Search Results (221)

The proliferation of mobile devices has driven significant growth in adaptive mobile applications (AMAs) that dynamically adjust their behavior based on contextual changes. While existing research has extensively studied individual adaptive systems, limited attention has been given to cooperative adaptation—where multiple AMAs coordinate their adaptive behaviors within shared mobile ecosystems. This systematic literature review addresses this research gap by analyzing 95 peer-reviewed studies published between 2010 and 2025 to characterize the current state of cooperative adaptation in mobile applications. Following established systematic review protocols, we searched six academic databases and applied rigorous inclusion/exclusion criteria to identify relevant studies. Our analysis reveals eight critical dimensions of cooperative adaptation: Monitor–Analyze–Plan–Execute–Knowledge (MAPE-K) structure, application domain, adaptation goals, context management, adaptation triggers, aspect considerations, coordination mechanisms, and cooperation levels. The findings indicate that 63.2% of studies demonstrate some form of cooperative behavior, ranging from basic context sharing to sophisticated conflict resolution mechanisms. However, only 7.4% of studies explicitly address high-level cooperative adaptation involving global goal optimization or comprehensive conflict resolution. Energy efficiency (21.1%) and usability (33.7%) emerge as the most frequently addressed adaptation goals, with Android platforms dominating the research landscape (36.8%). The review identifies significant gaps in comprehensive lifecycle support, standardized evaluation methodologies, and theoretical frameworks for multi-application cooperation. These findings establish a foundation for advancing research in cooperative adaptive mobile systems and provide a classification framework to guide future investigations in this emerging domain. Full article

Coccidiosis is one of the most serious parasitic diseases in poultry, with Eimeria-induced apoptosis of IECs recognized as a key pathogenic mechanism. This review systematically delineates the molecular mechanisms governing this apoptotic process. The invasion process of Eimeria app. is mediated by the AMA1-RON2 moving junction complex and secreted effector proteins. An integrated model of apoptotic regulation is proposed. This model comprises the mitochondrial, death receptor, and endoplasmic reticulum stress pathways, which are coordinated by signaling hubs, such as PI3K/Akt, NF-κB, and JNK/p38 MAPK, and is further finely modulated by non-coding RNA networks. It is notable that the apoptosis during coccidial infection exhibits a biphasic pattern, where early inhibition supports parasite development and late activation facilitates parasite release and dissemination. Although potential therapeutic targets have emerged for these signaling pathways, how the host precisely switches between different apoptotic pathways remains a current core knowledge gap. Future research needs to thoroughly analyze the molecular logic of host–parasite interaction and ultimately lay a theoretical foundation for developing new strategies targeting the process of cell apoptosis for coccidiosis prevention and control. Full article

Background/Objectives: To examine associations of mentally active and passive sedentary behavior (SB) with sleep quality and duration in pregnant women of advanced (AMA) and younger (YMA) maternal age, separately, and evaluate effects of SB patterns (weekends vs. weekdays). Methods: This secondary analysis of an observational, clinic-based, cross-sectional study included pregnant women of AMA (n = 225; 37.8 ± 2.6 years) and YMA (n = 710; 27.5 ± 3.8 years) from any trimester. SB and sleep were assessed using the Arabic version of the Sedentary Behavior Questionnaire and the Pittsburgh Sleep Quality Index, respectively. Logistic regression models evaluated associations of maternal mental activity-based SB with sleep outcomes. Results: Higher mentally passive SB on weekdays was unfavorably associated (odds ratios ranged between 1.58 and 2.12; p < 0.05 for all), and on weekends was paradoxically and favorably associated (odds ratios ranged between 0.53 and 0.62; p < 0.05 for all) with sleep quality only in pregnant women of AMA. Higher mentally passive SB across the week or on weekdays was unfavorably associated (odds ratios ranged between 1.11 and 1.65; p < 0.05 for all), while higher mentally passive SB on weekends and mentally active SB across the week or on weekends were paradoxically and favorably associated (odds ratios ranged between 0.57 and 0.91; p < 0.05 for all) with a higher adherence to sleep duration recommendations in both pregnancy groups. Conclusions: These findings suggest that some relationships between mental activity-based SB and prenatal sleep health may vary across maternal age groups. The cross-sectional design limits causal inference, emphasizing the need for longitudinal and randomized studies on mental activity-based SB and sleep health in pregnant women of AMA and YMA. Full article

