Search Results (5,900)

Background/Objective: Intermittent fasting (IF) shows promise for metabolic and mental health benefits, but evidence in older adults remains limited. This study systematically evaluated the safety and effectiveness of IF in adults aged ≥60 years, comparing different protocols using network meta-analysis. Methods: Systematic review and network meta-analysis following Cochrane and PRISMA guidelines were conducted, producing a literature search until June 2025 across PubMed, Scopus, and ScienceDirect databases, with inclusion criteria comprising randomized controlled trials, clinical trials, and observational studies evaluating IF in adults ≥60 years. Network meta-analysis compared time-restricted eating (TRE), IF 5:2 method, Islamic Sunnah fasting (ISF), Healthy Living Diet and usual diet. The NMA was conducted exclusively using randomized controlled trials (RCTs; n = 7); pre–post trials and observational studies were included solely in the narrative systematic review component and did not contribute to any pooled NMA estimates. Observational data contributed exclusively to the narrative synthesis. Results: Thirty-one studies were included; seven RCTs were eligible for network meta-analysis. ISF and TRE 16:8 were most effective for weight (ISF: −2.36 kg; TRE 16:8: −1.92 kg) and BMI reduction (−0.81 and −1.01 kg/m²) without lean mass loss. Findings on cardiometabolic parameters, mental health, and cognitive function are based on the narrative synthesis of individual studies. Long-term structured IF was associated with improvements in standardized cognitive performance assessed via validated instruments. However, very restrictive eating windows (≤10 h) and prolonged fasting (>12.38 h) were associated with adverse outcomes, including lower cognitive scores and 58% increased cardiovascular mortality. Conclusions: TRE 16:8 and ISF showed the strongest comparative evidence for weight reduction in the RCT-based NMA, with acceptable short-term safety profiles in the included trials. In the narrative review, these protocols were associated with clinically meaningful improvements in body weight, metabolic markers, and blood pressure while generally preserving lean muscle mass in older adults. The cardiovascular mortality risk associated with very restrictive eating windows may emphasize the importance of moderate fasting approaches in this vulnerable population. Further long-term research is needed to confirm optimal protocols and identify at-risk subgroups. Full article

In Cambodia, farmers construct artificial household bat roosts to collect and sell guano as fertilizer. We investigated farming practices and attendant spillover risks using (1) surveys on guano production; (2) an estimation of bat population size and species present using carcasses, visual identification, and audio recordings; (3) surveys of guano-producing and neighboring households on water, sanitation, and hygiene practices; and (4) the testing of guano and household food, water, and surfaces for coronaviruses using RT-qPCR. Bat roosts are constructed using dried palm leaves with coconut tree and/or steel/concrete supports. Roosting areas ranged from 42 to 327 m², bat abundance varied from 0 to 11,187, guano production was between 5 and 120 kg/week, guano yields were from 0.15 to 0.4 kg/m²/week, and farmers earned USD ~100–200/household/month. Higher guano production in the peak (normally wet) season was associated with greater bat abundance (p = 0.016). The lesser Asiatic yellow house bat (Scotophilus kuhlii) was the only bat species identified. Roosts were <20 m from guano-producing households. Neighbors and households’ hygiene risks included not having handwashing stations and not covering food in storage/while drying. Coronaviruses (Alphacoronaviruses or Infectious Bronchitis Virus) were detected in 14.6%, 17.3%, 2.9%, 1.4%, and 0.0% of guano, urine, household surface, food, and water samples, respectively. While guano farming offers economic benefits, spillover risks exist. Safe guano collection and storage, handwashing, and food covering in guano-producing communities are necessary to mitigate spillover risks. Full article

