Search Results (9,632)

Disordered eating has been identified as a concern among individuals with type 1 diabetes mellitus (T1DM) and is associated with poorer glycaemic control, which may result in vascular complications and increased morbidity and mortality. Despite this, there is a paucity of research examining disordered eating behaviour (DEB) among individuals with T1DM in Ireland. This study aimed to examine the prevalence of DEB among adults with T1DM attending an Irish hospital outpatient clinic. This cross-sectional study recruited 95 adults with T1DM attending an outpatient diabetes clinic at Sligo University Hospital. Screening for DEB was conducted using self-reported measures, including the Diabetes Eating Problem Survey–Revised (DEPS-R) and the Eating Disorder Examination Questionnaire (EDE-Q 6.0). DEB was identified in 16.3% (n = 15) of the participants using the DEPS-R and in 3.2% (n = 3) using the EDE-Q 6.0. Higher levels of DEB were observed among the female participants; however, a notable prevalence was also identified among the male participants. DEB demonstrated a weak positive correlation with body mass index (BMI) and a negative correlation with age and height. No association was found between DEB and glycated haemoglobin (HbA1c). The substantial prevalence of DEB among adults with T1DM, with nearly one in six participants affected, highlights the presence of clinically relevant disordered eating symptoms in this population. The findings suggest potential differences in case identification between diabetes-specific and generic screening tools. These results support further evaluation of diabetes-specific screening instruments such as the DEPS-R in adult T1DM populations within larger studies before routine clinical implementation. Full article

Risk perception and value assessment are key drivers of purchase intention. However, the literature lacks a consensus on how and when risk perception and perceived value impact consumers’ purchase intention, and their relationship remains unclear. To solve this gap, mechanisms of consumer purchase intentions must be elucidated. We conducted a systematic meta-analysis to examine the relationships and factors moderating it, and used meta-analytic structural equation modeling (MASEM) to reveal the mechanism and boundaries. Forty-four studies (N = 21,370) were included to examine how risk perception and perceived value impact consumer purchase intention, showing that consumer purchase intention is affected positively by perceived value and negatively by risk perception. Risk perception and perceived value exhibit mutual interaction effects. Perceived value has a stronger relationship with consumer purchase intention than risk perception. In the moderator’s analysis, the effects of perceived value on consumers’ risk perception and of perceived risk on perceived value and purchase intention are stronger when consumers come from developing (vs. developed) countries. Impacts of perceived value on consumer purchase intention and risk perception and of risk perception on perceived value and purchase intention are stronger when consumers are non-students (vs. students). When analyzing the three models’ mechanisms of action, Model 1 better explained consumer intention’s boundaries and impact mechanisms. To our knowledge, this is the first meta-analytic study summarizing how risk perception and perceived value impact consumers’ purchase intention, revealing the mechanism and boundaries of consumer behavior and illuminating a forward-looking new perspective outlining research directions. Full article

Cervical cancer is a malignant disease that affects women worldwide and is associated with both high incidence and a high mortality rate. miR-34 is a direct transcriptional-target of p53 and is downregulated in several types of cancers. 1,4-Naphthoquinones (NQs) have anticancer properties and have been used to modulate miR-34 expression. We tested (3-chloro-NQ-2-yl)-alanine (ANQCl), -methionine (MNQCl), -glycine (GNQCl), -phenylalanine (FNQCl), -asparagine (NNQCl), and (1,4-napthoquinon-2-yl)-asparagine (NNQ) in immortal and tumorigenic cells, both HPV-positive and -negative, simulating precancerous and cancerous status to observe the response of the p53-miR-34 system, migration and invasion. A dose–response was achieved to determine the IC50 of the compounds in SiHa, CaLo, C33-A and HaCaT cells. HaCaT cell migration inhibition was more potent than in SiHa, CaLo, and C33-A cells, while invasion hindrance was more evident in the tumorigenic SiHa, CaLo and C33-A. NNQCl, GNQCl, ANQCl and FNQCl compounds induced p53 overexpression in SiHa and CaLo cells. Compound ANQCl in SiHa and FNQCl in CaLo induced miR-34a overexpression, probably via p53. Migration and invasion of most compounds decreased independently of p53-miR-34. NQ-amino acids exert effect on cell proliferation, migration and invasion in cervical cancer cells, suggesting their potential use in the field of cancer treatment. Full article

