Search Results (3,099)

Background/Objectives: The aging global population has led to a rising prevalence of type 2 diabetes mellitus (T2DM), in which biomedical outcomes alone fail to capture patients’ lived experiences. Patient-Reported Outcome Measures (PROMs) can provide insights into psychological, psychosocial, and quality-of-life (QoL) dimensions, yet their use—particularly among older adults—remains inconsistent. This AI-assisted rapid review aimed to map how PROMs are currently applied in adults with T2DM, with specific attention to studies involving older populations, focusing on their role in assessing well-being, distress, depression, and treatment satisfaction, as well as their implementation in clinical and organizational practice. Methods: A rapid review was conducted using Elicit, an AI tool designed to support systematic evidence synthesis. Studies published between 2015 and 2025 were identified from Semantic Scholar, complemented by manual searches for recent or unindexed papers. Eligibility criteria required inclusion of adults with T2DM and use of validated PROMs in real-world settings. Studies explicitly describing older or elderly subgroups were highlighted separately. After screening 504 records, 167 studies were included. Data extraction covered study design, instruments used, populations, outcomes, and implementation details. Results: The most frequently assessed outcomes were diabetes distress, depression, QoL, treatment satisfaction, and self-efficacy. Common instruments included PAID, DDS, PHQ-9, WHO-5, EQ-5D, SF-36, DTSQ, and GDS. Evidence showed PROMs effectively identified high-risk patients and informed tailored interventions, but integration into routine care remained limited. Barriers included workflow disruption, lack of provider training, heterogeneity of tools, and insufficient cultural validation. Facilitators included brief instruments, digital administration, and linkage with care planning. Conclusions: PROMs are valuable in capturing psychosocial and psychological burdens in adults with T2DM, including but not limited to older populations, but routine implementation is inconsistent. Broader adoption will require digital infrastructure, clinician training, and organizational integration, as well as the development of PROMs that capture experiences with emerging diabetes technologies. Methodologically, this study illustrates the feasibility of AI-assisted rapid reviews to generate timely, evidence-informed syntheses. Full article

Background: Precision nutrition increasingly integrates mobile health (mHealth) and artificial intelligence (AI) tools. However, personalized hydration remains underdeveloped, particularly in accounting for both food- and beverage-derived water intake. Objective: This scoping review maps the existing literature on mHealth applications that incorporate machine learning (ML) or AI for personalized hydration. The focus is on systems that combine dietary (food-based) and fluid (beverage-based) water sources to generate individualized hydration assessments and recommendations. Methods: Following the PRISMA-ScR guidelines, we conducted a structured literature search across three databases (PubMed, Scopus, Web of Science) through March 2025. Studies were included if they addressed AI or ML within mHealth platforms for personalized hydration or nutrition, with an emphasis on systems using both beverage and food intake data. Results: Of the 43 included studies, most examined dietary recommender systems or hydration-focused apps. Few studies used hydration assessments focusing on both food and beverages or employed AI for integrated guidance. Emerging trends include wearable sensors, AR tools, and behavioral modeling. Conclusions: While numerous digital health tools address hydration or nutrition separately, there is a lack of comprehensive systems leveraging AI to guide hydration from both food and beverage sources. Bridging this gap is essential for effective, equitable, and precise hydration interventions. In this direction, we propose a hydration diet recommender system that integrates demographic, anthropometric, psychological, and socioeconomic data to create a truly personalized diet and hydration plan with a holistic approach. Full article

