Search Results (20,034)

Background: Obesity represents a major public health challenge worldwide and contributes substantially to the burden of type 2 diabetes and hypertension. While body mass index (BMI) is widely used in clinical practice, indices reflecting central adiposity may provide additional prognostic value. This study aimed to assess the prevalence of general and central obesity in an adult population across different age groups from Stara Zagora, Bulgaria, and to examine their associations with cardiometabolic outcomes and lifestyle factors. Methods: A quasi-representative cross-sectional study was conducted among 3512 adults (mean age 53.7 ± 14.9 years). Anthropometric indices, including BMI, waist circumference, waist-to-hip ratio, and waist-to-height ratio were measured. Cardiometabolic outcomes included diabetes, hypertension, and their combined presence. Multicollinearity was assessed using the Variance Inflation Factor (VIF), and the discriminatory ability of indices was evaluated using Receiver Operating Characteristic (ROC) analysis and DeLong’s test. Results: The prevalence of overweight/obesity (BMI ≥25) was 68.4%, while central obesity (WHtR ≥0.5) affected 66.9% of participants. BMI demonstrated the highest discriminatory ability in this dataset for hypertension (AUC = 0.852) and diabetes (AUC = 0.796), significantly outperforming WC and WHR (p < 0.05). However, 24.4% of individuals with normal BMI exhibited high-risk central adiposity. Significant sex-specific differences were observed: short sleep duration (<6 h) was a strong predictor of obesity in women (aOR = 2.98), whereas smoking showed stronger associations in men. Age-stratified analyses revealed that while BMI stabilizes in the oldest age group (75–89 years), WHtR continues to increase, reflecting age-related redistribution of visceral fat. A strong protective effect of physical activity was observed, supported by quasi-complete separation in active subgroups. Conclusions: General and central obesity represent a substantial health burden in this urban population. While BMI remains a robust screening tool, the integration of WHtR enhances the identification of “hidden” cardiometabolic risk particularly in older adults and individuals with normal BMI. Given the quasi-representative nature of the sample, these findings are primarily generalizable to similar urban populations and may inform targeted regional public health strategies. Full article

Marine heatwaves and invasive tunicate fouling increasingly co-occur in mussel aquaculture, yet their combined effects on rope-level performance and plankton dynamics remain unclear. A 9-day field-based mesocosm experiment in Georgetown Harbour (Prince Edward Island, Canada) examined the independent and interactive effects of heatwaves (~4.5 °C above ambient) and tunicates on 50 cm sections of Mytilus edulis culture rope. Oxygen consumption rate (OCR), clearance rate (CR), capture efficiency (CE), absorption efficiency (AE), scope for growth (SFG), and condition index (CI) were quantified to assess rope-level performance, and net primary productivity (NPP) was examined to evaluate ecosystem-level effects. OCR increased with rope biomass and exhibited a biomass-temperature interaction, with a stronger increase observed under heatwave conditions. CR also increased with biomass and decreased with temperature. These shifts in metabolism and feeding resulted in near-zero SFG and reduced CI under heatwave conditions, independent of biomass. Both grazer biomass and temperature significantly influenced NPP under high-light conditions, with increasing biomass reducing NPP. Tunicate presence enhanced the retention of smaller particles, highlighting species-specific differences in particle retention within the mussel rope community. The findings suggest that warming can reduce the performance of mussel rope communities, while fouling-associated shifts in community composition may amplify grazing pressure and alter particle removal dynamics, with potential consequences for ecosystem functioning. Full article

