Search Results (9,061)

Background: Nutrition during the perinatal period, including pregnancy, childbirth, postpartum, and lactation, is a critical determinant of maternal and neonatal health. While the importance of balanced nutrition is well established, the integration of nutritional counseling into midwifery care remains inconsistent across settings. Evidence suggests that midwives are uniquely positioned to deliver nutrition-related support, yet gaps persist in their formal training and in the availability of structured guidance. These gaps are particularly evident in certain regions, such as Greece, where dedicated national guidelines for perinatal nutrition are lacking. Methods: This systematized narrative review synthesises evidence from studies published between 2010 and 2025, retrieved through PubMed, CINAHL, Scopus, and relevant national guidelines. Although the synthesis draws on diverse study designs to provide contextual depth, randomized controlled trials (RCTs) were prioritized and synthesized separately to evaluate the effectiveness of midwife-led interventions. In total, ten randomized controlled trials were included in the evidence synthesis, alongside additional observational and qualitative studies that informed the narrative analysis. Both international and Greek literature were examined to capture current practices, challenges, and knowledge gaps in the nutritional dimension of midwifery care. Results: Findings indicate that adequate intake of macronutrients and micronutrients, including iron, folic acid, vitamin D, iodine, calcium, and omega-3 fatty acids, is essential for optimal maternal and neonatal outcomes. Despite this, studies consistently report insufficient nutritional knowledge among midwives, limited confidence in providing counseling, and variability in clinical practice. Socio-cultural factors, such as dietary traditions and migration-related challenges, further influence nutritional behaviors and access to guidance. Emerging approaches, including e-health tools, group counseling models, and continuity-of-care frameworks, show promise in enhancing midwives’ capacity to integrate nutrition into perinatal care. Conclusion: Nutrition is a cornerstone of perinatal health, and midwives are strategically placed to address it. However, gaps in training, inconsistent guidelines, and cultural barriers limit the effectiveness of current practices. Strengthening midwifery education in nutrition, developing context-specific tools, and fostering interdisciplinary collaboration are essential steps toward more comprehensive and culturally sensitive perinatal care. Future research should focus on longitudinal and intervention studies that assess the impact of midwife-led nutritional counseling on maternal and neonatal outcomes. Full article

Background and Objectives: Contrast-associated acute kidney injury (CA-AKI) is a frequent and clinically significant complication in patients with acute myocardial infarction (AMI) undergoing coronary angiography. Early and accurate risk stratification remains challenging with conventional models that rely on linear assumptions and limited variable integration. This study aimed to evaluate and compare the predictive performance of multiple machine learning (ML) algorithms with traditional logistic regression and the Mehran risk score for CA-AKI prediction and to explore key determinants of risk using explainable artificial intelligence methods. Materials and Methods: This retrospective, single-center study included 1741 patients with AMI who underwent coronary angiography. CA-AKI was defined according to KDIGO criteria. Multiple ML models, including gradient boosting machine (GBM), random forest (RF), XGBoost, support vector machine, elastic net, and standard logistic regression were developed using routinely available clinical and laboratory variables. A weighted ensemble model combining the best-performing algorithms was constructed. Model discrimination was assessed using area under the receiver operating characteristic curve (AUC), along with sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Model interpretability was evaluated using feature importance and SHapley Additive exPlanations (SHAP). Results: CA-AKI occurred in 356 patients (20.4%). In multivariable logistic regression, lower left ventricular ejection fraction, higher contrast volume, lower sodium, lower hemoglobin, and higher neutrophil-to-lymphocyte ratio (NLR) were independently associated with CA-AKI. Among ML approaches, the weighted ensemble model demonstrated the highest discriminative performance (AUC 0.721), outperforming logistic regression and the Mehran risk score (AUC 0.608). Importantly, the ensemble model achieved a consistently high NPV (0.942), enabling reliable identification of low-risk patients. Explainability analyses revealed that inflammatory markers, particularly NLR, along with sodium, uric acid, baseline renal indices, and contrast burden, were the most influential predictors across models. Conclusions: In patients with AMI undergoing coronary angiography, interpretable ML models, especially ensemble and gradient boosting-based approaches, provide superior risk stratification for CA-AKI compared with conventional methods. The high negative predictive value highlights their clinical utility in safely identifying low-risk patients and supporting individualized, risk-adapted preventive strategies. Full article