Background/Objectives: Jumping is a common movement pattern, often used in testing for both performance monitoring and decision-making in return to sport. Current methods of assessing movement coordination are time-, technology- and expertise-dependent. The use of force–time curves to analyse the execution of the movement would provide an accessible and detailed analysis of movement. Methods: Thirty endurance runners and triathletes (18–40 years) completed five maximal countermovement jumps (CMJs) and five maximal standing broad jumps (SBJs). Participants were grouped (HIGH, MOD and LOW) according to the magnitude of the time interval between peak hip and peak knee extension velocity. A separate grouping according to the magnitude of the time interval between peak knee and peak ankle extension velocity was created. A one-way Statistical non-Parametric Mapping ANOVA, with alpha set at 0.05 and iterations at 10,000, was used to compare vertical ground reaction force (CMJ and SBJ), horizontal ground reaction force (SBJ) and resultant ground reaction force (SBJ) between the three hip–knee groups and a separate analysis for the three knee–ankle groups. Results: Significant differences were observed between time interval groups in both hip–knee coordination and knee–ankle coordination for both jump types (p < 0.001) at several regions of the force–time curves. Conclusions: The results suggest there is potential for statistical parametric mapping analysis to detect differences in movement coordination patterns from force curves. Further research is needed to help explain the differences observed in the curves for the kinematic groupings, to explore different combinations of hip–knee and knee–ankle kinematic patterns and to associate curve characteristics with performance indicators. Full article

Background: The purpose of this study was to examine the relationship between qualitative characteristics and quantitative parameters from contrast-enhanced ultrasound (CEUS) and microvessel density (MVD) in hepatoblastoma (HB), as well as to investigate whether CEUS could be utilized as a non-invasive method for predicting HB progression. Methods: This retrospective analysis was carried out in one medical center and included 34 children with histopathologically confirmed HB. Both grayscale ultrasound and CEUS results were reviewed. Lesions were evaluated using time–intensity curve (TIC) analysis software to extract quantitative parameters. Postoperative tissue specimens were stained with CD34 immunohistochemistry, and MVD was quantified as the reference standard. Statistical analyses were conducted to assess the correlation between CEUS findings and MVD. Results: Lesions were separated into high (n = 21, 61.76%; MVD ≥ 41) and low (n = 13, 38.24%; MVD < 41) MVD groups, using the median microvessel density of 41 vessels per high-power field (HPF) as the cutoff. High MVD lesions exhibited a significantly higher incidence of penetrating vessels compared with low MVD lesions (p < 0.05). Elevated MVD levels were significantly associated with increased Adler-grade blood flow (p < 0.05). Both TIC-derived and relative quantitative parameters exhibited significant intergroup differences. Among the relative parameters, the relative wash-out rate (rWoR) was significantly higher in the low MVD group (p < 0.05). Moreover, the Receiver Operating Characteristic (ROC) curve analysis indicated that an rWoR threshold of ≥1.36 could serve as a predictor for low MVD, resulting in 76.9% sensitivity and 81.0% specificity (AUC = 0.802; 95% CI: 0.634–0.970; p = 0.003). Conclusions: CEUS revealed an association with MVD, supporting its potential as a non-invasive tool to characterize tumor vascularity. Full article

Photo(electro)-catalysis has increasingly attracted attention from researchers due to its wide applications in green chemical transformation, including organic synthesis and environmental remediation. As a promising candidate, the n-type semiconductor WO₃ possesses a suitable bandgap (~2.6 eV), good visible-light response, high chemical stability, and multi-electron transfer capability, thus endowing it with enormous potential in heterogeneous photocatalysis (PC) and photoelectrocatalysis (PEC) to address environment and energy issues. In this review, the recent research progress of WO₃-based photo(electro)-catalysts is examined and systematically summarized with regard to construction strategies and various application scenarios. To start with, the research background, functionalization methods and possible reaction mechanisms for WO₃ are introduced in depth. Key influencing factors, including light absorption capacity, charge carrier separation, and reusability, are also analyzed. Then, diverse applications of WO₃ for the elimination of organic pollutants (e.g., persistent organic pollutants and polymeric wastes) and green organic synthesis (i.e., oxidation, reduction, and other reactions) are intentionally discussed to underscore their vast potential in photo(electro)-catalytic performance. Finally, future challenges and insightful perspectives are proposed to explore effective WO₃-based materials. This comprehensive review aims to offer profound insights into innovative exploration of high-performance WO₃ semiconductor catalysts and guide new researchers in this field to better understand their vital roles in green organic synthesis and hazardous pollutants removal. Full article

