Search Results (1,882)

Background: Multiple sclerosis (MS) is a chronic disease of the central nervous system, characterised by high variability in both its progression and symptoms. The disease leads to progressive disability, which manifests itself as slow walking, low muscle mass and impaired manual dexterity, causing difficulties in performing everyday activities and reducing a patient’s social activity and quality of life. The aim of this study is to assess the relationships between muscle mass, physical activity and the food frequency of protein-rich products and the functional fitness of patients with MS. Methods: The study comprised 106 patients with MS (83 women and 23 men) aged 18–65 years. Measurements of their weight and body composition, motor function of the lower limbs using the Timed 25-Foot Walking Test (T25FW), and motor function of the upper limbs using the 9-Hole Peg Test (9-HPT) and the Handgrip Strength (HGS) test were performed. Daily moderate-to-vigorous physical activity (MVPA) and the consumption frequency of protein-rich products were also assessed. Results: Low muscle mass was associated with worse performance in the HGS test (non-dominant hand p = 0.001, dominant hand p = 0.001), while no significant associations were observed for manual dexterity or T25FW performance.. The second tercile of MVPA was significantly associated with reduced HGS in the dominant (p = 0.037) and non-dominant hands (p = 0.015). Conversely, the third tercile of the MVPA compared to the lower tertile was associated with better HGS of the non-dominant hand (p = 0.022) and faster completion of the 9-HPT with the non-dominant (p = 0.010) and dominant hands (p = 0.029). Furthermore, frequent consumption of protein-rich products was correlated with faster completion of the T25FW test (p = 0.033). Conclusions: Regular physical activity is associated with better functional fitness, while more frequent consumption of protein-rich foods may be associated with higher muscle mass of major muscle groups, which is important for effective locomotion. This study has a cross-sectional and exploratory design; therefore, the findings reflect associations only and do not allow casual inferences. Full article

The fundamental purpose of education—preparing new generations to be contributing members of society—remains constant, yet achieving this has become increasingly complex amid multifaceted technological, cultural, economic, and social transformations. Educational leaders worldwide continuously seek innovative pedagogical models addressing diverse learner needs and rapid societal changes. However, this article challenges the assumption that educational quality requires constant novelty, arguing that solutions lie in the innovative integration of established pedagogical theories developed over the past 150 years by scholars such as Dewey, Vygotsky, Piaget, Feuerstein, Gardner, Freire, and others. The article’s primary objective is to encourage education leaders and teacher educators to reconceptualize innovation by prioritizing pedagogical integration over continuous adaptation to rapidly expanding domain-specific knowledge and emerging technologies. Accordingly, this article employs a conceptual synthesis of major pedagogical approaches to equip educators with theoretical foundations and practical tools to foster learner independence, critical thinking, and holistic development across cognitive, emotional, and social domains. It will also promote inclusion through a practical framework integrating pedagogical theories, addressing diversity from a dual perspective, recognizing that both teachers and learners bring unique characteristics, strengths, and needs. Moreover, developing independent learners requires empowering teachers to cultivate unique professional methodologies grounded in integrated pedagogical understanding, so that a shift from innovation-centered to integration-centered teacher education may serve as a sustainable path toward educational quality and academic excellence. Full article

A review on the structure, properties, sustainability, and life cycle analysis of basalt fiber composites, emerging as a major sustainable alternative to traditional synthetic reinforcements such as glass and carbon fibers. Basalt fibers (BFs) are high-performance mineral fibers derived from volcanic rock with a high silica content. These fibers exhibit superior mechanical strength, excellent chemical resistance, and exceptional thermal stability across a broad temperature range. This review explores the multi-sectoral applications of basalt fibers, particularly within the energy and chemical industries. Specific focus is placed on their role as reinforcing agents in concrete and polymer matrix composites, where they provide enhanced durability and corrosion resistance. Central to this discussion is the environmental profile of basalt fibers. We evaluate recent life cycle assessments (LCAs) that compare the environmental gains of BF-reinforced structures. The analysis extends beyond environmental metrics to include the economic and social pillars of sustainability, highlighting basalt’s cost-effectiveness in corrosive environments and its safety as a non-carcinogenic material. This review concludes that basalt fibers offer a significant “green” advantage, encouraging wider industrial adoption. Full article

