Search Results (583)

Background/Objectives: Access to health services is often limited due to socio-economic and organizational determinants of health systems, which lead to increased unmet healthcare needs. This study aimed to identify access barriers for the general population in Greece, including those that may have emerged following the COVID-19 pandemic. Methods: This was a cross-sectional survey of 1002 Greek citizens. A questionnaire regarding socio-demographics, healthcare utilization, and access to health services was used. Interviews took place between October and November 2022. Results: Of 837 participants who used health services in 2022, 82.6% had a medical consultation, 80.6% took diagnostic tests, and 63.6% visited a pharmacy for pharmaceuticals. Of those having a medical consultation, 33.1% did so at an NHS health unit, while 75% of the participants taking diagnostic tests visited a contracted private laboratory. Out of the 135 participants requiring hospitalization, 62% were hospitalized in a public hospital, while 85% of the participants requiring pharmaceuticals visited a private pharmacy. Access barriers in the past year were reported by 48% of the participants requiring a medical consultation, 34% of the participants requiring diagnostic tests, and 40% of the participants requiring hospitalization. The most common barriers were long waiting times and financial constraints. The main barrier to accessing pharmaceuticals was the availability and administration of the product. Conclusions: The identified healthcare access barriers highlight the vulnerabilities of the current health system in Greece, which were further exposed during the COVID-19 pandemic crisis. Addressing socioeconomic factors that are considered key access indicators should be the focus of future health policy initiatives. Full article

Changes in habitat suitability are critical indicators of the ecological impacts of climate change. Syndiclis Hook. f., a rare and endangered genus endemic to montane limestone and cloud forest ecosystems in China, holds considerable ecological and economic value. However, knowledge of its current distribution and the key environmental factors influencing its habitat suitability remains limited. In this study, we employed the MaxEnt model, integrated with geographic information systems (ArcGIS), to predict the potential distribution of Syndiclis under current and future climate scenarios, identify dominant bioclimatic drivers, and assess temporal and spatial shifts in habitat patterns. We also analyzed spatial displacement of habitat centroids to explore potential migration pathways. The model demonstrated excellent performance (AUC = 0.988), with current suitable habitats primarily located in Hainan, Taiwan, Southeastern Yunnan, and along the Yunnan–Guangxi border. Temperature seasonality (bio7) emerged as the most important predictor (67.00%), followed by precipitation of the driest quarter (bio17, 14.90%), while soil factors played a relatively minor role. Under future climate projections, Hainan and Taiwan are expected to serve as stable climatic refugia, whereas the overall suitable habitat area is projected to decline significantly. Combined with topographic constraints, population decline, and limited dispersal ability, these changes elevate the risk of extinction for Syndiclis in the wild. Landscape pattern analysis revealed increased habitat fragmentation under warming conditions, with only 4.08% of suitable areas currently under effective protection. We recommend prioritizing conservation efforts in regions with habitat contraction (e.g., Guangxi and Yunnan) and stable refugia (e.g., Hainan and Taiwan). Conservation strategies should integrate targeted in situ and ex situ actions, guided by dominant environmental variables and projected migration routes, to ensure the long-term persistence of Syndiclis populations and support evidence-based conservation planning. Full article

