Search Results (2,804)

Accurate prediction of wear in lubricated metal-to-metal contacts remains a critical challenge, as calibration parameters derived from laboratory tests often lack transferability to finite element method (FEM) simulations. While classical linear Archard models are widely applied, they fail to capture the nonlinear load-dependent wear behavior observed under varying operating conditions. This study addresses this limitation by developing and validating a nonlinear wear formulation based on the Archard–Bayer law within a coupled experimental–numerical framework. A comprehensive Pin-on-Disc test matrix was conducted under lubricated conditions using carbide–steel contacts across varying loads and cycle counts. Wear progression was quantified and analysed using outlier-corrected weighted regression, yielding a force exponent $m_{exp}=1.58\pm 0.34$ and cycle exponent $n_{exp}= 0.41 \pm 0.17$. The calibrated nonlinear model was implemented in a FEM environment and systematically evaluated across multiple loading scenarios. The nonlinear formulation demonstrates improved predictive capability compared to the classical linear Archard model, particularly under higher load conditions (15 N–20 N), where deviations between simulation and experiment remain below 11%. The FEM-calibrated exponent (m = 1.35) lies within the 95% confidence interval of the experimental value, indicating that numerical adjustments required for stability are statistically non-significant. The results show that nonlinear wear models provide a more accurate representation of load-dependent wear behavior but require constrained calibration ranges for reliable application. The proposed methodology enables robust transfer of experimentally derived wear parameters into FEM simulations and provides a practical basis for tool-life prediction, parameter tuning, and model deployment in sheet metal forming processes. Full article

Background: Older adults undergoing percutaneous coronary intervention (PCI) often experience substantial physical and psychosocial challenges that may adversely affect their quality of life. Perceived social support, coping, and health literacy are important factors associated with health outcomes, yet the pathways linking these variables remain insufficiently understood. This study aimed to investigate the relationship between perceived social support and quality of life in older adults after PCI and to examine the mediating roles of coping and health literacy. Methods: This cross-sectional study included 353 older adults with coronary heart disease who underwent their first PCI at the cardiology department of a tertiary general hospital in Anhui Province, China. Data were collected using a general information questionnaire, the Perceived Social Support Scale, the Medical Coping Modes Questionnaire, the Health Literacy Scale for Patients Undergoing Percutaneous Coronary Intervention, and the Chinese Questionnaire for Quality of Life in Patients with Cardiovascular Disease. Pearson correlation analysis, hierarchical regression analysis, and structural equation modeling were used for data analysis. Results: The mean quality of life score was 82.20 ± 19.19. Perceived social support, coping, and health literacy were all positively associated with quality of life (all p < 0.01). Perceived social support had a direct positive effect on quality of life (effect = 0.071, [95% CI (0.012, 0.207)]). It also had indirect effects through coping (effect = 0.109, [95% CI (0.052, 0.174)]) and health literacy (effect = 0.511, [95% CI (0.191, 0.873)]). In addition, coping and health literacy showed a significant serial mediating effect in the association between perceived social support and quality of life (effect = −0.065, [95% CI (−0.236, −0.015)]). Conclusions: Perceived social support was associated with better quality of life in older adults after PCI, both directly and indirectly through coping and health literacy. These findings suggest that nursing care should pay greater attention to strengthening social support, encouraging positive coping, and improving health literacy in order to promote postoperative recovery and quality of life. Full article

