Search Results (6,341)

Background: Breast cancer survivors often experience long-term endocrine- and chemotherapy-related side effects, including sleep disorders, anxiety, and depression. Sleep disorders are particularly prevalent and affect patient adherence and quality of life. This study examined the prevalence and risk factors for sleep disorders in patients with breast cancer based on treatment exposure. Methods: Patients with breast cancer (2009–2015) were identified from the Health Insurance Review and Assessment database. They were categorized by chemotherapy exposure and further by endocrine or taxane use. Sleep disorders, anxiety, and depression were assessed using diagnostic and prescription codes. Propensity score matching and Cox proportional hazard models were applied to adjust confounders and evaluate risk factors. Results: Among the 62,714 patients, those receiving endocrine therapy had a higher risk of sleep disorders (hazard ratio [HR], 1.276; 95% confidence interval [CI], 1.087–1.497; p = 0.003), irrespective of tamoxifen or aromatase inhibitor use. In chemotherapy-treated patients, taxane exposure significantly increased sleep disorder risk (HR, 1.268; 95% CI, 1.159–1.389; p < 0.001). The cumulative incidence of sleep disorders peaked within two years post treatment and remained elevated over time. Anxiety and depression rates did not differ significantly between the treatment groups. Conclusions: Endocrine therapy and taxane chemotherapy are independent risk factors for sleep disorders in patients with breast cancer. Screening and interventions are essential for improving long-term well-being. Future studies should explore personalized approaches for managing treatment-related sleep disturbance. Full article

People living with and beyond cancer often face ongoing challenges related to nutrition, wellbeing, and long-term health. Many individuals express a need for evidence-based, tailored dietary support, yet practical approaches to sustaining healthy eating behaviours remain limited. Culinary nutrition interventions, which integrate nutrition education with hands-on culinary skills, may help address these needs; however, their effects have not been systematically synthesised. This systematic review evaluates the impact of culinary nutrition interventions, delivered alone or in combination with physical activity or mental health components, on dietary intake, psychosocial and health-related outcomes, anthropometric measures, clinical and metabolic markers, and feasibility among individuals living with or beyond cancer. Following PRISMA guidelines, 18 studies were identified across PubMed, Scopus, EMBASE, CINAHL, and Web of Science (last searched in April 2025) and narratively synthesised. A total of 1173 participants were included, with sample sizes ranging from 4 to 190 participants per intervention. Interventions were well received and rated as highly acceptable, with strong engagement and minimal adverse effects. Across studies, statistically significant improvements were reported in dietary intake (7/13 studies), quality of life (4/5), mental health (5/6), self-efficacy (2/3), symptom management (3/4), self-reported cognitive health (1/1), food-related behaviours (2/2), selected anthropometric measures (4/8), and selected metabolic biomarkers (4/6). The evidence suggests that culinary nutrition interventions hold promise as supportive, behaviour-focused strategies aligned with oncology nutrition guidelines and responsive to patient needs. However, due to heterogeneity across interventions and outcomes, and variability in methodological quality as assessed using the Cochrane risk of bias tool, quantification of effects was not possible, limiting interpretation of the evidence. Further high-quality studies using comparable outcome measures and longer-term follow-up are needed to quantify the magnitude of effects, assess their durability over time, and inform the integration of culinary nutrition programmes into cancer care. This systematic review is registered under the PROSPERO ID CRD42024567041 and was funded by the RCSI Research Summer School Fund. Full article