The squat exercise is one of the most widely practiced globally, prompting an investigation into the interplay among dimensional (particularly body height, BH), kinematic, and kinetic metrics. The study involved physically active men (n = 18, age: 23.8 ± 5 years, BH: 177.3 ± 10 cm, body mass: 78.1 ± 9 kg, body mass index: 24.9 ± 2.3 kg/m², at least 6 months of squat training experience). They performed five squat repetitions (hands at midwaist) while being recorded with a Basler camera (100 Hz, sagittal plane) to estimate kinematic metrics (segmental inclination and joint angles at the lowest descending position), in synchronization with vertical ground reaction force and center of pressure recording (forceplate 1000 Hz, Kistler Type-9286AA, Bioware v. 5.5.1.0 software). Statistical analysis (SPSS 30.0, p ≤ 0.05) included one-way ANOVA to test the BH effect and allometric analysis to produce scaling exponents for the squat performance indices (Force, Leverage, and Stability Index) used to rank participants’ performance efficiency while neutralizing the influence of body size. The body-dimensional metrics differed significantly among the 3 BH groups, except for segmental proportions (p > 0.05). Apart from the more upright shank (about 6 degrees) in the Tall than in the Medium and Short BH groups (p < 0.05), no significant BH effect was observed in the kinematic and kinetic metrics (p > 0.05). Allometric scaling allowed us to rank participants’ performance across geometrically similar body sizes and underpinned the overall mechanical disadvantage of taller participants, as well as the role of the trunk-to-thigh body proportion in postural stability during squatting. Full article

To study the influence of polyoxymethylene (POM) fibers on the mechanical properties of shotcrete for tunnel support, this research conducted four-point bending tests on concrete with different POM fiber dosages (0, 5, 7, and 9 kg/m³) and lengths (30 mm, 36 mm, and 42 mm). The mechanical properties are analyzed in terms of failure modes, flexural strength, and the toughness index. The results show that, with the increase fiber length and dosage, the incorporation of POM fibers can enhance the toughness of concrete and significantly improve the flexural performance of shotcrete, with the peak flexural strength increasing by 15.31% to 89.46%. Additionally, through scanning electron microscopy (SEM) image analysis, the reinforcing mechanism of POM fibers is revealed: when shotcrete with POM fibers is subjected to flexural loading, it undergoes four stages: elastic, elastic–plastic, yield, and failure. The addition of POM fibers increases the density and uniformity of concrete, and the flexural strength is indirectly enhanced by increasing frictional energy dissipation through the formation of fiber–matrix interfaces between fibers and concrete. The research findings provide a theoretical basis and design reference for the application of POM fiber-reinforced shotcrete in tunnel support. Full article

Background: Neoadjuvant chemotherapy (NACT) response in breast cancer is primarily influenced by tumor biology; however, the independent role of host-related factors such as body mass index (BMI) remains unclear. This study evaluated clinicopathological predictors of a high Miller–Payne response after neoadjuvant chemotherapy in patients with stage II–III non-metastatic breast cancer, with particular focus on the role of body mass index. Methods: In this retrospective cohort study, 647 patients with stage II–III non-metastatic breast cancer treated with standard NACT between January 2010 and December 2020 at a single tertiary center were included. High pathological response was defined as Miller–Payne Grades 4–5. Clinical and tumor-related variables were analyzed, including age, menopausal status, body mass index, clinical stage, tumor grade, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, and Ki-67 proliferation index. Univariate and multivariable logistic regression analyses were performed to determine independent predictors of high pathological response. Results: A total of 647 patients were included (mean age: 49.18 ± 10.94 years; mean BMI: 28.45 ± 5.45 kg/m²), of whom 47.45% were postmenopausal. High Miller–Payne response (Grades 4–5) was observed in 40.96% of patients. High response was significantly associated with clinical stage (p = 0.034), tumor grade (p < 0.001), HER2 status (p < 0.001), ER status (p < 0.001), PR status (p < 0.001), and Ki-67 levels (p < 0.001). Median Ki-67 was higher in the high-response group (35.00% [IQR: 20.00–62.75] vs. 25.00% [IQR: 15.00–45.75], p < 0.001). No significant associations were observed for age (p = 0.299), BMI (p = 0.874), or menopausal status (p = 0.289). In multivariable analysis, HER2 positivity (adjusted OR = 3.71, 95% CI: 2.23–6.20, p < 0.001) and Ki-67 (adjusted OR = 1.01 per 1% increase, 95% CI: 1.00–1.02, p = 0.009) were independently associated with high response, whereas ER positivity (adjusted OR = 0.50, 95% CI: 0.25–0.98, p = 0.043) and postmenopausal status (adjusted OR = 0.37, 95% CI: 0.17–0.81, p = 0.013) were inversely associated. BMI was not independently associated with response (p = 0.964). Conclusions: Response to neoadjuvant chemotherapy appears to be mainly determined by tumor biology, particularly receptor status and proliferative activity, rather than anthropometric measures such as body mass index. Full article