The Qinghai–Tibetan Plateau (QTP), often referred to as the “Third Pole” of the world, harbors alpine grassland ecosystems that play an essential role as global carbon sinks, helping to mitigate the pace of climate change. Nonetheless, alterations in natural environmental conditions coupled with escalating human activities have disrupted the seasonal growth cycles of grasslands, thereby intensifying degradation processes. To date, the key drivers and lifecycle dynamics of Grassland Depletion across the QTP remain contentious, limiting our comprehension of its ecological repercussions and regulatory mechanisms. This study comprehensively investigates grassland degradation on the Qinghai–Tibetan Plateau, analyzing its drivers and changes in ecological suitability during the growing season. By integrating natural factors (e.g., precipitation and temperature) and anthropogenic influences (e.g., population density and grazing intensity), it examines observational data from over 160 monitoring stations collected between the 1980s and 2020. The findings reveal three distinct phases of grassland degradation: an acute degradation phase in 1990 (GDI, Grassland Degradation Index = 2.53), a partial recovery phase from 1996 to 2005 (GDI < 2.0) during which the proportion of degraded grassland decreased from 71.85% in 1990 to 51.22% in 2005, and a renewed intensification of degradation after 2006 (GDI > 2.0), with degraded grassland areas reaching 56.39% by 2020. Among the influencing variables, precipitation emerged as the most significant driver, interacting closely with anthropogenic factors such as grazing practices and population distribution. Specifically, the combined impacts of precipitation with population density, grazing pressure, and elevation were particularly notable, yielding interaction q-values of 0.796, 0.767, and 0.752, respectively. Our findings reveal that while grasslands exhibit superior carbon sink potential relative to forests, their productivity and ecological functionality are undergoing considerable declines due to the compounded effects of multiple interacting factors. Consequently, the spatial distribution of ecologically suitable zones has contracted significantly, with the remaining high-suitability regions concentrating in the “twin-star” zones of Baingoin and Zanda grasslands, areas recognized as focal points for future ecosystem preservation. Furthermore, the effects of climate change and intensifying anthropogenic activity have driven the reduction in highly suitable grassland areas, shrinking from 41,232 km² in 1990 to 24,485 km² by 2020, with projections indicating a further decrease to only 2844 km² by 2060. This study sheds light on the intricate mechanisms behind Grassland Depletion, providing essential guidance for conservation efforts and ecological restoration on the QTP. Moreover, it offers theoretical underpinnings to support China’s carbon neutrality and peak carbon emission goals. Full article

Stylolites, common dissolution surfaces in carbonate rocks, form due to localized stress-induced pressure-solution during burial compaction or tectonic contraction. Their morphology and growth are influenced by dissolution kinetics, rock heterogeneity, clay content, burial depth, stress evolution, diagenesis, and pore fluid availability. This study applies the stylolite roughness inversion technique (SRIT), a proven paleopizometer that quantifies the principal vertical stress (σ_v = σ₁) prevailing in strata in the last moments of bedding-parallel stylolites (BPS) formation, to the Late Cretaceous Bagh Group carbonates in the Narmada Basin, India, to estimate their burial paleo-depth. Using the Fourier Power Spectrum (FPS), we obtained 18 σ₁ values from a collection of 30 samples, enabling us to estimate paleo-burial depths for the Bagh Group ranging from 660 to 1320 m. As the Bagh Group burial history is unknown, but as there is no subsequent sedimentary deposition above it, we relate this ca. 1.3 km burial depth to the now eroded thickness of the deposits related to Deccan volcanism at the end of the Cretaceous time, implying a quasi-instantaneous development of the BPS population in the strata. This research highlights the robustness of SRIT for reconstructing burial histories in carbonate sequences and that it can be a reliable way to reconstruct the thickness of eroded deposits in well-constrained geological history. Full article

Aim: To prepare two different kinds of wound care creams containing plant extracts and examine their effectiveness in comparison with a placebo cream and a commercial wound care cream, Madecassol^®. Methods: The two cream formulations were developed using the same placebo cream (PC) as base cream. One formulation contained balsam of oriental sweet gum, or Levant storax, named as Levant Storax Cream (LSC); the other contained oil of Calendula, extract of St. John’s Wort, aescin (an extract of horse chestnut), and freeze-dried powder from Aloe vera (L.) Burm. f. leaf juice, designated as Complex Cream (CC). In the characterization of the creams, organoleptic properties, pH, viscosity, size distribution, and zeta potential of oil globules were measured. Furthermore, the stability of the creams was assessed under different environmental conditions. In vitro studies were performed by using an excisional wound model in rats to assess the potential of the creams for stimulating wound healing. The efficacy of LSC and CC was compared with a commercial reference cream, Madecassol^® (M), and the placebo control. The study was also designed with a negative control group of rats that were not treated but handled the same way as the other treatment groups. The wound contraction rate, total skin thickness recovery, and results of histopathological parameter examinations were used to compare the effectiveness of the treatments. Results: The stability of formulated creams confirmed that they were stable for the duration of the study. In vivo studies showed that rats treated with LSC achieved the highest wound healing rates when compared with the other groups. A better response was recorded for the CC-treated population when compared to both control and placebo groups, but there was no significant difference seen in healing score between CC and M groups. Full article