Urban waterfronts are vital public spaces that contribute to urban sustainability by providing residents with opportunities for recreation, social interaction, and nature experiences. Understanding user perceptions in these environments is essential for evidence-based design. Taking Taiyuan Fenhe Park in China as a case with local residents as respondents, this study investigated how objective audiovisual characteristics are associated with tourist loyalty through perceptual dimensions, while also examining interactive associations between visual and auditory elements. Data were collected at 539 spatial samples spaced at five-minute walking intervals. Methods included on-site acoustic measurements, panoramic imaging, computer-based visual and auditory quantification, and questionnaire surveys, yielding a total of 1768 valid responses. Visual features were quantified using semantic segmentation, object detection, and depth prediction, whereas the auditory environment was characterized by physical acoustic and psychoacoustic indicators. Three perceptual dimensions—environmental restorativeness (ERS), spatial vitality (SVS), and environmental controllability (ECS)—were extracted and tested as mediators within the stimulus–organism–response (S-O-R) framework. Results indicated that ERS, SVS, and ECS function as three parallel mediating constructs in the statistical model, with SVS showing the strongest statistical association with tourist loyalty. In addition, fluctuation strength exhibited a significant direct effect on tourist loyalty independent of these three perceptual dimensions. A total of 17 significant audiovisual interactions were identified, revealing both synergistic and antagonistic effects. These findings contribute to theoretical frameworks of multisensory integration and provide practical guidance for sustainable waterfront design. Specifically, zoning strategies and carefully selected audiovisual combinations are relevant to enhanced user experience and may contribute to long-term social well-being. Full article

The Australian University Departments of Rural Health (UDRHs) promote the health and wellbeing of people in rural and remote Australia through health education, research, and advocacy. This narrative review evaluated the extent to which Indigenous health intervention research conducted by UDRHs over a 12-year period (2010–2021) aligned with the Principles and Priorities of the National Aboriginal and Torres Strait Islander Health Plan 2021–2031. The purpose was to reflect on past UDRH research contributions to identify existing strengths and areas for improvement in line with current policy. Thirty-three relevant UDRH publications were identified from a broader database of UDRH research outputs. Each paper was independently coded by at least two authors as demonstrating “yes”, “partial”, or “not evident” alignment with the twelve priorities of the Health Plan. UDRH intervention research demonstrated strengths in genuine shared decision making and partnerships with Indigenous communities, workforce development, health promotion, and identifying and addressing racism. However, gaps were evident in research addressing social and emotional wellbeing, mental health and suicide prevention, promotion of healthy environments, sustainability and preparedness, and transparency regarding shared access to data and information. UDRHs play a key role in building research capacity among staff and communities in rural settings and often maintain long-standing, respectful relationships with local Indigenous communities. While UDRH research aligns with many domains of the national Health Plan, future efforts should prioritise social and emotional wellbeing and mental health. Improved reporting of shared data access represents an immediate opportunity for enhancement. Full article

Background: Preterm birth is a significant early-life stressor associated with increased psychiatric vulnerability and long-term functional impairments in school-aged children. Objective: To compare behavioral–emotional outcomes and functional competence between school-aged preterm and term-born children, examining perinatal, cognitive, and socioeconomic predictors. Methods: 140 children aged 6–10 (70 preterm, 70 age-matched controls) were assessed using the Child Behavior Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ). Functional competence—defined as participation in daily activities, social interactions, and school performance—was examined alongside behavioral–emotional outcomes. Predictors included gestational age, birth weight, SES, and cognitive ability. Results: Preterm birth was associated with higher SDQ scores in emotional problems, hyperactivity, and peer problems. CBCL results showed lower total functional competence scores, specifically in activities, social participation, and school performance. Longer NICU stay predicted higher internalizing problems and lower social participation. Cognitive ability was linked to lower SDQ externalizing and internalizing scores. SES was not a significant predictor. Conclusions: Preterm birth and prolonged NICU hospitalization are linked to persistent behavioral–emotional and functional vulnerabilities. These findings underscore the need for early, integrated developmental monitoring within a preventive psychiatry framework to identify psychiatric vulnerability and support functional participation. Full article

