Search Results (25,533)

This study aimed to develop high-quality steamed buns enriched with spirulina powder (SP) to enhance their nutritional value. We investigated the effects of SP addition on the microscopic properties of the dough, as well as the texture, quality, and nutritional profile of the steamed buns. The results indicated that adding more than 5% SP disrupts the gluten network structure, resulting in a reduction in the specific volume of the steamed buns. However, the height-to-diameter ratio of the steamed buns increases slightly with the addition of SP in certain amounts. As the amount of SP added increases, the color of the steamed buns gradually turns green and darkens, while the texture becomes harder. A small amount of SP improves the elasticity and overall sensory score of the steamed buns. With a 2% SP addition, the sensory score of the steamed bun is relatively high; however, overall consumer preference declines when the addition exceeds 5%. SP steamed buns exhibit superior antioxidant properties. The steamed bun containing 5% SP exhibits a total phenolic content (TPC) of 1120.4 mg GAE per 100 g of dry weight, alongside a DPPH radical inhibition rate of 54.78%. These values were 2.21 and 3.51 higher, respectively, compared to buns without SP. Additionally, the protein content of the SP steamed buns increased significantly and the amino acid composition was more comprehensive, with increased levels of lysine and alanine. The results concluded that the steamed buns were of the best quality when 2% SP was added. This study provides a reference for the application of spirulina powder in steamed buns. Full article

Given the high incidence of calf diarrhea and the limited data on pathogenic and non-infectious factors in a large-scale dairy farm in Wuwei City, this study aims to investigate the pathogens associated with summer calf diarrhea and the non-infectious risk factors in local large-scale dairy farm. It included 664 diarrheic calves (1–60 days of age, from June 2024 to May 2025), detected 5 types of enteric pathogens in 81 fecal samples collected in summer via RT-qPCR, collected data on non-infectious factors, and applied binary logistic regression and ROC analysis. The annual diarrhea incidence was 14.44%, with a peak in summer. Clostridium perfringens (67.90%) and Bovine Rotavirus (48.14%) were the dominant pathogens, and the rate of mixed infections was 48.14%. Risk factors for calf diarrhea included birth in spring or summer, female, Wagyu, younger age, birth weight < 38.5 kg, primiparous dams, serum immunoglobulin level < 8.1 g/L, and dam calving score > 1; longer duration of treatment was associated with a lower recovery rate. This study identifies key pathogens, risk factors, and their thresholds, thereby providing a scientific basis for the control of calf diarrhea in similar regions. Full article

Background/Objectives: Obesity is a major risk factor for cardiovascular disease (CVD), but traditional risk calculators such as Systematic COronary Risk Evaluation (SCORE2) may not fully capture the elevated risks in individuals with obesity, especially when metabolic health is considered. This study aimed to evaluate the effectiveness of QRESEARCH risk estimator version 3 (QRISK3) in estimating 10-year cardiovascular risk in individuals with varying obesity phenotypes compared to SCORE2. Methods: A total of 88 participants (25 men, 63 women; mean age 37.4 ± 11.8 years) were categorized into four obesity phenotypes according to metabolic and anthropometric criteria. The 10-year CVD risk was calculated using SCORE2 and QRISK3 algorithms. Functional cardiovascular assessment included blood pressure (BP) measurement and electrocardiogram (ECG) interpretation for conduction abnormalities and left ventricular hypertrophy (LVH). Biochemical analysis included carbohydrate metabolism (fasting glucose, postprandial glucose, HbA1c) and lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides, atherogenic index). Results: SCORE2 underestimated CVD risk (3–8%), whereas QRISK3 predicted higher values (6–16%), particularly in metabolically unhealthy phenotypes. LVH occurred in 26–45% of participants, with elevated BP and early subclinical ECG changes even in metabolically healthy obesity individuals. Carbohydrate metabolism disturbances were observed in metabolically unhealthy participants with normal or elevated BMI, while lipid abnormalities—including elevated total cholesterol, LDL-C, triglycerides, and atherogenic index—were prominent in these metabolically unhealthy phenotypes. Insulin resistance, assessed via the triglyceride–glucose index, exceeded reference ranges in all obesity phenotypes, with the highest values seen in metabolically unhealthy individuals. Conclusions: QRISK3 provides a more precise and thorough assessment of 10-year cardiovascular risk in individuals with obesity than SCORE2. These findings highlight the importance of incorporating anthropometric and metabolic data into cardiovascular risk assessments and support the clinical use of QRISK3 for more personalized risk stratification, especially in populations with obesity and metabolic disturbances. Early identification of high-risk individuals using QRISK3 could lead to more timely and targeted preventive interventions, improving long-term cardiovascular outcomes. Full article