Background: Osteocalcin is a bone-derived protein traditionally regarded as a marker of bone formation, but experimental and clinical studies have suggested potential endocrine effects on energy and glucose metabolism. In pediatric populations, particularly in the context of obesity, the relationships between circulating osteocalcin, adiposity, and metabolic health remain inconsistent and poorly defined. Objective: To investigate associations between serum total osteocalcin and anthropometric, metabolic, biochemical, and body composition parameters in children and adolescents with obesity, with particular emphasis on adiposity and mineral metabolism. Methods: This retrospective cross-sectional study included 155 children and adolescents aged 4–18 years with obesity. Anthropometric measurements, laboratory parameters, and body composition assessed by dual-energy X-ray absorptiometry were extracted from medical records. Associations between osteocalcin z-scores and clinical variables were evaluated using linear regression models. Multivariable and extended regression models were applied to assess independent associations. Results: Osteocalcin was positively associated with markers of mineral metabolism, including serum 25-hydroxyvitamin D₃ (β = 0.19, p = 0.012), serum calcium (β = 0.19, p = 0.015), and free triiodothyronine (β = 0.32, p < 0.001) in multivariable analyses. No independent associations were observed between osteocalcin and measures of adiposity, including body mass index, visceral adipose tissue index, leptin, or markers of glucose and lipid metabolism. Conclusions: In children and adolescents with obesity, circulating osteocalcin is primarily associated with mineral metabolism rather than adiposity or metabolic health. These findings support the interpretation of total osteocalcin as a clinically accessible marker of bone turnover and mineral homeostasis rather than a robust surrogate of metabolic dysfunction in pediatric obesity. Full article

Assessing disease severity and prognosis in canine acute pancreatitis (AP) remains a major clinical challenge. This study evaluated the clinical utility of the Adapted Modified Canine Activity Index (aMCAI), a clinical scoring system refined from the original MCAI. A prospective observational study was conducted on 42 dogs diagnosed with AP, with aMCAI scores assessed on Days 1, 3, and 5. A linear mixed model (LMM) was used to analyze score progression over time and differences between survivors and non-survivors. Receiver operating characteristic (ROC) curves evaluated the prognostic accuracy for 30 day survival. The LMM analysis revealed that non-survivors had significantly higher aMCAI scores than survivors (p = 0.035), and overall scores decreased significantly over time (p < 0.001). ROC analysis showed poor discrimination on Days 1 and 3. However, on Day 5 the aMCAI demonstrated good prognostic performance (AUC = 0.813, p < 0.001). A cutoff value of ≥2.5 on Day 5 yielded 100% sensitivity, a negative likelihood ratio of 0.00 and a 100% negative predictive value, providing clinically relevant prognostic information. These findings suggest that the aMCAI is a practical tool for monitoring disease progression and may support the identification of dogs with a high likelihood of survival. Full article

Emotions play an important role in shaping aggressive behavior, and understanding their underlying psychological mechanisms is particularly relevant among college students. However, existing research has predominantly focused on reactive aggression, while comparatively less attention has been paid to proactive aggression, which is more instrumental in nature and associated with more severe social consequences. In addition, empirical evidence regarding the valence-specific effects of awe remains limited. The present study aimed to examine the differential effects of positive and negative awe on proactive aggression and to explore the role of empathy as a potential mediating mechanism. A total of 110 college students were randomly assigned to one of three conditions: positive awe, negative awe, or neutral emotion. Awe was induced through video clips depicting natural landscapes. Proactive aggression was assessed using a modified bug-killing paradigm, including two behavioral indicators: force intensity and proportion of bugs killed. Empathy was measured using the Interpersonal Reactivity Index. The results revealed a clear differentiation based on the valence of awe. Participants in the positive awe condition exhibited significantly lower levels of proactive aggression than those in the neutral condition across both force intensity (M = 2.86, SD = 0.81 vs. M = 4.17, SD = 0.81) and proportion of bugs killed (M = 0.68, SD = 0.25 vs. M = 0.93, SD = 0.11). In contrast, the inhibitory effects of negative awe were weaker and less consistent. Compared with the neutral condition, negative awe was associated with a lower proportion of bugs killed, although this effect only reached marginal significance (p = 0.06, η² = 0.04), and no significant difference was observed for force intensity. Mediation analyses indicated that empathy partially mediated the association between positive awe and proactive aggression. Empathy accounted for 31% of the total effect in the force intensity pathway (B = −0.02, t = −4.25, p < 0.001, 95% CI [−0.04, −0.01]) and 18% in the proportion-of-bugs-killed pathway (B = −0.003, t = −2.37, p = 0.02, 95% CI [−0.006, −0.001]). Notably, no significant mediating effect of empathy was observed in the negative awe condition, suggesting that the psychological processes linking awe to proactive aggression may differ as a function of emotional valence. Taken together, the present findings suggest that positive awe is reliably associated with lower levels of proactive aggression among college students, and that this association is partially explained by increased empathy. By contrast, the effects of negative awe appear to be fragile and context-dependent, as reflected in their failure to reach statistical significance, indicator-specific manifestation, and the absence of a consistent mediating pathway. These results highlight the importance of distinguishing between positive and negative awe when examining the behavioral consequences of self-transcendent emotions and underscore the need for further research to clarify the conditions under which negative awe may influence aggressive behavior. Full article

