Search Results (32,695)

Small Intestinal Bacterial Overgrowth (SIBO) is characterized by an abnormal proliferation of bacteria in the small intestine, leading to gastrointestinal symptoms and nutritional deficiencies. Short Bowel Syndrome (SBS), resulting from extensive surgical resection of the small intestine, predisposes children to SIBO due to anatomical disruptions, motility dysfunction, parenteral nutrition dependence, and immune dysregulation. Clinical manifestations of SIBO in SBS include bloating, diarrhea, malabsorption, and failure to thrive, with severe cases leading to complications such as D-lactic acidosis. Diagnosis remains challenging, with breath testing being the most commonly used method despite limitations in accuracy, especially in SBS patients. Jejunal aspiration, the gold standard, presents limitations due to contamination risks, potential for sampling error, and a relatively low diagnostic yield. Management involves antibiotics like rifaximin and metronidazole, alongside strategies to address anatomical dysfunction, optimize nutrition, and prevent recurrence. Adjunctive therapies, including probiotics and dietary modifications, show promise but require further validation in children. Emerging treatments, such as glucagon-like peptide-2 (GLP-2) analogs, may enhance mucosal integrity and reduce SIBO risk. Given the chronic and recurrent nature of SIBO in SBS, a multidisciplinary approach is essential, integrating gastroenterological, surgical, and nutritional care to effectively manage the condition. Future research should focus on improving diagnostic methods, refining treatment protocols, and exploring targeted therapies to enhance outcomes and quality of life for affected children. Full article

Background: Although smart products improve older adults’ quality of life, their acceptance and usage of smart assistive devices remain relatively low, and the influencing factors remain unclear. Methods: This study takes canes, which are commonly used by older adults, as the research object. To explore older adults’ acceptance of smart canes and the influencing factors, we constructed an integrated framework based on the extended Technology Acceptance Model (TAM), which incorporates multiple variables: Perceived Usefulness (PU), Perceived Ease of Use (PEOU), Attitude (ATT), Social Influence (SI), Safety Trust (ST), Self-Efficacy (SE), and Behavioral Intention (BI). A questionnaire survey was conducted to collect 232 valid responses, and structural equation modeling (SEM) was employed for data analysis. Results: The results indicate that factors including PU, PEOU, and SI have significant impacts on older adults’ ATT towards using smart canes, their SE, and BI. Among these factors, ATT and SE play a mediating role between PU, PEOU, SI, and BI in using smart canes. Conclusions: The practical implications of the current results are discussed with the aim of providing empirical evidence for the development and application of smart assistive devices for older adults. Full article

Purpose: Post-stroke spasticity (PSS) substantially affects functional recovery and quality of life in stroke survivors. However, the current clinical assessment methods exhibit certain subjectivity and equipment limitations. Human pose estimation presents a promising alternative for objective and user-friendly spasticity assessment. Materials and Methods: A total of 20 stroke survivors with PSS underwent pendulum tests with smartphones from multiple angles to quantitatively assess knee muscle spasticity. Pose estimation was conducted using the AlphaPose and STCFormer algorithms, with simultaneous measurements using an electronic goniometer as a reference. Three pendulum parameters were evaluated: normalized relaxation index (P1), first maximum of oscillation (P2), and relaxation index at half swing (P3). Bland–Altman analyses were used to analyze the consistency between pose estimation and electronic goniometer measurements. Intraclass correlation coefficient (ICC) and Spearman’s correlation analyses were conducted to evaluate agreement and reliability between electronic goniometer measurements and clinical evaluation. Results: P1 demonstrated the highest consistency between pose estimation and electronic goniometer measurements, with the highest ICC values (0.931 for AlphaPose and 0.911–0.94 for STCFormer). P1 and P3 differentiated between affected and unaffected limbs (p < 0.01) and demonstrated significant negative correlations with Modified Ashworth Scale scores, particularly for knee extensors (P1: ρ = −0.747 for AlphaPose and −0.781 for STCFormer; p < 0.01). P2 demonstrated low consistency and differential performance across all analyses. Conclusions: Video-based human pose estimation, particularly using P1, offers a reliable and objective method for evaluating PSS, demonstrating strong agreement with electronic goniometer measurements. This approach is clinically feasible for evaluating spasticity. Full article