In the era of smart agriculture, intelligent fruit maturity detection has become a critical task. However, in complex orchard environments, factors such as occlusion by branches and leaves and interference from bagging materials pose significant challenges to detection accuracy. To address this issue, this study focuses on maturity detection of ‘Jiang’ pomegranates and proposes an improved YOLO-AMAS algorithm. The method integrates an Adaptive Feature Enhancement (AFE) module, a Multi-Scale Convolutional Attention Module (MSCAM), and an Adaptive Spatial Feature Fusion (ASFF) module. The AFE module effectively suppresses complex backgrounds through dual-channel spatial attention mechanisms; the MSCAM enhances multi-scale feature extraction capability using a pyramidal spatial convolution structure; and the ASFF optimizes the representation of both shallow details and deep semantic information via adaptive weighted fusion. A SlideLoss function based on Intersection over Union is introduced to alleviate class imbalance. Experimental validation conducted on a dataset comprising 6564 images from multiple scenarios demonstrates that the YOLO-AMAS model achieves a precision of 90.9%, recall of 86.0%, mAP@50 of 94.1% and mAP@50:95 of 67.6%. The model significantly outperforms mainstream detection models including RT-DETR-1, YOLOv3 to v6, v8, and 11 under multi-object, single-object, and occluded scenarios, with a mAP50 of 96.4% for bagged mature fruits. Through five-fold cross-validation, the model’s strong generalization capability and stability were demonstrated. Compared to YOLOv8, YOLO-AMAS reduces the false detection rate by 30.3%. This study provides a reliable and efficient solution for intelligent maturity detection of ‘Jiang’ pomegranates in complex orchard environments. Full article

Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease characterized by progressive destruction of intrahepatic bile ducts. PBC encompasses several clinical subtypes, including classical AMA-positive PBC (90–95% of cases), AMA-negative PBC (5–10%), and overlap syndromes such as AIH-PBC. These subtypes exhibit distinct serological profiles, with AMA-negative cases often presenting PBC-specific antinuclear antibodies (anti-gp210, anti-sp100) and overlap syndromes demonstrating combined autoantibody patterns characteristic of both conditions. Autoantibodies serve as central biomarkers for diagnosis, prognosis, and understanding disease pathogenesis. This review provides a comprehensive overview of classical and emerging autoantibodies associated with PBC, including AMA-M2, anti-gp210, anti-sp100, anti-KLHL12, and anti-RPL30. We discuss their diagnostic significance across PBC subtypes, pathogenic implications, and potential utility in patient stratification and therapeutic monitoring. Recent evidence suggests that bile acid-induced neoantigen formation, rather than classical loss of immune tolerance, may drive AMA production. Advances in autoantibody profiling, including subclass-specific analysis and multi-marker panels, may pave the way for personalized medicine and improved outcomes in PBC. Full article