The sharp decline in the population along the northeastern border poses a significant threat to the security of the region, the prosperity of border areas, and the stability of the social economy in our country. Effective management of human and land resources is crucial for the high-quality development of border areas. Taking Changbai County on the northeastern border as an example, based on multi-source data such as land use, the natural environment, climate conditions, transportation location, and social economy from 2000 to 2020, the land use transfer matrix, spatial kernel density, and PLUS model were used to analyze the spatio-temporal evolution characteristics of land use and explore simulation scenarios and optimization strategies under different planning concepts. This study reveals the following: (1) During the study period, the construction land continued to increase, but the growth rate slowed down, mainly transferred from cultivated land and forest land, and the spatial structure evolved from a single center to a double center, with the core always concentrated along the border. (2) The distance to the port (transportation location), night light (social economy), slope (natural environment), and average annual temperature (climate conditions) are the main driving factors for the change in construction land, and the PLUS model can effectively simulate the land use trend under population contraction. (3) In the reduction scenario, the construction land decreased by 1.67 km², the scale of Changbai Town slightly reduced, and the contraction around Malugou Town and Badagou Town was more significant. The study shows that the reduction scenario is more conducive to the population aggregation and industrial carrying capacity improvement of shrinking county towns, which is in line with the high-quality development needs of border areas in our country. Full article

Engaging in sports, particularly at a competitive level, requires sustained muscle contractions before the onset of physical fatigue. Fatigue is highly prevalent in neuromuscular diseases, especially those affecting neuromuscular transmission (e.g., myasthenia gravis) or muscle membrane excitability (e.g., myotonia, certain metabolic myopathies). A decremental response in repetitive nerve stimulation (RNS) represents the neurophysiological analogue of exercise-induced muscle weakness. Patients with such responses exhibit abnormal suppression of muscle activity during repetitive or prolonged effort. Consequently, it is often assumed they should avoid strenuous physical activity. To assess the safety of sports participation in individuals with fatigability-related neuromuscular disorders, we examined the literature and report a new case of a patient with myotonia congenita who engaged in competitive sports without adverse events. The review identified only a few cases involving patients with myasthenia gravis or muscular dystrophies who also participated in competitive sports safely and with favorable outcomes. No adverse events were reported. While these findings suggest that sports participation may be feasible for selected patients, they cannot be generalized. Large-scale studies involving athletes with neuromuscular conditions are needed to evaluate the safety and long-term impact of exercise in these populations. Full article

As a carrier of civilization, cultural heritage reflects the dynamic relationship between humans and their environment within specific historical contexts. During the Ming and Qing Dynasties (1368–1912 CE), the Yangtze River Basin was one of the most prominent regions for economic and cultural activities in ancient China. The cultural heritage of this period was characterized by its dense distribution and continuous evolution. Considering the applicability bias of modern data in historical interpretation, this study selected four characteristic variables: population density, agricultural productivity, technological level, and temperature anomaly. A hierarchical Bayesian model was constructed and change points were detected to quantitatively analyze the driving mechanisms behind the spatiotemporal distribution of cultural heritage. The results show the following: (1) The distribution of cultural heritage exhibited a multipolar trend by the mid-period in both Dynasties, with high-density areas contracting in the later period. (2) Agricultural productivity consistently had a significant positive impact, while population density also had a significant positive impact, except during the mid-Ming period. (3) The cultural calibration terms, which account for observational differences resulting from the interaction between cultural systems and environmental variables, exhibited slight variations. (4) The change point for population density was 364.83 people/km², and for agricultural productivity it was 2.86 × 10⁹ kJ/km². This study confirms that the differentiation in the spatiotemporal distribution of cultural heritage is driven by the synergistic effects of population and resources. This provides a new perspective for researching human–land relations in a cross-cultural context. Full article

