Search Results (23,981)

The rapid evolution of the Open Radio Access Network (O-RAN) architecture and the exponential growth in specification complexity create significant barriers for researchers translating 5G standards into practical implementations. Existing evaluation frameworks for large language models, such as ORAN-Bench-13K, focus predominantly on the theoretical comprehension of regulatory documents while neglecting the critical aspect of software execution. This disparity results in a profound semantic gap, defined here as the structural and conceptual misalignment between abstract normative requirements and their concrete realization in the source code of open platforms like srsRAN. To bridge this divide and enable advanced cognitive reasoning, this paper presents a Hybrid Retrieval-Augmented Generation (RAG) framework designed to unify two heterogeneous knowledge domains: the O-RAN/3GPP specification corpus and the srsRAN C++ codebase. The proposed architecture leverages a hierarchical Parent–Child Chunking strategy to preserve the structural integrity of complex code and normative protocols. Additionally, it introduces a probabilistic Semantic Query Routing mechanism that dynamically selects the relevant context domain based on query intent. This routing actively mitigates semantic interference—a phenomenon where merging conflicting cross-domain terminology introduces informational noise, which our baseline tests showed degrades response accuracy by 4.7%. Empirical evaluation demonstrates that the hybrid approach successfully overcomes this, achieving an overall accuracy of 76.70% and outperforming the standard RAG baseline of 72.00%. Furthermore, system performance analysis reveals that effective context filtering reduces the average response generation latency to 3.47 s, compared to 3.73 s for traditional RAG methods, rendering the framework highly suitable for real-time telecommunications engineering tasks. Full article

Specific Learning Disability (SLD) describes persistent difficulties in academic skills in reading, writing, and mathematics, despite having normal intelligence. The exact origin of SLD is unknown. However, it is thought that biological factors and environmental conditions, along with genetic factors, contribute to the development of SLD. Agmatine, a neurotransmitter in the brain, plays a role in various biological processes. Agmatine has been reported to mediate antidepressant effects and neuroprotective effects, and it plays critical roles in learning and the processing of learned information into memory. Therefore, this study aimed to determine the relationship between SLD and agmatine metabolism by determining the enzyme levels of arginine decarboxylase (ADC) and agmatinase (AGMAT) in children with SLD. ADC and AGMAT levels in the blood serum of children with SLD and controls were analyzed using ELISA. When ADC levels in children with SLD (30.26 ± 5.06 ng/mL) were compared with those in the control group (29.82 ± 4.95 ng/mL), the difference was not statistically significant (p = 0.737). However, AGMAT levels in children with SLD (27.02 ± 4.46 ng/mL) were found to be statistically significantly higher than those in the control group (21.42 ± 3.98 ng/mL) (p < 0.001). In light of these findings, we can say that agmatine breakdown is significantly increased in children with SLD. Full article

Background: Since sedentary habits have become a growing global public health concern, the promotion of physical activity (PA) from early childhood could help children live healthy lifestyles. The aim of this systematic review was to analyze the level of compliance with PA in preschoolers in relation to the reference guidelines. Method: A systematic review of relevant articles was carried out using four databases (PubMed, ProQuest, SCOPUS, and FECYT (Web of Sciences, CCC, CIDW, KJD, MEDLINE, RSCI, and SCIELO)) until 14 May 2025. The methodological assessment process was performed by using an adapted version of the MINORS assessment criteria. Results: A total of 623 studies were initially found and 23 were included in the qualitative synthesis. Conclusions: The results revealed that the average in most contexts usually ranges between 30% and 65% of the child population. Due to different operational criteria, compliance was generally higher when PA was assessed separately using single-behavior guidelines as opposed to when integrated 24 h movement frameworks were used. However, these results should be considered with caution because establishing the level of adherence to PA guidelines is difficult due to the different outcomes and guidelines used to compare the level of children’s PA. In future research, it is important to establish common baseline criteria (specifying more specific ages, common questionnaires, and criteria for calculating PA quantity and intensity) to facilitate more objective and reliable comparisons between studies. This systematic review is important because it highlights the need for healthy educational habits from the first years of a person’s life. Full article

