Search Results (2,251)

Objective: To evaluate the utility of synovial iron quantification using Magnetic resonance imaging (MRI) in assessing structural joint damage in the knee of patients with rheumatoid arthritis (RA). Methods: This cross-sectional study employed a two-stage design. In the initial comparative stage, 6 patients with RA and 5 patients with osteoarthritis (OA) were recruited to compare synovial R2* values, a metric derived from iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ) MRI sequences representing synovial iron content. Following this, the RA cohort was expanded to a total of 51 patients to investigate the association between R2* values and clinical parameters, including disease activity and bone erosion. Synovial fluid iron levels were measured with an Iron Assay Kit and synovial iron deposits were semi-quantified via Prussian blue staining. Associations between R2* and clinical and laboratory parameters, including inflammatory factors and joint damage indices, were analyzed using Spearman’s rank correlation. Univariate and multivariate ordered logistic regression models were employed to identify factors associated with bone erosion severity. An R2*-based nomogram was developed and validated using receiver operating characteristic (ROC) analysis and calibration curves. Results: Synovial R2* values were significantly higher in RA patients than those with osteoarthritis (53.66 S⁻¹ vs. 31.38 S⁻¹, p < 0.05), consistent with Prussian blue staining results. While synovial R2* values showed no significant correlation with systemic iron metabolic markers, inflammatory indicators, or the Disease Activity Score 28, they were positively correlated with bone erosion severity (ρ = 0.500, p < 0.001) and negatively associated with the joint space width (ρ = −0.307, p < 0.05). Multivariate analysis identified R2* as an independent indicator linked to bone erosion extent (OR = 2358.336, p < 0.001). The R2*-based nomogram demonstrated good discriminative performance. (AUC = 0.83). Conclusions: The R2* value derived from IDEAL-IQ MRI is a reliable tool for quantifying synovial iron and may represent a promising non-invasive imaging biomarker reflecting bone erosion in RA patients. Full article

Background and Objectives: Dentofacial asymmetries are common in patients with malocclusions, while mild body postural asymmetries are frequently reported in otherwise healthy individuals. However, their interrelationship remains insufficiently investigated in adults without diagnosed spinal disorders. This study aimed to evaluate the association between dentofacial and body postural asymmetries in adults with malocclusions. Materials and Methods: A clinical cross-sectional observational study was conducted on 102 adults (18–45 years) with malocclusions and no spinal pathology. Standardized clinical morphometric examinations assessed dentofacial asymmetries (horizontal and vertical planes), dental parameters (dental midlines deviation and occlusal plane inclination), and body postural asymmetries (head, shoulder, trunk, pelvic, and lower limb alignment). Asymmetries were recorded using predefined clinical thresholds. Statistical analyses included the Wilcoxon signed-rank test, Pearson chi-square test, and Spearman’s rank correlation coefficient. Results: Dentofacial asymmetries were identified in both planes and occurred more frequently on the left side. Horizontal facial asymmetries were most common at the cheek (74.5%), nostril (66.7%), and mandibular angle levels (57.9%), and were influenced by sex, age, facial growth pattern, and facial profile (p ≤ 0.05). Mandibular dental midline asymmetry was present in 55.8% of patients. Body postural asymmetries were also frequent, particularly unilateral (60.8%) or anterior (55.9%) head inclination and shoulder asymmetries (54.9%), with a predominance on the left side and associations with age, body mass index, and postural attitude (p ≤ 0.05). Correlations were identified among facial asymmetries and among body postural asymmetries (p ≤ 0.01), indicating a bilateral distribution pattern. Additionally, right-sided facial asymmetries showed significant positive associations with right-sided body postural asymmetries (ρ = 0.197–0.229; p ≤ 0.05). Conclusions: Dentofacial and body postural asymmetries have been identified in adults with malocclusions and presented side-specific associations regarding the patterns of asymmetry. Full article

