Search Results (12,029)

New psychoactive substances (NPSs) have emerged as a significant global public health challenge due to their ability to mimic traditional drugs. Among these, mephedrone has gained attention because of its widespread use and associated toxicities. This review provides a comprehensive analysis of the structure, pharmacokinetic properties, and metabolic pathways of mephedrone, highlighting its phase I and phase II metabolites as potential biomarkers for detection and forensic applications. A comprehensive literature search was performed without date restrictions. The search employed key terms such as “mephedrone metabolites”, “pharmacokinetics of mephedrone”, “phase I metabolites of mephedrone”, and “phase II metabolites of mephedrone”. Additionally, the reference lists of selected studies were screened to ensure a thorough review of the literature. Mephedrone is a chiral compound existing in two enantiomeric forms, exhibiting different affinities for monoamine transporters and distinct pharmacological profiles. In vivo animal studies indicate rapid absorption, significant tissue distribution, and the formation of multiple phase I metabolites (e.g., normephedrone, dihydromephedrone, 4-carboxymephedrone) that influence its neurochemical effects. Phase II metabolism involves conjugation reactions leading to metabolites such as N-succinyl-normephedrone and N-glutaryl-normephedrone, further complicating its metabolic profile. These findings underscore the importance of elucidating mephedrone’s metabolic pathways to improve detection methods, enhance our understanding of its toxicological risks, and inform future therapeutic strategies. Full article

Background: Super morbid obesity (SMO), defined as a body mass index (BMI) ≥ 50 kg/m², represents a distinct and increasingly prevalent subgroup of patients undergoing bariatric surgery. Compared to individuals with lower BMI, patients with BMI ≥ 50 kg/m² often exhibit unique clinical, psychological, and social characteristics that may influence treatment outcomes. Objective: This study aimed to compare demographic, metabolic, and psychiatric profiles of patients with BMI ≥ 50 kg/m² and non-super morbid obesity (NSMO; BMI < 50 kg/m²) who were evaluated prior to bariatric surgery. Methods: A total of 319 patients were recruited between December 2022 and December 2023 at a bariatric center in Gdansk, Poland. All participants underwent a comprehensive preoperative assessment, including laboratory testing, psychometric screening (BDI, PHQ-9), and psychiatric interviews. Patients were stratified into class IV obesity and NSMO groups for comparative analysis. Results: Patients with BMI ≥ 50 kg/m² were significantly older and more likely to report a history of lifelong obesity, family history of obesity, and childhood trauma. They had higher rates of obesity-related health problems such as hypertension, obstructive sleep apnea, and chronic venous insufficiency, as well as worse liver function and lipid profiles. Although the overall psychiatric burden was high in both groups, patients with BMI ≥ 50 kg/m² reported fewer prior diagnoses of depression and eating disorders, despite similar scores on screening tools. Conclusions: Patients with BMI ≥ 50 kg/m² represent a clinically distinct population with elevated metabolic risk, complex psychosocial backgrounds, and possibly underrecognized psychiatric burden. These findings underscore the need for multidisciplinary preoperative assessment and individualized treatment strategies in this group of patients. Full article

The widespread adoption of heartbeat monitoring sensors has increased the demand for secure and trustworthy multimodal cardiac monitoring systems capable of accurate heartbeat pattern recognition. While existing systems offer convenience, they often suffer from critical limitations, such as variability in the number of available modalities and missing or noisy data during multimodal fusion, which may compromise both performance and data security. To address these challenges, we propose MultiHeart, which is a robust and secure multimodal interactive cardiac monitoring system designed to provide reliable heartbeat pattern recognition through the integration of diverse and trustworthy cardiac signals. MultiHeart features a novel multi-task learning architecture that includes a reconstruction module to handle missing or noisy modalities and a classification module dedicated to heartbeat pattern recognition. At its core, the system employs a multimodal autoencoder for feature extraction with shared latent representations used by lightweight decoders in the reconstruction module and by a classifier in the classification module. This design enables resilient multimodal fusion while supporting both data reconstruction and heartbeat pattern classification tasks. We implement MultiHeart and conduct comprehensive experiments to evaluate its performance. The system achieves 99.80% accuracy in heartbeat recognition, surpassing single-modal methods by 10% and outperforming existing multimodal approaches by 4%. Even under conditions of partial data input, MultiHeart maintains 94.64% accuracy, demonstrating strong robustness, high reliability, and its effectiveness as a secure solution for next-generation health-monitoring applications. Full article

