Search Results (11,087)

Osteoporosis (OP) is a common chronic disease that significantly increases the risk of bone fractures. Pharmacotherapy uses, among others, 17beta-estradiol (E2), which has been replaced in recent years by raloxifene hydrochloride (RLX). The need for long-term, high-dose therapy with these drugs is associated with serious adverse effects. The aim of this review is to analyze the current state of knowledge over the last 5 years (2020–2025) regarding the use of nanoparticles (NPs) in the delivery of E2 and RLX, with particular emphasis on their impact on bioavailability, pharmacokinetic profile, reduction in adverse effects, and improvement in the effectiveness of postmenopausal osteoporosis therapy. Preclinical studies show that combining E2 or RLX with various types of NPs reduces cytotoxicity, improves pharmacokinetic parameters, and enhances the therapeutic effects of drugs used in postmenopausal osteoporosis. These effects are mainly attributed to improved pharmacokinetics and controlled drug release, rather than confirmed active tissue targeting. However, these findings are based on preclinical models and require further validation in clinical studies. The analysis concludes that while NP systems significantly enhance the pharmacokinetic profile and safety of E2 and RLX in preclinical models, claims of true bone-specific targeting remain largely unsubstantiated, highlighting a key area for future research. Full article

The protection of human and ecological health has become more challenging because of the myriad of human and climate stressors, and the sustainability of our social, economic, and environmental systems would be enhanced by further defensible risk assessment. There are scientific, technological, and cultural challenges to interoperability, bridging the necessary disciplines and integrating data from the genome to globe. Interoperability makes possible the use and reuse of data and modeling approaches and is a contemporary and rapidly progressing area advancing toxicology and exposure science. We present a coherent vision of human and ecological risk assessment, including the types of information and modeling science to create knowledge and apply it for improved decision-making. We focus on science-based decision-making, emphasizing decisions where science is the primary or sole driver, as in human toxicology and ecological risk assessment. This contrasts with decision-making where science has a minor role, if at all, in weighing decision options. We also examine the barriers that exist in the creation and application of systems thinking. We identify: the (1) needs and challenges for the application of a systems approach to informing decisions; (2) case studies that illustrate informatics needs for 21st-century science-based decision-making; and (3) recommendations on how to progress towards a systems approach to informing decisions. Full article

Background/Objectives: There is still limited understanding of how psychotic symptoms and sexual risky behaviors (SRBs) are related to each other. Gaining more knowledge of the mechanisms involved in this relationship could inform interventions to reduce or prevent SRBs. This study aims to deepen comprehension of the relationship between psychotic experiences (PEs) and SRBs by examining the moderating effects of depression and childhood trauma. Methods: A web-based survey and a cross-sectional design were adopted to collect data from 466 young general population adults (aged 18–35 years) from Tunisia during the period January–March 2024. The snowball sampling technique was used to recruit participants. Results: Moderation analyses were adjusted over age, sex, household crowding index, marital status, and living situation. The interaction PEs by childhood trauma was significantly associated with SRB scores. At high and moderate levels of child abuse, higher PEs were significantly linked to higher SRBs. Furthermore, the interaction PEs by depression was significantly associated with SRB scores. At high, moderate, and low levels of depression, higher PEs were significantly associated with higher SRBs. Conclusions: Clinicians should consider including assessment of childhood trauma and depression in young adults with PEs who are engaged in sexual risk-taking behaviors. Findings may imply that strategies addressing these two factors can be effective in mitigating the association between PEs and SRBs. Full article

Background: With the worldwide resurgence of Mpox in 2022, understanding its regional features is important. This systematic review aimed to provide an overview of the epidemiology, risk factors, clinical features, and outcomes of Mpox in Saudi Arabia to fill the knowledge gaps in this area. Methods: Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic search was performed on PubMed, MEDLINE (via Ovid), Scopus and Wiley Online Library for case reports and series published on Mpox in Saudi Arabia after 2022. Results: Analysis included eight studies comprising a total of 410 patients with confirmatory data. The cohort was predominantly male (91%), with a mean age of 32.8 years. Extramarital sexual contact was the most frequently identified risk factor (28.8%), whereas most patients (63.4%) had unknown or denied exposure routes. The most common clinical manifestations were fever (97.1%) and rash (96.8%). Dermatological findings were usually pleomorphic. These included umbilicated pustules, crusted papules, and vesiculopustular lesions. Although management was primarily supportive, rare complications, such as keratitis and neurological deficits, were observed. Conclusions: In Saudi Arabia, Mpox primarily affects young adult males, particularly individuals with high-risk sexual behaviors. Much of this transmission remains undetermined, and better contact tracing and focused public health efforts are urgently required. Full article