Background: Medication nonadherence among patients with chronic diseases represents a major challenge in healthcare systems worldwide and is associated with poor clinical outcomes, increased hospitalizations, and higher healthcare costs. Patient-drug related factors such as knowledge of treatment, beliefs about medication, and the experience of side effects may significantly influence adherence behaviour. Methods: A cross-sectional quantitative study was conducted among 80 patients receiving treatment for chronic conditions at a primary healthcare facility in South Africa. Data were collected through face-to-face interviews using a standardized questionnaire that assessed demographic characteristics and patient-drug-related factors potentially associated with medication adherence. Statistical analysis was performed using IBM SPSS Version 30.0.0.0 (172). Descriptive statistics were used to summarize participant characteristics, while inferential analyses, including chi-square tests and Fisher’s exact tests, were applied to determine associations between demographic variables, patient-drug related factors, and medication nonadherence. Results: The majority of participants were female, aged between 41 and 50 years, single, unemployed, and had completed secondary education. Most participants lived in rural areas, and HIV/AIDS was the most commonly reported chronic condition. Significant associations with medication nonadherence were identified for the experience of medication side effects and inadequate knowledge about treatment. These factors demonstrated moderate effect sizes and suggest that both clinical and educational aspects of treatment may influence adherence behaviour. Conclusions: Patient-drug related factors, particularly medication side effects and insufficient knowledge regarding treatment, play a significant role in medication nonadherence among patients with chronic conditions in primary care settings. Interventions aimed at improving patient education, counselling regarding medication side effects, and strengthening patient-provider communication may help improve adherence and treatment outcomes. Full article

Background: To mitigate the negative impacts of the pandemic, it is essential to understand how the associations between different types of physical activity (PA) and adolescent well-being changed before and after the COVID-19 pandemic (defined here as the period marked by students’ return to stable in-person education). This study aimed to examine gender differences in the associations between school-related PA and subjective well-being before and after the pandemic. Methods: A cross-sectional design was used, including 430 boys and 571 girls from 22 high schools. Participants completed the Youth Activity Profile questionnaire to assess school-related and school-associated PA and the WHO-5 Well-Being Index to evaluate subjective well-being. Differences in participants’ PA across segments of the school day before and after the pandemic were evaluated using the Kruskal–Wallis test, and compliance with PA recommendations was analyzed using cross-tabulation and Pearson’s chi-square tests. Results: After the pandemic, both boys and girls reported significantly lower levels of active transportation to and from school compared with the pre-pandemic period. In addition, well-being levels were significantly lower in both genders after the pandemic. Before the pandemic, boys and girls with higher well-being met the recommendations for PA to school, from school, and outside of school significantly more often than their peers with lower well-being. Higher levels of well-being were observed both before and after the pandemic in boys and girls who participated in organized PA compared with non-participants. Conclusions: This study confirms lower levels of PA and well-being among adolescents after the pandemic. In particular, PA to and from school was at a lower level after the pandemic than before the pandemic. Participation in organized PA was significantly associated with higher well-being in both boys and girls before and after the pandemic. Supporting adolescents’ participation in organized PA should be a priority when addressing the negative consequences of societal crisis situations. Improved knowledge of the associations between PA and well-being may contribute to more effective support for adolescents’ PA and greater awareness of the importance of meeting PA recommendations. Full article

Background: Laser hair removal (LHR) is a widely used cosmetic procedure; however, misconceptions and anxiety regarding its safety and effectiveness remain common and may influence treatment decisions. Objective: The aim of this study was to assess attitudes, misconceptions, and anxiety related to LHR among adult dermatology clinic attendees in Saudi Arabia and to identify factors associated with LHR-related anxiety and knowledge levels. Methods: A cross-sectional clinic-based survey was conducted among adults in Saudi Arabia between August and December 2025 using a structured Arabic/English questionnaire. Data collected included sociodemographic characteristics, LHR-related anxiety measured on a visual analog scale (VAS), and LHR knowledge. Anxiety was analyzed as both a continuous score and a categorical variable, while knowledge was scored using an 11-item questionnaire. Associations were examined using chi-square tests, and independent predictors were assessed using multinomial logistic regression. Results: A total of 400 participants were included (mean age 24.5 ± 7.9 years; 89.5% female). Overall anxiety was low (mean VAS 2.5 ± 2.9), although 32.2% reported moderate-to-severe anxiety. Adequate knowledge was observed in 39.5% of participants. In adjusted analyses, adequate knowledge was independently associated with lower likelihood of severe anxiety. Female sex and Saudi nationality were strong predictors of higher knowledge levels. Conclusions: In this clinic-based sample, LHR-related anxiety was generally low, although misconceptions persisted in a substantial proportion of participants. Improving patient knowledge through targeted, evidence-based education may help reduce anxiety, support realistic expectations, and promote informed decision-making regarding LHR. Full article

