Search Results (864)

Current research and development in understanding road users’ driving behaviors play a key role in improving traffic safety. Recently, several driving simulators have been employed as a suitable approach to investigate several drivers’ responses in challenging traffic scenarios. Although professional drivers represent a particular category among driving populations, the body of literature about their comparative behavioral and psychological characteristics remains limited. This study examined the differences in driving performance and visual and physiological responses between civilian and professional drivers in a simulated environment. A total of 30 drivers, with an equal split between professional and civilian categories, took part in a series of driving simulations. The simulations incorporated various infrastructure types, including four cone avoidance tasks and a high-speed motorway task. This study collected comprehensive data on performance metrics, hand usage, heart rate, and eye movements. Eye-tracking technology was used to measure visual attention. The findings revealed that during cone avoidance scenarios, civilian drivers exhibited a similar performance, visual behavior, and physiological response, except for the speed, experiment duration, and throttle, to professional drivers. In the motorway scenario, all metrics showed no significant difference between the two driver groups. These results highlight the need for cautious interpretation, particularly given the limitations of the sample. Revalidation is needed in larger studies, especially for understanding the differences between drivers’ metrics, which is crucial to elevate drivers’ safety, and assessing training programs in Hungary. Full article

Introduction: Adolescent idiopathic scoliosis (AIS) presents not only physical but also psychological challenges for affected patients, frequently requiring comprehensive management that includes psychological interventions. Accurate and transparent reporting of interventions is essential to support reproducibility, facilitate clinical translation, and advance research quality. However, the completeness of intervention reporting and adherence to standardized guidelines in published studies on psychological interventions for pediatric AIS patients remains unclear. Methods: We searched Medline, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) for studies involving psychological interventions in AIS. Intervention reporting was analyzed using the Template for Intervention Description and Replication (TIDieR) checklist. Adherence to reporting guidelines was assessed for different study designs. Results: We identified 18 studies, which had suboptimal reporting of interventions. For key TIDieR items, all studies reported the brief name and rationale, but completeness for other elements varied: methods (14/18 studies), materials (10/18), provider (6/18), and mode of delivery (8/18) were described inconsistently. Setting was reported in only 3/18 studies, whereas the details about tailoring, modifications, and fidelity were largely lacking or deemed non-applicable. For eight randomized trials, several critical CONSORT items, such as trial design, randomization procedures, blinding, and trial registration were often unreported. Among five observational studies, reporting of STROBE key elements such as study design, setting, eligibility criteria, and funding was more consistent, but methods addressing bias, participant flow, missing data, and category boundaries for variables were largely insufficient. Similar gaps were observed for relevant TREND checklist items for nonrandomized intervention studies. Conclusions: The reporting of psychological interventions for AIS in the literature is frequently incomplete, especially for intervention details essential for the reproducibility of the intervention and assessment of risk of bias. Adoption of standardized reporting guidelines is necessary to improve intervention transparency, replicability, and translation into clinical practice. Future research should focus on prospective evaluations of reporting guideline implementation and its impact on research quality in this field. Full article

This study introduces a hybrid Brain–Computer (BCI) system with a robust and secure activation mechanism between sessions, aiming to minimize the negative effects of visual stimulus-based BCI systems on user eye health. The system is based on the integration of Electroencephalography (EEG) signals and Electrooculography (EOG) artefacts, and includes an LED stimulus operating at a frequency of 7 Hz for safe activation and objects moving in different directions. While the LED functions as an activation switch that reduces visual fatigue caused by traditional visual stimuli, moving objects provide command generation depending on the user’s intention. In order to evaluate the stability of the system against physiological and psychological conditions, data were collected from 15 participants in two different sessions. The Correlation Alignment (CORAL) method was applied to the data to reduce the variance between sessions and to increase stability. A Bootstrap Aggregating algorithm was used in the classification processes, and with the CORAL method, the system accuracy rate was increased from 81.54% to 94.29%. Compared to similar BCI approaches, the proposed system offers a safe activation mechanism that effectively adapts to users’ changing cognitive states throughout the day by reducing visual fatigue, despite using a low number of EEG channels, and demonstrates its practicality and effectiveness by performing on par or superior to other systems in terms of high accuracy and robust stability. Full article

