Search Results (180)

The increasing use of digital technologies (DT) among university students has raised concerns about their associations with mental health (MH) and academic performance. Grounded in the Diversity in Learning (DinL) framework, this cross-sectional study examines how age and sex moderate the relationships between DT use, MH indicators, learning-related psychological difficulties, and academic outcomes. Data were collected through an online questionnaire administered to 4519 university students in Chile. The survey included self-reported measures of MH indicators and learning-related psychological difficulties (bad mood/irritability, anxiety, lack of motivation, attentional difficulties, and low achievement expectations), as well as academic performance and frequency of use of digital tools (social media, smartphones, gamification and collaboration applications, and asynchronous classes). Descriptive analyses, ANOVAs, and multiple regression models were employed. Results showed that younger students reported more frequent use of gamification apps, social media, and smartphones, as well as higher levels across all mental health issues and learning-related psychological difficulties. Social media use and particularly smartphone use emerged among the DT variables as the strongest predictors of MH problems and learning difficulties, with age significantly moderating these relationships. These predictors were significant for both young female and male students, although stronger associations were observed among females. Female students reported higher levels of MH problems (especially anxiety), as well as greater use of social media and smartphones. However, neither social media use nor smartphone use showed a consistent negative relationship with academic performance. Overall, these findings highlight the importance of considering age and sex differences when examining the links between digital engagement and student well-being. They also underscore the need for targeted interventions to promote healthier digital habits and emotional regulation strategies, particularly among higher-risk groups. Full article

Introduction: Influenza has a major impact on public health. The best way to prevent it is through vaccination. In Catalonia, influenza vaccination has been recommended for children aged 6 to 59 months since the 2023–24 season. Objective: To assess the association between the implementation of this vaccination program and changes in influenza diagnoses in primary care and influenza-related hospitalizations in all age groups. Materials and Methods: Quasi-experimental study with interrupted time series (ITS) analysis. All influenza diagnoses made in primary care (PC) and all influenza-related hospitalizations in the Central Catalonia health region between October 2018 and August 2025 were included. The monthly aggregated cases were analyzed using segmented negative binomial regression models that accounted for temporal trends, the onset of COVID-19, and the introduction of systematic pediatric influenza vaccination. Results: A total of 6804 influenza diagnoses made in PC and 3252 hospitalizations for influenza were analyzed. A statistically significant decrease was observed in the percentage of influenza diagnoses in PC in the 2–4 (13.5% vs. 10.6%) and 5–14 (26.1% vs. 16.3%) age groups. In the ITS analysis conducted in primary care (PC) settings, the vaccination period was significantly associated with a 13% reduction in expected influenza cases among individuals aged 15–64 years (RR 0.87 [0.78; 0.99]). After sensitivity analysis, these results were no longer statistically significant. The ITS analysis in the hospital setting has not shown a significant reduction in expected influenza cases or in expected admissions. Conclusions: Systematic influenza vaccination in children aged 6 to 59 months has not been shown to be associated with a reduction in influenza cases in primary care or hospitals settings during the early stages of implementation of the new vaccination program. Full article

Background/Objectives: Metabolic alterations, including dyslipidemia, may influence tumor biology and treatment outcomes in neuroendocrine tumors. However, the clinical relevance of dyslipidemia and lipid-lowering therapy in bronchopulmonary neuroendocrine tumors (BP-NETs) treated with somatostatin analogues (SSAs) remains poorly defined. This translational proof-of-concept study evaluated progression-free survival (PFS) in patients with advanced BP-NETs receiving SSAs according to dyslipidemia and statin therapy and explored the effects of statin-SSA combination treatment in vitro. Methods: We retrospectively analyzed 24 patients with advanced well-differentiated BP-NETs treated with SSAs as first-line therapy. Fourteen patients (58.3%) had dyslipidemia, and 11 of them were receiving statins. In parallel, NCI-H727 cells were treated with atorvastatin (10 µM), lanreotide (5 or 10 µM), or their combination for 48–72 h. Cell viability, proliferation, cell death, apoptosis, DNA damage, and ATP production were assessed. Results: Median PFS was 22.5 months overall. A trend toward longer PFS was observed in non-dyslipidemic vs. dyslipidemic patients (70 vs. 36 months, p = 0.08). Among dyslipidemic patients, statin therapy was associated with a non-significant trend toward longer PFS compared with no statin therapy (36 vs. 18 months, p = 0.30). In vitro, combined atorvastatin–lanreotide treatment reduced cell viability and proliferation, increased cell death, enhanced cleaved caspase-3 and p-γH2AX expression, and reduced ATP production. Conclusions: These findings support the potential relevance of lipid metabolism modulation as an adjunct strategy in advanced BP-NETs while highlighting the need for larger prospective studies and dedicated biochemical investigation of the underlying lipid-related pathways. Full article

