Search Results (2,782)

Physical activity participation in young adulthood is typically explained by motivational and environmental determinants; however, regulatory models of daily behaviour suggest that transient fluctuations in sleep quality, circadian preference, and stimulant use may also be associated with how individuals appraise effort-related demands. Within this behavioural–temporal regulatory perspective, perceived barriers to physical activity may be related to variations in functional energy, alertness, and temporal alignment rather than solely stable contextual constraints. The present cross-sectional study examined whether insomnia symptoms (sleep initiation and awakening problems), chronotype, and daily caffeine intake were concurrently related to perceived personal, social, and environmental physical activity barriers in 788 university students (18–27 years). Standardized self-report measures were administered under controlled assessment conditions. Pearson correlations and theory-informed hierarchical regression models were applied. Sleep initiation problems demonstrated very weak positive correlations with total and domain-specific barriers (r = 0.12–0.17), whereas awakening problems showed very weak inverse correlations (r = −0.10 to −0.14, p ≤ 0.005). Chronotype was weakly associated only with personal barriers (β ≈ −0.09, p = 0.013). Daily caffeine intake showed a weak negative association with environmental barriers (β ≈ −0.15, p < 0.001). Across models, explained variance remained limited (adjusted R² = 0.040–0.053), indicating that these variables explained only a very small proportion of variance in perceived physical activity barriers. These findings suggest that sleep-related and chronobiological characteristics are not meaningful independent predictors of perceived physical activity barriers in this population and demonstrate only weak, domain-specific, and non-directionally consistent associations. Accordingly, the findings should be interpreted cautiously as exploratory rather than practically predictive. Given the cross-sectional design and low explained variance, the results primarily highlight the limited explanatory utility of these psychobiological factors relative to broader unmeasured contextual determinants. Longitudinal and time-sensitive designs incorporating objective behavioural assessments are required to clarify temporal ordering and potential regulatory mechanisms. Full article

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition frequently associated with psychiatric comorbidity, including disordered eating. Adult women remain under-recognized and underrepresented in ADHD research, and emerging evidence suggests that symptom expression may be shaped by gendered social factors, ovarian hormone fluctuations, and metabolic health. In this manuscript, we provide a gender-focused theoretical overview of the literature linking ADHD to binge eating symptoms in adult women, with attention to underdiagnosis, menstrual cycle-related symptom variability, and obesity-related metabolic risk, and empirically test the association between a self-reported ADHD diagnosis and binge eating symptoms in an online cross-sectional sample of adult women. Women reporting an ADHD diagnosis (n = 140) were compared with a random subsample of n = 140 women without ADHD drawn from the same survey; comparability between groups on age, education, and employment was formally verified; and binge eating symptoms were assessed with the Binge Eating Scale (BES) as a continuous outcome and as an ordered three-category variable. Women reporting an ADHD diagnosis showed significantly higher BES scores than controls (rank-biserial r = 0.28, 95% CI 0.15–0.41), and a higher proportion of severe binge eating symptomatology (BES ≥ 27; 22.1% vs. 11.4%; OR = 2.20, 95% CI 1.14–4.25) than controls. The association remained significant in a sensitivity analysis adjusting for age and BMI. Taken together, our findings support the need for routine, gender-sensitive screening for binge eating symptoms in women with ADHD, as well as ADHD screening in women presenting with binge eating and obesity. Full article

This study examines the causal impact of environmental, social, and governance (ESG) ratings on corporate green technology innovation using a panel of Saudi listed firms over the period 2015–2024. Adopting a multi-period difference-in-differences (DID) framework, the analysis evaluates three dimensions of innovation outcomes—quantity, quality, and efficiency (CGTI1–CGTI3). The results show that ESG ratings significantly enhance green technology innovation. Dynamic evidence indicates that these effects strengthen over time, reflecting gradual adjustment in firms’ innovation strategies. Mechanism analysis reveals that ESG ratings promote innovation primarily by alleviating financial constraints and mitigating agency problems. These effects are driven by improvements in the information environment, as ESG ratings reduce information asymmetry and enhance monitoring. From a theoretical perspective, ESG ratings are conceptualized as a digital information infrastructure that reduces informational entropy and provides algorithmic evaluation signals, thereby guiding managerial decision-making in R&D investment and project selection. Robustness tests, including propensity score matching difference-in-differences (PSM-DID), confirm that the results are not driven by selection bias. Focusing on Saudi Arabia under Vision 2030, the findings highlight the role of ESG information systems in shaping green innovation in an emerging market context. Full article

