Search Results (5,123)

Research shows that parent–child shared reading may create opportunities for early math learning, yet less is known about how reading different picturebook genres, such as narratives and information books, may promote math learning opportunities. Understanding how book genre influences mother–child math talk can help identify additional ways to leverage shared reading to support math development. Therefore, the present mixed-methods study investigated how the shared reading of narrative and information genre picturebooks related to the frequency and nature of mother–child math talk. This study utilized transcripts from 45 mother–child (M = 60.4 months; SD = 6.84) shared reading sessions among English-speaking families in Israel. Each mother–child dyad read two sets of narrative and information books characterized by genre-specific features, which were matched by theme—apples, ice cream, seasons, and animals in winter. The quantitative results indicated significantly more math talk during the shared reading of information books compared to narratives, beyond the contribution of paired book themes and total extratextual utterances. Qualitative coding was conducted iteratively with ChatGPT Codex used as an analytic support tool; suggestions for codes including references to counting, numbers, measurement, size, and comparison were proposed and evaluated by the authors. The qualitative analysis yielded four main themes: (1) Math talk prompted by math content that appears in books; (2) Genre-specific characteristics that promote different kinds of math talk; (3) The function of math talk, comprising noticing, explaining, and scaffolding; and (4) The child-led co-construction of math learning. These findings suggest that everyday picturebooks can support mother–child math talk, with genre influencing the mathematical opportunities available and mother–child interactions surrounding these opportunities. Full article

A strong body of evidence is established that links sex-hormone-regulated physiological processes across the female life course with increased risk of osteoarthritis (OA), although the strength and nature of these associations vary by joint site and OA phenotype. Much of the available mechanistic evidence relates to knee OA with comparatively less evidence available for hip and hand OA. These include reproductive milestones (menarche and menopause), major life events such as childbirth (parity), and sex-hormone-regulated physiological functions, including menstruation and breastfeeding. Many of these have also been shown to associate with poorer surgical and non-surgical responses to musculoskeletal (MSK) treatment. A thorough multidisciplinary analysis of sex-associated differences in MSK outcomes and OA risk across the female life course is long overdue. This thematic narrative review has been conducted by a multidisciplinary team comprising experts in fundamental biology, mechanobiology, immunology, orthopaedic surgery, pain medicine and gynaecology. The review will examine in detail early life and puberty (menarche), reproductive years (menstrual cycling and injury risk, contraception, parity and breastfeeding), midlife transition (perimenopause, menopause, and treatments) and clinical interactions (response to surgical and non-surgical interventions). Biological considerations in each life-course phase/transition will focus on the hormonal milieu, biomechanical influences, immune and metabolic functions and pain pathways. Full article

This paper presents a novel fault-tolerant model predictive control (FTMPC) framework for fuel cell hybrid electric vehicles (FCHEVs) used for postal delivery applications. The main contribution of the proposed FTMPC is the adaptive adjustment of the model predictive control cost function weights based on fault severity. The proposed reformulation incorporates fault characterization across the diverse degradation mechanisms while maintaining reliable vehicle operation. The FTMPC approach dynamically adapts cost function weights and system constraints based on the fault severity index. The resulting control strategy provides fault-aware power allocation between the fuel cell and battery while accounting for the specified operating and safety constraints. To isolate the contribution of the proposed health-dependent adaptation mechanism, a controlled ablation study was performed against a structurally identical fixed-MPC controller under the same vehicle model, driving cycle, initial conditions, prediction and control horizons, solver configuration, and fault scenarios. The adaptive FTMPC achieved a 10.6956% reduction in direct hydrogen consumption relative to the fixed-MPC baseline. Because differences in terminal battery state of charge (SoC) can influence comparisons based solely on hydrogen consumption, a charge-corrected hydrogen-equivalent metric was also evaluated; using this more conservative metric, the adaptive FTMPC retained a 2.7276% improvement. The final quadratic programming implementation achieved a 100% successful optimization rate in the validation run with no fallback-controller activation, while the maximum soft-constraint slack remained on the order of 10−9. Additional sensitivity analyses were conducted to evaluate the influence of relevant vehicle and operating conditions on energy consumption and battery utilization. These results provide direct quantitative evidence of the contribution of the proposed fault-adaptive mechanism and demonstrate its numerical feasibility for FCHEV energy management, while the limitations of the present simulation-based validation are explicitly acknowledged. Full article

