Search Results (837)

Background/Objectives: Health education plays a vital role in training health professionals and caregivers, supporting both prevention and the promotion of self-care. In this context, technology serves as a valuable ally by enabling continuous and flexible learning. Among the various domains of health education, nutrition stands out as a key element in the management of Amyotrophic Lateral Sclerosis (ALS), helping to prevent malnutrition and enhance patient well-being. Accordingly, this study aimed to evaluate the effectiveness of the teaching and learning processes within a learning pathway focused on food and nutrition in the context of ALS. Methods: This study adopted a longitudinal, quantitative design. The learning pathway, titled “Food and Nutrition in ALS,” consisted of four self-paced and self-instructional Massive Open Online Courses (MOOCs), offered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). Participants included health professionals, caregivers, and patients from all five regions of Brazil. Participants had the autonomy to complete the courses in any order, with no prerequisites for enrollment. Results: Out of 14,263 participants enrolled nationwide, 182 were included in this study after signing the Informed Consent Form. Of these, 142 (78%) completed at least one course and participated in the educational intervention. A significant increase in knowledge was observed, with mean pre-test scores rising from 7.3 (SD = 1.8) to 9.6 (SD = 0.9) on the post-test across all courses (p < 0.001). Conclusions: The self-instructional, technology-mediated continuing education model proved effective in improving participants’ knowledge about nutrition in ALS. Future studies should explore knowledge retention, behavior change, and the impact of such interventions on clinical outcomes, especially in multidisciplinary care settings. Full article

In the study of biomechanical models, balance represents a complex problem due to the issue of indeterminate forces while standing. In order to solve this problem, it is essential to measure the ground reaction forces (GRFs) applied to each foot independently. The present work proposes a methodology for determining the independent GRF applied to each foot while standing when only one forceplate is available. For this purpose, an analytical method is proposed to determine the distribution of vertical GRFs and the position of the independent center of pressure (CoP) in each foot. Concurrently, several neural network (NN) models are trained to improve the results obtained. This hypothesis is experimentally validated by a self-developed device that allows one to simultaneously obtain the vertical GRF and CoP location of each foot at the same time that the GRF and the global CoP location are obtained from a single forceplate. The results obtained achieve a CoP position error of less than 8% and a vertical force error of 2%. The analytical hypothesis is demonstrated to offer a satisfactory level of precision, while the NN is shown to result in considerable improvement in some cases. Full article

Background/Objectives: Malnutrition in older adults is both preventable and treatable, yet its detection and etiology remain complex. Therefore, the aim of this study was to evaluate the prevalence of malnutrition and various factors involved in the etiology of malnutrition in community-dwelling individuals aged 65 years and older. Methods: This cross-sectional study was conducted with community-dwelling individuals aged 65 years and older in a health center in Ağrı, Türkiye. The nutritional status of older adults was measured using the Mini Nutritional Assessment (MNA). Data were collected through face-to-face interviews and a series of validated instruments, including the Standardized Mini Mental Examination (MMSE), body composition measurements (BIA), dietary intake records, and physical performance tests such as hand grip strength, chair stand, and Timed ‘Up & Go’ (TUG) Test. Statistical analyses included chi-square and Mann-Whitney U tests for group comparisons and logistic regression to investigate independent factors associated with risk of malnutrition. Results: A total of 182 participants were included in the study. The mean age of the participants was 72.1 ± 6.0 years. Of the participants, 59.3% were male. 1.6% of the participants were malnourished, and 25.3% were at risk of malnutrition. Perceived health status compared to peers (OR: 1.734, 95% CI: 1.256–2.392, p = 0.001), lower appetite status (OR: 1.942, 95% CI: 1.459–2.585, p < 0.001) and lower waist circumference (OR: 1.089, 95% CI: 1.040–1.140, p < 0.001) were independent predictors of malnutrition risk. Conclusions: The risk of malnutrition was higher among individuals with lower appetite, poorer self-perceived health status compared to peers, and smaller waist circumference. Reduced physical function and strength were also associated with an increased risk of malnutrition. Full article