Reliable production forecasting is a critical task for evaluating asset valuation and commercial performance in oil and gas reservoirs. Conventional short-term forecasting methods, such as Arps’ decline curve analysis, rely on simple mathematical curve fitting and often oversimplify reservoir performance. On the other hand, long-term forecasting requires complex multidisciplinary models that integrate geophysics, reservoir engineering, and production engineering, but these approaches are time-consuming and have high turnaround times. To bridge the gap between long and short-term production forecasts, reduced-physics models such as Blasingame type curves have been developed, incorporating transient well behaviour derived from diffusivity equations and Darcy’s law. These models assume homogeneity and uniform reservoir properties, enabling faster results while honouring pressure performance. However, despite their efficiency, they still face limitations in reliability, particularly when extended to long-term forecasts. This paper proposes a hybrid modelling approach that integrates flowing material balance (FMB) concepts into physics-informed neural networks (PiNNs) and machine learning models to improve the accuracy and reliability of production forecasting. The proposed methodology introduces two hybrid strategies: physics-informed models enriched with FMB feature, and PiNNs. The first proposed hybrid model uses a created FMB-derived feature as input to neural networks. The second PiNN model embeds data-driven loss functions with a physics-based envelope to reflect reservoir response into the machine learning model. The primary loss function is mean squared error, ensuring minimization of data misfit between predicted and observed production rates. The study validates both proposed physically informed neural network models through performance metrics such as RMSE, MAE, MAPE, and R². Results application on field data shows that the integration of FMB into neural network models using the PiNN concept guides the neural network models to predict the production rates with higher reliability over the full span of the tested data period, which was the last year of unseen production data. Additionally, the proposed PiNN model is able to predict the well productivity index via hyper-tuning of the PiNN model. Furthermore, the PiNN is not improving the metric performance of conventional neural networks, as it has to satisfy an additional material balance equation. This is due to a lower degree of freedom in the PiNN models. Full article

Precipitation forecasting is essential for disaster prevention, water resource management, and socio-economic resilience. The field has evolved from numerical weather prediction (NWP) and optical-flow-based methods toward data-driven deep learning approaches that can exploit larger observational datasets and model complex nonlinear relationships. Against this background, this study evaluates multi-station temporal forecasting models within a single-year, station-based proof-of-concept benchmark under unified data conditions. We adapt the Transformer and Informer architectures to this meteorological setting, rigorously preprocess the AWS dataset to avoid data leakage, and select predictive variables using complementary linear and nonlinear relevance criteria. Model performance is assessed using continuous and categorical precipitation metrics, including the Critical Success Index (CSI). The results show that the Informer outperforms the recurrent neural network (RNN) baselines and achieves the lowest mean MAE and RMSE together with the highest mean CSI among the evaluated models while using substantially fewer parameters than the standard Transformer. However, its sample-wise absolute error distribution remains statistically comparable to that of the standard Transformer. Overall, this study establishes a single-year, station-based proof-of-concept benchmark for comparing architectures in very-short-term (1–5 h ahead) precipitation forecasting. Full article