Background: Alcohol-associated liver disease (ALD) involves ethanol-related metabolic injury, inflammation, gut–liver dysfunction, and progressive loss of skeletal muscle and functional reserve. Exercise could influence several of these pathways, but ALD-specific evidence remains limited. We therefore evaluated exercise as an adjunct, not a substitute for established care, across the ALD spectrum. Methods: We conducted a structured narrative review of PubMed/MEDLINE, Google Scholar, and publisher records updated through 20 August 2026. Evidence was classified as direct human ALD/MetALD evidence, direct preclinical alcohol-injury evidence, indirect clinical evidence from MASLD or mixed-etiology cirrhosis, or mechanistic evidence from broader exercise biology. Results: Direct human evidence is predominantly observational. Leisure-time physical activity is associated with lower liver mortality across drinking patterns and with lower odds of at-risk advanced fibrosis in MetALD/ALD. These associations do not establish the efficacy of structured exercise training. Preclinical alcohol-injury models support redox- and Nrf2-mediated hepatoprotection, whereas proposed effects on AMPK-SIRT1-PGC-1α signaling, mitochondrial quality, gut microbial metabolites, myokines, and ammonia handling remain largely extrapolated. Metabolomic studies identify disturbances in redox balance, lipid intermediates, acylcarnitines, bile acids, and amino acid and tryptophan metabolism. These alterations provide candidate endpoints for future trials. Myostatin and decorin are associated with ALD severity, but their responsiveness to exercise is unknown. We therefore propose a stage-specific research and practice framework with explicit safety considerations. Conclusions: Exercise is a promising but unproven multisystem adjunct for ALD. It should complement abstinence support, alcohol use disorder care, nutrition, and standard medical management. ALD-specific trials should integrate metabolomics, liver outcomes, functional measures, sex, alcohol exposure, disease stage, and adverse events. Full article

Mental health encompasses emotional, psychological, and social well-being, influencing how individuals’ function and cope with life events. In the agricultural industry, the use of machinery and chemicals to increase productivity exposes farmworkers to a range of occupational hazards. These hazards often create unsafe working conditions that can contribute to mental health problems, including anxiety and depression. This study explored the impact of the occupational hazards on the mental health of the farmworkers at Maruleng, Limpopo Province. A qualitative research approach and phenomenological research design were adopted. In-depth individual, semi-structured interviews were conducted with 15 farmworkers. The interviews were guided by a central question. Data were audio-recorded, transcribed and analysed using Tesch’s eight-step of open-coding method. The findings indicate that farmworkers in Maruleng are exposed to a range of occupational hazards that adversely affect their mental health. Participants reported experiencing significant psychological strain associated with unsafe working conditions on the farms. Employers were found to inadequately protect workers, as evidenced by poor maintenance of farm machinery, insufficient pesticides handling training, and the lack of appropriate and adequate personal protective equipment (PPE). The study concludes that limited institutional support and inadequate access to mental health services exacerbate risks to the health and safety of farmworkers in Maruleng. To address these challenges, mental health support should be strengthened through the implementation of employee assistance programmes on the farms and other relevant services. In addition, regular monitoring of machinery maintenance, working conditions and safety protocol practices on the farms is essential to ensure compliance with occupational health and safety standards. Full article