This study explores the self-healing properties of polyurethane nanocomposites enhanced by multiple hydrogen bonds from ureido-pyrimidinone and the incorporation of 1–3 wt.% graphene nanoparticles, based on polyol α,ω-dihydroxy[oligo(butylene-ethylene adipate)]diol, which, according to our knowledge, has not been previously used in such systems. These new materials were synthesized via a two-step process and characterized by their thermal, mechanical, chemical, and self-healing properties. The mechanical analysis revealed that all nanocomposites exhibited high self-healing efficiencies (88–91%). The PU containing 2% graphene stands out as it exhibits the highest initial mechanical strength of ~5 MPa compared to approximately 2MP for a pristine PU while maintaining excellent self-healing efficiency (88%). A cut on the PU nanocomposite with 2% graphene can be completely healed after being heated at 80 °C for 1 h, which shows that it has a fast recovery time. Moreover, 3D printing was also successfully used to assess their processability and its effect on self-healing behavior. Three-dimensional printing did not negatively affect the material regeneration properties; thus, the material can be used in a variety of applications as expected in terms of dimensions and geometry. Full article

Background/Objectives: The demand for accessible and reliable digital health services has increased significantly in recent years, particularly in regions facing physician shortages. HomeDOCtor, a conversational AI platform developed in Slovenia, addresses this need with a nationally adapted architecture that combines retrieval-augmented generation (RAG) and a Redis-based vector database of curated medical guidelines. The objective of this study was to assess the performance and impact of HomeDOCtor in providing AI-powered healthcare assistance. Methods: HomeDOCtor is designed for human-centered communication and clinical relevance, supporting multilingual and multimedia citizen inputs while being available 24/7. It was tested using a set of 100 international clinical vignettes and 150 internal medicine exam questions from the University of Ljubljana to validate its clinical performance. Results: During its six-month nationwide deployment, HomeDOCtor received overwhelmingly positive user feedback with minimal criticism, and exceeded initial expectations, especially in light of widespread media narratives warning about the risks of AI. HomeDOCtor autonomously delivered localized, evidence-based guidance, including self-care instructions and referral suggestions, with average response times under three seconds. On international benchmarks, the system achieved ≥95% Top-1 diagnostic accuracy, comparable to leading medical AI platforms, and significantly outperformed stand-alone ChatGPT-4o in the national context (90.7% vs. 80.7%, p = 0.0135). Conclusions: Practically, HomeDOCtor eases the burden on healthcare professionals by providing citizens with 24/7 autonomous, personalized triage and self-care guidance for less complex medical issues, ensuring that these cases are self-managed efficiently. The system also identifies more serious cases that might otherwise be neglected, directing them to professionals for appropriate care. Theoretically, HomeDOCtor demonstrates that domain-specific, nationally adapted large language models can outperform general-purpose models. Methodologically, it offers a framework for integrating GDPR-compliant AI solutions in healthcare. These findings emphasize the value of localization in conversational AI and telemedicine solutions across diverse national contexts. Full article

Background: Manual wheelchair propulsion is often associated with pain in the upper extremities. Recording spatio-temporal parameters can optimize movement patterns and prevent injuries. This study compares a marker-based camera system with inertial measurement units to validate their use in wheelchair propulsion on a test stand. Methods: Spatio-temporal parameters of 27 manual wheelchair users propelling at three self-selected speeds (slow, normal, fast) were simultaneously recorded using a marker-based camera system and inertial measurement units, and subsequently compared between both systems. Results: A high correlation was observed among all spatio-temporal parameters (ρ > 0.992). The biases for the start time of hand contact with the pushrim (−0.02 ± 0.02 s), hand release from the pushrim (−0.02 ± 0.01 s), and push length (−0.45 ± 21.45 ms) were slightly overestimated, while recovery length (0.54 ± 21.02 ms), cycle speed (2.37 ± 2.67°/s), and push angle (1.75 ± 4.14°) were slightly underestimated. No bias was found for propulsion frequency. Conclusions: The spatio-temporal parameters recorded using inertial measurement units are suitable for the evaluation of manual wheelchair propulsion and can be used in a clinical context. The low acquisition costs and simple installation process may increase the use of inertial measurement units in the future. Full article

