Search Results (4,838)

Background: Advanced glycation end products (AGEs) accumulate in tissues with age and are associated with the risk of chronic diseases. However, evidence regarding lifestyle factors related to AGE accumulation in healthy adolescents is limited. The aim of this study was to explore dietary and lifestyle factors that may attenuate tissue AGE accumulation, using skin autofluorescence (SAF) as a noninvasive proxy marker, in healthy Japanese early adolescent girls. Methods: This cross-sectional study included 315 first-year junior high school girls aged 12–13 years from a private school in Japan. SAF was measured on the volar forearm using an AGE Reader MU. Dietary intake was assessed using a validated brief diet history questionnaire (BDHQ-15y). Lifestyle factors, including weekday sleep duration, were assessed using a self-administered questionnaire. Health-related variables (including weight-loss dieting) were also collected. Associations between SAF and each factor were analyzed using generalized linear models and nonparametric tests, with multivariable adjustment for potential confounders. Results: The mean SAF was 1.06 ± 0.13 arbitrary units. No significant associations were observed between SAF and health-related characteristics, nutrient intakes, or major food-group intakes. Longer weekday sleep duration was significantly associated with lower SAF (p for trend = 0.019) and remained significant after multivariable adjustment (p for trend = 0.018). A similar association was observed for better perceived restorative sleep (p for trend = 0.033; adjusted p for trend = 0.048). Conclusions: In healthy early adolescent girls, longer weekday sleep duration and better perceived restorative sleep were associated with lower SAF, whereas dietary intake was not. Given the largely irreversible age-related accumulation of AGEs, promoting healthy sleep during adolescence may help attenuate AGE accumulation early in life and reduce long-term AGE-related disease risk. Prospective studies with more detailed dietary assessments are needed to clarify dietary influences and confirm temporality. Full article

Background: Cardiorenal syndrome (CRS) arises from interconnected cardiovascular, renal, and metabolic dysfunction driven by shared risk factors such as hypertension, diabetes, and obesity. Cardiac rehabilitation (CR) is a multidisciplinary intervention; however, its impact on CRS risks remains unclear. Methods: This retrospective cohort study analyzed electronic medical record data from 394 participants enrolled in a three-month CR program. Baseline and post-program measures included functional capacity, cardiometabolic risk factors, and psychosocial outcomes. Results: Participants (mean age 62.44 ± 12.15 years; 66.8% male) had a high burden of CRS risk factors, including hypertension (85.8%), diabetes (60.6%), and obesity (57.8%). Significant improvements were observed in functional capacity (6 min walk distance increased by 213 m, p < 0.001), muscular strength, flexibility, and psychosocial outcomes (anxiety, depression, perceived health; all p < 0.001). In contrast, changes in CRS risk factors were modest: fasting blood glucose decreased slightly (p = 0.043), while HbA1c, body fat, and cholesterol showed no significant change. Systolic blood pressure and body weight increased significantly. Cardiac rehabilitation improves functional and psychosocial outcomes but demonstrates limited short-term impact on CRS risk factors. Conclusions: These findings suggest CR may serve as an initial platform for CRS risk modification but requires integration with comprehensive cardio–renal–metabolic management strategies. Full article

Sustainable development results from the harmonious integration of economic growth, social equity, and environmental sustainability. Building on available risk analysis capacities, this study employs risk perception as a diagnostic tool to evaluate the adequacy of decision-making regarding environmental sustainability in vulnerable human settlements under a changing climate in the Dominican Republic. Using the perceived risk profile approach and a specially designed questionnaire, the research explores issues related to climate change and sustainability, targeting a population composed of decision-makers and professionals engaged in risk assessment. The findings reveal a systematic underestimation of risk across most perception variables, as well as a generally low collective risk perception. The study’s methodological framework enables the identification of proactive measures to strengthen knowledge and performance among decision-makers and stakeholders involved in advancing sustainable development in Dominican human settlements. Full article

