Search Results (2,027)

Background/Objectives: Excessive sugar intake through sugar-sweetened beverages (SSBs) has raised global concerns due to its association with various health risks. This study evaluates the effectiveness of nudges—in the form of order placement, variety expansion, and a combination of both—in promoting non-SSB purchases at self-service kiosks, a key environment for SSB consumption. Methods: This study was conducted using a real-world kiosk at food and beverage outlets in South Korea from 28 May to 12 July, 2024. A total of 183 consumers aged 19 to 29 participated in this study. A single kiosk device was used with four screen layouts, each reflecting a different nudge strategy. Participants were unaware of these manipulations when making their purchases. After their purchases, participants completed a survey. All data were analyzed using IBM SPSS Statistics for Windows, Version 29.0. Results: Females reported significantly higher positive attitudes, preferences, and perceived necessity regarding nudges compared to males. In particular, both the single (variety) and combination (order and variety) nudges received positive responses from females (p < 0.001). The combination nudge significantly increased non-SSB purchases compared to the control (p < 0.05) and single (order) nudge groups (p < 0.01), which suggests that combination nudge is effective in promoting healthier beverage choices. Females were also more likely to purchase non-SSBs than males (p < 0.05). Conclusions: The findings suggest that the combination nudge strategy effectively promotes healthier beverage choices in real kiosk settings. Notably, females demonstrate significantly higher positive attitudes, preferences, and perceived necessity regarding nudges compared to males, and are also more likely to purchase non-SSBs. These findings offer valuable insights for real-world applications aimed at encouraging healthier consumption behaviors. Full article

Background: Effective triage of women testing positive for high-risk HPV DNA is essential to reduce unnecessary colposcopies while preserving cancer prevention. Cytology, the current standard, has limited specificity and reproducibility. The genotype-specific 7-type HPV E6/E7 mRNA test (PreTect HPV-Proofer’7), targeting HPV types 16, 18, 31, 33, 45, 52, and 58, detects transcriptionally active infections and may enhance risk stratification. Methods: Between 2019 and 2023, 34,721 women aged 25–69 underwent primary HPV DNA screening with the Cobas 4800 assay at the University Hospital of North Norway, within the national screening program. Of these, 1896 HPV DNA-positive women were triaged with liquid-based cytology with atypical squamous cells of undetermined significance or worse (≥ASC-US) and the 7-type HPV mRNA test. Histological outcomes were followed through October 2024. Diagnostic performance for CIN2+ was evaluated overall and by genotype. Results: CIN2+ prevalence was 13.3%. The mRNA test reduced test positivity from 50.3% to 33.4% while maintaining comparable sensitivity (70.6% vs. 72.2%) and improving specificity (72.3% vs. 53.0%) and PPV (28.1% vs. 19.1%). Genotype-specific PPVs were highest for HPV16 mRNA (47.7%), followed by HPV33 (39.2%) and HPV31 (32.2%), all exceeding corresponding DNA-based estimates. Conclusion: Genotype-specific HPV mRNA triage offers superior risk discrimination compared to cytology, supporting more targeted, efficient, and accessible cervical cancer screening. Full article

Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ² tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article

Background/Objectives: Despite the importance of parent mental health for child health, there are no global prevalence data on parental mental health symptoms when children are hospitalized. We aimed to describe depression and anxiety symptom prevalence and associated factors among parents of hospitalized children. Methods: We conducted this 14-country prospective cohort survey with parents/primary caregivers staying at a nearby Ronald McDonald House^® during their child’s hospital treatment. We used the Hospital Anxiety and Depression Scale to measure depression and anxiety symptoms and validated scales and theory-based questions to measure parent, family, and child covariates. We calculated the prevalence of clinically significant or concerning symptoms of depression and anxiety, and used multivariable regression analyses to examine associations between covariates and outcomes. Results: Among 3350 participants, 1789 (49.7%) reported depression symptoms and 2286 (69.0%) reported anxiety symptoms. Worry about housing and poorer ratings of their child’s health were associated with increased risk of depression symptoms. Poorer rating of the child’s health, living with a partner, and discrimination in daily life were associated with increased risk of anxiety symptoms. Higher levels of self-care, hospital family-centered care, and social support were associated with reduced risk of depression symptoms. Higher levels of self-care and social support were associated with reduced risk of anxiety symptoms. Conclusions: Clinically significant or concerning depression and anxiety symptoms are common among parents of hospitalized children globally. Hospitals should consider offering routine mental health symptom screening and preventative mental health and support services to all parents. Full article