As higher education becomes more digitally mediated and internationally oriented, social media interaction has increasingly become a crucial way across linguistic and cultural boundaries. It functions as a space where interaction unfolds, and meanings are negotiated. To explore how it contributes to the development of intercultural digital communication competence, this study conducted a systematic literature review. Following a PRISMA-guided process, we identified 19 empirical studies published between 2015 and 2025 and evaluated them using the Mixed Methods Appraisal Tool (MMAT). The findings suggested that this competence develops through the combined influence of pragmatic resources, ongoing behavioral adjustment, and affective factors. Features of politeness strategies, stance-taking, and multimodal cues play a noticeable role in shaping interaction. The result showed that participation alone does not automatically lead to improvement, and structured support and opportunities for reflection also make a difference. These findings offered implications for communication training and digitally mediated learning in higher education. Full article

Alcohol and psychoactive substance use represent a major burden for global public health, increasing the risk of non-communicable diseases, violence, road traffic injuries, dependence, and mental disorders, and generating impacts on productivity and social welfare. This study aimed to estimate the burden of disease attributable to alcohol and other psychoactive substances in the departments of Colombia from 2016 to 2022. A burden-of-disease study was conducted using the Disability-Adjusted Life Years (DALYs) indicator, following the methodology of the World Health Organization Global Health Estimates. Official morbidity and mortality databases were used. An estimated 236,154.42 DALYs were attributable to alcohol and psychoactive substance use in Colombia during the study period, increasing from 14,158.7 DALYs in 2016 to 40,190.7 DALYs in 2022. The burden was heterogeneous across departments, with values above 1000 DALYs in Quindío (1779.5), Nariño (1624.3), and Norte de Santander (1008.0) and below 132 DALYs in La Guajira, Casanare, and Vaupés. Men accounted for 73.5% of total DALYs. The mean age of morbidity records associated with alcohol and psychoactive substance use disorders was 30.67 years in men and 32.37 years in women. The burden associated with psychoactive substance use is increasing in Colombia, with differences by sex and department of residence. Full article

Polymer-based product use is rapidly increasing worldwide, resulting in critical social, environmental, ecological, economic, and health effects. Worldwide efforts have increasingly focused on solutions to the equilibrium consumption, production, and disposal of plastics to tackle these issues. The frontiers of biodegradable and bio-based polymers are continually advancing in pursuit of sustainability. Therefore, designing ecological bioplastics made of both biodegradable and bio-based polymers reveals chances to overcome plastic pollution and resource depletion. Polymeric materials are mainly used to manufacture different products at the beginning of their lifespans and which become waste after usage. Numerous sustainability strategies and polymer recycling methods are described and mostly classified into chemical, mechanical, and thermal recycling processes. This manuscript presents a New Polymers Frontier in Recycling and Sustainability Using an Ensemble of Deep Learning with a Heuristic Search Algorithm (NPFRS-EDLHSA). This work is devoted to computational polymer typology, which is based on machine learning algorithms applied to data on physicochemical properties. Although polymer classification can facilitate downstream materials research, the present study does not directly simulate recycling, environmental impacts, or sustainability. The main contributions made by this work include (i) an exploratory analysis of ensemble deep learning models to classify polymers by type on a small and unbalanced dataset; (ii) an evaluation of the effect of feature selection with a heuristic optimization methodology; and (iii) a comparison of the effects on classification performance under limited data conditions. This research sets out to provide a methodological explanation, not arguments for industrial-scale applicability. For the polymer-type classification process, the proposed NPFRS-EDLHSA model designs an ensemble of deep learning techniques, namely a bidirectional recurrent neural network (BiRNN) model, a bidirectional gated recurrent unit (BiGRU) method, and a graph autoencoder (GAE) technique. Finally, the grasshopper optimization algorithm (GOA) adjusts the hyperparameter values of the ensemble models optimally and results in an improved classification performance. A wide-ranging set of experiments was conducted to validate the performance of the NPFRS-EDLHSA method. The experimental results indicated that the NPFRS-EDLHSA technique achieved a better performance than an existing model. Full article