Amanita exitialis is a lethal mushroom species found in southern China. Its amatoxins can cause acute liver injury with a high case-fatality rate. However, reports combining toxin detection in clinical specimens with autopsy pathology remain limited. We conducted a retrospective analysis of A. exitialis poisoning events treated at Chuxiong Yi Autonomous Prefecture People’s Hospital from 2019 to 2024. Toxins were measured in collected mushrooms, patient blood, and urine. Clinical data included demographics, complications, laboratory parameters, and autopsy findings. Associations between a time-weighted urinary amatoxin exposure metric and laboratory indices were assessed. Ten poisoning incidents involving 27 individuals were identified, including five deaths. We collected 10 mushroom samples, 120 urine samples, and 108 blood samples. α-amanitin, β-amanitin, phallacidin, and phallisacin were detected in mushrooms and urine. The detection rates of α-AMA, β-AMA, PCD, and PSC in urine samples were 31.67%, 5.00%, 38.33%, and 49.17%, respectively. Only three blood samples tested positive for α-AMA. The time-weighted urinary amatoxin exposure metric was positively correlated with total bilirubin (TBIL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), creatinine (Cr), creatine kinase (CK), creatine kinase isoenzymes (CK-MB), prothrombin time (PT), activated partial thromboplastin time (APTT), and international normalized ratio (INR). Early symptoms included nausea, vomiting, diarrhea, abdominal pain, and distention; later findings involved injury to the liver, kidneys, intestines, heart, and lungs. On the fourth day following ingestion, there was a marked increase in bilirubin levels and a concurrent decrease in liver enzymes, indicating severe damage to the hepatocytes. Platelet count, white blood cell count, hemoglobin, and red blood cell count decreased over time. Autopsies demonstrated hepatic, renal, and myocardial injury, gastrointestinal mucosal exfoliation, and multiorgan hemorrhage. In summary, A. exitialis poisoning is primarily characterized by liver damage, accompanied by injuries to the kidneys, myocardium, and intestines, as well as multiorgan hemorrhaging, which may lead to blood toxicity. The detection rate of toxins in urine samples is relatively high, and early urine toxin testing can help clarify the diagnosis and guide treatment. Full article

Background: Inequities in pain management are well documented in chronic pain and outpatient settings, yet little is known about disparities in inpatient Acute Pain Service (APS) care. This study evaluated demographic, clinical, and social factors associated with APS utilization and outcomes in an urban safety-net hospital, with a subgroup analysis of trauma patients who presented with at least three rib fractures. Methods: We performed a retrospective cohort study of two patient populations from our institution: (1) all patients receiving APS consultation from 1 January 2020 to 1 November 2022 (n = 1445) and (2) all patients with traumatic rib fractures during this time, stratified by APS consult status (n = 650). Demographics, insurance, comorbidities, opioid prescribing, and discharge outcomes were analyzed using descriptive statistics, multivariable logistic regression, and log-linear models. As APS consultation criteria were not standardized during the study period, referral patterns reflected routine clinical practice rather than predefined eligibility criteria. Results: Across the full APS cohort, patients were disproportionately represented from vulnerable groups: 30.5% were Black, 81.0% had public insurance, and 32.9% had a substance use disorder (SUD). Methadone use was a strong predictor of non-home discharge, including discharges to a medical facility, hospice, or against medical advice (AMA). In the rib fracture cohort, patients receiving APS consults had significantly higher injury severity scores (Injury Severity Score 17.1 vs. 13.0, p < 0.001). Black patients were less likely to receive APS consult (17.3% vs. 28.8%, p = 0.024). However, this association appeared to be attributable to the younger age and male predominance within this subgroup, as both factors were identified as significant predictors of APS consultation. Conclusions: APS utilization at a high-volume safety-net hospital highlights the intersection of medical vulnerability and structural inequities, with greater involvement among patients who were members of racial and ethnic minorities, publicly insured, or diagnosed with SUD. In trauma populations, younger Black men were over-represented, reinforcing the heightened injury risks Black men may face and the downstream effects on patient care. Taken together, these results highlight how APS involvement acts not only as a marker of increased injury severity but also as an intervention to improve care for vulnerable patient populations. As APS teams regularly serve these populations, they are well-positioned to bridge broader gaps through the integration of addiction and social support services, individualized pain management, and seamless coordination of care across specialties. These findings underscore the need for standardized consultation criteria and integration of social and addiction medicine resources into APS care models. Full article