Background/Objectives: Hyperuricemia (HUA) is a metabolic disease with increasing incidence. Chicory (Cichorium intybus L.), a traditional medicinal and edible plant, has demonstrated anti-HUA effects. However, the metabolic profiles of its aerial parts and roots are still not fully characterized. Moreover, few studies have investigated its anti-HUA effects using cell metabolomics. Methods: The metabolomes of chicory root and aerial parts were characterized using UPLC-QTOF-MS-based untargeted metabolomics. Subsequently, the anti-HUA mechanism of chicory root was investigated by performing non-targeted metabolomics in HK-2 cells. Results: The results demonstrated that various hydroxycinnamic acids and flavonoids were more abundant in aerial parts, whereas sesquiterpenes and oligosaccharides were characteristic of the root. Both chicory root and aerial part extracts significantly reduced uric acid (UA) levels in HK-2 cells induced by adenosine with xanthine oxidase (XO). Cellular metabolomic profiling indicated a distinct separation between the root extract (CR40, 40 mg/mL) and the model group. OPLS-DA identified 165 differential metabolites, including acylcarnitines, acylamino acids, peptides, phospholipids, glycerides, and lipid-like molecules. These metabolites were associated with key metabolic pathways of sphingolipids, glycerophospholipids, phosphonate and phosphinate, linoleic acid, biotin, purine, as well as taurine and hypotaurine metabolism. Conclusions: Chicory is rich in diverse bioactive compounds and exhibits significant anti-HUA activity by modulating multiple metabolic pathways. Full article

Background: Lonicera macranthoides (L. macranthoides) is a traditional Chinese medicinal plant, the flower buds of which are rich in bioactive compounds, such as chlorogenic acids (CGAs) and flavonoids, and exhibit diverse pharmacological activities. Methods: Integrated transcriptomic and metabolomic analyses were conducted across three floral developmental stages: flower bud (FB), white flower (WF), and golden flower (GF). Results: Clustering analysis revealed distinct molecular profiles, with the WF and GF stages clustering together and clearly separating from the FB stage. The most significant metabolomic variation was observed between the GF and FB stages. KEGG enrichment analysis consistently highlighted the phenylpropanoid biosynthesis pathway as a key hub. Stage-specific accumulation patterns were identified for critical metabolites: caffeoylquinic acid peaked at the WF stage, while ferulic acid, sinapic acid, cinnamic acid, and p-coumaric acid reached their highest levels at the GF stage. Within this pathway, we identified 11 DEGs encoding the core enzymes, alongside 15 associated DAMs. The expression trends of four PAL genes were fully consistent with the accumulation of related precursors, and F5H expression correlated with its downstream product, sinapic acid. WGCNA identified a key module highly correlated with key phenolic acids, containing 71 transcription factors, including MYB, bHLH, WRKY, and AP2/ERF families, potentially forming a complex regulatory network for phenylpropanoid biosynthesis. Conclusions: This study deciphers the stage-specific regulatory network of CGA biosynthesis, providing critical insights and genetic resources for cultivating high-medicinal-content varieties of L. macranthoides. Full article

Background: Takotsubo syndrome (TTS) is an acute cardiac condition characterized by transient left ventricular dysfunction. Although generally considered reversible, early arrhythmias are a dreaded complication and their prognostic significance remains incompletely understood. Methods: In this study, 104 consecutive patients diagnosed with TTS (January 2007 to September 2024) were examined for the prognostic relevance of in-hospital arrhythmias during monitoring at the time of diagnosis. The median follow-up was 2.1 years. The primary combined endpoint included cardiac death, TTS recurrence, occurrence of arrhythmias, and rehospitalization for cardiac causes. Results: In-hospital arrhythmias occurred in 35.6% of the patients. Ventricular arrhythmias were significantly associated with an increased risk of adverse cardiac events (odds ratio 3.94, 95% confidence interval 1.22–12.69; p = 0.021). Reduced left ventricular ejection fraction and QTc prolongation, while frequently observed, were not independently associated with adverse outcomes when analyzed separately from arrhythmic events. Supraventricular arrhythmias exhibited a non-significant trend (p = 0.145). Conclusions: In a large registry of consecutive TTS patients, in-hospital ventricular arrhythmias at diagnosis were significantly associated with adverse outcomes, underscoring the importance of early rhythm monitoring. Full article