Fathers are globally recognized as influential figures in children’s development, yet the specific mechanisms linking paternal beliefs to preschoolers’ social adjustment remain insufficiently explored. This study examined the sequential mediation effects of father involvement and the father–child relationship on the link between paternal progressive beliefs and children’s social adjustment (indexed by social competence and problem behaviors). A stratified random sample of 1862 Chinese mother–father dyads (3724 individual participants) was recruited. Structural equation modeling showed that the following: (1) Fathers’ progressive beliefs had a direct positive association with children’s social competence, and a small but significant direct positive link to children’s anger–aggression behaviors; (2) The associations between the fathers’ beliefs and children’s social adjustment were indirectly explained by a sequential mediation process: beliefs were associated with greater father involvement, which, in turn, connected to fostered closeness or increased father–child conflict, ultimately leading to more positive adjustments through closeness, or to more negative adjustments via conflict. This study also uncovered discrepancies between mothers’ and fathers’ perceptions of the fathering process. Notably, due to the lack of parallel measures of maternal constructs, these findings reflect paternal contributions within the family system rather than unique effects. These findings were discussed within the transitional context of culturally specific Chinese fathering. This study extends the traditional “parenting beliefs–practices–outcomes” framework to include the parent–child relationship, highlighting the importance of targeting fathers’ effective relationship-building practices in family programs. Full article

Enhancing the willingness of rural–urban migrant workers (RUMs) to pursue the withdrawal of rural homesteads is a key measure to deepen the reform of the rural land system and advance new-type urbanization. This study aims to examine the impact of trade union participation on RUMs’ willingness to withdraw from rural homesteads (WFRH). It further offers implications for improving trade union services and refining relevant institutional arrangements for homestead withdrawal. Based on valid questionnaire data from 1949 RUMs in Hefei, Anhui Province, China, analytical methods, including the ordered Probit model, Propensity Score Matching (PSM), and KHB model, are adopted for empirical analysis. The main conclusions are as follows: trade union participation significantly enhances RUMs’ willingness to WFRH. This conclusion remains robust after the replacement of explained variables, adjustment of econometric models, and use of the PSM method to correct for selection bias. Heterogeneity analysis based on an ordered probit model reveals that the impact of trade union participation on homestead withdrawal willingness is more pronounced among females, individuals under 45 years old, and those with a college degree or above. Mediation effect test based on the KHB model finds that urban identity and sense of social fairness play mediating roles between trade union participation and RUMs’ homestead withdrawal willingness. Trade union participation improves their withdrawal willingness by strengthening their urban identity and sense of social equity. Efforts should be made to enhance the willingness of RUMs to withdraw from homesteads by improving the service function system of “capacity cultivation + rights protection + emotional connection” of trade unions, expanding the effective coverage of trade union organizations, promoting the collaborative linkage between “trade unions and governments”, and strengthening the full process service support for homestead withdrawal. The study conclusions help optimize the allocation of rural land resources and advance the integration of urban and rural development. Full article