Background: Sickle cell disease (SCD) is a hereditary disorder affecting red blood cells’ shape and functional capacity. Individuals with SCD report relatively high co-occurrence of neurodevelopmental disorders (NDDs). In addition, these children also have higher rates of enuresis (incontinence) and pica, disorders prevalent in children with developmental delays. Both enuresis and pica can have negative effects on mental health, but their pathophysiology, especially in SCD, remains unclear. Objectives: The objective of this study was to determine the rates of pica and enuresis in a pediatric SCD clinic to compare the co-occurrence of NDDs and enuresis/pica. Methods: To do so, we performed a cross-sectional explanatory retrospective chart review of 275 pediatric SCD patients. Results: Our SCD cohort had a 27% prevalence of enuresis, 9% prevalence of pica, and 24% prevalence of one or more NDDs. We noted significant inter-group overlap between pica/enuresis and other risk SCD severity factors. NDDs were approximately twice as frequent in SCD patients with pica or enuresis compared to those without. While pica was associated with HbSβ⁺, it was not linked to disease severity indicators. Enuresis was associated with hydroxyurea usage (66.7% vs. 42.6%, p = 0.001) and reticulocyte counts, indicative of higher disease severity. Conclusions: Clinically, these results are the first to show co-occurrence between pica, enuresis, and NDDs in SCD. We suggest that the occurrence of pica or enuresis may serve as an indicator for previously unknown NDD risk. Together, these results underscore the need for targeted screenings of pica and enuresis in SCD populations. Full article

Non-albicans Candida (NAC) species have emerged as significant opportunistic pathogens due to their reduced susceptibility to antifungal agents combined with their strong ability to form biofilms. The severity of systemic candidiasis caused by NAC species highlights the need for novel antifungal strategies. Retinoids, a group of compounds derived from vitamin A, have been demonstrated to possess significant antifungal activity against the reference strain C. albicans ATCC 2091. This study aimed to assess the antifungal potential of three retinoids, all-trans retinoic acid (ATRA), trifarotene, and tazarotene, against NAC clinical isolates. Various concentrations of the retinoids (from 1 mM to 0.06 mM) were tested in vitro against the growth, adhesion, and biofilm development of NAC species, including Candida glabrata, Candida krusei, and Candida tropicalis, as well as a reference strain of C. auris (CDC B11903). At 1 mM, all three compounds maximally inhibited the growth, adhesion, and biofilm formation of all tested NAC species. At lower concentrations (0.5–0.06 mM), C. krusei remained the most susceptible, especially to tazarotene. Tazarotene also showed a strong inhibitory effect on C. auris and C. glabrata at 0.5–0.25 mM; however, this effect was weaker than that observed against C. krusei. At low concentrations (0.12–0.06 mM), only trifarotene induced a mild but statistically significant inhibition of C. tropicalis growth. Trifarotene at 0.5 mM was also the most effective retinoid in inhibiting C. glabrata and C. tropicalis adherence and biofilm formation, with inhibitory activity maintained even at sub-0.5 mM concentrations (0.25–0.12 mM). Overall, the results suggest that all three retinoids exhibited dose-dependent and species-specific antifungal activity against NAC species, supporting their potential as novel, tailored antifungal agents against drug-resistant Candida strains. Full article

The effectiveness of poly(isosorbide carbonate) (PIC)—a bio-based polycarbonate synthesized from isosorbide (ISB)—degradation products in complex soil environments remains unverified. In the present study, the agricultural potential of PIC ammonolysis products—comprising urea and ISB—as a nitrogen (N) fertilizer was evaluated in a soil system. A pot experiment was conducted using komatsuna (Brassica rapa var. perviridis) to compare PIC degradation products with commercial urea, a urea and ISB mixture, and a no-N control. Application of PIC degradation products significantly enhanced plant growth, yielding fresh weight and N uptake comparable to those associated with commercial urea. The calculated N recovery efficiency for the PIC degradation products was 50%, falling within the typical range (30–60%) for inorganic fertilizers. Contrary to previous in vitro study results, ISB exhibited no significant biostimulant effect in the soil environment, likely owing to rapid microbial degradation. These findings serve as a preliminary proof-of-concept that PIC degradation products are a highly effective and bioavailable N source. Overall, the results suggest that if scaled appropriately, PIC ammonolysis products could contribute to circular use pathways for this specific plastic. Nonetheless, further studies across a broader range of crops and soils are required to confirm the generalizability of these results. Full article