Young adults often underuse ultraviolet radiation (UVR) protective strategies and engage in indoor tanning, heightening lifetime skin cancer risk. The national Skin Smart Campus (SSC) initiative encourages universities to adopt policies that reduce UVR exposure. We evaluated a 6-month SSC university campaign using an independent-samples pre-post design with surveys before (N = 230) and after (N = 267) implementation. The campaign included SSC designation, an educational webpage, targeted Instagram content, small media, and sunscreen dispensers. Following campaign launch, knowledge increased over time (t = 5.02, df = 493, p < 0.001), as did dispenser use (21.9% to 57.7%; χ² = 64.4, p < 0.001). The sun safety behavior composite showed an upward trend (13.5 to 14.2, t = 1.71, df = 490, p = 0.09). Variance models indicated a significant time effect (F [1, 482] = 4.55, p = 0.03, η²p = 0.01; small effect), with higher sun safety associated with greater knowledge (F = 8.29, p = 0.004, η²p = 0.02; small effect) and SSC campaign awareness (F = 56.88, p < 0.001, η²p = 0.10; large effect). In multivariable regression, campaign engagement predicted higher odds of dispenser use (Odds Ratio = 3.01, 95% CI: 1.82–4.98, p < 0.001). Implementing SSC with environmental supports and tailored education increased knowledge, sun safety, and dispenser use, highlighting the strong influence of SSC visibility and multimodal campus-wide prevention strategies. Full article

This study presents a comprehensive evaluation and environmental risk assessment (ERA) of pharmaceutical residues in the Cerrón Grande Reservoir, one of the most important surface water bodies in El Salvador. Sampling campaigns were conducted over a one-year period, covering both the dry (January 2024) and rainy (July 2024) seasons. A total of 76 pharmaceutical compounds were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS), of which only five were not detected. During the dry season, the highest environmental concentrations were observed for mecamylamine (1710–6913 µg L⁻¹), 1,7-dimethylxanthine (379–2829 µg L⁻¹), chloroquine (2.29–362.7 µg L⁻¹), and hydroxychloroquine (5.02–315.4 µg L⁻¹). Concentrations generally decreased in the rainy season, with mecamylamine (1526–2198 µg L⁻¹), 1,7-dimethylxanthine (0.018–0.55 µg L⁻¹), and caffeine (0.2–0.474 µg L⁻¹) remaining the most prevalent. Compounds exceeding 1 µg L⁻¹ were assessed using predicted no-effect concentrations (PNEC) to calculate risk quotients (RQ). Chloroquine (RQ = 3346.3), mecamylamine (RQ = 1437.8), hydroxychloroquine (RQ = 1027.2), and manidipine (RQ = 271.0) posed the highest risks during the dry season, while only mecamylamine (RQ = 502.0) exceeded this threshold in the rainy season. To our knowledge, this represents the first in-depth study of pharmaceutical residues in Salvadoran surface waters, providing a foundational reference for future research and environmental policy in the region. Full article

