Search Results (902)

Background/Objectives: There is a growing need for autism spectrum disorder (ASD) assessment tools that are diagnostically aligned, clinically usable, and accessible across diverse service contexts. The Diagnostic Autism Spectrum Interview—Version 2 (DASI-2) is a freely available, semi-structured clinical interview mapped directly to DSM-5 and ICD-11 criteria. This pilot study aimed to adapt DASI-2 into Hungarian and explore the (1) acceptability of DASI-2 administration, (2) agreement with prior clinical ASD diagnoses, and (3) relationship between DASI-2 observational ratings and ADOS-2 classifications. Methods: Following a multistep translation procedure, DASI-2 was administered to seven children previously assessed for ASD in a multidisciplinary Hungarian clinical setting. The assessment included a parent interview, direct assessment with the child or young person, and completion of the DASI observational record (OR1–OR4). DASI diagnostic outcomes were compared with prior clinical decisions, and OR scores were analyzed in relation to ADOS-2 classifications. Results: All participants completed the DASI-2 interview in full. Agreement with prior clinical diagnosis was found in six of seven cases (κ = 0.70, indicating substantial agreement). When exploring the one non-aligned case, the divergence in diagnostic outcome was due to broader contextual information considered by the initial clinical team which influenced clinical opinion. The five participants diagnosed with ASD showed substantially higher DASI observational scores (mean = 15.26) than the two who were not diagnosed (mean = 1.57), mirroring ADOS-2 severity classifications. Conclusions: These findings support the acceptability and preliminary validity of DASI-2. Its inclusive structured observational record may provide a practical complement to resource-intensive tools such as the ADOS-2; however, further validation in larger and more diverse samples is needed. Full article

Social trust has been linked to the development and severity of depression, but trust is a complex, multidimensional construct. This study examines the extent to which two distinct forms of trust, general trust and specific trust, predict depressive symptoms. Drawing on longitudinal data from the Directorate of Health’s national surveys conducted in 2007 and 2009, the analysis includes responses from 3211 Icelanders selected through a stratified random sample. Depressive symptoms were assessed using the Depression, Anxiety, and Stress Scale (DASS), while specific trust captured trust in close relationships, and general trust measured broader perceptions of trustworthiness in others. The two forms of trust together explained 7.6% of the variance in depressive symptoms, with specific trust contributing a substantially greater share. Both remained significant predictors after controlling for prior depression and physical health. These findings highlight the protective role of specific trust and suggest that general trust, an indicator of broader social capital, may also help buffer against depression. The results underscore the relevance of trust as a public health resource and support continued research into social determinants of mental health in Iceland. Full article

Background/Objectives: The rising demand for total joint arthroplasty (TJA) and increasing incidence of prosthetic joint infections (PJIs) significantly burden patients and healthcare systems. This retrospective study describes the epidemiology, clinical characteristics and outcomes of PJIs in Iceland from 2003 to 2020. Methods: PJI cases were identified through synovial fluid cultures and ICD codes, with classification per EBJIS criteria. Unlikely cases were excluded. Results: Among 293 cases with a mean age of 70 years, 60% (176/293) were males and 58% (171/293) involved the knee. Over half of infections occurred within two years post TJA, with an incidence rate of 0.94%, increasing significantly over time (p = 0.012). Males had significantly higher incidence rates than females (incidence rate ratio 0.42; p < 0.001). The most common pathogens were coagulase-negative staphylococci (30%, 88/293), and 9% (27/293) of cases were culture-negative. DAIR was the first-line treatment in about 50% (147/293) of cases but it failed in nearly half, contributing to an overall treatment failure rate of 38% (98/259). PJI-related mortality was 2% (6/293). Conclusions: The results indicate an increased incidence, with the highest risk within two years of TJA. Males are at greater risk, while females more commonly undergo TJA. DAIR success rates were lower than reported elsewhere but improved significantly over time. Better methods to prevent PJIs are needed. Full article