Decision-making theory has developed over many decades at the intersection of economics, mathematics, psychology, and engineering. Its classical foundations include Bernoulli’s expected utility theory, von Neumann and Morgenstern’s rational choice theory, and the criteria proposed by Savage, Wald, Hurwicz, and others. However, in real-world contexts, decisions are made under uncertainty, incompleteness, and unreliability of information, which classical approaches do not adequately address. To overcome these limitations, modern multi-criteria decision-making methods such as Analytic Hierarchy Process (AHP), Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), VlseKriterijumska Optimizacija I Kompromisno Resenje (Compromise solution approach) (VIKOR), and ELimination Et Choix Traduisant la REalité (Elimination and Choice Expressing Reality) (ELECTRE), as well as their fuzzy and Z-number extensions, are widely applied to the modeling and evaluation of complex systems. These Z-number extensions are based on the concept of Z-numbers introduced by Lotfi Zadeh in 2011 to formalize higher-order uncertainty. This study introduces the Z-Regret principle, which extends Savage’s regret criterion through the use of Z-numbers. Supported by Rafik Aliev’s mathematical justifications concerning arithmetic operations on Z-numbers, the model evaluates regret not only as a loss relative to the best alternative but also by incorporating the degree of confidence and reliability of this evaluation. Calculations for the selection of digital advertising platforms in terms of performance assessment under various scenarios demonstrate that the Z-Regret principle enables more stable and well-founded decision-making under uncertainty. Full article

Background: Diabetes often causes microvascular complications such as neuropathy. Autonomic neuropathy remains under-recognized, and its impact on quality of life (QoL) is unclear. This study investigated associations between symptoms of autonomic dysfunction, including organ-specific subdomains, and QoL in individuals with type 1 (T1D) and type 2 diabetes (T2D). Methods: A cross-sectional population-based survey was conducted in the North Denmark Region among individuals with T1D and T2D, assessing autonomic symptom burden with the Composite Autonomic Symptom Score-31 (COMPASS-31), general well-being with the Short Form Health Survey (SF-36), and psychological well-being with the Hospital Anxiety and Depression Scale. Multivariate linear regression assessed associations between autonomic symptom scores and QoL outcomes. Results: The COMPASS-31 scores were 8.9 (2.9; 22.8) in T1D and 12.4 (5.3; 26.1) in T2D. SF-36 physical composite scores were 52.1 (43.2; 56.4) in T1D and 49.3 (40.3; 54.8) in T2D, with similar mental composite scores (50.7 (40.3; 56.9) vs. 51.4 (41.2; 57.2)). Signs of moderate to severe anxiety were observed in 9.9% (95% confidence interval (CI): 8.1–11.9) of T1D and 8.9% (95% CI: 8.1–9.6) of T2D, while depression was present in 5.9% (95% CI: 4.5–7.6) and 5.1% (95% CI: 4.5–5.7). Higher autonomic symptom burden, especially pupillary, vasomotor, and bladder domains, was associated with lower SF-36 score and higher anxiety and depression scores. Conclusions: the Autonomic symptom burden is associated with reduced QoL and increased psychological distress in individuals with diabetes. These findings emphasize the importance of assessing and managing autonomic symptoms in diabetes care to support overall well-being. Full article

Background and Objectives: Facebook groups have become support spaces for people with rare diseases such as amelogenesis imperfecta (AI). While their potential for revealing patient needs is recognized, no systematic analysis has been conducted in France. This study aims to better understand the psychological and practical needs of French AI patients by analyzing interactions within a dedicated Facebook group. Methods: A semantic and thematic analysis was conducted on 881 texts (39,647 words) from the French Facebook group Amelogenesis Imperfecta. A custom tool, TEXTRA©, and IRaMuTeQ© software were used for analysis, including similarity analysis (lexical co-occurrences), Descending Hierarchical Classification (DHC), Correspondence analysis to reveal discourse structures. Results: Correspondence analysis revealed two main discourse trends: individual experiences (symptoms, treatment logistics, and medical engagement) and collective narratives (focused on awareness, mobilization, and institutional recognition). DHC identified four thematic classes: (a) difficulties accessing healthcare, (b) genetic framing and family implications, (c) dental symptoms and treatment experiences, and (d) community advocacy. These findings highlight how the group fosters emotional support, peer exchange, and empowerment. Conclusions: Online communities play a vital role in supporting patients with rare diseases. This study shows that the analysis of user-generated content can guide improvements in clinical practice, psychosocial support, and health policy. Full article