Conventional methods for generating knock-out or knock-in mammalian cell models using CRISPR-Cas9 genome editing often require tedious single-cell clone selection and expansion. In this study, we develop and optimise rapid and robust strategies to engineer homozygous fluorescent reporter knock-in cell pools with precise genome editing, circumventing clonal variability inherent to traditional approaches. To reduce false-positive cells associated with random integration, we optimise the design of donor DNA by removing the start codon of the fluorescent reporter and incorporating a self-cleaving T2A peptide system. Using fluorescence-assisted cell sorting (FACS), we efficiently identify and isolate the desired homozygous fluorescent knock-in clones, establishing stable cell pools that preserve parental cell line heterogeneity and faithfully reflect endogenous transcriptional regulation of the target gene. We evaluate the knock-in efficiency and rate of undesired random integration in the electroporation method with either a dual-plasmid system (sgRNA and donor DNA in two separate vectors) or a single-plasmid system (sgRNA and donor DNA combined in one vector). We further demonstrate that coupling our single-plasmid construct with an integrase-deficient lentivirus vector (IDLV) packaging system efficiently generates fluorescent knock-in reporter cell pools, offering flexibility between electroporation and lentivirus transduction methods. Notably, compared to the electroporation methods, the IDLV system significantly minimises random integration. Moreover, the resulting reporter cell lines are compatible with most of the available genome-wide sgRNA libraries, enabling unbiased CRISPR screens to identify key transcriptional regulators of a gene of interest. Overall, our methodologies provide a powerful genetic tool for rapid and robust generation of fluorescent reporter knock-in cell pools with precise genome editing by CRISPR-Cas9 for various research purposes. Full article

Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence of mental health issues in Canadian pediatric patients with JIA and IBD remains unclear. We aimed to estimate the prevalence of documented mental health disorders and related medication use of youth with JIA or IBD at a tertiary care centre. Methods: We conducted a retrospective chart review of youths aged 12–17 diagnosed with JIA or IBD at McMaster Children’s Hospital (MCH) to understand the prevalence of generalized anxiety disorder (GAD), separation anxiety disorder, social anxiety disorder (SAD), obsessive–compulsive disorders (OCD), eating disorders, major depressive disorder (MDD), adolescent adjustment disorder, suicide attempt/suicide ideation, self-harm behaviour, substance use disorder, and attention deficit disorders (ADD). Results: We reviewed 429 patient charts, including 303 patients with IBD and 126 with JIA. Our findings identified 90 IBD patients and 20 JIA patients who had one or more documented mental health conditions. Proportionately, there was a higher prevalence of mental health conditions among IBD patients (30%) compared to JIA patients (16%). The most frequently observed conditions in both IBD and JIA patients were GAD (63%, 50%), ADD (33%, 35%), and MDD (29%, 15%). Conclusions: These findings highlight the critical need for early mental health screening and integrated care approaches that address both medical and psychosocial needs in adolescents with chronic illnesses. Future research should incorporate prospective study designs, include diverse geographic and demographic populations, and explore targeted interventions to improve mental and physical health outcomes in this vulnerable group. Full article

Introduction. Singapore had previously embraced at least two types of pre-participation questionnaires for those intending to take up or enhance their level of physical activity (PA). Concern over the usefulness of and difficulty in understanding these questions led to the design of a Singapore Physical Activity Readiness Questionnaire (SPARQ). The primary objective of this study was to review the level of difficulty in understanding the seven SPARQ questions. Secondary objectives included the rate of identifying individuals as unfit for PA and to seek public feedback on this tool. Method. A public, cross-sectional survey on the SPARQ was carried out, obtaining participants’ bio-characteristics, having them completing the SPARQ and then providing feedback on the individual questions. Results. Of the 1136 who completed the survey, 35.7% would have required referral to a medical practitioner for further evaluation before the intended PA. Significant difficulty was experienced with one question, moderate difficulty with four and only slight difficulty with the remaining two. The length of the questions and use of technical terms were matters of concern. Suggestions were provided by the participants on possible amendments to the questions. Conclusions. The very high acceptance rate of the SPARQ will need to be tempered with modifications to the questions to enhance ease of understanding and use by members of the public. Full article