Background: Inflammatory bowel disease (IBD) is a chronic condition characterized by persistent inflammation of the gastrointestinal tract. Sexual dysfunction is a common but often overlooked consequence of IBD, affecting approximately half of women and one-third of men living with the disease. Despite the significant role of sexuality in overall quality of life, discussions about sexuality frequently remain absent from clinical encounters between patients and healthcare providers. Purpose: This study aims to deepen understanding of how individuals with inflammatory bowel disease experience—and wish to approach—conversations about sexuality with healthcare professionals in specialist clinical settings. Method: A descriptive and exploratory qualitative design was employed, using semi-structured interviews with 12 individuals diagnosed with IBD, recruited from two outpatient clinics in Norway. The data were analysed using reflexive thematic analysis. Results: Our analysis generated three main themes: (1) sexuality as an overlooked dimension of IBD care, (2) unmet informational needs related to sexuality, and (3) relational prerequisites for discussing sexuality. Sexuality was seldom addressed in participants’ healthcare encounters. Only a minority had been invited into such discussions, and those experiences were typically brief. Some participants preferred not to engage in conversations about sexuality. Reported barriers included awkwardness, embarrassment, stigma, discomfort, and concerns about privacy. Participants also described limited access to reliable information and perceived some healthcare providers as insufficiently knowledgeable or dismissive when the topic was raised. Feeling safe, trusting the provider, and having an established therapeutic relationship were identified as essential conditions for discussing sexuality. Conclusion: Sexuality remains largely unaddressed in clinical encounters with individuals living with IBD. The findings reveal a gap between patients’ information needs and the support currently provided. Strengthening healthcare providers’ competence and ensuring access to appropriate resources may help create the trust and safety required for meaningful conversations about sexuality. Full article

Background: During life, all organisms experience multiple stressful events capable of disrupting their somatic integrity. As mammals, humans respond to environmental, sociocultural, and cognitive stressors via allostasis, a systemic neurophysiological response that supports physiological homeostasis. Unfortunately, allostatic mechanisms are incapable of countering all stressors, and systemic physiological damage accumulates with age; thereby contributing to physiological dysregulation and an increasing allostatic load (AL). Previously, we reported that a ten-factor allostatic load index (ALI) varied significantly by age, gender, and rural–urban residence in a sample of Polish citizens ages 55+ years but a five-biomarker frailty index did not. Here we determine whether an estimated ALI covaries with self-reported food intakes across age, residential setting, and gender. Methods: Two hundred and ten residents of Greater Poland ages 55–91 years, residing in either the Nekla commune (N = 103) or the capital of Greater Poland, Poznan (N = 107), participated in research designed to estimate a study-specific 10-biomarker ALI and its possible associations with their self-reported dietary choices, age, gender, and residential location. Of these, 206 completed study protocols including a food frequency questionnaire, verifying their age, self-reporting their gender, and allowing research personnel to obtain data for assessing 10 physiological biomarkers of allostatic load for inclusion in a study-specific ALI. Statistical significance for nominal measures was estimated using chi-square analyses; those for continuous measures, t-tests. Results: In the full sample, self-reported higher red meat and snack intakes were significantly associated with higher ALI at younger ages (55–69 years). No food item was significantly associated with estimated ALI at older ages (70+ years). Further, low self-reported intakes of fish and seafood consumption were significantly associated with a higher ALI in Poznan, but not Nekla residents. Within the full sample, average ALI was almost identical between younger and older women. Conclusions: In this cross-sectional sample of older Nekla and Poznan residents allostatic load not only varied by age, sex, and residential location, but also with self-reported consumption of red meat, snacks, fish and seafood. Observed differences in biomarkers of AL between younger and older residents of Poland across this sample suggest possible higher incidences of chronic disease occur among women residing in Nekla than those in Poznan. Similarly, the significant associations of red meat and snack consumption with ALI at younger ages in both settings may portend increasing vascular disease and related complications among those ages 55–69 years in this sample as they age. As does the higher estimated ALI among Poznan residents reporting low fish and seafood consumption. Full article