Nutrition is an essential component of colorectal cancer (CRC) care, influencing treatment tolerance, functional status, and quality of life, yet it remains inconsistently integrated into practice. This study examined experiences with nutrition management and gaps in nutrition care among patients with CRC, caregivers, and healthcare professionals across Canada through a multi-center, cross-sectional survey conducted from July 2025 to February 2026. A total of 243 participants completed the survey, including 121 patients, 45 caregivers, and 77 healthcare professionals. Among patients, 51.2% reported that nutritional status was discussed or assessed during treatment, while 24.0% reported it was never discussed. More than half of patients (55.4%) said they did not receive adequate information regarding weight loss during treatment. Caregivers described substantial nutrition impact symptoms and identified a need for clearer guidance, emotional support, and improved access to dietitians. Healthcare professionals rated nutrition care as highly important yet reported barriers to effective delivery, including limited staffing, lack of standardized screening, and reactive care processes. Across groups, respondents emphasized the importance of timely, personalized, and culturally relevant nutrition care. Overall, nutrition remains insufficiently embedded in CRC care, highlighting the need for routine screening, standardized referral pathways, earlier intervention, and integrated patient-centered nutrition care models to improve CRC care. Full article

Mineral homeostasis in horses is traditionally attributed to the coordinated regulation of the intestine, kidneys, skeleton, and endocrine system. Emerging evidence suggests the gut microbiota also shapes this process by modifying the intestinal environment where mineral absorption occurs. Despite the growing interest in host–microbiota interactions, the mechanisms linking the equine gut microbiota to mineral metabolism remain poorly understood and have not been comprehensively synthesized. This review integrates current knowledge of equine gastrointestinal physiology, gut microbial ecology, and mineral metabolism to examine how the gut microbiota influences mineral homeostasis, focusing on microbial fermentation, bioactive metabolite production, luminal pH regulation, epithelial barrier integrity, modulation of intestinal mineral transporters, and interactions with endocrine and immune pathways. The assessment of macro minerals such as calcium, phosphorus, and magnesium, along with trace minerals like iron, zinc, copper, selenium, and manganese, was conducted with a critical approach. This evaluation differentiates between results derived from equine research and those inferred from studies on other species. However, direct mechanistic evidence in horses remains limited, highlighting the need for future research. Advancing equine microbiome research through integrated microbiome profiling, metabolomics, molecular biology, and mineral balance studies will improve our understanding of host–microbiota interactions and support microbiome-informed nutritional strategies to enhance mineral utilization, gastrointestinal health, skeletal function, and long-term equine health and performance. Full article

Wind erosion poses a serious threat to land stability and agricultural sustainability across global arid and semi-arid zones. This study was conducted in Tuoksun County, China’s sole county situated below sea level; its unique low-elevation landform generates distinctive wind–sand movement processes, forming a representative research platform for elucidating shelterbelt functional mechanisms under extreme arid environments. In this work, we systematically monitored wind field characteristics, shelterbelt windbreak performance, and soil wind erodibility and quantitatively analyzed the regulatory effects of different shelterbelt configurations on sand-fixing efficiency and soil anti-wind erosion capacity. The results revealed an obvious decoupling between wind velocity and wind direction frequency within the study area: the maximum wind speed (≈5.5 m s⁻¹) occurred in the NNW direction, whereas the W and WSW directions exhibited the highest wind occurrence frequency. Shelterbelt height showed an extremely significant positive correlation with wind speed reduction efficiency (r = 0.817 ***), while ambient wind speed was significantly negatively correlated with windproof benefit (r = −0.690 ***). Among forest types, F2 and PF achieved significantly higher efficiency and lower wind speeds than F1. Intact shelterbelts reached >85% efficiency, while degraded belts fell below 40%. Soil texture acted as the dominant factor controlling soil erodibility: clay, fine sand, and very fine sand increased soil wind erodibility, while coarse sand and gravel suppressed erodibility. Hierarchical clustering analysis of vertical wind speed profiles confirmed that shelterbelts can substantially reduce near-ground wind velocity; compared with shelterbelt types, spatial position (windward side, leeward side, and central zone) exerted a stronger influence on wind field regulation. This study elucidates the internal correlations among shelterbelt spatial configuration, sand-fixing efficiency, and soil wind erodibility, providing scientific support for the optimization of shelterbelt layout in low-elevation arid ecological regions. Full article