Background: Evidence-based practice (EBP) has become a foundational component of modern healthcare globally. In Saudi Arabia, the understanding and application of EBP by respiratory therapists (RTs) remains underexplored. This study aimed to assess RTs’ behaviors, attitudes, awareness, knowledge, and barriers related to EBP. Methods: A previously validated online questionnaire was distributed to RTs across Saudi Arabia between February and July 2025. The survey collected sociodemographic data and included 14 items assessing behaviors, attitudes, awareness, knowledge, prior formal EBP training, and perceived barriers to EBP implementation. Results: A total of 301 RTs participated, with 290 completing the survey. Most participants (75.2%) held a bachelor’s degree. Overall, respondents demonstrated positive attitudes toward EBP, with more than 60% agreeing that understanding research methods is essential to respiratory therapy practice. The most frequently used resources for clinical decision-making were personal experience (67.3%), expert opinion (65.5%), and national or international guidelines (65.5%). Awareness of core EBP concepts was moderate; approximately 30% of participants reported a good understanding of terms such as “systematic review,” “quality of evidence,” and “risk of bias.” Several barriers to EBP implementation were identified, most commonly limited access to resources (25.2%), insufficient research knowledge and skills (23.8%), and lack of interest (21.0%). Conclusions: RTs in Saudi Arabia generally support EBP principles and use evidence-based resources in clinical decision-making. However, gaps in training, access to resources, and research competency limit full EBP implementation. Targeted strategies, including integrating mandatory EBP education, expanding professional development, and enhancing access to research resources, are recommended. Full article

Trait-based approaches, particularly those focusing on behavioral traits, have become increasingly important in ecology. However, empirical studies addressing behavioral trait variation in insects remain comparatively scarce. To address this knowledge gap, we investigated the behavior of six wild-living ground beetle species for which no behavioral data have previously been reported. Using standardized behavioral measures, we found that in species occurring in their preferred forest habitats, behavioral traits related to activity, exploration, boldness, and risk-taking showed weak or limited temporal consistency. In contrast, in species inhabiting modified forest habitats, behavioral traits exhibited pronounced and repeatable individual differences, were intercorrelated, and formed behavioral syndromes. Moreover, half of the studied species showed sex-specific differences in personality, reflecting drivers related to reproductive roles and investment. Overall, our findings emphasize that animal personality and behavioral syndromes in ground beetles are not universal species-level properties but emerge from the interaction between intrinsic traits, and sex-specific strategies, underscoring the importance of considering ecological context when interpreting individual-level behavioral variation. Full article

Heavy metal pollution in forest and agroforestry soils represents a persistent environmental challenge with direct implications for ecosystem functioning, food security, and human health. In tropical and subtropical regions, intense weathering, rapid organic matter turnover, and dynamic redox conditions strongly modulate metal mobility, bioavailability, and long-term soil vulnerability. This review synthesizes current knowledge on the sources, biogeochemical mechanisms, ecological impacts, monitoring approaches, and restoration strategies associated with heavy metal contamination in forest and agroforestry systems, with particular emphasis on tropical landscapes. We examine natural and anthropogenic metal inputs, highlighting how atmospheric deposition, legacy contamination, land-use practices, and soil management interact with mineralogy, organic matter, and hydrology to control metal fate. Key processes governing metal behavior include sorption and complexation, Fe–Mn redox cycling, pH-dependent solubility, microbial mediation, and rhizosphere dynamics. The ecological consequences of contamination are discussed in terms of soil health degradation, plant physiological stress, disruption of ecosystem services, and risks of metal transfer to food chains in managed systems. The review also evaluates integrated monitoring frameworks that combine field-based soil analyses, biomonitoring, and geospatial technologies, while acknowledging methodological limitations and scale-dependent uncertainties. Finally, restoration and remediation strategies—ranging from phytotechnologies and soil amendments to engineered Technosols—are assessed in relation to their effectiveness, scalability, and relevance for long-term functional recovery. By linking mechanistic understanding with management and policy considerations, this review provides a process-oriented framework to support sustainable management and restoration of contaminated forest and agroforestry soils in tropical and subtropical regions. Full article

Deceptive and evolving conversations on online platforms threaten trust, security, and user safety, particularly when concept drift obscures malicious intent. Large Language Models (LLMs) offer strong natural language reasoning but remain unreliable in risk-sensitive scenarios due to contextual ambiguity and hallucinations. This article introduces a domain knowledge-enhanced Dual-LLM framework that integrates structured cues with pretrained models to improve fraud detection and drift classification. The proposed approach achieves 98% accuracy on benchmark datasets, significantly outperforming zero-shot LLMs and traditional classifiers. The results highlight how domain-grounded prompts enhance both accuracy and interpretability, offering a trustworthy path for applying LLMs in safety-critical applications. Beyond advancing the state of the art in fraud detection, this work has the potential to benefit domains such as cybersecurity, e-commerce, financial fraud prevention, and online content moderation. Full article

