Maintenance factors for eating disorder symptoms based on ecological momentary assessment studies: A systematic review.

Hypoxia constitutes a common feature of tumor microenvironments, orchestrating cancer progression across various malignancies. Cancer growth and resistance to therapy are frequently associated with overexpression of antioxidant systems, such as the thioredoxin (Trx) system. This system is fundamental for cell survival and proliferation, playing a key role in maintaining redox homeostasis and regulating hypoxia-inducible factor-1alpha (HIF-1α) activity. This, in turn, regulates different genes involved in tumor progression, such as the vascular endothelial growth factor (VEGF), an indispensable factor for tumor invasiveness and microenvironment tumor maintenance. HIF-1α can also be regulated by the signal transducer and activator of transcription 3 (STAT3), an oncogene stimulated by pro-inflammatory cytokines and growth factors. Targeting antioxidant systems, such as the Trx system, is an emerging strategy in cancer therapy, as tumor cells are more vulnerable to disruptions in redox homeostasis than normal cells. Even though there are some studies correlating the use of Trx inhibitors and the inhibition of hypoxia-related factors, the diverse pathways in which this occurs are still elusive. Therefore, in this review, we explore the multiple pathways through which the Trx system influences HIF-1α and highlight drugs that have been studied targeting hypoxia-related factors by inhibiting the Trx system. Given the link between oxidative stress and apoptosis in cancer cells, and the low overall survival rates for many cancers despite new therapies, understanding the Trx system's connection to hypoxia-related pathways could be crucial for advancing therapeutic approaches and tackling therapy resistance.

Factors influencing performance of university lecturers in Tanzania: Mediating role of job satisfaction

As of 2025, an estimated 150.2 million children under 5 years globally were stunted-falling more than two standard deviations below the World Health Organization (WHO) Child Growth Standards median. Helminth infections represent a potentially significant yet under-addressed contributor to childhood stunting. Our aim was to elucidate the potential causal relationship between helminth infections and childhood stunting, including the mediating role of low birth weight (LBW). Three causal directed acyclic graphs (DAGs) were constructed using evidence synthesis for constructing DAGs (ESC-DAGs) methodology: (i) maternal infection, (ii) infant infection during exclusive breastfeeding (<6 months old), and (iii) child infection post-weaning (6-24 months old). Minimally sufficient adjustment sets (MSAS) were derived from our DAGs. All three DAG models included core adjustments for geographical location, healthcare access and water, sanitation and hygiene factors. The maternal infection model additionally incorporated maternal age, socioeconomic status (SES) and maternal education as key confounders. For the child models, both age groups included adjustments for child sex, age, birth weight and parental education. The model for infants <6 months of age additionally incorporated breastfeeding status, while the model for children post-weaning (6-24 months of age) included SES alongside the other shared variables. These MSAS provide researchers with standardized confounder adjustment frameworks, helping to resolve inconsistencies in prior literature stemming from incomplete confounder control and advancing methodologically rigorous causal inference. This article is part of the theme issue 'Biological, biomedical and environmental drivers of stunting'.

The broadcast media industry is a dynamic sector where attracting, developing, and retaining talent is a critical challenge, yet limited empirical research has examined how Human Resource Management (HRM) practices influence employee engagement in this context. This study addresses this gap by investigating the relationship between HRM practices and employee engagement, with a focus on the mediating roles of supervisory support and organizational commitment. Guided by Social Exchange Theory (SET), the Job Demand–Resources (JD–R) Model, and the Motivation–Hygiene Theory, a quantitative research design was employed. Data were collected through an online survey from 140 employees working in television, radio, and digital media organizations across Bangladesh, and analyzed using Partial Least Squares Structural Equation Modeling (PLS–SEM). The results indicate that performance appraisal, training and development, and recruitment and selection have significant positive effects on emotional commitment, satisfaction, and retention intent, while compensation and benefits show no significant impact on satisfaction. These findings suggest that, in creative industries such as broadcast media, developmental and relational HR strategies are more effective drivers of engagement than purely financial incentives. The study provides theoretical contributions by validating the applicability of established HRM-engagement frameworks in a creative industry context and offers practical guidance for HR professionals aiming to foster a motivated and committed workforce.