The pile foundations of hydraulic crossing structures are vulnerable to scour, which can significantly reduce bearing capacity and threaten structural safety. In existing studies, simplified assessment approaches have mainly been used, such as pre-defined scour holes or instantaneous scour, which cannot fully capture the progressive development of scour holes. In addition, there are limited systematic comparisons of the lateral responses of piles with different cross-sectional shapes under scour conditions. To address these issues, a series of finite element simulations were carried out in this study and the numerical model was validated against centrifuge test results. The “model change” technique was then used to simulate the progressive development of general scour. Circular and square piles with equal cross-sectional areas were considered under scour conditions, and the effects of instantaneous and progressive scour were compared at the same depth. The load–displacement response, pile–soil deformation and failure mode, bending moment, and pile displacement were analysed, with the results showing that square piles exhibited a higher lateral bearing capacity than circular under both no-scour and two types of general scour conditions. Scour altered the pile–soil failure mode and reduced the extent of the wedge-shaped failure zone around the pile, with that induced by square piles being larger than that induced by circular. At the same scour depth, the difference between the effects of instantaneous and progressive scour on lateral bearing capacity was not significant. The results indicate that the pile cross-sectional shape is a key factor affecting scour resistance and that square piles show a relative advantage. The findings provide useful guidance for the cross-sectional selection and lateral bearing capacity assessment of pile foundations in scour-prone areas. Full article

To address the suboptimal radiometric calibration accuracy observed in specific beam codes of the GaoFen-3 (GF-3) series satellite for sea surface wind speed (SSWS) retrieval, this study introduces a calibration constant correction method based on the geophysical model function (GMF). This approach enables high-precision SSWS retrieval from GF-3B data. Conventional SAR-based SSWS retrieval models typically rely on pointwise mapping relationships, which overlook the spatial characteristics inherent in dynamic sea surface wind fields. To overcome this limitation, this study proposes an attention-guided dual-branch feature-fusion network (ADBFF-NET). The first branch, implemented as a backpropagation neural network (BPNN), learns nonlinear mappings between the normalized radar cross-section (NRCS, σ⁰), incidence angle, azimuth look direction, and wind vectors (speed and direction). The second branch, designed as a residual convolutional neural network, extracts spatial features of wind fields. An attention mechanism fuses the outputs of both branches, thereby enhancing retrieval accuracy. Experiments conducted with GF-3 series satellite data were validated against the European Centre for Medium-Range Weather Forecasts (ECMWF) Reanalysis V5 (ERA5), Advanced Scatterometer (ASCAT) wind fields, and altimeter-derived wind speeds. The results indicate that the SSWS retrieved from GF-3B SAR data using the corrected calibration constants achieve a root mean square error (RMSE) of 1 m/s against ERA5 wind speeds, representing an approximately 40% reduction compared with the RMSE obtained using the original calibration constant. Furthermore, compared to ERA5 and ASCAT data, the RMSE of the wind speeds retrieved by the ADBFF-NET model reaches 1.17 m/s and 1.03 m/s, respectively. Full article

This study examined how social media content influences value co-creation among organic product consumers through the mediating roles of environmental awareness, green truth, and environmental attitude. Grounded in the Stimulus-Organism-Response (SOR) framework, social media content is conceptualized as a stimulus, environmental awareness, green trust, and environmental attitude as internal organism states, and value co-creation as the behavioral response. A cross-sectional quantitative design was applied using a 20-item questionnaire administered to 739 organic-product consumers. Data were analyzed using partial least-squares structural equation modeling (PLS-SEM). The results indicate that social media content does not directly affect value co-creation but significantly influences environmental awareness, green trust, and environmental attitude. Environmental awareness and green trust positively affect both environmental attitude and value co-creation, and environmental attitude emerges as the strongest direct predictor of value co-creation. These findings confirm the mediating role of cognitive and attitudinal mechanisms in transforming digital sustainability content into collaborative consumer behavior. This study contributes to the literature on sustainable consumption by integrating communication, cognitive, and attitudinal variables in a single explanatory model. Practically, the findings suggest that sustainability communication strategies in digital environments should prioritize credibility and environmental knowledge to foster consumer participation in value co-creation. Full article