Cell migration assays provide valuable insights into pathological conditions, such as tumor metastasis and immune cell infiltration, and the regenerative capacity of tissues. In vitro tools commonly used for cell migration studies exploit commercial transwell systems, whose functionalities can be improved through engineering of the pore pattern. In this context, we propose the fabrication of a transwell-like device pursued by combining the proton beam writing (PBW) technique with wet etching onto thin layers of polydimethylsiloxane (PDMS). The resulting transwell-like device incorporates a PDMS membrane with finely controllable pore patterning that was used to study the arrangement and migration behavior of HCMEC/D3 cells, a well-established human brain microvascular endothelial cell model widely used to study vascular maturation in the brain. A comparison between commercial polycarbonate membranes and the PBW-holed membranes highlights the impact of the ordering of the pattern and porosity on cellular growth, self-organization, and transmigration by combining fluorescent microscopy and advanced digital processing. Endothelial cells were found to exhibit distinctive clustering, alignment, and migratory behavior close to the pores of the designed PBW-holed membrane. This is indicative of activation patterns associated with cytoskeletal remodeling, a critical element in the angiogenic process. This study stands up as a novel approach toward the development of more biomimetic barrier models (such as organ-on-chips). Full article

The objective of this research was to conduct a comprehensive review of rainbow trout (Oncorhynchus mykiss) culture in recirculating aquaculture systems (RAS), identify knowledge gaps, and propose strategies oriented towards intelligent and sustainable aquaculture. A systematic review and bibliometric analysis of 387 articles published between 1941 and 2025 in the Scopus database was carried out. Since 2011, there has been a sustained growth in scientific production, with the United States, Denmark, Finland, and Germany standing out as the main contributors. The journals with the highest number of publications were Aquacultural Engineering, Aquaculture, and Aquaculture Research. The conceptual analysis revealed the following three thematic clusters: experimental studies on physiology and metabolism; research focused on nutrition, growth, and yield; and technological developments for water treatment in RAS. This evolution reflects a transition from basic approaches to applied technologies oriented towards sustainability. There was also evidence of a thematic transition toward molecular tools such as proteomics, transcriptomics, and real-time PCR. However, there is still limited integration of smart technologies such as the IoT. It is recommended to incorporate self-calibrating multi-parametric sensors, machine learning models, and autonomous systems for environmental regulation in real time. Full article

Background: Osteogenesis imperfecta (OI) is a rare genetic connective tissue disorder characterized by bone fragility, most often caused by pathogenic variants in type I collagen genes. In this context, we aimed to describe the clinical and epidemiological characteristics of patients with OI who were hospitalized for coronavirus disease (COVID)-19 in Brazil between 2020 and 2024. Methods: We conducted a retrospective descriptive analysis using data from the Brazilian Unified Health System (SUS, which stands for the Portuguese Sistema Único de Saúde) through the Open-Data-SUS platform. Patients with a confirmed diagnosis of OI and hospitalization due to COVID-19 were included. Descriptive statistical analysis was performed to evaluate demographic, clinical, and outcome-related variables. We included all hospitalized COVID-19 cases with a confirmed diagnosis of OI between 2020 and 2024. Results: Thirteen hospitalized patients with OI and COVID-19 were identified. Most were adults (9; 69.2%), male (7; 53.8%), self-identified as White (9; 69.2%), and all were residents of urban areas (13; 100.0%). The most frequent symptoms were fever (10; 76.9%), cough (9; 69.2%), oxygen desaturation (9; 69.2%), dyspnea (8; 61.5%), and respiratory distress (7; 53.8%). Two patients had heart disease, one had chronic lung disease, and one was obese. As for vaccination status, five patients (38.5%) had been vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Four patients (30.8%) required admission to an intensive care unit (ICU), and six (46.2%) required noninvasive ventilatory support. Among those admitted to the ICU, only two required invasive mechanical ventilation. The clinical outcome was death in two cases (15.4%). Both patients were male, White, and had not been vaccinated against SARS-CoV-2. One was 47 years old, was not admitted to the ICU, but required noninvasive ventilation. Despite the underlying condition most patients had favorable outcomes, consistent with an international report. Conclusions: This is the first report to describe the clinical and epidemiological profile of patients with OI hospitalized for COVID-19 in Brazil, providing initial insights into how a rare bone disorder intersects with an acute respiratory infection. The generally favorable outcomes observed—despite the underlying skeletal fragility—suggest that individuals with OI are not necessarily at disproportionate risk of severe COVID-19, particularly when appropriately monitored. The occurrence of deaths only among unvaccinated patients underscores the critical role of SARS-CoV-2 vaccination in this population. Although pharmacological treatment data were unavailable, the potential protective effects of bisphosphonates and vitamin D merit further exploration. These findings support the need for early preventive strategies, systematic vaccination efforts, and dedicated clinical protocols for rare disease populations during infectious disease outbreaks. Full article