This study investigated the effects of aqueous extracts of orange peel–derived biochar on seed germination and early seedling growth in durum wheat (Triticum durum Desf.) and common buckwheat (Fagopyrum esculentum Moench.). Biochar was produced by pyrolysis of orange peel at temperatures ranging from 250 to 550 °C. Germination assays were conducted under controlled laboratory conditions, and seedling growth parameters were evaluated after six days of cultivation. Untreated orange peel completely inhibited seed germination (0 %) in both species, while biochar produced at 250 °C significantly reduced germination (e.g., the germination index decreased from 54.21 % in the control to 47.2 % in T. durum). In contrast, biochar produced at 350 °C increased germination to >96 % in T. durum and 100 % in F. esculentum, accompanied by enhanced seedling vigor and biomass production. Chemical analyses revealed a pronounced decrease in total phenolic content (from 53.84 to 0.57 mg GAE g⁻¹ DW) and flavonoids (from 90.05 to 1.34 mg QE g⁻¹ DW) with increasing pyrolysis temperature, along with a reduction in antioxidant activity. Common buckwheat exhibited consistently higher tolerance to biochar extracts than durum wheat across all treatments. Overall, the results demonstrate that pyrolysis temperature is a key factor governing the transition from phytotoxic to biostimulatory effects, with optimal performance observed at approximately 350 °C. Full article

(1) Background: Hypofractionated radiotherapy and immunotherapy (IT) are possible treatment options for HNSCC patients unsuitable for standard curative treatment, yet no high-level evidence supports their combined use. We aim to report on the clinical outcome of a single-center cohort of HNSCC patients treated with a hypofractionated radiotherapy (hypoRT) regimen in combination with IT alone or chemo-immunotherapy (CT-IT). (2) Methods: We enrolled a cohort of elderly and frail HNSCC patients unsuitable for standard curative treatment, deemed candidates to undergo hypoRT in a sequential strategy (time interval < 6 months), followed or preceded by IT alone (hypoRT_IT) or CT-IT. We selected our sample using the Geriatric 8 (G8) score and the Charlson Comorbidity Index (CCI). (3) Results: At a median follow-up of 11 months (IQR 5–20), the median locoregional control (LRC) was 12 months (95% CI 7.0–17.1) with a 1-year progression-free survival rate of 63%. For the hypoRT-IT group, the median overall survival was 12 months (95% CI 0–24). No grade (G) 4–5 in-field acute side effects were observed, while one case of G3 oral mucositis and two cases of G3 radiation dermatitis were reported. (4) Conclusions: A sequential combination of checkpoint inhibitors and hypoRT may provide clinical benefit with acceptable toxicity in frail and elderly patients with advanced HNSCC unfit for standard therapy. Full article

The Technology Acceptance Model (TAM) has been widely used to explain e-banking and digital technology adoption. Existing literature supports the robustness of its core relationships, but the magnitude of the effects varies considerably across studies, raising questions about their stability and generalizability in new contexts. Existing meta-analysis studies focus primarily on pooled effect sizes, providing limited insight into the temporal stability of relationships, their sensitivity to individual studies, and the extent to which observed heterogeneity reflects contextual variation. This study contributes by reinterpreting heterogeneity not as a problem to be reduced, but as a feature that defines the limits of generalizability. We advance the TAM literature by moving beyond average effects and rethinking empirical evidence through the joint lens of robustness, stability, and dispersion. We conduct a random-effects meta-analysis on 44 effect sizes (correlation coefficients) coming from 43 research papers indexed in Web of Science and Scopus. In addition to pooled correlations, the analysis employed cumulative meta-analysis, leave-one-out influence diagnostics, prediction intervals, and publication bias assessments to evaluate the evolution, consistency, and variability of TAM relationships across contexts. The findings show that core TAM relationships are consistently positive and stable at the aggregate level yet display substantial variation across empirical settings. While some relationships remain robust across contexts, others exhibit prediction intervals that include zero, indicating that their strength and even direction may depend on contextual conditions. As prior TAM meta-analyses have not systematically incorporated prediction intervals, this study provides new evidence to the extent to which TAM relationships generalize beyond average effects. The results further show that although TAM offers a reliable structural framework, interventions and policies based on its core relationships must be context-sensitive, because relying on average effects alone may lead to ineffective or inconsistent adoption outcomes. Full article

