Search Results (135)

This review examines the current state of development and application of artificial intelligence (AI) tools for monitoring nutrition and physical activity in individuals with obesity, with a focus on the physiological complexity of energy balance and the role of chrono-nutrition. Energy intake and expenditure are dynamically coupled and circadian-regulated: meal timing and movement patterns influence insulin sensitivity, thermogenesis, and Non-Exercise Activity Thermogenesis within the same day. Traditional monitoring methods suffer from recall bias and low granularity, while isolated sensors operate in data silos, limiting accuracy. Effective solutions require multimodal, continuous, and temporally aligned data streams. Current AI models exhibit critical limitations in obesity-specific contexts: inaccurate gait and energy expenditure estimates due to biomechanical differences, dietary models underestimating glycemic variability, poor performance on mixed dishes, sauces, and culturally diverse foods, and a lack of validation against gold standards such as doubly labelled water (DLW) and weighed food records. This review proposes a paradigm shift toward obesity-specific AI design, including enriched datasets and multimodal integration. Physical activity monitoring faces similar challenges: systematic measurement bias in wearables, sensor placement issues, and algorithms trained on normal-weight cohorts. In the GLP-1/GIP era, if transparency, ethical safeguards, and equitable access are ensured, AI will act as a catalyst for personalized care, remote monitoring, trial optimization, and next-generation drug discovery. In conclusion, the integration of AI with rigorous validation procedures and inclusive sampling strategies is essential to achieve reliable, fair, and clinically relevant monitoring approaches for obesity management. Full article

We report a versatile, CMOS-compatible fabrication module for sub-100 nm TiN and TaN pillar electrodes, a key building block for sandwich-type test structures. As a demonstration, the electrodes were integrated into carbon nanotube-based nonvolatile random-access memory (CRAM) test structures. High-resolution hydrogen silsesquioxane (HSQ) masks defined by electron beam lithography were transferred into TiN films using optimized Ar/Cl₂ inductively coupled plasma reactive ion etching. Optical emission spectroscopy was used for real-time endpoint detection, ensuring precise etch control. The process achieved a TiN-to-HSQ selectivity of ~1.6 and reproducible nanoscale features with smooth sidewalls and an average taper angle of ~77°. Buffered hydrogen fluoride treatment effectively removed residual HSQ, revealing sharp TiN features and preserving pillar geometry. Atomic force microscopy (AFM) confirmed pillar height and profile fidelity, while conductive AFM verified electrical conductivity after planarization. The module was further demonstrated through the fabrication of TiN pillar arrays, TaN pillars, and sub-100 nm TiN line arrays. A CRAM test structure incorporating TiN pillars exhibited preliminary switching, indicating that both the test structure and fabrication process are feasible. This fabrication module provides a reproducible platform for nanoscale TiN and TaN electrodes, supporting laboratory-scale research and providing a pathway toward future integration of emerging memory and nanoelectronic technologies. Full article

Background: Adapted Physical Activity (APA) prescription is a complex decision-making process that integrates clinical guidelines and individual patient characteristics and remains strongly dependent on clinician experience. Generative artificial intelligence (AI) has recently emerged as a potential decision-support tool in exercise prescription; however, its interaction with professional expertise is still unclear. This study compared the perceived quality of APA protocols developed by expert professionals, novice professionals supported by AI, and AI operating autonomously across multiple orthopedic conditions. Methods: In this observational cross-sectional study, five real orthopedic prescriptions (scoliosis, low back pain, osteoporosis, high risk of falls, and osteoarthritis) were used to generate three APA protocols per condition: expert professional (EP), novice professional with AI support (NAI), and AI alone. All protocols were created using an identical standardized prompt and anonymized. A multidisciplinary panel of 135 professionals blindly evaluated the protocols using a structured questionnaire assessing effectiveness, safety, appropriateness, clarity, and progression. Overall quality scores were compared using Friedman tests with post hoc Wilcoxon signed-rank tests. Results: Across all conditions, EP protocols achieved the highest quality scores, followed by NAI, while AI-alone protocols consistently received the lowest ratings (all p < 0.05). NAI protocols showed intermediate performance, partially reducing the expertise gap. Post hoc analyses showed that EP protocols received significantly higher rating than AI protocols in all conditions (p < 0.01). NAI protocols received significantly higher rating than AI protocols in most conditions (p < 0.01) except osteoporosis (p = 0.362). Differences between EP and AI were most pronounced for safety (p < 0.01), appropriateness (tailoring p < 0.01), and progression (p < 0.05), whereas EP–NAI differences were smaller and condition-dependent. AI-alone protocols showed greater variability across pathologies. Conclusions: Professional expertise remains the main determinant of APA protocol quality. AI support can improve protocol structure and perceived quality when used by novice professionals but does not replace expert clinical reasoning. AI-generated protocols without human oversight are not yet suitable for autonomous APA prescription, supporting a complementary, expertise-dependent role of AI in exercise programming. Full article