Background/Objectives: Healthcare workers often experience chronic psychological stress, which may affect up to 71% of nurses, leading to mental outcomes, namely, depressive symptoms and a chronic state of physical and emotional depletion followed by burnout syndrome. Emotional exhaustion, depersonalization and poor personal accomplishment are three core features responsible for the development of burnout. Given sleep quality as a mediator is likely to play a key role in forecasting the potential impingement of burnout both directly and indirectly, this cross-sectional study aimed to explore any possible association between sleep disorders and burnout in a cohort of Lithuanian clinical nurses. Methods: During a six-week period in October–November 2024, a total of 269 female nurses ranging between 22 and 67 years old were recruited for a cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI) tool and the Maslach Burnout Inventory (MBI) were applied to assess the level of subjective sleep quality over the last month and the self-perceived occupational burnout experienced by clinical nurses, respectively. Results: This study highlighted a worrying proportion of nurses found to be at an increased risk of occupational burnout syndrome after more than 60% of nurses had experienced the symptoms of emotional exhaustion and depersonalization. A similar proportion of nurses was exposed to the risk of sleep disorders, which, as a potential trigger, played an important role in maintaining burnout syndrome. More specifically, the global PSQI score was related to the expression of depersonalization (β 0.5, 95% confidence interval (CI) 0.2; 0.9, p = 0.002, R² = 0.27). The higher levels of both emotion exhaustion (β 2.5, 95% CI 1.5; 3.5, p < 0.001, R² = 0.26) and depersonalization (β 1.9, 95% CI 0.8; 3.0, p = 0.001, R² = 0.28) were associated with perceived daily disturbances (in terms of sleep disturbances and daytime dysfunction) in nurses. Conclusions: Healthcare professionals should focus further attention on reducing high-level depersonalization expression and potential risk factors, namely sleep disturbances and daytime dysfunction associated with this burnout symptom in a population of clinical nurses. Therefore, by targeted integration of efficient sleep interventions, healthcare institutions could promote employee-friendly workplaces, and, eventually, improve not only the indicators of burnout syndrome but also nurses’ performance and patient safety as well as satisfaction with perceived nursing care. Full article

The social context for human social interactions between modern urban contexts and ancestral, small-scale contexts is different in many important ways. Before the advent of agriculture, all people lived in small-scale social contexts and were surrounded by kin and other familiar others. As these conditions characterized the lion’s share of human evolutionary history, we can expect much of our social psychology to be more designed for such small-scale contexts than for large-scale contexts. The study described here specifically predicted that informal forms of making an agreement (such as a handshake, which is more similar to how contracts are sealed in small-scale societies) would be weighted more heavily by people who are given an option to break a contract in a small-scale context. On the other hand, we predicted that people who are framed to think about large-scale social contexts will give more weight to written contracts. Using a 2*2 between-groups design (with 200 young adult participants), this interaction-based hypothesis was supported. We also found that, apart from experimental conditions, participants who reported coming from urban backgrounds were more likely to break a deal of any kind relative to others. Implications for cultivating prosocial outcomes against this backdrop are discussed. Full article