Background: Parent education is a key component of family-centred care in neonatal intensive care units (NICUs). It supports positive parent-infant interactions, reduces parental stress and anxiety, and contributes to shorter hospital stays. Objectives: This paper reports on the adaptation of a South African parenting education intervention for parents of premature infants in the NICU: the NeuroSense PremmieEd programme. The study aimed to demonstrate the programme’s content validity, feasibility, and acceptability for preterm parent–infant dyads in public hospital NICUs, using a hybrid focus group discussion (FGD) method. The programme was based on an existing intervention and informed by literature on the components of parenting educational programmes and empirical data on parental expectations. Methods: A qualitative, iterative refinement process was undertaken using hybrid-format FGDs. A conceptual FGD was held during the design phase, followed by two consensus FGDs after pilot testing (reported separately). Stakeholders included end-users (mothers), clinicians, an instructional designer, a neurodevelopmental care expert, and programme facilitators. Results: The first FGD reviewed draft version 0.1 of the programme, confirming content relevance and clarity, while recommending adjustments, such as module integration, cultural and language alignment, and visual aids to support comprehension. Version 0.2 was then ready for pilot testing (reported elsewhere). The second and third FGDs led to refinements addressing emotional sensitivity in terminology, improved layout and readability, and the addition of home care guidance. Stakeholders highlighted the potential use of low-cost digital formats to enhance accessibility and standardisation. These revisions informed the final version 0.3. Conclusions: The hybrid FGD approach enabled input from diverse and geographically dispersed stakeholders. The NeuroSense PremmieEd programme was found to be feasible and acceptable by both mothers and healthcare professionals, supporting its suitability for broader implementation in resource-constrained settings. Full article

Background/Objectives: Nitrosamine drug substance-related impurities (NDSRIs) are a class of potent genotoxic impurities that pose a critical risk to patient safety, thereby necessitating the stringent control of pharmaceutical products. Nortriptyline (NORT) and sertraline (SERT) are two widely prescribed antidepressants that form highly potent NDSRIs, N-nitroso-nortriptyline (NNORT) and N-nitroso-sertraline (NSERT), respectively. Despite these risks, a substantial gap exists in terms of the validated analytical methods for surveillance. Accordingly, this study addressed this need by developing a liquid chromatography–tandem mass spectrometry method for the quantification of NNORT and NSERT in drug products. Methods: A comparative evaluation of two reversed-phase columns (general-purpose C18 column and phenyl-hexyl column) was performed to achieve optimal chromatographic resolution of the parent active pharmaceutical ingredients (APIs). Results: The phenyl-hexyl column demonstrated superior separation for both NDSRI/API pairs by leveraging π-π interactions to markedly enhance the resolution. This was particularly critical for SERT. The method was fully validated according to the International Council for Harmonization guideline Q2(R1) and demonstrated excellent linearity (r² = 0.998 for both NNORT and NSERT) with limits of quantitation of 20 ng/g for NNORT and 125 ng/g for NSERT. Accuracy was confirmed with recoveries of 96.6–99.4% for NNORT and 98.6–99.4% for NSERT, and precision was acceptable, with relative standard deviation below 3.9% and 1.9%, respectively. The application of this method to commercial products subjected to accelerated stress testing revealed NNORT formation in NORT products with an average concentration of 190 ng/g, as well as NSERT formation in SERT products resulted in an average concentration of 172 ng/g. Conclusions: This validated method provides a reliable tool for routine quality control, thereby enabling pharmaceutical manufacturers and regulatory agencies to ensure safety and compliance with widely used antidepressant medications. Full article