Background/Objectives: The objective of this study was to compare muscular strength and neuromuscular activation characteristics between male gymnasts and physical education (PE) students during isometric shoulder extension and flexion tasks. Methods: Thirteen competitive male gymnasts (age: 19.59 ± 1.90 years; body mass: 66.54 ± 6.10 kg; height: 169.38 ± 6.28 cm; mean ± SD) and thirteen male physical education (PE) students (age: 20.96 ± 2.30 years; body mass: 74.00 ± 8.69 kg; height: 174.96 ± 4.93 cm) voluntarily participated in the study. Peak torque (PT), rate of torque development (RTD), RTD normalized to body mass (RTD/BM), and muscle activation assessed via surface electromyography (EMG), normalized to maximal EMG activity (EMG/EMGmax), were evaluated during bilateral isometric shoulder extension and flexion at a joint angle of 45°. Measurements were analyzed across the following time intervals: −50 to 0 ms (pre-tension), 0–30 ms, 0–50 ms, 0–100 ms, and 0–200 ms relative to contraction onset. Custom MATLAB R2024b scripts were used for data processing and visualization. One-way and two-way multivariate analyses of variance (MANOVAs) were conducted to test for group differences. Results: Gymnasts exhibit higher values of PT, PT/BM, RTD, and RTD/BM particularly within the early contraction phases (i.e., 0–50 ms and 0–100 ms) compared to PE students (p < 0.05 to <0.001; η² = 0.04–0.66). Additionally, EMG activity normalized to maximal activation (EMG/EMGmax) was significantly greater in gymnasts during both early and mid-to-late contraction phases (0–100 ms and 0–200 ms), (p < 0.05 to <0.001; η² = 0.04–0.48). Conclusions: These findings highlight gymnasts’ superior explosive neuromuscular capacity. Metrics like RTD, RTD/BM, and EMG offer valuable insights into rapid force production and neural activation, supporting performance monitoring, training optimization, and injury prevention across both athletic and general populations. Full article

Background: Sarcopenia (loss of muscle mass) and dynapenia (loss of strength) are prevalent in older adults aged 70 years and over. Both have an impact on their functional ability and quality of life, with type II muscle fibres being particularly affected. Although traditional resistance training (TRT) is effective, it presents technical difficulties and an increased risk of injury among this vulnerable population. Isometric strength training (IST) is a potentially safer, more accessible and more effective alternative. Objective: To describe the protocol of a single-arm, pre-post intervention trial designed to evaluate the efficacy and applicability of a 16-week IST programme on muscle strength, skeletal muscle mass, quality of life and applicability (safety, acceptability, perceived difficulty) in 18 older adults aged 70 years and above with a diagnosis of sarcopenia and dynapenia. The influence of genetic and environmental factors on the variability of response to IST will also be explored. Methodology: The participants, who have all been diagnosed with sarcopenia according to EWGSOP2 (European Working Group on Sarcopenia in Older People 2) criteria, will perform two IST sessions per week for 16 weeks. Each 30-min session will consist of one progressive set (total duration 45 s to 90 s) for each of the eight major muscle groups. This series will include phases at 20% and 40% of individual Maximal Voluntary Isometric Contraction (MVIC), culminating in 100% Maximal Effort (ME), using the CIEX SYSTEM machine with visual feedback. The primary outcome variables will be: change in knee extensor MVIC and change in Appendicular Skeletal Muscle Mass Index (ASMMI). Secondary variables will be measured (other components of sarcopenia, quality of life by EQ-5D-5L, use of Likert scales, posture and physiological variables), and saliva samples will be collected for exploratory genetic analyses. The main statistical analyses will be performed with t-tests for related samples or their non-parametric analogues. Discussion: This protocol details a specific IST intervention and a comprehensive evaluation plan. The results are expected to provide evidence on the feasibility and effects of IST among older adults with sarcopenia and dynapenia. Understanding individual variability in response, including genetic influence, could inform the design of more personalised and effective exercise strategies for this population in the future. Full article