Neurodevelopment is a dynamic and multifactorial process, critical in the early stages of life, involving the formation of neural networks, the establishment of synapses, and the maturation of cognitive, social and emotional circuits. In this context, the gut microbiome emerges as an essential regulator of neurodevelopment, exerting influences through multiple biochemical and immunological mechanisms that define the “gut-brain axis”. The microbiota modulates neurodevelopment by regulating neurotransmitters (serotonin, dopamine, GABA), the production of microbial metabolites, including short-chain fatty acids, the modulation of inflammatory cytokines, and vagal signaling to the central nervous system. Recent evidence highlights the role of microbiota in modulating microglia, synaptogenesis, dendritic maturation, and neuronal plasticity, emphasizing how these processes are influenced by microbial activity rather than providing a comprehensive treatise on plasticity itself. Gut microbiota disturbances, or dysbiosis, have been associated with various neuropsychiatric and neurodevelopmental disorders, contributing to cognitive, behavioral, and emotional dysfunctions. This article summarizes, in a narrative manner, the main dysbiosis patterns identified in these disorders and the biological mechanisms by which the microbiome influences neuronal development and function, including immune–neuronal interactions, metabolomic modulation, and neuroendocrine signaling. Finally, emerging directions of intervention aimed at adjusting the microbial profile, such as dietary adjustment, the use of probiotics, prebiotics, symbiotics, and fecal microbiota transplantation, are presented with the aim of positively influencing neurodevelopment and preventing or ameliorating associated dysfunctions. This review emphasizes the need for longitudinal, rigorous, and controlled clinical trials to validate the efficacy of microbiota modulation strategies and to substantiate their integration into individualized pediatric management protocols. Full article

Fear of crime (FOC) has been shown to be associated with negative physical and mental health effects, and older adults have been identified as a vulnerable group. As an individual as well as a societal problem, it is expected to increase in line with the growth of the older population. Nevertheless, the associations between FOC, life satisfaction (LS), and health-related quality of life (HRQoL) among non-victimized older adults are not well understood. Thus, the aim of the present study was to investigate whether levels of behavioral FOC in a sample of non-victimized older adults aged 60–93 years (mean age 69.6 years) were associated with HRQoL and LS. In this cross-sectional study a total of 5832 participants, representing both urban and rural areas, constituted the study sample. Associations between levels of behavioral FOC and LS as well as physical and mental HRQoL were examined in adjusted linear regression models. The results revealed that in those not previously exposed to violence or threats, FOC was associated with lower LS and poorer physical and mental HRQoL. When deterioration in HRQoL and LS in non-victimized older adults is discussed in a clinical setting, the possible link to FOC as an often unprovoked social stressor should be considered. Full article

Objective: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is an aggressive locoregional treatment for selected patients with peritoneal surface malignancies. Although its oncological role has been widely discussed, longitudinal data focusing on postoperative quality-of-life (QoL) trajectories remain limited. This study aimed to describe longitudinal QoL trajectories during the first two years after CRS/HIPEC and to provide exploratory descriptive comparisons according to selected clinical characteristics. Methods: This retrospective single-center cohort study included 144 consecutive adult patients who underwent CRS/HIPEC between January 2018 and July 2022. Patients were evaluated preoperatively and postoperatively at day 14 and at 1, 3, 6, 12, 18, and 24 months. QoL was assessed during routine follow-up primarily using the EORTC QLQ-C30 questionnaire; the EORTC QLQ-CR29 was also administered in institutional practice as a supplementary instrument in selected settings. Repeated QLQ-C30 measurements were analyzed descriptively using the Friedman test with post hoc Nemenyi comparisons. Results: Questionnaire completion rates were 100% at baseline, postoperative day 14, and month 1; 96.5% at months 3 and 6; 91.0% at month 12; 81.9% at month 18; and 75.7% at month 24. Longitudinal analyses demonstrated significant time effects across multiple QoL domains, including global health status, physical functioning, emotional functioning, role functioning, cognitive functioning, social functioning, pain, fatigue, and diarrhea. The most pronounced deterioration was observed in the early postoperative period, particularly at postoperative day 14. Thereafter, several domains improved gradually; however, recovery was domain-specific and did not consistently return to preoperative levels during follow-up. In exploratory descriptive analyses, patients with major postoperative complications showed more pronounced early impairment in global health status, physical functioning, and social functioning, together with greater pain and fatigue burden, particularly at postoperative day 14 and month 1. Exploratory subgroup comparisons also suggested heterogeneity in recovery patterns according to primary tumor origin. Later follow-up findings should be interpreted cautiously in view of attrition over time and the absence of adjusted longitudinal modeling. Conclusions: Quality of life declines substantially during the early postoperative period after CRS/HIPEC, followed by gradual but incomplete recovery over time. This recovery pattern is non-linear and varies across domains. Exploratory descriptive findings suggested that early postoperative QoL impairment may be greater in patients with major complications, but these subgroup patterns require confirmation in prospectively designed studies using adjusted longitudinal models. Longitudinal QoL assessment may provide clinically meaningful insight into postoperative recovery after CRS/HIPEC. Full article