The present study explores the production of metallized titanomagnetite briquettes, with a view to addressing two key issues. Firstly, it seeks to address the growing shortage of high-quality iron-bearing raw materials. Secondly, it looks at how to meet the increasingly stringent environmental constraints. The conventional blast-furnace treatment of titanomagnetite is hindered by the formation of refractory Ti-rich slags. It is hereby proposed that a single-cycle briquetting process in conjunction with a thermal reduction route should be utilized. This approach enables precise regulation of the Fe/flux ratio. Experiments were conducted on a low-grade titanomagnetite concentrate (68.5% Fe) from the Pervouralsk deposit (Russia). Cylindrical briquettes (D 15–20 mm, h 8–10 mm) were subjected to a pressure of 300 MPa during the pressing process, with the utilization of diverse binders comprising rubber cement, CaO, graphite + water, and basic oxygen-furnace (BOF) slag + sodium silicate. Following an oxidative pre-heating process at 1300 °C for two hours, followed by a gas-based reduction process at 1050 °C for three hours, with a CO/N₂ ratio of 90/10, the products demonstrated an oxidation rate of 85–95% and a cold compression strength of 16–80 MPa. The highest observed strength (80 MPa) was obtained with a binder comprising CaO·MgO·2SiO₂ (diopside/merwinite), which forms a low-viscosity melt, fills 90% of pores and crystallizes as acicular Mg-SFCA-I during cooling. Conversely, the CaO·TiO₂ and FeO·TiO₂ + Fe₃C associations yield brittle structures and a maximum strength of 16 MPa. The optimum briquette (0.55% CaO, D/H = 20/10 mm) exhibited a 95.7% metallization degree, a compressive strength of 48.9 MPa, and dimensional changes within acceptable limits, thus fulfilling the requirements for electric arc furnace feedstock. Further research is required in the form of a full Life Cycle Assessment and pilot-scale testing. However, the results obtained thus far confirm that titanomagnetite briquettes with a binder consisting of CaO, MgO and SiO₂ are a promising alternative to pellets for low-carbon steelmaking. Full article

Mango (Mangifera indica L.) is one of the most important tropical fruits; however, its limited postharvest shelf life restricts its commercial distribution. This study aimed to assess the influence of edible coatings formulated with high-acyl gellan gum (HAG), low-acyl gellan gum (LAG), and their blends enriched with an aqueous extract of Scenedesmus spp. on the preservation of mango quality during postharvest storage. The film-forming solutions based on HAG, LAG, and their combination (HAG/LAG) were enriched with Scenedesmus spp. extract at two concentrations (1 and 2% w/v) and subsequently employed for coating whole mango fruits. The coated samples were analyzed throughout storage to assess their physicochemical and physiological quality attributes, including weight loss, soluble solids content, titratable acidity, color variation, malondialdehyde accumulation, antioxidant activity, respiration rate, ethylene production, and hydrogen peroxide content. The results showed that coated fruits exhibited reduced color changes, lower weight loss, and improved visual acceptability compared to controls. Coatings containing 2% Scenedesmus spp., particularly HAG-based formulations, significantly decreased malondialdehyde (MDA) and hydrogen peroxide (H₂O₂) accumulation, enhanced antioxidant capacity, and stabilized respiration rate and ethylene production, delaying ripening and senescence. These effects were associated with the oxygen barrier properties of gellan gum and the antioxidant compounds present in Scenedesmus spp. Overall, the findings highlight that HAG coatings enriched with Scenedesmus spp. represent a sustainable and efficient approach to extend shelf life and preserve the physicochemical and nutritional attributes of mangoes. Full article