Accurate weed detection in soybean fields is essential for enhancing crop yield and reducing herbicide usage. This study proposes a YOLO-SW model, an improved version of YOLOv8, to address the challenges of detecting weeds that are highly similar to the background in natural environments. The research stands out for its novel integration of three key advancements: the Swin Transformer backbone, which leverages local window self-attention to achieve linear O(N) computational complexity for efficient global context capture; the CARAFE dynamic upsampling operator, which enhances small target localization through context-aware kernel generation; and the RTDETR encoder, which enables end-to-end detection via IoU-aware query selection, eliminating the need for complex post-processing. Additionally, a dataset of six common soybean weeds was expanded to 12,500 images through simulated fog, rain, and snow augmentation, effectively resolving data imbalance and boosting model robustness. The experimental results highlight both the technical superiority and practical relevance: YOLO-SW achieves 92.3% mAP@50 (3.8% higher than YOLOv8), with recognition accuracy and recall improvements of 4.2% and 3.9% respectively. Critically, on the NVIDIA Jetson AGX Orin platform, it delivers a real-time inference speed of 59 FPS, making it suitable for seamless deployment on intelligent weeding robots. This low-power, high-precision solution not only bridges the gap between deep learning and precision agriculture but also enables targeted herbicide application, directly contributing to sustainable farming practices and environmental protection. Full article

Social media applications (SMAs) stand at the forefront of emerging technologies in language education due to their transformative potential to enhance English speaking skills. Unlike traditional tools, SMAs leverage features like real-time communication, multimedia integration, and global connectivity, fostering authentic, meaningful interactions in socially engaging environments. Although learning management systems (LMSs) such as Brightspace have been predominantly used to conduct English language learning activities, including peer feedback, SMAs like Facebook offer unique affordances that may further promote student engagement and confidence. Developing public speaking skills is critical for effective communication in English language education; however, many students struggle with self-efficacy, speaking anxiety, and providing meaningful feedback to peers. Given the potential benefits of SMAs, this study explored their comparative impact on three dimensions of English language learning: English public speaking self-efficacy, peer feedback self-efficacy, and English speaking performance. This quasi-experimental study used a pretest–posttest design with undergraduate students (n = 15) at a large Midwestern university in the United States. Independent sample t-tests were conducted to compare outcomes between the Facebook and Brightspace groups. The results revealed that both SMAs and LMSs were equally effective platforms for peer feedback activities, with no significant differences found between groups across the three targeted areas of learning. Full article

