Abstract: Post-Traumatic Stress Disorder (PTSD) is a global mental health concern, with recent research focusing on psychological mechanisms that contribute to its development and maintenance. Alexithymia, characterised by difficulty identifying and expressing emotions, has been identified as a potential risk factor for PTSD. This study investigates a model of the relationship between alexithymia and PTSD symptoms, focusing on the potential mediating roles of self-compassion and emotional regulation deficits. Participants (N = 310), who were university students and members of the community, completed self-report measures of the key variables. As expected, alexithymia was a strong predictor of higher levels of PTSD symptoms. Two mediation pathways were also significant: one through emotion regulation difficulties for negative emotions, and the other a serial mediation involving self-compassion followed by negative emotion regulation difficulties. Contrary to expectation Self-compassion had no direct predictive relationship with PTSD symptoms. Although alexithymia and self-compassion predicted greater difficulty in regulating positive emotions the mediation pathway to PTSD symptoms was non-significant. The general pattern of results was found to extend to the specific PTSD symptom groupings of re-experiencing, negative affect, avoidance and hyperarousal symptoms although some differences were evident among the symptom groupings. The theoretical and clinical implications of these findings are discussed.

Abstract: In hospitals with limited resources, chlorine solutions are commonly used for biocleaning. The effectiveness of these solutions depends on the concentration of active chlorine and how they are prepared and stored. A study conducted in six University Hospitals in Benin from March 10 to July 11, 2025, aimed to evaluate the stability of active chlorine and the bactericidal efficacy of chlorine solutions used for disinfecting hospital environments. A total of 103 samples were analyzed using iodometric titration following AFNOR standard NF EN ISO 7393-3 (2000) and WHO recommendations. Bactericidal activity was tested on multi-resistant hospital strains using the germ carrier method based on standard NF T72-281. The study found that 88.4% of the solutions had inadequate active chlorine concentrations. Overall, the bactericidal efficacy was low at 14.6%, particularly ineffective against Gram-negative bacilli (79.6%) and Gram-positive cocci (84.5%). There was a significant association between compliance with active chlorine levels and bactericidal efficacy (OR = 42.5; p < 0.000001). Factors contributing to inefficiency included storage without light protection, use of transparent containers, storage for more than two days, inadequate active chlorine concentration, and incorrect pH levels. These issues compromise hospital disinfection and contribute to the persistence of multi-resistant bacteria in the hospital environment.

Abstract: Introduction Violence against women and girls (VAWG) is a major public health and human rights issue in Africa, with prevalence consistently among the highest globally. According to WHO and UNFPA, one in three women worldwide experience violence in their lifetime, but in sub-Saharan Africa the burden is compounded by poverty, food insecurity, conflict, and weak health systems. Despite its scale, evidence is fragmented across countries and populations, often excluding vulnerable groups such as pregnant women, sex workers, healthcare workers, adolescents, and HIV-positive women. This review synthesises available data to provide a comprehensive understanding of the scope, determinants, outcomes, and interventions addressing VAWG in Africa.Methods We conducted a systematic review in accordance with PRISMA 2020 guidelines. PubMed, Embase, Web of Science, Scopus, African Journals Online, WHO, UNFPA, and Demographic and Health Survey (DHS) repositories were searched (2000–2024). Eligible studies were conducted in African countries and reported prevalence, determinants, outcomes, or interventions for VAWG, including IPV, sexual violence, workplace violence, reproductive coercion, in-law abuse, or community-based violence. Data were extracted independently by two reviewers, appraised for quality, and synthesised using thematic, contextual, trend, and intersectional analyses.Results Eighty studies from 22 African countries were included. Lifetime IPV ranged from 30–65%, pregnancy IPV 25–60%, childhood sexual abuse ~33%, workplace violence 30–62%, and >50% among sex workers. Determinants included alcohol use, poverty, food insecurity, conflict, and inequitable gender norms. Outcomes included maternal morbidity, depression, adverse birth outcomes, HIV/STI risk, and sexual dysfunction. Interventions such as SASA!, Indashyikirwa, CETA, and MAISHA reduced IPV and improved secondary outcomes.ConclusionVAWG in Africa is pervasive, persistent, and particularly concentrated among marginalised groups. Integrated, trauma-informed, and equity-sensitive responses are urgently required to reduce its health and social consequences.