Background/Objectives: The prison environment presents a unique context for examining the impact of addiction on physical and psychological functioning. Individuals with substance use disorders (SUDs) are overrepresented in correctional facilities and often experience greater emotional difficulties and impaired physical capacity. This study aimed to conduct a comparative analysis of psychological and functional profiles between addicted and non-addicted male inmates in a semi-open correctional facility. Methods: The study included 47 male prisoners (19 addicted, 28 non-addicted). Physical performance was assessed using the Countermovement Jump (CMJ), handgrip strength, the Functional Movement Screen (FMS), and the FitLight reaction time test. Psychological functioning was evaluated using six standardized questionnaires: problem-focused, emotion-focused, and avoidant coping strategies, depression (PHQ-9), perceived stress (PSS-10), and self-compassion (SCS). Results: No statistically significant differences (p > 0.05) were found between addicted and non-addicted inmates in physical performance parameters. Addicted individuals demonstrated slightly higher handgrip strength with lower variability, while non-addicted inmates showed slightly better lower-body power in the CMJ test. Functional movement quality and reaction speed were similar between groups. Psychological assessments also revealed no significant differences between the groups. Coping styles, depressive symptoms, perceived stress levels, and self-criticism scores were comparable in both populations. In the addicted group, deeper squats correlated with lower stress (rho = −0.46, p = 0.047), and better hurdle step performance correlated with emotion-focused coping (rho = 0.46, p = 0.048). Conclusions: Although no statistically significant differences were found between addicted and non-addicted male inmates in the assessed physical and psychological outcomes, the limited sample size and context-specific nature of this pilot study suggest that these findings should be viewed as preliminary and interpreted with caution. Nonetheless, the observed associations between physical performance and psychological variables indicate subtle interconnections between motor capacity, stress perception, and coping mechanisms that merit further investigation in larger, longitudinal studies. Full article

Post-traumatic stress disorder (PTSD) is associated with long-term disturbances in stress regulation, neuroinflammation, and oxidative stress and reduced psychological coping capacity. The aim of the study was to assess the relationship between selected neurobiological biomarkers (Insulin-like Growth Factor 1—IGF-1; Caspase-9—CASP-9; Neuronal Nitric Oxide Synthase—nNOS; and Interleukin-10—IL-10) and coping styles evaluated using the Brief Coping Orientation to Problems Experienced (Brief-COPE) questionnaire in men with trauma experience. Particular emphasis was placed on analyzing the effect of PTSD chronicity (≤5 years vs. >5 years) on these relationships. The study included 92 adult men with a history of life-threatening situations. Participants were divided into three groups: PTSD within the past ≤5 years (n = 33), PTSD within the past >5 years (n = 31), and a No PTSD group (n = 28). Biomarkers were measured in blood serum. Coping strategies were assessed using the Brief-COPE questionnaire, which includes four subscales: task-oriented, emotion-oriented, avoidant, and general coping. Due to the lack of normal distribution, the Kruskal–Wallis test and Dunn’s post hoc test were used. Correlations between biomarkers and Brief-COPE subscales were calculated using Spearman’s Rank Correlation Coefficient (Rho). Significant differences between groups were found in all four biomarkers (p < 0.001). IGF-1 and IL-10 reached the highest values in the No PTSD group and the lowest in the PTSD ≤ 5 years group, indicating neuroprotective and anti-inflammatory deficits in PTSD. Conversely, CASP-9 and nNOS levels (markers of apoptosis and oxidative stress) were highest in PTSD ≤ 5 years, with partial normalization in the PTSD > 5 years group. In terms of coping strategies, the No PTSD group displayed a highly adaptive profile (task-oriented: 30/32; emotion-oriented: 43/48; and avoidant: 12/32). Individuals with PTSD ≤ 5 years presented a maladaptive pattern (task-oriented: 13/32; avoidant: 26/32; and emotion-oriented: 27/48), while in PTSD > 5 years, a further decline in emotion-oriented (21/48) and general coping (59/112) was observed, suggesting progressive depletion of psychological resources. The strongest correlations between biomarkers and coping strategies occurred in PTSD groups. Low IGF-1 levels in PTSD ≤ 5 years correlated negatively with emotion-oriented coping (Rho = −0.39) and general coping (Rho = −0.35). High CASP-9 levels were associated with reduced task-oriented coping in PTSD > 5 years (Rho = −0.29). Similar trends were observed for nNOS and IL-10, indicating a disturbance in neurobiological balance that favors persistence of PTSD symptoms. PTSD, both in its acute and chronic phases, is associated with an abnormal profile of neuroprotective, apoptotic, and inflammatory biomarkers, which correlates with impaired adaptive coping capacity. Although partial normalization of biological parameters is observed in chronic PTSD, deficits in emotion-oriented and task-oriented coping persist. The Brief-COPE questionnaire, combined with biomarker analysis, may serve as a useful clinical tool for assessing psychophysiological balance and designing early interventions. These results highlight the potential of IGF-1, CASP-9, nNOS, and IL-10 as biomarkers of stress adaptation and therapeutic targets in PTSD. Full article