Achieving sustainable land restoration in southern Chinese ionic rare earth mining areas remains a significant challenge due to the extended duration and low efficiency of conventional remediation approaches. Although the hyperaccumulator Dicranopteris pedata possesses a remarkable capacity for rare earth element (REE) enrichment, a significant knowledge gap exists regarding how to effectively combine exogenous organic acids with agronomic practices like clipping to enhance its remediation efficiency in an environmentally sustainable manner. Crucially, the potential environmental risks associated with such synergistic strategies have not been systematically evaluated, hindering their practical application. To address this, our study focused on Dicranopteris pedata and employed integrated pot and soil column leaching experiments to systematically analyze the effects of different concentrations of citric acid and tartaric acid on REE migration and transformation within the soil–plant system. The results demonstrated that exogenous organic acids significantly reduced soil pH and promoted the conversion of REEs from the residual to the exchangeable fraction. Specifically, the 20 mmol·kg⁻¹ citric acid treatment increased the proportion of exchangeable REEs by 43.46%. Furthermore, organic acid treatments significantly altered the REE uptake patterns in Dicranopteris pedata, inhibiting the translocation and accumulation of REEs in the aboveground tissues. Soil column leaching experiments revealed that citric acid drove the migration of REEs to deeper soil layers, with the concentration peaking at 288.33 mg·kg⁻¹ at a depth of 6–8 cm; concomitantly, the REE content in the leachate reached its maximum on the 5th day. This study demonstrates that the combined application of 20 mmol·kg⁻¹ citric acid and 100% clipping management increased the annual REE accumulation in Dicranopteris pedata to 4.85 g·m⁻², thereby significantly shortening the theoretical remediation period from 25.0 years in the control to 12.1 years. Soil column leaching experiments indicated no significant secondary pollution risk associated with this strategy. These findings provide a feasible, low-risk, and sustainable technical strategy for the synergistically enhanced remediation of REE-contaminated soils, offering a promising path for ecological restoration and sustainable land management in degraded mining ecosystems. Full article

Background/Objectives: Across geographical and cultural contexts, how individuals identify, communicate and help-seek for distress is often shaped by how mental health itself is understood. Insight into how adolescents and adults in their routine environment, such as teachers, understand mental health is crucial for developing context-specific mental health promotion strategies to young people. Sri Lanka, a country that navigates the dual legacies of pre-and-post-colonial mental health frameworks, has this need. The aim was to explore Sri Lankan school-going adolescents’ and their teachers’ perspectives of mental health and its determinants. Methods: Semi-structured interviews were conducted with 28 school-going adolescents in grades 10–12/13 and 14 of their school teachers, from seven secondary schools in Gampaha District, Sri Lanka. Interviews were transcribed, translated, coded inductively and analysed thematically. Results: All participants drew on culturally meaningful language that is rooted in Buddhist perspectives to conceptualise mental health. Causes and risk factors of poor mental health were attributed to individual, immediate environmental and structural factors. School environment played a central role in exacerbating other risk factors. Adolescents exhibited more knowledge of informal care avenues for mental health-related concerns. Conclusions: Findings highlight several implications including opportunities to leverage culturally contextualised language/frameworks when promoting mental health to Sri Lankan adolescents, diversifying mental health research and initiating school-based mental health programmes that integrate mental health promotion into routine educational practice to transform learning institutions across Sri Lanka to become mental health-promoting schools. Full article