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Introduction: Parotid tumours represent about 3% of head and neck neoplasms, of which 80% are benign. The most common being the Pleomorphic Adenoma (PA). Objective: To analyse the morphological characteristics of the PA by Magnetic Resonance (MRI scan) and its behaviour in advanced diffusion (ADC - Apparent Diffusion Coefficient- value) and perfusion sequences. Materials and methods: Descriptive and inter-observer study of patients with a suspected PA diagnosis in an MRI scan and subsequent histological confirmation. All studies were carried out with the same MRI. The MRI protocol included enhanced sequences in T1 (T1W), T2 (T2W) diffusion study (DWI) and enhanced sequences in T1 with fat saturation (T1W FS) after injecting the contrast. Results: 39 of the 43 cases with suspected PA were confirmed (90.67%). They were morphologically well defined homogeneous tumours, with an average value of high ADC (1.85 x 10-3 mm2/s) and a type A perfusion curve (associated to benignity). The inter-observer concordance was 100%. Conclusions: PAs show typical morphological characteristics in an MRI scan. In case of diagnostic doubt, the diffusion and perfusion sequences help establish a definite diagnosis.

Abstract: This study investigates the classification of nine sitting postures using pressure distribution data from hard and soft seat surfaces. Three neural network architectures (FNN, CNN, ResNet) were evaluated under single-surface and mixed-domain training regimes. While all models achieved high accuracy (>96%) when trained on mixed-domain dataset, significant performance degradation occurred in cross-domain testing. CNN demonstrated superior capability in leveraging spatial pressure features under mixed training conditions, while FNN exhibited relatively better cross-domain robustness. Results indicate model performance highly depends on architectural inductive biases and training data diversity. These findings underscore the importance of employing representative multi-surface datasets for ensuring generalization in practical sitting posture recognition systems.

Abstract: Background/Objectives: This study evaluates the effectiveness of an ecological momentary assessment (EMA) tool for real-time monitoring of burnout among healthcare workers during times of crisis. Methods: Utilizing an intensive longitudinal design, 398 healthcare workers, including physicians, physician assistants, nurses, and trainees, were surveyed every five days over the first year of the COVID-19 pandemic. Results: The EMA approach successfully captured dynamic trends in burnout, identifying significant associations between workforce redeployment, elevated caseloads, and increased burnout, with effects persisting beyond a return to usual roles. Nurses were particularly vulnerable, reporting the highest burnout levels during periods of high patient volume. Conclusions: These findings validate EMA as an innovative and scalable method for continuous burnout surveillance, enabling the early identification of at-risk groups, guiding resource allocation, and informing timely interventions. This study highlights the critical role of real-time burnout monitoring tools in fostering workforce resilience and operational readiness during public health emergencies and other extended crises.

Abstract: Implant dentistry constitute an important option in the prosthetic treatment of patients with tooth loss. This study reports the evaluation of treatment by immediate loading of immediate placed im-plants in fresh sockets. Methods. 52 partially edentulous patients, 27 females and 25 males, (mean age of 53.6 years), were treated with 112 Galimplant ® immediate placed implants in fresh sockets for prosthodontic rehabilitation. Implants were loaded im-mediately. Clinical findings (implant and prosthodontics) were followed during 10 years. Results. Nine patients (17.3%) had a previous history of periodontitis, 26.9% were smokers and 21.1%) exhibited chronic systemic conditions. Clinical results indicate a survival and success rate of implants of 97.1%, demonstrating that immediate placed implants with immediate loading achieve and maintain a successful osseointegration. Three implants was lost during the healing period. The mean marginal bone loss was 1.09±0.75 mm. 21.4% implants were associated with mucositis and 11.6% were associated with peri-implantitis. Fourteen implants (7.1%) were associated with technical complications (loss screw, chipping). Conclu-sions. Clinical results of this study showed that the immediate loading of immediate placed implants in fresh extraction sockets demonstrates good treatment outcomes. Regarding to implants and prostheses, the study shows a high success rate.