Background: Functional cure of chronic hepatitis B (CHB) can be achieved with appropriate antiviral treatment. However, few studies have evaluated the added benefits of achieving functional cure. We aimed to conduct a quantitative analysis of the health-related quality of life (HRQoL) of CHB patients who achieved functional cure to provide evidence for economic analysis. Methods: We conducted a cross-sectional study in five provinces in China in 2021. The study population was recruited in hospitals and divided into three groups: functional cure, antiviral treatment, and healthy control group. Data were collected through face-to-face interviews using the Short Form-36 version 2. Results: 497 participants (163 with functional cure, 192 with antiviral treatment, and 142 with healthy control) were used in this study. The eight scale scores (physical function, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health) and two summary scores (physical composite and mental composite) in the functional cure and healthy control groups were similar. Compared to the healthy control group, the general health scores in the functional cure group were worse with −0.052 (95% CI: −0.094, −0.010), and the antiviral treatment group had significantly worse scores with −0.127 (95% CI: −0.170, −0.083). The antiviral treatment group had lower vitality scores (β = −0.048, 95% CI: −0.089 to −0.007) and MCS scores (β = −0.023, 95% CI: −0.042, −0.003, p = 0.022) compared to the healthy control. The mental composite summary scores of all groups were >50 (p > 0.05). Conclusions: Health-related quality of life decreases with CHB disease progression. The results indicate that functional cure is associated with HRQoL levels comparable to those of the healthy population, both on the physical and psychological aspect, reinforcing the clinical value of this therapeutic goal. Full article

In the context of China’s increasingly competitive agricultural product branding, authenticity has become a pivotal mechanism for shaping consumer trust and willingness to pay. This study takes Perceived Brand Authenticity (PBA) as its focal construct and builds a chained mediation framework incorporating experiential quality (EQ) and consumer trust. Employing a dual-evidence strategy that combines structural discovery and causal validation, the study integrates Jaccard similarity clustering and PLS-SEM to examine both behavioral patterns and psychological mechanisms. Drawing on 636 valid survey responses from across China, the results reveal clear segmentation in channel choice, certification concern, and premium acceptance by gender, age, income, and education. Younger and highly educated consumers rely more on e-commerce and digital traceability, while middle-aged, older, and higher-income groups emphasize geographical indications and organic certification. The empirical analysis confirms that PBA has a significant positive effect on EQ and consumer trust, and that the chained mediation pathway “PBA → EQ → Trust → Purchase Intention” robustly captures the transmission mechanism of authenticity. The findings demonstrate that verifiable and consistent authenticity signals not only shape cross-group consumption structures but also strengthen trust and repurchase intentions through enhanced experiential quality. The core contribution of this study lies in advancing an evidence-based framework for sustainable agricultural branding. Theoretically, it reconceptualizes authenticity as a measurable governance mechanism rather than a rhetorical construct. Methodologically, it introduces a dual-evidence approach integrating Jaccard clustering and PLS-SEM to bridge structural and causal analyses. Practically, it proposes two governance tools—“evidence density” and “experiential variance”—which translate authenticity into actionable levers for precision marketing, trust management, and policy regulation. Together, these insights offer a replicable model for authenticity governance and consumer trust building in sustainable agri-food systems. Full article