This research examined the component structure of two child measures, the Trait Emotional Intelligence Questionnaire–Child Form (TEIQue-CF; 75 items) and its short form (TEIQue-CSF; 36 items), developed specifically for children aged 8 to 12 years. Study 1 analysed TEIQue-CF data using the nine facet scores from 720 UK primary school pupils in Years 3 through 6 using principal component analysis with parallel analysis for factor retention. Results supported a unifactorial solution in the total sample, with a single factor explaining 43.48% of the variance. Exploratory subgroup factor analyses (in boys and older children in Years 5 to 6) in Study 1 suggested a potentially interpretable bifactorial pattern, though parallel analysis did not support retaining the second factor. Study 2 examined the TEIQue-CSF in 1582 Year 6 pupils using parcel-level analysis. A clearer two-factor structure emerged, with Socioemotionality (Adaptability, Peer relations, Self-esteem, Emotion expression, Affective disposition, Emotion perception) and Emotion control (Impulse control, Emotion regulation, Self-motivation) explaining 53.7% of the variance. This structure replicated across gender subgroups. Taken together, the findings suggest a developmental trend in which trait EI shifts from a largely undifferentiated structure in middle childhood to a more differentiated two-factor organisation by the end of primary school. They support the use of global trait EI scores in younger children while indicating that differentiated assessment becomes appropriate as children approach adolescence. Full article

Background: Difficulties in recruiting patients for clinical trials increase costs and delay the implementation of new therapies. A better understanding of participants’ motivations and barriers can help with developing effective recruitment strategies. The aim of the study was to identify the factors influencing the decisions of adult Poles to participate in clinical trials. Methods: The survey was conducted among Polish adults aged 18 years and older by the independent research company Ariadna between January and February 2023. The questionnaire consisted of 22 questions, nine of which related to the determinants of participation in clinical trials. 1079 people took part in the survey. Results: The study population included 568 women (52.6%) and 511 men (47.4%). The mean age of respondents was 44.96 years (SD = 16.30). 49.9% of respondents (n = 538) declared their willingness to participate in clinical trials in the future. Among those who were reluctant (n = 158, 14.6%), the main barriers were: safety concerns (n = 59, 5.5%), lack of trust (n = 43, 4.0%), and insufficient knowledge (n = 33, 3.1%). The strongest motivation was the desire to improve health (n = 869, 80.5%), and the most frequently indicated reason for participation was cancer (n = 740, 68.6%). The least frequently indicated were diseases of the urinary and reproductive systems (n = 125; 11.6%). Conclusions: The results highlight key aspects important to patients when deciding whether to participate in clinical trials. Such findings may prove useful for researchers in getting to know their patients better and in developing effective strategies to recruit and retain participants in clinical trials. Full article

Aim: We aimed to evaluate the clinical efficacy and safety of Shenqu Xiaoshi Oral Liquid in the treatment of functional constipation in children. Methods: A comprehensive literature search was conducted from inception to 20 October 2025, across PubMed, Embase, Scopus, Web of Science, the Cochrane Library, Chinese VIP Information Database, China National Knowledge Infrastructure (CNKI), and Wan Fang Med Database. For quantitative analysis, the mean difference (MD) was used for continuous outcomes and the risk ratio (RR) for dichotomous outcomes. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool. Statistical analyses were performed using RevMan 5.3 and Stata 13 software. Results: Eight studies involving 692 pediatric patients were included (Shenqu Xiaoshi Oral Liquid group: 345; control group: 347). Compared to the control group, Shenqu Xiaoshi Oral Liquid demonstrated superior clinical effectiveness [RR = 1.36, 95% CI: (1.25, 1.47); z = 7.11, p < 0.00001] and a lower recurrence rate [RR = 0.49, 95% CI: (0.26, 0.93); z = 2.18, p = 0.03]. Both the post-treatment [WMD = −0.91, 95% CI: (−0.97, −0.86); z = 31.94, p < 0.00001] and post-recurrence [WMD = −1.49, 95% CI: (−1.56, −1.41); z = 40.12, p < 0.00001] defecation intervals were shorter in the Shenqu Xiaoshi Oral Liquid group. No significant difference was observed in the incidence of adverse reactions between the two groups [RR = 0.67, 95% CI: (0.35, 1.29); z = 1.20, p = 0.23]. Furthermore, serum levels of motilin [WMD = 41.66, 95% CI: (34.17, 49.16); z = 10.90, p < 0.00001] and gastrin [WMD = 23.74, 95% CI: (7.30, 40.19); z = 2.83, p = 0.005] were significantly higher in the Shenqu Xiaoshi Oral Liquid group. Conclusions: Shenqu Xiaoshi Oral Liquid shows favorable clinical efficacy and an acceptable safety profile for treating functional constipation in children. However, these outcome measures are influenced by the limited sample size and potential heterogeneity of the included studies, warranting cautious interpretation of the results. Full article