Background: Pediatric hematopoietic cell transplantation (HCT) conveys significant risk of mortality, morbidity, impaired quality of life, and multifactorial distress. One potential strategy for improving experience and relieving suffering is proactive specialty palliative care (SPC) utilization. However, SPC is not routinely incorporated into pediatric HCT. One barrier to SPC integration is unknown pediatric HCT provider perceptions of SPC services, particularly among providers with lived experience working within a collaborative HCT-SPC partnership. Objective: This single-institution pilot study aimed to (1) describe an approach to standardized, proactive pediatric HCT-SPC clinical partnership, and (2) quantify acceptability, appropriateness, and satisfaction regarding the program among pediatric HCT providers. Methods: Survey methods were used to assess attitudes among HCT providers who had worked with the SPC clinical partnership for at least three months. Core survey metrics were the validated Acceptability of Intervention Measure and Intervention Appropriateness Measure. Additional survey items were adapted from the Perceptions of Palliative Care Instrument. Results: Respondents reported high mean scores for acceptability (4.96) and appropriateness (4.93) on a 5-point scale. Overall satisfaction with SPC integration averaged 8.72 (SD 1.13) on a 10-point scale. Satisfaction scores for each individual service provided by SPC were similarly high. No significant differences in responses were found based on provider type, prior SPC training, or years in practice. Conclusions: In this single-institution pilot study, pediatric HCT providers with lived experience working in an environment with standardized SPC collaboration view SPC as highly acceptable, appropriate, and beneficial for their patients, supporting the feasibility and value of proactive SPC integration in pediatric HCT care. Full article

The article examines the protective role of the family and youth formative communities against substance and behavioral addictions in adolescence. Its aim is to synthesize knowledge of risk and protective factors and to indicate how family and community environments can lower the likelihood of risky behaviors. The first part of the paper presents a multifactorial paradigm for explaining young people’s use of psychoactive substances, drawing on data about the situation in Poland. The second part explores the social significance of the family and participation in formative groups, especially religious ones, by referring to the concepts of social capital, normative socialization, and communal rootedness. The third part depicts Scouting and the Light-Life Movement as examples of educational settings that promote a lifestyle grounded in self-discipline, abstinence, and communal responsibility. Overall, the conducted analyses conclude that the protective potential of these environments is not automatic but depends on the quality of relationships, the presence of significant adults, the credibility of norms, and the communities’ capacity to respond to young people’s experiences amid ongoing secularization and cultural individualization. Full article

Apical pelvic organ prolapse (POP) is characterized by descent of the uterus or post-hysterectomy vaginal vault resulting from failure of level I pelvic support and represents a major contributor to pelvic floor dysfunction and recurrent prolapse surgery. Loss of apical support is frequently associated with anterior and posterior compartment defects, leading to vaginal bulge symptoms, pelvic pressure, urinary and bowel dysfunction, sexual dysfunction, and reduced quality of life. This narrative review summarizes current knowledge on POP, from molecular mechanisms and emerging biomarkers to contemporary surgical management, with particular emphasis on sacrocolpopexy and robotic-assisted approaches. A literature search of PubMed, Scopus, Google Scholar, and Consensus identified peer-reviewed studies published up to February 2026. Evidence demonstrates that POP has a multifactorial and polygenic background involving extracellular matrix remodeling, connective tissue integrity, smooth muscle dysfunction, and altered level of protein expression. Several candidate biomarkers, including single-nucleotide polymorphisms, circulating proteins, metabolites, and imaging-based parameters, show potential for risk prediction and earlier diagnosis, although routine clinical implementation remains limited. Sacrocolpopexy remains the gold standard for apical prolapse repair because of superior anatomical outcomes, low recurrence, and significant quality-of-life improvement. Laparoscopic and robotic-assisted sacrocolpopexy provide comparable efficacy with reduced blood loss, shorter hospitalization, and faster recovery. The objective success rate is usually over 90%. Complications are very rare and typically include mesh erosion in 2–4% of cases and the need for reoperation in 6% of cases. Our own experience shows that, for a group of surgeons, the learning curve for the laparoscopic approach reached a plateau after a total of 30 operations. Robotic platforms may facilitate complex pelvic dissection and shorten the learning curve, although higher procedural costs remain a major limitation. Full article