The growing need for developing safer and more effective methods for obtaining enantiomers of chiral compounds, particularly those with pharmacological activity, highlights the potential of biocatalysis as an appropriate pharmaceutical research direction. However, low catalytic activity and stability of free enzymes are often among the substantial limitations to the wide application of biocatalysis. Therefore, to overcome these obstacles, new technological procedures are being designed. In this study, we present optimized protocols for the immobilization of Candida antarctica lipase B (CALB) on an octyl- agarose support, ensuring high enantioselectivity in an organic reaction medium. The immobilization procedures (with drying step), including buffers with different pH values and concentrations, as well as the study of the influence of temperature and immobilization time, were presented. It was found that the optimal conditions were provided by citrate buffer with a pH of 4 and a concentration of 300 mM. The immobilized CALB on the octyl-agarose support exhibited high catalytic activity in the kinetic resolution of (R,S)-1-phenylethanol via enantioselective transesterification with isopropenyl acetate in 1,2-dichloropropane (DCP), as a model reaction for lipase activity monitoring on an analytical scale. HPLC analysis demonstrated that the (R)-1-phenylethyl acetate was obtained in an enantiomeric excess of ee_p > 99% at a conversion of approximately 40%, and the enantiomeric ratio was E > 200. Thermal and storage stability studies performed on the immobilized CALB octyl-agarose support confirmed its excellent stability. After 7 days of thermal stability testing at 65 °C in a climatic chamber, the (R)-1-phenylethyl acetate was characterized by enantiomeric excess of ee_p > 99% at a conversion of around 40% (similar values of catalytic parameters to those achieved using a non-stored lipase). The documented high catalytic activity and stability of the developed CALB-octyl-agarose support allow us to consider it as a useful tool for enantioselective transesterification in organic medium. Full article

Novel therapeutic approaches for wound healing have included biomaterials from the Atlantic cod (Gadus morhua L.), with promising results in wound management. The use of extracellular vesicles (EVs), which can be isolated from cod biofluids, remains to be studied. EVs play key roles in cellular communication, and their use both as biomarkers and as therapeutic agents is widely reported in human pathologies, particularly with respect to mesenchymal stem cells. This pilot study characterized the total proteomic cargo content of EVs from cod serum and mucus and assessed the EVs’ potential for regenerative activity in wound-healing processes, using human and mouse fibroblast and keratinocyte in vitro scratch injury models. The pro-regenerative potential of both cod serum EVs and mucus EVs was identified, with differing capacities for accelerating wound closure in fibroblast and keratinocyte cells. This was further supported by varying effects of the cod serum EVs and mucus EVs on cellular vimentin and FGF-2 levels. The serum EV and mucus EV protein cargoes differed with respect to abundance of protein hits and associated enriched functional GO and KEGG pathways, but both were associated with immune, stress and wound-healing processes. Cod EVs may present as innovative therapeutic options for regenerative medicine applications, and our reported findings provide valuable insights for future in-depth studies. Full article

In the intersecting field of energy consumption and human well-being, many macro-level studies link national energy use with well-being. These studies often rely on aggregate data, however, limiting insights into intra-national inequities and diverse well-being outcomes. To bridge this gap, this study used a single Nordic survey that allowed for the calculation of consumption-based energy footprints alongside well-being measures, focusing on Icelandic participants. A factor analysis of well-being responses identifies four factors: Eudaimonic, Financial, Housing/Local, and Health-related well-being. We found that well-being in Iceland largely remains decoupled from energy footprints across income and consumption groups, except for financial well-being. However, these groups differ significantly in consumption lifestyles and associated footprints, with only a small fraction of consumers maintaining energy use within global sufficiency thresholds. Most exceed these levels, suggesting that Iceland could reduce energy consumption without significantly harming well-being. Future research should explore strategies to lower consumption without triggering negative social reactions or declines in well-being. Full article

Background/Objectives: Sarcomas are a rare and heterogeneous group of malignant tumors, which makes early detection and grading particularly challenging. Diagnosis traditionally relies on expert visual interpretation of histopathological biopsies and radiological imaging, processes that can be time-consuming, subjective and susceptible to inter-observer variability. Methods: In this study, we aim to explore the potential of artificial intelligence (AI), specifically radiomics and machine learning (ML), to support sarcoma diagnosis and grading based on MRI scans. We extracted quantitative features from both raw and wavelet-transformed images, including first-order statistics and texture descriptors such as the gray-level co-occurrence matrix (GLCM), gray-level size-zone matrix (GLSZM), gray-level run-length matrix (GLRLM), and neighboring gray tone difference matrix (NGTDM). These features were used to train ML models for two tasks: binary classification of healthy vs. pathological tissue and prognostic grading of sarcomas based on the French FNCLCC system. Results: The binary classification achieved an accuracy of 76.02% using a combination of features from both raw and transformed images. FNCLCC grade classification reached an accuracy of 57.6% under the same conditions. Specifically, wavelet transforms of raw images boosted classification accuracy, hinting at the large potential that image transforms can add to these tasks. Conclusions: Our findings highlight the value of combining multiple radiomic features and demonstrate that wavelet transforms significantly enhance classification performance. By outlining the potential of AI-based approaches in sarcoma diagnostics, this work seeks to promote the development of decision support systems that could assist clinicians. Full article