As a key constituent of lignocellulosic biomass, the role of hemicellulose in anaerobic digestion (AD) remains inadequately characterized, particularly regarding its methane potential and degradation process patterns. This study systematically characterized the AD performance of hemicellulose using xylan as a representative substrate. The results showed that xylan achieved a high methane potential of 350–390 mL/g VS and 89.57% biodegradability, exhibiting a shorter lag phase (λ) and higher reaction rate (k) than other biomass fractions. Substantial acetic acid and ethanol accumulated within the first 24 h, while late-stage dissolved organic matter (DOM) shifted toward complex lignin/CRAM-like. The results of microbial dynamics indicated that the collaborative interaction among Anaerobium, Lactobacillus, and Clostridium accelerated xylan transformation. While methanogenesis was predominantly driven by the acetoclastic route (specifically Methanosarcina), hydrogenotrophic Methanobacterium thrived during temporary pH fluctuations. This work serves as a valuable guide for developing high-performance strategies in industrial lignocellulosic biogas plants. Full article

Low back pain (LBP) remains a leading cause of disability worldwide, imposing substantial socioeconomic burdens. Among its many causes, facetogenic pain accounts for a significant proportion of cases and is generally attributed to irritation of the richly innervated facet joint capsule, mediated by the medial branches of the dorsal rami. This narrative, hypothesis-driven review synthesises the current anatomical, biomechanical, neurophysiological, and clinical literature and advances a conceptual framework proposing a novel anatomical mechanism that may contribute to LBP. We hypothesise that ossification of the mamillo-accessory ligament (MAL) may be a plausible but under-recognised anatomical variant that may influence lumbar biomechanics and neural interfaces. The MAL connects the mammillary and accessory processes of lumbar vertebrae, serving as a stabilising anchor for deep paraspinal muscles and forming a conduit for the medial branch of the dorsal ramus (MBDR). Ossification of the MAL, resulting in a mamillo-accessory foramen, may theoretically impair spinal biomechanics via three principal mechanistic domains: (1) disruption of muscle attachment and segmental stabilisation, (2) potential compression of the MBDR causing denervation and muscle atrophy, and (3) chronic nerve entrapment leading to asymmetrical postural adaptations and persistent pain. Collectively, these pathways may contribute to spinal instability, facet degeneration, and variable response to standard interventional treatments such as radiofrequency ablation. Recognition of MAL ossification may have potential implications for clinical assessment, targeted imaging strategies, and treatment stratification in patients with chronic, non-specific LBP. Full article

In recent years, the food processing industry in the Gulf Cooperation Council (GCC) has faced increasing pressures to improve operational efficiency while improving its environmental performance. This research examines whether Lean Six Sigma (LSS) methodologies can be used as tools to incorporate sustainability into current operational processes at a date processing facility in Saudi Arabia. In addition to illustrating the ways in which production was improved, this research developed and preliminarily validated a Sustainability Integration Index (SII) framework to measure the contributions of improvement projects to sustainable practices in terms of their impact on the environment, society, and economy. Furthermore, this research examined the role of organizational culture as a moderator of the effectiveness of integrated LSS–sustainability approaches using a Cultural Readiness Assessment Model (CRAM). This research addressed production bottlenecks and aligned production with selected United Nation Sustainable Development Goals (SDGs) using the Define–Measure–Analyze–Improve–Control (DMAIC) methodology. Production bottlenecked in packaging operations resulted in schedule overruns and excessive overtime; therefore, the intervention focused on improving the production process in these areas. There were three distinct improvement streams: demand-based resource leveling, advanced production planning to allow for pull-based flow, and targeted maintenance to raise Overall Equipment Effectiveness (OEE) from 48.2% to 74.6%. Results indicated a 23% increase in daily processing capacity, a 38 min decrease in the average length of time of production closures, and estimated annual cost savings of 940,000 SAR (approximately USD 250,000). The SII framework showed a 21.2% improvement in sustainability scores, with a total composite score improvement from 0.66 to 0.80. Social sustainability had the greatest relative increase (+24.2%). Exploratory correlation analysis found that improvements in cultural maturity and cross-functional collaboration are possible predictors of successful sustainability integration; however, the limitations of the single case study limit the ability to draw causal inferences. The results provide both empirical evidence and possible measurement tools to an under-explored area: the use of LSS in Middle Eastern food processing industries with specific sustainability goals. Validation of the frameworks across different industries will be necessary to establish generalizability. Full article