Background: Early detection of Parkinson’s disease (PD) is vital for improving patient outcomes, yet traditional diagnostic methods often depend on subjective clinical evaluations. Methods: This study proposes a novel deep learning framework for PD detection based on spiral and wave handwriting patterns from the PaHaW dataset. A comprehensive preprocessing pipeline is implemented, integrating histogram equalization and Canny edge detection. The processed spiral and wave images are evaluated independently using a fine-tuned EfficientNetV2-S architecture for binary classification. In addition to the EfficientNetV2-S experiments, a baseline Convolutional Neural Network (CNN) model is implemented separately for the spiral and wave handwriting images. The proposed model is further assessed using a 5-fold cross-validation strategy to ensure robustness and generalizability. Results: The models achieved validation accuracies of 98.68% on the spiral dataset and 98.10% on the wave dataset, with high Receiver Operating Characteristic–Area Under the Curve (ROC–AUC) scores, indicating robust discrimination between healthy and PD subjects. Analysis of the confusion matrix and classification results confirmed consistent sensitivity and specificity across the dataset. The 5-fold cross-validation yielded a standard deviation of ±0.0109. Conclusions: These results highlight the strong potential of handwriting analysis for early PD detection. Full article

Background: Accurate reconstruction of the orbit after trauma or oncological resection requires reliable anatomical references. In unilateral cases, the contralateral orbit can guide repair, but bilateral injuries or pathologies remove this option. To address this problem, we developed a new morphological classification of orbits based on three linear dimensions. Methods: A total of 499 orbits from patients of Caucasian descent (age 8–88 years) were analyzed using three-dimensional models generated from cone-beam and fan-beam CT scans. Orbital depth (D), height (H), and width (W) were measured, and proportional indices were calculated. K-means clustering (k = 3) identified recurring morphotypes, validated by linear discriminant analysis (LDA) and supported by ANOVA, Kruskal–Wallis, and correlation tests (age and sex). Results: Three morphotypes were identified: Tall & Broad (type A, 33.5%), Deep & Broad (type B, 30.2%), and Compact (type C, 36.2%). All dimensions differed significantly between groups (ANOVA, p < 1 × 10⁻¹⁶; η² = 0.40–0.51). Male orbits were significantly deeper and wider than female ones (p < 0.001). LDA demonstrated excellent separation with 97.5% accuracy. A simplified decision algorithm achieved 82.1% classification accuracy. In situations where only orbital depth could be measured, an alternative cut-off-based method reached 61.5% accuracy, with type B and C better distinguished than type A. Conclusions: The proposed classification provides a reproducible framework for describing orbital morphology. It may serve as a reference in cases where local anatomy is disrupted or the contralateral orbit is unavailable. Even millimeter-scale differences in orbital dimensions may correspond to clinically relevant changes in orbital volume and globe position, underlining the potential usefulness of this system in surgical planning. Full article

Background/Objectives: Vaccination is a critical public health measure for older adults in residential aged care facilities (RACFs). In Australia, COVID-19, influenza, pneumococcal, and shingles vaccines are recommended and funded for this group. However, vaccination coverage remains suboptimal, with limited understanding of the underlying causes. Methods: A mixed-methods design explored the enablers and barriers to vaccination from the perspectives of frontline providers, RACF staff, residents and family members. Descriptive statistics were used to quantify the prevalence of perceived enablers and barriers within stakeholder groups. Qualitative data—collected through open-ended questions—were analysed using manual, deductive-iterative coding to identify key themes. Key quotes illustrate the findings. Results: Input was gathered from seven in-reach geriatric staff, 40 general practitioners (GPs), 90 RACF staff, 17 RACF residents, and 84 family members of residents. Results were grouped under four key themes: operational, communication, coordination, and financial. RACF staff identified limited access to vaccination histories as the most significant barrier and relied on external providers to upload data to the Australian Immunisation Register (AIR). On-site clinics were essential, but organisational policies prevented nurse-led vaccination of residents. Most RACFs stored only influenza vaccines and depended on external providers for others. Simplified, translated information was called for. Healthcare provider and RACF endorsement was valued, but RACF staff felt ill-equipped to handle conversations around vaccine hesitancy. Consent processes were burdensome, and responsibility for tracking vaccination schedules was unclear with calls for streamlined processes. Low provider remuneration was also noted, with calls for increased government support. Conclusions: This work identifies key enablers and barriers to resident vaccination in RACFs. Improving delivery requires organisational policy change, staff support, digital access, and continued advocacy. Analysis of targeted interventions and coverage will be reported separately. The approach is replicable for other vulnerable groups. Full article