Dromedary camels possess unique anatomical, physiological, and metabolic adaptations that enable survival in arid environments; however, these same adaptations make them highly sensitive to nutritional imbalance under modern feeding conditions. This review synthesizes current knowledge on nutritional pathologies and metabolic disorders in camels, emphasizing the links between diet composition, foregut fermentation, mineral status, and systemic health. Imbalances in energy and carbohydrates predispose camels to subacute and acute acidosis, negative energy balance, and ketosis-like syndromes, particularly when rapidly fermentable feeds are introduced without adequate fiber or water. Protein and nitrogen disorders, including ammonia toxicity and impaired urea recycling, arise from mismatches between degradable protein, fermentable energy, hydration, and mineral availability. Widespread deficiencies of phosphorus, copper, cobalt, zinc, selenium, and vitamins A and E remain major constraints, leading to pica, poor microbial fermentation, oxidative stress, immunosuppression, reproductive failure, and skeletal disorders. Nutritional disturbances frequently extend beyond the gastrointestinal tract, forming a gut–liver–kidney metabolic axis characterized by hepatic dysfunction, renal compromise, and systemic oxidative stress. The review also addresses gastrointestinal impaction, foreign-body ingestion, toxic plant consumption, and feeding on human food waste as emerging nutritional challenges, particularly in peri-urban systems. Advances in diagnostic ultrasonography, feed evaluation techniques, probiotics, mineral–vitamin supplementation, and omics-based approaches are discussed as tools for improving early diagnosis and precision nutrition. Despite growing research interest, the lack of camel-specific feeding standards and reliance on cattle-based recommendations remain critical gaps. This review highlights the need for species-specific nutrient requirement models, sustainable rangeland management, and integrative research to support the health, resilience, and productivity of camels under changing environmental and production systems. Full article

Global warming and international trade are accelerating biological invasions, making the Mediterranean basin a hotspot for alien arthropods. Two invasive species, the drosophilid Zaprionus tuberculatus and the wax scale Ceroplastes ceriferus, were recently detected in central-southern Italy. Surveys conducted between 2023 and 2024 detected Z. tuberculatus across several sites in Campania and Lazio, and C. ceriferus in Campania. Zaprionus tuberculatus was reared from ten host plants, including three new records, and reached its highest abundance on persimmon. Laboratory assays showed that Z. tuberculatus adults reproduced only on intact fig fruits and blueberry, indicating a limited risk for most crops. Ceroplastes ceriferus was found on four hosts, confirming its polyphagy and establishment in southern Italy. Molecular analyses revealed two COI haplotypes in the Italian populations of both species, while three haplotypes were detected globally in Z. tuberculatus and seven in C. ceriferus. Sequence divergences were moderate, indicating limited but appreciable mitochondrial differentiation among geographic populations. In Z. tuberculatus, the COII haplotype detected in Italy did not match available African sequences, underscoring gaps in reference data and complicating the reconstruction of invasion routes. Despite contrasting ecological traits and dispersal strategies, both species achieved successful establishment in Italy, showing that ecological plasticity and human-mediated transport can offset reduced genetic diversity. These records expand the known European range of both species and highlight the need for coordinated surveillance, genetic monitoring, and preventive measures to limit further introductions in the Mediterranean region. Full article

