MDPI - Publisher of Open Access Journals

12 pages, 1079 KiB

Open AccessArticle

Healthcare Models and Quality Indicators in the Management of Patients with Heart Failure in Spain: Results from the CARABELA-HF Initiative

by Inmaculada Mediavilla, Manuel Anguita, Álvaro González Franco, Manuel Leal, CARABELA-HF Scientific Committee and José Francisco Soto

J. Clin. Med. 2025, 14(10), 3378; https://doi.org/10.3390/jcm14103378 (registering DOI) - 12 May 2025

Abstract

Background/Objectives: Heart failure (HF) poses a significant global health burden. In Spain, its prevalence rises annually, contributing significantly to cardiovascular-related hospitalizations and deaths. Through a broad and integrative perspective, the CARABELA-HF initiative seeks to improve the organization and delivery of HF care in [...] Read more.

Background/Objectives: Heart failure (HF) poses a significant global health burden. In Spain, its prevalence rises annually, contributing significantly to cardiovascular-related hospitalizations and deaths. Through a broad and integrative perspective, the CARABELA-HF initiative seeks to improve the organization and delivery of HF care in Spain, addressing the key challenges identified across the care continuum. Methods: CARABELA-HF involved four phases: characterization of HF care models, validation of improvement areas, potential solutions and healthcare quality indicators, refinement of results from a regional perspective, and local dissemination and implementation. Ten pilot centers participated, and nine variables were identified to characterize operating HF care models. Results: Four HF care models were identified based on the degree of coordination between departments and resource availability. Structure, quality of care, and transformation indicators were used to evaluate these models, revealing improvement areas. Overall, this process identified solutions for generating a comprehensive and integrated HF care model, highlighting enhanced coordination, digital transformation, enhanced nursing roles, professional training and patients’ education, accredited HF care models, resource accessibility, and data-based evaluation. Conclusions: CARABELA-HF provides insights into current HF care models in Spain and identifies healthcare quality indicators for future improvement efforts. It strives to enhance patient outcomes, raise healthcare standards, and improve overall system efficiency through the promotion of a comprehensive and integrated HF care pathway. Full article

(This article belongs to the Section Cardiology)

► Show Figures

Figure 1

16 pages, 687 KiB

Open AccessArticle

Differential Profiles of Gut Microbiota-Derived Metabolites of Bile Acids and Propionate as Potential Predictors of Depressive Disorder in Women with Morbid Obesity at High Risk of Metabolic Dysfunction-Associated Steatotic Liver Disease—A Pilot Study

by Joanna Michalina Jurek, Belen Xifré, Elena Cristina Rusu, Helena Clavero-Mestres, Razieh Mahmoudian, Carmen Aguilar, David Riesco, Javier Ugarte Chicote, Salomé Martinez, Marga Vives, Fàtima Sabench and Teresa Auguet

Curr. Issues Mol. Biol. 2025, 47(5), 353; https://doi.org/10.3390/cimb47050353 - 12 May 2025

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a liver condition linked to cardiometabolic diseases and mental health issues, with studies highlighting disruptions in gut microbiota activity, including bile acid (BA) metabolism. Therefore, the main aim of this exploratory analysis was to assess microbiota-derived [...] Read more.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a liver condition linked to cardiometabolic diseases and mental health issues, with studies highlighting disruptions in gut microbiota activity, including bile acid (BA) metabolism. Therefore, the main aim of this exploratory analysis was to assess microbiota-derived metabolites, specifically BAs and short-chain fatty acids (SCFAs), as potential biomarkers of depressive disorder (DD) in women with morbid obesity at MASLD risk. In this pilot study, 33 females with morbid obesity who were scheduled for bariatric surgery were evaluated. Medical and clinical data were collected, and microbial metabolites from pre-surgery blood samples were analyzed. Patients were stratified according to the presence of DD. Analysis with Spearman’s rank test was used to assess correlations and logistic regression models were built to evaluate biomarkers as predictors of DD risk using both receiver operating characteristic (ROC) and precision–recall curves. In this cohort, 30.3% of females were reported to have DD, in addition to significantly elevated levels of certain BAs and SCFAs, including glycodeoxycholic acid (GDCA) and propionate, which were also correlated with some metabolic biomarkers. However, there were no differences in the incidence of MASLD or metabolic syndrome between patients with DD or without. In conclusion, microbiota-derived metabolites such as GDCA and propionate may influence DD risk in females with morbid obesity; however, their potential use as predictive biomarkers should be further investigated to confirm their role in psycho-metabolic conditions. Full article

(This article belongs to the Special Issue Molecular Mechanisms Underlying Fatty Liver Disease: From Pathogenesis to Treatment, 2nd Edition)

16 pages, 679 KiB

Open AccessArticle

Exploring Adolescents’ Perceptions of Hearing Loss and Hearing Aids in Greece: A Survey Study

by Ioanna Fragoulia, Nikolaos Trimmis and Voula Chris Georgopoulos

Audiol. Res. 2025, 15(3), 58; https://doi.org/10.3390/audiolres15030058 - 12 May 2025

Abstract

Objectives: This study investigates Greek teenagers’ general knowledge and perception of hearing loss, hearing aid accessibility, and the challenges associated with hearing impairment. Methods: A 27-item self-reported questionnaire was developed and distributed to 152 participants (aged 12–18) to assess their familiarity with [...] Read more.

Objectives: This study investigates Greek teenagers’ general knowledge and perception of hearing loss, hearing aid accessibility, and the challenges associated with hearing impairment. Methods: A 27-item self-reported questionnaire was developed and distributed to 152 participants (aged 12–18) to assess their familiarity with hearing loss, amplification availability, communication strategies, and perceptions of hearing loss. Results: While 94.7% of participants recognized that hearing loss affects communication, only 10.5% correctly identified how hearing aids are accessed. Additionally, 42.1% reported having temporarily experienced some form of hearing loss. Most participants (94.7%) acknowledged communication difficulties faced by individuals with hearing loss, and only 3.4% reported being unable to communicate effectively with someone affected. Among those aware of bullying incidents involving individuals with hearing loss, 78.1% identified classmates as the primary source. Conclusions: These findings are consistent with international research and highlight the need for targeted education, awareness initiatives, and clearer access pathways to hearing technology. Improving adolescent hearing health literacy may facilitate early intervention, reduce stigma, and promote inclusion for peers affected by hearing impairment. Full article

► Show Figures

Figure 1

11 pages, 552 KiB

Open AccessArticle

The Link Between Anxiety and Depression, and Balance in Young Adults

by Tatiana Marques, Patrícia Bernardo and Margarida Serrano

Audiol. Res. 2025, 15(3), 57; https://doi.org/10.3390/audiolres15030057 - 12 May 2025

Abstract

Background/Objectives: The ability of young adults to control their balance is generally effortless and can occur automatically with minimal cognitive involvement. However, this ability may be compromised when integration conflicts arise due to impairments in vestibular, visual, or somatosensory functions. Hence, psychomotor symptoms [...] Read more.