Abstract: Background/Objectives: The Manchester Colour Wheel (MCW) was developed as an alternative way of assessing health status, mood and treatment outcomes by Carruthers et al in 2010. There has been a dearth of research on this alternative assessment ap-proach. The present study examines the sensitivity of the MCW to pain, psychological factors and recovery status in 1098 people with insured injuries treated in an interdis-ciplinary clinic. Methods: A deidentified data set of clients treated in a multidiscipli-nary clinic were conveyed to the researchers containing results of MCW and injury specific psychometric tests at intake, and recovery status at discharge. Systematic ma-chine modeling was applied. Results: There were no significant differences between the four injury types studied, being motor crash related Whiplash Associated Disorder (WAD) and workplace related Shoulder Injury (SI), Back Injury (BI) and Neck Injury (NI) on the MCW. Augmenting the MCW with Machine Learning (ML) models showed overall classification rates for Classification and Regression Tree (CRT) of 75.6% for anxiety, 70.3% classified for depression, and 68.5% for stress, and Quick Unbiased Ef-ficient Statistical Trees could identify 68.5% of pain catastrophisation and 62.7% of kinesiophobia. Combining MCW with psychometric measurements markedly in-creased the predictive power with a CRT model predicting WAD recovery status with 80.7% accuracy, SI recovery status 81.7% accuracy, BI recovery status with 78% accu-racy. A Naïve Bayes Classifier predicted recovery status in NI with 96.4% accuracy. However, this likely represents overfitting. Conclusions: Overall, MCW augmented with ML offers a promising alternative to questionnaires and the MCW appears to measure some unique psychological features that contribute to recovery from injury.

Abstract: Aim: To examine the professional role development of new graduate nurses (NGNs) across three transition stages within a major Australian health service. Background: The shift from student to registered nurse is a critical period marked by emotional strain, role ambiguity, and transition shock. Structured support programs have emerged to ease this transition, yet few are evaluated through longitudinal, theory-informed approaches using validated tools. Design: A longitudinal quantitative study guided by Duchscher’s Stages of Transition Theory and the Transition Shock Model. Methods: A customised 75-item questionnaire, adapted from the Professional Role Transition Risk Assessment Instrument and Professional and Graduate Capability Framework, was distributed across three transition points (March 2020 to March 2021). The survey assessed four domains: Responsibilities, Role Orientation, Relationships, and Knowledge and Confidence. Descriptive statistics, Principal Component Analysis, Chi-square tests, and multinomial logistic regression were used to analyse patterns, trends, and predictors of successful transition. Results: A clear developmental trajectory emerged. Early-stage participants experienced stress, low self-efficacy, and role confusion. By Stage 3, most demonstrated increased clinical confidence, autonomy, and integration into professional healthcare teams. A coordinator-to-graduate ratio of 1:12 facilitated personalised mentorship and supportive practice environments. Statistically significant improvements were observed in critical thinking, leadership perception, emotional resilience, and team communication. Conclusions: This study provides robust empirical support for theoretically grounded and policy-aligned Graduate Nurse Transition Programs. Targeted interventions tailored to each transition phase—such as early mentorship, mid-stage stress support, and end-stage leadership development—can enhance confidence, improve role clarity, and promote long-term workforce capability and sustainability.