The meteoric rise in generative AI has created both opportunities and ethical challenges for the mental health disciplines, namely in clinical mental health counseling, psychology, psychiatry, and social work. While these disciplines have been grounded in well-established ethical principles such as autonomy, beneficence, justice, fidelity, and confidentiality, the exponential ubiquity of AI in society has rendered mental health professionals unsure as to how to navigate ethical decision making in the AI era. The author proposes a preliminary ethical framework which synthesizes the code of ethics of the American Counseling Association (ACA), the American Psychological Association (APA), the American Medical Association (AMA), and the National Association of Social Workers (NASW), which is then organized around five pillars: (i) autonomy and informed consent; (ii) beneficence and non-malfeasance; (iii) confidentiality, privacy, and transparency; (iv) justice, fairness and inclusiveness; and (v) fidelity, professional integrity, and accountability. These pillars are juxtaposed with AI ethical guidelines developed by multinational organizations, governmental and non-governmental entities, and technology corporations. The resulting integrated ethical framework provides a practical cogent structure that mental health professionals can use when navigating this uncharted terrain. A case study based on the proposed ethical framework and strategies that clinical mental professionals can consider prior to incorporating AI into their clinical repertoire are offered. Limitations of the framework and its implications for future research are addressed. Full article

Introduction: Lateral epicondylitis (LE) typically affects the extensor carpi radialis brevis (ECRB) tendon, while isolated degeneration of the extensor digitorum communis (EDC) origin is rare and poorly characterized. Surgical debridement of these lesions may result in capsular exposure requiring soft-tissue coverage, which can be achieved through a vascularized muscle flap to enhance tendon healing potential and reduce recurrence. This study aimed to describe a modification of the anconeus rotation flap as originally described by Almquist in 1998, and to evaluate its clinical and functional outcomes in patients with isolated EDC tendinopathy. The modified technique consists of a simpler muscle advancement (AMA) that preserves the distal vascular pedicle and reduces soft-tissue dissection. Methods: A retrospective study was conducted on 12 consecutive patients with lateral epicondylitis with isolated EDC tendon involvement (10.71% of all operative cases at our Institution between 2019 and 2022), who were surgically treated with the anconeus muscle advancement modification. Clinical outcomes, including the visual analog pain scale (VAS), grip strength and patient-reported outcome measures (PROMs), which include the QuickDASH score, the Mayo Elbow Performance Score (MEPS) and the Patient-Rated Tennis Elbow Evaluation (PRTEE) score were assessed. Paired statistical tests with 95% confidence intervals and minimal clinically important difference (MCID) thresholds were applied. Results: At a mean follow-up of 38 months, all outcomes demonstrated statistically significant and clinically meaningful improvements (p < 0.05). Reductions in pain/disability (VAS, QuickDASH, PRTEE scores) and functional gains (Grip strength, MEPS) far exceeded their respective MCID thresholds, with 100% attainment for each outcome. Conclusions: This modified anconeus muscle advancement appears to be a technically feasible option for managing isolated EDC-related lateral epicondylitis, preserving vascular integrity while limiting dissection. Although favorable results were obtained, the small retrospective cohort precludes definitive conclusions regarding efficacy. The findings support the technical feasibility of the proposed modification and warrant further prospective comparative investigations. Full article