Background: Parental burnout results from chronic stress related to the parental role and reflects a persistent imbalance between parenting demands and available psychological resources, negatively affecting parental well-being and parent–child relationships. This study examined the associations between parental burnout, parenting attitudes, and psychological resilience within the parental adaptation of the job demands–resources model, with particular attention to the potential mediating role of parenting styles in the relationship between resilience and parental burnout, while controlling for sociodemographic factors. Methods: A cross-sectional design was applied with 447 Hungarian parents who completed an anonymous online questionnaire including the Parental Burnout Assessment, the Parenting Styles and Dimensions Questionnaire, and the 10-item Connor–Davidson Resilience Scale. Data were analyzed using nonparametric correlations, group comparisons, multiple linear regression models with bootstrap estimation, and mediation analyses. Results: Resilience showed negative associations with all dimensions of parental burnout. Authoritarian and permissive parenting styles were positively associated with burnout, whereas authoritative parenting style showed negative associations. In multivariate analyses, authoritative parenting attitudes and fulfillment of the ideal parental role emerged as protective factors, while authoritarian parenting style functioned as a significant risk factor. Mediation analyses further indicated that the association between resilience and parental burnout may partly operate through parenting styles, particularly across the dimensions of emotional exhaustion, contrast, and emotional distancing. Conclusions: Parental burnout appears to be a dynamic psychological process shaped by the interaction of internal resources and parenting functioning, underscoring the importance of resource-oriented approaches in prevention and intervention. Full article

The present contribution provides a systematic review of the international scientific literature on the relationship between contaminated sites and real estate market dynamics. The objective is to investigate whether and to what extent the presence of environmental risk sources—both active or decommissioned—affects the value of surrounding residential properties. In particular, the review is focused on an examination of the methods commonly used in relevant studies to measure, interpret, and represent this impact across different geographical contexts, identifying the main magnitude ranges found in the selected contributions. Several studies consistently confirm a statistically significant negative relationship between proximity to polluting sites and real estate values, although the relevance of this effect varies considerably across case studies. Other records highlight non-notable impacts or even positive effects following remediation and redevelopment interventions. The evidence suggests that this relationship is complex and influenced by factors such as site type, contamination severity, specificities of the local urban context and community perception. Moreover, the findings underscore regional variations in the extent and nature of price impacts, reflecting diverse regulatory frameworks and remediation efforts. The outcomes of the literature review provide a robust foundation for developing more effective evaluation tools able to support decision-making processes, enabling policymakers, planners, and investors to promote sustainable urban regeneration, improve environmental justice, and reduce spatial inequalities. Ultimately, this study highlights the critical need for integrating environmental, social, and economic dimensions to fully capture the multifaceted effects of contaminated sites on property markets, thereby orienting more informed and equitable urban development strategies worldwide. Full article

Background/Objectives: Dental fear and anxiety (DFA) in children can negatively affect oral health behaviors and dental care utilization. Family-related factors, particularly parental anxiety, parenting styles, and socioeconomic characteristics, may be associated with DFA. This study aimed to investigate the association between family-related factors and DFA among children aged 6–8 years in Jakarta, Indonesia. Methods: A cross-sectional study was conducted among 294 child–parent pairs recruited from 10 primary schools using multistage cluster sampling. Children’s DFA was assessed using the Children’s Fear Survey Schedule–Dental Subscale (CFSS-DS), whereas parental dental anxiety was measured using the Modified Dental Anxiety Scale (MDAS). Sociodemographic and family-related characteristics, including parenting styles, were collected using self-administered questionnaires. Data were analyzed using chi-square tests and multivariable logistic regression. Results: Overall, 34.7% of the children were classified as having DFA. Maternal employment was significantly associated with children’s DFA, with children of formally employed mothers having higher odds of DFA (aOR = 2.01, 95% CI: 1.05–3.85; p = 0.034). Parental dental anxiety was associated with children’s DFA. Children whose fathers and mothers reported high levels of dental anxiety had 4.68-fold (95% CI: 1.64–13.33; p = 0.004) and 2.50-fold (95% CI: 1.10–5.74; p = 0.029) higher odds of experiencing DFA, respectively. Dental drilling and injections were the most frequently reported fear-provoking stimuli. The final regression model explained 13% of the variance in children’s DFA. Conclusions: Parental dental anxiety and maternal employment were significantly associated with DFA among children aged 6–8 years. Family-centered preventive strategies and early identification of at-risk children may help reduce DFA and promote positive dental experiences and oral health outcomes. Full article