As Gen-AI shopping chatbots become increasingly prevalent in e-commerce, limited research has examined how consumers’ appraisals of interactive cues shape trust and continued use in privacy-sensitive retail settings. Drawing on Cognitive Appraisal Theory (CAT) and the AIDUA framework, this study investigates how novelty value, anthropomorphic attribute, and social presence influence performance anticipation, effort anticipation, and perceived privacy risk and how these appraisals subsequently shape perceived trust and continued use. Data from 549 experienced users in mainland China were analyzed using partial least squares structural equation modeling (PLS-SEM). The results show that while novelty value enhances performance and effort anticipation, it does not significantly elevate perceived privacy risk. Anthropomorphic attribute positively affects performance anticipation and negatively affects perceived privacy risk, while social presence enhances performance anticipation and effort anticipation and reduces perceived privacy risk. Performance anticipation and effort anticipation positively predict perceived trust, whereas perceived privacy risk negatively predicts perceived trust; perceived trust, in turn, strongly predicts continued use. Mediation analyses further show that cognitive appraisal variables mediate the effects of primary appraisal factors on perceived trust, while perceived trust mediates the effects of cognitive appraisal variables on continued use. Serial mediation results additionally indicate that primary appraisal factors influence continued use through cognitive appraisal and trust formation. These findings deepen understanding of the cognitive and trust-building mechanisms underlying consumer interactions with Gen-AI shopping chatbots and offer practical implications for e-commerce platforms. Full article

Farmers’ land transfer-out decisions involve weighing benefits against risks. However, existing studies tend to examine the separate effects of livelihood capital or risk perception on land transfer, overlooking whether and how risk-bearing capacity mediates the relationship between livelihood capital and transfer-out decisions. Moreover, most research treats land transfer-out as a simple binary choice (transfer or not), ignoring that farmers also decide to whom to transfer—a choice that affects both risk and return. This study investigates the effects of livelihood capital and risk-bearing capacity on these decisions, drawing on 2021 China Land Economy Survey data. Logistic regression and mediation models are employed to assess both direct and indirect impacts. The results indicate that natural and financial capital represent the most binding constraints on farmers’ livelihood capital. Higher levels of livelihood capital increase the likelihood of land transfer-out, with this effect operating partly through enhanced risk-bearing capacity. When selecting a transfer object, farmers with greater livelihood capital show a preference for village collectives over other farmers, cooperatives, or enterprises—a choice reflecting a trade-off between expected returns and perceived risks. Risk-bearing capacity partially mediates the effect of livelihood capital on the choice of village collectives and other farmers, but does not play a mediating role in transfers to enterprises or cooperatives. These findings suggest that policies designed to facilitate land transfer-out should consider not only the enhancement of farmers’ livelihood capital endowments but also the strengthening of their risk-bearing capacity. China still needs to strengthen the organizational framework for rural land transfers and improve the rights protection mechanisms for such transfers. This will reduce the risks associated with land transfer-out for farmers, encourage more proactive and market-oriented decision-making, and ultimately improve land transfer efficiency. Full article

Introduction: Distress during pediatric magnetic resonance imaging (MRI) neuroimaging can compromise scan quality and negatively impact children’s experiences. This review aimed to systematically synthesize biomarkers and psychological factors associated with distress in children, adolescents, and young adults undergoing neuroimaging. Methods: This systematic review was conducted according to PRISMA and AMSTAR-2 guidelines and preregistered in OSF. A systematic search was performed in six electronic databases, including observational articles published between 2000 and 2025 that assessed distress during MRI and functional MRI (fMRI). Data extraction and risk of bias assessment (QUIPS tool) were performed independently by two reviewers. Results: Ten studies (n = 558) examining distress during neuroimaging were included in this review. Distress was assessed through subjective self- and parent-reports, objective physiological measures, and qualitative interviews. Overall, distress levels were low to moderate; most participants tolerated scans well, though younger age, male sex, parental anxiety, procedure length, and chronic illness were associated with greater discomfort. Noise, immobility, and boredom emerged as the most frequent triggers, while strategies such as distraction, age-appropriate information, and reducing waiting times were perceived as helpful. Among participants with cancer, scan-related anxiety was closely linked to fear of recurrence and perceived stress. Risk of bias across studies was moderate to high, particularly in domains of attrition and statistical reporting. Conclusions: Distress during scanning is driven by anticipatory and parental anxiety, procedure length, and chronic illness. Biomarkers (e.g., cortisol, blood pressure) showed inconsistent links with subjective distress, highlighting the need for integrated measures. Full article