Background/Objectives: Children with developmental disabilities (DD) may experience feeding problems that increase their risk of malnourishment. However, data concerning factors linked to feeding problems in children with DD are lacking. The present study aimed to investigate feeding problems and their associated factors in children with DD who are fed orally. This cross-sectional study included data from 160 children with DD aged 2–18 years, recruited from 9 disability centers and schools located in Madinah, Saudi Arabia. Methods: A total of 666 envelopes were distributed randomly to children to take home. Caregivers were asked to provide sociodemographic, health, and nutrition information. Feeding problems were assessed using a validated screening tool for eating/feeding problems (STEP-AR), which included 17 items divided into 5 subdomains (Aspiration risk, Food refusal, Food selectivity, Nutrition behaviors, and Skill). Phone interviews were conducted with caregivers within two weeks of data collection for dietary assessment. Results: The most frequently reported feeding problems involved feeding skills and food selectivity, with 39.3% unable to feed themselves, 33.1% showing overeating behavior, and 31.2% exhibiting pica-like behavior. Chewing difficulties (28.7%), limited food intake (25.6%), and swallowing challenges (21.2%) were moderately reported, while aspiration-related problems were less common. Multiple linear regression analysis revealed significant positive associations between feeding problems and caregiver education level, family income, caregiver’s relationship to the child, and the child’s living arrangement. Dietary intake was not associated with feeding problems. Conclusions: The findings of this study indicate a range of feeding problems and key sociodemographic factors associated with feeding problems in children with DD. These results highlight the need for targeted interventions such as behavioral support and caregiver education to effectively address and manage feeding challenges in children. Full article

Background: Plant-based diets are recommended in guidelines for the prevention of cancer and cardiometabolic diseases, which remain major causes of death in breast cancer survivors (BCS). Since not all plant foods are healthy, we calculated the plant-based dietary index (PDI), healthy (hPDI) and unhealthy (uPDI), and their associations with cardiometabolic targets in BCS. Methods: Baseline dietary and cardiometabolic data were derived from 492 (median age 51, IQR 46–59) female BCS participating in a multicentric lifestyle trial conducted in Italy. Dietary data were collected with 7-day food records. PDI, hPDI, and uPDI were calculated by assigning positive scores to all plant foods, healthy plant foods or less healthy plant foods, respectively, as defined by the literature (scores ranged from 18 to 90). Using logistic or multinomial regression models, we estimated the odds ratios (OR) and the corresponding 95% confidence intervals (CI) between PDIs and cardiometabolic risk factors. Results: The OR of being obese (BMI ≥ 30 Kg/m²) was 0.47 (95%CI: 0.29–0.77), 0.37 (95%CI: 0.22–0.61) and 1.38 (95%CI: 0.83–2.28) with higher PDI, hPDI and uPDI, respectively. The OR of having a large waist circumference (≥88 cm) was 0.64 (95%CI: 0.42–1.00) with higher hPDI. The OR for hypercholesterolemia (≥200 mg/dL) was 1.80 (95%CI: 1.16–2.78) with higher uPDI. The ORs of hypertriglyceridemia (≥150 mg/dL) and metabolic syndrome were 0.38 (95%CI: 0.20–0.71) and 0.59 (95%CI: 0.35–0.97), respectively, with higher PDI. No other significant association was observed. Conclusions: Maintaining cardiometabolic risk factors within normal ranges is clinically relevant in BCS, and this may be more likely when a plant-based diet is consumed, especially if low in unhealthy plant foods. Full article

Background/Objectives: Complex aneurysms of the posterior inferior cerebellar artery (PICA) remain challenging because of their deep location, variable morphology, and proximity to critical neurovascular structures. Although endovascular therapy is preferred, its feasibility is limited in wide-necked, fusiform, or dissecting lesions. We describe our tertiary referral hospital single-center experience with tailored microsurgical and endovascular strategies—emphasizing occipital artery–PICA (OA-PICA) bypass, transcondylar fossa craniotomy, and cerebellomedullary fissure opening—and analyze perioperative factors that influence outcome. Methods: All consecutive patients treated for PICA origin or distal-PICA aneurysms between January 2021 and April 2025 were retrospectively reviewed. Demographics, aneurysm characteristics, procedure type, antithrombotic regimen, complications, diffusion-weighted MRI findings, and 3-month modified Rankin Scale scores were collected. Results: Twelve aneurysms (mean age 61.4 ± 15.2 years; 8 women) were treated: trapping + OA-PICA bypass in 5, direct clipping in 2, flow diverter in 1, endovascular parent artery occlusion in 2, coil embolization in 1, and a hybrid bypass-plus-coil strategy in 1. Two cases were ruptured aneurysms. Perioperative aspirin was used in 2/5 bypass cases; heparin was added in one hybrid case. Asymptomatic PICA-territory infarcts occurred in the three bypasses performed without antiplatelet therapy (one with intra-anastomotic thrombus). No leaks or subcutaneous collections of cerebrospinal fluid were encountered, and no graft occlusions were observed. At 3 months, 9/12 patients achieved a good outcome (mRS 0–2); among them, only one patient with subarachnoid hemorrhage (SAH) experienced postoperative worsening of the mRS. Two cranial nerve palsies (one permanent, one transient) and one wound site hematoma (heparin-associated) resolved without sequelae. Conclusions: Meticulous operative planning allows safe treatment of complex PICA aneurysms. Perioperative aspirin appears beneficial for OA-PICA bypass, whereas perioperative heparin increases bleeding risk. Individualized selection of endovascular, microsurgical, or combined strategies yields favorable early neurological outcomes in this demanding subset of cerebrovascular disease. Full article

