Search Results (3,024)

Background: Psychological distress is one of the leading causes of ill health in the United Arab Emirates (UAE). Nursing students often report higher levels of stress than the general population. Identifying the determinants of mental distress is essential to raise awareness and enable universities to implement preventive interventions. Aim: To examine the relationship between physical activity and psychological distress among nursing students at RAK Medical and Health Sciences University. Methods: A descriptive cross-sectional design was employed. A total of 187 students completed a three-part survey: (I) sociodemographic characteristics, (II) the International Physical Activity Questionnaire-Short Form (IPAQ-SF), and (III) the Depression Anxiety Stress Scale-21 (DASS-21). Results: Among participants, 28.3% were inactive, 36.9% engaged in moderate activity, and 34.8% engaged in vigorous activity. Significant associations were observed between physical activity and gender (χ² = 9.64, p < 0.001), nationality (χ² = 8.09, p = 0.01), anxiety (FET = 99.34, p < 0.001), and stress levels (χ² = 12.41, p = 0.05). Regression analysis showed that gender, nationality, anxiety, and stress significantly predicted physical activity levels (F(3,183) = 62.47, p < 0.001), explaining 51% of the variance (R² = 0.506, adjusted R² = 0.498). Conclusion: Physical activity among nursing students was significantly associated with gender, nationality, anxiety, and stress. Programs that promote physical activity may help reduce psychological distress and improve students’ health and well-being. Failure to address high levels of stress and anxiety may increase the risk of burnout in future professional practice. Full article

Background/Objectives: The emergence of artificial intelligence (AI) has revolutionized the healthcare industry. However, its integration into clinical practices raises ethical and practical concerns. This study aims to explore ethical and practical considerations perceived by physicians and nurses in Saudi Arabia. Methods: It employed a cross-sectional design with 400 physicians and nurses, using a pre-established online questionnaire. Descriptive data were analyzed through means and standard deviations, while inferential statistics were performed using the independent samples t-test. Results: Most participants were male (57%) and physicians (73.8%), with most employed in governmental organizations (87%). The participants’ use and awareness of AI was low, as 34.0% said they had never used it, but 74.5% of respondents were willing to use AI in clinical practices. Also, 80.5% of participants were aware of the AI benefits, and 71.0% had background knowledge about the ethical concerns related to AI’s implementation in their clinical practices. Moreover, (62.0%) of respondents recognized the applicability of AI in their specialty. Key findings revealed significant concerns: participants perceived a lack of skills to effectively utilize AI in clinical practice (mean = 4.04) and security risks such as AI manipulation or hacking (mean = 3.83). The most pressing ethical challenges included AI’s potential incompatibility with all populations and cultural norms (mean = 3.90) and uncertainty regarding responsibility for AI-related errors (mean = 3.84). Conclusions: These findings highlight substantial barriers that hinder the effective integration of AI in clinical practices in Saudi Arabia. Addressing these challenges requires leadership support, specific training initiatives, and developing practical strategies tailored to the local context. Future research should include other healthcare professionals and qualitatively explore further underlying factors influencing AI adoption. Full article

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) raced around the world across different populations; there needs to be a consolidated effort to understand the divergence of the epidemiology of SARS-CoV-2. Population-based epidemiological characteristics studies measure the extent of SARS-CoV-2 infection in a country. The current research study was designed to report epidemiological data from Pakistan. For this purpose, 246 SARS-CoV-2-infected patients were included in the study. For SARS-CoV-2 confirmation, viral samples were collected from all the study participants; SARS-CoV-2 infection was confirmed by viral nucleic acid detection using a nucleic acid detection kit. After SARS-CoV-2 confirmation, all the study participants were interviewed for epidemiological data through a detailed questionnaire. The study results showed that the disease ratio was higher between 30 and 59 years (51.21%) of age. The male ratio (55.28%) was higher compared to the female ratio (44.71%). The patients’ illiteracy and low socioeconomic status were 32.52% and 59.75%, respectively. The majority of the patients (97.56%) had cough, smell or taste disturbance (79.67%), or fever (76.42%), and 70.73% had fatigue. For comorbidities, a higher ratio was observed for diabetes (38.61%), hypertension (36.17%), and respiratory disease (16.26%). The vaccination status analysis revealed that 51.21% of patients had not received routine immunizations, and 65.5% were un-vaccinated against SARS-CoV-2. Notably, not a single patient was vaccinated for influenza vaccine. The current research study concluded that SARS-CoV-2 was more prevalent in individuals who were middle aged, male, and had low socio-economic status. The most common symptoms were cough, smell or taste disturbance, and fever. The patients’ vaccination status highlights a critical gap in preventive healthcare and shows the need to strengthen vaccination awareness and accessibility in the population to reduce vulnerability to future outbreaks. Future research should focus on investigating the impact of COVID-19 outcomes on comorbidities such as diabetes and hypertension. Full article

