Search Results (5,411)

Background: Iron deficiency (ID) is a prevalent comorbidity of heart failure (HF), affecting up to 59% of patients, regardless of the presence of anaemia. Although its negative impact on left ventricular (LV) function is well documented, its effect on right ventricular (RV) function remains unclear. This study assessed the effects of ID on RV global longitudinal strain (RV-GLS) in patients diagnosed with acute decompensated HF (ADHF). Methods: This study included data from 100 patients hospitalised with ADHF irrespective of LV ejection fraction (LVEF) value. ID was defined according to the European Society of Cardiology HF guidelines as serum ferritin <100 ng/mL or ferritin 100–299 ng/mL, with transferrin saturation <20%. Anaemia was defined according to World Health Organization criteria as haemoglobin level <12 g/dL in women and <13 g/dL in men. RV systolic function was assessed using parameters including RV ejection fraction (RVEF), tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (FAC), peak systolic tissue Doppler velocity of the RV annulus (RV TDI S′), acceleration time of the RV outflow tract, and RV free wall GLS. Results: The mean (±SD) age of the study population (64% male) was 70 ± 10 years. The median LVEF was 35%, with 66% of patients classified with HF with reduced ejection fraction, 6% with HF with mid-range ejection fraction, and 28% with HF with preserved ejection fraction. Fifty-eight percent of patients had ID. There were no significant differences between patients with and without ID regarding demographics, LVEF, RV FAC, RV TDI S′, or systolic pulmonary artery pressure. However, TAPSE (15.6 versus [vs.] 17.2 mm; p = 0.05) and RV free wall GLS (−14.7% vs. −18.2%; p = 0.005) were significantly lower in patients with ID, indicating subclinical RV systolic dysfunction. Conclusions: ID was associated with subclinical impairment of RV systolic function in patients diagnosed with ADHF, as evidenced by reductions in TAPSE and RV-GLS, despite the preservation of conventional RV systolic function parameters. Further research validating these findings and exploring the underlying mechanisms is warranted. Full article

Urban and regional ecosystems are increasingly challenged by the compounded effects of climate change and intensive land use. In this study, a predictive assessment framework for ecosystem resilience in the Beijing–Tianjin–Hebei region was developed by integrating multi-source remote sensing data, with the aim of quantitatively evaluating the coupled effects of climate change and land use change on future ecosystem resilience. In the first stage of the study, the SD-PLUS coupled modeling framework was employed to simulate land use patterns for the years 2030 and 2060 under three representative combinations of Shared Socioeconomic Pathways and Representative Concentration Pathways (SSP1-2.6, SSP2-4.5, and SSP5-8.5). Building upon these simulations, ecosystem resilience was comprehensively evaluated and predicted on the basis of three key attributes: resistance, adaptability, and recovery. This enabled a quantitative investigation of the spatio-temporal dynamics of ecosystem resilience under each scenario. The results reveal the following: (1) Temporally, ecosystem resilience exhibited a staged pattern of change. From 2020 to 2030, an increasing trend was observed only under the SSP1-2.6 scenario, whereas, from 2030 to 2060, resilience generally increased in all scenarios. (2) In terms of scenario comparison, ecosystem resilience typically followed a gradient pattern of SSP1-2.6 > SSP2-4.5 > SSP5-8.5. However, in 2060, a notable reversal occurred, with the highest resilience recorded under the SSP5-8.5 scenario. (3) Spatially, areas with high ecosystem resilience were primarily distributed in mountainous regions, while the southeastern plains and coastal zones consistently exhibited lower resilience levels. The results indicate that climate and land use changes jointly influence ecosystem resilience. Rainfall and temperature, as key climate drivers, not only affect land use dynamics but also play a crucial role in regulating ecosystem services and ecological processes. Under extreme scenarios such as SSP5-8.5, these factors may trigger nonlinear responses in ecosystem resilience. Meanwhile, land use restructuring further shapes resilience patterns by altering landscape configurations and recovery mechanisms. Our findings highlight the role of climate and land use in reshaping ecological structure, function, and services. This study offers scientific support for assessing and managing regional ecosystem resilience and informs adaptive urban governance in the face of future climate and land use uncertainty, promotes the sustainable development of ecosystems, and expands the applicability of remote sensing in dynamic ecological monitoring and predictive analysis. Full article