Introduction This systematic review provides comprehensive hierarchisation of e-learning service quality determinants predicting student satisfaction in public universities worldwide. Public universities face unprecedented challenges delivering quality e-learning while managing severe resource constraints and equity mandates. Unlike previous reviews aggregating findings across institutional types through qualitative synthesis, this study provides effect size stratification enabling evidence-based resource allocation for public sector contexts systematically underrepresented in literature. Methods A systematic bibliographic search of Scopus and Web of Science (June 2025) identified 15 empirical studies (2016–2025) examining e-learning quality-satisfaction relationships in public universities. Studies were selected through purposive sampling based on predefined eligibility criteria: public university contexts, quantitative designs reporting standardised effect sizes ( β coefficients), and peer-reviewed publications (2016–2025) in English/Spanish. Following PRISMA 2020 guidelines, studies underwent Mixed Methods Appraisal Tool (MMAT) 2018 quality assessment (mean score: 3.67/5). Standardised regression coefficients ( β ) were extracted, tabulated, and stratified by effect magnitude. Synthesis employed Synthesis Without Meta-analysis (SWiM) guidelines given methodological heterogeneity precluding meta-analysis. Results Fifteen studies encompassed 9,847 students across 12 countries. Hierarchisation revealed perceived value as dominant predictor ( β = 0.626, R 2 = 0.568), surpassing instructor competence by 5.35×. Four-tier classification emerged: Critical ( β &amp;gt;0.40), High ( β = 0.35–0.44), Moderate ( β = 0.20–0.34), Low ( β &amp;lt;0.20). Geographic heterogeneity was extreme (online interaction β = 0.197–0.768, coefficient of variation CV = 74.3%). Institutional quality dimensions remained systematically absent (80.0% omission). Methodological limitations included absolute cross-sectional dominance (100%) and socioeconomic status omission (0%). Discussion Findings reveal value-centric paradigm challenging technology-centric frameworks, wherein students prioritise outcome-oriented dimensions [employability, return on investment (ROI)] over process-oriented attributes. System/information quality function as hygiene factors—absence guarantees dissatisfaction, presence insufficient beyond functional thresholds. Strategic implications: prioritise value articulation over technological sophistication, achieve technological parity rather than pursuing “arms races”, invest in compensatory offline infrastructure, and contextualise frameworks through local validation. Future research should pursue longitudinal designs, geographic diversification, and equity-oriented conceptualisations incorporating socioeconomic moderators.

The PROMIS Sleep Disturbance Short Form 8b (PROMIS SD-SF-8b) is an 8-item self-report measure evaluating two dimensions of sleep disturbance: Insomnia symptoms and dissatisfaction with sleep. This study aims to validate the PROMIS SD-SF-8b for use among Arab nurses. A cross-sectional, descriptive, correlational design was employed. The instrument underwent a rigorous five-step cross-cultural adaptation process. Psychometric testing included descriptive statistics, internal consistency analysis, test-retest reliability, exploratory and confirmatory factor analyses (EFA, CFA), and evaluation of convergent and discriminant validity. The Ar-PROMIS SD-SF-8b demonstrated excellent internal consistency (Cronbach's alpha = 0.81; McDonald's omega = 0.82) and test-retest reliability (ICC = 0.90). EFA revealed a two-factor structure explaining 57.44% of the total variance. CFA supported the two-factor model (CFI = 0.96, RMSEA = 0.07, CMIN/df = 2.03). Composite reliability exceeded average variance extracted, indicating strong convergent validity. The AVE values surpassed the MSV values, further supporting the discriminant validity of the Ar-PROMIS SD-SF-8b. No significant floor or ceiling effects were observed, indirectly suggesting the instrument's robustness and sensitivity to detect variations in sleep disturbance among Arab nurses. The Ar-PROMIS SD-SF-8b is a valid and reliable instrument for assessing sleep disturbance among Arab nurses. By providing precise measurement of sleep-related impairments, this instrument can aid healthcare organizations and researchers in identifying nurses at risk and effectively monitoring sleep-related outcomes, thereby facilitating the implementation of targeted occupational health and well-being interventions. Its application may inform targeted interventions and broader evaluations in culturally comparable healthcare settings.