Background/Objectives: The proportion of middle-aged and elderly people in the total population is increasing, and it is of utmost importance to monitor their quality of life (QoL), which largely depends on mobility, health and mental state, diet, nutritional status (especially overweight and obesity). The population in Croatia is among the leading in terms of the proportion of overweight and obese people, therefore the aim is to study QoL and determine which aspects can potentially be mitigated by public health actions. Methods: In accordance with the available data from the SHARE study (Survey on Health, Aging and Retirement in Europe), data were taken from the most recently published—9th wave conducted in 2021/2022. In this study, the Croatian population older than 50 years is represented by 4687 respondents. Health-related parameters were monitored (cardiovascular diseases, diabetes, mental health, handgrip strength (HGS) as a biomarker in older people and body mass index) and quality of life (self-assessed quality of life (CASP, self-assessed health SPH, physical activity) and dietary habits. A logistic regression model was used to link HGS as a biomarker in older people with quality of life and health parameters. Results: There is an undeniable decline in social and physical activity with age; the proportion of people engaged in vigorous physical activity decreased from 47% in the 51–64 age group to only 5.4% in people over 85 years of age, while physical inactivity increased from 3% to 37.7%. Chronic diseases, especially hypertension, accumulate with age, while self-rated health worsens with age, as does mental health (the proportion of depressed people (according to the EURO-D scale) increased significantly from 21.1% in the 51–64 age group to 54.1% in those over 85 years of age). Results of multinomial logistic regression showed that sports (in)activity was consistently associated with a lower likelihood of reduced handgrip strength (OR = 1.94 for low strength, p < 0.001). Conclusions: Sports activities and social engagement are crucial for maintaining good handgrip strength. Higher BMI, lower education and adverse psychological states are risk factors for a weaker handgrip. These findings highlight the need for an integrated public health approach that promotes physical activity, balanced nutrition and mental and social well-being in the older population. Full article

Background/Objectives: To evaluate the cost-effectiveness of β-blocker use in addition to standard care compared to standard care alone for women with triple-negative breast cancer (TNBC), with effectiveness measured by years of life lived (YLL), quality-adjusted life years (QALYs), and equal-value life years (evLYs) gained. Methods: A population cohort Markov model was developed to compare clinical and economic outcomes for TNBC treated with 1) lifelong β-blocker prescription initiated at diagnosis in addition to standard care versus 2) standard care alone. Life-table modelling was used to capture mortality over a lifetime horizon for the estimated eligible population of Australian women diagnosed with TNBC in 2022 (n = 767). Costs were derived from Australian healthcare perspective, and measured in Australian dollars (AUD) at 2022 prices with 5 percent annual discounting and AUD 28,000 willingness to pay threshold applied. Results: The model estimated 628 (95% CI 139, 1035) YLL, 526 (116, 865) QALYs, and 566 (125, 932) evLYs gained in the β-blocker group compared to standard care. The difference in health costs between β-blocker and standard care groups was AUD −935,116 (−2,365,417, 405,350). The β-blocker intervention was dominant over standard care in terms of both QALYs and evLYs gained. Conclusions: Preliminary modelling suggests that implementing β-blockers as an adjunct pharmacotherapy in the treatment of TNBC was more effective and less costly than current standard care. Further monitoring of long-term outcomes is recommended to validate the findings of observational and preclinical studies, and define the incidence, severity, and cost of β-blocker associated adverse events in cancer populations. Full article