Background/Objectives: The ability of young adults to control their balance is generally effortless and can occur automatically with minimal cognitive involvement. However, this ability may be compromised when integration conflicts arise due to impairments in vestibular, visual, or somatosensory functions. Hence, psychomotor symptoms linked to emotional states can also influence postural control. The purpose of this study was to understand the effects of anxiety and depression on balance in young adults. Methods: Our study included 50 young adults (21.86 ± 2.63 years), consisting of 13 males and 37 females. Anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), while balance was assessed through the Modified Clinical Test for the Sensory Interaction on Balance (mCTSIB). Data analysis was conducted using Pearson’s correlation coefficient test and the Kruskal–Wallis test. Results: Pearson’s correlation analysis indicated that young adults exhibited stable postural control. However, a positive correlation (0.259, p < 0.1) was observed between anxiety levels and the sway index. Additionally, positive correlations were found between anxiety and both somatosensory (0.281, p < 0.05) and visual (0.276, p < 0.1) ratios. Conclusions: The results suggest that higher anxiety levels are associated with reduced postural balance, with sensory inputs, particularly visual and somatosensory, playing a key role in this decreased stability. Full article

► Show Figures

Figure 1

9 pages, 1123 KiB

Open AccessCase Report

A Case of Pulmonary Fibrosis and COVID-19-Related Pneumonia in a Pembrolizumab-Treated Patient

by Alberto Zolezzi, Gina Gualano, Annelisa Mastrobattista, Pietro Vittozzi, Virginia Di Bari, Carlotta Cerva, Silvia Mosti, Antonio Lugini, Fabrizio Albarello, Federica Di Stefano, Maria Beatrice Valli and Fabrizio Palmieri

Infect. Dis. Rep. 2025, 17(3), 53; https://doi.org/10.3390/idr17030053 - 12 May 2025

Abstract

Pembrolizumab is used as a first-line treatment of non-small cell lung cancer. Pneumonitis and interstitial lung disease are among the most common immune-related adverse events. The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on patients with cancer treated with chemotherapy [...] Read more.

Pembrolizumab is used as a first-line treatment of non-small cell lung cancer. Pneumonitis and interstitial lung disease are among the most common immune-related adverse events. The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on patients with cancer treated with chemotherapy or immune checkpoint inhibitors (ICIs) is not fully known. Blocking immune checkpoints may conversely augment dysfunctional T-cell responses in severe patients and, in turn, mediate immunopathology. Here, we present a case of SARS-CoV-2 infection complicated by acute respiratory distress syndrome (ARDS) and a fibrotic-like pattern in a patient treated with pembrolizumab for lung cancer. The patient showed a dramatic clinical and radiological response after steroid therapy. Further research is needed to better understand the long-term implications of pembrolizumab therapy in patients recovering from coronavirus disease 2019 (COVID-19) and to develop evidence-based guidelines for managing these complex cases. Patients undergoing oncologic immunotherapy might benefit from early high-dose steroid treatment in cases of viral infections, such as SARS-CoV-2. Full article

(This article belongs to the Section Infections in the Immuncompromised Host)

► Show Figures

Figure 1

23 pages, 881 KiB

Open AccessReview

Comparative Characteristics of Various Cereals in Terms of Fodder Value, Antinutrients and Use for Poultry Feeding

by Olena V. Gaviley, Oleg O. Katerynych, Igor A. Ionov, Darren K. Griffin, Olena O. Dekhtiarova and Michael N. Romanov

Encyclopedia 2025, 5(2), 63; https://doi.org/10.3390/encyclopedia5020063 - 12 May 2025

Abstract

The primary ingredients in poultry feed, cereals, are among the most widely used crops in worldwide agriculture, with principal staples being wheat, rice, corn (maize), sorghum, barley, oat and millet. The scope of this review is to provide a detailed comparative analysis of [...] Read more.

The primary ingredients in poultry feed, cereals, are among the most widely used crops in worldwide agriculture, with principal staples being wheat, rice, corn (maize), sorghum, barley, oat and millet. The scope of this review is to provide a detailed comparative analysis of the nutritive values of cereal crops, and the antinutrients they contain, with reference specifically to their use for feeding poultry. These cereal crops range in biological value from 55 to 77.7%, in protein digestibility from 77 to 99.7%, and in net protein utilization from 50 to 73.8%. Most essential amino acids, including lysine, are found in cereal grains, whereas the nutritional value of cereals is impacted by antinutritional elements. These include non-starch polysaccharides (NSPs), such as pentosans (arabinoxylans) and β-glucan, as well as alkylresorcinols. Around 100 g/kg of pentosans are found in rye, 50–80 g/kg in wheat and 68–92 g/kg in triticale. There are strategies to reduce NSPs and other antinutrients and maximize the effectiveness of utilizing grains in compound feed for poultry. These include the application of enzyme preparations, along with dry and wet extrusion methods, for processing grains. By restricting our narrative to a direct comparison of all major staples for poultry feed, we conclude that further research is required specifically in the area of determining how economically viable it is to feed adult and young chickens with compound feeds containing various cereal crops. Furthermore, we speculate on the utility of employing enzyme preparations and extrudates to maximize feed efficiency. Full article

(This article belongs to the Section Biology & Life Sciences)

► Show Figures

Figure 1

11 pages, 316 KiB

Open AccessArticle

Understanding Needlestick Injuries Among Estonian Nurses: Prevalence, Contributing Conditions, and Safety Awareness

by Ülle Parm, Triinu Põiklik and Anna-Liisa Tamm

Nurs. Rep. 2025, 15(5), 169; https://doi.org/10.3390/nursrep15050169 - 12 May 2025

Abstract

Background/Objective: Needlestick injuries (NSIs) are a significant source of bloodborne infections among nurses. This study aimed to assess the prevalence, contributing factors, and awareness of post-exposure prophylaxis (PEP) among Estonian nurses. Methods: This prospective cross-sectional study was conducted using an electronic [...] Read more.