Background/Objectives: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and causes cervical cancer in women. Patients with human immunodeficiency virus (HIV) are particularly susceptible to this virus. An effective vaccine against high-risk HPV genotypes is available. This study sought to evaluate barriers to HPV vaccination in HIV-positive female patients between the ages of 18 and 65 in a county clinic in Houston. Methods: A cross-sectional survey was conducted in May–June 2025 with 131 patients at Thomas Street Health Center in Houston. The survey assessed patient demographics, attitudes toward and knowledge of HPV vaccination (at least one dose), as well as self-reported cervical dysplasia and HPV infection history. Clinical data on available cervical dysplasia history were also gathered from the electronic medical record. Descriptive statistics were compiled, and comparisons between vaccinated and unvaccinated participants were performed using one-way analysis of variance for continuous variables and chi-square tests for categorical variables in R. Results: 75% of patients had prior knowledge of the HPV vaccine, but only 33% reported receiving at least one dose. The most common reason for not receiving the vaccine was never having been offered the vaccine by a provider. Separately, almost 40% of unvaccinated individuals had never heard of the vaccine. Of note, only 8.6% of respondents reported fully understanding the implications of vaccination and still choosing to decline. In this cross-sectional study, there was no statistically significant association between vaccination status and either recent dysplasia history in the electronic record or reported dysplasia or HPV infection history. Among eligible unvaccinated participants, 41% received the HPV vaccine after completing the survey. Conclusions: Addressing gaps in HPV vaccine communication and supporting clinicians in delivering confident counseling may improve vaccination rates in this at-risk population. Full article

Background: Systemic arterial hypertension (SAH) shows a high prevalence among postmenopausal women and represents an important public health concern. Objective: To evaluate factors associated with SAH in postmenopausal women participating in a resistance training program. Methods: This observational, cross-sectional study included 55 postmenopausal women (66.0 ± 4.9 years) recruited from the “More Active Women” research project, an umbrella experimental and longitudinal study involving resistance training interventions. Cross-sectional data were collected during the baseline assessment (April–May 2025). Sociodemographic variables, nutritional status (body mass index and waist circumference), and behavioral and health-related variables obtained through structured interviews and anthropometric assessments were analyzed. Associations were tested using Pearson’s chi-square test or Fisher’s exact test, with effect size estimated by Phi or Cramer’s V when appropriate, and binary logistic regression was performed for adjusted analyses. Results: Significant associations were observed between SAH and elevated BMI (p = 0.03; φ = 0.30), waist circumference > 88 cm (p = 0.006; φ = 0.40), and lower educational level (p = 0.003; V = 0.47). In the adjusted analysis, waist circumference ≤ 88 cm was associated with a lower likelihood of SAH (OR = 5.54; 95% CI: 0.965–31.872; p = 0.007), whereas lower educational level was associated with a higher likelihood of hypertension (OR = 13.98; 95% CI: 1.505–129.833; p = 0.004). Conclusion: Excess central adiposity and lower educational level are associated with SAH in postmenopausal women, highlighting the importance of integrated health promotion strategies that address both cardiometabolic risk factors and social determinants of health during aging. Full article