Fibromyalgia is a chronic pain condition associated with reduced quality of life, psychological symptoms, cognitive impairment, and low adherence to exercise-based interventions. Immersive virtual reality (IVR) has gained attention as a rehabilitation approach; however, the relationship between user experience, adherence, and clinical outcomes remains unclear. This post hoc exploratory secondary analysis was derived from a randomized controlled clinical trial (NCT07605143) and included 16 women with fibromyalgia who completed a six-week IVR-based rehabilitation program. Associations between user experience, adherence, and clinical outcomes were explored among participants exposed to IVR. Quality of life was assessed using the Fibromyalgia Impact Questionnaire-Revised (FIQ-R), psychological symptoms using the Depression Anxiety Stress Scales (DASS-21), and user experience using the Player Experience of Need Satisfaction (PENS) questionnaire. Within-group changes were observed in FIQ-R scores (p = 0.001; d = 1.08) and DASS-21 stress levels (p = 0.025). Participants demonstrated favorable adherence and positive user experience. A significant correlation was identified between intuitive control and changes in depression scores (ρ = 0.63, p = 0.008). This exploratory analysis identified favorable user experience and adherence among women participating in an IVR-based rehabilitation program. However, due to the absence of a concurrent control group, no conclusions regarding treatment efficacy can be drawn. These findings should be considered hypothesis-generating. Full article

Suspended ceiling systems are among the most seismically vulnerable non-structural components in buildings, posing significant life-safety risks and economic losses, yet understanding their full-field kinematic behavior under seismic loading remains a major experimental challenge. Conventional contact sensors offer limited spatial coverage and can alter the dynamic properties of lightweight panels due to mass loading. In contrast, non-contact optical alternatives are rarely feasible in shake-table environments due to restricted viewing angles, extensive areal coverage requirements, and the risk of equipment damage from falling panels. This study proposes an end-to-end three-dimensional displacement measurement framework for large-scale shake-table testing of suspended ceiling systems, employing consumer-grade cameras with purpose-built tools that cover the complete experimental workflow, including motion-based video trimming, semi-automated calibration, a robust multi-stage image-tracking pipeline that maintains trajectory continuity under extreme inter-frame displacements, and a ceiling system motion visualization and analysis tool. The framework was validated through a full-scale shake-table experiment continuously tracking 324 spatial nodes across 81 ceiling panels, achieving an RMSE below 3 mm in all spatial directions and exact peak-frequency agreement in 9 out of 10 test cases. A parallel processing architecture reduced total processing time from over 27 h to under 10 min without GPU acceleration, and six-degree-of-freedom rigid-body analysis resolved the complete panel failure sequence from constrained oscillation through multi-axis rotation to gravitational free fall, a level of kinematic detail unattainable with conventional instrumentation. This framework establishes a practical, scalable foundation for full-field seismic performance assessment of non-structural systems where conventional instrumentation is physically or logistically infeasible. Full article

The patron saint celebrations of the colonias of Afro-Colombian migrants from the South Pacific region in Cali (Colombia) provide a significant context for understanding the perseverance of paisanaje (a shared experience of origin) bonds and ritual vitality in migration contexts. Organized consistently since the 1960s, these celebrations bring together dispersed communities year after year, activating and reshaping memories, emotions, and collective identities. Building on this celebratory perseverance, this article explores the factors that produce and sustain the emotional and social commitments that transcend the celebration itself. Drawing on the theory of interaction rituals, the concepts of collective effervescence, and embodied memory, this study proposes interpreting these celebrations as spaces where emotion, memory, and social time intertwine. This is based on the understanding that the ritual experience enacts the community through a shared repetition that brings the past to life and projects the expectation of reunion. For this analysis, this study draws on research conducted between 2015 and 2018 and a reflective re-examination of this material in 2026, which included participant observation at 10 celebrations and semi-structured interviews with members of 7 hometown communities or colonias. The results show that longing—the tension between the joy of reunion and the melancholy for what is absent—acts as a constitutive emotional state and the primary amplifier of the ritual’s emotional energy, adding precision to Collins’s model of how energy accumulates and enables the continuity of communal bonds. Full article