Background/Objective: Needlestick injuries (NSIs) are a significant source of bloodborne infections among nurses. This study aimed to assess the prevalence, contributing factors, and awareness of post-exposure prophylaxis (PEP) among Estonian nurses. Methods: This prospective cross-sectional study was conducted using an electronic questionnaire in September 2024. Results: The majority of the 211 nurses participating in this study were females aged 21 to 75 years. Notably, 57.1% (n = 109, aged 43.9 ± 12.2) had experienced an NSI in the past decade. Most injuries occurred during sharps’ disposal (33%) and with syringe needles (72%). Among those injured, 84% washed the area with water and soap, 80% used alcohol-based disinfectants, and 69% reported the incident. However, 20.6% did not report due to perceived insignificance or lack of follow-up actions. Additionally, 14.7% were unaware of the reporting requirement, and 8.8% did not know who to report to. Conclusions: Improved training and reporting practices are essential to reduce NSIs among nurses. Full article

15 pages, 1076 KiB

Open AccessArticle

Absorption of FD-150 in Brain Endothelial Cells by Cold Atmospheric Microplasma

by Md Jahangir Alam, Abubakar Hamza Sadiq, Jaroslav Kristof, Mahedi Hasan, Farhana Begum, Yamano Tomoki and Kazuo Shimizu

Plasma 2025, 8(2), 19; https://doi.org/10.3390/plasma8020019 - 12 May 2025

Abstract

The blood–brain barrier (BBB) limits drug delivery to the brain, particularly for large or hydrophilic molecules. Brain microvascular endothelial cells (bEND.3), which form part of the BBB, play a critical role in regulating drug uptake. This study investigates the use of cold atmospheric [...] Read more.

The blood–brain barrier (BBB) limits drug delivery to the brain, particularly for large or hydrophilic molecules. Brain microvascular endothelial cells (bEND.3), which form part of the BBB, play a critical role in regulating drug uptake. This study investigates the use of cold atmospheric microplasma (CAM) to enhance membrane permeability and facilitate drug delivery in bEND.3 cells. CAM generates reactive oxygen species (ROS) that modulate membrane properties. We exposed bEND.3 cells to CAM at varying voltages (3, 3.5, 4, and 4.5 kV) and measured drug uptake using the fluorescent drug FD-150, fluorescence intensity, ROS levels, membrane lipid order, and membrane potential. The results showed a significant increase in fluorescence intensity and drug concentration in the plasma-treated cells compared to controls. ROS production, measured by DCFH-DA staining, was higher in the plasma-treated cells, supporting the hypothesis that CAM enhances membrane permeability through ROS-induced changes. Membrane lipid order, assessed using the LipiORDER probe, shifted from the liquid-ordered (Lo) to liquid-disordered (Ld) phase, indicating increased membrane fluidity. Membrane depolarization was detected with DisBAC2(3) dye, showing increased fluorescence in the plasma-treated cells. Cell viability, assessed by trypan blue and LIVE/DEAD™ assays, revealed transient damage at higher voltages (≥4 kV), with recovery after 24 h. These results suggest that CAM enhances drug delivery in bEND.3 cells by modulating membrane properties via ROS production and changes in membrane potential. CAM offers a promising strategy for improving drug delivery to the brain, with potential applications in brain-targeted therapies. Full article

(This article belongs to the Special Issue Feature Papers in Plasma Sciences 2025)

► Show Figures

Graphical abstract

35 pages, 1293 KiB

Open AccessArticle

A Visual Guidance and Control Method for Autonomous Landing of a Quadrotor UAV on a Small USV

by Ziqing Guo, Jianhua Wang, Xiang Zheng, Yuhang Zhou and Jiaqing Zhang

Drones 2025, 9(5), 364; https://doi.org/10.3390/drones9050364 - 12 May 2025

Abstract

Unmanned Surface Vehicles (USVs) are commonly used as mobile docking stations for Unmanned Aerial Vehicles (UAVs) to ensure sustained operational capabilities. Conventional vision-based techniques based on horizontally-placed fiducial markers for autonomous landing are not only susceptible to interference from lighting and shadows but [...] Read more.

Unmanned Surface Vehicles (USVs) are commonly used as mobile docking stations for Unmanned Aerial Vehicles (UAVs) to ensure sustained operational capabilities. Conventional vision-based techniques based on horizontally-placed fiducial markers for autonomous landing are not only susceptible to interference from lighting and shadows but are also restricted by the limited Field of View (FOV) of the visual system. This study proposes a method that integrates an improved minimum snap trajectory planning algorithm with an event-triggered vision-based technique to achieve autonomous landing on a small USV. The trajectory planning algorithm ensures trajectory smoothness and controls deviations from the target flight path, enabling the UAV to approach the USV despite the visual system’s limited FOV. To avoid direct contact between the UAV and the fiducial marker while mitigating the interference from lighting and shadows on the marker, a landing platform with a vertically placed fiducial marker is designed to separate the UAV landing area from the fiducial marker detection region. Additionally, an event-triggered mechanism is used to limit excessive yaw angle adjustment of the UAV to improve its autonomous landing efficiency and stability. Experiments conducted in both terrestrial and river environments demonstrate that the UAV can successfully perform autonomous landing on a small USV in both stationary and moving scenarios. Full article

(This article belongs to the Special Issue Autonomous Flight of Drone: Control, Trajectory Optimization and Mission Planning: 2nd Edition)

31 pages, 10695 KiB

Open AccessArticle

Exergy Assessment and Exergetic Resilience of the Large-Scale Gas Oil Hydrocracking Process

by Luisa José Acosta-Esalas and Ángel Darío González-Delgado

Sci 2025, 7(2), 65; https://doi.org/10.3390/sci7020065 - 12 May 2025

Abstract

Fossil fuels remain essential to the world’s energy supply, but the decline in the quality of the oil extracted has increased the relevance of processes such as hydrocracking. Despite its potential, this process involves high energy consumption. In order to assess its efficiency, [...] Read more.

Fossil fuels remain essential to the world’s energy supply, but the decline in the quality of the oil extracted has increased the relevance of processes such as hydrocracking. Despite its potential, this process involves high energy consumption. In order to assess its efficiency, an exergy analysis of a conventional hydrocracking unit was carried out using Computer Aided Process Engineering (CAPE) tools. After simulations, the physical and chemical exergies of the input and output streams were calculated, which showed a remarkable energy efficiency of 98.76%, attributable to the high exergy content of the products obtained (171,243,917.70 MJ/h) compared to the residues generated (1,065,290.8 MJ/h). The most significant irreversibilities were found in the Recycle Gas Sweetening stage, while the lowest exergy efficiency, 87.16%, was observed in the Residual Gas Sweetening phase. By valorizing the waste, the overall efficiency of the process increased to 99.26%, which allowed for a 40% reduction in the total irreversibilities. Optimization of the stages with the highest unavoidable losses and better energy integration of the process are suggested to maximize its performance. Full article

(This article belongs to the Section Chemistry Science)

► Show Figures

Figure 1

17 pages, 7919 KiB

Open AccessFeature PaperArticle

Recycling Face Mask Fibers in Geopolymer-Based Matrices for Sustainable Building Materials

by Roberto Ercoli, Paola Stabile, Elena Ossoli, Irene Luconi, Alberto Renzulli and Eleonora Paris

Ceramics 2025, 8(2), 54; https://doi.org/10.3390/ceramics8020054 - 12 May 2025

Abstract

This study investigates the upcycling of disposable face masks, which were produced in vast quantities during the COVID-19 pandemic and are now widely stockpiled in public institutions, destined for landfills after reaching expiration dates. The research focuses on incorporating shredded mask fibers into [...] Read more.

