Search Results (5,446)

Background/Objectives: Digital technologies are increasingly used in interventions for children with Autism Spectrum Disorder (ASD) to support language development. However, existing evidence remains fragmented due to heterogeneity in intervention types, participant characteristics, and outcome measures. This systematic review aims to synthesize current empirical findings on the effects of digital interventions on language development in children with ASD and to identify key factors influencing intervention effectiveness. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Searches were performed in PubMed, Scopus, Web of Science, ERIC, and PsycINFO for studies published between 2010 and 2025. Eligible studies included experimental, quasi-experimental, and intervention-based designs involving children aged 2–18 years with ASD and reporting at least one language-related outcome. Data extraction was performed independently by two reviewers using a structured form. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist and CASP tools. Due to heterogeneity across studies, a narrative synthesis approach was applied. Results: A total of 61 studies met the inclusion criteria. Findings indicate that digital interventions generally have positive effects on language development in children with ASD, with stronger and more consistent outcomes in receptive and expressive language domains. Intervention effectiveness varied according to duration, intensity, content quality, and contextual factors such as family involvement and technological access. Conclusions: The evidence suggests that digital interventions may have positive effects on language development in children with ASD, particularly in receptive and expressive language domains. Among intervention types, video modeling and AI-supported approaches appear to show promising outcomes; however, these findings should be interpreted with caution due to the limited number of AI-focused studies and substantial heterogeneity in study designs, sample characteristics, and outcome measures. Gamified and mobile applications demonstrate moderate effects, especially in vocabulary and pragmatic language skills. Overall, intervention effectiveness varies according to duration, intensity, content quality, and contextual factors such as family involvement and technological access. Future research should prioritize standardized methodologies and longitudinal designs. Full article

Background/Objectives: Chronic pain represents a major global health burden and significantly impacts quality of life and functional capacity. Physiotherapy plays a central role in its management, yet the rapid growth of research in this field makes it difficult to identify current trends and emerging directions. The aim of this study was to analyze global research trends in chronic pain physiotherapy using a bibliometric approach. Methods: A bibliometric analysis was conducted using data retrieved from PubMed, Scopus, and Web of Science. A predefined search strategy was applied to identify relevant publications. Data were analyzed and visualized using VOSviewer. Co-occurrence analysis of terms based on titles and abstracts was performed using full counting. The most relevant terms were selected using a relevance score threshold, and a thesaurus file was applied to improve data quality. Results: The number of publications increased steadily from 2015 to 2025, indicating growing research interest in chronic pain physiotherapy. Network analysis revealed key research clusters related to clinical interventions, functional assessment, and outcome evaluation. The most prominent and central terms included “pelvic pain”, “neck disability index”, and “radicular pain”. Overlay visualization identified emerging topics such as “stratified care”, “multidisciplinary rehabilitation”, and “psychometric property”, reflecting a shift toward personalized and patient-centered approaches. Conclusions: Research in chronic pain physiotherapy is rapidly expanding, with a clear transition from traditional intervention-focused approaches toward individualized, multidisciplinary, and outcome-driven strategies. These findings provide insight into current research directions and may support clinicians and researchers in identifying future priorities in chronic pain management. Full article

Background/Objectives: Periodontitis is a highly prevalent inflammatory disease and a major cause of tooth loss worldwide. Accurate diagnosis requires integration of clinical and radiographic findings, but interpretation of panoramic radiographs is subject to variability. Artificial intelligence (AI) has emerged as a promising adjunct for radiographic assessment. This systematic review evaluated the diagnostic performance of AI-based models for detecting periodontitis using panoramic radiographic images. Methods: A systematic search of PubMed, Scopus, and Web of Science identified studies published between 1 January 2015 and 1 March 2026. Eligible studies assessed AI models for periodontitis detection on panoramic radiographs and used either clinically confirmed periodontal diagnosis or expert radiographic annotation as the reference standard. Data extraction and quality assessment were performed independently by two reviewers using the QUADAS-2 tool. Owing to heterogeneity in AI architectures, datasets, and outcome measures, a narrative synthesis was conducted. Results: Nine studies met the inclusion criteria, comprising more than 20,000 radiographs. AI models included convolutional neural networks (CNNs), segmentation-based systems, and hybrid architectures. Sensitivity ranged from 0.795 to 1.00, specificity from 0.784 to 0.99, and AUC values from 0.843 to 0.967. Studies using clinical periodontal diagnosis as the reference standard generally reported lower performance than those relying solely on expert annotation. Only four studies performed external validation, and dataset sizes varied widely. One study combining panoramic and periapical radiographs showed moderate diagnostic performance. Conclusions: AI-based diagnostic models demonstrate promising performance for detecting periodontitis on panoramic radiographs, with several studies reporting high sensitivity and AUC values. However, heterogeneity in reference standards, limited external validation, and inconsistent dataset quality restrict generalizability. AI should be considered an adjunct to, rather than a replacement for, comprehensive clinical periodontal examination. Standardized datasets and robust external validation are needed to support clinical implementation. Full article