Amid the prevailing trend of “pan-entertainment” in cyberspace, adults increasingly interpret children’s lives through utilitarian, adult-centric, and entertainment-focused perspectives, leading to the alienation of children’s online images. This study examines child influencer accounts on Douyin—typically managed by parents—and conducts content and discourse analysis on them. Drawing on critical theories by Douglas Kellner, we employed Scrapy and NVivo to analyze 30 popular children’s videos and 15,000 user comments posted beneath them. The analysis identifies five key characteristics in the construction of such images: spectacular visual mechanisms, younger-age production trends, covert commercial penetration, homogenized spectacle types, and adult-centric implicit influence. The study underscores the urgency of strengthening protective mechanisms to counteract platform capitalism’s intrusion into childhood and to uphold children’s digital privacy and agency. Full article

Background/Objectives: Breastfeeding represents a critical developmental window during which maternal biology, environmental exposures, and nutrition converge to influence infant gastrointestinal health and long-term developmental trajectories. From a One Health perspective, breastfeeding can be conceptualized not as a static nutritional act, but as a dynamic and modifiable biological system in which maternal factors shape early-life microbiota assembly and immune programming. This narrative review explores how microbiota-oriented strategies during breastfeeding may foster a favorable trajectory of infant health, potentially extending to transgenerational outcomes. Methods: This narrative review is structured around a ten-point decalogue addressing interconnected domains relevant to the maternal–milk–infant microbiota axis, including maternal diet, microbial diversity, environmental exposures, psychological stress and probiotic use. Current mechanistic and clinical evidence was examined to evaluate how these domains may modulate microbiota composition and function during breastfeeding. Attention was given to probiotic supplementation, including strain specificity, timing of administration, and clinical context, as well as to the broader implications of a One Health framework. Results: Available evidence suggests that maternal nutritional patterns, environmental and psychosocial exposures, and targeted microbiota-modulation strategies may influence the composition and functional properties of human milk and the developing infant microbiota. Probiotic use during breastfeeding appears to have strain-specific and context-dependent effects, with potential benefits in selected clinical scenarios. However, findings remain heterogeneous, and uncertainties persist regarding optimal strains, timing, and long-term outcomes. Conclusions: Breastfeeding can be understood as a dynamic biological interface shaped by maternal and environmental factors. Integrating microbiota-oriented strategies within a One Health framework may support infant gastrointestinal health and possibly contribute to longer-term developmental trajectories. Nevertheless, careful interpretation of the current evidence is warranted to avoid reductionist, supplement-centered approaches and to prevent maternal overmedicalization or blame. Full article

Antibiotic therapy represents one of the strongest ecological perturbations of the human gut microbiota, inducing rapid and often prolonged alterations in community structure, metabolic activity, and functional resilience. While the use of probiotics to mitigate antibiotic-associated dysbiosis is widely adopted in clinical practice, probiotic selection is still largely empirical and insufficiently grounded in biological compatibility with specific antibiotic pressures. In this conceptual review, antibiotics are reframed not merely as antimicrobial agents, but as ecological forces that shape microbial survival, quiescence, and recolonization dynamics. We propose a biologically informed framework that distinguishes genetic antibiotic resistance from functional or ecological insensitivity, highlighting how microbial traits, such as the absence or inaccessibility of the antibiotic target, metabolic state, sporulation, and cellular architecture, influence the persistence of probiotics during antibiotic exposure. By integrating the mechanisms of action of antibiotics with key physiological and structural features of probiotic microorganisms, we develop a conceptual framework aimed at rationalizing the compatibility of probiotics and antibiotics. This framework does not imply clinical efficacy but provides an interpretative tool to guide hypothesis generation, experimental validation, and the design of future targeted probiotic strategies. A more ecologically grounded approach to probiotic selection may ultimately improve microbiota support during antibiotic therapy and advance personalized microbiome modulation. Full article