Background/Objectives: The underlying molecular mechanisms of deep vein thrombosis (DVT), which continues to be a major global public health concern, remain unclear. A key component of anticoagulant therapy, heparin (HP) interacts with heparin-binding growth factors including pleiotrophin (PTN) and midkine (MK), both of which have basic amino acid-rich domains that have a strong affinity for HP. The purpose of this study was to determine if changes in the levels of circulating HP, MK, and PTN are linked to the onset of acute DVT. Methods: Thirty patients diagnosed with acute DVT by venous Doppler ultrasonography (VDU) and 28 healthy controls with normal VDU findings were enrolled. Serum HP, MK, and PTN concentrations were measured using ELISA. In DVT patients, blood samples were obtained before and after routine subcutaneous low-molecular-weight heparin treatment; controls provided a single blood sample. ROC curve analysis was used to assess diagnostic performance. Results: Prior to treatment, patients with acute DVT exhibited significantly lower serum HP levels (p < 0.05) and significantly higher MK and PTN levels compared with healthy controls (both p < 0.05). Following heparin administration, serum HP levels increased significantly (p < 0.05), while MK and PTN levels showed a decreasing trend that did not reach statistical significance (p > 0.05). ROC curve analysis demonstrated limited diagnostic performance for HP (sensitivity 10.3%, specificity 68.8%), PTN (62.1%, 54.2%), and MK (82.8%, 35.4%). Conclusions: Decreased circulating HP and increased MK and PTN levels are characteristics of acute DVT that may indicate endogenous HP sequestration through binding to these growth factors. This imbalance could lead to less free HP being available, which would encourage the formation of thrombus. Therapeutic approaches that target MK- and PTN-mediated HP interactions may constitute a unique approach for the therapy of acute DVT, as evidenced by the partial normalization seen after exogenous heparin delivery. Full article

MicroRNAs (miRNAs) are promising biomarkers for the early detection of various diseases, particularly cancer, driving active development of highly sensitive and selective detection technologies. This study aims to establish a novel miRNA detection technique that utilizes image analysis to track the Brownian motion (diffusivity) of fluorescent probe-modified miRNA particles. This method identifies the presence and concentration of miRNAs by exploiting the change in particle size upon hybridization with the target. Furthermore, the use of a probe modified with a photo-crosslinkable artificial nucleic acid (CNV-D) enables the covalent capture of the target miRNA, ensuring high selectivity in biological samples even under stringent washing conditions. By integrating Hybridization Chain Reaction (HCR), the complex size is significantly amplified, dramatically enhancing the detection sensitivity. Consequently, we successfully demonstrated the highly sensitive and specific detection of the cancer biomarker miR-21 in serum, achieving an exceptionally low limit of detection (LOD) of 1 fM. This technology holds great potential to contribute to the early diagnosis of cancer. Full article

Arsenic occurs in food in both inorganic (iAs) and organic (oAs) forms. Inorganic arsenic is highly toxic and classified as carcinogenic to humans, whereas oAs species, such as arsenobetaine (AB), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA), generally exhibit lower toxicity. Rice and rice-based products represent major contributors to dietary iAs exposure. Within this context, the present study provides an updated assessment of the occurrence of iAs and oAs in rice-based beverages available on the Italian market. A method for the simultaneous determination of iAs, AB, DMA, and MMA was developed and validated, and it exhibits adequate sensitivity to ensure robust occurrence data, eliminating left-censoring for iAs. A comprehensive analysis of twenty-five representative rice-based beverages was conducted, revealing that the contamination profiles exhibited a high degree of homogeneity, with iAs as the predominant species. All samples complied with the European maximum level for iAs in non-alcoholic rice-based beverages. When combined with recent Italian consumption data, these results enabled age-specific dietary exposure assessment. Although rice drinks contribute marginally to overall population exposure, estimated intakes for regular consumers in early childhood are associated with a small margin of exposure, raising potential concern for vulnerable subgroups. The increasing diversification of dietary habits and the rising consumption of plant-based beverages point to the necessity of continuous monitoring of iAs. Ongoing efforts in monitoring studies, updated food consumption surveys, and effective risk communication are essential to refine exposure assessment and thereby enhance public health protection. Full article