Background/Objectives: Understanding the seroepidemiology of P. falciparum antibody responses is essential for assessing the acquisition of natural immunity and may guide interventions that impact the acquisition of immunity against malaria in endemic areas. This study assessed the association between antigen-specific IgG responses and protection against P. falciparum infection in children from Burkina Faso. Methods: Children aged 1.5 to 12 years were followed using cross-sectional and longitudinal approaches. IgG responses to 16 P. falciparum antigens were measured using a multiplex assay and analyzed by age group and malaria infection status. Associations between antibody levels and clinical malaria risk were assessed using incidence rate ratios (IRRs), and predictive performance of antibody combinations was evaluated using ROC analysis. Results: IgG responses to AMA1, CSP, and MSP2 CH150 showed weak but significant positive correlation with age. Children aged 5–12 years had higher antibody levels than younger children aged 1.5–5 years. Uninfected children had higher levels of antibodies to EBA181 RIII-V, Rh5.1, and SEA1, while infected children had elevated AMA1 and MSP2 CH150. Anti-GLURP R2 and anti-Rh5.1 antibodies were associated with reduced malaria risk (adjusted IRR = 0.52 and 0.40, respectively). The antibody combination of AMA1, GLURP R2, and Etramp5 Ag1 showed the best predictive performance (AUC = 0.70). Conclusions: This study underlines the value of less-studied antibodies (Etramp5 Ag1, Rh5.1, HSP40 Ag1) for diagnosing and protecting against malaria, opening up prospects for the development of more effective tests and targeted vaccine approaches. The variability of responses according to age and infection status calls for further studies to optimize prevention strategies. Full article

While adaptogens are popular in dietary supplements for their health-promoting properties, their safety is compromised by the risk of heavy metal contamination, a threat amplified by inconsistent regulatory standards. This study aimed to assess the extent of heavy metal contamination in adaptogenic supplements on the Polish market and evaluate their compliance with international safety limits. Eleven commercially available supplements (tablets, powders, dried materials) containing Withania somnifera, Rhodiola rosea, Panax ginseng, and Schisandra chinensis were analyzed for lead (Pb), cadmium (Cd), mercury (Hg), nickel (Ni), and other elements using flame atomic absorption spectroscopy (FAAS) and mercury analysis (AMA 254). Results demonstrated widespread contamination, primarily with Pb and Ni. In processed forms (tablets and dried fruits), Pb concentrations exceeded permissible limits by up to 235%, while Ni levels were exceeded by up to 321%. Schisandra chinensis preparations showed the highest contamination levels. Furthermore, raw materials from India contained significantly higher Ni concentrations than those from China (p < 0.01). These findings reveal that a majority of the tested supplements fail to meet toxicological safety criteria, posing a significant health risk to consumers. This underscores a critical regulatory gap and highlights the urgent need for harmonized standards and stringent quality control for dietary supplements. Full article

Background/Objectives: Rotator cuff (RC) tears are a leading cause of shoulder pain and disability. Artificial intelligence (AI)-based chatbots are increasingly applied in healthcare for diagnostic support and patient education, but the reliability, quality, and readability of their outputs remain uncertain. International guidelines (AMA, NIH, European health communication frameworks) recommend that patient materials be written at a 6th–8th grade reading level, yet most online and AI-generated content exceeds this threshold. Methods: We compared responses from three AI chatbots—ChatGPT-4o (OpenAI), Gemini 1.5 Flash (Google), and DeepSeek-V3 (Deepseek AI)—to 20 frequently asked patient questions about RC tears. Four orthopedic surgeons independently rated reliability and usefulness (7-point Likert) and overall quality (5-point Global Quality Scale). Readability was assessed using six validated indices. Statistical analysis included Kruskal–Wallis and ANOVA with Bonferroni correction; inter-rater agreement was measured using intraclass correlation coefficients (ICCs). Results: Inter-rater reliability was good to excellent (ICC 0.726–0.900). Gemini 1.5 Flash achieved the highest reliability and quality, ChatGPT-4o performed comparably but slightly lower in diagnostic content, and DeepSeek-V3 consistently scored lowest in reliability and quality but produced the most readable text (FKGL ≈ 6.5, within the 6th–8th grade target). None of the models reached a Flesch Reading Ease (FRE) score above 60, indicating that even the most readable outputs remained more complex than plain-language standards. Conclusions: Gemini 1.5 Flash and ChatGPT-4o generated more accurate and higher-quality responses, whereas DeepSeek-V3 provided more accessible content. No single model fully balanced accuracy and readability. Clinical Implications: Hybrid use of AI platforms—leveraging high-accuracy models alongside more readable outputs, with clinician oversight—may optimize patient education by ensuring both accuracy and accessibility. Future work should assess real-world comprehension and address the legal, ethical, and generalizability challenges of AI-driven patient education. Full article