Background: Childhood oral hygiene behaviors are crucial to preventing oral diseases and can influence the development and progression of malocclusions. The World Health Organization (WHO) Oral Health Questionnaire is a standardized tool for assessing oral hygiene behaviors, oral health-related behaviors, and preventive dental awareness in children. Aim: This study aimed to assess oral hygiene behaviours and examine associations between WHO Oral Health Questionnaire variables and Angle malocclusion classes among children aged 6–9 years. Materials and Methods: This cross-sectional study included 90 children aged 6–9 years from the Pristina region, Kosovo. Data were collected using the WHO Oral Health Questionnaire for Children, which assessed oral hygiene habits, toothbrushing frequency, fluoride awareness, dental attendance, dietary behaviors, oral symptoms, and oral-health-related quality of life. Malocclusion was classified according to Angle classification into Class I, II, and III malocclusions with 3D intraoral scanners, Aerolscan 3. Descriptive statistical analysis, Chi-square (χ²) test, Spearman correlation analysis, and reliability analysis using Cronbach’s Alpha were performed using SPSS Statistics 23.0 (IBM Corp., Armonk, NY, USA) and Statistica 7.1 (StatSoft Inc., Tusla, OK, USA). Results: Most participants reported regular oral hygiene practices, with 46.7% brushing their teeth two or more times daily. However, limited awareness regarding fluoride-containing toothpaste was observed, as most children answered “don’t know” regarding fluoride use. Occasional toothache or oral discomfort was reported by 33.3% of participants, while 23.3% reported dissatisfaction with dental appearance. Difficulty biting hard foods was present in 34.4% of children. Reliability analysis of the Q10 section demonstrated moderate internal consistency (Cronbach’s Alpha = 0.500). Chi-square analysis demonstrated no statistically significant association between Angle malocclusion classes and WHO questionnaire variables (p > 0.05). The highest χ² value was observed for tooth-cleaning frequency (Q7) (χ² = 11.97; p = 0.152), although the association remained statistically non-significant. Psychosocial impact questions and oral health-related quality of life questions also demonstrated no statistically significant association with malocclusion classes. Conclusions: oral hygiene practices, preventative oral health practices, and oral health-related experiences were comparatively similar among children in different Angle malocclusion classes. Although there were no statistically significant correlations found between malocclusion classes and WHO questionnaire variables, the results show that some children have psychosocial concerns about their dental appearance and insufficient awareness of preventive oral health. The WHO Oral Health Questionnaire is a useful epidemiological tool for evaluating pediatric oral health behaviors and may help build youth orthodontic and preventive oral health policies. Full article

Adult mental disorders (aMD), including borderline personality disorder (BPD), major depressive disorder (MDD), and social anxiety disorder (SAD), share adverse childhood experiences (ACEs) as an environmental risk factor. Epigenetic mechanisms, including DNA methylation (DNAm), may mediate the biological link between early adversity and psychiatric risk. SIAH3, implicated in stress-related and mitochondrial pathways, has been previously associated with both ACE and aMD. This study examined SIAH3 DNAm in adults with BPD, MDD, or SAD, relative to healthy control participants (HC), testing effects of diagnosis, ACE exposure, and their interaction across the pooled sample and within each diagnostic group. Both aMD diagnosis and high ACE exposure showed trends toward SIAH3 hypomethylation, and a significant diagnosis × ACE interaction emerged, with inconclusive post-hoc tests. Disorder-specific analyses revealed heterogeneous patterns: in BPD, high ACE showed a trend toward hypermethylation in unadjusted models; in MDD, interaction effects were marginal and not robust to covariate adjustment; in SAD, significant main effects and a diagnosis × ACE interaction were observed, with high ACE associated with lower DNAm exclusively in HC. These findings suggest disorder-specific epigenetic responses to ACE, positioning SIAH3 as a potential molecular link between early life stress, mitochondrial function, and aMD. Full article