Background: Inborn errors of immunity (IEI) are mainly genetically driven disorders that affect immune function and present with highly heterogeneous clinical manifestations, ranging from severe combined immunodeficiency (SCID) to adult-onset immune dysregulatory diseases. This clinical heterogeneity, coupled with limited awareness and the absence of a universal diagnostic test, makes early and accurate diagnosis challenging. Although genetic testing methods such as whole-exome and genome sequencing have improved detection, they are often expensive, complex, and require functional validation. Recently, artificial intelligence (AI) tools have emerged as promising for enhancing diagnostic accuracy and clinical decision-making for IEI. Methods: We conducted a systematic review of four major databases (PubMed, Scopus, Web of Science, and Embase) to identify peer-reviewed English-published studies focusing on the application of AI techniques in the diagnosis and treatment of IEI across pediatric and adult populations. Twenty-three retrospective/prospective studies and clinical trials were included. Results: AI methodologies demonstrated high diagnostic accuracy, improved detection of pathogenic mutations, and enhanced prediction of clinical outcomes. AI tools effectively integrated and analyzed electronic health records (EHRs), clinical, immunological, and genetic data, thereby accelerating the diagnostic process and supporting personalized treatment strategies. Conclusions: AI technologies show significant promise in the early detection and management of IEI by reducing diagnostic delays and healthcare costs. While offering substantial benefits, limitations such as data bias and methodological inconsistencies among studies must be addressed to ensure broader clinical applicability. Full article

Background: Autoimmune diseases and other immune-mediated disorders are associated with an increased risk of malignancy, influenced by chronic inflammation, immune dysregulation, and treatment-related factors. Clarifying cancer risk patterns across specific conditions is essential to improve clinical vigilance and inform screening practices. Objective: The aim of this study was to synthesise current evidence on the association between autoimmune and immune-mediated diseases and cancer, with a focus on practical implications for clinicians. Methods: Recent cohort studies, meta-analyses, and expert consensus documents were analysed to describe cancer epidemiology, pathogenic mechanisms, high-risk phenotypes, and treatment considerations across major autoimmune diseases and other immune-mediated conditions. The review covers idiopathic inflammatory myopathies, Sjögren’s syndrome, systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, antiphospholipid syndrome, ANCA-associated vasculitis, giant cell arteritis, polymyalgia rheumatica, sarcoidosis, mixed connective tissue disease, IgG4-related disease, VEXAS syndrome, and eosinophilic fasciitis. Special attention was given to identifying warning features for underlying malignancy and evaluating cancer screening strategies. Results: The magnitude and distribution of cancer risk vary across diseases. In some conditions such as dermatomyositis, systemic sclerosis or Sjögren’s syndrome, increased risk is well established, particularly for haematological and certain solid tumours. However, tumour patterns may differ across populations, and findings are not always consistent. Distinct clinical and serological features help stratify individual cancer risk and may guide the intensity of screening. The first years after disease onset often represent a window of higher vulnerability, during which intensified surveillance may be warranted in selected patients. Conclusions: Cancer risk in autoimmune diseases should be assessed on an individual basis. Awareness of disease-specific risk factors and clinical warning signs supports early recognition of malignancy and informs screening decisions in routine practice. Full article

The human virome—comprising viruses that can persist in a host, those that benefit the host, and those that remain latent—has gained increasing acceptance as a modulator of immune response toward vaccination. The factors known to influence vaccine efficacy include host genetics, age, and bacterial microbiota, while the virome is a much less considered fourth dimension. This article reviews how components of the virome such as Torque Teno Virus (TTV), cytomegalovirus (CMV), Epstein–Barr virus (EBV), and bacteriophages impact both innate and adaptive immune responses, including mechanisms of immune pre-activation, trained immunity, and molecular mimicry from both beneficial and detrimental perspectives for vaccine-induced immunization. Emphasis is given to immunocompromised populations such as transplant recipients and those with HIV, where virome composition has been shown to correlate with vaccine responsiveness. Experimental models support clinical observations on how chronic viral exposures can either enhance or inhibit vaccine efficacy. Finally, we discuss virome-aware precision vaccinology and call for the integration of the virome in the development of immunization strategies, thus improving outcomes through customization. Full article