In recent years, harmful algal blooms have led to frequent occurrences of shellfish toxin contamination, posing a significant threat to the safety of aquatic products and public health. As a potent neurotoxin, domoic acid (DA) can accumulate in shellfish, highlighting the urgent need for rapid and highly sensitive detection methods. In this study, we developed a fluorescent aptasensor based on a dual-signal amplification system by combining G-quadruplex (G4) dimers with multi-walled carbon nanotubes (CNTs). The sensor is designed with a hairpin-structured aptamer as the recognition probe, where short multi-walled CNTs serve as both a fluorescence quencher and platform, and G4 dimers are incorporated into the sensing interface to enhance signal output. In the absence of the target, the hairpin-structured aptamer remains closed, keeping the fluorescence signal “off”. Upon binding to DA, the aptamer undergoes a specific conformational change that exposes the G4-dimer sequence. The exposed sequence then binds to thioflavin T (ThT), which in turn generates a greatly enhanced fluorescence signal, leading to a substantial fluorescence enhancement and completing the second stage of the cascade amplification. Under optimal conditions, the constructed sensor achieves rapid detection of DA within 5 min, with a low detection limit of 1.1 ng/mL. This work presents a valuable tool for the rapid and sensitive detection of DA in shellfish, with promising applications in marine environmental monitoring and food safety regulation. Full article

Chemical contaminants are increasingly detected in freshwater environments, yet the physiological and molecular responses of many non-model freshwater invertebrates to acute chemical stress remain poorly understood. In this study, we investigated the physiological and transcriptomic responses of the freshwater hydrozoan Craspedacusta sowerbii to two widespread aquatic pollutants: the antibiotic sulfamethoxazole (20 μM) and the heavy metal salt CdSO₄ (10 μM). Morphological and behavioral observations showed that sulfamethoxazole exposure led to reduced motility and body shrinkage, whereas cadmium exposure caused rapid loss of movement and complete mortality within 24 h. RNA sequencing revealed distinct transcriptional response patterns to the two stressors. Sulfamethoxazole exposure primarily induced the up-regulation of genes associated with oxidative stress, apoptosis, immune responses, and signaling pathways, suggesting an active but limited stress-adaptation response. In contrast, cadmium exposure resulted in extensive down-regulation of genes involved in metabolic pathways, cell cycle regulation, fatty acid metabolism, and anti-aging processes, suggesting severe disruption of core metabolic processes. Comparative pathway analyses identified both shared stress-related responses and pollutant-specific transcriptional signatures, with cadmium exerting markedly stronger inhibitory effects at both physiological and molecular levels. These results reveal clear thresholds of stress tolerance and response failure in C. sowerbii under chemical pollution, and highlight its ecological sensitivity to water quality deterioration. Together, these findings provide mechanistic insight into acute pollutant-induced stress responses in a freshwater Cnidarian and offer a useful reference for understanding how freshwater invertebrates respond to short-term chemical disturbances. Full article