Rising global electricity demand and the expansion of distribution networks require a critical assessment of component-level greenhouse gas contributions. Distribution transformers, although indispensable, have significant life-cycle carbon impacts due to the use of materials, manufacturing, and in-service losses. This study conducts a life-cycle assessment of a single-phase, 75 kVA oil-immersed distribution transformer manufactured in Newfoundland, one of the provinces with the cleanest, hydro-dominated grids in Canada, and evaluates it over a 40-year lifespan. Using a cradle-to-use boundary, the analysis quantifies embodied emissions from raw material extraction, manufacturing, and transportation, alongside operational emissions derived from empirically measured no-load and load losses. All the data are collected directly during the manufacturing process, ensuring high analytical fidelity. The energy efficiency of the transformer is analyzed in MATLAB version R2023b using measured no-load and load losses to generate efficiency, load characteristics under various operating conditions. Under varying load factor scenarios and based on Newfoundland’s 2025 grid intensity of 18 g CO₂e/kWh, the lifetime operational emissions are estimated to range from 0.19 t CO₂e under no-load operation to 4.4 t CO₂e under full-load conditions. A linear regression-based decarbonization model using Microsoft Excel projects grid intensity to reach net-zero around 2037, two years beyond the provincial target, indicating that post-2037 transformer losses will remain energetically relevant but carbon-neutral. Sensitivity analysis reveals that temporary overloading can substantially elevate lifetime emissions, emphasizing the value of smart-grid-enabled load management and optimal transformer sizing. Comparative assessment with fossil fuel-intensive provinces across Canada demonstrates the dominant influence of grid generation mix on life-cycle emissions. Additionally, refurbishment scenarios indicate up to 50% reduction in cradle-to-gate emissions through material reuse and oil reclamation. The findings establish a scalable framework for integrating grid decarbonization trajectories, life-cycle carbon modelling, and circular-economy strategies into sustainable distribution network planning and transformer asset management. Full article

Food allergy diagnosis remains challenging due to the difficulty of distinguishing true clinical allergy from asymptomatic sensitization. Inaccurate diagnosis may result in unnecessary dietary restrictions, reduced quality of life, or, conversely, failure to identify individuals at risk of severe allergic reactions. This review critically analyzes the efficacy, limitations, and clinical utility of currently available diagnostic tests for food allergy, with particular emphasis on their ability to predict true clinical reactivity. A comprehensive literature review was conducted to evaluate the sensitivity, specificity, and predictive values of both traditional and emerging diagnostic modalities. English-language guidelines, systematic reviews, and key clinical studies published primarily within the past 15 years (up to 2025) were identified through PubMed and Google Scholar. Classic diagnostic tools, including skin prick testing (SPT) and serum-specific IgE (sIgE), were assessed alongside novel approaches such as component-resolved diagnostics (CRD), basophil activation test (BAT), mast cell activation test (MAT), atopy patch testing (APT), cytokine profiling, and omics-based diagnostics. Particular attention was given to how these tests compare with the oral food challenge (OFC), which remains the diagnostic gold standard. The findings demonstrate that while conventional tests offer high sensitivity and are valuable for initial risk assessment, their limited specificity often leads to overdiagnosis. Emerging molecular and cellular assays show improved specificity and functional relevance, especially in complex cases involving polysensitization or unclear clinical histories and may reduce reliance on OFCs in the future. However, accessibility, cost, and lack of standardization currently limit their widespread clinical application. Advances in artificial intelligence and data integration hold promise for improving diagnostic accuracy through enhanced interpretation of complex immunological data. Based on the synthesized evidence, this review proposes an evidence-based, stepwise, and individualized diagnostic algorithm for food allergy. Integrating clinical history, targeted testing, and selective use of OFCs can improve diagnostic certainty, enhance food safety, minimize unnecessary dietary avoidance, and optimize patient outcomes. The review underscores the need for continued research, standardization, and validation of novel diagnostic tools to support personalized and precise food allergy management. Full article