Otomycosis is the commonest cause of otitis externa seen in otorhinolaryngology clinics, especially in tropical and subtropical regions of the world. Diagnosis is usually made clinically and confirmed by laboratory identification of fungal elements. We conducted a cross-sectional and hospital-based epidemiological study that aimed to determine the prevalence, distribution and antifungal susceptibility profile of common aetiologic agents of otomycosis in Kano, northwestern Nigeria. We collected clinical samples from 300 patients who presented with symptoms of external ear infection, out of which 117 subjects (39.0%) were mycologically positive. Aspergillus species were the predominant isolate, with 90 (77.0%), followed by Candida species at 27 (23.0%). Otomycosis accounts for 39% of otitis externa seen in our center, mostly presenting with pruritus and otalgia. Raising the awareness of the general population to the predisposing factors may significantly reduce the incidence of otomycosis. Full article

Purpose: The popliteus tendon (PT), though often overlooked, plays a vital role in the functional and mechanical stability of the posterolateral corner (PLC) of the knee. This narrative review consolidates the current anatomical, biomechanical, imaging, clinical, and surgical data on the PT, with an emphasis on its morphological variability and relevance in orthopedic sports medicine. Methods: A comprehensive review of the literature was conducted, including classical anatomical studies, recent classification systems, biomechanical evaluations, imaging protocols, and rehabilitation strategies. Particular focus was given to the anatomical classification proposed by Olewnik et al. and its implications in surgical and diagnostic contexts. Results: Anatomical investigations have demonstrated considerable variability in the PT, including bifid tendons and accessory fascicles. These variants have a measurable impact on preoperative planning, diagnostic imaging interpretation, and outcomes of surgical procedures, such as anterior cruciate ligament (ACL) and PLC reconstructions. The PT also contributes significantly to knee rotational control and meniscal stabilization, particularly in athletic populations. Imaging modalities, such as MRI and dynamic ultrasound, show high diagnostic utility, while arthroscopy remains the definitive diagnostic and therapeutic modality. Rehabilitation should emphasize neuromuscular re-education and progressive control of tibial rotation. A phase-based rehabilitation framework and clinical action table are proposed. Conclusions: The PT should be recognized as a critical structure in both the conservative and the surgical management of posterolateral and rotational knee instability. Enhanced awareness of its anatomical variability and functional importance can improve diagnostic accuracy, surgical precision, and clinical outcomes. In particular, MRI and high-resolution ultrasound can aid in identifying accessory fascicles and bifid tendons, while arthroscopy benefits from preoperative knowledge of PT variants to avoid misidentification and iatrogenic injury. Surgical planning for ACL and PLC reconstructions may be refined by applying the classification system described. Future research should focus on refining diagnostic algorithms, developing PT-specific functional tests, and integrating popliteus evaluation into high-level clinical decision-making and surgical navigation systems. Full article

(1) Background: Prematurity remains a leading contributor to neonatal morbidity and mortality, with long-term consequences that extend well beyond the neonatal period. This cross-sectional study aimed to identify key maternal, perinatal, and neonatal factors that influence the short- and long-term evolution of preterm infants. It also seeks to evaluate the level of post-discharge follow-up care, parental involvement during NICU hospitalization, access to supportive therapies such as physiotherapy and RSV prophylaxis, and the impact of breastfeeding practices. Additionally, the study explores parental awareness and use of recent national initiatives in Romania, such as the “Premature and Vulnerable Newborn’s Notebook”. (2) Methods: A total of 360 mothers of preterm infants born between 2001 and 2025 responded to a structured questionnaire assessing clinical characteristics, NICU care, parental involvement, and post-discharge support. (3) Results: The findings indicate that assisted reproduction and pregnancy plurality were associated with higher maternal age, while vaginal delivery was associated with lower gestational age at birth. Notably, only 25% of infants were enrolled in structured follow-up programs, and a large proportion of families relied on private services for physical therapy. Kangaroo mother care was reported by just 16.4% of mothers. While breastfeeding rates improved after discharge, access to multidisciplinary follow-up and public physiotherapy remains limited. Encouragingly, most mothers endorsed the proposed national initiative for a “Premature and Vulnerable Newborn’s Notebook.” (4) Conclusions: This study underscores the urgent need for a comprehensive national follow-up strategy to ensure equitable and continuous care for Romania’s vulnerable preterm population. Full article