This study examines how emotional and reflexive processes jointly relate to transfer of learning in workplace training contexts. Drawing on organizational learning theory, it introduces Reflexivity on Emotions (RoE) as a metacognitive capability through which individuals become aware of, critically examine, and respond to their emotional experiences. Integrating RoE, reflexivity on practice, positive affect, and negative affect within a person-centered framework, the study applies Latent Profile Analysis (LPA) to data collected from 609 correctional officer cadets enrolled in a six-month training program. The analysis identified four emotional–reflexive profiles (Generative–Reflexive, Balanced–Reflexive, Detached–Unreflexive, and Inhibited–Unreflexive), which showed different levels of transfer of learning. Notably, the Generative–Reflexive profile, characterized by elevated negative affect alongside strong reflexive resources, was associated with the highest levels of transfer, suggesting that negative emotions are not uniformly associated with poorer learning outcomes. More broadly, the findings indicate that transfer of learning is better understood through emotional–reflexive configurations rather than through isolated factors. The study contributes to organizational learning research by extending reflexivity into the emotional domain and by demonstrating the value of person-centered approaches for understanding individual differences in workplace learning. Practical implications for training design and the development of emotionally reflective learning environments are discussed. Full article

Rural household energy-saving behavior is central to low-carbon development in ecologically fragile plateau regions. This study explores whether climate risk perception promotes household energy-saving behavior, through which livelihood capital mechanisms this effect operates, and which livelihood capital configurations support high levels of such behavior. Drawing on survey data from 315 rural households in Xining, China, a sustainable livelihood framework is integrated with the pressure–state–response model, and PLS-SEM, an ANN, and fsQCA are applied. The integrated framework regards climate risk perception as external pressure, livelihood capital as the household livelihood state, and energy-saving behavior as the behavioral response. The sustainable livelihood framework identifies the multidimensional resource conditions of rural households, whereas the pressure–state–response model specifies the causal sequence through which perceived climate pressure affects livelihood states and induces behavioral responses. The results show that climate risk perception significantly promotes energy-saving behavior. Physical, human, and social capital exert positive effects, whereas natural and financial capital exert negative effects. Moreover, natural, financial, and social capital significantly mediate the link between climate risk perception and energy-saving behavior. Multi-group analysis shows that physical capital matters more for agriculture-dominated households than non-farm households. The ANN results identify social and human capital as the strongest predictors, and the fsQCA results show that high levels of energy-saving behavior arise not from any single condition but from multiple capital configurations, in which social capital is consistently central. Energy conservation under climate risk is therefore best understood as a multidimensional, nonlinear adaptation process embedded in household livelihood structures rather than a response to any single factor. These findings extend rural energy-saving research by linking climate pressure, livelihood conditions, and configurational decision logic in a plateau socio-ecological context. Policy interventions should combine energy-efficient infrastructure, targeted financial incentives, community-based diffusion, and livelihood-sensitive support for rural households. Full article

Background: Male infertility affects millions of couples, accounting for 50 percent of cases. Despite such a major contribution of the male factor, it is not properly evaluated and is often overlooked in infertility assessments. Semen analysis, which is routinely performed to assess infertility status, is unable to assess the defects at the molecular level which are important to assess the fertilizing capacity of the sperm. This study aims to determine the utility of sperm function tests as biomarkers for male infertility in addition to standard semen analysis. Methods: Thirty-five men (aged 25–45 years) were recruited and divided into two groups: those with at least one altered semen parameter (infertile group) and those with normal semen parameters but unable to conceive after more than one year of unprotected intercourse (unexplained male infertility group). The DNA Fragmentation Index (DFI), Nuclear Chromatin Decondensation Test (NCDT) and Hypoosmotic Swelling Test (HOS) were used in diagnosing sperm dysfunction in both groups. The Mann–Whitney U testand Spearman’s rank correlation were used for analyzing the parameters of the groups. A p value < 0.05 was considered statistically significant. Results: While motility and vitality were nearly identical in both groups, the infertile group showed more morphological abnormalities. The DFI was higher in the unexplained male infertility group (UMI) (82%) than in the infertile group (36%). Poor decondensation capacity was present in 27% of the unexplained male infertility group and 60% of the infertile group. Both groups’ hypoosmotic swelling values fell within the usual range. Spearman correlation analysis revealed that the NCDT showed significant positive correlations with sperm vitality (r = 0.36; p = 0.02) and morphology (r = 0.53; p = 0.001). The DFI demonstrated significant negative correlations with vitality (r = −0.45; p = 0.006) and motility (r = −0.39; p = 0.01). HOS was significantly positively correlated with motility (r = 0.56; p = 0.0004) and vitality (r = 0.57; p = 0.0003). Additionally, the NCDT and DFI showed a significant inverse correlation (r = −0.33; p = 0.04). Conclusions: These findings highlight the potential of sperm function tests as valuable diagnostic tools alongside conventional semen analysis for a more comprehensive assessment of male fertility. Full article