This study investigates the upcycling of disposable face masks, which were produced in vast quantities during the COVID-19 pandemic and are now widely stockpiled in public institutions, destined for landfills after reaching expiration dates. The research focuses on incorporating shredded mask fibers into geopolymer matrices, evaluating the effects on mechanical and thermal properties to develop sustainable, high-performance materials. This approach addresses critical environmental, social, and economic challenges by transforming problematic waste into valuable resources while promoting sustainable building practices, such as developing insulating products for the construction industry. Mechanical testing demonstrated that adding shredded mask fibers (2 mm and 6 mm in size, up to 5 wt.%) enhanced the flexural strength of geopolymeric products. The optimal performance was achieved by adding 3 wt.% of 2 mm-length fibers, resulting in a flexural strength of 4.56 ± 0.23 MPa. Regarding compressive strength, the highest value (54.78 ± 2.08 MPa) was recorded in geopolymers containing 1 wt.% of 2 mm fibers. Thermal insulation properties of the materials improved with higher mask content, as evidenced by reductions in thermal conductivity, diffusivity, and specific heat. The lowest thermal conductivity values were observed in geopolymers containing 5 wt.% (0.4346 ± 0.0043 W·m⁻¹·K⁻¹) and 3 wt.% (0.6514 ± 0.0002 W·m⁻¹·K⁻¹) of 2 mm mask fibers. To further enhance thermal insulation, geopolymers with 5 wt.% mask fibers were foamed using H₂O₂ to obtain highly porous light materials, obtaining a reduction of thermal conductivity (0.3456 and 0.3710 ± 0.0007 W·m⁻¹·K⁻¹). This research highlights the potential of integrating fibrous waste materials into advanced construction technologies, offering solutions for waste reduction and development in the building sector toward sustainability. Full article

(This article belongs to the Special Issue The Production Processes and Applications of Geopolymers, 2nd Edition)

► Show Figures

Figure 1

27 pages, 1947 KiB

Open AccessArticle

Penalty Strategies in Semiparametric Regression Models

by Ayuba Jack Alhassan, S. Ejaz Ahmed, Dursun Aydin and Ersin Yilmaz

Math. Comput. Appl. 2025, 30(3), 54; https://doi.org/10.3390/mca30030054 - 12 May 2025

Abstract

This study includes a comprehensive evaluation of six penalty estimation strategies for partially linear models (PLRMs), focusing on their performance in the presence of multicollinearity and their ability to handle both parametric and nonparametric components. The methods under consideration include Ridge regression, Lasso, [...] Read more.

This study includes a comprehensive evaluation of six penalty estimation strategies for partially linear models (PLRMs), focusing on their performance in the presence of multicollinearity and their ability to handle both parametric and nonparametric components. The methods under consideration include Ridge regression, Lasso, Adaptive Lasso (aLasso), smoothly clipped absolute deviation (SCAD), ElasticNet, and minimax concave penalty (MCP). In addition to these established methods, we also incorporate Stein-type shrinkage estimation techniques that are standard and positive shrinkage and assess their effectiveness in this context. To estimate the PLRMs, we consider a kernel smoothing technique grounded in penalized least squares. Our investigation involves a theoretical analysis of the estimators’ asymptotic properties and a detailed simulation study designed to compare their performance under a variety of conditions, including different sample sizes, numbers of predictors, and levels of multicollinearity. The simulation results reveal that aLasso and shrinkage estimators, particularly the positive shrinkage estimator, consistently outperform the other methods in terms of Mean Squared Error (MSE) relative efficiencies (RE), especially when the sample size is small and multicollinearity is high. Furthermore, we present a real data analysis using the Hitters dataset to demonstrate the applicability of these methods in a practical setting. The results of the real data analysis align with the simulation findings, highlighting the superior predictive accuracy of aLasso and the shrinkage estimators in the presence of multicollinearity. The findings of this study offer valuable insights into the strengths and limitations of these penalty and shrinkage strategies, guiding their application in future research and practice involving semiparametric regression. Full article

13 pages, 1477 KiB

Open AccessArticle

Evaluating Machine Learning Models for Predicting Late Leprosy Diagnosis by Physical Disability Grade in Brazil (2018–2022)

by Lucia Rolim Santana de Freitas, José Antônio Oliveira de Freitas, Gerson Oliveira Penna and Elisabeth Carmen Duarte

Trop. Med. Infect. Dis. 2025, 10(5), 131; https://doi.org/10.3390/tropicalmed10050131 - 12 May 2025

Abstract

The severity of physical disability at leprosy diagnosis reflects the timeliness of case detection and the effectiveness of disease surveillance. This study evaluates machine learning models to predict factors associated with late leprosy diagnosis—defined as grade 2 physical disability (G2D)—in Brazil from 2018 [...] Read more.

The severity of physical disability at leprosy diagnosis reflects the timeliness of case detection and the effectiveness of disease surveillance. This study evaluates machine learning models to predict factors associated with late leprosy diagnosis—defined as grade 2 physical disability (G2D)—in Brazil from 2018 to 2022. Using an observational cross-sectional design, we analyzed data from the Notifiable Diseases Information System and trained four machine learning models: Random Forest, LightGBM, CatBoost, XGBoost, and an Ensemble model. Model performance was assessed through accuracy, area under the receiver operating characteristic curve (AUC-ROC), recall, precision, F1 score, specificity, and Matthew’s correlation coefficient (MCC). An increasing trend in G2D prevalence was observed, averaging 11.6% over the study period and rising to 13.1% in 2022. The Ensemble model and LightGBM demonstrated the highest predictive performance, particularly in the north and northeast regions (accuracy: 0.85, AUC-ROC: 0.93, recall: 0.90, F1 score: 0.83, MCC: 0.70), with similar results in other regions. Key predictors of G2D included the number of nerves affected, clinical form, education level, and case detection mode. These findings underscore the potential of machine learning to enhance early detection strategies and reduce the burden of disability in leprosy, particularly in regions with persistent health disparities. Full article

(This article belongs to the Special Issue Towards Zero Leprosy: Epidemiology and Prevention Strategy)

► Show Figures

Figure 1

15 pages, 620 KiB

Open AccessArticle

Effects of Stocking Density on Phytoplankton Community and Water Quality in Polyculture Ponds of Tegillarca granosa and Litopenaeus vannamei

by Jing He, Lin He, Zhihua Lin and Yongjian Xu

Fishes 2025, 10(5), 222; https://doi.org/10.3390/fishes10050222 - 12 May 2025

Abstract

This study investigated the effects of culture density on the phytoplankton communities in an integrated culture model of the blood clam Tegillarca granosa and Pacific white shrimp Litopenaeus vannamei. Two treatments were set up: L (L. vannamei 18 ind/m² [...] Read more.