Background and hypothesis: Per- and polyfluoroalkyl substances (PFAS) are highly persistent synthetic chemicals that can accumulate in renal tissue and potentially disrupt kidney function. Most prospective studies on PFAS–renal associations have focused on middle-aged or older adults, leaving uncertainty about whether similar patterns exist in younger populations. Methods: We investigated decade-long trajectories of plasma concentrations of 11 PFAS and their longitudinal associations with estimated glomerular filtration rate (eGFR) among 529 Taiwanese adolescents and young adults (aged 12–30 years) enrolled in the prospective YOung TAiwanese Cohort (YOTA), with measurements obtained in 2006–2008 and 2017–2019. Results: Nearly all plasma PFAS declined significantly over the 10-year period. Despite these reductions, higher baseline levels and greater annualized increases (Δln-PFAS/Δt) in linear perfluorooctanoic acid (PFOA), linear and branched perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) were consistently associated with larger eGFR gains over time (β = 0.33–0.40, q < 0.05). In complementary models using follow-up eGFR as the outcome, both baseline and cumulative PFAS changes (Δln-PFAS) remained positively associated with higher eGFR (β = 1.71–3.84, q < 0.05). Polynomial analyses further indicated mild non-linear exposure–response patterns for several PFAS, suggesting that renal effects may deviate from linearity across exposure ranges. The composite PFAS exposure index (mean of standardized ln-PFAS concentrations) was robustly associated with higher eGFR across sensitivity analyses excluding participants with chronic conditions. These associations were more pronounced among individuals with greater metabolic or physiological vulnerability. Conclusions: Higher PFAS exposure was associated with elevated eGFR in young adults, which may be consistent with early glomerular hyperfiltration or other renal hemodynamic alterations. These findings raise the hypothesis of early renal stress in early life and underscore the need for ongoing biomonitoring and longitudinal follow-up with additional kidney injury markers to clarify long-term renal consequences. Full article

Carbon capture is an essential technology for reducing industrial CO₂ emissions, particularly in the power and cement sectors. Among the various capture methods, solvent-based absorption systems are widely used due to their efficiency and scalability, making the selection of the right solvent critical for near-term applications. This study analyzes several solvents for use in an absorption-based CO₂ capture system, emphasizing identifying the most suitable solvent for 2025–2030. The research methodology involves process modeling in Aspen Plus, sensitivity analysis, and evaluation of the regeneration duty for each solvent. The objective is to achieve at least 90% CO₂ capture and 95% CO₂ purity. The flue gas composition considered in this analysis is 19.8% CO₂, 9.3% O₂, 63% N₂, 7.5% H₂O, and other trace gases. Various solvents are evaluated to determine their effectiveness in capturing CO₂ while minimizing the energy consumption during solvent regeneration. A sensitivity analysis was conducted to optimize the system’s performance based on the solvent type, operating conditions, and regeneration duty. The results showed that amine blends demonstrated a CO₂ capture rate of 92% and a CO₂ purity of 96%, with regeneration energy requirements of around 3.2 GJ/ton of CO₂, significantly lower than those of traditional MEA systems, which typically require around 4.0 GJ/ton. In contrast, ionic liquids showed a CO₂ capture rate of 89% and a purity of 95%, with a regeneration energy of 2.8 GJ/ton, though their current cost is higher, limiting their immediate large-scale application. Annual capital expenditure (CAPEX) calculation revealed that amine blends could potentially reduce the CAPEX by 15–20% compared to MEA, while amino acid salts showed similar CAPEX reductions with a capture efficiency of 90%. Overall, the results indicate that hybrid amine solvents are the most cost-effective and practical solution for 2025–2030, with ionic liquids and amino acid salts emerging as promising alternatives as their costs decrease. Full article

Background: Uremic pruritus is a distressing and common symptom in patients with end-stage renal disease. The development of uremic pruritus involves a multifactorial pathogenesis, including systemic inflammation, dysregulated immune responses, and altered opioid receptor activity. Omega-3 polyunsaturated fatty acids have been reported to mitigate uremic pruritus symptoms. Among omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been reported as potential candidates for alleviating uremic pruritus due to their anti-inflammatory properties. Methods: A meta-analysis of seven randomized controlled trials was conducted to evaluate the efficacy of omega-3 supplementation in alleviating uremic pruritus among patients affected with end-stage renal disease. Effect sizes were calculated using Hedges’ g with a random-effects model. Heterogeneity, sensitivity, and meta-regression analyses were performed to explore influencing factors. Results: A total of 266 participants were included for analysis. Omega-3 supplementation significantly reduced pruritus severity compared with placebo. Sensitivity analyses were conducted to exclude a single large trial contributing to the results. Meta-regression indicated that higher EPA, DHA, and total omega-3 dosages, and longer treatment duration, were associated with reduced severity of the uremic pruritus than the placebo. No serious adverse events were reported. Conclusions: Omega-3 fatty acid supplementation significantly alleviates uremic pruritus in patients with ESRD. These findings support the use of omega-3 fatty acids as a safe and effective adjunct therapy. Further large-scale, long-term trials are warranted to verify these results and assess the long-term effects and safety of omega-3 fatty acids in attenuating uremic pruritus. Full article