To develop sustainable strategies for mitigating ruminal methanogenesis and improving nitrogen efficiency in dairy systems, this study investigated how low-dose tannic acid (T), tea polyphenols (TP), and their combination (T+TP; 50:50) modulate rumen microbiota and function. A sample of Holstein cows were given four dietary treatments: (1) control (basal diet); (2) T (basal diet + 0.4% DM tannic acid); (3) TP (basal diet + 0.4% DM tea polyphenols); and (4) T+TP (basal diet + 0.2% DM tannic acid + 0.2% DM tea polyphenols). We comprehensively analyzed rumen fermentation, methane production, nutrient digestibility, milk parameters, and microbiota dynamics. Compared with the control group, all diets supplemented with additives significantly reduced enteric methane production (13.68% for T, 11.40% for TP, and 10.89% for T+TP) and significantly increased milk protein yield. The crude protein digestibility significantly increased in the T group versus control. The results did not impair rumen health or fiber digestion. Critically, microbiota analysis revealed treatment-specific modulation: the T group showed decreased Ruminococcus flavefaciens abundance, while all tannin treatments reduced abundances of Ruminococcus albus and total methanogens. These microbial shifts corresponded with functional outcomes—most notably, the T+TP synergy drove the largest reductions in rumen ammonia-N (34.5%) and milk urea nitrogen (21.1%). Supplementation at 0.4% DM, particularly the T+TP combination, effectively enhances nitrogen efficiency and milk protein synthesis while reducing methane emissions through targeted modulation of key rumen microbiota populations, suggesting potential sustainability benefits linked to altered rumen fermentation. Full article

Background/Objectives: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country’s population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. Methods: Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). Results: The review identified three domains of factors and the ways in which each factor shapes older adults’ virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). Conclusions: This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts. Full article

Background/Objectives: Cancer represents a significant health challenge, with high mortality and morbidity rates. Its diagnosis often triggers chronic stress, adversely affecting patient outcomes. Exercise has emerged as complementary therapy, enhancing treatment adherence and mitigating the side effects of chemotherapy. This study examines the effects of mild exercise during chemotherapy on patient anxiety. Methods: This prospective paired cohort study was conducted in the General Oncology Hospital of Kifisia “Agioi Anargyroi” in Athens, Greece. Adult cancer patients undergoing chemotherapy participated, excluding those with cognitive, hearing, or motor impairments, those who experienced side effects, or those who declined consent. Anxiety was measured before and after a 20-minute exercise routine performed during chemotherapy, using the Greek-translated State–Trait Anxiety Inventory (STAI). The exercise regimen included warm-up, full-body stretching, and cool-down exercises. Pre- and post-exercise scores were analyzed using the Wilcoxon signed-rank test. Results: Forty-five patients (20 women, 25 men; mean age 69.02 ± 10.62 years) with various cancer backgrounds participated. Pre-intervention anxiety levels were in the borderline “moderate” range, dropping post-exercise to the “low” range. Mean STAI scores decreased from 37.73 ± 13.33 to 32.00 ± 14.22 (p < 0.0001), with a medium-large effect size (Cohen’s d for paired samples = −0.646). No significant correlation was found between age and anxiety scores. Discussion: This study found a significant short-term reduction in anxiety, suggesting that incorporating mild exercise during chemotherapy may help in alleviating patient stress. The medium-to-large effect size supports the potential for meaningful short-term benefits. Conclusions: Incorporating mild exercise during chemotherapy may help reduce anxiety and psychological burden. These findings underscore the need for more comprehensive research in larger, more diverse populations to better understand the benefits of incorporating mild exercise during chemotherapy. Full article