This study investigated the effects of culture density on the phytoplankton communities in an integrated culture model of the blood clam Tegillarca granosa and Pacific white shrimp Litopenaeus vannamei. Two treatments were set up: L (L. vannamei 18 ind/m², T. granosa 33 ind/m²) and H (L. vannamei 36 ind/m², T. granosa 66 ind/m²). The management methods were the same during the experimental period, and the feed intake was determined according to L. vannamei. The results showed that there were more than 38 species of phytoplankton in the ponds, belonging to six phyla and 28 genera; the diversity index of the phytoplankton was higher in the early stage of the experiment and lower in the later stage; the average biomass of phytoplankton was 21.74 × 10⁴ind/L; and the culture density had no significant effect on water quality. This study showed that a reasonable increase in culture density would not cause significant adverse effects on the environment. It is possible to increase the stocking density of shrimp with the mollusk without causing inadequate conditions for the phytoplankton community and water quality. Full article

(This article belongs to the Section Sustainable Aquaculture)

17 pages, 3107 KiB

Open AccessArticle

Diversity and Interactions of the Naso-Buccal Bacteriome in Individuals with Allergic Rhinitis, Asthma and Healthy Controls

by Marcos Pérez-Losada

Allergies 2025, 5(2), 16; https://doi.org/10.3390/allergies5020016 - 12 May 2025

Abstract

Allergic rhinitis and asthma are significant public health concerns worldwide. While previous studies have explored how nasal and buccal bacteriotas influence these conditions, few have directly compared their bacteriomes within the same cohort. To bridge this gap, I analyzed 16S rRNA next-generation sequencing [...] Read more.

Allergic rhinitis and asthma are significant public health concerns worldwide. While previous studies have explored how nasal and buccal bacteriotas influence these conditions, few have directly compared their bacteriomes within the same cohort. To bridge this gap, I analyzed 16S rRNA next-generation sequencing data from 347 individuals, including participants with allergic rhinitis, asthma and healthy controls. The nasal and buccal bacteriomes shared all dominant bacterial taxa but differed significantly in their phylum- and genus-level relative abundances. Alpha-diversity was significantly higher in the buccal cavity, while beta-diversity varied significantly across all indices and clinical groups. Over 80% of the predicted metabolic pathways were differentially regulated between the two cavities, yet these functional differences remained fairly consistent across clinical groups. Naso-buccal bacterial networks exhibited striking differences in structure, complexity and hub nodes. Notably, the network of healthy controls showed a clear segregation between nasal and buccal bacteria, with 93.5% of the interactions occurring within each respective cavity, and contained few pathogenic keystone taxa. In contrast, bacterial networks from diseased individuals exhibited reduced ecological specialization and more pathogenic keystone taxa linked to airway disease. These findings, thus, demonstrate that the naso-buccal bacteriome plays distinct yet interconnected roles in allergic rhinitis and asthma. Full article

(This article belongs to the Section Asthma/Respiratory)

► Show Figures

Figure 1

19 pages, 2076 KiB

Open AccessArticle

Optimization of Irrigation and Nitrogen Fertilization Improves Biomass, Yield, and Quality of Fertigation Tomatoes

by Linsong Liu, Dongliang Qi, Chunmei Ding, Si Chen, Lihua Gao and Wenjun Yue

Horticulturae 2025, 11(5), 521; https://doi.org/10.3390/horticulturae11050521 - 12 May 2025

Abstract

Enhancing water and fertilizer use efficiencies is pivotal for sustainable tomato production. Adequate nitrogen and water management strategies have shown promise in improving the soil environment and crop productivity. However, the effects of fertigation modes on plant growth, yield, and quality remain largely [...] Read more.

Enhancing water and fertilizer use efficiencies is pivotal for sustainable tomato production. Adequate nitrogen and water management strategies have shown promise in improving the soil environment and crop productivity. However, the effects of fertigation modes on plant growth, yield, and quality remain largely unknown. To bridge this knowledge gap, an experiment was conducted in a greenhouse to investigate the effects of varied levels of water and nitrogen on the net photosynthetic rate, biomass, yield, and quality of tomatoes. The irrigation treatments included 0.75, 1.0, and 1.25 times the crop water requirement (ET_c), designated as W1, W2, and W3, respectively. The nitrogen rates included 120, 220, 320, and 420 kg N·hm⁻², designated as N1, N2, N3, and N4, applied in each irrigation treatment. The results showed that the W2N3 treatment achieved the most significant net photosynthetic rate and biomass of leaves. The tomato yield increased with the increase in nitrogen rate and irrigation amount, and the increment peaked at the threshold (1.0 ET_c, 320 kg·hm⁻²), then declined with the further increase in water and nitrogen inputs. Principal component analysis revealed that the W2N3 exhibited superior quality characteristics compared to other treatments. Therefore, the combination of 100% ET_c and 320 kg N·hm⁻² achieved a triple goal of high quality, yield, and water–nitrogen-use efficiency in greenhouse tomato production. These results provide scientific insights for guiding fertigation for tomato production under greenhouse conditions. Full article

(This article belongs to the Special Issue Irrigation and Water Management Strategies for Horticultural Systems)

► Show Figures

Figure 1

20 pages, 6364 KiB

Open AccessArticle

Skeleton Photoperiod Enhances Photosynthetic Yield in Celery via Circadian-Regulated Metabolic Coordination

by Hengmin Lv, Chen Chen, Jian Luo, Mengting Xiao, Aisheng Xiong, Xilin Hou and Xiong You

Horticulturae 2025, 11(5), 520; https://doi.org/10.3390/horticulturae11050520 - 12 May 2025

Abstract

The circadian clock orchestrates photosynthetic and metabolic processes in plants, but the molecular mechanisms underlying the photoperiodic regulation of photosynthetic yield remain poorly understood. Here, we integrated computational modeling and experimental validation to investigate how the skeletal photoperiod modulates photosynthetic efficiency in celery [...] Read more.

The circadian clock orchestrates photosynthetic and metabolic processes in plants, but the molecular mechanisms underlying the photoperiodic regulation of photosynthetic yield remain poorly understood. Here, we integrated computational modeling and experimental validation to investigate how the skeletal photoperiod modulates photosynthetic efficiency in celery (Apium graveolens L.). Our model revealed that endogenous circadian rhythms dynamically regulate photosynthetic gene expression (e.g., Lhcb1, psbA, RbcS1, and atpA) and photosynthetic parameters (net photosynthetic rate and stomatal conductance) through interactions between clock components (CCA1/LHY and PRR9/PRR7) and light signaling. In particular, the 3L:3D skeleton photoperiod induced the highest 24 h photosynthetic accumulation (a 32% and 22% increase in chlorophyll and nitrogen content, respectively, vs. 12L:12D), outperforming continuous light (LL) and longer photoperiods. Rhythmic peaks of photosynthetic genes aligned with circadian-driven oscillations in the photosynthetic parameters, while a strong negative correlation between the net photosynthetic rate (Pn) and intercellular CO₂ concentration (Ci) emerged under 3L:3D cycles. Model simulations demonstrated robustness in capturing phase-specific gene expression and parameter dynamics across photoperiods, highlighting the role of the circadian clock in optimizing energy use. These results demonstrate that abnormal L/D cycles, particularly 3L:3D, increase photosynthetic yield by enhancing circadian-regulated metabolic coordination, providing a low-energy, high-efficiency strategy for agricultural productivity. This work advances our understanding of photoperiodic manipulation in crop systems and provides a predictive framework for circadian-informed crop management. Full article