Background: Cryptococcal meningitis (CM) remains a leading cause of mortality among people with advanced HIV disease (AHD) in sub-Saharan Africa. Current guidelines recommend induction therapy with amphotericin B and flucytosine, typically administered in an inpatient setting due to concerns over severe clinical presentation and drug-related toxicities. This requirement poses a significant burden on resource-limited health systems. We evaluated the real-world outcomes of a fully outpatient model for CM therapy in Maputo, Mozambique. Methods: A longitudinal retrospective cohort study was conducted at the Centro de Referência de Alto-Maé (CRAM), a specialized AHD outpatient clinic. We included 83 PLWH with laboratory-confirmed CM treated between October 2020 and December 2024. The primary outcome was hospitalization-free survival (HFS) within the first 10 weeks of treatment. Secondary outcomes included the frequency and severity of adverse drug reactions (ADRs), analysed by tracking haemoglobin (Hgb), potassium (K+), and creatinine (Creat) levels on days 1, 3, and 7 of induction therapy, and retention in care (RIC) at 6, 12, and 24 months. Statistical analyses included Kaplan–Meier survival estimates and paired t-tests. Results: The median age was 37 years (IQR: 27–42), 63.9% were male, and the median CD4 count was 62 cells/µL (IQR: 27–105). Most patients (95.2%) were symptomatic at presentation, and 56.6% had concurrent tuberculosis. For the 52 patients who completed the full induction protocol at CRAM, the HFS rate at 10 weeks was 84.6% (44/52), with an overall survival of 90.4% (47/52). ADR analysis (n = 52) showed a predictable pattern of mild, manageable toxicity: a significant decline in Hgb (11.2 ± 1.8 to 10.6 ± 2.0 g/dL, p < 0.001) and K+ (4.27 ± 0.66 to 3.86 ± 0.78 mmol/L, p = 0.008), and a transient increase in Creat (0.83 ± 0.42 to 1.13 ± 0.64 mg/dL, p = 0.001) from day 1 to day 3, with stabilization or a trend toward recovery by day 7. No significant differences in ADRs were found between single-dose (47%) and multiple-dose (53%) L-AmB regimens. RIC for the entire cohort (n = 83) was high at 81.9% at 6 months, declining to 74.0% at 12 months and 70.4% at 24 months. Conclusions: An ambulatory model for CM therapy is feasible and effective in a resource-limited setting, demonstrating high hospitalization-free survival, manageable and reversible adverse drug reactions, and excellent medium-term retention in care. These findings suggest potential benefits and provide support for re-evaluating the standard of inpatient care. They indicate that integrating outpatient CM management into advanced HIV disease (AHD) care packages could help alleviate health system burdens and may contribute to improved patient outcomes. Full article

Background: Brace adherence is a key determinant of treatment success in adolescents with idiopathic scoliosis. However, adherence is influenced by multiple clinical, psychological, and social factors, and reported wear times vary widely across studies. This systematic review and meta-analysis aimed to identify determinants of brace adherence and assess their quantitative impact on real wear. Methods: A comprehensive search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, and Google Scholar from database inception to November 2025. A total of 1040 records were identified, 620 were screened, and 45 full-text articles were assessed for eligibility. In total, 17 studies met the inclusion criteria and were included in the qualitative synthesis, and 10 provided extractable quantitative data and were included in the meta-analysis. A random-effects model was used to calculate pooled mean differences for identified determinants, including sex, age, early adherence, and sensor-based monitoring. Results: In total, 17 studies involving 1716 adolescents were included, and 10 provided extractable quantitative data for meta-analysis. Objective sensor-based monitoring was consistently associated with higher adherence, with a pooled mean difference of 25.6 percent compared with non-sensor methods. Early adherence significantly predicted long-term compliance, with a mean difference of 9.6 percent. Younger adolescents demonstrated greater adherence than older patients, with a mean difference of 19.1 percent, while sex differences favored females but did not reach statistical significance. Psychosocial determinants such as body image perception, stress, family dynamics, and religious environment played an important role in modulating adherence. Higher body mass index (BMI) and reduced quality of life were associated with poorer compliance. Overall, studies evaluating positive determinants reported a pooled mean adherence of 89.6 percent compared with 67.7 percent in studies characterized by negative determinants. Conclusions: Brace adherence is determined by a combination of clinical and psychosocial factors. Sensor-based monitoring, strong early adherence, and supportive environments consistently enhance compliance, whereas stress, poor body image, and higher BMI hinder wear. Targeted interventions, early counseling, and standardized adherence metrics are needed to improve outcomes in brace-treated scoliosis. Full article

