Search Results (1,113)

Background: Dysphagia and malnutrition are common among head and neck squamous cell carcinoma (HNSCC) patients. Evidence and guidelines emphasize treatment and prevention of these conditions before surgery. In this context, multimodal prehabilitation (MP) is an essential part of a holistic treatment approach. However, the specific components and their relative importance remain debated. This study aimed to evaluate the impact of nutritional, logopedic and psychological MP. Methods: Adult HNSCC patients who completed the German version of the Functional Assessment of Cancer Therapy—Head and Neck (FACT-H&N) quality-of-life (QOL) questionnaire after undergoing curative resection and reconstructive surgery were included in this cross-sectional study. Clinical data on psychological, logopedic and nutritional MP and possible confounders was collected. To evaluate the nutritional status, bodyweight loss, the body mass index (BMI) and the Graz Malnutrition Screening (GMS) score were recorded. We determined the length of stay (LOS), the QOL, the Clavien–Dindo type III and IV complication rate (CR) as the outcome parameters for MP. Results: In total, 102 patients were included. Of those, 68 were male, while the other 34 were female. The mean age was 59.82 ± 12.27 years. The average GMS was 3.11 ± 1.45. Simultaneously, 62.75% of patients were at risk or malnourished. Malnutrition was significantly associated with adverse outcomes in the univariate, but only with decreased QOL in the multivariate model. On the other hand, MP was significantly associated with reduced LOS and improved QOL. These findings remained robust even after adjustment for possible confounders. Neither had a significant effect on the CR. Conclusions: Our findings suggest that malnutrition is a potential risk factor for adverse outcomes in curative HNSCC therapy. The GMS is a sensitive tool for identifying patients at risk of malnutrition in HNSCC surgery prehabilitation. Our multimodal protocol was associated with improved postoperative outcomes following curative surgical resection and free flap reconstruction. The observed associations may reflect potential synergistic interactions within the multimodal framework. Full article

Large-scale smart city Internet of Things (IoT) infrastructures must simultaneously provide strong cybersecurity protection, real-time anomaly detection, and energy-efficient operation despite the strict resource limitations of sensing devices. The current body of research typically addresses secure data management, edge intelligence, or energy optimization in isolation, leaving a practical gap in unified frameworks that jointly optimize these objectives. This paper proposes a jointly co-designed energy-aware cybersecurity framework that integrates lightweight secure sensing, hybrid edge-based anomaly detection, Practical Byzantine Fault Tolerance (PBFT)-enabled blockchain integrity, and Grey Wolf Optimization (GWO)-driven edge deployment within a single end-to-end architecture. The practical contribution of the proposed framework lies in enabling tamper-evident trusted sensing, real-time detection of both data and energy anomalies, and communication-efficient operation suitable for scalable smart city deployments. The simulation results demonstrate that the proposed method achieves strong operational efficiency, reaching up to 234.6 transactions per second while maintaining end-to-end latency of approximately 140–194 ms and reducing total energy consumption to about 1.68 J under high-load conditions. In addition, the hybrid anomaly detection mechanism achieves an F1-score of 0.985 and ROC-AUC of 0.992, confirming strong detection capability under realistic sensing and attack scenarios. Full article

Overweight and obesity are prevalent among companion dogs and cats in the Western world. Affected animals are at risk of comorbidities and reduced longevity. This narrative review found that veterinary literature generally characterises overweight and obesity as nutritional disorders that are primarily addressed by reducing caloric intake. However, veterinary management of overweight and obesity has limited success outside research settings. The Five Domains model for animal welfare assessment is applied to explore impacts of overweight and obesity and their management in dogs and cats by focusing on nutrition, health, physical environment, behavioural interactions and mental state. A second focus is on the practical strategies for addressing non-diet-related barriers and client communication through the provision of management recommendations. This novel and integrative approach aims to inform veterinarians and improve the success of weight management protocols. Full article