With the growth of the global population and the increasing scarcity of arable land, traditional agricultural production is confronted with multiple challenges, such as efficiency improvement, precision operation, and sustainable development. The progressive advancement of artificial intelligence (AI) technology has created a transformative opportunity for the intelligent upgrade of agricultural equipment. This article systematically presents recent progress in computer vision, machine learning (ML), and intelligent sensing. The key innovations are highlighted in areas such as object detection and recognition (e.g., a K-nearest neighbor (KNN) achieved 98% accuracy in distinguishing vibration signals across operation stages); autonomous navigation and path planning (e.g., a deep reinforcement learning (DRL)-optimized task planner for multi-arm harvesting robots reduced execution time by 10.7%); state perception (e.g., a multilayer perceptron (MLP) yielded 96.9% accuracy in plug seedling health classification); and precision control (e.g., an intelligent multi-module coordinated control system achieved a transplanting efficiency of 5000 plants/h). The findings reveal a deep integration of AI models with multimodal perception technologies, significantly improving the operational efficiency, resource utilization, and environmental adaptability of agricultural equipment. This integration is catalyzing the transition toward intelligent, automated, and sustainable agricultural systems. Nevertheless, intelligent agricultural equipment still faces technical challenges regarding data sample acquisition, adaptation to complex field environments, and the coordination between algorithms and hardware. Looking ahead, the convergence of digital twin (DT) technology, edge computing, and big data-driven collaborative optimization is expected to become the core of next-generation intelligent agricultural systems. These technologies have the potential to overcome current limitations in perception and decision-making, ultimately enabling intelligent management and autonomous decision-making across the entire agricultural production chain. This article aims to provide a comprehensive foundation for advancing agricultural modernization and supporting green, sustainable development. Full article

Smart walking aids represent a growing trend in assistive technologies designed to support individuals with mobility impairments in their daily lives and rehabilitation. Previous research has introduced sensor-integrated systems that provide user feedback to enhance safety and functional mobility. However, a comprehensive overview of their technological and functional characteristics is lacking. To address this gap, this scoping review systematically mapped the current state of research in sensor-based walking aids, focusing on device types, sensor technologies, application contexts, target populations, and reported outcomes. In addition, integrated artificial intelligence (AI)-based approaches for functional support and health monitoring were examined. Following PRISMA-ScR guidelines, 35 peer-reviewed articles were identified from three databases: ACM Digital Library, IEEE Xplore, and Web of Science. Extracted data were thematically analyzed and synthesized across device types (e.g., walking canes, crutches, walkers, rollators) and use cases, including gait training, fall prevention, and daily support. Findings show that, while many prototypes show promising features, few have been evaluated in clinical settings or over extended periods. A lack of standardized methods for sensor location assessment, often the superficial implementation of feedback modalities, and limited integration with other assistive technologies were identified. In addition, system validation and user testing lack consensus, with few long-term studies and often incomplete demographic data. Diversity in data communication approaches and the heterogeneous use of AI algorithms were also notable. The review highlights key challenges and research opportunities to guide the future development of intelligent, user-centered mobility systems. Full article

Dermal fibroblasts, the primary stromal cells of the dermis, exhibit remarkable plasticity in response to various stimuli, playing crucial roles in tissue homeostasis, wound healing, and ECM production. This study examines the molecular mechanisms underlying fibroblast plasticity, including key signaling pathways, epigenetic regulation, and microRNA-mediated control. The impact of aging on ECM synthesis and remodeling is discussed, and the diminished production of vital components such as collagen, elastin, and glycosaminoglycans are highlighted, alongside enhanced ECM degradation through upregulated matrix metalloproteinase activity and accumulation of advanced glycation end products. The process of cellular senescence in dermal fibroblasts is explored, with its role in skin aging and its effects on tissue homeostasis and repair capacity being highlighted. The senescence-associated secretory phenotype (SASP) is examined for its contribution to chronic inflammation and ECM disruption. This review also presents therapeutic perspectives, focusing on senolytics and geroprotectors as promising strategies to combat the negative effects of fibroblast senescence. Current challenges in translating preclinical findings to human therapies are addressed, along with future directions for research in this field. This comprehensive review explores the complex interplay between dermal fibroblast plasticity, cellular senescence, and extracellular matrix (ECM) remodeling in the context of skin aging. In conclusion, understanding the complex interplay between dermal fibroblast plasticity, cellular senescence, and extracellular matrix (ECM) remodeling is essential for developing effective anti-aging interventions, which highlights the need for further research into senolytic and geroprotective therapies to enhance skin health and longevity. This approach has shown promising results in preclinical studies, demonstrating improved skin elasticity and reduced signs of aging. Full article