Background: Food bank users experience food insecurity, a social determinant of health linked to poorer physical and mental health. However, evidence on the health-related quality of life (HRQoL) of food bank users in Spain is scarce. Objectives: This study sought to assess HRQoL among users of the Navarra Food Bank and identify associated sociodemographic factors. Methods: We performed a cross-sectional study of heads of household using the Navarra Food Bank. A simple random sample of 350 participants was selected from a population of 2749 families. HRQoL was assessed by telephone using the EQ-5D-5L. We described the prevalence of problems in the five EQ-5D-5L dimensions, calculated the EQ-5D-5L utility index using the Spanish value set, and analyzed EuroQol Visual Analogue Scale (EQ-VAS) scores. Associations with sociodemographic characteristics were examined using multivariable general linear models. Results: Mean EQ-VAS was 73.56 (95% CI: 71.62–75.50), and mean EQ-5D-5L utility index was 0.815 (95% CI: 0.800–0.831). The most frequently reported problems were anxiety/depression (62.9%) and pain/discomfort (55.7%), while mobility (25.5%), usual activities (19.7%), and self-care (8.7%) were less commonly affected. Older age was significantly associated with both EQ-VAS and EQ-5D-5L utility index. Employment status and nationality were significantly associated with EQ-VAS, whereas sex was significantly associated with the EQ-5D-5L utility index. Conclusions: HRQoL was impaired among users of the Navarra Food Bank, with the greatest burden observed in the anxiety/depression and pain/discomfort dimensions. Older age and selected sociodemographic characteristics were associated with poorer HRQoL. Given the cross-sectional design, the findings should be interpreted as associative rather than causal. Full article

Economic entropy, as an emerging concept in econophysics, has gained increasing relevance in the analysis of complex systems characterized by uncertainty, nonlinearity, and out-of-equilibrium dynamics. However, its integration into conventional economic modeling—particularly in production functions such as the Cobb–Douglas function—remains fragmented and lacks systematic empirical validation. This study conducts a scientometric analysis of 345 Scopus-indexed documents (1973–2024) addressing the intersection between entropy, econophysics, and production functions, with the aim of mapping the intellectual structure of the field, characterizing its growth trends, identifying its core contributions, and highlighting its main research gaps. The results reveal that the field has experienced sustained growth since 2004, with a notable acceleration between 2020 and 2023, although it exhibits a fragmented authorship structure that does not conform to Lotka’s Law, suggesting that the field is still in a stage of scientific consolidation. The Cobb–Douglas function emerges as a niche topic within the econophysics literature, with limited integration between entropy-based approaches—informational, thermodynamic, and maximum entropy—and the empirical modeling of production. Furthermore, weak citation linkages between econophysics and conventional economics are observed, confirming the interdisciplinary fragmentation of the field. These findings provide a structured reference for researchers interested in advancing toward analytical frameworks that explicitly incorporate uncertainty, information, and physical constraints into economic analysis, thereby contributing to the development of econophysics as an integrative discipline. Full article

Background/Objective: Postoperative recovery after spine surgery varies substantially and cannot be fully explained by structural pathology alone. This study evaluates postoperative outcomes using a structured 2 × 2 Surgical Trauma Gradient integrating exposure-related invasiveness (minimally invasive vs. open) and biomechanical strategy (decompression vs. fusion), and examines the modifying role of Type-D personality. Methods: This observational cohort study included 200 patients undergoing elective spine surgery. Patients were stratified into four surgical subgroups: minimally invasive decompression, open decompression, minimally invasive fusion, and open fusion. Primary outcomes included pain intensity (Visual Analog Scale), functional disability (Oswestry Disability Index), patient satisfaction (Patient Satisfaction Index), and postoperative complications at 12-month follow-up. Surgical invasiveness was modeled both categorically and as an ordinal gradient. Multivariable regression, logistic regression, interaction analysis, and longitudinal mixed-effects models were applied. Results: Postoperative outcomes demonstrated a consistent gradient across increasing surgical burden. In multivariable models, higher surgical invasiveness independently predicted greater residual pain (β = 0.69; 95% CI 0.55–0.82; p < 0.001) and higher functional disability (β = 6.20; 95% CI 5.10–7.30; p < 0.001). Increasing invasiveness was also associated with lower patient satisfaction (β = −0.38; 95% CI −0.47 to −0.29; p < 0.001) and higher complication risk (OR = 1.64; 95% CI 1.12–2.41; p = 0.01). Type-D personality independently predicted worse postoperative pain (β = 0.41; p = 0.008) and significantly modified the association between surgical burden and pain (interaction β = 0.22; p = 0.012). Conclusions: Postoperative outcomes follow a structured Surgical Trauma Gradient influenced by both surgical burden and psychosocial vulnerability, particularly Type-D personality. Integrating these dimensions may improve perioperative risk stratification and support individualized treatment strategies. Full article