Background/Objectives: Software is now core infrastructure in biomedical science, yet fragmented workflows across subfields hinder reproducibility and delay the translation of data into actionable decisions. There is a critical need for a cross-disciplinary synthesis to bridge these silos and establish a unified framework for software maturity. This narrative review addresses this gap by synthesizing representative software ecosystems across three major pillars: bioinformatics, molecular modeling/simulations, and epidemiology/public health. Methods: A narrative review of articles indexed in PubMed/NCBI, Web of Science, and Scopus between 2000 and 2025 was conducted. Domain-specific terms related to bioinformatics, molecular modeling, docking, molecular dynamics, epidemiology, public health, and workflow management were combined with software- and algorithm-focused keywords. Studies describing, validating, or applying documented tools with biomedical relevance were included. Results: Across domains, mature data standards and reference resources (e.g., FASTQ, BAM/CRAM, VCF, mzML), widely adopted platforms (e.g., BLAST+ (v2.16.0, NCBI, Bethesda, MD, USA), Bioconductor (v3.20, Bioconductor Foundation, Seattle, WA, USA), AutoDock Vina (v1.2.5, Scripps Research, La Jolla, CA, USA), GROMACS (v2024.3, GROMACS Team, Stockholm, Sweden), Epi Info (v7.2.6, CDC, Atlanta, GA, USA), QGIS (v3.40, QGIS.org, Gossau, Switzerland), and increasing use of workflow engines were identified. Software pipelines routinely transform molecular and surveillance data into interpretable features supporting hypothesis generation. Conclusions: Integrated, standards-based, and validated software pipelines can shorten the path from measurement to decision in biomedicine and public health. Future progress depends on reproducibility practices, benchmarking, user-centered design, portable implementations, and responsible deployment of machine learning. Full article

Dissolved organic matter (DOM) in salt lake brines comprises organic compounds dissolved in high-salinity aquatic systems. With complex composition and diverse sources, DOM significantly influences biogeochemical cycles, mineral formation, and resource development in salt lakes. However, few studies have investigated the characteristics and sources of DOM in salt lake brines. In this study, a DOM sample (YC-4) from brine of Shanxi Yuncheng Salt Lake was isolated and characterized using FT-ICR-MS, nuclear magnetic resonance spectroscopy, three-dimensional fluorescence spectroscopy, and parallel factor analysis. The results demonstrate that YC-4 DOM exhibits rich chemical diversity, primarily composed of lignin/CRAM-like compounds (54.26%), tannins (16.75%) and proteins (13.43%). The predominant carbon forms in YC-4 DOM were aliphatic C-O bonded compounds (33.74%), aliphatic compounds (24.31%), and carboxylic acid compounds (23.95%). YC-4 DOM consists of five fluorescent components: marine-like humic substances, two types of humic-like substances, fulvic-like substances, and one protein-like substance. The fluorescence signature, characterized by high fluorescence index (FI 1.99), low humification index (HIX 0.66), and high biological index (BIX 1.27), collectively indicates that the DOM in Yuncheng Salt Lake brine is predominantly autochthonous, weakly humified, and highly bioavailable. This study reveals the DOM feature within the “human–environment coupled system” of Yuncheng Salt Lake. The findings provide a scientific basis for the sustainable utilization of its brine DOM resources and further enrich the theoretical system of DOM biogeochemical cycle in high-salinity lake system. Full article

Ten years have already passed since we made this journal available to the academic community, I must say that after all the results we have achieved in these ten years, I was not wrong to launch and found this journal and for this I thank the Founder and Chairman of the MDPI Board, for believing in me and granting me this important mission and trust [...] Full article