Antibiotics represent a unique and diverse group of drugs, which are known to exert deleterious effects on non-target species and contribute to the phenomenon of antimicrobial resistance. With central inclusion on the EU Surface Water Watch List, and reported known affects in multiple model organisms, the importance of the sufficient monitoring of antibiotics in the aquatic environment has been highlighted. Most studies report the impact of individual antibiotics following exposure for a single generation in animals. In this study, we assessed the impact of four antibiotics with different modes of action (amoxicillin, trimethoprim, erythromycin, and sulfamethoxazole) and their mixture on the sentinel species Daphnia magna over three generations, via biochemical markers and a targeted metabolomic analysis of central metabolic pathways. No mortality was observed at 50 mg/L of each selected antibiotic and their composite mixture. Thus, a working concentration of 1 mg/L was chosen to progress this study. Results indicated that enzyme activity was particularly sensitive to exposure to amoxicillin and the mixture, whereas trimethoprim and the mixture induced the most metabolic changes in glycolysis and the TCA cycle. Additionally, the quaternary mixture had a stronger impact on the first generation of daphnids, altering the activity of β-galactosidase, glutathione S-transferase, and acid and alkaline phosphatase, suggesting that Daphnia can adapt to stress caused by antibiotics. Full article

Background: The increasing prevalence of low-birth-weight (LBW) offspring from obese mothers underscores the need for dietary strategies to mitigate the transgenerational propagation of metabolic diseases. Objectives: We determined whether dietary protein restriction under obesogenic conditions altered maternal energy balance and led to LBW offspring and whether branched-chain amino acid (BCAA) supplementation improved maternal energy balance and mitigated weight and craniofacial skeletal deficits in offspring. Methods: High-fat-fed obese pregnant Sprague Dawley rats (~8–10 weeks of age, n = 8–11/group) were randomized in study 1 to control high-fat diet (20% protein; HFD), low-protein diet (LP; 5% protein), and LP + BCAA diet (100% BCAA requirements) and in study 2 to control HFD (20% protein), LP (10% protein), and LP + 2BCAA diet (200% BCAA requirements). Post-weaning offspring were fed HFD until 8 weeks of age. Results: Protein restriction promoted hyperphagia and energy expenditure, whereas BCAA supplementation attenuated such hyperphagic effects in pregnancy but not in lactation. Protein restriction reduced maternal body weight in lactation, and although BCAA supplementation did not reverse the weight loss, it enhanced insulin sensitivity and paradoxically reduced offspring survival. Maternal protein restriction reduced offspring body weight and craniofacial bone growth that persisted into adulthood, but BCAA supplementation did not rescue such deficits. Conclusions: Maternal protein restriction in obese dams enhanced maternal energy expenditure but impaired offspring growth and development. Although BCAA supplementation improved maternal energy balance, it was insufficient to reverse the adverse effects of maternal protein restriction on offspring growth under obesogenic conditions. Full article

Plant-based fermented foods are increasingly promoted for glycemic control, yet their mechanisms and clinical impact remain incompletely defined. This narrative review synthesizes mechanistic, preclinical, and human data for key matrices—kimchi and other fermented vegetables, tempeh/miso/natto, and related legume ferments, kombucha and fermented teas, plant-based kefir, and cereal/pulse sourdoughs. Across these systems, microbial β-glucosidases, esterases, tannases, and phenolic-acid decarboxylases remodel polyphenols toward more bioaccessible aglycones and phenolic acids, while lactic and acetic fermentations generate organic acids, exopolysaccharides, bacterial cellulose, γ-polyglutamic acid, γ-aminobutyric acid, and bioactive peptides. We map these postbiotic signatures onto proximal mechanisms—α-amylase/α-glucosidase inhibition, viscosity-driven slowing of starch digestion, gastric emptying and incretin signaling, intestinal-barrier reinforcement, and microbiota-dependent short-chain–fatty-acid and bile-acid pathways—and their downstream effects on AMPK/Nrf2 signaling and the gut–liver axis. Animal models consistently show improved glucose tolerance, insulin sensitivity, and hepatic steatosis under fermented vs. non-fermented diets. In humans, however, glycemic effects are modest and highly context-dependent: The most robust signal is early postprandial attenuation with γ-PGA-rich natto, strongly acidified or low-glycemic sourdough breads, and selected kombucha formulations, particularly in individuals with impaired glucose regulation. We identify major sources of heterogeneity (starters, process parameters, substrates, background diet) and safety considerations (sodium, ethanol, gastrointestinal symptoms) and propose minimum reporting standards and trial designs integrating metabolomics, microbiome, and host-omics. Overall, plant-based ferments appear best positioned as adjuncts within cardiometabolic dietary patterns and as candidates for “purpose-built” postbiotic products targeting early glycemic excursions and broader metabolic risk. Full article