Prolonged standing and repetitive lifting are routine occupational stressors that elevate plantar pressures across workers. In those with diabetes, these demands represent additional risk factors for diabetic foot pathology, highlighting the need for ergonomic interventions beyond standard safety footwear. This study evaluated the perceived ergonomic performance of the MoonWalking^® insole, a novel adaptive pneumatic system designed for real-time pressure stabilization and offloading when integrated into safety footwear. A comparative experimental protocol tested two conditions: safety footwear with the manufacturer’s original insole and the same footwear with the MoonWalking prototype. Twenty participants assessed perceived comfort using a VAS and binary ergonomic questionnaires. The results showed statistically significant improvements in perceived cushioning, foot fit, and overall comfort when using the MoonWalking insole. Participants consistently identified pressure-stabilizing and offloading functions across all plantar regions, indicating that adaptive pressure control was clearly perceptible. No pain or movement restrictions were reported. Although perceived fatigue did not reach statistical significance, a decreasing trend was observed. A slight reduction in intention to reuse the footwear occurred with the prototype, possibly due to its increased weight. These findings provide evidence that integrating an adaptive pneumatic insole into safety footwear may improve plantar pressure redistribution and user comfort. Full article

Rising production costs have increased interest in lower-cost, non-inversion crop establishment systems in Ireland, yet uptake remains relatively limited. Growers’ perceptions of relative performance of innovations compared to current practice are key determinants of adoption. We surveyed 154 Irish arable growers (77 plough-based, 59 min-till, 18 direct drill) to assess perceived performance of min-till and direct drill across multiple parameters relative to ploughing to identify potential barriers to adoption. Respondents rated impacts on Likert scales; analyses summarized response distributions and between-system differences. For example: >30% of min-till growers believed min-till winter cereal yields exceed ploughing, compared with 0% of plough and <10% of direct drill growers. Growers generally favoured their own establishment system, consistent with adoption theory. Potential barriers to non-inversion adoption included perceived lower establishment reliability, crop performance concerns (especially spring crops), and anticipated increases in weed pressure, herbicide reliance, and herbicide resistance development risk. Several perceptions diverged from the Ireland-relevant literature, revealing both knowledge gaps (notably establishment stability and winter/spring crop performance of establishment systems) and misperceptions (including establishment system on soil structure). Targeted research to address knowledge gaps, combined with focused, grower-centred knowledge exchange, is required to support evidence-based evaluation and sustainable adoption of establishment systems in Ireland. Full article

Background/Objectives: We aimed to test two different visual arrays for helping individuals accurately interpret colorectal cancer risk in Lynch syndrome. We also sought to examine factors associated with intention to share genetic test results with blood relatives. Methods: Participants were recruited through Amazon Mechanical Turk (July–August 2025). Participants completed an online REDCap survey evaluating genetic literacy/numeracy and risk perception (Tripartite Model of Risk Perception). Participants were randomized to a risk visualization—either a standard icon array or a sequential icon array intended to decrease cognitive load. Subsequently, participants were randomized to a communication choice scenario—a nondirective (choice) frame or an “enhanced choice” with a behavioral nudge based on the Theory of Planned Behavior. Results: Participants’ (n = 1041) estimation of colorectal cancer risk did not differ according to visualization type (icon array: 60.36 ± 15.86%, sequential array: 60.91 ± 15.73%, p = 0.58). Intention to share genetic testing outcomes with family members was not influenced by the behavioral nudge (p = 0.23). Neither risk estimation nor intent to communicate results to blood relatives were affected by individual perceived colorectal cancer risk, health literacy/numeracy, education, previous genetic testing, personal cancer history, or family cancer history (all p > 0.11 and p > 0.21, respectively). Conclusions: This study found that visual array type did not affect estimated cancer risk, and decision frame did not affect intention to share genetic testing results. Findings could inform the development of online approaches to expand decision support for hereditary cancer syndromes (Clinicaltrials.gov #NCT06994832). Full article