Bone conduction hearing implant systems (BCHIs) are established treatments for patients with conductive or mixed hearing loss or single-sided deafness when conventional hearing aids are unsuitable. This study evaluated the cost-effectiveness of the active transcutaneous system Sentio versus a similar system, i.e., Osia in an Australian setting. Scenario analyses also compared Sentio to other systems, i.e., Ponto and Baha Attract. A Markov cohort model was adapted from a previously published source to reflect Australian practice, incorporating device acquisition, surgery, maintenance, battery replacement and adverse event management over a 15-year horizon from a healthcare perspective. Effectiveness inputs were derived from published evidence using a naïve indirect comparison. Extensive sensitivity analyses and external validation tested robustness. In the base case, Sentio was associated with lower costs and a small modelled incremental quality-adjusted life years (QALYs) gain versus Osia. Scenario analyses confirmed cost-effectiveness relative to Ponto and Baha Attract, with outcomes below the Australian willingness-to-pay threshold. Health state utility, device price and reimplantation assumptions were the most influential drivers, yet Sentio remained cost-effective in over 95% of simulations. These findings support Sentio as a clinically and economically efficient BCHI in Australia and highlight the need for direct utility and long-term durability data. Full article

Background/Objectives: The identification of individuals from human remains is crucial in any scenario where their identity is unknown. The study of ontogenetic allometry, which refers to proportional changes in the shape and size of bones during growth, provides important baseline information for constructing biological profiles. Methods: This study focuses on the analysis of the ontogenetic allometry of the scapula in Portuguese reference skeletal samples, using geometric morphometric techniques. The sample includes 140 individuals (67 females, 73 males), ranging from birth to 89 years old. Scapulae were photographed, and seven landmarks and forty semi-landmarks were digitized using the “tps” programs. Statistical analyses were performed using the MorphoJ (v. 1.08.02) and PAST (v. 5.2) programs. Results: The results point to a significant and continuous growth of the scapula in the early stages of life, with a tendency to stabilize after adolescence. Centroid size significantly influenced shape variation across the full sample. Conclusions: These findings provide a descriptive baseline of scapular development that can aid future anthropological and forensic research, including studies on population variation and age-related morphological trajectories. Full article

Background/Objectives: Self-care is a cornerstone of healthy aging and chronic disease management; however, evidence on the most effective intervention models for improving quality of life in older adults with chronic non-communicable diseases (NCDs) remains fragmented. This review aimed to evaluate the effectiveness of self-care interventions in promoting quality of life and health outcomes in older adults with NCDs. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251040613). Randomized and non-randomized clinical trials published between 2019 and 2024 were retrieved from Scopus, Web of Science, and EBSCOhost. Eligible studies included adults aged ≥60 years with NCDs receiving self-care interventions. Data extraction and risk of bias assessment were independently performed using Joanna Briggs Institute tools. Results: Twenty-nine studies involving 7241 older adults were included. Self-care interventions comprised nurse-led educational programs, digital health strategies, community- and peer-based approaches, and person-centered care models. Multicomponent and continuous interventions demonstrated consistent improvements in physical and psychological domains of quality of life, self-efficacy, autonomy, symptom management, and treatment adherence. Digital interventions enhanced monitoring and engagement, although their effectiveness varied according to sensory and health literacy limitations. Conclusions: Structured, person-centered, and nurse-led self-care interventions are effective in improving quality of life and autonomy among older adults with NCDs. These findings support their integration into primary and community-based care, reinforcing their relevance for clinical practice, care planning, and the development of assistive and educational strategies in aging care. Full article

Background/Objectives: Quadriceps arthrogenic muscle inhibition (AMI) represents a key impairment following anterior cruciate ligament reconstruction (ACLR), contributing to quadriceps weakness. Although transcutaneous electrical nerve stimulation (TENS) and percutaneous electrical nerve stimulation (PENS) have been primarily investigated for analgesia, their effects on quadriceps strength in the early postoperative period remain underexplored. Methods: This study describes a single-blinded, parallel-group randomized controlled trial investigating the short-term effects of a single high-frequency TENS session and a novel long-term potentiation (LTP) PENS protocol on quadriceps strength and related clinical outcomes after ACLR. Fifty-four participants will be randomly allocated using block randomization in a 1:1:1 ratio to one of three groups: a control group (conventional post-ACLR rehabilitation only), a TENS group (conventional rehabilitation plus a single high-frequency TENS session), or a PENS group (conventional rehabilitation plus a single LTP PENS session). Participants will receive neuromodulatory intervention during the sixth postoperative week. The LTP PENS protocol consists of five 5 s stimulation bursts at 100 Hz and 250 μs pulse width and has only been investigated once in patients with upper limb pathology, underscoring its novelty in a postoperative setting. Results: The primary outcome is quadriceps maximal voluntary isometric contraction, selected as a clinically relevant surrogate of quadriceps activation deficits associated with AMI. Secondary outcomes include pain intensity, pressure pain threshold, knee range of motion, thigh muscle perimeter, knee effusion and swelling, and self-reported function and knee-related quality of life. Outcomes will be assessed at baseline, immediately post-treatment, and 1 and 7 days post-intervention by a blinded assessor. Full article