Traditional fermented cereals are affordable, embedded foods that may provide viable microorganisms, fermentable substrates, and bioactive metabolites that can influence the gut microbiota and human physiology. However, evidence linking indigenous cereal fermentations in Sub-Saharan Africa (SSA) to microbiome-mediated health outcomes and precision nutrition applications remains limited. This scoping review mapped the types of traditional fermented cereal foods studied in SSA; their microbial communities and probiotic attributes; the reported effects on gut microbiota composition and function; the documented health outcomes; and the geographic gaps. The review followed the Arksey and O’Malley framework, subsequent methodological refinements, and the PRISMA-ScR reporting guideline. Searches were conducted in Scopus, PubMed, Web of Science, ScienceDirect, and Google Scholar from 2000 to mid-2026, complemented by citation searching. Eligible human, animals, and in vitro studies examined SSA-fermented cereal products and reported microbial, probiotic, gut microbiota, metabolite, or health-related outcomes. After deduplication and screening, 53 studies were included. The evidence was concentrated in SSA, particularly in cereal-based foods. Lactic acid bacteria and yeasts dominated reported fermentation communities, but strain-level validation, dose definition, and controlled human studies were uncommon. Evidence for direct gut–microbiota modulation and clinically important health effects was substantially weaker than evidence for food-level microbial diversity, in vitro probiotic properties, and improved nutrient bioaccessibility. Overall, traditional fermented cereals in sub-Saharan Africa demonstrate promising microbial, nutritional, and functional properties, but current evidence remains heterogeneous and insufficient to establish consistent effects on gut microbiota and human health. Further well-designed human studies integrating dietary, microbiome, and metabolic outcomes are needed to clarify their potential role in precision nutrition. Full article

Background/Objectives: The prescription of aerosolized antimicrobial agents for lower respiratory tract infections varies significantly among clinicians. This study investigated the practices and perceptions of clinicians regarding aerosolized antimicrobial therapy. Methods: A cross-sectional study was conducted among infectious diseases (ID) and critical care clinicians (physicians and clinical pharmacists) in eight acute care hospitals in Qatar using a validated and pretested self-administered online questionnaire. Data was collected between September and October 2025, and analyzed using the Statistical Package for the Social Sciences (SPSS). Results: The majority of the respondents were physicians (70.5%), and about one-third (31.8%) had more than 15 years of work experience. A vast majority (97.7%) had previously prescribed or recommended aerosolized antimicrobial agents. Some respondents (34.1%) reported using aerosolized antimicrobial agents at least once every three months. The indications for aerosolized antimicrobial prescribing were for the treatment of bacterial infections (86.4%) and prophylaxis against bacterial infections (38.6%). Aerosolized antimicrobials were used for the treatment of ventilator-associated pneumonia (68.2%), cystic fibrosis (61.4%) and ventilator-associated tracheobronchitis (34.1%). Gentamicin (88.6%) and colistin (72.7%) were the most frequently used aerosolized antimicrobial agents. The majority (88.6%) of the respondents combined aerosolized antimicrobial agents with systemic antimicrobial agents, 65.9% of whom combined different antimicrobials for aerosolized and systemic routes. Pseudomonas aeruginosa (97.7%) and Acinetobacter baumannii (56.8%) were the most common microorganisms treated with aerosolized antimicrobial agents. Most respondents (61.4%) did not provide pre-treatment prior to aerosolized antimicrobial therapy. However, 38.6% used bronchodilators for pre-treatment. Bronchospasm (79.5%) and hypoxemia (20.5%) were the adverse effects reported by the respondents. Some respondents (40.9%) strongly agreed/agreed that aerosolized antimicrobial therapy improves clinical and microbial cure rates. While 81.8% strongly agreed/agreed that aerosolized antimicrobial therapy reduces systemic toxicity. Practices and perceptions varied significantly between ID and critical care specialties, and between physicians and pharmacists. Conclusions: Clinicians need training on aerosolized antimicrobial therapy for lower respiratory tract infections. Immunosuppression, renal function and infections due to multidrug-resistant organisms were reported by clinicians as factors that influenced their decision to use aerosolized antimicrobial therapy. A protocol for the administration of aerosolized antimicrobial therapy is recommended. Full article