Background: Arterial stiffness (AS) is a key marker of vascular aging and an independent predictor of cardiovascular risk. Although diet has been proposed as an important modifiable factor influencing vascular health, the independent associations between specific macronutrients and minerals and the progression of arterial stiffness remain insufficiently characterized. Objective: The aim of this longitudinal study was to evaluate the independent associations of baseline dietary macronutrient and mineral intake with the 5-year progression of arterial stiffness (assessed via carotid–femoral pulse wave velocity (cfPWV) and cardio-ankle vascular index (CAVI) in adults without prior cardiovascular disease. Methods: This longitudinal study included 466 participants from the EVA study who were evaluated at baseline and after a five-year follow-up (mean age 55.96 ± 14.15 years; 51.1% women). Arterial stiffness was assessed using cfPWV and CAVI. Dietary intake of macronutrients and minerals was estimated using the EVIDENT smartphone application. Multivariable linear regression models were used to examine the association between nutrient intake and arterial stiffness progression. Model 1 was adjusted for age and sex, and Model 2 was additionally adjusted for lifestyle variables and cardiovascular risk factors. Dietary intake was exclusively documented at baseline using a 3-day dietary record, while arterial stiffness parameters (cfPWV and CAVI) were assessed both at baseline and at the five-year follow-up. Results: Higher dietary fiber intake was independently associated with a lower increment in cfPWV after full adjustment (β = −0.025; 95% CI (confidence interval): −0.046 to −0.005). Alcohol intake showed a positive association with CAVI increment in the fully adjusted model (β = 0.020; 95% CI: 0.006 to 0.034). Iron intake was also independently associated with increased CAVI (β = 0.022; 95% CI: 0.004 to 0.041). Carbohydrate intake showed a small positive association with CAVI, whereas no consistent independent associations were observed for other macronutrients or minerals. Conclusions: In this adult population without previous cardiovascular disease, higher dietary fiber intake was associated with lower progression of central arterial stiffness, whereas alcohol and iron intake showed positive associations with peripheral arterial stiffness. Overall, most nutrients were not independently related to arterial stiffness after comprehensive adjustment. These findings suggest that selected dietary components may contribute modestly to vascular aging. Full article

Background: Body mass index (BMI) is widely used as a simple anthropometric indicator, but its functional relevance to physical fitness in physically active populations, such as Physical Education students, remains debated. Aim: This study examined the association between BMI and selected components of physical fitness in Physical Education students, considering sex and country differences. Methods: A cross-sectional study was conducted among undergraduate Physical Education students from Poland and Romania (n = 515; mean age: 21.64 ± 1.34 years). BMI was calculated from measured height and body mass and analyzed as both a continuous and categorical variable. Physical fitness was assessed using three Eurofit tests evaluating upper-limb movement speed, trunk muscular endurance, and lower-limb explosive power. Analyses included correlation methods and multiple linear regression models with subgroup analyses, interaction terms, and quadratic BMI terms to assess nonlinearity. Results: Associations between BMI and fitness components were small in magnitude and inconsistent (r = −0.28 to 0.143; β = −1.614 to 0.005) and varied across tests and subgroups. No significant interaction effects by sex or country were observed, as interaction terms were not statistically significant, and no clear nonlinear relationships were identified. Sex and country were significantly associated with performance levels, whereas BMI contributed only marginally to explaining variability (ΔR² = 0.005–0.011). Conclusions: BMI showed limited and inconsistent associations with the assessed fitness components in this relatively homogeneous group of Physical Education students. It should be interpreted cautiously as a functional indicator and complemented with more precise measures of body composition and physical fitness. Full article