Accumulation of DNA damage, particularly oxidative DNA damage, is a major molecular driver of senescence and aging. The enzyme apurinic/apyrimidinic endonuclease-1 (Apex1) is essential for base-excision repair, but its role in protecting the brain from age-related deterioration remains unclear. Here we show that conditional knockout (cKO) of Apex1 in forebrain neurons causes early and progressive cognitive impairment in mice. Apex1 cKO mice display deficits in spatial learning and memory (8-12 weeks), alongside reduced synaptic proteins, altered neuronal morphology, and impaired long-term potentiation at 48 weeks. We further show that a 30% caloric restriction (CR) regimen at 8-48 weeks markedly attenuates these premature aging features and improves cognitive outcomes in Apex1 cKO mice. These findings confirm Apex1 as a critical genomic maintenance factor in the aging brain and highlight the Apex1 cKO model as a valuable tool for studying endogenous defenses and dietary interventions against aging.

Rtt107 cooperates with Rad55 to limit specific types of genome instability in Saccharomyces cerevisiae.

Healthcare costs not subsidized by the government and are covered by patients, are known as out-of-pocket healthcare expenditure (OOPHE). In Australia, OOPHE disproportionately impacts Aboriginal households, particularly in rural and remote regions. Currently no patient reported measures (PRM) to assess OOPHE exist, despite being an identified priority in Aboriginal communities. This study developed and psychometrically evaluated (validity and test-retest reliability) of an OOPHE PRM for Aboriginal households in outer regional to remote areas. This Aboriginal led study was governed by an Aboriginal Governance Group, which involved a 4-stage process: (i) identification of community-derived OOPHE themes; (ii) item development and expert judgment quantification; (iii) exploratory factor analysis (EFA) to determine factor structure through pilot testing with Aboriginal participants; and (iv) assessment of reliability and stability through test-retest methods. Stage 1 identified OOPHE themes (i.e. barriers, financial strain), informing development of a 15 item PRM in Stage 2. In Stage 3, 39 Aboriginal participants completed Test 1, with EFA revealing a two-factor model; Factor 1 (8 items, internal consistency = 0.91) and Factor 2 (6 items, internal consistency = 0.85). In Stage 4, 32 participants completed Test 2, with over 60% of items showing substantial to perfect agreement (κ = 0.61-0.87) and scale-level reliability as good to excellent (ICC = 0.75-0.92). Two items performed poorly and were removed, resulting in a final 13-item PRM. The OOPHE PRM demonstrates promising psychometric properties as a culturally grounded measure of OOPHE burden among Aboriginal families, supporting advocacy for equitable policy, funding, and health system reform.

Loneliness is a key risk factor for youth mental health; however, existing scales often fail to capture its multidimensional and relational nature. This study developed the [blinded] University Loneliness Scale (KULoS) for students in Grades 1-9 and evaluated its psychometric properties using cross-sectional and longitudinal survey data collected in Ishikawa, Japan (Time 1: n = 856; Time 2: n = 709). Exploratory factor analyses conducted separately for grades 1-4 and grades 5-9 supported a two-factor structure primarily reflecting item wording (direct vs. indirect items). The four-item direct subscale (KULoS-D) demonstrated good internal consistency (ω = 0.801-0.862), whereas the indirect subscale (KULoS-I) showed lower reliability (ω = 0.662-0.666). Confirmatory factor analyses at both time points indicated a good fit for the two-factor model. KULoS-D showed strong associations with single-item loneliness and depressive symptoms (rs ≈ 0.50) and moderate correlations with aggressive and prosocial behavior in the expected directions, whereas KULoS-I demonstrated weaker convergent and criterion-related validity. Cross-lagged panel analyses revealed that KULoS-D at Time 1 significantly predicted depressive symptoms at Time 2 after controlling for baseline depressive symptoms, whereas KULoS-I did not predict depressive symptoms. Overall, these findings support the KULoS-D as a brief and psychometrically robust measure of loneliness in children and early adolescents, with potential utility for large-scale research and early screening.