(This article belongs to the Section Protected Culture)

► Show Figures

Figure 1

11 pages, 17605 KiB

Open AccessArticle

A Self-Expanding Nitinol Fixation System for Atrial Leadless Pacemakers: Biomechanical Design and Evaluation

by Yu-Tzu Wang, Yu-Sheng Lin, Yu-Wei Lin, Chun-Ming Chang, Lung-Sheng Wu, Chao-Sung Lai and Pao-Hsien Chu

Bioengineering 2025, 12(5), 512; https://doi.org/10.3390/bioengineering12050512 - 12 May 2025

Abstract

Atrial leadless pacemakers (ALPMs) offer a minimally invasive solution for patients requiring atrial pacing, but current designs face significant challenges related to fixation stability, perforation risk, and retrievability. This study presents a novel self-expanding nitinol fixation system designed for deployment within the left [...] Read more.

Atrial leadless pacemakers (ALPMs) offer a minimally invasive solution for patients requiring atrial pacing, but current designs face significant challenges related to fixation stability, perforation risk, and retrievability. This study presents a novel self-expanding nitinol fixation system designed for deployment within the left atrial appendage (LAA), incorporating a flexible adapter for secure pacemaker engagement and retrieval. Finite-element simulations were conducted to assess gravitational displacement across different anatomical orientations, and fixture-expansion behavior was analyzed under various mesh configurations. The pacemaker drop analysis results demonstrated minimal displacement in neutral and upward-tilted LAA models, with increased instability observed in downward-tilted orientations. The fixture-expansion study showed that the 0.2 mm mesh design provided adequate mechanical strength and strain tolerance while maintaining a compact profile. This novel fixation system improves current ALPM limitations by providing stable, retrievable anchoring and favorable biomechanical performance. It may also serve as a dual-function platform for atrial pacing and stroke prevention when integrated with a left atrial appendage (LAA) occluder. These findings support further preclinical validation for clinical translation. Full article

(This article belongs to the Section Biomedical Engineering and Biomaterials)

► Show Figures

Graphical abstract

15 pages, 2192 KiB

Open AccessArticle

Development, Validation, and Deployment of a Time-Dependent Machine Learning Model for Predicting One-Year Mortality Risk in Critically Ill Patients with Heart Failure

by Jiuyi Wang, Qingxia Kang, Shiqi Tian, Shunli Zhang, Kai Wang and Guibo Feng

Bioengineering 2025, 12(5), 511; https://doi.org/10.3390/bioengineering12050511 - 12 May 2025

Abstract

Background: Heart failure (HF) ranks among the foremost causes of mortality globally, exhibiting particularly high prevalence and significant impact within intensive care units (ICUs). This study sought to develop, validate, and deploy a time-dependent machine learning model aimed at predicting the one-year all-cause [...] Read more.

Background: Heart failure (HF) ranks among the foremost causes of mortality globally, exhibiting particularly high prevalence and significant impact within intensive care units (ICUs). This study sought to develop, validate, and deploy a time-dependent machine learning model aimed at predicting the one-year all-cause mortality risk in ICU patients diagnosed with HF, thereby facilitating precise prognostic evaluation and risk stratification. Methods: This study encompassed a cohort of 8960 ICU patients with HF sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database (version 3.1). This latest version of the database added data from 2020 to 2022 on the basis of version 2.2 (covering data from 2008 to 2019); therefore, data spanning 2008 to 2019 (n = 5748) were designated for the training set, while data from 2020 to 2022 (n = 3212) were reserved for the test set. The primary endpoint of interest was one-year all-cause mortality. Least Absolute Shrinkage and Selection Operator (LASSO) regression was employed to select predictive features from an initial pool of 64 candidate variables (including demographic characteristics, vital signs, comorbidities and complications, therapeutic interventions, routine laboratory data, and disease severity scores). Four predictive models were developed and compared: Cox proportional hazards, random survival forest (RSF), Cox proportional hazards deep neural network (DeepSurv), and eXtreme Gradient Boosting (XGBoost). Model performance was assessed using the concordance index (C-index) and Brier score, with model interpretability addressed through SHapley Additive exPlanations (SHAP) and time-dependent Survival SHapley Additive exPlanations (SurvSHAP(t)). Results: This study revealed a one-year mortality rate of 46.1% within the population under investigation. In the training set, LASSO effectively identified 24 features in the model. In the test set, the XGBoost model exhibited superior predictive performance, as evidenced by a C-index of 0.772 and a Brier score of 0.161, outperforming the Cox model (C-index: 0.740, Brier score: 0.175), the RSF model (C-index: 0.747, Brier score: 0.178), and the DeepSur model (C-index: 0.723, Brier score: 0.183). Decision curve analysis validated the clinical utility of the XGBoost model across a broad spectrum of risk thresholds. Feature importance analysis identified the red cell distribution width-to-albumin ratio (RAR), Charlson Comorbidity Index, Simplified Acute Physiology Score II (SAPS II), Acute Physiology Score III (APS III), and the age–bilirubin–INR–creatinine (ABIC) score as the top five predictive factors. Consequently, an online risk prediction tool based on this model has been developed and is publicly accessible. Conclusions: The time-dependent XGBoost model demonstrated robust predictive capability in evaluating the one-year all-cause mortality risk in critically ill HF patients. This model offered a useful tool for early risk identification and supported timely interventions. Full article

(This article belongs to the Special Issue Machine Learning Technology in Predictive Healthcare)

► Show Figures

Figure 1

23 pages, 14210 KiB

Open AccessArticle

In Vivo Evaluation of the Anti-Skin-Ageing Bioactivity of a Recombinant Dual Humanised Collagen and Poly-L-Lactic Acid

by Mingjie Tong, Xin Zhou, Jiongni Zhong, Dengjian Qu, Wei Chen, Chun Chen, Yiting Wang, Yaoping Liu, Shaochuan Li, Yuan Xiao, Ning Wang, Chaowan Guo, Qiuling Xie and Sheng Xiong

Bioengineering 2025, 12(5), 510; https://doi.org/10.3390/bioengineering12050510 - 12 May 2025

Abstract

This study introduces a novel recombinant humanised collagen (DuCol) developed through codon optimisation and prokaryotic soluble expression, exhibiting exceptional biocompatibility and bioactivity. Structural integrity was confirmed via RP-HPLC, SEM, and CD spectroscopy. In vitro evaluations revealed DuCol’s dose-dependent enhancement of NIH-3T3 fibroblast proliferation, [...] Read more.