This study aimed to analyze whether recreational soccer, through small-sided and traditional soccer formats, can promote improvements in different dimensions of physical literacy among adolescents with high cardiometabolic risk. Methodology. A randomized controlled trial was conducted with two experimental conditions (small-sided soccer games and traditional soccer) and one control condition. A total of 51 male adolescents aged 11–15 years with high cardiometabolic risk participated in the study. A model including three dimensions of physical literacy was established: physical, psychological, and cognitive dimensions. Data were standardized using z-scores to allow variable weighting within the model, and effect sizes and ANCOVA were used for inter- and intragroup comparisons. Results. The overall effect on physical literacy was small (ES: 0.31). The small-sided soccer group showed better results in the physical and psychological dimensions. The per-protocol analysis showed small effects in the high-adherence groups (ES = 0.43 and 0.38) and significant within-group differences; however, the post hoc analyses only revealed trends when compared with the low-adherence groups. Conclusions. Recreational soccer, whether in SSG or TSG formats, was insufficient to elicit significant improvements in physical literacy among adolescents with high cardiometabolic risk. Participants with higher adherence showed better outcomes, with SSG showing a clear tendency toward greater improvements in the physical and psychological domains. Full article

Working memory training (WMT) has promising effects on cognitive and clinical outcomes in children with attention deficit hyperactivity disorder (ADHD). However, few studies have explored the effectiveness of such programs in developing countries with different populations and sociocultural backgrounds. This study aimed to pilot Cogmed WMT (CWMT) and examine its impact on clinical and cognitive outcomes in children diagnosed with ADHD in Saudi Arabia. We assessed 34 children with ADHD assigned to either a CWMT or standard-of-care group. Both groups were evaluated at baseline and five weeks for ADHD symptoms and cognitive function, including working memory (WM), sustained attention, and impulsivity. Compared with the baseline and the control group, the intervention group demonstrated improved parent ratings of ADHD clinical symptoms and cognitive function scores, including WM, sustained attention, and impulsivity. CWMT improved cognitive and clinical measures in our sample of Saudi children with ADHD and is a promising non-pharmacological therapy for treating children with ADHD in developing countries. Full article

Background/Objectives: Readiness for hospital discharge after kidney and liver transplantation is a complex process influenced not only by clinical factors but also by psychological and social aspects. This cross-sectional, analytical study aimed to assess discharge readiness and examine the psychological and social factors affecting patients’ preparations for leaving the hospital among renal and liver transplant recipients. Methods: A diagnostic survey was conducted using standardized questionnaires, including assessment of readiness for discharge (based on Canadian Health Outcomes for Better Information and Care-C-HOBIC), Hospital Anxiety and Depression Scale (HADS), Multidimensional Scale of Perceived Social Support (MSPSS), and Resilience Measurement Scale (SPP-25). The collected data were analyzed using IBM SPSS Statistics version 28. The study included 117 recipients (31.6% liver, 68.4% kidney) who received transplants at centers in Poland between February and May 2025. Results: The average discharge readiness score was 34.51 ± 5.37. Overall, 79.5% of respondents had high discharge readiness, while 20.5% reported moderate readiness. A multiple regression model with eight predictors (SPP-25, HADS-depression, HADS-anxiety, Friends, Family, Significant person, Knowledge of self-care, Communication and information support) was statistically significant (F(8,108) = 11.629, p < 0.001), explaining 46.3% of the variance in discharge readiness (R² = 0.463; adjusted R² = 0.423). Knowledge of self-care emerged as the strongest predictor (B = 0.475, β = 0.577, t = 5.424, p < 0.001), followed by psychological resilience (SPP-25) (B = 0.011, β = 0.221, t = 2.381, p = 0.019). Other variables were not significant predictors (p > 0.05). Conclusions: Discharge readiness after kidney and liver transplantation is significantly affected by patients’ self-care knowledge and psychological resilience, highlighting the importance of education and psychological support in preparing patients for discharge. Full article