The changes in adolescents’ visions for the future are important to adolescents’ developmental trajectories, motivation, and educational outcomes, yet understudied. This study examined the change in possible selves and its association with grit during school closure and life interruption during COVID-19. We conducted a school-based longitudinal survey among 1577 students (Mage = 13.05, SD = 0.86) from 12 secondary schools at the start and end of an academic year prior to and during the COVID-19 pandemic with a 9-month interval. Demographic, grit, socioeconomic status (SES), self-control, and possible selves were measured. Paired t-tests indicated a significant decrease in academic possible selves and strategies. Hierarchical regression analysis results show that participants with higher grit scores reported higher academic and life possible selves; in particular, the effect of grit–perseverance was stronger than grit–passion after controlling self-control. SES moderated the effect of grit–passion on academic possible selves. The current longitudinal study provides important implications for education and youth social work practice for young people growing up with the influence of the pandemic. Full article

Background/Objectives: Daily caloric restriction (DCR) is a common dietary weight loss strategy, but leads to metabolic and behavioral adaptations, including maladaptive eating behaviors and dysregulated appetite. Intermittent fasting (IMF) may mitigate these effects by offering diet flexibility during energy restriction. This secondary analysis compared changes in eating behaviors and appetite-related hormones between 4:3 intermittent fasting (4:3 IMF) and DCR and examined their association with weight loss over 12 months. Methods: Adults with overweight or obesity were randomized to 4:3 IMF or DCR for 12 months. Both randomized groups received a matched targeted weekly dietary energy deficit (34%), comprehensive group-based behavioral support, and a prescription to increase moderate-intensity aerobic activity to 300 min/week. Eating behaviors were assessed using validated questionnaires at baseline and months 3, 6, and 12. Fasting levels of leptin, ghrelin, peptide YY, brain-derived neurotrophic factor, and adiponectin were measured at baseline and months 6 and 12. Linear mixed models and Pearson correlations were used to evaluate outcomes. Results: Included in this analysis were 165 adults (mean ± SD; age 42 ± 9 years, BMI 34.2 ± 4.3 kg/m², 74% female) randomized to 4:3 IMF (n = 84) or DCR (n = 81). At 12 months, binge eating and uncontrolled eating scores decreased in 4:3 IMF but increased in DCR (p < 0.01 for between-group differences). Among 4:3 IMF, greater weight loss was associated with decreased uncontrolled eating (r = −0.27, p = 0.03), emotional eating (r = −0.37, p < 0.01), and increased cognitive restraint (r = 0.35, p < 0.01) at 12 months. There were no between-group differences in changes in fasting appetite-related hormones at any time point. Conclusions: Compared to DCR, 4:3 IMF exhibited improved binge eating and uncontrolled eating behaviors at 12 months. This may, in part, explain the greater weight loss achieved by 4:3 IMF versus DCR. Future studies should examine mechanisms underlying eating behavior changes with 4:3 IMF and their long-term sustainability. Full article

This study investigated quality changes in seaweed–yak patties before and after freeze–thaw by varying seaweed addition levels (10–70%). Macroscopically, the effects on water-holding capacity, textural properties, and oxidative indices of restructured yak patties were evaluated. Microscopically, the impact of seaweed-derived bioactive ingredients on patty microstructure and myofibrillar protein characteristics was examined. LF-NMR and MRI showed that 40% seaweed addition most effectively restricted water migration, reduced thawing loss, and preserved immobilized water content. Texture profile analysis (TPA) revealed that moderate seaweed levels (30–40%) enhanced springiness and minimized post-thaw hardness increases. SEM confirmed that algal polysaccharides formed a denser protective network around the muscle fibers. Lipid oxidation (MDA), free-radical measurements, and non-targeted metabolomics revealed a significant reduction in oxidative damage at 40% seaweed addition, correlating with increased total phenolic content. Protein analyses (particle size, zeta potential, hydrophobicity, and SDS-PAGE) demonstrated a cryoprotective effect of seaweed on myofibrillar proteins, reducing aggregation and denaturation. These findings suggest that approximately 40% seaweed addition can improve the physicochemical stability and antioxidant capacity of frozen seaweed–yak meat products. This work thus identifies the optimal seaweed addition level for enhancing freeze–thaw stability and functional quality, offering practical guidance for the development of healthier, high-value restructured meat products. Full article