Soil organic carbon (SOC) storage in forests is governed by complex interactions between site conditions and vegetation. This study quantifies SOC stocks across a gradient of Target Management Sets (TMS) in the Czech Republic (Central Europe) to evaluate the baseline storage capacity of distinct ecological sites and the modifying effects of dominant tree species, specifically Norway spruce and European beech. Utilizing large-scale spatial data, linear mixed-effects models, and piecewise structural equation modeling (pSEM), we analyzed SOC stratification across middle (≈400–600 m a.s.l.) and higher (≈600–800 m a.s.l.) elevational zones. The results indicate that while overall SOC stocks inherently increase with elevation due to climatic constraints, tree species dictate the vertical carbon distribution within the soil profile. Specifically, conifers (i.e., Norway spruce and Scots pine) accumulate SOC primarily in the organic layer, whereas broadleaves (mainly European beech and oak) translocate and stabilize carbon in deeper mineral horizons. The pSEM analysis revealed that beech functions as a ‘calcium pump’, increasing topsoil pH and driving calcium-mediated SOC stabilization in mineral soils. This mechanism is highly effective at middle elevations but partially overridden by abiotic limits at higher elevations. We conclude that inherent site conditions (TMS) determine total SOC capacity, whereas tree species management controls SOC stability. Although no significant differences were observed in total SOC stocks between conifers and broadleaves at the same sites (medians of total SOC ranged from approx. 5 to 16 kg·m⁻², depending on the site), converting purely coniferous stands into broadleaves represents an effective strategy for long-term mineral SOC stabilization, particularly in middle-elevation sites. Full article

Conventional wiped-film molecular distillers(WFMDs) often show limited hydrodynamic renewal and mixing when processing high-viscosity materials because of liquid pooling and weak secondary flow. This study investigates a novel grooved scraper design for a wiped-film molecular distiller handling an ethylene glycol/glycerol mixture (42.0 mol% ethylene glycol; density 1196.0 kg/m³; dynamic viscosity 0.222 Pa·s), used here as a representative high-viscosity, heat-sensitive system. Three-dimensional multiphase CFD simulations were performed to examine the combined effects of groove width (2.0–10.0 mm) and scraper tip angle (30–75°) on flow behavior. The results show that a groove width of 7.0 mm increases vorticity gain by 9% and wall shear stress gain by 20% relative to the inline scraper baseline. The grooved geometry generates periodic shear disturbances, promotes radial secondary flow, and strengthens turbulent mixing. A balance between radial mixing enhancement and axial transport continuity is required. Among the tested angles, a tip included angle of 45° produces the highest average vorticity magnitude and more coherent vortex structures. These findings clarify the hydrodynamic regulation mechanism of scraper micro-geometry and support its use as a process-intensification strategy for distiller parameter selection. Full article