There is increasing evidence that exposure to environmental toxicants may impact fertility, especially during critical windows of reproductive axis development. Hypothalamic gonadotropin-releasing hormone (GnRH) neurons, essential for puberty onset and fertility, originate from the olfactory placode and migrate toward the hypothalamus during development, making them particularly vulnerable to environmental insults. Cadmium (Cd), a widespread heavy metal, is well known for its gonadotoxicity, but its impact on human hypothalamic neuron development remains unclear. Using human fetal GnRH neuroblasts (FNCB4) we investigated the effects of Cd exposure on their morpho-functional and developmental features. Cd induced oxidative stress and COX2 mRNA upregulation, indicative of inflammatory pathway activation, which was accompanied by reduced cell migration and downregulation of motility-related genes. These effects were associated with F-actin disassembly and altered expression of adhesion molecules. Electrophysiological analyses showed that Cd altered membrane potential, increased capacitance and permeability, and disrupted gap junctional communication, as also confirmed by connexin-43 delocalization. Moreover, Cd significantly reduced the expression of specific GnRH neuronal markers, suggesting impaired functional maturation. Overall, our findings provide the first evidence that Cd may interfere with mechanisms crucially involved in human GnRH neuron development, adding new mechanistic insights into the comprehension of how early-life exposure to Cd may contribute to fertility concerns. Full article

Background and Objectives: Biological therapies improve disease severity and quality of life in patients with psoriasis, but data on Romanian patients remain limited. Our study aimed to characterize patients with psoriasis from Transylvania and to evaluate the impact of biologics on disease severity, treatment switching, affected special areas response, quality of life, and laboratory biomarkers. Materials and Methods: We conducted a retrospective exploratory study at two centers in Cluj-Napoca, Romania, using routinely collected medical data. Results: One-hundred and fifteen patients (aged 2–72 years) were evaluated; 45 patients received anti-TNF, 43 received anti-IL-17, and 27 received anti-IL-23. Patients treated with anti-IL-17 or anti-IL-23 were older at diagnosis than those treated with anti-TNF (p = 0.0001). Psoriatic lesions were prevalent in the scalp (58.3%) and nails (36.5%). Methotrexate was the most common prior systemic therapy (87.8%), with no difference between the groups (p = 0.7668). Patients receiving anti-TNF therapy (46.7%) or anti-IL-17 therapy (20.9%) also most frequently received prior treatment with systemic retinoids. Cardiometabolic comorbidities, including hypertension (40.9%) and diabetes mellitus (20.9%), were prevalent. Anti-IL-17 therapies were used more frequently in patients with hypertension (46.5%), diabetes mellitus (34.9%), and psoriatic arthritis (34.9%). Baseline severity scores were comparable across the groups (p > 0.10). A therapeutic switch occurred in approximately one-quarter of the patients, most frequently in the anti-TNF group (57.8%), which also showed higher PASI and DLQI scores at switching (p < 0.0001). At 36 weeks, anti-IL-17 and anti-IL-23 therapies demonstrated superior outcomes compared to anti-TNF therapy (p = 0.045). All patients receiving anti-IL-23 therapy achieved a PASI 100 at the 60-week follow-up. Significant improvements in PASI and DLQI were observed for all biologics (p < 0.0001). Conclusions: Biological therapies were associated with significant improvements in disease severity and quality of life. Anti-TNF therapies were switched more frequently due to reduced efficacy, while clinical improvement was observed regardless of lesion localization. Full article