Background/Objectives: Caregiver burden represents a critical yet under-integrated dimension of clinical care in head and neck cancer, where complex treatments and functional impairments impose substantial demands on informal caregivers. This study aimed to evaluate caregiver burden and to identify its clinical and psychological correlates among caregivers of patients with head and neck cancer. Methods: This prospective cross-sectional study included 132 caregivers. Caregiver burden was assessed using the Zarit Burden Interview, and psychological distress was evaluated using the Hamilton Depression (HAM-D) and Anxiety (HAM-A) Rating Scales. Clinical variables, including tracheostomy status, radiotherapy, disease stage, chemotherapy, reconstructive surgery, and disease recurrence, were analyzed. Univariate and multivariate analyses were performed to identify factors associated with caregiver burden. Statistical significance was defined as p < 0.05. Results: Caregiver burden was highly prevalent, with a substantial proportion of participants experiencing moderate to severe levels. In the univariate analyses, caregiver burden was significantly higher among caregivers of patients who underwent tracheostomy (p = 0.003), radiotherapy (p < 0.001), chemotherapy (p < 0.001), reconstructive surgery (p = 0.024), and those with advanced-stage disease (p < 0.001). Higher levels of depression and anxiety were significantly associated with increased caregiver burden (both p < 0.001) in the univariate analyses. In the adjusted analysis, anxiety and cohabitation status remained independently associated with caregiver burden, whereas disease stage, tracheostomy, radiotherapy, chemotherapy, reconstructive surgery, disease recurrence, and depression did not retain statistical significance. Educational level, professional caregiving support, and relationship to the patient were also not significantly associated with caregiver burden. Conclusions: Caregiver burden in head and neck cancer is primarily associated with caregiver psychological status and certain social characteristics, while clinical factors play a less prominent role after adjustment. These findings suggest the need for systematic identification of high-risk caregivers based on psychological vulnerability and caregiving demands. Integrating caregiver-focused assessment and targeted psychosocial interventions into multidisciplinary care could improve caregiver well-being and patient-related outcomes. Full article