The efficient separation of antimonate minerals from quartz remains a significant challenge in mineral processing due to their similar surface properties and strong hydrophilicity. This study explored the application of sodium dodecyl sulfonate (SDS) as a selective collector for antimonate–quartz flotation separation. Micro-flotation tests demonstrated that SDS achieved optimal recovery of antimonate minerals (90.25%) at pH 8 with a dosage of 70 mg/L, while quartz recovery remained below 10%. Contact angle measurements revealed a significant increase in the hydrophobicity of antimonate minerals after SDS treatment, whereas quartz remained highly hydrophilic. FTIR and XPS analyses confirmed the selective chemisorption of SDS on antimonate mineral surfaces through Sb-O-S bond formation, while negligible adsorption occurred on quartz. Adsorption isotherms further showed the higher SDS uptake on antimonate minerals compared to quartz. These findings collectively demonstrate the effectiveness of SDS as a selective collector for the flotation of antimonate minerals, providing a promising approach to enhancing the recovery of fine antimonate particles. Full article

Background/Objectives: Young female cancer survivors often face specific informational needs related to the physical and emotional effects of cancer and its impact on life plans, particularly fertility and parenthood. However, few tools are tailored to assess these needs during this critical life stage. This study aimed to (i) validate a multidimensional measure—the Satisfaction with Information Provided to Young Oncology Patients Scale (SIPYF-CPS)—to assess the specific informational needs of young adult female cancer survivors; and (ii) explore preferences regarding the provision of information and counseling. Methods: A total of 124 women (M[age] = 38.18; SD = 5.49; range 21–45), 76.6% diagnosed with breast cancer, participated in the study. Psychometric analyses included exploratory factor analysis and correlation coefficients to assess reliability and construct validity. Convergent validity was evaluated through standardized measures of anxiety, reproductive concerns, and quality of life. Results: A final 22-item measure demonstrated strong reliability and validity, capturing four factors: (i) Disease-Related Information, (ii) Symptoms and Functional Limitations, (iii) Implications for Fertility and Parenthood, and (iv) Support Services. Participants expressed low satisfaction with information on fertility preservation, sexual health, and support services. Lower satisfaction was moderately associated with higher anxiety and depression while positively related to quality of life. Most participants preferred phased, face-to-face communication throughout the illness trajectory. Conclusions: The SIPYF-CPS is a valid, multidimensional tool that captures the complex and evolving informational needs of young female cancer survivors. Its clinical use may promote earlier, personalized, and emotionally responsive communication—supporting psychological well-being, informed decision-making, and long-term survivorship care. Full article

The build-up of a fouling layer on the membrane surface is believed to deteriorate flux and salt rejection by hindering back-diffusion of rejected salts, a phenomenon called cake-enhanced concentration polarization (CECP). Nevertheless, CECP effects have not been linked to the salt rejection properties of the membrane. Furthermore, the decline in salt rejection during fouling has not been related to the decreasing flux, to elucidate the effects of flux on solution rejection as described by the solution-diffusion (SD) model. Therefore, this work examined whether CECP is substantial in membranes with poor salt-rejection properties. Fouling was performed using sodium alginate, Al₂O₃, latex, and SiO₂. The effects of fouling on salt rejection were studied using two nanofiltration (NF) membranes, namely NF270 membrane (46% NaCl rejection) and NF90 membrane (>97% NaCl rejection). The measured flux and salt rejection profiles were compared to those predicted by the CECP and SD models. Overall, the flux declined more (30–60%) for the NF90 membrane (contact angle: 50 ± 3°) compared to the NF270 membrane (10–55%, contact angle: 39 ± 2°) under similar hydrodynamic conditions. Moreover, fouling had more effects on NaCl rejection for the NF90 membrane (2–45% decline) compared to the NF270 membrane (10–30% decline). The decrease in NaCl rejection for the NF90 membrane was ascribed to CECP effects and declining flux. Contrary, CECP effects were less important for the NF270 membrane, and rejection declined due to reduction in flux as predicted by the SD model, indicating that CECP may not be predominant in membranes that poorly reject salts. Full article