This study introduces a novel recombinant humanised collagen (DuCol) developed through codon optimisation and prokaryotic soluble expression, exhibiting exceptional biocompatibility and bioactivity. Structural integrity was confirmed via RP-HPLC, SEM, and CD spectroscopy. In vitro evaluations revealed DuCol’s dose-dependent enhancement of NIH-3T3 fibroblast proliferation, adhesion, and migration. In a D-galactose-induced ageing rat model, subcutaneous implantation of DuCol showcased time-dependent anti-ageing effects. Early-stage intervention (30 days post-injection) markedly upregulated COL1A1 expression through the TGF-β/Smad3 pathway activation, outperforming poly-l-lactic acid (PLLA) in collagen deposition. Histological analysis revealed 23.4% greater dermal thickness in DuCol-treated groups compared to PLLA at 90 days. While PLLA exhibited sustained collagen stimulation beyond 90 days, DuCol exhibited superior early-phase efficacy (p < 0.001) with comparable safety profiles (no inflammatory response observed through 180-day monitoring). The combinatorial PLLA/DuCol (P&C) formulation synergistically enhanced dermal regeneration, achieving a 31.7% thicker collagen matrix than monotherapy groups. These results underscore the potential of DuCol as a novel implantable filler material for skin repair and regeneration. Full article

(This article belongs to the Special Issue Biologically Active Constituents and Their Applications for Skin Regeneration and Repair)

► Show Figures

Figure 1

19 pages, 16843 KiB

Open AccessArticle

Potential of Hyperthermophilic L-Asparaginase from Thermococcus sibiricus to Mitigate Dietary Acrylamide Assessed Using a Simplified Food System

by Maria Dumina, Stanislav Kalinin and Dmitry Zhdanov

Foods 2025, 14(10), 1720; https://doi.org/10.3390/foods14101720 - 12 May 2025

Abstract

The Maillard reaction is a network of interconnected interactions yielding in formation a number of toxic derivatives in processed foods. Acrylamide, a potential carcinogen and a product of the Maillard reaction, is formed under food processing, predominantly from asparagine and reducing sugars at [...] Read more.

The Maillard reaction is a network of interconnected interactions yielding in formation a number of toxic derivatives in processed foods. Acrylamide, a potential carcinogen and a product of the Maillard reaction, is formed under food processing, predominantly from asparagine and reducing sugars at temperatures over 120 °C. In this study, we investigated the potency of recombinant hyperthermophilic L-asparaginase from Thermococcus sibiricus TsAI to mitigate dietary acrylamide by hydrolyzing substrate for its synthesis under various operation conditions. Using a simplified food system for self-cooking, high acrylamide levels were found in baked samples regardless of whether L- or D-enantiomer of asparagine was added. TsAI effectively reduced acrylamide content under various pretreatment conditions, such as temperature, concentration, and time of incubation. The lowest acrylamide level of 1.0–1.1% of the control values or 3.52–3.76 µg/kg was observed in samples pretreated with TsAI 20 U/mL at 90 °C for 20–25 min. Due to the exceptionally high D-asparaginase activity of hyperthermophilic TsAI, the dietary acrylamide content formed from D-asparagine was reduced by 54.8% compared to the control. Comparison of the wild-type TsAI and its mutant reveal that an enzyme displaying enhanced stability is more functional for food-processing application. The native TsAI decreased acrylamide level by 98.9%, while the highly active mutant, with increased structural flexibility, decreased it by only 26.8%. TsAI treatment effectively blocked acrylamide synthesis, but not melanoidin formation via the Maillard reaction, thus not affecting sample characteristics such as color (browning) and aroma, which are important for consumer perception. Full article

(This article belongs to the Special Issue Formation, Occurrence and Mitigation Strategies of Food Contaminants and Natural Toxicants: 2nd Edition)

► Show Figures

Figure 1

34 pages, 1390 KiB

Open AccessReview

A Comprehensive Review of Edible Flowers with a Focus on Microbiological, Nutritional, and Potential Health Aspects

by Angela Daniela Carboni, Tiziana Di Renzo, Stefania Nazzaro, Pasquale Marena, Maria Cecilia Puppo and Anna Reale

Foods 2025, 14(10), 1719; https://doi.org/10.3390/foods14101719 - 12 May 2025

Abstract

Edible flowers have been used since ancient times directly as food, flavoring agents, and garnish in food products, and are now reappearing in modern cuisine. Edible flowers have gained popularity due to changing consumer habits focused on healthier food options. In addition to [...] Read more.

Edible flowers have been used since ancient times directly as food, flavoring agents, and garnish in food products, and are now reappearing in modern cuisine. Edible flowers have gained popularity due to changing consumer habits focused on healthier food options. In addition to contributing to the esthetics and flavor of various dishes, edible flowers are now recognized for their nutritional value, as they contain bioactive components with different health benefits. However, a significant concern regarding edible flowers is the potential contamination by undesirable microorganisms. Since edible flowers are often consumed fresh or minimally processed, they can pose a microbiological risk. Edible flowers may be susceptible to contamination by various pathogenic microorganisms, particularly Bacillus spp., Enterobacter spp., Salmonella spp., and Staphylococcus aureus. In addition, mycotoxin-producing fungi, such as Aspergillus, Penicillium, Alternaria, or Fusarium, can be found in various flowers. Good agricultural practices, hygienic handling, and appropriate storage are essential to reduce contamination and guarantee the safe consumption of edible flowers. Since current investigations on the microbiological safety aspects of edible flowers are scarce, this review aims to provide an overview of the consumption of edible flowers and a discussion of their uses, health benefits, and risks, focusing on microbiological aspects. Full article

(This article belongs to the Special Issue Feature Reviews on Food Microbiology)

► Show Figures

Figure 1

12 pages, 768 KiB

Open AccessArticle

Improving Medication Safety Through Medication Reconciliation in Pediatric Neurology: Clinical Pharmacist Recommendations and Physician Uptake in a 13-Week Study

by Margherita Zennaro, Anna Trotter, Daniele Mengato, Laura Camuffo, Claudio Ancona, Irene Toldo, Maria Cecilia Giron, Maria Federica Pelizza, Margherita Nosadini, Giorgio Perilongo, Stefano Sartori and Francesca Venturini

Children 2025, 12(5), 625; https://doi.org/10.3390/children12050625 - 12 May 2025

Abstract

Background/Objectives: Clinical pharmacy plays a crucial role in optimizing medication use, particularly in pediatric settings where drug therapy can be complex and understudied. This study aims to assess the impact of clinical pharmacists in the Pediatric Neurology and Neurophysiology Unit of the Padova [...] Read more.