Drinking water is essential for humans; its quality determines the health and proper functioning of the body. In order to obtain drinking water in accordance with the legislation in force, the performance of the technology applied for water treatment and the infrastructure for transport and distribution to the consumer are equally important. Particular importance to this last aspect was given by the introduction of European Directive 2020/2184. Infrastructure can significantly influence water quality due to the fact that there are periods when water stagnates in the pipe and electro-corrosion processes, and salt deposits or degradation/corrosion of the pipes can occur, or periods when water circulates under pressure, when deposits but also particles from the pipes are mechanically detached and transported to the consumer. In this article, we aim to present the behavior of asbestos-cement pipes, AC, special steel for pipes OLT 37, galvanized steel, OLT 37.1, and high-density polyethylene, HDPE, in contact with drinking water. The study was conducted in Calarasi city, Calarasi county, Romania, where some of the old pipes were replaced. A comparative study of new pipes of the same type with pipes in use for more than 20 years, up to 46 years, was conducted, and at the same time the changes that the pipes (which have not yet been replaced) have on the quality of drinking water for street consumers were also analyzed. Following the analyses performed, it can be stated that the water quality is within the maximum permissible limits, but the micropollutants that appear can accumulate in the body (such as AC microfibers, microplastics, metallic zinc, zinc ions, iron ions, manganese, aluminum) with effects that can be evident after a long period of consumption through bioaccumulation. Full article

Frailty represents a significant challenge for aging populations, as population age and the prevalence of functional decline, chronic conditions, and complex health needs increase. This study examines the role of the built environment in the prevention and management of pre-frailty and frailty, with the aim of identifying and synthesizing evidence on environmental elements that influence physical, mental, and social health. The review also explores different interventions and planning approaches that may help reduce the risk of frailty or delay its onset. This study used an umbrella review approach based on existing systematic reviews and meta-analyses focusing on adults aged 45 years and older. Eligible reviews focused on built environment characteristics in relation to frailty, healthy aging, or related health outcomes; reviews of institutionalized populations or those without relevant built-environment or health outcomes were excluded. PubMed, Scopus, ScienceDirect, the Cochrane Library, and COBISS were searched, with final searches conducted on 1–2 July 2025. Methodological quality was assessed using the JBI Critical Appraisal Checklist, and findings were synthesized narratively. A total of 26 reviews were included. The findings suggest that built environments that support and promote physical activity, social interaction, accessibility of services, and community engagement are consistently associated with a lower risk of (pre-)frailty and improved quality of life. In particular, high-quality green and blue spaces, safe and walkable neighborhoods with good connectivity, and accessible housing play an important role in maintaining functional independence. Furthermore, the review highlights the importance of subjective perceptions of safety, social cohesion, and neighborhood quality. The evidence is limited by methodological heterogeneity and by the frequent use of indirect frailty-related outcomes. These results provide a basis for the development of evidence-informed recommendations, planning guidelines, and spatial measures to support active and healthy aging in the community. The review was co-financed by the European Union and by the Republic of Slovenia’s State Budget under the European Cohesion Policy Programme 2021–2027 in Slovenia. The review was not registered. Full article