Hemodialysis-associated pericarditis is a significant but insufficiently acknowledged complication in patients with end-stage renal disease (ESRD). It can manifest as either uremic pericarditis, typically occurring before or shortly after the initiation of dialysis, or dialysis-associated pericarditis, which results from prolonged dialysis treatment. The condition is associated with substantial morbidity and potential mortality due to risks, such as cardiac tamponade and constrictive pericarditis. Pericardial involvement in ESRD most frequently presents as acute uremic or dialysis-associated pericarditis, whereas chronic constrictive pericarditis represents a less common manifestation. The aim of the article is to review the current understanding of the epidemiology, pathophysiology, clinical presentation, diagnostic criteria and therapy strategies of this pathology based on a case of hemodialysis-associated pericarditis in a patient diagnosed with sudden shortness of breath during a hemodialysis session. When assessing pericarditis in this group of population, it is recommended to distinguish between uremic and dialysis-associated forms, to recognize clinical warning signs, and to customize the treatment. Probably the therapy should include anti-inflammatory drugs, colchicine, intensified dialysis, and in severe cases, even pericardiocentesis or surgical intervention. Rising awareness and timely intervention are critical to improve outcomes in this vulnerable population. Full article

The Cultural STEM Night (CSN) initiative was developed to address the persistent lack of culturally relevant STEM teaching materials, which often contributes to student disengagement—particularly among underrepresented populations. This study examined the impact of the CSN program on enhancing STEM affinity and cultural intelligence (CQ) among American and Korean teacher candidates. Over six weeks, participants engaged in synchronous workshops, virtual cultural exchanges, and collaborative STEM lesson design integrating Korean cultural contexts. Quantitative analysis of pre- and post-program surveys using the STEM Affinity Test and Cultural Intelligence Scale revealed statistically significant improvements across all subdomains of STEM affinity (identity, interest, self-concept, value, and attitudes) and in most dimensions of CQ (metacognitive, cognitive, and behavioral). However, motivational CQ did not show significant gains, likely due to limited student interaction time during the event. Qualitative data from written reflections and focus group discussions supported these findings, indicating increased instructional adaptability, cultural awareness, and confidence in designing inclusive STEM lessons. These results demonstrate the transformative potential of interdisciplinary, culturally immersive programs in teacher education. The CSN model, supported by digital collaboration tools, offers a scalable and effective approach to preparing educators for diverse classrooms. Findings underscore the importance of integrating culturally responsive teaching into STEM education to promote equity, engagement, and global competence. Full article

Rice, wheat, and maize are important food grains consumed by most of the population in Asian countries (like India, Japan, Singapore, Malaysia, China, and Thailand). These crops’ production is affected by biotic and abiotic factors that cause diseases in several parts of the crops (including leaves, stems, roots, nodes, and panicles). A severe infection affects the growth of the plant, thereby undermining the economy of a country, if not detected at an early stage. This may cause extensive damage to crops, resulting in decreased yield and productivity. Early safeguarding methods are overlooked because of farmers’ lack of awareness and the variety of crop diseases. This causes significant crop damage and can consequently lower productivity. In this manuscript, a lightweight vision transformer (MaxViT) with 814.7 K learnable parameters and 85 layers is designed for classifying crop diseases in paddy and wheat. The MaxViT DNN architecture consists of a convolutional block attention module (CBAM), squeeze and excitation (SE), and depth-wise (DW) convolution, followed by a ConvNeXt module. This network architecture enhances feature representation by eliminating redundant information (using CBAM) and aggregating spatial information (using SE), and spatial filtering by the DW layer cumulatively enhances the overall classification performance. The proposed model was tested using a paddy dataset (with 7857 images and eight classes, obtained from local paddy farms in Lalgudi district, Tiruchirappalli) and a wheat dataset (with 5000 images and five classes, downloaded from the Kaggle platform). The model’s classification performance for various diseases has been evaluated based on accuracy, sensitivity, specificity, mean accuracy, precision, F1-score, and MCC. During training and testing, the model’s overall accuracy on the paddy dataset was 99.43% and 98.47%, respectively. Training and testing accuracies were 94% and 92.8%, respectively, for the wheat dataset. Ablation analysis was carried out to study the significant contribution of each module to improving the performance. It was found that the model’s performance was immune to the presence of noise. Additionally, there are a minimal number of parameters involved in the proposed model as compared to pre-trained networks, which ensures that the model trains faster. Full article