Abstract: Background: Physical exercise has emerged as a promising intervention for depressive disorder, yet its efficacy and optimal implementation remain under investigation. Ob-jective: To thoroughly assess the effectiveness of structured physical exercise as a con-ventional treatment for adults with depressive disorder. Methods: Adhering to PRISMA 2020 guidelines, a comprehensive literature search was conducted across PubMed/MEDLINE and institutional multi-databases. Peer-reviewed randomized controlled trials (RCTs) published between 2010 and 2025, studying adults diagnosed with depressive disorder under supervised exercise interventions, were se-lected. Methodological rigor was ensured through two independent reviewers. The in-fluence of moderating variables (workload and the instrument used to evaluate depres-sive disorder: instrument) was analyzed using meta-regression, and the pooled effect size was estimated using both frequentist and Bayesian meta-analyses. Results: From 15,542 screened records, 20 RCTs met the inclusion criteria. Workload accounts for 60% of the variance in the effect size, and instrument accounts the 15%. Supervised physical exercise significantly reduced depressive symptoms (standardized mean difference = 0.80; 95% CI: 0.57–1.03; I² = 59%). Robust Bayesian meta-analysis confirmed the consistency of these findings. Conclusion: Physical exercise serves as a valuable complement to traditional therapies for adults diagnosed with depressive disorder, resulting in clinically significant reductions in depressive symptoms.

Abstract: Clinical governance is a systematic approach to maintaining and improving the quality of patient care within health systems. This research assessed the implementation of clinical governance activities by health professionals at Grey hospital, a district hospital in the Eastern Cape Province of South Africa. A descriptive cross-sectional study was used to collect quantitative data from doctors and nurses across various disciplines using a structured questionnaire. Data were captured using Microsoft Excel and analysed using STATA. Of the 107 participants who consented to participate, the majority were female (66.4%) and aged between 37-47 years (48.6%), with a mean age of 43.9 years. Most participants were professional nurses (59.6%), while doctors constituted a smaller proportion (3.8%). The findings show that most clinical governance protocols and/or quality improvement activities were being implemented. However, less than 60% of the participants reported regular morbidity and mortality meetings. These results suggest that while a clinical governance framework exists at Grey hospital, its effectiveness could be strengthened through sustained engagement and collaboration among clinical and non-clinical stakeholders. Improved information sharing and institutional support are essential to optimise governance practices and uphold care standards.

Abstract: Background: Hepatocellular carcinoma (HCC) remains a major cause of cancer-related mortality, with many patients initially unsuitable for curative resection or transplantation. Transarterial radioembolization (TARE) has emerged as a locoregional therapy to downstage tumors and expand surgical eligibility. Methods: This retrospective study included 25 patients with HCC who underwent TARE as a bridging treatment. The primary outcomes assessed were the efficacy of TARE in facilitating curative surgery and long-term oncological outcomes, specifically overall survival (OS) and disease-free survival (DFS). Results: Seventeen patients subsequently underwent surgical resection and eight underwent living donor liver transplantation (LDLT). At a median follow-up of 33.4 months, the median DFS was 11.2 months, with patients experiencing recurrence showing significantly shorter DFS (3.65 months) than those without recurrence (27.1 months). Median OS for the cohort was 33.4 months, with 76% of patients alive and disease-free at last follow-up. Kaplan–Meier analysis demonstrated sustained OS in the LDLT group, while resection patients gradually declined within the first two years. Conclusion: TARE is an effective bridging strategy that enables curative-intent surgery in selected patients with HCC and supports favorable long-term oncological outcomes. Careful patient selection and multidisciplinary management remain essential to optimize survival benefits.

Abstract: The efforts to achieve early detection of autism spectrum disorders (ASD) are becoming increasingly important due to the high prevalence that continues to persist globally. The World Health Organization (WHO) and other official institutions agree that in marginalized regions, it is urgently necessary to develop effective alternatives and methods to improve the quality of life of children and their families. This study presents an integrated model for the early detection of ASD, based on the analysis of parental observations and supported by validated diagnostic tools. The proposed approach consists of four sequential modules, aiming to improve early detection through techniques such as natural language processing (NLP) and machine learning (ML) metrics. Records from two Latin American countries were standardized, thereby consolidating a single database comprising 153 records of children aged 2 to 6 years. The Parent Interview Instrument (PII) was administered by specialists to caregivers and subsequently compared with standardized tests. Encouraging results were obtained from the support vector machine (SVM) classification algorithm, yielding an accuracy range of 89.88%–91.34%, a maximum precision of 90.02%, a recall of 89.02%, and a maximum F-measure of 91.12%. The results of the case study allow us to identify disorders related to autism, such as the repetition of behaviors, difficulties in social interaction, and issues with verbal expression. This contribution aligns with the United Nations Sustainable Development Goal 3, which promotes health and well-being.