Internet advertising, while enabling unprecedented commercial reach, has become a pervasive vehicle for deceptive practices that inflict measurable harm on consumers. This study empirically investigates the structural relationships between internet advertising falsity and consumer harm by integrating analyses of the mediating role of consumer cognitive processes and the moderating role of consumer vulnerability within a unified structural framework. Survey data were collected from 600 adult consumers with online purchase experience in the Republic of Korea—an advanced digital economy characterized by exceptionally high mobile-commerce penetration, mature e-commerce infrastructure, and evolving digital consumer protection regulation—and analyzed using structural equation modeling (SEM) with AMOS 24.0, supplemented by Hayes’ PROCESS macro Model 59 for conditional process analysis. All 13 hypotheses were supported, although path magnitudes varied substantially across falsity dimensions and mediator pathways—with direct effects ranging from β = 0.156 (false scarcity) to β = 0.224 (performance exaggeration), and indirect effects dominated by the risk assessment distortion pathway. Among the four sub-dimensions of advertising falsity—factual misrepresentation, performance exaggeration, price deception, and false scarcity—performance exaggeration exerted the strongest direct effect on consumer harm. The three cognitive mediators—perceived advertising credibility, risk assessment distortion, and purchase decision pressure—all demonstrated significant partial mediation, with risk assessment distortion emerging as the most powerful indirect pathway. All four consumer vulnerability dimensions—digital literacy level, demographic vulnerability, prior victimization experience, and impulsive buying tendency—significantly moderated the falsity–harm relationship, with low-digital-literacy consumers experiencing approximately 1.7 times the adverse effect of high-literacy counterparts. Moderated mediation analysis revealed that the conditional indirect effect for the high-vulnerability group was approximately 2.3 times that of the low-vulnerability group, confirming that the cognitive harm mechanism intensifies systematically for vulnerable consumers. These findings advance consumer vulnerability theory in the digital context and offer evidence-based implications for consumer protection policy, platform governance, and digital literacy education. Full article

Debates around corporate greenwashing increase consumer skepticism toward environmental claims and heighten reputational risks in sustainability communication. Consequently, some corporations strategically limit the visibility of their environmental practices, making it more difficult for stakeholders to interpret sustainability communication. This study develops and validates a multidimensional scale to measure consumer attitudes toward greenhushing. An initial pool of 35 items was refined through evaluation by 12 experts, followed by sequential exploratory and confirmatory factor analyses using pilot (n = 94) and main study (n = 401) data. The resulting 16-item, three-dimensional scale comprising greenhushing approval, price-based trust, and greenwashing skepticism was supported by convergent and discriminant validity tests alongside internal consistency measures. Rather than directly measuring sustainability communication performance, the scale offers a stakeholder-level diagnostic indicator of how limited sustainability communication is perceived by consumers, providing a quantitative foundation for empirical research and managerial decision-making. Full article

Generation Z (Gen Z) consumers exhibit a distinctive multi-platform purchase behavior: they habitually discover products through social commerce (S-commerce) stimuli—including influencer content and livestream shopping—yet systematically migrate to e-marketplaces to complete their transactions. Despite the strategic importance of this behavioral pattern for platform operators, brand managers, and policymakers, the underlying mechanisms remain poorly understood. This study advances a Consumer Decision Journey framework comprising five stages—Social Commerce Stimuli, Discovery, Risk Evaluation, Marketplace Evaluation, and Purchase Decision—and integrates Stimulus-Organism-Response theory and the Elaboration Likelihood Model to explain how Gen Z consumers navigate cross-platform purchase decisions. Employing a sequential explanatory mixed-methods design, we conducted a large-scale survey (n = 423 Gen Z respondents) analyzed via Partial Least Squares Structural Equation Modeling, complemented by 18 in-depth qualitative interviews. Results confirm that influencer persuasion, livestream engagement, and perceived product authenticity drive product discovery; price comparison mediates, and price sensitivity moderates the discovery-to-risk pathway. Critically, perceived risk in S-commerce paradoxically accelerates cross-platform migration and elevates trust in e-marketplaces. Trust in e-marketplaces and logistics reliability each moderate the risk-to-purchase relationship. Qualitative analysis reveals that cross-platform behavior is a deliberate, internalized strategy among Gen Z—a platform arbitrage norm. These findings have substantial implications for S-commerce platform design, influencer marketing strategy, and e-marketplace positioning in emerging economies. Full article