Introduction: Knee osteoarthritis (OA) is defined by articular cartilage loss, increased discomfort, and functional restrictions. Changes in lifestyle, painkillers, intra-articular injections, and, as a last resort, surgery are all part of clinical therapy. In this setting, intra-articular injections of hyaluronic acid (HA) represent a relevant and diffused therapeutic option. Materials and Methods: A prospective observational study was performed from October 2024 to May 2025 in 70 patients with knee OA. HA was administered in three intra-articular injections and was followed up at 3 and 6 months from the last injection. Knee Injury and Osteoarthritis Outcome Score (KOOS) was evaluated as primary outcome measure; Visual Analogue Scale (VAS), time up and go test, six-minute walking test, general health assessment with 36-Item Short Form Health Survey (SF-36), Zung’s Self-Rating Anxiety Scale (Zung SAS), and Zung’s Self-Rating Depression Scale (Zung SDS) as secondary outcome measures. Results: We observed a statistically significant improvement in clinical scores at 3 months in both HA formulations compared to the control group. No relevant side effects were described during the study. Conclusion: Hyalubrix 30 mg/2 mL and DIART 1.8%/2 mL are two safe and effective therapeutic options to manage knee OA, offering benefits in pain control, functionality and emotional wellness. Full article

Providing long-term care for a person with Alzheimer’s disease is associated with chronic stress and emotional overload. One of the key predictors of emotional burden is the amount of time devoted to caregiving, which intensifies the experienced stress. Additional risk factors include the stage of the illness, difficulties in the care recipient’s activities of daily living, the caregiver’s neglect of their own needs, and challenging behaviours exhibited by the person receiving care. Therefore, it is essential to identify the psychological protective resources of caregivers that can buffer the impact of stress. Background/Objectives: The objective of the study was to explore the psychological mechanisms underlying the involvement of caregivers supporting individuals with Alzheimer’s disease. A moderated mediation model was employed, in which stress indirectly affects caregiver involvement through a sense of coherence, and the strength of this relationship is moderated by the amount of time devoted to caregiving. Methods: The bootstrapping method was applied using 5000 resamples within a 95% bias-corrected confidence interval. The analysis accounted for variables such as stress levels, sense of coherence, involvement in caregiving, duration of care, education, gender, age, and stage of the illness. Results: The sense of coherence mediated the relationship between stress and involvement in caring (B = 0.0063, SE = 0.0031, 95% CI [0.0012, 0.0135]), and this indirect effect was contingent upon the amount of time devoted to helping. The relationship between sense of coherence and involvement in caring was significant at the mean level (B = 0.005, SE = 0.002, 95% CI [0.0004, 0.0101]) and became stronger at high levels of time devoted to caring (+1 SD; B = 0.009, SE = 0.003, 95% CI [0.0030, 0.0148]). These results indicate that the positive association between sense of coherence and caregiver involvement increases with the amount of time spent caring. Conclusions: The results highlight the importance of strengthening caregivers’ resilience resources—such as a sense of coherence—in preventing overload. The model may serve as a foundation for developing interventions aimed at supporting caregivers’ mental health. Full article