Background: Topical statin therapy holds promise for ocular diseases, such as age-related macular degeneration, but the effective delivery to the posterior segment is limited by poor aqueous solubility, chemical instability, and ocular barriers. Cyclodextrins (CDs) can enhance statin solubility and stability; however, the behavior of CD–statin complexes in aqueous eye drops—particularly their influence on the equilibrium between the inactive lactone (ring closed) and active hydroxyacid forms (ring open)—remains unclear. This study aimed to (i) investigate how 5% and 10% (w/v) concentrations of selected CDs affect the lactone/acid equilibrium of simvastatin and atorvastatin and (ii) define formulation parameters (statin form, CD type and concentration, and pH range) for stable eye drop development. Methods: Simvastatin or atorvastatin was added to buffered solutions (pH 2.0 to pH 9.5) of RMβCD, HPβCD, γ-CD, or SBEβCD at 0%, 5%, and 10% (w/v), incubated at 23 ± 1 °C, and sampled over time for UPLC quantification of lactone and hydroxyacid forms, and rate constants for the forward and reverse reaction were calculated. Phase solubility studies were also conducted to further characterize equilibrium behavior in aqueous CD systems. Results: The lactone form was most stable at a pH of 4.5, while the hydroxyacid form prevailed at a pH ≥ 7. γ-CD and HPβCD accelerated lactone hydrolysis for both statins, whereas RMβCD exerted a stabilizing effect. Increasing the CD concentration from 5% to 10% provided minimal additional stabilization. Conclusions: These findings highlight that the precise control of the pH, an appropriate cyclodextrin choice, and the selection of the statin form are critical to developing chemically stable eye drops. Full article

Understanding the mechanisms of protein preservation in extreme environments is essential for identifying potential molecular biosignatures on Mars. In this study, we investigated five sabkha sedimentary samples from the Abu Dhabi coast, spanning from the present day to ~11,000 years before present (BP), to assess how mineralogy and environmental conditions influence long-term protein stability. Using LC-MS/MS and direct Data-independent Acquisition (DIA) proteomic analysis, we identified 722 protein groups and 1300 peptides, revealing a strong correlation between preservation and matrix composition. Carbonate- and silica-rich samples favored the retention of DNA-binding and metal-coordinating proteins via mineral–protein interactions, while halite- and gypsum-dominated facies showed lower recovery due to extreme salinity and reduced biomass input. Functional profiling revealed a shift from metabolic dominance in modern samples to genome maintenance strategies in ancient ones, indicating microbial adaptation to prolonged environmental stress. Contrary to expectations, some ancient samples preserved large, multi-domain proteins, suggesting that early mineral encapsulation can stabilize structurally complex biomolecules over millennial timescales. Taxonomic reconstruction based on preserved proteins showed broad archaeal diversity, including Thaumarchaeota and thermophilic lineages, expanding our understanding of microbial ecology in hypersaline systems. These findings highlight sabkhas as valuable analogs for Martian evaporitic environments and suggest that carbonate–silica matrices on Mars may offer optimal conditions for preserving ancient molecular traces of life. Full article

Whiplash-associated disorder (WAD) is common following motor vehicle collisions (MVCs). The yearly incidence rate in the Western world has been reported to be around 300 per 100,000 habitants, but no publications have examined yearly incidence across a period that includes the COVID-19 pandemic. A retrospective, epidemiological study was conducted in Iceland involving data from the University Hospital and the healthcare centers for the Capital Region for all individuals who visited the emergency department during 2010–2024 due to TAs, with a diagnosis indicating whiplash injury. The yearly incidence rate was calculated and presented per 100,000 person-years and analyzed by age, sex, months, and weekdays. The overall incidence of whiplash injuries was 267 per 100,000 person-years, greater for females than males (p < 0.001) with a significant effect of age (p < 0.001), the greatest rate being seen in young adulthood. A significant effect of time was seen across the study period (p < 0.001) due to a sharp decline between 2016 and 2020, followed by a continued low yearly incidence rate, with the smallest one seen in 2024 (78 per 100,000). Despite an increase in MVCs worldwide, the incidence of whiplash injuries following MVCs has declined significantly over the past decade. This trend may reflect shifts in injury patterns, healthcare-seeking behavior, or reporting practices. Full article