Gerbera piloselloides (L.)Cass. is an important ethnomedicinal plant. Wild populations are steadily declining, however, posing a risk of failure to meet future market demand. Investigating suitable habitats for this plant and key influencing factors is crucial for its artificial cultivation. In this study, we implemented an optimized MaxEnt to project suitable habitats for the target species in five different periods and explored the impact of different environmental variables on its distribution. Our study findings provide confirmation of the following: (1) The current and future potential distributions of Gerbera piloselloides are primarily located in the areas south of the Qinling–Huaihe boundary in China, with future expansions expected to shift northward and westward. (2) Notably, there was a contraction in the junction regions of the provinces of Jiangxi, Anhui, Hunan, and Hubei. (3) The number of highly suitable habitats in Fujian, Guangdong, Yunnan, and Guangxi is expanding; in comparison, the number in Guizhou, Sichuan, and Hainan is declining. (4) The primary environmental determinants shaping its range, together with the threshold values for highly suitable habitats, are the minimum temperature of the coldest month (bio6, 0.88–22.58 °C) and the temperature seasonality (bio4, 461.54–763.9). The findings presented in this work provide support for the artificial cultivation and conservation of this plant. Full article

The saiga antelope (Saiga tatarica), a keystone migratory species of the Central Asian steppes and deserts, is increasingly threatened by habitat fragmentation due to the rapidly expanding transport infrastructure in Kazakhstan, which hosts approximately 95% of the species’ global population. This study provides a spatial assessment of railway and road infrastructure across the contemporary ranges of the Betpaqdala, Ustyurt, and Ural saiga populations. Using the literature and our field data from the 1980s to the present day, combined with geographic information system (GIS)-based analysis of 80,427 km of roads and 4021 km of railways, we have quantified infrastructure densities and identified critical barriers to saiga migration using kernel density and minimum convex polygons (MCP) estimations. The results reveal a negative connection between infrastructure density and occurrences of saiga herds, particularly in the Ustyurt population, where a high railway density coincides with severely reduced migratory activity and a reduction in this population’s winter range by 79.84% since 2015. Major railways such as Sekseuildi–Zhezqazgan, Zhezqazgan–Zharyk, and Shalqar–Beineu intersect essential migratory pathways and have contributed to significant range contraction, subpopulation isolation, and northward shifts in seasonal habitats. In contrast, the Ural population (subject to minimal railway infrastructure interference) has shown robust demographic recovery. While roads are more widespread, their impact is less severe due to greater permeability. However, upcoming projects such as the China–Europe transit corridor and the “Center–West” regional development corridor could amplify future threats. We recommend immediately implementing wildlife-friendly infrastructure, including overpasses and ecological corridors, to preserve the connectivity of saiga ranges and support the long-term conservation of this ungulate species. Full article

With the nationwide completion of China’s large-scale Poverty Alleviation Relocation (PAR) initiative in 2020, the government’s poverty alleviation efforts have officially entered the “post-poverty era”. However, many regions still lack well-established sustainable development mechanisms and face a potential risk of returning to poverty. To better stabilize the achievements of poverty alleviation, this study examines the potential risk of returning to poverty after the first Five-Year Transition Period (2021–2025) from a livelihood space perspective and proposes optimization directions for PAR policies in future poverty reduction efforts. Research findings indicate that simply altering geographical conditions is insufficient to achieve stable poverty alleviation. The production space of relocated populations is vulnerable to the stability and precision in resource supply, which may lead to recurring poverty due to policy discontinuities and administrative preferences. Meanwhile, improvements in living spaces are constrained by imbalances in household income and expenditure. This study also found that, on the one hand, changes in residential patterns break the original boundaries of administrative villages by incorporating migrants from different villages into concentrated communities, leading to the expansion of weak-tie networks while, on the other hand, the relocation process disrupts some of the migrants’ original strong-tie networks, and the concentration and clustering of impoverished groups in relocation communities further lead to the contraction of these networks. Additionally, the unique characteristics of relocation communities generate exorbitant governance costs and population management difficulties that far exceed the service provision and administrative capacities of community organizations. In the long run, this situation proves detrimental to normalized community governance and dynamic poverty relapse monitoring and interventions. Accordingly, this study proposes relevant policy recommendations from the following four aspects, i.e., strengthening endogenous development capacity, improving social security mechanisms, expanding social support networks, and enhancing organizational governance capabilities, aiming to provide both a theoretical basis and a decision-making reference for future poverty alleviation efforts. Full article