Background/Objectives: Hospitalized peripartum patients who later decompensate and require an upgrade to the intensive care unit (ICU) may have an increased risk for poor outcomes. Most of the literature regarding the need for ICU involves Modified Early Warning Scores in already hospitalized patients or the evaluation of specific comorbid conditions or diagnoses. This systematic review and meta-analysis aimed to assess the differences in clinical scores at admission among adult peripartum patients to identify the later need for ICU. Methods: We systematically searched Ovid-Medline, PubMed, EMBASE, Web of Science and Google Scholar for randomized and observational studies of adult patients ≥18 years of age who were ≥20 weeks pregnant or up to 40 days post-partum, were admitted to the wards from the emergency department and later required critical care services. The primary outcome was the Sequential Organ Failure Assessment (SOFA) score. Secondary outcomes included other clinical scores, the hospital length of stay (HLOS) and mortality. The Newcastle–Ottawa Scale was utilized to grade quality. Descriptive analyses were performed to report demographic data, with means (±standard deviation [SD]) for continuous data and percentages for categorical data. Random-effects meta-analyses were performed for all outcomes when at least two studies reported a common outcome. Results: Seven studies met the criteria, with a total of 1813 peripartum patients. The mean age was 27.2 (±2.36). Patients with ICU upgrades were associated with larger differences in mean SOFA scores. The pooled difference in means was 2.76 (95% CI 1.07–4.46, p < 0.001). There were statistically significant increases in Sepsis in Obstetrics Scores, APACHE II scores, and HLOS in ICU upgrade patients. There was a non-significantly increased risk of mortality in ICU upgrade patients. There was high overall heterogeneity between patient characteristics and management in our included studies. Conclusions: This systematic review and meta-analysis demonstrated higher SOFA or other physiologic scores in ICU upgrade patients compared to those who remained on the wards. ICU upgrade patients were also associated with a longer HLOS and higher mortality compared with control patients. Full article

Pangasius (Pangasianodon hypophthalmus) minced muscle with 1 and 2% salt was treated with different high-pressure processing and thermal methods, including conventional heat-induced gels (HIGs), high-pressure processing (HPP) prior to cooking (PC), HPP prior to setting (PS), and setting prior to HPP (SP), to evaluate for their effects on the selected physicochemical properties. The results showed that the PC treatment produced gels with a significantly higher gel strength (496.72–501.26 N·mm), hardness (9.62–10.14 N), and water-holding capacity (87.79–89.74%) compared to the HIG treatment, which showed a gel strength of 391.24 N·mm, a hardness of 7.36 N, and a water-holding capacity of 77.98%. PC gels also exhibited the typical microstructure of pressure-induced gels, with a denser and homogeneous microstructure compared to the rough and loosely connected structure of HIGs. In contrast, SP treatment exhibited the poorest gel quality in all parameters, with gel strength ranging from 319.79 to 338.34 N·mm, hardness from 5.87 to 6.31 N, and WHC from 71.91 to 73.72%. Meanwhile, the PS treatment showed a comparable gel quality to HIGs. SDS-PAGE analysis revealed protein degradation and aggregation in HPP-treated samples, with a decrease in the intensity of myosin heavy chains and actin bands. Fourier-transform infrared spectroscopy (FTIR) analysis showed minor shifts in protein secondary structures, with the PC treatment showing a significant increase in α-helices (28.09 ± 0.51%) and a decrease in random coil content (6.69 ± 0.92%) compared to α-helices (23.61 ± 0.83) and random coil structures (9.47 ± 1.48) in HIGs (p < 0.05). Only the PC treatment resulted in a significant reduction in total plate count (TPC) (1.51–1.58 log CFU/g) compared to 2.33 ± 0.33 log CFU/g in the HIG treatment. These findings suggest that HPP should be applied prior to thermal treatments (cooking or setting) to achieve an improved gel quality in reduced-salt pangasius products. Full article