Background/Objectives: The rise in unhealthy habits such as a sedentary lifestyle, coupled with increasing obesity rates among children and young people, presents a health problem that must be addressed from various perspectives. Thus, the educational context, and specifically physical education, offers a prime setting for implementing programmes that reduce the levels of physical inactivity and improve pupils’ nutritional behaviours. Therefore, the aim of this study was to conduct a systematic review to collect and analyse the scientific literature addressing the effects of school-based intervention programmes on physical activity and nutrition. Methods: To this end, a systematic review was carried out, based on the PRISMA method, in the ERIC, PubMed, Scopus, SportDiscus and Web of Science databases, analysing the scientific literature that included school-based interventions combining physical activity and nutrition. A total of 410 articles were identified, with 16 studies ultimately included following the application of the inclusion and exclusion criteria. Results: The results indicated that the implementation of school programmes combining physical activity and nutrition can bring benefits in both areas, or at least in one of them. Similarly, several of the studies analysed showed improvements within the community, which helped to increase health literacy. Conclusions: The main conclusion is that the educational setting can serve as a platform for implementing programmes that improve the physical activity and nutritional habits of pupils and their wider environment, and, crucially, enhance health literacy. Full article

Background/Objectives: The systematic review aims to highlight the effects of school-based physical activity and nutritional supplementation programs in obese children from preschool to high school, based on randomized controlled trials. Methods: The search strategy was designed based on the PICOS framework. Then, a systematic review of relevant articles was conducted across six databases (Cochrane Library, PubMed, ProQuest, SCOPUS, Web of Sciences and SPORTDiscus) to identify articles that included children from preschool to high school who engaged in physical activity at school and received nutritional supplementation. All the included studies were assessed using the RoB-2 checklist. Results: Of the 234 studies reviewed, six met the inclusion criteria for this systematic review (publication years: 2023–2025). The results revealed highly heterogeneous interventions and mixed outcomes, often influenced by factors such as supplement type, dosage and participant gender. This limited and inconsistent body of evidence underscores a significant gap in the literature concerning the combined effects of school-based exercise and nutritional supplementation in obese youth. Conclusions: Limited evidence suggests mixed results with multi-micronutrient supplementation showing some benefits in boys from resource-limited settings, while several interventions demonstrated no effects. Energy-dense supplementation proved counterproductive. Gender-stratified approaches are recommended, but cautious implementation is warranted given methodological limitations and inconsistent findings. Full article