BACKGROUNDA substantial proportion of earthquake-related fatalities result from severe trauma at the time of the event and entrapment under debris. Prolonged compression significantly increases the risk of developing crush syndrome, which is considered a critical determinant of mortality and morbidity. This study aimed to develop and evaluate a scale designed to assess pediatric surgical nurses' knowledge of earthquake-related crush syndrome.METHODSThis methodological study was conducted between August and September 2023. The sample consisted of 77 pediatric surgical nurses working in pediatric surgery units of a city hospital who voluntarily participated in the study. Data were collected using a data collection form and a draft 30-item version of the scale. Content and construct validity were assessed to validate the instrument. Tetrachoric factor analysis was used to examine construct validity. Reliability was evaluated using the Kuder–Richardson Formula 20 coefficient and the person reliability coefficient. Rasch analysis was performed to assess item difficulty and discrimination.RESULTSThe Content Validity Index for the Earthquake-Related Crush Syndrome Knowledge Scale was 0.99. Tetrachoric factor analysis revealed two subdimensions comprising nine items. Goodness-of-fit indices for the confirmatory two-factor model indicated an acceptable to excellent fit. The Kuder–Richardson Formula 20 reliability coefficients were 0.90 for Factor 1 and 0.88 for Factor 2. According to Rasch analysis, the scale demonstrated a two-subdimension structure comprising seven items, with factor loadings ranging from 0.59 to 0.90; the factors were interrelated. In the Rasch model, the person reliability coefficient was 0.433, indicating low reliability. The mean absolute deviation of Q3 residual correlations (MADaQ3), used to assess model fit, was 0.116, while the information-weighted fit (infit) and outlier-sensitive fit (outfit) statistics were within the acceptable range (0.5–1.5).CONCLUSIONPreliminary findings suggest that the scale demonstrates acceptable validity and reliability for assessing pediatric surgical nurses’ knowledge of earthquake-related crush syndrome.

Background/Objectives: Dyspnoea in heart failure with reduced or mildly reduced ejection fraction (HFrEF/HFmrEF) is multidimensional, yet conventional unidimensional scales do not capture its sensory and affective components. The Multidimensional Dyspnea Profile (MDP) addresses this gap; however, its psychometric properties have not been established in a dedicated HFrEF/HFmrEF cohort. We assessed structural validity, internal consistency, test–retest reliability, and construct validity of the MDP using COSMIN methodology. Methods: In this prospective, single-centre psychometric validation study, 101 clinically stable adults with HFrEF or HFmrEF were enrolled at a tertiary outpatient cardiac clinic in Riyadh, Saudi Arabia. Participants completed the MDP alongside Dyspnea-12, modified Medical Research Council scale, Kansas City Cardiomyopathy Questionnaire-12, Fatigue Severity Scale, and 6 min walk test. Test–retest data were obtained at 12 days in patients confirmed stable by the Global Rating of Change (n = 87). Psychometric evaluation included Cronbach’s α, intraclass correlation (ICC2,1), standard error of measurement, minimum detectable change (MDC95), confirmatory factor analysis (comparative fit index [CFI], root mean square error of approximation [RMSEA], standardised root mean square residual [SRMR]), and 12 a priori construct hypotheses. A preliminary minimal clinically important difference (MCID) was estimated using anchor- and distribution-based methods. Results: The mean age was 55 ± 11 years and 80% were male. CFA supported the two-factor model (CFI = 0.96; RMSEA = 0.061; SRMR = 0.058). Cronbach α was 0.92 for the full scale, 0.88 for immediate perception, and 0.91 for emotional response. ICC2,1 was 0.94 (95% CI: 0.91–0.96), and MDC95 was 4.2 points. All 12 hypotheses were confirmed. The preliminary MCID was 8 points. Conclusions: The MDP is a reliable, valid, and clinically interpretable multidimensional dyspnoea measure in HFrEF/HFmrEF. The 8-point MCID is preliminary and requires confirmation in larger longitudinal intervention studies.