Background: Malnutrition and its risk are prevalent in older adults and contribute to frailty, morbidity, and mortality. Poor oral health—particularly tooth loss and inadequate prosthetic rehabilitation—may impair chewing, limit dietary variety, and accelerate nutritional decline. We investigated associations between dentition status, denture use, and nutritional status in a nationally representative sample of Polish older adults. Methods: We analyzed data from 5214 participants aged ≥60 years from the nationwide cross-sectional PolSenior2 study. Dentition status was classified as functional dentition (≥20 teeth), partial dentition (1–19 teeth), or edentulism (0 teeth). Nutritional status was assessed using the Mini Nutritional Assessment—Short Form (MNA-SF); impaired nutritional status was defined as MNA-SF <12 (malnourished or at risk). Additional indicators included hypoalbuminemia (<35 g/L) and small calf circumference (<31 cm). Associations were tested using chi-square and multivariable logistic regression adjusted for age, sex, education, and place of residence. Results: Functional dentition was present in 15.5%, partial dentition in 48.1%, and edentulism in 36.4% of participants. The proportion of edentulous individuals increased across worsening MNA-SF categories (26.2% in well-nourished, 41.8% in at risk, 46.9% in malnourished). In adjusted models, edentulism was associated with higher odds of impaired nutritional status compared with functional dentition (OR: 1.66; 95% CI: 1.32–2.10; p < 0.001), while partial dentition showed a non-significant trend (OR: 1.22; 95% CI: 0.98–1.52; p = 0.077). Among edentulous participants, denture use was more common in well-nourished individuals than in those with impaired nutritional status (93.0% vs. 77.2%), suggesting a possible association between active prosthetic rehabilitation and better nutritional status. Conclusions: In Polish older adults, tooth loss—particularly edentulism—is associated with poorer nutritional status. Screening for malnutrition risk may benefit from incorporating basic oral health and denture-use assessment while improved access to prosthetic rehabilitation may support nutritional resilience in ageing populations. Full article

Background: Medication use in paediatric populations is inherently complex and carries a heightened risk of prescribing errors, particularly within primary health-care settings. Despite this concern, evidence describing paediatric prescribing errors in Saudi Arabia remains scarce. Hence, the present study aimed to evaluate the prevalence and patterns of prescribing errors in paediatric primary care and to characterize the pharmacist-led interventions undertaken to resolve these errors. Methods: A prospective, mixed-methods cross-sectional study was conducted over three months at a primary health-care centre. Paediatric outpatient prescriptions were systematically reviewed during routine practice by trained clinical pharmacists. All suspected errors were independently validated and classified for severity by a multidisciplinary expert panel. Descriptive statistics were used to summarise prescribing errors, and associations with patient and prescription characteristics were assessed using chi-square tests. Qualitative data were analysed using a descriptive thematic approach to explore mechanisms of error identification and the nature of corrective pharmacist interventions. Results: A total of 545 paediatric outpatient prescriptions were reviewed, of which 142 prescriptions (26.1%) contained at least one prescribing error. Across these prescriptions, a total of 145 individual prescribing errors were identified. Dose-related errors were the most common (68.3%), followed by inaccuracies in dosing frequency (11.0%) and inappropriate drug selection (9.0%). The occurrence of prescribing errors was significantly associated with patient weight (p = 0.016), the number of medications per prescription (p < 0.001), and the recorded diagnosis (p = 0.018). The majority of errors were intercepted prior to medication dispensing (93.0%), and no cases of patient harm were identified. Qualitative analysis revealed that errors were predominantly detected through cross-checking with authoritative drug references, recalculation of weight-based doses, and application of clinical judgement, and were most often resolved through direct communication with the prescribing clinician. Conclusions: Prescribing errors occur frequently in paediatric outpatient settings; however, most are preventable with appropriate safeguards. Pharmacists play a critical role in identifying and resolving these errors before they result in patient harm. Enhancing paediatric prescribing support systems and strengthening interprofessional collaboration may further advance medication safety within primary health-care services. Full article

Background: Oocyte cryopreservation has emerged as a viable fertility preservation method, gaining popularity among women delaying motherhood for non-medical reasons. This study examines the awareness, perceptions, and social factors influencing young women’s decisions regarding elective oocyte cryopreservation (EOC), intending to identify key demographic and psychosocial determinants. Methods: A cross-sectional study was conducted using an online survey distributed via digital platforms between November 2024 and February 2025. A structured questionnaire comprising 31 multiple-choice questions assessed participants’ sociodemographic characteristics, reproductive health history, lifestyle factors, and perceptions of fertility and EOC. Statistical analyses included Chi-square tests, t-tests, and binary logistic regression to identify factors associated with willingness to undergo EOC. Results: A total of 390 women (mean age 22.57 ± 1.41 years) participated. Awareness of oocyte cryopreservation was remarkably high (93.1%). Significant predictors for the intention to undergo EOC included higher educational attainment (Master’s level) (OR = 4.27, 95% CI: 1.10–16.48) and living in a student dormitory (OR = 15.39, 95% CI: 4.86–48.71). Conversely, living with a partner showed a non-significant downward trend in interest (OR = 0.07, 95% CI: 0.01–1.43). Psychological factors, specifically anxiety about future fertility (OR = 0.23, 95% CI: 0.08–0.62 for moderate vs. high anxiety) and a strong desire for future parenthood (OR = 21.75, 95% CI: 1.45–32.99), also emerged as primary drivers of women’s reproductive decisions. Conclusions: Despite high awareness, the willingness to undergo elective oocyte cryopreservation remains limited. Targeted fertility education and supportive policies are needed to address misconceptions, financial barriers, and psychological concerns influencing reproductive decision-making. Further research should explore longitudinal trends in women’s attitudes toward EOC. Full article