Background: Fibromyalgia is a chronic condition characterized by a complex array of symptoms that impact multiple domains, including physical, psychological, and social aspects of an individual’s well-being. Although home-based adapted physical activity (HAP) interventions represent a promising strategy to improve health-related physical fitness (PF), studies on the topic are still lacking and further research is required. The objective of the present study was to evaluate the impact of participation in a 12-week HAP intervention on health-related PF in adult women with fibromyalgia syndrome (FS). Methods: Participants were women with fibromyalgia (n = 29; 47.1 ± 9.5 yrs) assigned to the 12-week HAP program (n = 17) or wait-list control group (n = 12). Participants completed two weekly circuit-training sessions delivered through an online platform. PF components were assessed through a standardized test battery: 30-s chair stand (lower-body strength), arm curl (upper-body strength), 2-min step (cardiorespiratory fitness), back scratch (flexibility) and 8-foot up-and-go test (agility and balance). Three time-point evaluations were planned: at baseline (T0), after 6 weeks (T1), and after 12 weeks (T2). Linear mixed models were used, and partial eta-squared (η²p) effect sizes were calculated. Results: A significant time × group interaction emerged for upper body strength (p = 0.001; η²p = 0.404), agility (p < 0.001; η²p = 0.569) and cardiorespiratory fitness (p = 0.009, η²p = 0.292). Specifically, from baseline to 12 weeks, the experimental group improved in the arm-curl test (from 15.8 ± 4.5 to 18.9 ± 5.0 repetitions), agility (from 6.6 ± 1.5 to 5.2 ± 1.1 s), and cardiorespiratory fitness (from 69.1 ± 18.8 to 77.2 ± 21.1 repetitions), while the control group showed no meaningful changes. Conclusions: The participation in a 12-week HAP intervention had a positive impact on different components of PF in women with FS, which may have implications for greater physical autonomy and well-being. Full article

Fear of missing out (FoMO) is a cognitive-affective factor that has been consistently linked to problematic social media use (PSMU), but less is known about whether this association differs across severity-based subgroups or changes over time at the node level. This study examined the cross-sectional and two-wave associations between FoMO and PSMU in Chinese university students. Two-wave data were collected one year apart from 853 participants at Time 1 and 817 participants at Time 2. Partial correlation and regression analyses showed that FoMO was positively associated with PSMU. Latent profile analysis identified broad higher- and lower-level subgroups for both FoMO and PSMU. Node-level network analyses further indicated that FoMO and PSMU nodes were positively interconnected. Most subgroup and two-wave network comparisons suggested that overall network structure was relatively stable. The clearest temporal difference emerged in the global strength of the PSMU network. When differences were observed, they were more evident in the relative prominence of specific nodes, including several bridging nodes, than in broader network organization. Overall, the findings suggest that the FoMO-PSMU association is robust, whereas subgroup- and time-related variation appears limited and is better understood as node-level variation within a broader pattern of structural stability. Full article