ABSTRACT This paper describes the development and initial validation of the ambivalent prejudice towards gay men scale (APGS) – a multidimensional 19-item measure of hostile and benevolent prejudice towards gay men – in two British samples. In Study 1 (N = 801), exploratory factor analysis produced a four-factor (repellent, romanticised, paternalistic, and adversarial) scale, with men scoring higher in repellent and adversarial prejudice and women scoring higher on romanticised prejudice, supporting known-groups validity. The APGS further evidenced convergent and discriminant validity relative to hostile and benevolent prejudice measures and ideologies associated with prejudice, and good internal and test-retest reliability. Romanticised (benevolent) and adversarial (hostile) subscales were positively correlated, and used to create an individual differences index of ambivalent prejudice towards gay men associated with system justifying beliefs and insensitive to self-presentational concerns. In Study 2 (N = 300), confirmatory factor analysis showed that the four-factor model demonstrated superior fit compared to alternative one-factor (generalised ambivalence) and two-factor (hostility and benevolence) models after minor re-specifications to parameters. The four-factor model demonstrated full scalar invariance between men and women and between data collected in 2016 and 2023, suggesting superior psychometric properties compared to currently available alternatives. Implications and directions for prejudice, intergroup relations, and scale validation research are presented.

Soil-transmitted nematode (STN) infections and schistosomiasis frequently co-occur in endemic regions, imposing substantial combined health burdens. This study aimed to characterize the global co-occurrence patterns, long-term trajectories, and key risk factors of STN-schistosome co-occurrence using Global Burden of Disease (GBD) data. We analyzed GBD 1990-2021 data from 69 countries and territories with available STN infections and schistosomiasis prevalence data. Co-occurrence patterns were classified into consistent, schistosomiasis-dominant, and STN infection-dominant regions based on global prevalence quartiles. Group-based trajectory modeling (GBTM) and similarity network clustering identified long-term evolutionary trajectories and epidemiological clusters. Negative binomial regression and population-attributable fraction (PAF) analysis quantified associations between 22 risk factors and disease burden. Global co-occurrence patterns remained stable over 32 years, with 68.1% of countries and territories showing concordant high or low burdens of both diseases. GBTM identified three distinct trajectories for each disease, with sub-Saharan Africa dominating high-burden groups. Similarity network clustering partitioned countries into six epidemiological clusters, ranging from persistently high co-burden to near-eliminated schistosomiasis with low STN prevalence. Key shared drivers included inadequate water, sanitation, and hygiene (WASH) factors, while nutritional deficiencies (iron deficiency, child growth failure) were specific risk factors for STN infections, particularly in co-endemic regions (PAF = 19.08% and 8.82%, respectively). Both high and low temperatures exerted protective effects against both infections. STN-schistosome co-occurrence exhibits distinct global epidemiological clusters with heterogeneous drivers. Integrated control strategies should combine WASH improvements, preventive chemotherapy, and targeted nutritional interventions, especially in co-endemic regions, to align with the WHO 2021-2030 Neglected Tropical Diseases Roadmap and accelerate elimination efforts.