Background/Objectives: In this study, we aimed to examine the effect of creatine monohydrate (CrM) supplementation on recovery from eccentric exercise-induced muscle damage (EIMD) in diverse populations, including different sexes and age groups. EIMD decreases maximal voluntary contraction (MVC), restricts the range of motion (ROM), and increases muscle stiffness and delayed-onset muscle soreness, all of which negatively impact athletic performance. Therefore, developing effective recovery strategies is essential. Methods: A double-blind, randomized, placebo-controlled trial was conducted with 40 healthy male and female participants. After 33 days of supplementation with either CrM or placebo (crystalline cellulose), the participants performed eccentric exercises. Recovery indices, including MVC, muscle stiffness, subjective muscle extensive soreness, fatigue, and upper arm circumference, were measured at baseline, immediately after exercise, 48 h post-exercise, and 96 h post-exercise. Results: The creatine supplementation group (CRE) demonstrated a significantly quicker recovery of MVC than the placebo group (PLA). Furthermore, reductions in shear modulus and muscle fatigue were observed in the CRE group. Notably, females in the CRE group exhibited a significant suppression of post-exercise edema, suggesting a sex-specific response. Conclusions: These findings indicate that CrM supplementation may enhance recovery from EIMD, contributing to the maintenance of muscle function and the reduction of discomfort after exercise. CrM has the potential to serve as a practical nutritional strategy to promote recovery, not only for athletes, but also for a broader population. Full article

Introduction: Spinal and bulbar muscular atrophy (SBMA) is an X-linked neuromuscular disorder characterized by progressive muscle weakness, along with muscle cramps, tremors, and sensory neuropathy. Previous research has shown that patients with SBMA have difficulty with dynamic balance and sensory postural control during quiet stance. There have been no reports on automatic postural reactions in SBMA. Objectives: In this study, we aimed (1) to augment previous findings of sensory postural control, (2) to investigate automatic postural reactions in SBMA, and (3) to explore the relationship between strength and balance. Design: A cross-sectional design was used for the analysis. Participants: The participants were fifty male individuals with a confirmed diagnosis of SBMA. Outcome Measures: Balance testing included the NeuroCom modified Clinical Test of Sensory Interaction on Balance (mCTSIB), which measures sway velocity during quiet stance, and the NeuroCom Motor Control Test (MCT), which measures the latency and strength of postural reactions following sudden perturbations. Strength testing included maximal voluntary isometric contractions measured via fixed-frame dynamometry. Results: Forty-seven out of fifty participants were able to complete the mCTSIB test, but only thirty-eight completed the MCT test. Patients who were unable to complete the MCT were significantly weaker in all lower extremity muscles compared to those who were able to complete testing. Compared to normative data, participants showed significantly higher sway velocity during quiet stance across all conditions of the mCTSIB, except when standing on foam with eyes open. They also exhibited significantly slower postural reactions in response to sudden shifts of the force plate on the MCT. Plantarflexor weakness was significantly correlated with poor postural control on the mCTSIB and MCT. Conclusions: This study confirms previously reported abnormalities of sensory postural control in SBMA and highlights patients’ heavy reliance on visual inputs for postural control. Additionally, this study shows that automatic postural corrections are slower than normal in SBMA and provides a unique approach for measuring the combined sensory and motor components of the disease. Both the sensory and automatic balance abnormalities were found to be associated with plantarflexor weakness and may contribute to a higher risk of falls under challenging situations. Therefore, addressing this weakness may be an important step toward fall prevention in this population. Full article