Background/Objectives: DNA interstrand cross-links (ICLs) mark one of the most deleterious lesions that can preclude strand separation required for essential cellular processes. Efforts to discover ICL-inducing agents and endogenous substrates for ICL repair pathways have led to the identification of structurally diverse ICLs produced by reactive aldehydes and abasic sites, among others. While several studies point to UV rays as ICL-inducing agents, UV ray-induced ICL formation from biologically relevant DNA lesions has been rarely reported. We conjectured that solar radiation-induced reactive oxygen species may give rise to ICLs via further oxidation of DNA lesions with lower redox potential (e.g., 8-oxoadenine (oxoA)). Here, we present the discovery of ICL production via light-induced modification of the major oxidative adenine lesion oxoA. Methods/Results: In the absence of a photosensitizer, both UVC and UVB rays, but not UVA and visible rays, trigger the formation of oxoA-G ICLs, albeit in low yields. By contrast, the inclusion of the naturally occurring photosensitizer riboflavin in the cross-linking reaction makes UVA and visible rays readily generate oxoA-G ICLs, suggesting solar radiation facilitates the formation of oxoA ICLs in vivo. Conclusions: The plausible oxoA-G ICL formation mechanism concerns the further oxidation of oxoA into an iminoquinone, followed by the nucleophilic attack of the opposite guanine on the iminoquinone. OxoA-G ICLs represent rare examples of ICLs produced by photosensitization. These results will contribute to the discovery of a novel form of ICLs induced by solar radiation. Full article

Given the yearly challenging environmental scenario with more and more frequent and intense heat waves, the livestock sector has to find affordable and sustainable solutions to face the expected increase in meat demand by 2050. Among livestock species, rabbits are particularly sensitive to heat stress (HS) but, paradoxically, the scientific background on the response of different genetics to environmental stressors like HS is rather scarce. This is a significant gap, especially considering that most of the demographic growth, and meat demand, is expected in developing countries where rabbits play a key role in subsistence farming. Therefore, this research investigated the effects of environmental temperature (Control—20 °C; High—28 °C) on growth performance, slaughter traits and meat quality of three Hungarian rabbit genotypes (Pannon Large—PL; Pannon White—PW; Pannon Ka—PK). Animals (n = 360) were housed in wire-mesh cages (3 animals/cage) in two separate controlled-temperature rooms (60 rabbits/genotype/room), from 5 to 11 weeks of age, during which they received ad libitum feed and water. Even if the three genotypes were exposed to the same environmental challenge, they exhibited different responses. The PL line showed superior performance, with the highest carcass weight and yield (p < 0.001), and the greatest water-holding capacity (p < 0.01) in the loin muscle. The PW rabbits showed the largest reduction in overall weight gain (−24.7%; p < 0.001) and the lowest decrease in feed conversion ratio (−3.20%; p < 0.001). PK rabbits experienced the greatest reduction in total dissectible fat (−34.6%; p < 0.001) and hind leg lipid content (−20.3%; p < 0.01), with the highest proportion of polyunsaturated fatty acids (p < 0.01), which fostered meat lipid oxidation (p < 0.05). As expected, these differences in performance and meat quality traits reflected the distinct selection criteria and genetic background of these genotypes: the PL is a paternal line, the PK is a maternal line, and the PW is a productive line. Regarding the temperature effect, PK and PW genotypes were the most impacted by chronic HS: PW rabbits suffered the largest performance depression, while PK rabbits showed the worst carcass and meat quality traits. Instead, PL rabbits demonstrated the best outcomes under chronic HS, showing the greatest productive efficiency and satisfactory meat quality traits. Full article