Nutrition knowledge is essential for optimizing performance, recovery, and overall health in athletes. This study aimed to (1) adapt and validate the Hungarian version of the ANSKQ (Trakman et al., 2017) (ANSKQ-HU) and (2) assess the nutrition knowledge of Hungarian elite and recreational athletes. Following standard translation procedures and expert review, face validity was established. Data were collected from 1.335 athletes, and item difficulty, exploratory factor analysis (EFA), and reliability analyses were performed. A three-factor structure emerged: (1) Fundamentals of nutrition, energy needs, and prohibited substances; (2) Micronutrients and performance-enhancing sports nutrition; and (3) Utilization of macronutrients. While Cronbach’s alpha values were low (α = 0.41–0.62), this seemed acceptable given the dichotomous nature of the questionnaire. Most participants scored poorly (63.3%), with the lowest results in the micronutrients and performance-enhancing nutrition factor. Only 6.9% had formal nutrition education and most frequently respondents received help from coaches, family members, and friends. These findings highlight a significant gap in sports nutrition knowledge among Hungarian athletes and support the need for educative activities organized by sport nutrition professionals. The ANSKQ-HU is a reliable and valid tool for assessing nutrition knowledge in Hungarian athletes and can be a useful questionnaire for their support team (nutritionists, physicians). Full article

Background: Knee osteoarthritis (KOA) is a progressive joint disorder that leads to pain, functional limitations, and reduced quality of life. While physical therapy (PT) and resistance exercise are effective in managing KOA, creatine supplementation (CS) may provide additional benefits. Aims/Objectives: To determine the additive effects of creatine supplementation alongside physical therapy (PT) and resistance exercise training in individuals with KOA. Methods: A parallel-design, double-blind, randomized controlled trial was conducted on 40 patients with KOA (≤grade III on Kellgren classification), aged 40–70 years. Participants were randomly allocated to either a placebo control group, which received placebo supplementation (maltodextrin) along with PT, including heat therapy, electrotherapy, manual therapy, and resistance exercises, for four weeks, or an experimental group, which received CS instead of maltodextrin in addition to the same treatment. Outcome measures included the visual analog scale (VAS), fall risk, Knee Injury and Osteoarthritis Outcome Score (KOOS), isometric muscle strength (IMS), five-repetition sit-to-stand test (5xSST), knee range of motion (ROM), and body composition analysis. Results: No significant differences were observed between the two groups at baseline. After four weeks of treatment, a significant interaction effect (treatment group x time) was observed for VAS (p = 0.001), fall risk score (p < 0.001), KOOS overall score (p < 0.001), IMS (p < 0.001), and body composition parameters (p < 0.05) in favor of the CS group. However, no significant interaction effect was observed for knee ROM and KOOS QOL subscale. Conclusions: CS, when combined with PT and resistance exercise, may provide additional benefits in terms of pain, function, muscle strength, and body composition parameters in individuals with KOA. However, no supplementary benefits of CS are observed in terms of quality of life and ROM. Full article