Introduction: Post-hospital rehabilitation is essential for survivors of severe COVID-19, as prolonged immobility and clinical severity often lead to muscle weakness, reduced cardiovascular capacity, and impaired respiratory function. Physical exercise during and after hospitalization may mitigate these effects and support functional recovery. This study aimed to evaluate the effectiveness of a physical exercise-based rehabilitation program in survivors of severe COVID-19. Methodology: A randomized clinical trial was conducted with 30 survivors allocated to two groups: multicomponent exercise (GEm) and multicomponent exercise combined with inspiratory muscle training (GEmTMI). The interventions were performed three times per week for 40–60 min. Quality of life, physical activity level, functional status, and physical capacity were assessed before and after six weeks. Results: Comparisons between GEm and GEmTMI showed significant differences in the 6 min walk test (6MWT) at baseline (p = 0.043) and in the Physical Activity Index (IPAQ) after the intervention (p = 0.002). When the total sample was analyzed, significant improvements were observed across all outcomes after rehabilitation, including quality of life (SF-36), functional capacity (PCFS), physical activity level (IPAQ), respiratory muscle strength, and additional functional tests. Notable improvements included SF-36 Physical Functioning (p = 0.006) and Social Functioning (p = 0.009), PCFS (p = 0.011), IPAQ (p = 0.012), and performance in the 6MWT, STS, STS-1min, TUG, handgrip strength, PEmax, and PImax (all p < 0.001). Discussion: Multicomponent physical rehabilitation, with or without inspiratory muscle training, produced significant gains in physical activity level, functional capacity, dynamic balance, neuromuscular fitness, respiratory muscle strength, and quality of life. These findings underscore the importance of structured post-ICU rehabilitation to support comprehensive physical and psychosocial recovery in survivors of severe COVID-19. Full article

From a sustainability perspective, lifestyle choices shape behavioral patterns that extend beyond individual experiences, influencing both human well-being and environmental outcomes. Amid escalating human-induced climate change and its widespread social and ecological consequences, understanding lifestyle transformation has become increasingly important. This study traces the trajectories of lifestyle change within globalized contexts and examines the evolving relationships between lifestyle orientations and life satisfaction, with the aim of informing individual-level strategies to support sustainable development aligned with China’s 2060 carbon neutrality goal. Using data from Chinese General Social Survey across three time points (2003, 2013, 2023), a series of two-way analyses of variance reveal that individuals aged 19–35 with higher levels of income and education are more likely to adopt consumption-oriented lifestyles, whereas those aged 60 and above with middle income and lower educational attainment tend to exhibit leisure-oriented lifestyles. Hierarchical multiple regression analyses further indicate that both consumption-oriented and leisure-oriented lifestyles are positively associated with life satisfaction beyond the effects of income alone, although the strength of these associations varies across stages of the life course. Overall, the findings suggest that promoting leisure-oriented lifestyles may offer a viable pathway for enhancing subjective well-being while advancing long-term sustainability goals in contemporary China. Full article

Inter-basin water transfer projects (IBWTPs) play a pivotal role in alleviating the spatiotemporal imbalances of water resources. However, their operation is exposed to multiple, highly interdependent safety risks that can significantly undermine system stability and water supply reliability. Existing studies predominantly focus on isolated risk factors or rely heavily on subjective data, which limits their ability to capture the complex interrelationships among risks and reveal their underlying propagation mechanisms. To address these limitations, this study proposes a novel risk correlation analysis framework that integrates Interpretive Structural Modeling (ISM) with copula functions. ISM is first employed as a preprocessing tool to structure expert knowledge and develop an initial risk correlation framework. It is then used to hierarchically organize the complex interrelationships among risks. Subsequently, copula functions are utilized to model nonlinear dependencies and tail behaviors among risk variables. This enables a quantitative assessment of correlation strengths and facilitates the construction of a risk topological network. An empirical case study is conducted based on the Middle Route of the South-to-North Water Diversion Project. The results reveal 13 significant correlations among six second-level risk categories. Natural risks (e.g., floods and geological hazards) are identified as the primary driving factors. They exhibit a strong positive correlation (0.6155) with engineering risks and serve as the most critical nodes for proactive risk prevention and control. Engineering risks function as central intermediary hubs in the risk transmission process, whereas water quality and economic risks are characterized as terminal endpoints. Furthermore, three principal risk propagation pathways are identified: (1) natural risks → engineering risks → economic risks; (2) natural risks → operational scheduling risks → social risks; and (3) engineering risks → water quality risks → economic risks. The resulting risk topological network demonstrates significant small-world properties, indicating highly efficient risk transmission within the system. Ultimately, this study provides a robust quantitative approach for analyzing risk interactions in complex engineering systems and enriches the theoretical framework of engineering risk management. It also identifies critical nodes and key transmission pathways for risk prevention and control in IBWTPs, thereby offering significant practical implications for operational safety. Full article