Background/Objectives: Resveratrol, a natural polyphenol with anti-inflammatory and antioxidant properties, has emerged as a promising adjunctive agent in periodontal therapy. This systematic review and meta-analysis evaluated evidence from in vitro, in vivo, and human clinical studies regarding the effects of resveratrol on periodontal disease, with the clinical component focusing on systemically healthy non-smoking patients. Methods: Electronic searches of MEDLINE/PubMed, Scopus, Embase, and Web of Science were conducted for studies published between 2000 and 2025. Eligible studies included periodontal-related in vitro cell models, in vivo experimental periodontitis models, and randomized clinical trials assessing resveratrol as an adjunctive therapy. Data extraction, risk-of-bias assessment, and meta-analyses were conducted in accordance with PRISMA guidelines. Results: Fifteen studies were included (five in vitro, six in vivo, and five human randomized controlled trials). Meta-analysis showed the inhibitory effect of resveratrol on the lipopolysaccharide-induced protein expression of IL-1β, IL-6, TNF-α, and IL-8 in vitro, with low to moderate heterogeneity. In animal studies, resveratrol significantly attenuated ligature-induced dental alveolar bone loss, IL-1β protein, and relative mRNA expression. However, reductions in relative mRNA expressions of TNF-α and IL-6 were inconsistent and highly heterogeneous; in contrast, nanoparticle- and liposomal-modified resveratrol consistently and significantly reduced these mRNA levels. In human trials, adjunctive resveratrol was associated with improvements in probing pocket depth and clinical attachment level compared with root planing alone in patients with periodontitis, as well as reductions in bleeding and plaque indices in patients with periodontal diseases, including gingivitis and periodontitis. Conclusions: Resveratrol suppresses pro-inflammatory cytokine expression in vitro and attenuates alveolar bone loss in vivo, with enhanced and more consistent molecular effects observed using modified formulations. Preliminary clinical evidence suggests that resveratrol may be associated with modest adjunctive effects on periodontal outcomes in systemically healthy non-smokers. However, given the limited number of clinical trials, small sample sizes, heterogeneity among studies, short follow-up periods, and limited certainty of the evidence, these findings should be interpreted cautiously. Further well-designed RCTs with longer follow-up periods are required to determine their clinical relevance. Full article

Background: Conventional ophthalmic eye drops have low bioavailability (<5%) and poor patient adherence, driving the development of sustained-release ophthalmic drug delivery systems. The lacrimal drainage system represents a unique anatomical site for minimally invasive depot formulations. Objective: To summarize and critically appraise punctal and intracanalicular drug delivery systems, occlusive devices, and in situ-forming hydrogels with respect to composition, release mechanisms, clinical efficacy, safety, and critical quality attributes (CQAs). Methods: A narrative literature review was conducted using PubMed, Scopus, Web of Science, Google Scholar, ClinicalTrials.gov, and patent/regulatory sources, including FDA materials and Google Patents, covering 2001–2026. Anatomical features, materials, active pharmaceutical ingredients, release profiles, and adverse events were analyzed. Results: Seventy-one sources were included. Occlusive plugs without an active pharmaceutical ingredient demonstrate premature expulsion in up to 57.4% of cases and bacterial colonization in 44%. Drug delivery systems provide release from 7 days (PEGDA hydrogels) to 3 months (Eximore, Ocular Therapeutix™). DEXTENZA^® (dexamethasone) is FDA-approved for postoperative inflammation, whereas pivotal trials of travoprost (OTX-TP) and latanoprost systems (L-PPDS, EXP-LP) did not demonstrate superiority over placebo or eye drops. In situ systems eliminate size-fitting requirements but face challenges related to gelation control and biodegradation. Conclusions: We propose the following candidate CQAs: retention (>80% over 4 weeks), swelling degree (30–60%), controlled burst release (<40% within 24 h), and mechanical compatibility. The proposed QTPP matrices for punctal, intracanalicular, and in situ systems may guide the development of ophthalmic drug delivery platforms. Full article

Background/Objectives: Knee osteoarthritis (OA) is increasingly recognized as a condition with an inflammatory component. Elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are associated with disease severity. However, the effects of physical therapy on inflammatory biomarkers remain unclear. This review aimed to evaluate the effects of physical therapy interventions on CRP and ESR in adults with knee OA. Methods: Following PRISMA 2020 guidelines, PROSPERO (CRD42024590843), PubMed, MEDLINE, Embase, Scopus, Web of Science, and Google Scholar were searched from inception to 3 November 2024. Randomized controlled trials comparing any physical therapy intervention with a control condition were included. Risk of bias was assessed using the Physiotherapy Evidence Database (PEDro) scale, and certainty of evidence was evaluated using the GRADE approach. Random-effects meta-analyses were performed using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results: Seven RCTs (n = 523 participants) were included. Pooled analysis showed a statistically significant reduction in CRP (SMD = −1.05; 95% CI: −1.80 to −0.31; p = 0.006); however, substantial heterogeneity was observed (I² = 93%), limiting confidence in the pooled estimate. Certainty of evidence for CRP was rated as moderate. No significant effect was observed for ESR (SMD = −0.20; 95% CI: −0.84 to 0.45; p = 0.56; I² = 63%), with low certainty. Conclusions: Physical therapy may reduce CRP levels in knee OA; however, substantial heterogeneity limits confidence in the precision and generalizability of this effect. These findings should be interpreted cautiously and considered exploratory. Further well-designed RCTs are required. Full article