Background: Circulating microRNAs (miRNAs) have emerged as potential biomarkers of platelet reactivity and thrombotic risk. Among them, miR-223-3p regulates P2Y12 receptor expression and may influence response to antiplatelet therapy. This study aimed to evaluate the prognostic value of selected circulating miRNAs in post-stroke patients receiving antiplatelet treatment. Methods: Sixty ischemic stroke survivors were prospectively enrolled and followed for 18 months for recurrent vascular events (stroke, transient ischemic attack, or myocardial infarction). Plasma levels of miR-126-3p, miR-223-3p, miR-24-3p, and miR-199a-5p were quantified using reverse transcription real-time PCR. Clinical data, antiplatelet regimen, statin use, and Essen Stroke Risk Scores (ESRS) were recorded. Logistic regression was applied to identify independent predictors of thrombotic events. Results: Expression of all examined miRNAs differed significantly across treatment groups. The dual antiplatelet therapy (DAPT) group showed the highest levels of miR-126-3p and miR-199a-5p (p < 0.01). Within the statin-naïve DAPT subgroup, lower miR-199a-5p levels (p < 0.001) were observed among patients who experienced ischemic events (n = 7/60; 12%; stroke = 4, TIA = 2, ACS = 1) during 18 months of follow-up. In multivariate analysis, reduced miR-223-3p remained the only independent predictor of recurrent thrombotic events (OR 1.18, 95% CI 1.01–1.37, p = 0.036), independent of ESRS and platelet reactivity. Elevated miR-126-3p and miR-199a-5p were associated with favorable treatment response, particularly among statin users. Conclusions: This study identifies low circulating miR-223-3p as an independent biomarker of thrombotic risk in post-stroke patients, potentially reflecting enhanced platelet activation via P2Y12 signaling. In contrast, higher miR-126-3p and miR-199a-5p levels may indicate more effective antiplatelet response. These findings support the potential utility of miRNA profiling for individualized antiplatelet therapy and long-term risk stratification after ischemic stroke. Full article

Background and Objectives: Ankylosing spondylitis (AS) is a chronic inflammatory disorder frequently associated with acute anterior uveitis; however, it may also predispose individuals to dry eye disease. We aimed to evaluate dry eye in AS participants employing both conventional tests and conjunctival impression cytology (Nelson grading) to compare their sensitivity in detecting ocular surface changes. Materials and Methods: This prospective case–control study enrolled 24 patients with AS and 27 age- and sex-matched healthy controls. Dry eye was evaluated using the Schirmer I test (measuring tear production), fluorescein tear break-up time (BUT, assessing tear film stability), the Ocular Surface Disease Index (OSDI) questionnaire (evaluating symptoms), and conjunctival impression cytology (analyzing ocular surface changes). Intergroup differences were assessed using non-parametric statistical methods, and their correlations with clinical variables were examined. Results: Nelson conjunctival cytology scores were significantly higher in AS patients than control subjects (1.63 ± 0.92 vs. 0.74 ± 0.86; p = 0.001), indicating greater conjunctival goblet cell loss and squamous metaplasia. In contrast, Schirmer, BUT, and OSDI observations did not differ significantly between AS and control subjects (all p > 0.05). Within AS, the Nelson cytology grade did not correlate accompanied by tear test observations or disease activity indices, and symptom scores did not align accompanied by Schirmer or BUT values. Conclusions: AS patients demonstrated evidence of subclinical dry eye changes detectable by impression cytology even when standard tests were normal. Conjunctival cytology was more sensitive than Schirmer, BUT, or symptom assessment in identifying ocular surface involvement in AS. Integrating such ocular surface evaluation into AS management could allow earlier diagnosis of dry eye and prompt intervention to improve patient quality of life. Full article