Dichondra (Dichondra repens) is an important thermophilic Chinese herbal medicine and a key component in traditional herbal tea and beverages. It is also commonly used as an excellent ground cover plant for landscapes and cover cropping in orchards. In temperate and transition zones, thermophilic dichondra often suffers from chilling stress resulting in growth retardation and yield loss. This study aims to compare differences in photochemical efficiency, cell membrane stability, lipid peroxidation, and global lipid remodeling between two dichondra genotypes (chilling-tolerant Dr5 and chilling-sensitive Dr17) in response to a prolonged chilling stress. The results demonstrated that chilling stress significantly accelerated membrane lipid peroxidation and chlorophyll loss, resulting in reduced cell membrane stability and photochemical efficiency in two genotypes. However, Dr5 exhibits less oxidative damage, better cell membrane stability, and higher photochemical efficiency than Dr17 under chilling stress. The analysis of lipidomics found that both Dr5 and Dr17 accumulated phospholipids (Phls), glycoglycerolipids (Glls), and sphingolipids (Spls). More importantly, Dr5 exhibited 95%, 72%, 71%, 526%, 39%, 89%, 131%, 695%, or 865% increase in phosphatidic acid (PA), ceramide (Cer), hexosyl ceramide (Hex1Cer), lyso PA (LPA), lyso phosphatidylcholine (LPC), lyso phosphatidylethanolamine (LPE), lyso phosphatidylglycerol (LPG), lyso phosphatidylinositol (LPI), or lyso phosphatidylserine (LPS) content than Dr17 on day 10 of chilling stress, respectively. Dr5 also maintained significantly higher contents of PC (52%), PE (53%), PI (24%), PS (81%), PG (30%), and digalactosyl diacylglycerol (DGDG, 53%) after 20 days of chilling stress. In addition, two genotypes could maintain a stable unsaturation level of total lipids under chilling stress. These findings indicate that lipid remodeling is attributed to genetic variation in chilling tolerance of dichondra species. The current study provides an interesting data set that could be the starting point for analyzing the underlying mechanisms of chilling tolerance in thermophilic dichondra species. Full article

Nitrite, as a widely present nitrogen oxide compound in nature, and is extensively distributed in production and daily life; precise and rapid detection of it is of great significance for ensuring human health. This study developed nitrogen-doped carbon dots (N-CDs) using malic acid and 3-diethylaminophenol as precursors by one-step hydrothermal treatment. The obtained N-CDs exhibited strong green fluorescence with a high quantum yield of 20.86%. More importantly, they served as a highly effective fluorescent probe for NO₂⁻ sensing, demonstrating a low detection limit of 28.33 μM and a wide linear response range of 400 to 1000 μM. The sensing mechanism was attributed to an electrostatic interaction-enhanced dynamic quenching process. Notably, the probe enabled dual-mode detection: a distinct color change from light pink to dark brown under daylight for visual semi-quantification, and quantitative fluorescence quenching. The N-CDs showed excellent selectivity over common interfering ions. Furthermore, their low cytotoxicity and good biocompatibility allowed for successful bioimaging of exogenous and endogenous NO₂⁻ fluctuations in live HeLa cells. This work presents a facile green strategy to synthesize multifunctional N-CDs that realized the sensitive, selective, and visual detection of NO₂⁻ in environmental and biological systems. Full article