Background/Objectives: Pulmonary hypertension (PH) is an increasingly recognized complication in patients with end-stage renal disease (ESRD) undergoing hemodialysis, particularly those utilizing arteriovenous fistulas (AVF) or grafts (AVG) for vascular access. The prevalence and clinical impact of PH in this population remain unclear due to methodological heterogeneity and variable diagnostic criteria. This systematic review and meta-analysis aimed to quantify the association between AVF/AVG use and PH prevalence in ESRD patients and to explore sources of heterogeneity. Methods: A systematic search of PubMed, Embase, Scopus, and Web of Science was conducted for studies published through 31 December 2024, without language or date restrictions. Eligible studies included adults (≥18 years) with ESRD on dialysis, comparing those with AVF/AVG access to non-AVF/AVG controls (e.g., tunneled dialysis catheters or peritoneal dialysis), and reporting PH prevalence or mean pulmonary artery pressures. Study quality was assessed using the Newcastle–Ottawa Scale, and risk of bias was evaluated. A random-effects meta-analysis calculated pooled odds ratios (OR) for PH prevalence, with heterogeneity assessed by I² and Cochran’s Q. Sensitivity analyses and tests for publication bias (Egger’s and Begg’s) were performed. Secondary analysis compared pooled mean pulmonary artery pressures between groups. Results: Eleven observational studies (1299 dialysis patients) met the inclusion criteria; ten studies (1224 patients) contributed to the quantitative meta-analysis after exclusion of one study with a zero-event control arm. Most studies were small, predominantly cross-sectional, and of moderate methodological quality. The pooled analysis showed a statistically significant association between AVF/AVG use and PH (OR 2.06, 95% CI: 1.69–2.52), with low statistical heterogeneity (I² = 0%). This estimate was sensitive to individual studies: in leave-one-out analysis the association lost statistical significance when the single most influential study was removed indicating that the pooled result is driven in part by a small number of studies rather than being uniformly robust. No statistical evidence of publication bias was detected. Five studies reported continuous pulmonary artery pressures, which were directionally higher in AVF/AVG patients but were not pooled because of extreme heterogeneity (I² = 99.4%). Conclusions: In this synthesis of observational data, AVF/AVG use was associated with higher odds of pulmonary hypertension than non-AVF/AVG access. Because all included studies were observational and the pooled estimate is sensitive to individual influential studies, these findings indicate a possible association rather than a causal effect and should be interpreted with caution. They support the rationale for prospective hemodynamic studies and for evaluating—rather than presuming the benefit of—PH monitoring and individualized access strategies in higher-risk dialysis patients. Full article

Building Information Modeling (BIM) usually represents a building as a static snapshot of the model’s state. Dynamic extensions, such as Internet of Things(IoT)-enabled sensing or immersive visualization, already exist, but the underlying data model remains state-based. The Industry Foundation Classes (IFC) standard does not define a formal mechanism that would link the same physical element across successive phases of a building’s life cycle. Design, construction, and operation are recorded in separate IFC files, and the same element is assigned different Globally Unique Identifiers (GUIDs) in each. The result is fragmentation of the element’s identity, loss of the history of property changes, and the inability to formulate cross-phase queries. This paper proposes the BIM-Phase ontology based on the fundamental Descriptive Ontology for Linguistic and Cognitive Engineering (DOLCE) ontology, which solves this problem by introducing a distinction between a building element as an endurant and its life cycle phases as perdurants. The ontology comprises nine classes, six object relations, and six axioms expressed in Web Ontology Language 2 Description Logic (OWL 2 DL). Phase properties and relations are represented using a reification pattern, which maintains full compatibility with the expressiveness of OWL 2 DL. The ontology was validated using an example of a single-family residential building developed in Autodesk Revit. Three structural elements (external wall, floor slab, and column) were tracked across three phases of the life cycle. Eight competency questions covering scalar, constitutional, and mereological changes were defined and mapped to ontology constructs, confirming that the BIM-Phase enables the recording of changes and the formulation of cross-phase queries that are impossible in classic IFC. All eight questions were answered correctly on the published knowledge graph, and the HermiT reasoner confirmed the logical consistency of the model. The findings show that preserving element identity across phases requires only a minimal ontological layer on top of existing standards. We recommend introducing persistent, phase-independent identifiers of building elements alongside IFC GUIDs, as this single change enables full lifecycle change tracking. Full article