Background/Objectives: This exploratory single-arm study evaluated the effects of non-ablative Erbium-doped Yttrium Aluminum Garnet (Er:YAG) laser therapy in a real-world healthcare setting. Methods: A prospective pre–post study was conducted in 47 postmenopausal women who received two sessions of non-ablative Er:YAG vaginal laser therapy (IncontiLase^®®/IntimaLase^®®). Assessments were performed at baseline and two follow-ups (FSFI, ICIQ-SF, I-QOL, and Oxford Scale). Wilcoxon signed-rank tests and Spearman correlations were used. Results: Vaginal hiatus was significantly reduced from 2.5 cm (IQR 2.0–3.0) to 2.0 cm (IQR 1.0–3.0) (p < 0.001). Vaginal length showed a small, non-significant increase, and pelvic floor strength was unchanged. Total FSFI scores remained stable; pain showed a non-significant upward trend, and arousal decreased transiently. ICIQ-SF scores did not significantly improve, although they correlated inversely with vulvar energy at second follow-up (r = −0.424; p = 0.016). I-QOL domains showed short-term improvements in social embarrassment (p = 0.002), psychosocial impact (p = 0.002), and behavioral limitations (p = 0.013) at first follow-up. Cystocele stage improved at second follow-up (p = 0.013). Conclusions: Non-ablative Er:YAG vaginal laser therapy was associated with reduced vaginal hiatus and produced short-term improvements in select quality-of-life domains and cystocele stage, while effects on sexual function and urinary symptoms were limited. Findings remain exploratory and inform the design of future controlled studies evaluating innovative outpatient care models for GSM. Given the absence of a control group and short follow-up, these findings should be interpreted as hypothesis-generating and may be influenced by placebo or expectation effects. Full article

Despite the growing importance of Environmental, Social, and Governance (ESG) performance in shaping brand perception and consumer trust, limited empirical evidence exists on how ESG indicators translate into measurable digital consumer engagement outcomes, particularly in ethically driven markets such as the vegan food sector. This study addresses this gap by examining how ESG performance translates into digitally observable consumer engagement and frames this relationship as a strategic performance measurement and decision-support problem. Building on the sector’s reliance on ethical positioning, trust, and online visibility, we integrate ESG indicators with digital marketing and web analytics metrics (e.g., traffic and engagement proxies) for a panel of five leading vegan food firms [Nestlé SA (Vevey, Switzerland), Kellanova (Chicago, IL, USA), Beyond Meat Inc. (El Segundo, CA, USA), Danone SA (Paris, France), and Conagra Brands Inc. (Chicago, IL, USA)], using data from the Semrush web analytics platform and the Eikon Refinitiv ESG database for the period January–December 2024. We employ a mixed-method design combining descriptive analytics with correlation analysis and simple linear regression to estimate the direction and strength of ESG–digital performance links, and we extend inference through Fuzzy Cognitive Mapping (FCM) using the MentalModeler platform to simulate “what-if” scenarios that support managerial foresight under digital uncertainty. Results indicate that stronger ESG profiles are associated with more favorable digital outcomes, with specific ESG mechanisms (e.g., human-capital and environmental initiatives) aligning with deeper engagement signals. The FCM scenarios further suggest that coordinated ESG improvements can amplify digital traction and reinforce sustainable brand growth. The proposed framework contributes to strategic management by operationalizing an ESG-enabled digital performance measurement system and a lightweight Decision Support System (DSS) that can guide resource allocation, KPI monitoring, and risk-aware positioning in sustainability-oriented markets. Full article