Abstract: Academic health systems are increasingly recognized as environments where education, research, and clinical practice intersect to drive innovation in patient care. Yet, the potential of design-led methods to enable such integration is still emerging within academic discourse. This paper presents a case study of the Dubai Academic Health Corporation’s initiative to embed design thinking and patient journey mapping within the medical curriculum at the Mohammed Bin Rashid University of Medicine and Health Sciences. Through a six-week innovation capstone and an intensive Design4Health Bootcamp, pre-clinical medical students engaged as co-designers in reimagining patient experiences across emergency, dental, and homecare services. Using design thinking frameworks, students conducted research, mapped journeys, and developed prototypes addressing real system challenges, including triage inefficiencies and care accessibility. Findings suggest that involving students in design-led innovation strengthens competencies in empathy, systems thinking, and collaborative problem-solving, while providing health institutions with new perspectives on service improvement. The initiative demonstrates how co-design processes can bridge the gap between education and practice, positioning academic health systems as enablers of patient-centered transformation and cultural change in healthcare.

Abstract: Arboviruses spread in urban tropics under climate change. We designed intelligent systems to predict cases and breeding sites of Aedes‑borne diseases in Recife, Brazil. We linked surveillance and climate data from APAC, INMET, LIRAa, and Recife’s Open Data Portal. We modeled 2013–2021 cases and 2009–2017 breeding sites. We generated spatial fields with inverse distance weighting. We built bimonthly training grids with 5,000 points and validation grids with 50,000 points. We tested linear regression, random forests, multilayer perceptrons, support vector regressors, and extreme learning machines in Weka and PyRCN. We ran 30 repetitions with cross‑validation. Random forests performed well. Multilayer perceptrons reached very high correlations but needed longer training. Polynomial SVMs reached near‑perfect accuracy but required very high computation. Single‑layer extreme learning machines delivered the best trade‑off, with low errors, correlations near 1.0, and short training times. The models produced fine‑scale risk predictions and highlighted priority areas. The findings support earlier, targeted control and guide public health plans in Recife.

Abstract: Criminal justice system (CJS) involvement is common among individuals with opioid use disorder (OUD), yet limited research examines retention in medications for OUD (MOUD) within community settings. This study assessed whether CJS involvement predicted retention on buprenorphine/naloxone and explored related demographic and clinical factors. A retrospective cohort included adults (n = 367) enrolled in a low-barrier outpatient MOUD program in Texas (January 2022–April 2024). CJS involvement was identified from program records. Retention was measured as continuous days with buprenorphine/naloxone prescriptions. Analyses used univariate tests, logistic regression, and nonparametric kernel regression. Nearly one-quarter (24.8%) were CJS-involved. Retention at 180 days was similar between CJS and non-CJS groups (38%). CJS participants initiated substance use earlier and reported higher heroin and injection drug use. Behavioral health sessions predicted both CJS involvement (OR = 1.10, p ≤ 0.001) and longer retention (β = 10.81 days/session, p = 0.001). With comprehensive, low-barrier services, CJS-involved individuals achieved MOUD retention comparable to peers. Early behavioral health engagement was a strong predictor of retention, suggesting a key intervention point to enhance outcomes and advance equity for justice-involved populations.

Abstract: Shoulder injuries are highly prevalent in tennis due to repetitive unilateral loading and the asymmetrical demands of the sport. Preventive protocols often focus on scapular stabilizers, yet evidence on muscle recruitment patterns during unilateral elastic re-sistance exercises remains limited. This study compared trapezius activation and asymmetry in tennis players (n = 16) and non-tennis athletes (n = 23) during unilateral scapular retraction exercises at 45° and 90° of shoulder abduction. Surface electromyog-raphy recorded bilateral activity of the middle and lower trapezius using a validated wireless system. Repeated-measures ANOVA was applied to examine the effects of angle, dominance, side, and athlete type. Results showed significantly greater activation at 90° compared to 45° (p < 0.05) and pronounced interlimb asymmetries between dominant and non-dominant sides (p < 0.01). Tennis players exhibited higher non-dominant trapezius activation, suggesting compensatory adaptations to repetitive unilateral strokes, whereas non-tennis athletes demonstrated more symmetrical recruitment. These findings high-light the role of elastic resistance exercises in selectively engaging scapular stabilizers, addressing sport-specific asymmetries, and reducing injury risk in overhead athletes.