The broader adoption of crumb rubber asphalt mixtures (CRAM) as sustainable pavement materials is currently limited by two key technical barriers. Firstly, there is a lack of standardized methods to evaluate mixing uniformity. Secondly, the material’s tendency for elastic recovery after compaction remains problematic. These barriers ultimately hinder the realization of CRAM’s full potential in vibration reduction, noise abatement, and resource recycling. To improve the performance evaluation system of CRAM and promote its development in engineering applications. Based on the distribution characteristics of crumb rubber in asphalt mixtures, this study established a crumb rubber distribution area moment model. It proposed a coefficient of area–distance variation to evaluate the mixing uniformity of CRAM. Through compaction tests and orthogonal tests, the effects of mixing process, mixing time, mixing temperature, compaction temperature, compaction times, and compaction method on the mixing uniformity and performance of CRAM are systematically investigated. The results show that, compared with specimens prepared by single compaction and compaction after high-temperature curing, CRAM specimens prepared by secondary compaction exhibit superior mechanical performance. The 24 h elastic recovery rate of these specimens is reduced to 24% of that in single-compacted specimens. The mixing process and mixing time have a significant impact on the mixing uniformity of CRAM. Pre-mixing crumb rubber with aggregates or extending the mixing time can improve the CRAM mixing uniformity by 45% and 18%, respectively. The mixing and compaction temperatures primarily affect the bulk density and Marshall stability of the specimens. When the mixing and compaction temperatures are 180 °C and 170 °C, respectively, the bulk density and Marshall stability of the molded specimens reach their maximum values. Through orthogonal analysis, the optimal mixing method for CRAM is determined as follows: mix aggregates and crumb rubber at 180 °C for 40 s, then add asphalt and continue mixing for another 80 s. The optimal process for secondary compaction is as follows: the first compaction at 170 °C, compacting each side 47 times, and the second compaction at 80 °C, compacting each side 23 times. Full article

This study compared the effects of core (CTG) or mobility training (MTG) on basketball-specific skills in youth players, focusing on dynamic balance. Both training modalities have a recognized role in enhancing performance, but few studies have examined their impact on this population. Thirty-one young (age 14.71 ± 2.27 years) males were assigned to an 8-week CTG or MTG. Overhead Squat, Y-Balance Test, Agility T-Test, Sit-and-Reach, Functional Hop Tests, and the Balance Error Scoring System were assessed before (pre) and after (post) the intervention for both dominant (D) and non-dominant (ND) limbs. Both groups improved the postero-lateral direction of the Y-Balance Test for the D (CTG, MD [95% CIs] = −8.108 [−15.620, −0.595], p = 0.035; MTG, MD [95% CIs] = −15.234 [−23.512, −6.956], p = 0.024) and ND (CTG, MD [95% CIs] = −9.110 [−16.150, −2.070], p = 0.013; MTG MD [95% CIs] = −13.899 [−21.657, −6.141], p = 0.001) limb and the medial reach for D (CTG, MD [95% CIs] = −17.279 [−26.364, −8.194], p = 0.001; MTG, MD [95% CIs] = −22.050 [−32.061, −12.039], p = 0.03) and ND (CTG, MD [95% CIs] = −9.309 [−17.093, −1.526], p = 0.021; MTG, MD [95% CIs] = −13.614 [−22.190, −5.037], p = 0.003), the Overhead Squat Test (CTG, MD [95% CIs] = −3.059 [−3.797, −2.321], p = 0.001; MTG, MD [95% CIs] = −3.643 [−4.456, −2.830], p = 0.001), and Agility T-Test (CTG, MD [95% CIs] = 0.572 [0.072, 1.073], p = 0.026; MTG, MD [95% CIs] = 0.696 [0.145, 1.248], p = 0.024) skills. Only CTG showed a significant improvement (MD [95% CIs] = −8.294 [−16.162, −0.426], p = 0.04) in single-leg hop performance for the ND limb. No significant improvements were observed in static balance or flexibility. No time × group effect was found. Both interventions improved key basketball-specific motor abilities and could be added to the basketball training session without adverse effect. Full article

Orexin is a neuropeptide produced in the hypothalamus that plays a key role in regulating slee—wake cycles, energy metabolism, feeding behavior, and physical activity. It exists in two forms, orexin-A and orexin-B, which bind to G protein-coupled receptors OX₁R and OX₂R with differing affinities. Orexin signaling is widespread in the brain and extends to peripheral tissues, including adipose tissue. Its involvement in hypothalamic and extrahypothalamic circuits suggests a broad role in homeostatic regulation. Dysfunctions in the orexinergic system are implicated in neurodegenerative diseases such as Alzheimer’s, Parkinson’s, and multiple sclerosis, particularly through mechanisms involving sleep disturbances and neuroinflammation. This study examines how orexin influences neural circuits related to arousal, motivation, and motor control. It also explores how physical activity stimulates orexin release, enhancing neuroplasticity and cognitive resilience. In addition, orexin’s role in reward-related feeding, genetic susceptibility to obesity, and brown adipose tissue thermogenesis is discussed. Overall, the orexinergic system represents a vital neurochemical link between physical activity, metabolism, and cognitive health. Although many of its mechanisms remain to be clarified, its central role in integrating energy balance and behavioral responses makes it a promising target for future therapeutic strategies. Full article