Background/Objectives: Disc herniation, also termed herniated nucleus pulposus (HNP), is a common spinal disorder affecting approximately 10% of the global population, associated with pain, neurological complications, and diminished quality of life. Despite its global burden, regional variations in public awareness and sociodemographic determinants remain inadequately characterized, particularly in Middle Eastern populations. This study aimed to assess the prevalence, public awareness, and sociodemographic determinants of HNP among adults in Saudi Arabia at a nationwide level. Methods: An analytical cross-sectional study was conducted from December 2024 to July 2025. Using a convenience sampling approach via social media platforms, an online questionnaire was distributed nationwide across Saudi Arabia. Data from 1112 participants were analyzed using descriptive statistics and multiple logistic regression. The questionnaire comprised two sections: sociodemographic characteristics and knowledge and awareness of HNP. Results: The prevalence of disc herniation was 8.9%, consistent with global estimates. Overall awareness was relatively high at 67.6%, though knowledge of specific risk factors varied considerably. Most participants recognized obesity (88.0%), poor sitting posture (85.8%), history of lower back trauma (86.2%), and work requiring physical effort (88.8%) as risk factors, while fewer acknowledged smoking (46.4%), diabetes (51.2%), sleeping on a soft bed (36.9%), and increased height (35.9%). Multiple logistic regression, adjusted for all sociodemographic, lifestyle, and health-related covariates, identified significant independent predictors of HNP including marital status (married OR = 2.90), current smoking (OR = 2.91), hyperlipidemia (OR = 1.86), family history (OR = 8.95), and prior knowledge of the condition (OR = 2.28). Knowledge of HNP was significantly associated with university education (OR = 1.70), higher income levels (OR = 2.23 for ≥15,000 SAR; OR = 2.07 for 5000–9999 SAR), and family history (OR = 4.70), while those in low and medium workload jobs demonstrated lower knowledge. Conclusions: Although overall public awareness of HNP is relatively high in Saudi Arabia, substantial gaps persist in knowledge of modifiable risk factors, particularly smoking and diabetes mellitus. Targeted smoking cessation campaigns, diabetes awareness programs, and ergonomic education initiatives delivered through primary healthcare centers, workplaces, and schools are recommended. Full article

Background: Foreign citizenship and low socioeconomic status are key determinants of health inequalities and may influence maternal and neonatal outcomes. This study aimed to assess maternal health during pregnancy and the main adverse maternal and neonatal outcomes related to labour and childbirth among women living in Trentino (Northern Italy), comparing women with Italian and foreign citizenship. Methods: A retrospective epidemiological study was conducted using data from the Birth Assistance Certificate (CedAP) database of the Autonomous Province of Trento. This study included all women who gave birth in Trentino between 2012 and 2016. Associations between citizenship and adverse outcomes were assessed using multivariable logistic regression models adjusted for potential confounders. Results: The analysis included 23,165 women, of whom 25.9% had foreign citizenship. Women with foreign citizenship showed a significantly higher risk of gestational diabetes mellitus compared with Italian women and an increased risk of extremely preterm birth (<28 weeks of gestation), particularly among women from Central and South America, Asia and Eastern Europe. Regarding labour and mode of delivery, women with foreign citizenship had a higher risk of caesarean section, especially among women from Central and South America and Africa. In terms of neonatal outcomes, infants born to women with foreign citizenship showed a higher likelihood of requiring phototherapy and admission to the neonatal intensive care unit. Conclusions: Significant differences were observed between immigrant and Italian women in both social determinants and maternal and neonatal perinatal outcomes. Identifying factors associated with adverse outcomes during pregnancy may help improve targeted maternal care and reduce health inequalities for both mothers and newborns. Full article

Problematic internet use among children and adolescents is a major public health concern. In this protocol, it is defined as construct encompassing problematic gaming, social media use, smartphone use, and undifferentiated use, characterized by impaired control, prioritization, and persistence despite harm. It is associated with academic, sleep, and psychosocial difficulties. However, preventive interventions—particularly family-based—remain underexplored despite evidence linking parenting and family functioning to risk. This protocol outlines systematic review and meta-analysis of family-based preventive interventions among children and adolescents (6–18 years). Randomized controlled, quasi-randomized, cluster-randomized, and quasi-experimental studies with parallel comparison groups will be included. Comparators defined as no intervention, waitlist, usual care, or non-family-based prevention. Searches will be conducted in CENTRAL, PubMed, PsycINFO, Web of Science, and CiNii Research, supplemented by reference screening. Risk-of-bias will be assessed using RoB 2 and ROBINS-I. Primary outcomes include changes in overall and subtype-specific severity; secondary outcomes include use time, family functioning, and parental involvement. Random-effects meta-analyses with Hartung–Knapp adjustment will be conducted when ≥3 homogeneous studies are available; otherwise, findings will be synthesized narratively following the Synthesis Without Meta-analysis guideline. This review will synthesize current evidence and clarify role of family-based prevention, informing research and public health strategies. Full article