Abstract: This study aimed to identify socio-economic and demographic factors associated with meeting the recommended physical activity (PA) guidelines for older adults. This analyt-ical, cross-sectional study used data from the 2022 NHIS including 8189 older adults (≥65 years). Compliance with aerobic and strengthening PA guidelines was the main outcome variable. Covariates included sex, education, income, relationship status, race, housing stability, urban/rural county, health status and region. Unadjusted and adjusted log re-gression analyses calculated odd ratios (OR) and 95% confidence intervals (CI). Only 14.4% (n=1235) of older adults met the PA guidelines. Odds of complying decreased by 40% in NH single/multiple races (OR 0.6; 95 CI 0.4-1.0). Men had higher odds (OR 1.4; 95 CI 1.2-1.6) of adhering than women. Compared with bachelor graduates, odds of adhering were 1.4 (95 CI 1.2-1.7) in graduate participants, 0.3 (95% CI 0.2-0.4) less than HS, 0.4 (95% CI 0.3-0.5) HS, and 0.7 (95% CI 0.6-0.8) some college. The odds decreased by 40% for those with an income-to-poverty ratio threshold < 1 (OR 0.6; 95 CI 0.4-0.9), 1-1.99 (OR 0.6; 95 CI 0.4-0.7), and 2-3.99 (OR 0.6; 95 CI 0.5-0.8) compared with ≥5. Healthcare providers should develop targeted interventions to meet individuals’ unique circumstances, addressing these inequities.

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This study explores the relationships among companionate love, organizational culture practices (OCP), work engagement, and burnout among 649 Brazilian workers. Using a quantitative, exploratory, and correlational design, data were analyzed through descriptive statistics, group comparisons, and network modeling. Results revealed strong positive associations between companionate love, OCP, and work engagement, as well as negative associations with burnout. Companionate love was most strongly linked to OCP, suggesting that emotionally expressive environments foster perceptions of supportive organizational practices. Work engagement emerged as a central construct, mediating the relationship between emotional culture and burnout. Group comparisons showed higher engagement among postgraduate professionals and managers, and stronger OCP perceptions among remote workers and those in the private sector. Network centrality analysis identified OCP and engagement as key influencers. These findings underscore the significance of emotional culture and organizational practices in fostering workplace well-being, and suggest strategic pathways for mitigating burnout through enhanced engagement and cultural support.

Abstract: Background: In a context of profound transformation within Public Administration, the growing generational diversity of the workforce poses critical challenges to organisa-tional well-being and worker health. Discriminatory phenomena such as ageism and, in particular, gendered ageism, can undermine job satisfaction and employee health, with potential repercussions for the effectiveness of public services. Methods: This qualitative study explored the work experience of 30 employees in the Italian Public Administration through semi-structured interviews. Data were analysed using a thematic analysis of elementary contexts via T-Lab software. Results: The results reveal an experience struc-tured along two main axes: individual/organisation and difficulties/potential. While positive relationships with colleagues and teamwork emerge as a pillar of well-being and satisfaction, significant critical issues also strongly surface. Significant experiences of ageism and, notably, gendered ageism were identified, manifesting as stereotypes, pressure on women’s physical appearance, and exclusionary dynamics, with a negative impact on individual psychological health. Furthermore, challenges in managing organ-isational dynamics and a complex negotiation of work-life balance emerged. Conclusions: To ensure the sustainability and effectiveness of the public sector, it is essential to actively combat age and gender-based discrimination. This objective represents a strategic priority to safeguard the well-being of the workforce, retain skills, and build a healthy, resilient, and productive working environment.