Introduction: Intermittent fasting (IF) is becoming increasingly popular as a method of weight management, but it is unknown whether it affects plasticiser intake with resultant changes in glycaemic control in diabetes and vitamin D (VitD) levels; therefore, this study was undertaken in a cohort of control and type-2 diabetic (T2D) subjects during Ramadan time-restricted feeding (TRF). Methods: In T2D subjects (n = 19) and controls (n = 31) undertaking TRF, 24 h urinary levels of phthalate metabolites, bisphenols and serum VitD were determined pre- and post-TRF by liquid chromatography–tandem mass spectrometry (LC-MS/MS). Anthropometric data and glycosylated haemoglobin (HbA1c) were measured. Results: T2D subjects were older (52 versus 36.73 years, p < 0.001), and had higher BMI (36.54 versus 27.67 kg/m², p < 0.001), body weight (101.77 versus 80.36 kg, p < 0.001), and HbA1c (8.38 versus 5.46%, p < 0.001) compared to controls, while VitD levels did not differ (60.43 versus 63.95 nmol/L, p > 0.05). Post-TRF, HbA1c was unchanged in T2D subjects and there was no difference in weight, BMI or VitD. Increased mono-iso-butyl phthalate (MiBP) in T2D subjects (10 versus 6.1 ng/mL, p = 0.001) and mono-n-butyl phthalate (MnBP) in T2D subjects (37 versus 13 ng/mL, p = 0.018) and controls (8.3 versus 5.4 ng/mL, p = 0.007) were observed post-TRF; however, significance was lost after adjusting for baseline differences in age, BMI, and HbA1c using a general linear model (GLM) repeated-measures ANOVA. Despite having no median differences in DEHP (di-2-ethylhexyl phthalate) metabolites pre- and post-TRF, analyses revealed a significant time × HbA1c interaction for [mono(2-ethyl-5-carboxypentyl) phthalate, MECPP: F(1,42) = 4.79, p = 0.03, mono(2-ethyl-5-hydroxyhexyl) phthalate, MEHHP: F(1,42) = 8.56, p = 0.006, mono(2-ethylhexyl) phthalate, MEHP: F(1,42) = 4.64, p = 0.03 and mono(2-ethyl-5-oxohexyl) phthalate, MEOHP: F(1,42) = 8.19, p = 0.007] and time × group interactions [MEHHP: F(1,42) = 14.27, p < 0.001, MEHP: F(1,42) = 6.35, p = 0.01 and MEOHP: F(1,42) = 10.30, p = 0.003]. Estimated marginal means (adjusted for age, BMI, HbA1c, and VitD) further confirmed higher concentrations of DEHP metabolites [MECPP, MEHHP, MEHP, and MEOHP] in T2D participants over time compared with controls. Additionally, monomethyl phthalate (MMP) trajectories were significantly influenced by the time × group interaction (F(1,42) = 4.28, p = 0.04), with post-TRF elevations observed in T2D subjects. Vitamin D status was observed to modify MCPP and MEP trajectories over time. Conclusion: Ramadan TRF is associated with changes in plasticiser metabolite levels, with estimated increased levels in T2D subjects versus healthy controls. Metabolite levels were influenced by HbA1c and vitamin D, though BMI was not observed to be a contributing factor. Full article

Background: Body mass index (BMI) is widely used as a proxy of nutritional status and related lifestyle risk patterns in public health, yet it does not capture body composition–related heterogeneity in cardiometabolic risk. Evidence on whether a more detailed body composition assessment improves population-level screening efficiency remains inconsistent, particularly in Central European populations. Methods: We conducted a cross-sectional analysis of 868 Hungarian adults participating in a nationwide mobile screening program. Locally weighted regression identified sex-specific BMI inflection points for cardiometabolic risk. Stratified receiver operating characteristic (ROC) analyses compared BMI with bioelectrical impedance-derived parameters across five outcomes. Cost- and time-effectiveness of scalable screening strategies were modeled at the population level. Results: Cardiometabolic risk increased at BMI levels below current WHO thresholds (females: 21.8–22.3 kg/m²; males: 23.8–24.3 kg/m²). Overall, body composition parameters did not outperform BMI in the full population. Subgroup-specific differences were observed, particularly among men with BMI 24–36 kg/m² for atherosclerosis risk, suggesting limited and outcome-specific added value rather than broad superiority over BMI. Together, non-linear risk patterns, stratified performance, and population-level modeling converged on mid-range BMI intervals (females: 22–30 kg/m²; males: 24–30 kg/m²) as likely screening windows of phenotypic heterogeneity. Within these ranges, targeted InBody assessment may help refine risk assessment for selected individuals. A mixed screening strategy covering 52% of the population would cost 178.4% of BMI-only screening, while reducing throughput by 24.3%. Conclusions: Population-specific BMI thresholds may more accurately reflect early deviations in nutritional and cardiometabolic risk than current universal cutoffs. BMI remains a useful first-line marker, and body composition assessment may add complementary information in selected BMI ranges. Overall, these findings support a potentially useful, subgroup-specific screening approach, but the modeled cost and time trade-offs should be considered hypothesis-generating and require further validation. Full article