Background: Preliminary evidence supports high-intensity functional training (HIFT) for improving various health outcomes in non-disabled adults with overweight/obesity. It remains unknown whether HIFT produces similar benefits in individuals who are overweight/obese and also have a mobility disability (e.g., spinal cord injury, multiple sclerosis)—a population disproportionately affected by obesity-related health conditions and systemic barriers to exercise. This pilot study aimed to evaluate the feasibility and preliminary effects of a 24-week HIFT intervention, delivered at community sites by certified trainers, for adults with mobility disabilities (MDs) who were overweight/obese. Methods: Twenty adults with MD and overweight/obesity (self-reported BMI 25–46 kg/m²) enrolled in a 24-week HIFT intervention (3 days/wk, 60 min sessions) delivered at four community-based facilities by certified trainers. Feasibility indicators included recruitment, retention, and attendance; adverse events were tracked. Effect sizes (Cohen’s d) were calculated for changes in obesity-related measures, physical function, work capacity, and psychological measures from baseline to post-intervention. Results: Feasibility targets were met, with a recruitment rate of 72.2%, 76.9% retention, and 80.7% attendance. Thirteen adverse events occurred. Effects on obesity-related measures ranged from negligible to moderate, with stable weight/BMI, reduced waist circumference (45% ≥ 3 cm decrease), decreased body fat, and increased lean mass. Functional outcome effects ranged from small to large and included grip strength, balance, and walking speed. Large improvements were observed for the endurance, speed, work capacity, and self-reported physical function. Conclusions: A community-based HIFT program is feasible and may improve health outcomes in adults with MD and overweight/obesity. Full article

The COVID-19 pandemic has placed a considerable psychological burden on healthcare workers, potentially leading to increased burnout and anxiety. This study aimed to evaluate burnout and anxiety levels among healthcare workers compared to non-healthcare professionals during the pandemic. We initially recruited 438 adults; 351 (217 HCWs and 134 non-HCWs) provided complete responses across all three survey waves and were analyzed. Burnout was assessed using the Maslach Burnout Inventory, and anxiety with the State–Trait Anxiety Inventory. Data were collected through an online self-administered survey at three different time points during the pandemic, and analyzed with non-parametric tests and effect sizes. Healthcare workers exhibited significantly higher levels of emotional exhaustion, depersonalization, overall burnout, and anxiety compared to non-healthcare workers across all three periods (p < 0.05). Of 438 consented individuals, 351 (80.1%) completed all waves, allowing within-population longitudinal comparisons. Within the healthcare worker group, women, individuals living alone, those working night shifts, and those considering a career change had notably higher burnout and anxiety scores. No significant differences were observed in personal accomplishment scores. Healthcare workers experienced greater psychological distress than non-healthcare workers during the COVID-19 pandemic. Identifying vulnerable subgroups and implementing supportive strategies are essential to protect the mental health and well-being of healthcare professionals during pandemics and similar crises. Full article

Clozapine and olanzapine are important medications in the management of psychiatric conditions such as schizophrenia. However, metabolic disturbances and weight gain are common side effects of these drugs. We aimed to evaluate the effects of GLP-1 RAs treatment for metabolic disturbances and weight gain in patients on clozapine/olanzapine. For this systematic review, searches were conducted in eight different databases. After screening, outcome data was synthesized regarding weight gain and biochemical and clinical indicators of metabolic disturbance, as well as for adverse events/side effects, and any other benefits of GLP-1 RA treatment. A total of 14 studies were included in this medical systematic review, of which four were unique randomized control trials (RCTs), with study contexts including Australia and Denmark. GLP-1 RAs that were utilized include semaglutide, exenatide, and liraglutide. It was consistently demonstrated across studies that, when followed-up, those on GLP-1 RAs had achieved statistically lower levels of weight gain compared to those receiving placebo. A similar effect was seen on fasting glucose levels and glycated haemoglobin levels. Effects on other metabolic parameters were inconsistent. There were minimal gastrointestinal, psychological, cardiac, and other side effects noted across studies. GLP-1 RAs may offer utility in addressing the metabolic side effects of olanzapine/clozapine, but further research is needed. There remains a need to better understand impacts and potential side effects in larger and more diverse populations, as well as a need to better evaluate the long-term outcomes for patients. Full article