Background: Pain during orthodontic debonding is a common clinical concern. Although previous studies have mainly focused on mechanical approaches to reduce discomfort, the influence of emotional characteristics of patients on pain perception remains insufficiently explored. In this study, we aimed to evaluate the association between pain perception, emotional affect, and anxiety during orthodontic bracket removal using different clinical protocols. Methods: A prospective observational comparative study was conducted at Rey Juan Carlos University (Madrid, Spain). A total of 140 orthodontic patients underwent bracket removal according to four routine clinical protocols determined by clinical scheduling: ligated with interocclusal cotton rolls (used for tooth stabilization), non-ligated with cotton rolls, ligated without cotton rolls, and non-ligated without cotton rolls. Pain intensity was assessed using a Visual Analog Scale (VAS) immediately before (T0) and after (T1) bracket removal. Baseline pain (T0) was recorded to control for pre-existing discomfort. Anxiety and emotional affect were measured using the State–Trait Anxiety Inventory (STAI) and the Positive and Negative Affect Schedule (PANAS), respectively. Statistical analyses included ANOVA, factorial ANCOVA adjusted for baseline pain, and multivariable regression models. Results: No significant baseline differences were observed among groups. The highest post-debonding pain scores were found in the group without cotton rolls and without ligatures. ANCOVA revealed a significant main effect of cotton roll use, with lower adjusted pain scores in patients treated with cotton rolls, whereas ligation showed no statistically significant independent effect. In multivariable regression analyses, baseline pain, age, and negative affect were independently associated with higher post-debonding pain. Conclusions: Within the limitations of a non-randomized design, cotton roll use was associated with lower post-debonding pain, whereas ligation appeared to have a limited influence. Patient-related factors—particularly negative affect, age, and baseline pain—were also associated with pain perception, supporting a biopsychosocial perspective. These findings should be interpreted as exploratory evidence rather than causal effects. Full article

For over 70 years, microalgae have been considered promising ingredients for developing sustainable, nutritionally rich foods. Their high protein content, presence of essential amino acids, fatty acids, natural pigments, and a myriad of bioactive compounds position them as potential alternatives to conventional ingredient sources. However, despite their significant potential, the large-scale incorporation of microalgae into food products remains limited. This study presents a critical analysis of the main challenges associated with the use of microalgae in the food industry. Key bottlenecks include high production costs, technological difficulties related to biomass processing, and challenges in extracting desirable compounds. Additionally, the strong flavor, odor, and intense coloration of microalgal biomass can negatively affect sensory acceptance in food products. Other limitations involve scalability issues in cultivation systems, risks of contamination during production, and regulatory constraints related to food safety approval. Consumer perception and limited familiarity with microalgae-based foods also contribute to slower market adoption. Therefore, although microalgae represent a promising and sustainable food resource, overcoming technological, economic, and sensory barriers is essential for their broader integration into the food industry and for achieving successful market consolidation. Full article

Introduction: Climate change is reducing freshwater availability worldwide, making it essential to understand how freshwater inflow influences estuarine ecosystem functioning and marine fisheries productivity. In the Gulf of Cádiz (SW Spain), one of the most important fishing areas in Spain, the Guadalquivir Estuary serves as a key nursery habitat for commercially important fish and crustacean species. Objective: The aim of this study is to evaluate the effects of droughts and floods on estuarine functioning and coastal fisheries. Methodology: We analyzed 25 years of monthly data (1997–2022) from the Guadalquivir Long-Term Ecological Research Program (GUADALQUIVIR-LTER), using time-series analyses and dynamic structural equation modelling. Environmental variables, zooplankton and mysid biomass, and juvenile biomass of anchovy, sardine, and meagre were examined to assess trophic relationships and recruitment dynamics. Results: Our findings show that positive North Atlantic Oscillation (NAO) phases, associated with drought conditions in southern Europe, reduced freshwater inflow from the Alcalá del Río Dam into the estuary. Freshwater input increased organic matter and turbidity, which positively affected the mysid Rhopalophthalmus tartessicus, an important prey species for anchovy recruits. The mysid Mesopodopsis slabberi showed the strongest positive effect on anchovy recruitment (0.39). Although turbidity initially had a negative effect on M. slabberi, a significant positive effect appeared after monthly lag = 4. Conclusions: These findings demonstrate that spring freshwater inflow is essential for maintaining estuarine productivity, enhancing mysid abundance, and supporting anchovy recruitment, ultimately benefiting adult fish stocks after juveniles migrate from the estuary to coastal waters. Full article