To solve quartz sand shortage and poor mechanical properties of fly ash-based autoclaved aerated concrete (AAC) in traditional production, this study prepared AAC blocks using Yellow River sediment as the main siliceous raw material, combined with slag, quicklime and other additives. Seven sample groups (S1–S7) with different mix proportions were designed by adjusting the water-to-material ratio and replacing some raw materials with quartz sand or fly ash. The results showed that as the water-to-material ratio increased (S1–S4), AAC slurry fluidity improved, but foaming rate and expansion volume showed a non-monotonic trend. With the same water-to-material ratio, the S5 sample had lower bulk density (695 kg/m³) and moderate but favorable strength (4.25 MPa). Microscopic analysis revealed AAC strength mainly derived from tobermorite and C-S-H gel, and xonotlite enhanced structural stability. This study provides a feasible method for resource utilization of Yellow River sediment in AAC production, with environmental and engineering value. Full article

Background/Objectives: Obesity in young adults is a major public health concern and a key contributor to cardiometabolic risk. Vitamin K2 (VK2) has been proposed as a potential adjuvant therapy; however, evidence from randomized controlled trials remains limited. This study evaluated the effect of VK2 supplementation on cardiometabolic risk factors in young adults with overweight or obesity. Methods: In this 12-week randomized, double-blind, placebo-controlled trial (NCT05995522), men and women aged 18–35 years with overweight or obesity (BMI 25–40 kg/m²) were assigned to receive VK2 (menaquinone-4, 100 µg/day) or placebo. Both groups received standardized nutritional counseling. Body composition, blood pressure, glucose homeostasis, lipid profile, and vitamin K-dependent proteins were assessed at baseline and post-intervention. Between-group differences were analyzed using ANCOVA adjusted for baseline values. Results: Forty-six participants completed the study (placebo n = 24; VK2 n = 22). VK2 supplementation significantly reduced total cholesterol (−10.64 mg/dL, p = 0.038) and LDL cholesterol (−6.12 mg/dL, p = 0.005) compared with placebo. A reduction in systolic blood pressure showed a trend toward significance (−5.56 mm Hg, p = 0.067). No significant effects were observed on body composition, glucose metabolism, or vitamin K-dependent proteins. Conclusions: VK2 supplementation resulted in improvements in total and LDL cholesterol levels, with no significant changes in vitamin K-dependent proteins, and may represent a safe and potentially beneficial adjunct to nutritional strategies aimed at early cardiometabolic risk modulation. Full article

Objectives: The primary aim of this study was to compare the acute effects of two stretching techniques—static stretching (SST) and proprioceptive neuromuscular facilitation (PNF)—on functional outcomes related to postural balance (stabilographic parameters) and ankle range of motion (ROM; active and passive measures). Furthermore, the study aimed to assess the association between changes in balance- and ROM-related parameters. Methods: The study sample consisted of 24 young adults in the age range of 21–24. The SS group (n = 12) mean body height was 174.3 ± 7.8 [cm], body weight 68.0 ± 13.1 [kg], and BMI 22.2 ± 2.8 [kg/m²]. The PNF group’s (n = 12) mean body height was 173.7 ± 7.3 [cm], body weight 68.6 ± 13.5 [kg], and BMI 22.5 ± 3.0 [kg/m²]. The subjects performed static stretching or proprioceptive neuromuscular facilitation stretching involving the tibialis anterior, gastrocnemius, and soleus muscles. Before and immediately after the intervention, the active and passive range of plantar and dorsal flexion of the foot and the stability of the body posture in the anterior–posterior plane were measured based on the analysis of the center of pressure (COP) sway. Results: The results of the mixed model ANOVA (intervention × time) showed no statistically significant effect of the intervention or interaction between intervention and time for ROM and COP measurements. In both cases, a statistically significant time effect was found. After intervention, significant differences were found in COP variability (p = 0.02), COP range (p = 0.03), fractal dimension (p = 0.04), and sample entropy (p = 0.01). Similarly, for range of motion, differences were observed in passive dorsiflexion (p < 0.01), active plantarflexion (p < 0.01), and passive plantarflexion (p = 0.01). Pearson’s correlation analysis did not reveal significant associations between changes in ankle range of motion and COP variables. Conclusions: The results of this study indicate that both static and PNF stretching acutely increase the range of motion in the ankle joint; however, they also lead to a decrease in postural stability under more challenging conditions involving visual or vestibular deprivation. The magnitude of the range of motion changes was not associated with alterations in stabilographic parameters. Full article