The Internet has been progressively more integrated into daily life through its evolutionary stages, ranging from web1.0 to the current development of web3.0. These continued integrations broaden the attack surface that cybercriminals aim to exploit. The prevalence of cybercrimes, particularly malware attacks, has become increasingly sophisticated and made more accessible through dark web marketplaces. Including artificial intelligence (AI) within anti-virus solutions has challenged the traditional dichotomy of malware detection schemes, offering more accurate and holistic detection capabilities. Research has shown that transforming malware files into textured images offers resistance to obfuscation and the potential to detect zero days. This paper explores the application of image quality assessment (IQA) techniques in enhancing visual malware dataset curation. We propose a novel framework that applies a no-reference IQA algorithm to evaluate current datasets and offer guidance in future dataset curation. Using multiple popular datasets, our evaluation demonstrates that the proposed MalScore framework effectively differentiates dataset quality—for example, MalNet Tiny achieves the highest score of 95%, while the NARAD malicious-image subset scores 50%. Additionally, BRISQUE was the only IQA algorithm to exhibit a strong linear sensitivity to blur levels across datasets. These results highlight the practical utility of MalScore in assessing and ranking visual malware datasets and lay the groundwork for uniting IQA and visual malware detection in future research. Full article

Contact dermatitis is a highly prevalent inflammatory disease of the skin with substantial impact on patients’ quality of life and occupational function. Although randomized controlled trials (RCTs) provide the highest level of evidence for treatment evaluation, previous research has shown that the reporting quality of RCT abstracts is often suboptimal. This study aimed to assess the completeness of reporting of RCT abstracts on contact dermatitis according to the CONSORT extension for abstracts (CONSORT-A). A cross-sectional analysis of 304 abstracts indexed in PubMed between 1975 and 2024 was conducted. Each abstract was independently evaluated by two reviewers using the 17-item CONSORT-A checklist, with inter-rater agreement calculated by Cohen’s κ. The median adherence score was 5 out of 17 items (29.4%), with a range from 1 (5.9%) to 14 (82.4%). The reporting of study aims (82.9%), interventions (82.2%), and conclusions (91.1%) was frequent, whereas critical methodological elements such as participant criteria (4.6%), randomization (2.0%), trial registration (3.0%), and funding (0.7%) were rarely reported. Structured abstracts, hospital settings, significant study results, and more than seven authors were independent predictors of higher adherence in multivariate analysis. Abstracts published after 2008, when CONSORT-A was introduced, showed modest but significant improvement. These findings indicate that reporting quality of contact dermatitis RCT abstracts remains inadequate, underscoring the need for stricter journal requirements, structured abstract formats, and broader dissemination of CONSORT-A guidelines. Full article

Background/Objectives: The COVID-19 pandemic substantially altered children’s daily experiences, limiting social interactions, which are critical for language development. This study aims to explore how the pandemic influenced receptive and expressive language abilities in children under six years, focusing on the impact of exposure duration and differences with the pandemic period. Methods: This retrospective cross-sectional study reviewed 189 children assessed for language delay at our outpatient clinic between 2018 and 2021. Only children evaluated using the Sequenced Language Scale for Infants or the Preschool Receptive-Expressive Language Scale were included. Participants were categorized by assessment period: pre-COVID (2018–2019), acute-COVID (2020), and chronic-COVID (2021), and by age (toddlers vs. preschoolers). Linear regression assessed the relationship between pandemic exposure duration and language scores; non-parametric tests compared groups. Results: During the acute-COVID period, longer exposure was associated with lower receptive and expressive percentile scores. In preschoolers, receptive scores were significantly lower in the chronic-COVID group than in the pre-COVID group, while expressive scores were lower in the chronic-COVID group than in the acute-COVID group. Conclusions: Prolonged exposure to the pandemic environment was associated with measurable delays in both receptive and expressive language development, especially in preschoolers. The results suggest that pandemic restrictions can hinder children’s language acquisition, indicating the need to strengthen early screening and provide timely interventions to support their developmental recovery. Full article