Background/Objectives: Patient experience is increasingly recognised as a key dimension of healthcare quality, yet most tools fail to capture its temporal and processual nature, limiting its contribution to system improvement. This study aimed to demonstrate how a biographical approach to patient experience can generate actionable insights for improving care pathways. Specifically, we sought to: (i) identify and characterise distinct types of prehospital care pathways among patients hospitalised for COVID-19; (ii) identify patient-perceived significant events and safety issues; and (iii) generate structured variables to inform a subsequent quantitative phase. Methods: We conducted semi-structured biographical interviews with 31 patients hospitalised for COVID-19 in two French university hospitals. Data were collected using a life-events calendar (LEC), enabling day-by-day reconstruction of symptoms, healthcare contacts, and decision-making processes. Thematic analysis was performed with multidisciplinary triangulation. The qualitative phase identified three pathway types and the key mechanisms underlying each; these patterns were subsequently confirmed in a separate quantitative follow-up study (n = 312) using state sequence analysis. Results: Three distinct pathway types emerged: short (≤3 days), intermediate (4–9 days), and long (≥10 days). Delayed pathways were associated with repeated false-negative tests, underestimation of severity, and silent hypoxaemia. Across all pathways, patient experience suggested critical system-level failures, including diagnostic delays and inadequate escalation of care. Notably, in many cases, hospitalisation was triggered by a relative rather than a healthcare professional. These findings highlight the role of patient and social context as key components of care pathways. Conclusions: When captured longitudinally, patient experience may provide actionable insights into healthcare system functioning, suggesting structural mismatches between clinical trajectories and care responses. The life-events calendar method offers a replicable framework for transforming patient experience data into clinically and organisationally relevant knowledge. Integrating such approaches into healthcare evaluation could enhance patient safety, improve care coordination, and support more responsive care systems beyond COVID-19. Full article

Viral myocarditis (VMC), predominantly driven by Coxsackievirus B3 (CVB3) infection and the resultant excessive immune response, lacks effective treatments and specific antiviral drugs in clinical practice. Chlorogenic acid (CGA) has been proven to have significant antiviral and anti-inflammatory properties. This study evaluated the potential and mechanism of action of CGA against CVB3-induced viral myocarditis. Our research results showed that CGA significantly alleviated myocardial tissue damage in vivo. This protective effect was accompanied by effective inhibition of myocardial inflammatory responses and viral replication. Further in vitro experiments confirmed that CGA significantly inhibited the replication of CVB3 in a dose-dependent manner, and its inhibitory effect mainly targeted the replication stage of the viral life cycle. Mechanistically, CGA treatment correlates with reduced ZBP1 expression and accelerated ZBP1 degradation involving the ubiquitin–proteasome pathway, accompanied by suppressed activation of PANoptosis markers. These findings suggest that CGA alleviates CVB3-induced myocarditis through concerted antiviral and anti-inflammatory effects, with ZBP1-mediated PANoptosis as a potential contributing mechanism. Full article

Emotional well-being has become a central concern in contemporary educational research, particularly in contexts shaped by social and cultural diversity. However, dominant approaches to educational assessment continue to prioritize cognitive outcomes, often overlooking the affective dimensions of children’s everyday experiences. In this context, play emerges as a key yet underexplored process through which emotional well-being is constructed in childhood. This study aimed to analyze the role of play in the configuration of emotional well-being in sociocultural educational contexts from a sociocultural and relational perspective. A qualitative multiple-case study was conducted in two rural schools located in Mapuche territories in southern Chile, involving students, teachers, caregivers, and Mapuche knowledge holders (kimches). Data were generated through semi-structured interviews and focus groups and analyzed using inductive coding procedures supported by qualitative data analysis software. The findings indicate that play operates as a socioemotional ecology through which children participate in collective forms of life, construct relationships, and experience emotional well-being in interaction with others, territory, and culturally meaningful practices. Three interconnected dimensions emerged. First, play was experienced as a relational, territorialized, and culturally situated practice sustained through participation, collective interaction, and intergenerational transmission. Second, emotional well-being emerged through enjoyment, companionship, belonging, and opportunities for social participation. Third, well-being appeared as a situated experience dependent on access to meaningful spaces, material conditions, cultural repertoires, and opportunities for play. Participants also identified tensions associated with technological change, the reduction in free play opportunities, and transformations in community life, while highlighting the potential role of schools in revitalizing culturally significant play practices such as palín and linao. These findings suggest that emotional well-being is not simply an individual psychological state but a relational and sociocultural accomplishment emerging through participation in meaningful play practices. The study contributes to interdisciplinary debates on childhood, emotional well-being, intercultural education, and sociocultural approaches to development by proposing the concept of play as a socioemotional ecology. Full article