Background: Temporomandibular disorders (TMD) are common musculoskeletal conditions affecting the temporomandibular joints, masticatory muscles, and associated structures. Their etiology is complex and multifactorial, involving anatomical, behavioral, and psychosocial contributors. Parafunctional habits such as clenching, grinding, and abnormal jaw positioning have been proposed as contributing factors, yet their individual and cumulative contributions remain unclear. This exploratory cross-sectional study aimed to evaluate the prevalence and severity of parafunctional habits and their association with TMD in medical students—a group exposed to elevated stress levels. Subjects were examined in Krakow, Poland, using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol. Methods: Participants completed a 21-item Oral Behavior Checklist (OBC) assessing the frequency of oral behaviors on a 0–4 scale. A self-reported total parafunction load was calculated by summing individual item scores (range: 0–84). Logistic regression was used to evaluate associations between individual and total parafunction severity scores and TMD presence. Results: The study included 66 individuals aged 19–30. TMD was diagnosed in 55 participants (83.3%). The most commonly reported habits were resting the chin on the hand (90.9%) and sleeping in a jaw-compressing position (86.4%). Notably, jaw tension (OR = 14.5; p = 0.002) and daytime clenching (OR = 4.7; p = 0.027) showed significant associations with TMD in the tested population. Each additional point in the total parafunction score increased TMD odds by 13.6% (p = 0.004). Conclusions: These findings suggest that parafunctional behaviors—especially those involving chronic muscle tension or abnormal mandibular positioning—may meaningfully contribute to the risk of TMD in high-stress student populations. Moreover, the cumulative burden of multiple low-intensity habits was also significantly associated with increased TMD risk. Early screening for these behaviors may support prevention strategies, particularly among young adults exposed to elevated levels of stress. Full article

Background/Objectives: In an increasingly pervasive digital environment, trait boredom has been identified as a key psychological factor in the onset and maintenance of problematic digital technology use. This systematic review aims to investigate the role of trait boredom in digital behavioral addictions, including problematic smartphone use, Internet and social media overuse, and gaming addiction, through theoretical models such as the I-PACE model and the Compensatory Internet Use Theory (CIUT). Methods: A systematic literature search was conducted across multiple scientific databases (PsycINFO, Web of Science, PubMed, and Scopus), yielding a total of 4603 records. Following the PRISMA guidelines after duplicate removal and screening based on title and abstract, 152 articles were assessed for full-text eligibility, and 28 studies met the predefined inclusion and exclusion criteria and were included in the final review. Results: Findings reveal that trait boredom functions as both a direct and indirect factor in problematic technology use. It serves as a mediator and moderator in the relationship between psychological vulnerabilities (e.g., depression, alexithymia, vulnerable narcissism) and dysfunctional digital behaviors. Furthermore, as an independent variable, it has an influence on technological variables through Fear of Missing Out (FoMO), loneliness, low self-regulation, and dysfunctional metacognitions, while protective factors such as mindfulness and attentional control mitigate its impact. Conclusions: Boredom represents a central psychological lever for understanding behavioral addictions in the digital age and should be considered a key target in preventive and therapeutic interventions focused on enhancing self-regulation and meaningful engagement with free time. Full article

Frequent corn leaf diseases and pests pose serious threats to agricultural production. Traditional manual detection methods suffer from significant limitations in both performance and efficiency. To address this, the present paper proposes a novel biotic condition screening (BCS) model for the detection of corn leaf diseases and pests, called BCS_YOLO, based on the You Only Look Once version 11n (YOLOv11n). The proposed model enables accurate detection and classification of various corn leaf pathologies and pest infestations under challenging agricultural field conditions. It achieves this thanks to three key newly designed modules—a Self-Perception Coordinated Global Attention (SPCGA) module, a High/Low-Frequency Feature Enhancement (HLFFE) module, and a Local Attention Enhancement (LAE) module. The SPCGA module improves the model’s ability to perceive fine-grained targets by fusing multiple attention mechanisms. The HLFFE module adopts a frequency domain separation strategy to strengthen edge delineation and structural detail representation in affected areas. The LAE module effectively improves the model’s discrimination ability between targets and backgrounds through local importance calculation and intensity adjustment mechanisms. Conducted experiments show that BCS_YOLO achieves 78.4%, 73.7%, 76.0%, and 82.0% in $precision$, recall, $F1score$, and $mAP@50$, respectively, representing corresponding improvements of 3.0%, 3.3%, 3.2%, and 4.6% compared to the baseline model (YOLOv11n), while also outperforming the mainstream object detection models. In summary, the proposed BCS_YOLO model provides a practical and scalable solution for efficient detection of corn leaf diseases and pests in complex smart-agriculture scenarios, demonstrating significant theoretical and application value. Full article