Introduction: In recent decades, the burden of mental disorders has become a major determinant of population health in the European Union, generating profound clinical, socioeconomic, and institutional consequences. Despite political recognition of this silent crisis, substantial methodological challenges persist in the transnational monitoring of mental health and in linking disease burden with the resources allocated to address it. The present analysis develops a multivariate taxonomy of EU Member States from a psychosocial perspective, using an integrative quantitative approach. Methods: This cross-sectional, comparative study follows international standards for transparent and reproducible quantitative reporting and is based on 18 harmonized clinical, epidemiological, and institutional indicators collected for 27 EU Member States over the period 2014–2023. The indicators used in this study were grouped according to their position along the care continuum. Hospital-based indicators refer to inpatient activity and institutional capacity, including total hospital discharges, psychiatric admissions (affective disorders, schizophrenia, dementia, alcohol- and drug-related disorders), and hospital bed availability. Outpatient and community-level indicators reflect the capacity of systems to provide non-hospital psychiatric care and consist primarily of psychiatrist density and total specialist medical workforce. Finally, subjective perception indicators capture population-level self-assessed health status, complementing clinical and institutional measures by integrating a psychosocial perspective. After harmonization and standardization, Principal Component Analysis (PCA) with Varimax rotation was applied to identify latent dimensions of mental health. Model adequacy was confirmed using the Kaiser–Meyer–Olkin coefficient (0.747) and Bartlett’s test of sphericity (p < 0.001). Results: Three latent dimensions explaining 77.7% of the total variance were identified: (1) institutionalized psychiatric burden, (2) functional capacity of the health care system, and (3) suicidal vulnerability associated with problematic substance use. Standardized factor scores allowed for the classification of Member States, revealing distinct patterns of psychosocial risk. For example, Germany and France display profiles marked by high levels of institutionalized psychiatric activity, while the Baltic and Southeast European countries exhibit elevated suicidal vulnerability in the context of limited medical resources. These results highlight the deep heterogeneity of psychiatric configurations in Europe and reveal persistent gaps between population needs and institutional response capacity. Conclusions: The analysis provides an empirical foundation for differentiated public policies aimed at prevention, early intervention, and stigma reduction. It also supports the case for institutionalizing a European mental health monitoring system based on harmonized indicators and common assessment standards. Overall, the findings clarify the underlying structure of mental health across the European Union and underscore the need for coherent, evidence-based strategies to reduce inequalities and strengthen system performance at the continental level. Full article

Background/Objectives: A caudal epidural steroid injection (CESI) is a widely used technique for managing low back and lower extremity pain due to its relative ease and safety. However, cephalic spread of the injectate may be limited by the long distance from the sacral hiatus and by increased intra-abdominal pressure caused using conventional abdominal pillows during prone positioning. This study aimed to investigate whether an eleven-bar cushion could facilitate higher cephalic spread of contrast medium during CESI compared to a conventional pillow. Methods: This retrospective study was approved by the Institutional Review Board (IRB number: AJOUIRB-DB-2025-103). Data from 76 patients, who underwent CESI between January 2023 and March 2024, were analyzed. Patients were divided into two groups the eleven-bar group (n = 38) using a pelvic eleven-bar cushion and the pillow group (n = 38) using a conventional pillow. Fluoroscopic images were reviewed to identify the highest vertebral level reached by the injectate and the number of nerve roots visualized. Visual analogue scale (VAS) scores before and one month after the procedure were also assessed. Statistical analyses included Mann–Whitney U tests, linear regression, and Poisson regression. Results: Baseline demographic characteristics were similar between groups. The cephalic spread of contrast medium was significantly higher in the eleven-bar group compared with the pillow group (median level L3/4 vs. L4/5, p = 0.0002). No significant differences were observed in the number of nerve roots reached or in the VAS score improvement between groups. Conclusions: The eleven-bar cushion facilitated greater cephalic spread of contrast medium during CESI compared with a conventional pillow. Although this technique did not affect nerve root distribution or pain reduction outcomes, it may represent a useful positioning strategy to enhance drug delivery to higher lumbar levels during caudal epidural injections. Full article