In this study, the invasive orange spiny whitefly (“OSW”; Aleurocanthus spiniferus) and a species of Encarsia parasitising its puparia were studied in three different areas of the province of Modena (Emilia-Romagna, northern Italy): a pear orchard in Bomporto, an organic pear orchard in Carpi, and the semi-natural botanical garden “La Pica” in San Felice sul Panaro. The material of both species was collected for taxonomic and molecular studies. The abundance of OSW and parasitoid activity were surveyed in whitefly puparia, with a focus on the botanical garden. A total of 1800 leaves of Malus domestica, Pyrus communis and Vitis vinifera were sampled to assess whitefly infestation. The results showed a significant variation in the abundance of A. spiniferus puparia, with the highest infestation observed in V. vinifera. Morphological and molecular analyses, including mitochondrial COI and rRNA 16S for whiteflies and COI and 28S for parasitoids, confirmed the identity of A. spiniferus and identified the parasitoid as Encarsia nipponica. Molecular data also revealed the presence of three haplotypes of A. spiniferus, including a haplotype from China, new to Europe. The parasitisation rate by E. nipponica was low (0.015%). Our results provide the first European record of E. nipponica and new genetic data on the invasion pathways of A. spiniferus. Collectively, these findings offer a critical baseline for monitoring their ecological interactions and developing future pest management strategies. Full article

Background: Medium vessel occlusions (MeVOs) are an increasingly recognized but heterogeneous target for endovascular therapy (EVT). This study aims to compare primary MeVO, rescue MeVO, and large vessel occlusion (LVO) thrombectomy cases to identify which MeVO subtypes derive a meaningful benefit from EVT under appropriate safety conditions. Methods: We retrospectively analyzed a multicenter registry of patients undergoing EVT for acute ischemic stroke. MeVO was defined as the occlusion of the A1-A3, M2-M3, P1-P3, fetal PCA, or PICA segments and classified as primary or rescue. Clinical outcomes were assessed by NIHSS score at baseline, discharge, and 90 days; functional outcome by the modified Rankin scale (mRS); and reperfusion by modified thrombolysis in cerebral infarction (mTICI). Safety endpoints included intracranial hemorrhage and mortality. Results: Among 603 EVT patients, 202 (33.5%) had MeVO. Compared to LVO, MeVO patients were older and had more prior strokes but achieved similar reperfusion and safety outcomes. At 90 days, mRS distribution differed, with MeVO showing more mRS 2 and LVO more mRS 1, while higher-disability strata were comparable. Within MeVO, 119 (58.9%) were primary and 83 (41.1%) rescue occlusions. Rescue MeVO patients presented with higher baseline severity (NIHSS score of 19 vs. 18) and, despite similar reperfusion, experienced worse 90-day outcomes and higher mortality (21.7% vs. 0.8%). Conclusions: EVT for primary MeVO is feasible, effective, and safe, whereas rescue MeVO is associated with poor functional outcomes and markedly higher mortality. These findings highlight rescue MeVO as a distinct phenotype and support a selective approach prioritizing disabling syndromes, proximal/dominant branch occlusions, and IVT non-response. Full article

The analysis of published data on geophagy in humans, including manifestations of its variant known as “pica”, as well as information on geochemical endemics associated with geophagy and rare earth elements, together with our own research experience, allows us to conclude that geophagy in humans, as well as in animals, is primarily a natural, evolutionarily determined form of maintaining the necessary balance of rare earth elements in the neuroimmunoendocrine system. Disturbances in the composition and concentration of necessary rare earth elements (REE) in the structures of the most important protective and controlling system in the mammalian organism lead to disorders of mineral and general metabolism in the body and, as a result, to geochemical endemics. Geochemical endemics occur in landscapes with anomalous levels of biologically available REE forms, i.e., levels that differ significantly both towards deficiency and towards exceeding background levels. The imbalance in the metabolism of other chemical elements in the body seems to have a subordinate importance in the mechanism of occurrence of geochemical endemics in relation to REE. Full article