Background/Objectives: Healthcare professionals face high occupational stress, emotional burden, and demanding conditions that increase the risk of burnout, depression, and anxiety, with recent post-pandemic evidence indicating a high and rising global prevalence. Early identification of distress is therefore essential. This review compared three widely used instruments—the Depression, Anxiety and Stress Scales (DASS), the Maslach Burnout Inventory (MBI), and the Zung Self-Rating Depression Scale (SDS)—selected because they jointly cover depression, anxiety, stress, and burnout, unlike unidimensional tools (PHQ-9, GAD-7, PSS, CBI) that would need combining for comparable coverage. Methods: A narrative integrative review searched PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar for peer-reviewed articles (English/Croatian) published up to December 2025 (final search: 26 June 2026). Two reviewers independently screened records, resolving disagreements by consensus; quality was appraised narratively. Of 55 records, 35 were included. Results: The DASS showed a replicated three-factor structure and strong reliability, with shortened forms (DASS-8, DASS-12) enabling rapid screening at reduced domain coverage. The MBI remained the most widely used burnout measure but was limited by its emotional-exhaustion focus, proprietary licensing, and scoring heterogeneity. The Zung SDS offered a brief depression screen, though dated wording and context-dependent cut-offs favor initial-screen use. Notably, much evidence is derived from non-healthcare populations—the principal limitation. Conclusions: The instruments appear complementary rather than interchangeable; their combined use is proposed—as a reasonable suggestion from the literature, not an empirically demonstrated finding—as a multidimensional approach, contingent on context, objective, and appropriate cultural validation. Full article

Background and Objectives: Facial gender-confirmation surgery (FGCS) has expanded rapidly but remains uneven across procedures, specialties, and outcome domains, limiting clinically useful interpretation for surgeons. The aim is to characterize how FGCS evidence has developed and to identify gaps relevant to surgical reporting and patient-centered outcome evaluation. Materials and Methods: Systematic searches were conducted without date restriction in PubMed, Scopus, Web of Science, LiLACS, and EBSCOhost through June 2025. Eligible studies included original clinical research, systematic reviews (SR), technical notes, and economic evaluations. Two reviewers independently screened and extracted data. PROSPERO: CRD420251041192. Results: Among 338 included studies, the literature was concentrated on feminization procedures (78%) and hard-tissue interventions (51%). Outcome reporting was dominated by surgical technique (36%) and complications (29%); patient-centered domains were less represented, including satisfaction (25%), preferences (7%), recovery (2%), and ethics (3%). Masculinization and soft-tissue procedures were less frequently studied. Methodological quality of the 36 included SRs was predominantly critically low (72%) or low (28%). Conclusions: Procedural reporting in FGCS has developed asymmetrically relative to standardized patient-centered outcome measurement, a pattern consistent with the formative stages observed in other surgical fields. For surgeons, this limits comparability across procedures and weakens the evidence base for counseling, multidisciplinary planning, and postoperative evaluation. Future research should prioritize more consistent and validated patient-reporting frameworks. Full article

Introduction: Prostate cancer (PC) is a highly prevalent malignant tumour associated with significant morbidity and mortality. While physical activity has been linked to a lower risk of PC and exercise has been shown to reduce mortality, the evidence for the association between physical activity and mortality is limited. Objective: This study aimed to assess the association between physical activity and mortality risk in men with or at risk of PC. Methods: A systematic search was conducted in Medline, Scopus and Web of Science from inception until April 2026. Observational studies analysing physical activity and all-cause and PC-specific mortality were included. The data were synthesised and interpreted using a synthesis without meta-analysis (SWiM) approach. The quality of the studies was assessed using the NHLBI tool. The certainty of the evidence was assessed using the GRADE framework. Results: Fifteen observational studies were included. The hazard ratio (HR) was the predominant effect measure. Physical activity was associated with a reduction in all-cause mortality (HRs: 0.40–0.88; highest versus lowest categories), and a dose–response gradient was observed within two cohorts. Associations with PC-specific mortality were less consistent, with significant inverse findings concentrated in post-diagnosis assessments. The quality of the studies was generally poor, and the certainty of the evidence was very low for both outcomes. Conclusions: Physical activity was associated with lower all-cause mortality risk in men with or at risk of PC, and the most consistent inverse estimates were observed in post-diagnostic assessments. These findings are observational and should not be interpreted as a clinical recommendation. A dose–response pattern was noted within individual studies, although the certainty of evidence was very low for this outcome. Additionally, evidence for PC-specific mortality was inconsistent and of very low certainty. Prospective studies with standardised, objective measures of physical activity are required. Full article