Background: Elevated levels of the C-3 epimer (3-epi-25(OH)D) of 25-hydroxyvitamin D (25(OH)D) have been identified in premature infants as compared to most adults, and an immature liver has been suggested as a possible cause. We hypothesised that patients with cirrhosis might present with elevated C-3 epimerisation due to impaired liver function. The aim was to assess whether 3-epi-25(OH)D levels differ in patients with chronic liver disease with cirrhosis vs. those without cirrhosis. Methods: A total of 309 patients were included (254 patients with cirrhosis vs. 55 without cirrhosis). Serum 25(OH)D and 3-epi-25(OH)D levels were determined using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results: Patients with cirrhosis had significantly higher median relative 3-epi-25(OH)D concentrations, as compared to patients without cirrhosis (7.4% (5.5–10.4) vs. 4.8% (2.4–5.7), respectively; p < 0.001). They also had similar absolute 3-epi-25(OH)D levels (despite having lower 25(OH)D serum concentrations) than patients without cirrhosis. A progressive increase in relative 3-epi-25(OH)D levels was observed with more advanced cirrhosis (p < 0.001). An analysis of the ROC area under the curve determined 6% as the optimal cut-off for relative 3-epi-25(OH)D. All patients with Child–Pugh stage C and 88.6% with stage B were above the 6% cut-off and had significantly higher absolute serum 3-epi-25(OH)D concentrations (0.9 ng/mL vs. 0.6 ng/mL; p < 0.05) and lower serum 25(OH)D levels (9.3 vs. 14.1 ng/mL; p < 0.001) than patients <6% cut-off. Conclusions: These results reflect the marked increases in relative 3-epi-25(OH)D levels that occur with cirrhosis. The specific hepatic metabolic alterations still need to be unravelled, including whether cirrhosis might lead to reduced epimer clearance. Full article

Background/Objectives: The mediating role of the diverse range of screen-based sedentary behaviors (SBs) remains understudied, particularly at younger ages. The present study examined the direct and indirect effects of parental BMI and education on ultra-processed food (UPF) consumption among preschoolers, testing the potential mediating role of screen time. Methods: The cross-sectional study sample comprised 919 kindergarten children (484 boys, 52.7%), with ages ranging from 2.2 to 6.8 years (mean: 4.7 ± 1.0 years). Screen-based sedentary behaviors (television viewing, smartphone use, tablet use, computer use, and playing electronic games) were measured by proxy-report fulfilled by parents, separately for weekdays and weekends. UPF consumption (drinks/yogurts, packaged/fast foods, and sweet/salty snacks) was assessed via 24 h recall scales. Path analysis mediation models tested direct effects of maternal/paternal BMI and education on UPF intake, and indirect effects through screen time, controlling for child age and sex. Results: Lower parental education and higher parental BMI were associated with increased mobile device use and UPF consumption (r = 0.10–0.28). Screen-based sedentary behaviors mediated the association between maternal BMI and UPF pathways (15–90% of total effects), particularly for sweet and salty snacks (50–90%). Parental education effects were also mediated by screen time (9–23% indirect effects), with paternal education showing stronger protection against packaged/fast foods. Conclusions: Mobile devices and watching television partially mediate intergenerational transmission of obesogenic dietary patterns from parental BMI/education to preschoolers’ UPF consumption. Findings of the current study support family-centered interventions targeting screen-time limits and UPF exposure, mainly at the weekends, to prevent early obesity trajectories. Full article

When using traditional approaches, such as pharmacokinetics and pharmacodynamics, the entire cellular or molecular response to drugs in the body cannot be fully ascertained or established. The oral medication process involves pharmacokinetics, followed by oral microbiomics and then gut microbiomics and pharmacodynamics. Recently, there has been increasing interest in the role of genetics (pharmacogenetics and pharmacogenomics) in both humans and microbiomes, as well as omics alterations (e.g., epigenetic, transcriptomic, proteomic, and metabolomic alterations as a consequence of drug exposure), which can help to ascertain the cellular responses to medications. Both the efficacy and toxicity of a drug are influenced by these factors. To assess these at an individual level, an integrative Personalized Medicine Model may be needed to help with medication management. Two example application cases for SSRIs and statins demonstrate the clinical usefulness of such a model, which can guide clinicians during drug selection and dosing to reduce reliance on trial-and-error, thus potentially improving patient outcomes and safety. Integrating this framework into practical clinical workflows requires the capture, analysis, and translation of multi-omics data in order to realize decision support protocols and actionable drug recommendations. This review also discusses IT requirements and different stakeholder roles. Although the proposed model can guide the treatment of diseases at the individual patient level, further research is still needed before it can be implemented as part of drug development research, clinical care, and healthcare delivery systems. Full article