Background/Objectives: Poor diet quality is common among young Saudi adults, characterised by high fast-food intake and low fruit and vegetable consumption. This study investigated the association between diet quality and lifestyle factors using a validated short Healthy Eating Index (sHEI). Methods: This study adopted a cross-sectional design, gathering responses through a self-completed online questionnaire. Demographic data were collected. Diet quality was assessed using the Arabic version of the sHEI, physical activity was evaluated with the Arabic short form of the International Physical Activity Questionnaire (IPAQ), and sleep quality was measured using the Athens Insomnia Scale (AIS). Saudi residents aged 18–25 years were eligible; pregnant or lactating individuals and those with chronic conditions affecting dietary intake were excluded. Results: Among 478 participants (mean age 21.1 ± 1.9 years), 88.1% were female, 24.7% were overweight or obese, and half reported poor diet quality. Moderation scores were slightly higher (54.2% high), whereas adequacy scores were nearly equal (49.8% high and 50.2% low). Most participants reported low physical-activity levels (78.5%) and poor sleep quality (55.2%). Sleep quality was significantly associated with all diet quality measures, increasing the odds of good total sHEI (OR = 1.74, p = 0.003), adequacy (OR = 1.49, p = 0.034), and moderation (OR = 1.54, p = 0.021). Conclusions: Sleep quality is significantly associated with diet quality among young Saudi adults. While body mass index and physical activity showed no significant associations, improving sleep quality may promote healthier dietary behaviours. Future studies should explore pathways linking sleep and diet. Full article

Using alternative energy sources for animal feed, such as hybrid corn varieties rather than genetically modified ones, is important. Therefore, the objective of this work was to assess the effects of supplementation at the end of gestation with Mexican Puma hybrid corn grain on productive and behavioral parameters in sheep. Twenty Columbia multiparous ewes were used; along with their diet, they were provided 600 g/animal/day of cracked corn during the last 20 days of pregnancy and the first week of lactation. The animals were divided into two groups: one fed commercial cracked corn (n = 11) and the other Mexican Tlaoli Puma hybrid cracked corn (n = 9). The productive parameters evaluated in the mother were: body weight, body condition score (BCS), feed intake, weight change, glucose, and ketone body levels, as well as the estimated quality of milk using Brix refractometer values on days 15 and 30 of lactation. In lambs, their rectal and external temperature was measured 2 h after birth, while their weight was measured 2 h after birth and every week until week 6 postpartum. Behavioral parameters were measured in the first two hours postpartum, including the maternal latency of cleaning the offspring, duration of the first cleaning episode, the lamb’s latencies of standing and nursing, and vocalizations in mother and lamb. Weight, BCS and weight change were not affected by the group but were affected by time; these parameters increased at the end of gestation and decreased significantly after delivery (p < 0.05). Ketone body levels were not affected by group or time (p > 0.05) and remained at low values. Glucose levels were not affected by the group but were affected by time; they increased significantly after birth (p < 0.05). Feed intake was similar in both groups (p > 0.05) and decreased as parturition approached (p < 0.05). The estimated milk quality was not affected by the group, nor by the time (p > 0.05). Mothers in both groups began cleaning their offspring within the first three minutes after giving birth and emitted a similar frequency of vocalizations (p > 0.05). However, mothers in the commercial maize group had a longer cleaning episode than those in the hybrid maize group (p < 0.05). The lambs in both groups stood up within the first half hour of birth, suckled before one hour after birth and emitted a similar number of vocalizations (p > 0.05). Temperatures and lamb weight were similar in both groups (p > 0.05); however, lamb weight increased as they aged (p < 0.05). It is concluded that supplementing sheep at the end of gestation with Puma hybrid Mexican corn grain can yield similar productive and behavioral benefits as supplementing with commercial grain. Full article

Corydalus cornutus hellgrammites are known to inhabit riffles, but information is scarce regarding their habitat relationships at the plot scale and in the northern part of their range in the United States. We investigated the relationship of C. cornutus hellgrammite occurrence, density, and body size with environmental variables at the 1 m² plot scale within central Ohio riffles. We collected hellgrammites and measured hydrological, substrate, large instream wood, and canopy cover variables in nine riffles in 2023 and ten riffles in 2024. Occurrence and density were best predicted by water velocity and grain size score, while none of the measured variables were a good predictor of head capsule width. Occurrence and density increased with increasing water velocity, grain size score, and substrate richness. Density also increased with increases in edge-interior scores. Head capsule width increased with increasing distances to the nearest plot with hellgrammites. Our results suggest that C. cornutus hellgrammites can serve as an indicator species because their occurrence and density reflect the water velocity and substrate conditions within riffles in the Midwestern United States. Full article

Accurate and scalable body condition scoring (BCS) is important for health monitoring and productivity management in precision livestock farming. However, manual scoring is subjective, labor-intensive, and difficult to standardize, while many automated methods are too computationally demanding for edge deployment in real farm environments. This study proposes EdgeBCS-YOLO, a lightweight object detection framework for real-time beef cattle BCS in unstructured farming scenarios. Built on YOLO11n, it combines Position-Sensitive Feature Fusion (PSFF), a Texture-Aware Star Module (TASM), an Efficient Grouped Detection Head (EGDH), and a Focal and Global Knowledge Distillation (FGD)-based distillation strategy. On a dynamic blurring dataset, EdgeBCS-YOLO achieved 90.8% precision, 82.7% recall, and 88.9% mAP@50. On the NVIDIA Jetson Orin NX Super, it achieved a model size of 3.95 MB, a system FPS of 33.35, and an average inference latency of 13.26 ms. These results suggest that it is a practical and potentially efficient solution for automated BCS on edge devices. Full article