The increasing demand for food necessitates that agri-food systems adopt innovative techniques to enhance food production while optimizing the use of limited resources, such as water. In agriculture, hydrogels are being increasingly used to enhance water retention and reduce irrigation requirements. However, most of these materials are based on synthetic polymers that are not biodegradable. This raises serious environmental and health concerns, highlighting the urgent need for sustainable, biodegradable alternatives. Biomass-derived from agro-industrial waste presents a substantial potential for producing hydrogels, which can effectively function as water collectors and suppliers for crops. This review article provides a comprehensive overview of recent advancements in the application of agro-industrial waste for the formulation of hydrogels. Additionally, it offers a critical analysis of the development of hydrogels utilizing natural and compostable materials. Agro-industrial and food waste, which are rich in hemicellulose and cellulose, have been utilized to enhance the mechanical properties and water absorption capacity of hydrogels. These biomaterials hold significant potential for the development of effective hydrogels in agricultural applications; they can be either hybrid or natural materials that exhibit efficacy in enhancing seed germination, improving water retention capabilities, and facilitating the controlled release of fertilizers. Natural hydrogels derived from agro-industrial waste present a sustainable technological alternative that is environmentally benign. Full article

Background: Alcohol-associated liver disease (AALD) represents significant health burdens worldwide. This study aims to provide a comprehensive overview of the AALD outcomes that were incompletely understood. Methods: The current study utilizes data from the National Health and Nutrition and Examination Survey (NHANES) from 2011–2020, using a stratified, multistage probability cluster design. AALD in the NHANES was defined using clinical laboratory data and self-reported alcohol use, among which fibrosis-4 score of >2.67. Analysis is conducted using weighted, logistic, and Cox linear regression. Results: The initial sample included 23,206 participants aged 20 and older, with recorded cardiovascular status and AST/ALT levels. Participants reporting AALD had a higher percentage of college degrees (p < 0.001) and were more likely to be daily smokers. Asians exhibited the highest rates of AALD compared to other demographics (p < 0.001). The prevalence in private insurance is significantly greater than Medicaid, but the usage trends have been increasing in Medicaid. The trends of advanced fibrosis have been increasing in blacks and Asians, while they have been decreasing among whites and Mexicans. Those with AALD also had higher mean systolic and diastolic blood pressure, as well as elevated fasting glucose levels (p < 0.001). The mortality rate among AALD participants with heart diseases was 25%, compared to 3% among those without (p < 0.001). After adjusting for potential confounding variables, no statistically significant associations were found between AALD status and HF or CAD. However, a clinically significant increase in the odds of stroke was observed within the AALD group (p < 0.001). Conclusions: Our findings indicate Asians have the highest rates of AALD. The trends of advanced fibrosis have been increasing in blacks and Asians. There is an increased prevalence of AALD with heart diseases and a significant increase in mortality with stroke. Full article

Despite the increasing adoption of a syndemic approach in HIV research, few health communication campaigns have used a syndemic approach in messaging to improve health outcomes for persons living with HIV (PWH). This paper introduces a framework for practitioners and researchers developing health communication messages in support of a syndemic approach to HIV care for PWH in the United States. Grounded in insights from a review of counseling and psychosocial interventions that demonstrated significant positive effects on HIV clinical outcomes, the C4H Framework emphasizes four components: compassion, comprehensive messaging, capacity-building, and coordination. Compassion ensures that messages resonate with individuals experiencing the intertwined challenges of HIV, substance abuse, and mental health issues. Comprehensive messaging integrates a holistic view of the barriers faced by PWH. Capacity-building empowers individuals to effectively engage with and act upon health information. Coordination promotes alignment between stakeholders and resources to ensure consistent and supportive messaging. The C4H Framework bridges the gap between research and practice, offering a foundation for crafting effective communication messages that resonate with individuals facing the complex challenges inherent in HIV syndemics. Future research should explicitly test the effectiveness and acceptability of messages developed using the C4H Framework with people living with HIV. Full article