Background/Objectives: Despite medical advances, stigma remains a major challenge for people living with HIV (PLWH). This study examined clinical, sociodemographic, and psychological predictors of HIV-related stigma, and explored whether affective temperament moderates the impact of depression on stigma. Methods: This cross-sectional observational study included 97 PLWH attending a tertiary infectious disease unit in Rome, Italy. Participants completed a battery of validated psychometric instruments assessing depressive symptoms, anxiety, manic symptoms, mixed affective states, general psychopathology, impulsivity, and affective temperament. HIV-related stigma was evaluated using the Berger HIV Stigma Scale, which measures personalized stigma, disclosure concerns, negative self-image, and concerns with public attitudes. Descriptive statistics were used to characterize the sample. Univariate linear regressions were conducted to explore associations between clinical, psychometric, and sociodemographic variables and each stigma subdimension, as well as the total stigma score. Variables significant at p < 0.05 were included in five multivariate linear regression models. Moderation analyses were subsequently performed to assess whether affective temperaments moderated the relationship between significant psychopathological predictors and stigma. Bonferroni correction was applied where appropriate. Results: Higher depressive symptom scores are significantly associated with greater internalized stigma (B = 0.902, p = 0.006) and total stigma (B = 2.603, p = 0.008). Furthermore, moderation analyses showed that anxious temperament significantly intensified the relationship between depressive symptoms and both negative self-image (interaction term B = 0.125, p = 0.001) and total stigma (B = 0.336, p = 0.002). Conclusions: Depressive symptoms and anxious temperament are associated with HIV-related stigma. Integrating psychological screening and targeted interventions for mood and temperament vulnerabilities may help reduce stigma burden in PLWH and improve psychosocial outcomes. Full article

Autonomous earthwork machinery is gaining traction as a means to boost productivity and safety on space-constrained urban sites, yet the fast-growing literature has not been fully integrated. To clarify current knowledge, we systematically searched Scopus and screened 597 records, retaining 157 peer-reviewed papers (2015–March 2025) that address autonomy, integrated control, or risk mitigation for excavators, bulldozers, and loaders. Descriptive statistics, VOSviewer mapping, and qualitative synthesis show the output rising rapidly and peaking at 30 papers in 2024, led by China, Korea, and the USA. Four tightly linked themes dominate: perception-driven machine autonomy, IoT-enabled integrated control systems, multi-sensor safety strategies, and the first demonstrations of fleet-level collaboration (e.g., coordinated excavator clusters and unmanned aerial vehicle and unmanned ground vehicle (UAV–UGV) site preparation). Advances include centimeter-scale path tracking, real-time vision-light detection and ranging (LiDAR) fusion and geofenced safety envelopes, but formal validation protocols and robust inter-machine communication remain open challenges. The review distils five research priorities, including adaptive perception and artificial intelligence (AI), digital-twin integration with building information modeling (BIM), cooperative multi-robot planning, rigorous safety assurance, and human–automation partnership that must be addressed to transform isolated prototypes into connected, self-optimizing fleets capable of delivering safer, faster, and more sustainable urban construction. Full article

Background/Objectives: Since the World Health Organization (WHO) recommended HIV self-testing as an alternative to traditional facility-based testing in 2016, it has been increasingly adopted worldwide. This study aimed to evaluate the performance of the ConfiSign HIV Self-Test (GenBody Inc., Republic of Korea), a newly developed blood-based immunochromatographic assay for the qualitative detection of total antibodies (IgG and IgM) against HIV-1/HIV-2. Methods: The evaluation included four components: (1) retrospective analysis of 1400 archived serum samples (400 HIV-positive and 1000 HIV-negative samples), (2) prospective self-testing by 335 participants (112 HIV-positive participants and 223 individuals with an unknown HIV status, including healthy volunteers), (3) assessment using seroconversion panels and diverse HIV subtypes, and (4) analytical specificity testing for cross-reactivity and interference. The Elecsys HIV combi PT and Alinity I HIV Ag/Ab Combo assays were used as reference assays. Results: In retrospective testing, the ConfiSign HIV Self-Test achieved a positive percent agreement (PPA) of 100%, a negative percent agreement (NPA) of 99.2%, and a Cohen’s kappa value of 0.986, showing excellent agreement with the reference assays. In the prospective study, the test showed 100% sensitivity and specificity, with a low invalid result rate of 1.8%. All HIV-positive samples, including those with low signal-to-cutoff (S/Co) values in the Alinity I assay, were correctly identified. The test also reliably detected early seroconversion samples and accurately identified a broad range of HIV-1 subtypes (A, B, C, D, F, G, CRF01_AE, CRF02_AG, and group O) as well as HIV-2. No cross-reactivity or interference was observed with samples that were positive for hepatitis viruses, cytomegalovirus, Epstein–Barr virus, varicella zoster virus, influenza, HTLV-1, HTLV-2, or malaria. Conclusions: The ConfiSign HIV Self-Test demonstrated excellent sensitivity, specificity, and robustness across diverse clinical samples, supporting its reliability and practicality as a self-testing option for HIV-1/2 antibody detection. Full article