Background/Objectives: Postoperative atrial fibrillation (POAF) is a frequent complication after cardiac surgery and is associated with increased morbidity, prolonged hospitalization, and higher healthcare costs. Numerous multivariable prediction models have been developed to estimate individual risk; however, their methodological robustness, validation status, and clinical transportability remain uncertain. This systematic review aimed to critically evaluate the methodological quality, validation strategies, and predictive performance of multivariable prediction models developed to estimate the risk of postoperative atrial fibrillation (POAF) after cardiac surgery. Methods: In accordance with PRISMA 2020 guidelines, we conducted a comprehensive search of PubMed, Scopus, Web of Science, and Embase from inception to July 2025. Studies that developed or externally validated multivariable prediction models for POAF in adult patients undergoing cardiac surgery were eligible. Data extraction was performed using the CHARMS checklist, and methodological quality was assessed with PROBAST. Model performance was summarized descriptively, focusing on discrimination (C-statistic/AUC), calibration reporting, and validation strategies. Results: A total of 39 studies were included. Most models were based on logistic regression, whereas a minority employed Cox regression or machine learning techniques. Reported discrimination ranged from 0.60 to 0.98, demonstrating substantial heterogeneity in predictive performance. Calibration was inconsistently reported. Six studies performed external validation. According to PROBAST, 32 of 39 studies (82%) were rated at high risk of bias, predominantly within the analysis domain due to inadequate handling of overfitting, insufficient events-per-variable ratios, and limited validation procedures. Conclusions: Existing prediction models for POAF show variable discrimination but are frequently limited by high risk of bias, inadequate validation, and incomplete calibration assessment, thereby restricting their clinical applicability. Future research should prioritize rigorous external validation, transparent reporting in accordance with TRIPOD recommendations, and methodological strategies that enhance model generalizability and transportability across diverse surgical populations. Full article

Background/Objectives: Fortified eggs have been proposed as food-based vehicles for delivering micronutrients and other bioactive compounds. However, human intervention evidence remains fragmented across nutrient targets, populations, intervention designs, and outcome domains. This review mapped human intervention studies and summarized the reported nutritional and health-related outcomes associated with fortified egg consumption. Methods: PubMed, Embase, Web of Science, the Cochrane Library, CNKI, Wanfang Data, and SinoMed were searched for studies published in English or Chinese from 1 January 2005 to 1 June 2025. Eligible studies were human intervention studies evaluating fortified, enriched, or bio-enhanced eggs and reporting at least one nutritional or health-related outcome. Owing to substantial heterogeneity in nutrient type, intervention design, comparator, duration, and outcome assessment, findings were synthesized narratively. Results: Thirty-seven human intervention studies met the eligibility criteria. Most evaluated eggs enriched with n-3 polyunsaturated fatty acids, followed by carotenoid-enriched eggs, whereas relatively few examined iodine or other fortified nutrients. Across studies, fortified egg consumption was generally associated with improvements in intake estimates and biomarkers of targeted nutrient status, including circulating fatty acids, serum carotenoids, and, in a limited number of studies, urinary iodine. Evidence for downstream health-related outcomes was more limited, inconsistent, and difficult to compare across nutrient categories and study populations. Conclusions: Fortified eggs may serve as useful food-based vehicles for improving the delivery of selected nutrients and short-term nutrient-status biomarkers. However, the evidence base remains heterogeneous and nutrient-specific, and it is still uncertain whether these changes translate into consistent, clinically meaningful health benefits. Larger, longer-term, and more rigorously reported trials, particularly in populations at nutritional risk, are needed. Full article