This study optimized γ-aminobutyric acid (GABA) formation in Vietnamese fermented pork (nem chua) using a central composite design to tune salt, sugar, and monosodium glutamate (MSG) under co-inoculation with Lactiplantibacillus plantarum CP1.2 and Pediococcus acidilactici CP1.4. Fermentations proceeded at room temperature; pH, titratable acidity, GABA (colorimetry), formal nitrogen, ammoniacal nitrogen (indophenol blue), and microbial counts were measured, with a packaging comparison between polypropylene (PP) and polyethylene (PE). Response surface analysis (R² = 0.8897) predicted an optimum at 2.0% salt, ~15.9–16.0% sugar, and ~2.9–3.0% MSG, yielding 7.44 mg/g GABA. Validation at these conditions achieved higher GABA (8.32 ± 0.24 mg/g), with pH near 4.70 and lactic acid ~18.5 g/kg. Across seven storage days, GABA peaked at day 1 (8.72–8.84 mg/g) and declined to 4.74–5.07 mg/g (day 7) as acidity increased. PE tended to preserve GABA better and reduced aerobic counts relative to PP, whereas PP limited ammoniacal nitrogen later in storage; lactic acid bacteria remained abundant (≥9.4 log CFU/g). Sensory attributes (color, aroma, taste, firmness) decreased over time but were higher in PE. The results show that balanced seasoning ratios, starter cultures, and packaging can maximize GABA enrichment while maintaining safety and quality in nem chua, providing a practical basis for scale-up of GABA-enhanced fermented meat products and tailoring shelf-life with packaging. Full article

Apple purée is a processed food typically obtained from ground apples, where quality depends on colour, consistency, and shelf-life. Thermal treatments are commonly applied to adjust rheology and deactivate enzymes responsible for post-packaging deterioration. This study evaluated the effects of heating temperature (87–102 °C) and duration (6–17 min) on the physical and chemical properties of Golden Delicious apple purée. Three independent batches were processed to examine intra-varietal variability. Chemical analyses assessed enzyme activity and nutritional profile, while physical tests focused on rheology. Image analysis was employed to characterise colour and syneresis. Results showed that short-duration heating at higher temperatures (>100 °C, <12 min) achieved desirable rheological properties but intensified browning. No significant correlations were found between residual enzymatic activity, polyphenol content, antioxidant activity, and thermal treatment conditions. This suggests that changes in colour and texture are primarily related to the physical parameters of heating independently of the origin batch. In contrast, the batch had a significant impact on enzymatic and nutritional profiles, highlighting the need for strict monitoring of incoming fruit. Overall, the heating conditions influenced the visual and textural quality of the purée, while the variability in raw materials remained a significant factor affecting its biochemical characteristics. Full article

Background: Abdominal aortic aneurysm (AAA) is a multifactorial vascular disease with limited therapeutic options, as no pharmacological treatments currently exist to mitigate the progression of small AAAs. Quality of life (QoL) has emerged as a valuable supplementary metric for assessing the efficacy of pharmacological interventions. This study evaluated QoL scores of MetAAA trial patients on metformin therapy compared to those with placebo intake. Methods: Overall, 54 patients with AAA were included in the MetAAA trial (ClinicalTrials.gov-Identifier:NCT03507413) and randomized to either metformin or placebo treatment. All participants were asked to complete three established and validated (in total 659 longitudinally collected) QoL questionnaires: (1) the 36-Item Short Form Health Survey (SF-36), (2) the Aneurysm Symptom Rating Questionnaire (ASRQ), and (3) the Aneurysm-Dependent Quality of Life questionnaire (ADQoL). Results: A superior health-related QoL was found in metformin-treated AAA patients compared to enrolled AAA patients receiving a placebo. In detail, AAA patients undergoing metformin treatment showed a superior overall current QoL score (p = 0.038), general health perception (p = 0.013), improved physical functioning (p = 0.004), and increased energy/lower fatigue scores (p = 0.008). Furthermore, fewer limitations due to cognitive distress (p = 0.001) and lower limb function (p = 0.021) were detected. Other QoL subscales did not show statistical significance. Inflammatory blood parameters suggest that while systemic inflammation may have some impact on perceived QoL, the relationship is largely limited. Conclusions: In patients with small AAA, metformin led to a limited improvement in health-related QoL compared to a placebo. Full article