Objectives: The aim of this study was to assess the association of diabetes mellitus and its medications with overall response (ORR) and mortality or cancer-specific survival (CSS) in patients with metastatic urothelial cancer receiving enfortumab vedotin monotherapy. Methods: This multicentre retrospective cohort study was designed according to the guidelines for the synthesis of qualitative research (ENTREQ). Eligible patients were adults (≥18) years treated with enfortumab vedotin monotherapy for metastatic urothelial cancer between June 2024 and January 2025. A total of 125 patients were reported across 11 centres. Results: The cohort included 93 males (74.4%) and 32 females (25.6%), with a mean age of 68.3 years (SD 9.3). The primary tumour site was the bladder in 109 (87.2%) cases and the upper tract (UTUC) in 16 (12.8%) cases. Interestingly, medication with metformin was significantly associated with cancer-specific mortality (37.9% versus 77.8%; p = 0.019), while patients with insulin-dependent diabetes mellitus had a significantly better CSS (Log Rank = 0.004). Upon comparing only patients who already had diabetes mellitus and then received anti-diabetic medication, there was a significant association between patients with diabetes mellitus receiving metformin and a worse 3-month ORR (80.0% versus 55.6%; p = 0.039). Regarding the subpopulation of UTUC, cancer-specific mortality was significantly associated with metformin medication (p = 0.033). Conclusions: Despite recent reports that metformin has protective effects in urothelial cancer, our findings suggest that metformin use may be linked to worse responses and survival outcomes in patients treated with enfortumab vedotin monotherapy. Further research, particularly translational research into the underlying diabetic and pharmacologic pathways, is warranted. Full article

International students are an important group at German higher education institutions. Yet few studies have considered the psychosocial situation of these students. The present study combines the study demands-resources model (SD-R model) and the acculturation framework to adapt the former to the specific situation of international students, and examines the effects of study demands, institutional resources, individual resources (acculturation orientations, i.e., affective and cognitive orientations towards the home and host country), stress, and engagement on their life satisfaction as one indicator of well-being. We used cross-sectional survey data from 503 international students across more than 20 higher education institutions. Latent structural equation models showed that lower study demands were associated with lower stress and higher student engagement, which in turn predicted greater life satisfaction. Although higher institutional resources also related to increased engagement and, thus, higher life satisfaction, they were unexpectedly linked to increased stress, which was in turn associated with lower life satisfaction. Additionally, the expected positive effect of affective host country orientation on life satisfaction, mediated through perceived stress and engagement, was confirmed. The consideration of acculturation orientations in the SD-R model helps to understand the specific conditions of well-being amongst international students in Germany. Full article

The broad-spectrum insect growth regulator (IGR) and insecticide 2-((1-(4-Phenoxyphenoxy)propan-2-yl)oxy)pyridine (MPEP; also known as pyriproxyfen) is increasingly being used to address public health programs for vector control, initiated by the spread of Zika virus in 2015–2016. While considered relatively safe for humans under normal conditions, limited toxicology data are available. Current studies were undertaken to address the data gap regarding potential immunotoxicity of MPEP, with particular emphasis on host resistance to viral infection. Hsd:Harlan Sprague Dawley SD^® rats were treated for 28 days by oral gavage with doses of 0, 62.5, 125, 250 or 500 mg/kg/day of MPEP in corn oil. There was a dose-dependent increase in liver weights which is consistent with the liver playing a dominant role in MPEP metabolism. However, no histological correlates were observed. Following treatment, rats were subjected to a battery of immune tests as well as an established rat model of influenza virus infection to provide a comprehensive assessment of immune function and host resistance. While several of the immune tests showed minor exposure-related changes, evidenced by negative dose–response trends, most did not show significant differences in any of the MPEP treatment groups relative to vehicle control. Most notable was a negative trend in pulmonary mononuclear cell phagocytosis with increases in dose of MPEP. There was also a positive trend in early humoral immune response (5 days after immunization) to keyhole limpet hemocyanin (KLH) as evidenced by increased serum anti-KLH IgM antibodies which was followed later (14 days following immunization) by decreasing trends in anti-KLH IgM and IgG antibody levels. However, MPEP treatment had no effect on the ability of rats to clear the influenza virus nor the T-dependent IgM and IgG antibody response to the virus. The lack of effects of MPEP on host resistance to influenza suggests the immune effects were minimal and unlikely to present a hazard with respect to susceptibility to respiratory viral infection. Full article