Background: Asymptomatic structural joint abnormalities are prevalent among athletes, yet studies on their multi-joint distribution and comparisons with low-activity controls remain lacking. This article evaluated the prevalence and characteristics of asymptomatic structural abnormalities across joints in collegiate athletes compared with controls using 3.0-T MRI. Methods: The cross-sectional study enrolled 53 asymptomatic elite collegiate athletes (high physical activity, HPA) and 84 healthy volunteers (low physical activity, LPA) aged 18–25 years. All participants were asymptomatic with no history of joint trauma or surgery. Generalized estimating equation (GEE) logistic regression was employed to identify independent risk factors for joint abnormalities after evaluation. Results: A total of 666 joints were analyzed. Participants with at least one joint abnormality were significantly more common in the HPA group than LPA group (49.1% vs. 6.0%, p < 0.001). At the joint level, overall abnormality prevalence was 13.5% versus 2.2%, respectively. In the HPA group, knee joints were the most frequently affected (24.2%), predominantly involving meniscal lesions. Shoulder pathologies consisted exclusively of supraspinatus tendon lesions (6.8%), while ankle abnormalities were primarily bone marrow edema (5.9%). GEE analysis identified high physical activity (adjusted OR = 5.23; 95% CI: 1.55–17.71; p = 0.008) and elevated BMI (adjusted OR = 1.09 per kg/m²; 95% CI: 1.03–1.15; p = 0.001) as independent risk factors. Conclusions: Asymptomatic abnormalities are highly prevalent and demonstrate intra-individual clustering across multiple joints. MRI-based surveillance represents a promising strategy for early risk identification and injury prevention. Full article

Background/Objectives: In the last decade, the prevalence of metabolic-associated fatty liver disease (17–46%) and non-alcoholic fatty pancreas disease (NAFPD) (16–33%) has increased due to their association with obesity, both predictors of early atherosclerosis and metabolic risk. Computed tomography (CT) has been proposed as a diagnostic method. Currently, the factors associated with NAFPD have not been fully described. The aim of this study is to describe the prevalence and association of NAFPD and liver steatosis in patients with very high cardiovascular risk. Methods: A retrospective evaluation was conducted on the medical records of patients classified as very high cardiovascular risk who had undergone a CT scan. NAFPD was determined by the difference in pancreatic and splenic attenuation (−1.9), while liver steatosis was identified by hepatic attenuation <40. Bivariate and multivariate analyses were performed to determine the independent factors associated with NAFPD. Results: 169 medical records were collected; 68.6% (n = 116) were men, with a median age of 70 [IQR 61–78] years and 25.8 [IQR 23.7–28.7] kg/m² of body mass index. According to the CT scans, 80.5% (n = 136) presented NAFPD, 24.3% (n = 41) had liver steatosis, and 21.3% (n = 36) had both. In the multivariate analysis, liver steatosis, abnormal levels of aspartate aminotransferase, and being overweight were independent factors associated with NAFPD. Conclusions: In a very high cardiovascular-risk population, the prevalence of NAFPD is high, and it is independently associated with the presence of liver steatosis. Full article

Background and Objectives: Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed metabolic and bariatric surgeries worldwide. Marginal ulcers (MU) are a common complication following RYGB, yet their pathophysiology and the contributing risk factors to their development are not fully understood. Materials and Methods: This retrospective cohort study examined patients who underwent RYGB between January 2008 and December 2023, with 1 to 5 years of follow-up. Data collected included patient- and procedure-related risk factors, as well as postoperative MU events. Statistical analysis methods included the independent samples t-tests, multivariate regression, and Cox regression analyses. Results: Our final cohort included 2106 patients and was predominantly female (80.5%), with a mean age of 47.8 ± 12.1 years and body mass index (BMI) of 45.5 ± 7.5 kg/m². MU occurred in 241 (11.4%) patients, with a mean time to occurrence of 4.5 ± 0.02 years. History of smoking (HR = 1.87, p < 0.001) and gastroesophageal reflux disease (HR = 2.36, p < 0.001) significantly increased hazard for MU, while proton pump inhibitor use (HR = 0.18, p < 0.001) was associated with reduced hazard. Aspirin exposure, regardless of dose and chronicity, did not impact MU. Conclusions: Our findings highlight the importance of preoperative assessment and counseling in patients planning to undergo RYGB. Patient-related factors should guide postoperative monitoring and prophylaxis of MU, as this remains a debated topic amongst experts. Full article