This study aimed to develop rating scales for assessing an individual's misconceptions and overexpectations regarding sleep medications. An online survey was conducted among the general population in Korea. Scale items were generated and refined using exploratory factor analyses, and the final versions were validated using confirmatory factor analyses. Convergent validity was examined using the Insomnia Severity Index (ISI), Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder-7 (GAD-7), Dysfunctional Beliefs and Attitudes about Sleep-6 (DBAS-6), Glasgow Sleep Effort Scale (GSES), and sleep indices, including the two-item questionnaire version of the discrepancy between desired time in bed and desired total sleep time (DBSTq-2). Responses from 550 participants were analyzed. The two-factor model of the 10-item Sleep medications MYTH-understanding (SMYTH) scale demonstrated excellent model fit (comparative fit index [CFI] = 0.99, Tucker-Lewis index [TLI] = 0.99, root mean square error of approximation [RMSEA] = 0.019, and standardized root mean square residual [SRMR] = 0.054) and good reliability of internal consistency (McDonald's ω = 0.895). The SMYTH scale was significantly correlated with the DBSTq-2, GAD-7, DBAS-6, and GSES. Additionally, a single-factor model, the 10-item Sleep Medications Overexpectation of REsponses (SMORE) scale, was developed. The SMORE scale demonstrated excellent fit indices (CFI = 1.00, TLI = 1.00, RMSEA = 0.005, and SRMR = 0.059) and high reliability (McDonald's ω = 0.935). The SMORE scale was also significantly correlated with the DBSTq-2, ISI, PHQ-2, GAD-7, DBAS-6, and GSES. The SMYTH and SMORE scales are reliable and valid rating instruments for measuring misunderstandings and overexpectations related to sleep medications.

Validation of the PHQ-4 in the general population of Quebec, Canada.

Site-2 protease-like protein 2 mediates phenol tolerance in Rhodococcus ruber through transcriptomic and functional analyses.

Intolerance of uncertainty (IU) is a development and maintenance factor for depression and anxiety. Previous reviews found that it associated with anxiety in children and adolescents. However, there was insufficient evidence at the time to review its association with depression in this population. 20 studies investigating the relationship between IU and depression in children and adolescents were identified. Random effects meta-analysis was used to aggregate cross-sectional associations, with age, gender, and measure as moderators. A narrative review of longitudinal findings from relevant studies (K=6) was also conducted. Meta-analysis of cross-sectional associations found an overall effect size of r=0.47. There was limited evidence that age or gender moderated the effect, however there was a significant moderating effect of measure. Namely, when including studies using 'child-friendly' measures (i.e., developed and normed with children as opposed to adults), the effect size was r=0.37. Another analysis revealed that the inhibitory IU subscale was more strongly associated with depression than prospective IU. Longitudinal findings suggested that the association between IU and depression persists over time. Studies were limited to those published in English and including general population samples (e.g., typically developing, without significant medical needs). There is a medium-strong association between IU and depression symptoms in children and adolescents. However, it may be overestimated by the use of IU measures that are not child-friendly. Future research can further extend the evidence-base through careful measure selection, as well as longitudinal and experimental designs.

Virtual reality (VR) adoption in fashion e-commerce represents a disruptive innovation that redefines how brands craft immersive consumer experiences. This study aims to validate a research model about VR-based brand engagement in the fashion commerce context. It seeks to uncover the effect of VR attributes such as interactivity, vividness, product reality congruence, and modality richness on perceived realism, as well as subsequent outcomes of immersion and VR-based brand engagement. Data were collected from 306 respondents through Credamo’s paid panel using purposive sampling to recruit consumers with relevant online fashion purchasing and VR brand experience. The Partial Least Squares Structural Equation Modeling (PLS-SEM) and combined importance-performance map analyses were employed. The study reveals that interactivity, vividness, product reality congruence, and modality richness positively influence perceived realism, which in turn strongly drives immersion and subsequently enhances VR-based brand engagement in fashion e-commerce. Combined importance-performance map analysis further identifies immersion as the primary strategic lever and perceived realism as a key bottleneck, while the antecedent features serve as well-performing hygiene factors requiring only maintenance. This study contributes to the literature on VR-related fashion research and offers practical insights for fashion e-commerce managers seeking to use virtual reality to enhance brand engagement.