Refugees experience disproportionately high rates of sleep disturbances due to trauma, displacement, and resettlement stressors. Sleep health is critically linked to both physical and mental well-being, yet remains an underexplored area of intervention for refugee populations. This systematic review aimed to (1) identify interventions implemented to improve sleep health among refugees, (2) assess their effectiveness, and (3) evaluate the extent of cultural adaptation in their design and implementation. A comprehensive search of peer-reviewed literature from 2004 to 2024 identified nine studies focused on adult refugees in high-income countries. Interventions included psychoeducation, music-assisted relaxation, guided imagery, and nightmare-focused therapies. Several demonstrated improvements in sleep quality, insomnia severity, and nightmare frequency. Music-based interventions and sleep health education stood out as accessible, non-stigmatizing strategies that may be particularly well suited to refugee contexts. However, cultural adaptation emerged as the most significant gap. Using the 4-Domain Cultural Adaptation Model (CAM4)—which assesses adaptation across context, content, delivery, and engagement—most studies showed only surface-level modifications. Few incorporated community voices, and none validated sleep assessment tools for cultural relevance. Future research should prioritize co-creation with refugee communities to ensure interventions are not only evidence-based, but also culturally grounded, trusted, and sustainable across diverse refugee populations. Full article

Salmonella is a major foodborne pathogen, yet real-time data on duck-derived strains in China remain scarce. This study investigated the epidemiology, antimicrobial resistance (AMR), gene profiles, and PFGE patterns of 114 Salmonella isolates recovered from 397 deceased ducks (2021–2024) across nine provinces (isolation rate: 28.72%). Fourteen serotypes were identified, with S. Typhimurium (23.68%), S. Indiana (21.93%), S. Kentucky (18.42%), and S. Enteritidis (12.28%) being predominant. Most isolates showed high resistance to β-lactams, tetracyclines, quinolones, and sulfonamides, with extensive multidrug resistance (MDR) observed—especially in S. Indiana, S. Typhimurium, and S. Kentucky. Among the 23 detected resistance genes, tet(B) had the highest prevalence (75.44%), particularly in S. Indiana. Biofilm formation was observed in 99.12% of isolates, with 84.21% demonstrating moderate to strong capacity. Eighteen virulence genes were detected; S. Enteritidis carried more spvB/C, sipB, and sodC1, while S. Indiana had higher cdtB carriage. PFGE revealed substantial genetic diversity among strains. This comprehensive analysis highlights the high AMR and biofilm potential of duck-derived Salmonella in China, emphasizing the urgent need for enhanced surveillance and control measures to mitigate public health risks. Full article

(1) Background: Dioxins and dioxin-like polychlorinated biphenyls (dl-PCBs) are persistent organic pollutants (POPs), characterized by high toxicity and strong lipophilicity, which promote their bioaccumulation in human tissues. Their detection in breast milk raises concerns about early-life exposure during lactation. Although dietary intake is the primary route of maternal exposure, environmental pathways—including inhalation, dermal absorption, and residential proximity to contaminated sites—may also significantly contribute to the maternal body burden. (2) Methods: This narrative review examined peer-reviewed studies investigating maternal and environmental determinants of dioxin and dl-PCB concentrations in human breast milk. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science (2000–2024), identifying a total of 325 records. Following eligibility screening and full-text assessment, 20 studies met the inclusion criteria. (3) Results: The included studies consistently identified key exposure determinants, such as high consumption of animal-based foods (e.g., meat, fish, dairy), living near industrial facilities or waste sites, and maternal characteristics including age, parity, and body mass index (BMI). Substantial geographic variability was observed, with higher concentrations reported in regions affected by industrial activity, military pollution, or inadequate waste management. One longitudinal study from Japan demonstrated a declining trend in dioxin levels in breast milk, suggesting the potential effectiveness of regulatory interventions. (4) Conclusions: These findings highlight that maternal exposure to dioxins is influenced by identifiable environmental and behavioral factors, which can be mitigated through public health policies, targeted dietary guidance, and environmental remediation. Breast milk remains a critical bioindicator of human exposure. Harmonized, long-term research is needed to clarify health implications and minimize contaminant transfer to infants, particularly among vulnerable populations. Full article