Postural sway derived from center-of-pressure (CoP) trajectories is widely used to assess balance and fall risk in older adults, but conventional linear metrics mainly quantify sway magnitude and may overlook temporal organization. Guided by the loss-of-complexity hypothesis, we re-examined associations between fall history and linear and non-linear CoP metrics in an open-access dataset. Quiet-standing trials under eyes-open and eyes-closed conditions were analyzed in adults ≥60 years (fallers n = 19; non-fallers n = 57). To reduce confounding, propensity score matching was performed using age, sex, body mass index, activities of daily living level, illness status, number of medications, disability status, and orthosis/prosthesis use. Linear and non-linear indices, including recurrence quantification analysis, detrended fluctuation analysis, fractal dimension, multiscale entropy, stabilogram diffusion analysis, and sway density measures, were examined. After matching, no CoP metric differed significantly between groups. However, SHAP-based exploratory analysis suggested that non-linear features related to temporal structure and multiscale organization contributed more prominently to model output than conventional magnitude-based metrics. Given the limited sample size, these findings should be interpreted as exploratory and hypothesis-generating. Full article

Background: Work-related musculoskeletal disorders (WMSDs) are prevalent among orthopaedic surgeons as a result of prolonged exposure to non-neutral postures and forceful manual tasks during surgery. Although working height is a key determinant of trunk and upper-limb posture, the systematic evaluation of ergonomic working-height recommendations in orthopaedic surgery remains limited. Methods: A simulated left total knee arthroplasty (TKA) was divided into twelve critical surgical steps and analysed across four commonly used surgeon positions (A–D). Two conditions were compared: uncorrected working height (N) and working height corrected according to Canadian Centre for Occupational Health and Safety (CCOHS) recommendations (C). Joint angles were measured from standardized photographs using Kinovea software, and postural load was quantified with the Rapid Entire Body Assessment (REBA) method. Two trained evaluators conducted three independent assessments, yielding 288 REBA scores. Results: Mean REBA scores decreased across all surgeon positions following ergonomic correction, with statistically significant reductions observed in positions A, B, and D. When pooled across all position–step combinations (n = 48), the mean reduction was 0.92 REBA points (95% CI 0.50–1.33; p < 0.001). Notably, 27 of the 48 position–step comparisons exceeded the minimal detectable change threshold. The largest reductions occurred during force-intensive surgical steps, including bone cutting, drilling, and implant impaction. Conclusions: Adjusting working height in accordance with CCOHS ergonomic recommendations reduces surgeons’ postural load during TKA. These findings support the integration of evidence-based ergonomic adjustments into routine orthopaedic surgical practice. Full article

Windsurfing (WS) and kitesurfing (KS) share the same environment but differ in biomechanics and equipment demands. This cross-sectional study compared physical performance between WS and KS athletes. Twenty-five male recreational athletes participated (WS n = 13, age 27.7 ± 7.0 years; KS n = 12, age 29.0 ± 7.5 years). Body composition, isometric strength (handgrip and back-and-leg dynamometer), dynamic balance (Y-Balance Test: YBT), functional movement quality (FMS), and drop-jump performance (ground contact time, reactive strength index, jump height, take-off time) were assessed. Groups were compared using the Mann–Whitney U test (p < 0.05), and Cliff’s δ was calculated for significant outcomes. Participant characteristics were similar, although surfing experience was greater in WS. KS showed higher leg strength (p = 0.041; δ = 0.481) with no difference in handgrip strength. KS also demonstrated higher FMS shoulder mobility (p = 0.022; δ = 0.532) and total FMS score (p = 0.014; δ = 0.577). No between-group differences were found for YBT metrics or drop-jump variables (p > 0.05). These findings indicate that KS athletes exhibit greater isometric pulling strength and movement proficiency, whereas balance and reactive jump performance are comparable, supporting discipline-specific conditioning priorities. Full article