Shrimp farming often suffers due to high mortalities and poor growth. Mycotoxins can be one of the causes but often underestimated. BIŌNTE^® QUIMITŌX^® AQUA PLUS, an anti-mycotoxin additive (AMA) was tested to assess its efficacy and determine the best dose for Pacific white shrimp (Litopenaeus vannamei). Four treatments (0, 1, 2, and 3 g/kg of diet) were randomly allocated in 12 aquaria during larval rearing (day 1–20) and 12 fiberglass tanks during subsequent grow-out (day 21–111). Results showed positive impacts on feed conversion, protein efficiency, survival, and growth. A decreasing trend in FCR and increasing trend in PER with the increase in AMA dose. The higher the dose, the better was the immunity as indicated by the survival of shrimp against bacterial challenge. However, the survival and growth showed significant quadratic relationships indicating that the dose of 1.4 g/kg can have the highest daily weight gain (66.7 mg) and the dose of 2.5 g/kg results in the highest survival (60.3%) which is more than double the survival of the control group (27.3%). Therefore, the doses between 1.4 and 2.5 g/kg of feed are recommended for the grow-out phase to enhance growth and survival of shrimp. However, further studies should be conducted in outdoor pond conditions for varying feeding regimes, contamination levels and stocking densities. Full article

Background/Objectives: This study examines the effect of the 2024 update to the AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, on lower limb impairment determinations in comparison to the 2008 edition. It also explores the broader influence of these changes on regulatory, economic, and adjudicative considerations relevant to physician application and interpretation. Methods: Two experienced evaluators independently reviewed 23 standardized lower limb case scenarios, applying both the 2008 and 2024 methodologies. Each assessment was based solely on clinical history, physical examination findings, and diagnostic test results. Impairment values were then calculated and analyzed for consistency across editions. Results: The 2024 lower limb impairment framework produced outcomes that closely mirrored those of the 2008 edition, with intraclass correlation coefficients of 0.9962 for the lower limb and 0.9951 for whole-person impairment, underscoring the strong consistency between editions. Conclusions: The revised 2024 edition for lower limb assessment enhances procedural clarity and integrates improved diagnosis-based impairment tools without disrupting prior impairment values. These refinements are intended to improve utility for clinical and nonclinical stakeholders, ensuring reliable evaluations while minimizing systemic disruption. Full article

The evolution of Human–Computer Interaction (HCI) has laid the foundation for more immersive and dynamic forms of communication between humans and machines. Building on this trajectory, this work introduces a significant advancement in the domain of Human–Robot Manipulation (HRM), particularly in the remote operation of humanoid robots in complex scenarios. We propose the Advanced Manipulation Assistant System (AMAS), a novel manipulation method designed to be low cost, low latency, and highly efficient, enabling real-time, precise control of humanoid robots from a distance. This method addresses critical challenges in current teleoperation systems, such as delayed response, expensive hardware requirements, and inefficient data transmission. By leveraging lightweight communication protocols, optimized sensor integration, and intelligent motion mapping, our system ensures minimal lag and accurate reproduction of human movements in the robot counterpart. In addition to these advantages, AMAS integrates multimodal feedback combining visual and haptic cues to enhance situational awareness, close the control loop, and further stabilize teleoperation. This transition from traditional HCI paradigms to advanced HRM reflects a broader shift toward more embodied forms of interaction, where human intent is seamlessly translated into robotic action. The implications are far-reaching, spanning applications in remote caregiving, hazardous environment exploration, and collaborative robotics. AMAS represents a step forward in making humanoid robot manipulation more accessible, scalable, and practical for real-world deployment. Full article