In many developing countries, seismic vulnerability remains high due to the widespread presence of informally constructed buildings without professional design or technical supervision. In Colombia, where nearly 60% of structures are non-engineered, this issue is especially acute. The objective of this study is to design, implement, and quantitatively evaluate the Learning Experience for Earthquake Awareness Program (LEAP), an experiential educational strategy for young students that enhances seismic knowledge, promotes sustainable construction awareness, and contributes to disaster risk reduction as a component of social sustainability. To address this challenge, LEAP introduces students to basic principles of structural mechanics and seismic behavior through playful, hands-on activities combining theoretical instruction, practical experimentation, collaborative design, and the testing of model structures. An experimental design with pre- and post-surveys was implemented with 141 participants, including 80 secondary school students (grades 8th–11th) and 61 university students enrolled in engineering, architecture, and construction programs, using 3D-printed models, earthquake simulators, and interactive games. Statistical analysis using the Wilcoxon signed-rank test ($p<0.05$) revealed significant improvements in conceptual understanding and perception, including gains in distinguishing between the hypocenter and epicenter ($+45.39\%$, $p=5.10\times {10}^{-8}$, $r=0.50$), understanding seismic magnitude ($+39.01\%$, $p=1.67\times {10}^{-12}$, $r=0.71$), and visually identifying structural vulnerabilities ($+25.50\%$, $p=4.50\times {10}^{-2}$, $r=0.41$). Overall, LEAP contributes to disaster risk reduction and social sustainability by strengthening seismic awareness and responsible construction practices. The most significant results were observed among secondary school students, while university participants mainly reinforced applied and visual comprehension. Given its convenience sample, lack of control group, and immediate post-test, findings should be interpreted as exploratory and associative. Full article

Synoptic assessment has gained prominence in higher education as a way to bridge fragmented curricula by enabling students to synthesize knowledge across modules. However, structural integration through assessment does not automatically produce authentic learning. Drawing on theoretical analysis and three reflective case studies from UK undergraduate programmes, this paper offers a critical practitioner perspective on how synoptic assessment and authentic learning intersect in practice. We argue that integration and authenticity represent distinct pedagogical imperatives that require deliberate alignment. Through comparative analysis of successful, partially successful, and unsuccessful implementations of assessment strategies, we demonstrate that authentic learning emerges not from integration per se, but from intentional design embedding real-world relevance, developmental scaffolding, clear purpose, and student agency. Our case studies reveal that without such intentionality, synoptic assessments risk becoming structurally coherent but pedagogically hollow exercises that fail to engage students meaningfully. Key challenges include inconsistent staff understanding, inadequate contextual framing, and insufficient attention to progressive capability development. We propose practical design principles grounded in practitioner experience: embedding authenticity through professional relevance, scaffolding complexity appropriately, enabling open-ended student responses, and establishing strong programme-level leadership with authority over assessment strategy. The core contribution of the paper is to articulate these design principles for embedding authenticity within synoptic assessment at programme level, particularly in increasingly modularised and flexible curricula, such as those designed to enable lifelong learning. By positioning integration as necessary but insufficient for authentic learning, we advance critical understanding of assessment reform and address emerging tensions between programme coherence and increasingly modularized curricula serving diverse learner pathways. Full article

The rising incidence of invasive fungal infections (IFIs) and the associated antifungal resistance underscore the need for antifungal stewardship (AFS) programs. Evaluating physicians’ knowledge and practices is crucial for identifying gaps and planning effective AFS interventions. A self-administered questionnaire was distributed to staff and resident physicians at a referral university-affiliated hospital in Greece in November 2025. The survey examined participants’ knowledge on fungal diagnosis and treatment, their prescribing attitudes and practices, and their AFS-related education, knowledge and preferences. In total, 70 physicians (46 residents and 24 staff consultants) participated in the survey from medical departments (63%), surgical departments (30%), and intensive care units (7%). Physicians surveyed demonstrated a low average knowledge score of 36.6% correct answers (SD, 22.7%; range 0% to 90%) regarding IFIs and antifungal agents, and significant variation was observed across different hospital departments. Awareness of risk factors for IFI varied widely, with recognition rates of different factors ranging from 10% to 100% across departments. Many physicians (71%) reported a lack of confidence in prescribing antifungal therapy and reliance on infectious disease experts was common (84%). Most preferred training methods were case-based discussions and printed guidelines. The substantial knowledge gaps and low confidence in prescribing antifungals among physicians highlight the urgent need for education and implementation of local guidelines to optimize antifungal use that might improve patient outcomes. Full article