Musculoskeletal disorders (MSDs) among orthopaedic surgeons are associated with sustained, constrained postures during demanding intraoperative tasks. Total hip arthroplasty (THA) comprises sequential steps that may impose different postural loads on both the surgeon and assistant, yet team-level ergonomic design interventions remain underexplored. This study compared ergonomic risk during primary THA performed through the direct lateral (modified Hardinge) and posterolateral (Moore) approaches and assessed a simple workflow redesign: swapping surgeon and assistant positions during acetabular cup preparation (bottom reaming, perimeter reaming, and cup impaction). In a controlled Sawbones-based simulation using standard THA instruments, eight standardised surgical steps were recorded with 360° photographs. Forty-two postural instances (22 for the surgeon, 20 for the assistant) were analysed. Joint angles were measured with Kinovea and converted to Rapid Entire Body Assessment (REBA) scores; intra- and inter-rater reliability (ICC) and minimum detectable change (MDC95) were calculated. Surgeon REBA scores were in the medium-risk range and slightly lower with the posterolateral approach (mean 5.5) than with the direct lateral approach (mean 5.88), whereas assistant scores were in the low-risk range (means 3.43 and 3.29, respectively). The position-swap intervention successfully lowered the surgeon’s REBA action level, most notably during cup impaction, where ergonomic risk dropped from 10 (high risk) to 4 (medium risk) in the posterolateral approach, and from 7 (medium risk) to 3 (low risk) in the direct lateral approach, without increasing assistant risk. These findings provide controlled simulation-based evidence that this simple, zero-cost positional change can reduce the surgeon’s ergonomic action level during THA, although confirmation under real operative conditions is needed before broad generalization. Full article

This study aimed to evaluate the potential of Lonicera japonica Flos (LJF) as an alternative agent against Eimeria tenella (E. tenella) in chickens and to conduct phytochemical analysis to obtain compositional insights. Seventy-two one-day-old chickens were allocated to six groups and fed diets supplemented with LJF powder (LJFp) at three concentrations (LJFp-L, LJFp-M, and LJFp-H) or maduramicin (MDM) or two non-supplemented control diets, namely, an infected unmedicated control (IUC) and an uninfected unmedicated control (UUC). Dietary treatments were initiated at chick arrival (Day 0) and continued for 28 days. At 21 days of age, all groups except the UUC group were orally challenged with a field isolate of E. tenella (PT-Te003; 2.0 × 10⁴ oocysts/bird). Anticoccidial efficacy was assessed using the lesion score (LS), oocysts per gram of feces (OPG), relative body weight gain (rBWG), and anticoccidial index (ACI). The results demonstrated that all LJFp treatment groups had significantly reduced cecal OPG and LS (all LJFp treatments: p < 0.05 vs. IUC), indicating the effective suppression of E. tenella replication and intestinal damage. Regarding growth performance, the rBWG values of the LJFp-L and LJFp-M groups were the highest and comparable to those of the UUC group, showing no significant differences. In contrast, the LJFp-H and MDM groups exhibited significantly lower values (p < 0.05). Based on ACI evaluation, all LJFp-treated groups exhibited moderate to partial efficacy (LJFp-L > LJFp-M > LJFp-H), while MDM showed limited effectiveness. A gas chromatography–mass spectrometry (GC-MS) analysis of the LJFp ethanol extract revealed 15 essential oils, 10 organic acids, and three other compound classes, several of which have been associated with anticoccidial activity. Overall, the in vivo results suggest that LJF may exert potential anticoccidial effects against a field isolate of E. tenella. Phytochemical analysis provided preliminary compositional insights, and further studies are warranted to optimize extraction methods and evaluate efficacy at lower concentrations under additional in vitro and in vivo conditions. However, the current evidence remains insufficient to determine whether the field isolate exhibits reduced sensitivity to commercially available anticoccidial drugs, and additional studies are needed to clarify this issue. Full article