Background: Iatrogenic injuries of the inferior alveolar nerve (IAN) and lingual nerve (LN) are among the most relevant complications in oral surgery. Although most cases show spontaneous recovery, a significant proportion of patients develop persistent post-traumatic trigeminal neuropathies (PTNs). The aim of this narrative review is to critically analyze current diagnostic approaches for IAN and LN injuries, highlighting the limitations of conventional assessment tools and evaluating the potential role of emerging neurophysiological and imaging techniques in improving early diagnosis, prognostic stratification and medico-legal management. Methods: A structured narrative review was conducted using PubMed/MEDLINE, Scopus and Web of Science for English-language studies published up to 23 March 2026. Evidence on trigeminal nerve injuries, neurosensory assessment, quantitative sensory testing (QST), advanced imaging techniques and medico-legal implications was qualitatively synthesized. Results: The prognosis of iatrogenic PTNs of both IAN and LN is influenced by the severity of nerve injury and the timing of diagnosis and management. Although conventional neurosensory testing (NST) is widely used in the clinical assessment of trigeminal nerve injuries, its ability to objectively characterize the extent and severity of nerve damage is limited. Complementary neurophysiological and quantitative sensory approaches may provide additional functional information, while magnetic resonance neurography (MRN) offers direct structural assessment of the injured nerve. Early objective identification of nerve injury may support prognostic evaluation and timely clinical decision-making. Conclusions: An integrated approach combining clinical assessment, neurophysiology and advanced imaging is essential for early characterization of iatrogenic trigeminal nerve injuries. MRN may provide structural information, contributing to early stratification of injury severity. Quantitative sensory and neurophysiological techniques may complement conventional clinical testing. These diagnostic advances may also have important medico-legal implications, as delayed diagnosis may lead to loss of therapeutic opportunity and increased professional liability. Full article

Background/Objectives: Recovery of function and mobility after stroke is frequently improved through physical rehabilitation that incorporates multiple therapeutic approaches. However, access to rehabilitation services remains limited globally, particularly for individuals living in rural areas or those with restricted transportation options. These barriers highlight the need to explore technology-enabled approaches to delivering rehabilitation care, including telerehabilitation interventions. This study aimed to explore the experiences and perspectives of people with stroke, their carers, and physiotherapists toward the development and implementation of telerehabilitation interventions after stroke in Saudi Arabia. Methods: Semi-structured interviews were conducted with six people with stroke and their carers and ten physiotherapists between March 2025 and July 2025. Purposive sampling was employed, and reflexive thematic analysis was used. Results: Three themes were identified. The first theme focused on self-efficacy in the use of telerehabilitation, emphasising the barriers that influence it and what is required to enhance self-efficacy and confidence. The second theme related to motivation to use and engage in telerehabilitation was shaped by various barriers and strategies that promote motivation. The final theme explored cultural aspects and approaches that affect self-efficacy and motivation and support the use and implementation of telerehabilitation interventions in clinical practice. Conclusions: Telerehabilitation adoption for people with stroke in Saudi Arabia is influenced by self-efficacy and motivation, which are shaped by cultural factors and barriers such as digital inequity, limited awareness, insufficient training, cultural norms, and preference for in-person care. However, with appropriate training, family involvement, culturally sensitive approaches, and hybrid models, telerehabilitation can support continuity of rehabilitation. Full article

Patient motivation is fundamental to engagement, rehabilitation, and recovery within forensic psychiatric hospitals, yet it is often interpreted primarily through the lens of psychopathology and the negative symptoms of schizophrenia. This instrumental case study was conducted in a medium-security forensic inpatient unit within a Canadian tertiary mental health hospital and included two patients and four members of the interdisciplinary clinical team. Qualitative findings were interpreted using Self-Determination Theory and situated within contemporary literature on schizophrenia, institutionalization, organizational behaviour, and forensic mental health care. The findings suggest that patient motivation is influenced by the interaction of individual clinical characteristics with organizational, environmental, interpersonal, and institutional conditions. Participants described barriers that may undermine the basic psychological needs for autonomy, relatedness, and competence, contributing to reduced engagement in recovery-oriented behaviours. Rather than supporting a single explanatory mechanism, the findings highlight the importance of understanding motivation as an emergent outcome of both patient factors and the environments in which treatment is delivered. The study introduces a decision-support framework that prioritizes identified barriers according to the degree of organizational control and their systemic reach, together with an integrative conceptual model that synthesizes qualitative findings with contemporary psychiatric and interdisciplinary theory. The findings suggest that patient motivation should be understood not only as a function of individual psychopathology but also as an outcome shaped by the environments and organizational systems in which care is delivered. By identifying modifiable organizational and environmental determinants of motivation, the proposed framework shifts the focus of intervention beyond patient-level approaches toward system-level strategies—including organizational practice, environmental design, and institutional policy—that may better support engagement in recovery-oriented forensic mental health care. Full article