Background/Objectives: Despite the psychological benefits of breast reconstruction (BR) after mastectomy, uptake remains limited among women with breast cancer. This study explores psychosocial and personality predictors of BR intentions in the pre-mastectomy phase, aiming to inform strategies for mental health promotion in oncology care. Methods: This cross-sectional analysis used preoperative data from a longitudinal study at a university hospital in Greece. Women with primary breast cancer scheduled for mastectomy completed a battery of validated self-report measures, including the International Personality Item Big-Five Factor Markers (IPIP-BFFM), the Hospital Anxiety and Depression Scale (HADS), and the Short Form-36 Health Survey (SF-36). Demographic, clinical, and psychosocial data were also collected. Binary logistic regression was used to examine predictors of (a) BR information-seeking and (b) BR intention. Results: Seventy-four women participated (mean age = 61.1 years). Older age predicted lower BR intention (Exp(b) = 0.897, 95% CI: 0.829–0.970) and information-seeking (Exp(b) = 0.925, 95% CI: 0.859–0.997). Single/divorced status was associated with reduced BR information-seeking (Exp(b) = 0.053, 95% CI: 0.005–0.549). Openness to experience significantly predicted both outcomes (BR information-seeking: Exp(b) = 1.115, 95% CI: 1.028–1.209); BR intention: Exp(b) = 1.095, 95% CI: 1.016–1.181). Higher physical health-related QoL scores were associated with increased BR intention (Exp(b) = 1.039, 95% CI: 1.007–1.072), whereas higher mental health-related QoL (Exp(b) = 0.952, 95% CI: 0.912–0.994) and higher depression scores (Exp(b) = 0.797, 95% CI: 0.638–0.996) were linked to decreased BR intent. No psychological factor significantly predicted information-seeking. Conclusions: These findings underscore the value of psychosocial screening and personality-informed counseling prior to surgery. By identifying individuals less likely to seek information or consider BR, pre-mastectomy assessments can contribute to tailored, mental health-promoting interventions and support informed, patient-centered surgical decision-making. Full article

Background: Antenatal depression and anxiety contribute significantly to maternal morbidity and adverse pregnancy outcomes. However, structured screening and targeted interventions are largely absent from standard prenatal care in many Eastern European countries, including Bulgaria. This study examines the prevalence and psychosocial predictors of antenatal psychosocial risk using the validated Antenatal Risk Questionnaire–Revised (ANRQ-R) in a nationally underrepresented population. Methods: A cross-sectional survey was conducted among 216 third-trimester pregnant women in Bulgaria. Data on sociodemographic characteristics, health behaviours, and reproductive history were collected. Multivariate logistic regression identified predictors of elevated psychosocial risk. Results: A total of 65.7% of participants met the criteria for elevated psychosocial risk. Significant risk factors included passive smoking exposure during pregnancy (OR = 5.03, p < 0.001), physical activity prior to pregnancy (OR = 1.81, p = 0.004), and a family history of hereditary disease (OR = 42.67, p < 0.001). Protective factors were better self-rated current health (OR = 0.37, p = 0.004), the presence of chronic illness (OR = 0.42, p = 0.049), previous childbirth experience (OR = 0.11, p = 0.032), and residence in Northwestern Bulgaria (OR = 0.31, p = 0.028). Despite the high prevalence of psychosocial vulnerability, only 9.5% of affected women sought professional help. Conclusions: While our findings point to important unmet needs in antenatal mental health, further research is required before national screening policies can be implemented. Pilot programs, cultural validation of tools, and system-level readiness assessments should precede broad adoption. Full article