness and extent of these mandates vary across settings and countries. Therefore, this study aims to map and explore modern technologies used for safe newborn delivery and correct identification aligned with healthcare accreditation and regulatory frameworks. Methods: This review adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR) guidelines. The Problem, Intervention, Comparison, and Outcome (PICO) framework was employed to facilitate the development of the research question. This study examined studies reporting technologies such as radio frequency identification (RFID), biometric identification, and real-time monitoring across healthcare settings for infant protection through the Normalization Process Theory (NPT). Among three databases and search engines (PubMed, Google Scholar, and Web of Science). The risk of bias for each study was assessed using the AACODS Checklist, SQUIRE 2.0 Checklist, TIDieR Checklist, and JBI tools. Results: Out of 8753 records, only 27 reports were eligible to be included in this review. The most frequently reported technologies were RFID systems (11 studies, 37.9%) and biometric systems such as footprint and facial recognition (6 studies, 20.7%). Despite strong technological potential, many healthcare institutions struggled with the adoption of infant protection technologies. Accreditation systems among the high-resource settings actively mandate advanced technologies and support the integration of staff training and simulation drills. Comparably, middle- and low-income regions usually face challenges related to regulatory enforcement, infrastructure, staff readiness, and limited adoption of modern technologies. Conclusions: Accreditation and standards development are critical catalysts for the adoption of modern infant protection technology. Standards must be comprehensible, adaptable, and supported by investment in human resources and infrastructure. Future regulation must focus on strengthening enforcement, continuous quality improvement, and capacity building to achieve sustainable protection across the world. Full article

Soft grippers exhibit excellent adaptability in handling objects of various shapes. However, due to the large deformation and high compliance of their constituent materials, the integration of sensing capabilities has long been a major research challenge. Based on the swallowing-type soft gripper proposed in previous work, this study explores the gripper’s capability to perceive object information by leveraging the characteristic that the sealed cavity undergoes volume change due to compression by the object during swallowing, thereby altering the pressure of the internal fluid medium. By establishing the geometric configuration of the sealed cavity composed of elastic membranes, the volume-pressure variation sensing model during the object swallowing process was derived. The performance of this sensing method was tested, and the application of the fluid pressure sensing strategy in closed-loop control was demonstrated, including the classification of objects by shape and sorting by size. This work provides a solution for the object shape-adaptive swallowing-type soft gripper to achieve sensory grasping functionality. Full article