Background/Objectives: Nursing turnover represents an increasing threat to the sustainability of healthcare systems. Burnout, a syndrome of chronic work-related stress, is one of the primary predictors of intention to leave work; however, certain organizational factors may be associated with variations in its impact. Among these, the leadership of the Unit Coordinator may represent a potential resource, but its association with the relationship between burnout and intention to leave remains poorly explored. This study investigates the role of coordinators’ leadership in the relationship between burnout and intention to leave the profession. Methods: A cross-sectional study was conducted among 668 nurses providing direct patient care in various Italian healthcare settings. Data were collected through an online questionnaire comprising validated scales reported in the literature. A structural equation modeling approach was used for the analysis. Results: More than 30% of the variance in burnout is explained by interpersonal conflicts, workload, and organizational constraints. Burnout accounts for 24.4% of the variance in nurses’ intention to leave their jobs. The leadership of the nurse coordinator partially mediates the relationship between burnout and nurses’ intention to leave their job (total effect β = 0.532; p < 0.001; indirect effect β = 0.139; p = 0.007; direct effect β = 0.393; p < 0.001). Conclusions: Burnout is a key predictor of nurses’ intention to leave the profession, while ethical leadership of nurse coordinators emerges as a potential organizational resource associated with this relationship. Nursing implications: These findings highlight the importance of promoting ethical leadership within nursing management as part of broader organizational strategies to improve staff well-being and potentially support efforts aimed at reducing nurses’ intention to leave the profession. Full article

The perception that hormonal contraception causes weight gain is a general belief that frequently hinders the initiation and continuation of effective family planning. This narrative review analyses data from Cochrane systematic reviews and recent pharmacogenomic studies to separate patient perception from metabolic reality. Analysis of high-quality data, including Cochrane systematic reviews, indicates that the association between Combined Hormonal Contraceptives (CHCs)—including oral pills, the transdermal patch, and the vaginal ring—and weight gain is not supported by consistent high-quality evidence. Placebo-controlled trials demonstrate that these methods are weight-neutral on average. Perceived weight increases in CHC users are likely mediated in part by fluid retention linked to the estrogenic stimulation of the Renin–Angiotensin–Aldosterone System (RAAS), rather than adipose tissue accumulation. Conversely, Depot Medroxyprogesterone Acetate (DMPA) represents a verified clinical risk for weight gain, showing a demonstrated clinical association with significant fat mass accumulation. Hypothesized biological mechanisms for this increase include hypothalamic appetite stimulation and glucocorticoid-like activity. The etonogestrel implant occupies a complex middle ground. While population-level data suggests weight neutrality, recent exploratory pharmacogenomic research has identified a specific variant in the Estrogen Receptor 1 (ESR1) gene. For the minority of women carrying this variant, the implant may trigger clinically significant weight gain, suggesting a biological basis for their subjective experience despite statistical evidence. Ultimately, the persistence of the weight gain concern is fueled by the nocebo effect and the misattribution of natural age-related weight trajectories to contraceptive use. Full article

Background: Chronic heart failure (CHF) in older adults requires sustained self-management and close follow-up, yet day-to-day care is often carried out by families with support from primary healthcare nurses. In Saudi Arabia, where family caregiving is culturally normative, collaboration between nurses and patients’ families may be pivotal to effective CHF management, but remains insufficiently understood in primary healthcare contexts. Methods: A qualitative study informed by an interpretive phenomenological approach was conducted. Participants (n = 24; 12 nurses and 12 family caregivers) were recruited using purposive sampling from primary healthcare centers in Riyadh, Saudi Arabia. In-depth, semi-structured interviews were conducted in Arabic or English, audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis following Braun and Clarke’s six-phase framework. Strategies to enhance trustworthiness included member checking, peer debriefing, maintenance of an audit trail, and reflexive journaling. Results: Twenty-four participants (12 nurses and 12 family caregivers) were interviewed. Four interrelated themes were generated from both nurses’ and family caregivers’ accounts. (1) “We Are Caring Together”: Collaboration was experienced as shared responsibility for daily CHF management, grounded in trust; (2) Navigating Roles and Boundaries: Participants described unclear expectations, role overlap, and tension between professional authority and family knowledge; (3) Communication as the Engine of Collaboration: Effective partnerships depended on clear information exchange, caregiver-tailored education, and continuity of contact, while communication gaps created uncertainty and delayed support-seeking; and (4) Cultural and System Constraints Shaping Collaboration: Strong family obligation motivated caregiving but also intensified moral pressure and limited help-seeking, while time pressure and fragmented services constrained meaningful engagement and continuity across settings. Conclusions: Nurse–family collaboration in CHF management is relational, shaped by trust, role negotiation, and communication, and constrained by cultural norms and system pressures. This study contributes to the literature by demonstrating how moral obligation, hierarchical professional norms, and system fragmentation distinctively shape collaboration in the Saudi primary care context, extending existing conceptualizations derived primarily from Western individualist settings. Strengthening collaboration requires explicit role clarification, health literacy–informed caregiver education, continuity of contact, and organizational supports. Findings are limited by purposive sampling, single-city context, and exclusion of patient perspectives. Full article