Additive manufacturing offers rapid and customizable production, yet conventional plastic-based methods remain energy-intensive and environmentally harmful, often resulting in higher impacts per part than traditional manufacturing. The goal of this study was to evaluate whether upcycled biomaterials, specifically oyster shells, pistachio shells, and clay, could be used as lower-impact alternatives to PLA in 3D printing. The scope included detailed measurement of print parameters for each material and a full life cycle assessment (LCA) of the printed elements, covering printer manufacturing, raw material extraction, transport, operation, and end of life. The results show that ambient-temperature extrusion of these upcycled biomaterials can reduce energy consumption by up to 89% and overall environmental impact by up to 94% (as measured by ReCiPe Endpoint H points) compared to PLA printing. These reductions were observed for the Netherlands and EU contexts, where electricity mixes are relatively clean and recycling rates are high; even greater improvements were observed for the US. Although the printed biomaterial objects exhibit lower mechanical strength, limited waterproofness, and reduced print resolution, they are already suitable for low-load applications such as prototypes and architectural models. Overall, the findings demonstrate that upcycled biomaterial extrusion has strong sustainability potential, outperforming both conventional plastics and bioplastics such as PLA in terms of material impacts and energy use. Continued development of material formulations as well as pre- and post-processing techniques could further expand functionality and support the broader adoption of low-impact 3D printing across a wide range of applications. Full article

This paper presents a systematic review conducted under the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, analyzing 286 scientific articles focused on vibration-based predictive maintenance strategies for wind turbines within the context of advanced Prognostics and Health Management (PHM). The review combines international standards (ISO 10816, ISO 13373, and IEC 61400) with recent developments in sensing technologies, including piezoelectric accelerometers, microelectromechanical systems (MEMS), and fiber Bragg grating (FBG) sensors. Classical signal processing techniques, such as the Fast Fourier Transform (FFT) and wavelet-based methods, are identified as key preprocessing tools for feature extraction prior to the application of machine-learning-based diagnostic algorithms. Special emphasis is placed on machine learning and deep learning techniques, including Support Vector Machines (SVM), Random Forest (RF), Convolutional Neural Networks (CNN), Long Short-Term Memory networks (LSTM), and autoencoders, as well as on hybrid digital twin architectures that enable accurate Remaining Useful Life (RUL) estimation and support autonomous decision-making processes. The bibliometric and case study analysis covering the period 2020–2025 reveals a strong shift toward multisource data fusion—integrating vibration, acoustic, temperature, and Supervisory Control and Data Acquisition (SCADA) data—and the adoption of cloud-based platforms for real-time monitoring, particularly in offshore wind farms where physical accessibility is constrained. The results indicate that vibration-based predictive maintenance strategies can reduce operation and maintenance costs by more than 20%, extend component service life by up to threefold, and achieve turbine availability levels between 95% and 98%. These outcomes confirm that vibration-driven PHM frameworks represent a fundamental pillar for the development of smart, sustainable, and resilient next-generation wind energy systems. Full article

Background: Ambient yoghurt, also known as room-temperature yoghurt, has gained increasing attention due to its convenience in distribution and consumption without needing cold storage. To ensure extended shelf life, ambient yoghurt normally undergoes an additional heat treatment during manufacturing, the post-fermentation sterilisation process (typically at 65–85 °C), which may induce the formation of fine particle aggregates and result in undesirable textural attributes, particularly graininess. Assessing textural attributes of such products remains a challenge. Methods: By mimicking the oral behaviour of ambient yoghurt, this study uses rheological as well as tribological techniques for objective assessment of the textural sensations of slipperiness and graininess. Various experimental conditions, including the amount of saliva incorporation, sliding speed, and ball-contact and plate-contact lubrication, were examined, and results were analysed against perceived texture by panellists. Main findings: The results indicate that viscosity changes are closely associated with perceived slipperiness under the tested conditions. The friction coefficient obtained from a plate-contact tribometer shows a positive correlation with the sensation of graininess (Pearson’s r was 0.74, p < 0.05, N = 8). It was also observed that a 20% saliva incorporation showed the closest agreement with sensory perception, although this observation should be interpreted cautiously due to the limited sample size. Implications: Results obtained from this work indicate the feasibility of using rheology and tribology techniques for texture prediction in ambient yoghurt. The findings are exploratory in nature, and further studies with larger sample sets are required to validate the proposed approach. The methodology presented here may serve as a reference framework for investigating texture perception in other dairy systems. Full article