Background: Cesarean section (CS) frequently results in abdominal scarring, affecting recovery, aesthetics, and quality of life. Platelet-rich plasma (PRP), an autologous concentrate rich in growth factors, may enhance wound healing. This pilot trial assessed the effect of intraoperative PRP on CS scar outcomes. Methods: In this single-center, single-blind randomized controlled trial (February 2023–December 2024), 100 women undergoing elective CS were randomized to PRP treatment (n = 50) or standard care (n = 50). PRP, prepared from 20 mL autologous blood, was infiltrated into uterine incision margins and subcutaneously before skin closure. Scar healing was evaluated at day 7 and day 40 postpartum using the Patient and Observer Scar Assessment Scale (POSAS; physician and patient), Vancouver Scar Scale, Manchester Scar Scale, REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation) Scale, Visual Analog Scale (VAS), and Numeric Rating Scale (NRS). Mann–Whitney U tests and Cohen’s d effect sizes were calculated. Results: Follow-up was complete for all participants. On day 7, PRP-treated patients had lower mean scores across most scales (e.g., Vancouver: 1.74 ± 1.58 vs. 2.54 ± 2.30; p = 0.063). At day 40, improvements persisted, with POSAS Patient scores significantly lower in the PRP group (7.24 ± 1.81 vs. 8.00 ± 2.06; p = 0.029). Effect sizes were small-to-moderate (<0.5), suggesting underpowering. No adverse events occurred. Conclusions: PRP administration during CS showed favorable trends toward improved scar quality and reduced patient-reported discomfort, with statistical significance for POSAS Patient scores at 40 days. Larger, multicenter trials with extended follow-up are needed to confirm these findings. Full article

Chronic pain conditions are debilitating and have an enormous impact on quality of life, yet underlying biological mechanisms remain poorly understood, hindering the development of diagnostic tools and effective treatments. Emerging evidence suggests a role for immune dysfunction in chronic pain. Among the various forms of immune dysfunction, T cell exhaustion and senescence, well-characterized in cancer and chronic infections, remain largely unexplored in chronic pain research. At the same time, lifestyle factors such as sleep, stress, physical activity, and diet are increasingly recognized as modulators of both pain and immune function. This review explores the potential interplay between these behavioural factors, immune exhaustion/senescence, and chronic pain. Critical gaps in current knowledge are identified, and future directions are outlined to clarify immune dysfunction and the influence of lifestyle factors in chronic pain conditions. Full article

Background and Objectives: Spinal cord lesion is a severe disorder of the central nervous system, leading to partial or complete interruption of nerve impulse transmission between the brain and the periphery and causing severe neurological and functional deficits. Conventional rehabilitation offers limited outcomes, while robotic gait training (Lokomat^®) and Vojta Therapy have shown benefits individually. Evidence on their combined effect remains scarce. To evaluate the combined effect of Vojta Therapy and Lokomat-assisted gait training on motor recovery, functional independence, and quality of life in SCL patients. Materials and Methods: A retrospective clinical study was conducted on 205 patients with traumatic and non-traumatic SCL. Patients were allocated to four groups: (F)—conventional rehabilitation; (V)—conventional + Vojta; (L)—conventional + Lokomat; (VL)—conventional + Vojta + Lokomat. Assessments included the ASIA Impairment Scale (AIS), ASIA motor/sensory scores, spasticity (Modified Ashworth Scale, MAS), functional independence (Functional Independence Measure, FIM), and health-related quality of life (EQ-5D), performed at admission and discharge. Statistical analyses comprised paired t-tests, Wilcoxon signed-rank tests, chi-square tests, Kruskal–Wallis with Dunn’s post hoc corrections, and linear regression. Results: The most frequent lesion levels were C7 (21%) and L1 (20%). All groups showed improvement in FIM scores, with the greatest gains in the VL group (from 79.25 to 84.79, p < 0.05). Post hoc analysis confirmed significantly higher FIM outcomes in VL compared with L. Regression analysis identified the ASIA motor score as the strongest predictor of functional independence (β = 0.76, p < 0.001), with VL group membership adding +10.3 points (p = 0.004). EQ-5D indicated persistent deficits in mobility and self-care, especially in VL patients, consistent with higher lesion severity. Conclusions: Combining Vojta Therapy with Lokomat training provides additional functional benefits compared with Lokomat or Vojta alone. Multimodal individualized rehabilitation appears promising for patients with spinal cord lesions. Prospective randomized controlled trials with long-term follow-up are warranted. Full article