Background: Parental knowledge and perceptions towards Functional Foods (FFs) play a critical role in shaping children’s dietary behaviors. This study aimed to investigate dietary habits, FFs knowledge and perceptions among Greek primary school children and their parents and to evaluate the feasibility of a one-month pilot asynchronous nutrition education program. Methods: A cross-sectional study included 374 children aged 9–11 years and 159 parents from urban (Thessaloniki) and rural (Lemnos) areas. Children completed questionnaires on dietary habits, FFs knowledge and Mediterranean Diet (MD) adherence (KIDMED score), while parents provided sociodemographic information, BMI, dietary habits, FFs knowledge and perceptions. A pilot asynchronous nutrition education intervention was delivered via pre-recorded videos on FFs, the MD, portion sizes and food label interpretation, with participation tracked and program evaluation conducted among parents. Data was analyzed using IBM SPSS Statistics (version 28). Descriptive statistics were calculated, group differences were assessed with t-tests and ANOVA and associations between variables were examined using chi-square tests and Pearson correlations (p < 0.06). Results: Children showed moderate MD adherence, frequent fast-food and soft drinks consumption and low FF knowledge, with a substantial gap between perceived and actual understanding. Parental FF knowledge was uneven, higher among normal-weight participants and largely limited to fortified products. Positive associations were found between children’s and parents’ diet quality and natural FF consumption, as well as between parental and child physical activity. The asynchronous intervention was positively rated; substantial attrition was observed across sessions and follow-up, which limited the ability to assess the intervention’s effects on behavioral change. Conclusions: This study highlights critical gaps in FFs knowledge among families and demonstrates that asynchronous, family-based nutrition education is feasible but challenged by engagement attrition. Targeted interventions are needed to clarify FF concepts and promote healthier family dietary behaviors. Full article

Background/Objectives: Traumatic dental injuries (TDIs), particularly avulsion, require immediate and appropriate first aid to ensure favorable outcomes. Adolescents are often the first responders during school or sports activities, yet their preparedness remains unclear. This study aimed to assess the knowledge, attitude, and awareness of adolescents regarding the emergency management of TDIs. Methods: A descriptive cross-sectional survey was conducted among 400 adolescents aged 15 to 18 years from four randomly selected colleges in Mangaluru, Karnataka. A structured, validated 16-item questionnaire assessed demographic characteristics and domains of knowledge (6 items), attitude (6 items), and awareness (6 items). Data was analyzed using descriptive statistics, chi-square tests, and one-way ANOVA. Results: The mean knowledge score was 2.50 ± 1.04 (95% CI: 2.40–2.60), indicating limited knowledge of dental trauma management; only 26.3% of participants recognized that avulsed permanent teeth can be replanted and 7% identified an appropriate storage medium. The mean attitude score was comparatively high (4.38 ± 1.12; 95% CI: 4.27–4.49), with 88.8% of students willing to assist an injured peer, reflecting a large attitude–knowledge discrepancy (Cohen’s d = 1.47). The mean awareness score was 2.24 ± 1.24 (95% CI: 2.12–2.36), indicating limited awareness of preventive practices, including low mouthguard use (11.5%). Shapiro–Wilk testing confirmed non-normal distribution of KAA scores (p < 0.05); accordingly, non-parametric analyses showed no significant differences across schools, academic streams, gender, or education level (Kruskal–Wallis and Mann–Whitney U tests; p > 0.05). Conclusions: Despite favorable attitudes toward assisting peers, adolescents demonstrated limited knowledge and awareness regarding the emergency management and prevention of traumatic dental injuries, particularly in tooth replantation, appropriate storage media, and mouthguard use, highlighting the need for targeted, school-based dental first-aid education programs. Full article