Background: Malnutrition is a prevalent but underrecognized condition in cardiovascular disease (CVD) patients, associated with adverse outcomes including longer hospitalizations, higher readmission rates, and increased mortality. Traditional measures such as body mass index (BMI) often fail to detect malnutrition, especially in patients with fluid retention, sarcopenia, or obesity. Methods: This review critically examines current tools used to assess nutritional status in CVD populations. Screening instruments such as Nutritional Risk Screening 2002 (NRS 2002), Mini Nutritional Assessment (MNA, MNA-SF), Malnutrition Universal Screening Tool (MUST), Subjective Global Assessment (SGA), and the Controlling Nutritional Status (CONUT) score are discussed, alongside diagnostic frameworks including the Global Leadership Initiative on Malnutrition (GLIM) criteria. The role of body composition assessment, particularly bioelectrical impedance analysis (BIA) and phase angle (PA), is also highlighted. Results: These tools differ in diagnostic performance and applicability, with many influenced by the pathophysiological features of CVD, such as inflammation, altered fluid balance, and pharmacotherapy. GLIM criteria provide a standardized two-step approach, combining phenotypic and etiologic factors, but require further validation in cardiology settings. Conclusions: A tailored, multimodal approach could be recommended: initial screening followed by confirmatory assessment using GLIM criteria and objective measures of muscle mass or cellular integrity. Clinicians should be aware of tool-specific limitations and interpret findings in the context of CVD-specific challenges. Full article

Background: Structured postoperative rehabilitation is not routinely provided for individuals with adolescent idiopathic scoliosis (AIS) after surgery, with physiotherapy typically limited to the immediate inpatient period. Telerehabilitation offers an accessible and supervised option to address persistent functional limitations, pain, and quality-of-life concerns in this population. Objectives: This study aimed to evaluate the effects of a synchronous telerehabilitation program—designed to support post-surgical recovery in individuals with adolescent idiopathic scoliosis (AIS)—on trunk muscle endurance, trunk flexibility, functional capacity, pain severity, perception of appearance, and quality of life. Methods: Thirty-two individuals with AIS, who had undergone surgery 6 months to 2 years prior, were randomly assigned to either an intervention group or a control group. The intervention group participated in a supervised telerehabilitation program twice weekly for eight weeks, while the control group received no exercise intervention. All outcome measures were assessed before and after the intervention. Results: The telerehabilitation group demonstrated significant improvements across all outcome measures compared with the control group (p < 0.05). Post-intervention, the telerehabilitation group had superior trunk muscle endurance, flexibility, and quality-of-life scores, as well as reduced pain intensity (p < 0.05). However, no significant differences were observed between the groups in functional capacity or perception of appearance (p > 0.05). Conclusions: A supervised telerehabilitation program initiated six months after surgery can effectively improve trunk muscle endurance, flexibility, pain intensity, and quality of life in individuals with AIS. These findings emphasize the value of structured post-surgical rehabilitation and raise awareness of the potential benefits of remotely delivered exercise programs in this population. Full article

With the global population steadily rising, the demand for sustainable protein sources has become increasingly urgent. Traditional animal- and plant-based proteins face challenges related to scalability, resource efficiency, and environmental impact. In this context, single-cell protein has emerged as a promising alternative. Derived from microorganisms such as algae, bacteria, fungi, and yeast, single-cell protein offers a high nutritional profile- including all essential amino acids and vitamins—while enabling rapid production, minimal land and water requirements, and no generation of greenhouse gas emissions. A particularly compelling advantage of single-cell protein is its ability to be produced from agro-industrial waste, converting low-cost residues into valuable nutritional resources and contributing to environmental sustainability. Among these waste streams, lignocellulosic biomass from agricultural and forestry residues stands out as a renewable, biodegradable, and abundant feedstock. This review explores the potential of lignocellulosic waste as a substrate for single-cell protein production, emphasizing both its environmental advantages and nutritional value. It highlights the single-cell protein role as a sustainable and scalable alternative to conventional protein sources. The review also identifies key scientific, economic, and regulatory challenges, and recognizes the importance of targeted investments, particularly in policy development, public awareness, and technological innovation, to enable the broader adoption and acceptance of single-cell protein -based products. Full article