Background/Objectives: Interindividual variability in polyphenol metabolism may help explain the inconsistent effects of polyphenol intake on health outcomes. This study compared, for the first time, (i) polyphenol-related gut microbiota metabotypes (urolithins: UM0, UMA, UMB; equol: EP, ENP; lunularin: LP, LNP) and their clusters (MCs) in non-medicated premenopausal (Pre-M) and postmenopausal (Post-M) women and (ii) the impact of an 8-week intake of a polyphenol-rich plant extract mixture (PPs) on the quality of life (QoL) of Post-M. Methods: Polyphenol metabotypes were determined in urine via UPLC-QTOF-MS after a 3-day intake of PPs containing resveratrol, pomegranate (ellagitannins and ellagic acid), and red clover (isoflavones) in Pre-M (n = 120) and Post-M (n = 90) women. QoL was assessed with the short-form Cervantes Scale in a randomized, placebo-controlled crossover trial (8-week PPs vs. placebo), completed by 78 Post-M participants. Results: At baseline, Pre-M and Post-M women showed only minor differences in metabotype and MC distributions linked to menopausal status. MC3 (UMA+EP+LP) predominated in Pre-M, while MC7 (UMA+EP+LNP) was most frequent in Post-M. PPs intake in Post-M women led to modest shifts in metabotype and MC distributions toward Pre-M patterns. Quantitative metabolite production was comparable between groups, except for equol, which showed a median 2.8-fold increase after PPs intake in EP Post-M women. Clinically meaningful improvements (score reduction ≥ 6.7 points) in QoL were observed in the Psychic domain in EP women (28%, p = 0.039) and in the Menopause and Health domain, specifically in EP (24.1%, p = 0.004), MC3 (22.5%, p = 0.043), and MC4 (UMB+EP+LP; 41.3%, p = 0.022), were mainly driven by a reduction in hot flashes (p = 0.001). Conclusions: These findings support metabotyping as a tool to guide targeted dietary strategies and enhance QoL through precision health in Post-M women. Full article

Background/Objectives: Women who have genetic predisposition to breast cancer often opt for risk-reducing mastectomy with immediate reconstruction. Evaluating their satisfaction and quality of life is essential for guiding shared decision-making. Methods: This exploratory study assessed quality-of-life outcomes in two cohorts of patients undergoing bilateral prophylactic nipple-sparing mastectomy with immediate prepectoral implant-based reconstruction. Only patients without postoperative complications (necrosis, infection) were included. Each patient completed the BREAST-Q questionnaire both preoperatively (1–2 days before surgery) and postoperatively. Results: Postoperative BREAST-Q scores demonstrated significant improvement, with self-confidence increasing from 40.75 to 44.33, satisfaction with breast size and appearance from 50.42 to 58.50, and general esthetic/functional satisfaction from 26.92 to 33.17 (all p < 0.01). In contrast, physical comfort decreased from 48.00 to 32.42 (p < 0.001). Preoperative responses may have been influenced by anticipatory stress related to the imminent surgery and concern regarding the breast area to be operated. In contrast, postoperative results reflect psychological relief and satisfaction following a successful surgery, with no complications. Conclusions: Nipple-sparing mastectomy with immediate prepectoral reconstruction is associated with high patient-reported satisfaction and perceived improvements in quality of life, particularly regarding body image and emotional well-being. However, functional limitations such as reduced physical comfort should also be acknowledged. These findings further support evidence-based recommendations for prophylactic surgery in high-risk patients. Full article