Background and Objectives: It is well established that obstructive sleep apnea syndrome (OSAS) is associated with functional lung volumes. The aim of this study was to investigate the relationship between morphological lung volume and the severity of OSAS. Materials and Methods: Adult patients evaluated for sleep disorders between January 2020 and January 2024 were retrospectively reviewed. Patients with an AHI greater than 5, who underwent both spirometry and thoracic CT within a three-month interval, were included. Spirometric functional volume and morphological CT lung volume were assessed. Associations between OSAS severity and both functional and morphological lung volumes were analyzed. Results: A total of 195 patients were enrolled, of whom 166 had CT scans suitable for lung volume assessment. Among all patients, 20 (10.3%) were in the mild, 39 (20.0%) in the moderate, and 136 (69.7%) in the severe OSAS group. Ordinal regression analysis was performed to evaluate the factors influencing these categories. Age (p < 0.001) and BMI (p < 0.001) were positively correlated with disease severity, whereas female sex was associated with a lower risk of severe disease (p = 0.003). Conclusions: Functional and morphological lung volumes did not affect OSAS severity. Functional and morphological lung volumes were positively correlated with each other. Both morphological and functional lung volumes showed negative correlations with BMI. Full article

The growing use of artificial intelligence (AI) in social media marketing has accelerated the emergence of AI-generated virtual influencers. While these influencers offer brands advantages such as scalability and message control, they also raise concerns regarding manipulation and ethical persuasion. Grounded in the Persuasion Knowledge Model (PKM), this study examines how different AI disclosure conditions influence perceived manipulation, perceived ethics, and purchase intention in AI influencer marketing. A three-condition between-subjects experimental design was employed to compare a human influencer, a disclosed AI influencer, and an undisclosed AI influencer using identical Instagram stimuli. Data were collected from 762 Generation Z female consumers in Türkiye. Structural equation modeling (SEM) was used to test the proposed relationships. The findings revealed that both disclosed and undisclosed AI influencer conditions significantly increased perceived manipulation. Perceived manipulation negatively affected perceived ethics, whereas perceived ethics positively influenced purchase intention. In addition, AI literacy positively affected perceived manipulation and perceived ethics while negatively affecting purchase intention. The findings further demonstrated that disclosure conditions indirectly influenced purchase intention through sequential cognitive and ethical evaluation processes. The study contributes to the AI influencer and digital persuasion literature by demonstrating that disclosure cues shape consumer responses through interconnected psychological mechanisms. Full article

Background: Critically ill patients experience rapid muscle wasting during their ICU stay. Ultrasound (US) and bioelectrical impedance analysis (BIA) are widely used to assess muscle mass; however, their accuracy may be affected by fluid balance alterations. This study aimed to compare the reliability of US and BIA in detecting muscle loss under varying fluid balance conditions in ICU patients. Methods: In this prospective observational study, adult ICU patients with an ICU stay of ≥7 days were evaluated on Days 1, 5, and 7. Muscle thickness was measured using US, and phase angle (PhA) using BIA. Cumulative fluid balance, C-reactive protein (CRP), and lactate levels were recorded. Patients were stratified according to cumulative fluid balance. Results: A total of 143 ICU patients were included in the final analysis. US demonstrated a progressive decrease in muscle thickness (−3.54% ± 10.90% from Day 1 to Day 5 and −7.56% ± 11.82% from Day 1 to Day 7 (both p < 0.0001)), whereas BIA showed no significant change in PhA. Positive fluid balance significantly reduced PhA compared with the negative balance group, p < 0.001, whereas no statistically significant effect on US measurements was detected. CRP > 200 mg/L was associated with greater US-detected muscle loss on Day 5, while lactate > 2.5 mmol/L was associated with lower PhA. Conclusions: Ultrasound reliably identified structural muscle wasting in critically ill patients, with no statistically significant effect of fluid balance detected in this cohort. Furthermore, ultrasound measurements were associated with inflammation-related muscle loss. In contrast, BIA was strongly influenced by hydration and perfusion status, limiting its ability to assess true muscle mass loss in the ICU setting. Full article