Introduction: The escalating scarcity of skilled healthcare professionals is particularly pronounced within surgical specialties, where the prospect of attracting prospective medical practitioners poses formidable challenges. Throughout their academic journey, students exhibit diminishing enthusiasm and motivation to pursue careers in surgery, including trauma surgery. It is postulated that the caliber of teaching plays a pivotal role in influencing students’ subsequent specialization choices. Methods: This prospective observational study was conducted among a cohort of third-year medical students at the German University Medicine Greifswald. The methodology encompassed the utilization of a self-administered questionnaire to procure data. Results: The study encompassed 177 participants, of whom 34.7% expressed an inclination toward a career in surgery (22.7% in trauma surgery). Participants who reported a favorable impact from the examination course displayed a significantly heightened interest in clinical clerkships within trauma surgery (p < 0.001), and even expressed a contemplation of specializing in orthopedics and trauma surgery (p = 0.001). Logistic regression analysis highlighted that the convergence of practical training and positive role modeling emerged as the most influential factors augmenting the allure of trauma surgery. Conclusions: Evidently, students who gleaned substantial benefits from high-quality practical instruction in trauma surgery exhibited a significantly heightened likelihood of pursuing this domain in their future endeavors. Surgical academic institutions stand to leverage this insight in their strategic planning for attracting and retaining potential residents. Cultivating a positive affinity for trauma surgery should be instilled early in the curriculum, subsequently sustained through ongoing immersive engagement that encompasses professional as well as interpersonal dimensions. Full article

Robinia pseudoacacia is one of the most widely introduced—but also controversial—tree species in Europe. On the one hand, it is valued for its productivity, timber quality, and melliferous blossom. On the other hand, it is highly invasive and causes habitat change and homogenization. The aim of the study reported on here was to assess the genetic diversity of selected R. pseudoacacia stands in Lithuania in districts with the highest black locust stands frequency and to evaluate its spatial distribution in self-establishing stands. To achieve this aim, we employed four nuclear SSR loci (Rops 02, Rops 05, Rops 06, and Rops 08) and investigated the genetic diversity of five R. pseudoacacia plots. The study results reveal that R. pseudoacacia in Lithuania is genetically diverse (the average allele number per plot was 3.66, and the average Ho was 0.83). R. pseudoacacia in the plots forms tight clonal groups that hardly intermix with each other; it also spreads by seeds (66 single-copy genotypes were found in total in all 5 investigated plots). R. pseudoacacia stands in Lithuania originate from different seed sources and from different introduction events, as revealed by the allelic pattern, genetic diversity, and genetic differentiation among the research plots. Full article

Due to the high demand for fuel efficiency, electric vehicles have come into the picture, as they only use batteries to power the vehicle. This requires constant charging of the batteries at charging stations, which are costly and impractical to install. But it is possible to install charging stations by making use of photovoltaic (PV) cells and demagnetization currents to self-charge batteries under stand-still conditions. The design of a bidirectional converter with asymmetrical half-bridge converter based on a switched reluctance motor (SRM) drive, using PV for electric vehicles, is implemented in this paper. It consists of developing a control unit (GCU), Li-ion battery pack, and photovoltaic (PV) solar cells that are integrated with a bidirectional converter and asymmetrical half-bridge converter (AHBC) to provide power to the SRM drive. The solar-assisted SRM drive can be operated in either the motoring mode or charging mode. In the motoring-mode GCU, the battery or PV energy can be used in any combination to power the SRM. In the charging-mode PV, the GCU and AC grids are used to charge the battery under stand-still conditions. This work helps in the self-charging of batteries using either the GCU or PV cells, as well as aids in the improvement in the performance characteristics. Also, this work compares the performance metrics for the proposed system and conventional system. The performance of the drive system using PV cells/GCU is evaluated and verified through MatLab/Simulink and experimental results. Full article

This article aims to provide an account of the political thought of Archbishop John Carroll on the topic of religious liberty as a core principle of the American founding. It examines the relationship of Church and State through the lens of a developing self-understanding in the American and Roman Catholic identities. American Catholic colonists were accused of having a divided allegiance that made them dangerous to the social compact, divided between papal authority and the authority of the republic. Further, the place of the Catholic Church in a more pluralistic religious landscape following the Reformation demanded a reexamination of the traditional Catholic teaching on religious liberty. One man in particular stands out as a seminal figure in the development of a rapprochement between the American liberal understanding of religious liberty and that of the Catholic tradition. This man was Archbishop John Carroll, the first Roman Catholic Bishop in America. Carroll’s theoretical and practical approach to the highly contentious issue of religious liberty is a noteworthy example of simultaneous commitment to the Catholic faith and responsiveness to the exigencies of the moment and the perennial demands of political life. Carroll’s example is useful for Catholics and all others, as a model for Church–State separation. Full article