Background/Objectives: Multiple sclerosis (MS) is a chronic neurological disease characterized by demyelination, inflammation, and autoimmunity, leading to progressive physical and psychological impairments. Anxiety and depression are among the most prevalent neuropsychiatric comorbidities in MS, significantly impacting patients’ quality of life (QoL). This study aimed to assess the evolution of anxiety and depression in individuals with relapsing-remitting multiple sclerosis (RRMS) over a six-month follow-up period, identify associated factors, and explore potential predictors of these psychological conditions. Methods: A prospective observational study was conducted with 35 RRMS patients diagnosed at the Lucus Augusti University Hospital between January 2023 and March 2025. Psychological symptoms were assessed at baseline, after 3 months, and after 6 months using the Goldberg Anxiety and Depression Scale (GADS), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Data were analyzed using non-parametric tests to account for the small sample size and non-normal distribution of variables. Results: Anxiety and depression were prevalent and persistent in the study population, with no significant changes in mean scores over time (p > 0.05). However, specific symptoms, such as pessimism and loss of pleasure, showed worsening trends, while sadness and guilt remained stable. Sociodemographic factors, including lower income and employment status, were significantly associated with higher anxiety and depression scores (p < 0.05). Additionally, clinical factors such as autoimmune comorbidities and a history of mononucleosis were linked to higher depressive symptoms. Baseline anxiety and depression scores emerged as strong predictors of future levels (p < 0.01), emphasizing the importance of early assessments. Conclusions: Anxiety and depression are prevalent and persistent in RRMS patients, with specific symptoms fluctuating over time. Sociodemographic and clinical factors play a significant role in psychological outcomes, highlighting the need for integrated care models that address both physical and psychosocial aspects of MS. Early psychological assessments and targeted interventions are critical for improving QoL and mitigating the long-term burden of mental health challenges in RRMS. Full article

The fall armyworm (FAW) Spodoptera frugiperda is a polyphagous pest that causes significant damage to various crops and rapidly develops resistance to insecticides. Broflanilide, a novel meta-diamide insecticide, has shown effectiveness against lepidopteran pests, but the risk of resistance and associated fitness costs in FAW remain unclear. This study evaluated the development of resistance to broflanilide over nine generations of selection using the diet incorporation method at the 70% lethal concentration (LC₇₀) concentration. Following nine generations of selection, the LC₅₀ value increased from 0.134 mg/kg to 0.232 mg/kg, showing a 1.73-fold increase in resistance ratio (RR). The calculated heritability of resistance (h²) was 0.084, which suggested that resistance of FAW against broflanilide is evolving at a slow rate. Based on the projected rate of resistance progression, a 10-fold increase in LC₅₀ would take between 30.1 and 66.4 generations, assuming selection mortality rates of 90% and 50%, respectively. Fitness costs were evaluated using age-stage, two-sex life table analysis, revealing reduced fecundity and pupal weight in the broflanilide-selected (Brof-SEL) strain compared to the wild-type. The relative fitness of the Brof-SEL strain was 0.38, indicating trade-offs in biological traits. These findings suggested a low risk of rapid resistance development against broflanilide. However, effective integrated pest management strategies against FAW require the judicious use of this insecticide in combination with biological control measures, including the deployment of parasitoids and predators, to promote a more environmentally sustainable approach. Full article