This study explores the link between brand image and Net Promoter Score (NPS) in Iceland’s banking sector using data from three survey waves (2021, 2023, and 2025). While NPS is widely used to track customer loyalty, its relationship with brand image, especially in financial services, remains unclear. Drawing on repeated cross-sectional data (n = 1504), we examine how trust, corporate social responsibility, customer satisfaction, and perceived corruption relate to NPS across three major banks. Results show a consistently strong positive correlation (r > 0.5), with Arion Bank customers showing the highest association (r = 0.68). This suggests that customers with a positive image of the bank are far more likely to recommend it. The findings offer both theoretical and practical value: they reinforce the role of brand image in driving customer advocacy and support a more contextualized use of NPS in brand strategy and customer experience management. Full article

A novel processing route of producing CrFeNiMo, Co_0.5CrFeNiMo, and Al_0.5CrFeNiMo high-entropy alloy coatings was proposed in this work. Pre-alloyed HEAs were consolidated by spark plasma sintering (SPS) in order to fabricate electrodes for electrospark deposition (ESD) coatings on carbon steel substrates. Investigations were performed to observe aspects such as phase composition and stability, contamination level, homogeneity, elemental distribution, and microstructural integrity. The results indicated phase stability and lower porosity when increasing the SPS temperature by 50 °C for all cases, with tetragonal distortion related to the HEAs’ severe lattice distortion core effect. The coating surface analysis indicated that a continuous and compact coating was obtained, correlated with the ESD layering count, but microfissures were present after 6 layers were applied due to the reduced ductility combined with rapid cooling under Ar atmosphere. The chemical integrity of both the sintered samples and the coatings was preserved during the processing, revealing a uniform elemental distribution with no contaminations or impurities present. The results indicated successful HEA sintering and deposition, highlighting the potential of the combined SPS-ESD process for high-performance material fabrication with possible applications in aggressive environments. Full article

Background/Objectives: Malnutrition is a key contributor to poor outcomes in older adults with fragility fractures, increasing the risk of complications, functional decline, prolonged hospital stays, mortality, and healthcare costs. Substantial evidence limited to hip fracture supports early, interdisciplinary nutrition care. However, global audits reveal that most hip fracture patients do not receive recommended interventions. This quality improvement (QI) project aimed to co-create and test a pathway and toolkit to help apply evidence-based nutrition care in different fragility fracture settings globally. Methods: The SIMPLER Pathway and toolkit (SIMPLER) were developed through a multiphase, co-creation QI initiative (2018–2025), guided by the Knowledge-to-Action framework. Global experts and clinical teams synthesized evidence, identified the “know-do” gap, and adapted SIMPLER to context through iterative action–reflection cycles. The Model for Improvement guided team building, goal setting, testing changes, and measuring outcomes at pilot sites. Results: Over 100 co-creation activities between 2018 and 2025 engaged staff and patients to shape and refine SIMPLER. A global clinician survey (n = 308, 46 countries), two bi-national audits (n = 965, 63 hospitals), and qualitative interviews (n = 15) confirmed a widespread evidence-practice gap. The pathway and toolkit were pilot-tested in five hospitals across four countries, with action–reflection cycles enabling continuous refinement of prioritized nutrition improvements tailored to the local context. Following endorsement in late 2024, 46 healthcare services in 23 countries have formally committed to implementing SIMPLER. Conclusions: The SIMPLER Nutrition Pathway provides a scalable, adaptable framework to support the delivery of evidence-based nutrition care in fragility fracture settings. A global evaluation is underway. Full article

Cerebral malaria (CM) is a life-threatening disease that affects mainly children in sub-Saharan Africa. Studies have shown that children who survive CM are often left with neurological disabilities after recovery, such as behavioral changes similar to attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). However, diagnosis and treatments for ADHD are limited in many places in Africa. The purpose of this study was to assess behavioral changes following CM infection in Children in Malawi and parents’ acceptability of behavioral treatments. Twenty-one parents of children who had survived CM were compared to forty parents from the general population. Assessment instruments included the Disruptive Behavior Rating Scale (DBRS), Treatment Evaluation Inventory-Short Form (TEI-SF), and ADHD symptom checklist. The results showed that the most acceptable treatments among parents in Malawi were interrupt/redirect, discussion, and medication. Parents of CM-surviving children were significantly more accepting of medication (F(1,59) = 7.92, p < 0.007). The majority of the children who survived CM were rated above the clinical cut-off for ADHD and ODD symptoms. Full article