Background/Objectives: Aging is associated with physiological, biochemical, and psychosocial changes that can significantly affect nutritional status and overall health. In Sub-Saharan Africa (SSA), older adults face unique age-related challenges that may compromise healthy aging, yet evidence remains fragmented. This systematic review synthesized the existing literature on the nutritional status, age-related challenges, and strategies to promote healthy aging of older adults in SSA. Methods: A systematic literature search was conducted on PubMed, Scopus, ScienceDirect, and Cochrane Library to identify relevant studies published up to 10 December 2025. Results: Fifty-five studies met the inclusion criteria, with most of the studies coming from South Africa, Ghana, and Nigeria. Amongst community-dwelling populations, approximately 30–65% of the older adults were either malnourished or at risk of malnutrition, while hospital-based studies reported markedly higher burdens, with malnutrition prevalence exceeding 70% in some settings. Undernutrition, micronutrient deficiencies, and the coexistence of overweight and obesity were frequently observed, reflecting the region’s ongoing nutrition transition. Frailty emerged as the predominant age-related challenge, with prevalence ranging around 10–60%. Other common challenges included sarcopenia, reduced muscle strength, functional disability, cognitive impairment, and dysphagia, all of which were closely related to poor nutritional status, food insecurity, multimorbidity, and reduced quality of life. Few studies reported on healthy aging strategies, with the limited evidence suggesting that nutrition education, physical activity, and psychosocial interventions may enhance nutritional and functional outcomes. Conclusions: The need for context-specific, nutrition-sensitive interventions, and stronger health and social support systems is warranted to promote healthy aging in SSA older adults. Full article

Background: Suicide among emerging adults has become a significant global public health concern. Suicidal ideation is the prerequisite for suicide, and social support is recognized as a key protective factor against suicidal ideation. However, the relationship between the strength and consistency of social support and suicidal ideation among undergraduate students remains unclear. This study synthesized empirical studies to quantify the relationship between social support and suicidal ideation among undergraduate students and determine the different correlations between various sources of social support and suicidal ideation. Methods: A systematic review and meta-analysis was conducted following PRISMA 2020 guidelines. Five electronic databases (Web of Science, Scopus, PubMed, ProQuest, and ScienceDirect) were searched for studies published from 2016 to 2025. Eligible studies reported quantitative associations between social support and suicidal ideation among undergraduate students. Correlation coefficients were transformed using Fisher’s z and pooled using a random-effects model. Heterogeneity was evaluated using Cochran’s Q and I² statistics. Risk of bias assessments, moderator analysis, sensitivity analysis, subgroup analysis, and publication bias assessments were conducted. Results: Fifteen studies with sixteen independent effect sizes and more than 26,000 participants were included. The meta-analysis showed a moderate negative association between social support and suicidal ideation (pooled r = −0.33, 95% CI [−0.40, −0.25]) under a random-effects model. A high heterogeneity was observed among studies (I² = 97%, p < 0.001). There are no studies classified as having a high risk of bias. The standardized sample size demonstrated a significant moderating effect (β = 0.2568, p = 0.0022). Sensitivity analysis confirmed the stability of the pooled effect. Subgroup analysis indicated that the strength of the association between social support and suicidal ideation did not differ significantly between Asian and non-Asian studies. No significant publication bias was detected (Egger’s p = 0.19). Narrative synthesis further suggested that family support showed the most consistent protective association compared with friends’ support and support from others. Conclusions: Social support is moderately and consistently associated with reduced suicidal ideation among undergraduate students. These findings highlight social connectedness, particularly family support, as a central interpersonal protective factor and strengthen social support’s role in university suicide prevention initiatives. Full article