Background/Objectives: Periodontitis and diabetes mellitus (DM) are chronic inflammatory conditions that share common biological mechanisms, including systemic inflammation and insulin resistance. Adipokines are considered key mediators in this interrelationship; however, the roles of many adipokines remain unclear. Apelin and asprosin are relatively novel adipokines that have not yet been sufficiently investigated in dentistry. Therefore, this study aimed to evaluate salivary apelin and asprosin levels in periodontally healthy individuals, patients with periodontitis, and patients with periodontitis + DM and to investigate their associations with clinical periodontal parameters. Methods: A total of 90 individuals were included in the study, comprising 30 periodontally healthy subjects, 30 with periodontitis, and 30 with periodontitis and DM. Clinical periodontal indices and body mass index (BMI) were measured for each participant. Unstimulated saliva was collected from each participant, and apelin and asprosin concentrations were analyzed using an enzyme-linked immunosorbent assay (ELISA). The normality of continuous variables was examined with the Shapiro–Wilk test. For non-normally distributed data, non-parametric procedures such as the Mann–Whitney U and Kruskal–Wallis tests were applied. Comparisons of categorical variables between groups were performed using Pearson’s chi-square or the Fisher–Freeman–Halton test. Associations between continuous parameters were assessed through Spearman’s rank correlation analysis. A significance threshold of 5% (p < 0.05) was adopted for all statistical evaluations. Results: No significant intergroup differences were detected for age, gender, or BMI. The healthy group exhibited significantly lower plaque index (PI), gingival index (GI), and probing depth (PD) scores compared with both periodontitis groups, and these differences reached statistical significance (p < 0.001).The median salivary apelin level in the periodontitis + DM group was significantly reduced relative to the healthy group (p = 0.009). However, salivary asprosin concentrations did not differ significantly among the groups (p = 0.053). Spearman’s correlation analysis revealed positive correlations between asprosin and PD and clinical attachment loss (CAL), whereas apelin showed negative correlations with these parameters. Conclusions: Salivary apelin may serve as a potential biomarker for distinguishing healthy individuals from those with diabetic periodontitis. The opposing correlation patterns indicate that apelin and asprosin may be differentially related to periodontal tissue breakdown. However, further longitudinal and mechanistic studies are required to clarify the biological significance of these associations. Full article

Background/Objective: Health is a multidimensional construct shaped not only by clinical conditions but also by psychological, social, environmental and cultural factors. In low- and middle-income countries undergoing rapid epidemiological transition, understanding health requires integrated and culturally informed approaches. However, quality of life, perceived health status and lifestyle behaviors are often investigated separately, limiting the interpretation of well-being in specific local contexts. This study aimed to provide an integrated assessment of quality of life, perceived health status and lifestyle behaviours among adults attending a peri-urban public hospital in Kenya, using internationally validated instruments applied within a specific local cultural context. Methods: A cross-sectional observational study was conducted at Tigoni Level 4 Hospital, Kiambu County, Kenya. Adult outpatients (N = 40) were consecutively recruited. Quality of life was assessed using the WHOQOL-BREF, perceived health status using the EQ-5D-5L and EQ-VAS, and lifestyle behaviours using selected modules of the WHO STEPS instrument. Descriptive statistics were performed, and exploratory associations were examined using Spearman’s rank correlation coefficient. Results: Participants had a mean age of 35.9 ± 11.4 years, with a balanced gender distribution. Lifestyle risk factors were prevalent, including insufficient physical activity (40%) and overweight or obesity (>50%). WHOQOL-BREF scores revealed a heterogeneous profile, with relatively preserved social relationships and lower scores in the psychological and environmental domains. Pain/discomfort and anxiety/depression were the most frequently reported EQ-5D-5L problems. The mean EQ-VAS score was 68.2 ± 15.7. Perceived health was positively associated with physical and psychological quality of life, while higher body mass index was associated with lower physical quality of life. Mental health emerged as a cross-cutting factor across instruments. Conclusions: The findings highlight the multidimensional nature of health in a peri-urban Kenyan context and suggest the importance of considering local social and cultural influences when interpreting standardized health measures. Mental health and environmental conditions play a central role in shaping quality of life and perceived health, while lifestyle risk factors are already prevalent in a relatively young outpatient population. Integrating standardized health measures within a cross-cultural framework may support more holistic and person-centred approaches in primary care and public health in similar settings. Full article

A cross-sectional study was carried out on small-scale dairy farms in Paraíba State, Brazil, to evaluate the prevalence and anatomical distribution of integument injuries in grazing dairy cows. Twelve herds (n = 12) were assessed, recording herd size, milk yield, and daily hours of pasture access. The integument of five body regions (back/shoulder/neck, carpus, flank/side/udder, tarsus, and hindquarters) was scored for hairless spots, lesions, and swellings (0 = absent; 1 = present). Among 335 cows observed, 267 (81.5%) presented at least one injury. The most frequent conditions were hairless patches on the hock (65.4 ± 5.03%), lesions on the flank/side/udder (34.5 ± 1.46%), and swelling in the back/shoulder/neck region (52.9 ± 5.86%). Cluster analysis revealed distinct patterns of integument injuries among cows. The high prevalence of integument injuries indicates that even in grazing systems, welfare concerns persist. Neck swelling and hairless spots on the hock were the most common problems, emphasizing the need for improved management and environmental practices to enhance welfare outcomes. These findings have practical implications for welfare assessment and management strategies in tropical grazing dairy systems. Full article