Background/Objectives: Clinical pharmacy plays a crucial role in optimizing medication use, particularly in pediatric settings where drug therapy can be complex and understudied. This study aims to assess the impact of clinical pharmacists in the Pediatric Neurology and Neurophysiology Unit of the Padova University Hospital, focusing on physician acceptance of pharmacist suggestions and the types of advice most frequently followed. Methods: A retrospective observational study was conducted over 13 weeks to describe the implementation phase of clinical pharmacists’ involvement in medication reconciliation in this setting. The study consisted of three steps. The study utilized a cluster model to categorize pharmacist suggestions and to evaluate physician acceptance rates. Results: The study included 57 hospitalized pediatric patients (53% male) with a median age of 3 years (IQR: 1–10.25). A total of 138 recommendations were shared, with an overall acceptance rate of 42%. Medication errors accounted for the largest cluster of suggestions (45%), though only 32% were accepted. Among the most frequently shared categories of suggestions, pharmaceutical form optimization (A) and drug supply (E) exhibited higher acceptance rates by clinicians (64% and 42%, respectively). The acceptance rate increased over time, peaking at 100% during weeks 7 and 11, correlating positively with enhanced collaboration between pharmacists and clinicians (R² = 0.59). Conclusions: This study highlights the importance of clinical pharmacists in pediatric care, particularly in improving medication management through targeted interventions. The findings suggest that integrating clinical pharmacists into multidisciplinary teams can enhance patient care quality by fostering collaboration and trust among healthcare professionals. Full article

(This article belongs to the Special Issue The Pediatric Formulations: The Present and a Challenge for Future)

16 pages, 1536 KiB

Open AccessSystematic Review

Growth Patterns of HIV-Exposed and -Unexposed Infants in African Countries: A Systematic Review and Meta-Analysis

by Perpetua Modjadji, Kabelo Mokgalaboni, Wendy N. Phoswa, Tebogo Maria Mothiba and Sogolo L. Lebelo

Children 2025, 12(5), 624; https://doi.org/10.3390/children12050624 - 12 May 2025

Abstract

Background/Objectives: The purpose of this study is to understand the prevalence and odds of poor growth patterns among HIV-exposed but uninfected (HEU) versus HIV-unexposed (HUU) infants in the era of antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) in Africa. Methods: We [...] Read more.

Background/Objectives: The purpose of this study is to understand the prevalence and odds of poor growth patterns among HIV-exposed but uninfected (HEU) versus HIV-unexposed (HUU) infants in the era of antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) in Africa. Methods: We reviewed and meta-analyzed studies on growth patterns among HEU versus HUU infants in Africa. Evidence was gathered from the PubMed and Scopus databases following PRISMA guidelines. We independently evaluated the quality of included studies using Newcastle Ottawa guidelines. Data analysis was performed using an online meta-analysis tool, and the results are reported as odds ratios (OR) and prevalence with 95% confidence intervals (CI). Results: A total of 17 studies met the inclusion criteria for this review. The odds of stunting were significantly higher among HEU infants compared to HUU infants, with an odds ratio of 1.56 (95% CI: 1.23–1.97; p < 0.01). The pooled prevalence of stunting was 25% (95% CI: 17–33%) in HEU infants and 19% (95% CI: 12–26%) in HUU infants. In contrast, no significant differences were observed for underweight and wasting. The odds of being underweight in HEU infants compared to HUU was 0.85 (95% CI: 0.47–1.56; p = 0.60), with a pooled prevalence of 11% (95% CI: 5–17%) in HEU and 14% (95% CI: 5–24%) in HUU. Similarly, the odds of wasting were 1.10 (95% CI: 0.78–1.56; p = 0.58), with a pooled prevalence of 9% (95% CI: 3–14%) in HEU and 7% (95% CI: 3–12%) in HUU. Conclusions: Stunting was the most prevalent growth deficit among HEU infants compared to their HUU counterparts, with no significant differences observed in the rates of underweight and wasting. To improve postnatal growth outcomes, especially in the evolving landscape of HIV treatment and prevention, efforts should focus on educating and supporting mothers living with HIV. Full article

(This article belongs to the Special Issue Maternal Health and the Impact on Infant Growth)

17 pages, 580 KiB

Open AccessSystematic Review

Strength Training in Children: A Systematic Review Study

by Borys Bismark León-Reyes, Dilan Galeano-Rojas, Manuel Gámez-Vílchez, Claudio Farias-Valenzuela, Claudio Hinojosa-Torres and Pedro Valdivia-Moral

Children 2025, 12(5), 623; https://doi.org/10.3390/children12050623 - 12 May 2025

Abstract

Background: With the increasing prevalence of sedentary lifestyles and childhood obesity, physical activity and exercise have emerged as essential pillars of health promotion in childhood. In this context, schools play a fundamental role as key players in the implementation of interventions that promote [...] Read more.

Background: With the increasing prevalence of sedentary lifestyles and childhood obesity, physical activity and exercise have emerged as essential pillars of health promotion in childhood. In this context, schools play a fundamental role as key players in the implementation of interventions that promote healthy habits and a more physically active life. Objectives: The purpose of the present study was to conduct a systematic review of the benefits of strength training in primary school students. Methods: The review was carried out using the Web of Science and Scopus databases, following the guidelines of the PRISMA statement and a PICO strategy. The studies were selected according to different inclusion and exclusion criteria, resulting in 11 scientific articles published in English during the last 5 years (2020–2024). The methodological quality of the studies was assessed using the STROBE checklist. Results: The results suggest that strength training with elementary school students improves physical and motor performance variables, as well as cognitive, psychosocial and health variables. Likewise, it can be observed that plyometric strength-training methods and unilateral and combined programs with aerobic and motor skills training are highly effective and favor adherence to physical exercise. This also demonstrates the importance and necessity of developing motor coordination skills from an early age, since they represent a determining factor in strength training as the exercises become more specific and complex. Conclusions: In conclusion, implementing strength training programs in primary education confers several benefits at an integral level for the students and is crucial to improving the lifestyle and quality of life of students. Full article

(This article belongs to the Special Issue Effects of Exercise Interventions on Children)

► Show Figures

Figure 1

4 pages, 157 KiB

Open AccessEditorial

The Special Issue on Neonatology for the 10th Anniversary of Children: From Preclinical Findings to Bringing Families to the Centre of Contemporary Neonatal Care

by Karel Allegaert

Children 2025, 12(5), 622; https://doi.org/10.3390/children12050622 - 12 May 2025

Abstract

Neonatology is a specialized branch of medicine, focussed on the care of newborns, either related to preterm birth or other medical conditions like sepsis, asphyxia, or congenital malformations [...] Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Neonatology)

Recent Articles

Open Access Journals

Highly Accessed Articles

Latest Books

News

Blog Posts

Topics

Selected Special Issues

Selected Collections

Journals by Subject

Further Information

Guidelines

MDPI Initiatives

Follow MDPI