Empowered by nanotechnology, messenger RNA (mRNA) therapeutics have shown a rapid evolution post COVID-19 from a conceptual platform to a clinically validated modality, and they diversified into oncology, cardiovascular diseases, and rare disorders. As a template for in situ protein production, it offers several advantages over traditional proteins and DNA drugs. The intrinsic stability of mRNA and its sensitivity to innate immune sensing hinder its capacity for immediate cellular entry, necessitating its need for a delivery system to obtain optimal therapeutic potential. This review explores the innovations in nanocarrier engineering, design principles for lipid nanoparticles-mRNA (LNPs) platforms, and their clinical translation across the prominent indications. It also addresses their safety, immunogenicity, and scalability while addressing the key limitations and manufacturing scalability through comparative platform analysis. Although LNPs usually dominate their delivery through encapsulation and manufacturability, their limitations, like repeat dose reactogenicity and liver tropism, require next-generation designs like SORT lipids, stimuli-responsive hybrids for extrahepatic targeting. In oncology, LNP-mRNA drives the neoantigen vaccines, and rare diseases leverage the transient enzyme replacement. While the safety profiles highlight the innate immune tuning through nucleoside mods and lipid biodegradability, chronic administration risks are still persistent. While there are novel scalability options like microfluidic mixing to support the production gaps in organ selectivity and durability, their adoption is hindered. We outline the future directions to perceive mRNA’s full potential as a broader therapeutic class. Full article

Travel companion matching presents unique challenges compared with conventional recommendation domains, as it involves real-world interpersonal interaction, perceived safety risks, and limited historical user data under cold-start conditions. Existing platforms often lack structured multi-factor matching and transparent integration of trust and safety constraints. This study makes three contributions. First, it introduces a methodology for deriving interpretable compatibility weights from user preference data under cold-start conditions. Second, it presents a four-algorithm comparative evaluation framework that identifies user-preferred matching strategies through controlled real-user testing. Third, it proposes a safety-enhanced empirical hybrid algorithm that integrates a hard trust gate (T ≥ 0.7), safety-oriented components (51.3% normalised weight), and empirically derived preference personalisation (48.7%) within a single scoring framework. A three-phase empirical methodology is adopted: Phase 1 (n = 26 survey) derives compatibility weights, revealing safety (69.2%), travel pace (76.9%), and budget (73.1%) as dominant factors; Phase 2 (n = 15) compares four algorithms, with safety-first matching receiving the highest acceptance rate (60.0%, 95% Wilson CI: 35.7–80.2%); Phase 3 (n = 13 journeys) evaluates the hybrid algorithm, achieving an 84.6% selection rate with Precision@6 = 0.333, MRR@6 = 0.554, and NDCG@6 = 0.597. These results provide preliminary evidence that trust-aware constraints can be integrated with empirically derived preference modelling to produce actionable recommendations under cold-start conditions, offering a reproducible approach for peer-to-peer travel platforms prioritising user safety. Full article

Background: Although menstrual cycle-based training has attracted increasing attention in endurance sports, research has predominantly focused on ergometric parameters. However, the subjective perspectives and lived realities of athletes remain relatively underexamined. Accordingly, this study aimed to explore performance perceptions and self-regulatory experiences of female endurance athletes within real-life training and competitive contexts. Methods: Qualitative semi-structured interviews were conducted with twelve female endurance athletes (ages 18–42) across triathlon, running, swimming, cycling, and skiing. Data were analysed inductively using descriptive thematic analysis in MaxQDA. Results: Six themes emerged related to menstrual cycle experiences: body awareness and cycle-related perceptions; the influence of expectations and self-efficacy on perceived performance; heterogeneous approaches to cycle-based training; training and recovery adjustments; the ambivalent role of digital tracking tools; and communication openness and barriers. Overall, cycle-based training was applied inconsistently and served more as a framework for interpreting physical symptoms than as a means of optimising performance. Conclusions: In this sample of endurance athletes, cycle-related effects on performance and symptom perceptions were primarily shaped by biopsychosocial factors rather than physiological considerations alone. The menstrual cycle supported self-regulation, but rigid interpretations may risk reinforcing negative expectancies. These insights extend existing work by foregrounding athlete-centred, flexible approaches over deterministic training models. Full article