Search Results (1,726)

Urban public transportation systems face increasing pressure from shifting travel patterns, rising peak-hour demand, and the need for equitable and resilient service delivery. While complex network theory has been widely applied to analyze transit systems, limited attention has been paid to behavioral segmentation within such networks. This study introduces a frequency-based framework that differentiates high-frequency (HF) and low-frequency (LF) passengers to examine how distinct user groups shape network structure, congestion vulnerability, and robustness. Using over 20 million smart-card records from Beijing’s multimodal transit system, we construct and analyze directed weighted networks for HF and LF users, integrating topological metrics, temporal comparisons, and community detection. Results reveal that HF networks are densely connected but structurally fragile, exhibiting lower modularity and significantly greater efficiency loss during peak periods. In contrast, LF networks are more spatially dispersed yet resilient, maintaining stronger intracommunity stability. Peak-hour simulation shows a 70% drop in efficiency and a 99% decrease in clustering, with HF networks experiencing higher vulnerability. Based on these findings, we propose differentiated policy strategies for each user group and outline a future optimization framework constrained by budget and equity considerations. This study contributes a scalable, data-driven approach to integrating passenger behavior with network science, offering actionable insights for resilient and inclusive transit planning. Full article

Down syndrome (DS), stemming from the triplication of human chromosome 21, results in intellectual disability, with early mid-life onset of Alzheimer’s disease (AD) pathology. Early interventions to reduce cognitive impairments and neuropathology are lacking. One modality, maternal choline supplementation (MCS), has shown beneficial effects on behavior and gene expression in neurodevelopmental and neurodegenerative disorders, including trisomic mice. Loss of basal forebrain cholinergic neurons (BFCNs) and other DS/AD relevant hallmarks were observed in a well-established trisomic model (Ts65Dn, Ts). MCS attenuates these endophenotypes with beneficial behavioral effects in trisomic offspring. We postulate MCS ameliorates dysregulated cellular mechanisms within vulnerable BFCNs, with attenuation driven by novel gene expression. Here, choline acetyltransferase immunohistochemical labeling identified BFCNs in the medial septal/ventral diagonal band nuclei of the basal forebrain in Ts and normal disomic (2N) offspring at ~11 months of age from dams exposed to MCS or normal choline during the perinatal period. BFCNs (~500 per mouse) were microisolated and processed for RNA-sequencing. Bioinformatic assessment elucidated differentially expressed genes (DEGs) and pathway alterations in the context of genotype (Ts, 2N) and maternal diet (MCS, normal choline). MCS attenuated select dysregulated DEGs and relevant pathways in aged BFCNs. Trisomic MCS-responsive improvements included pathways such as cognitive impairment and nicotinamide adenine dinucleotide signaling, among others, indicative of increased behavioral and bioenergetic fitness. Although MCS does not eliminate the DS/AD phenotype, early choline delivery provides long-lasting benefits to aged trisomic BFCNs, indicating that MCS prolongs neuronal health in the context of DS/AD. Full article

Background/Objectives: This study aimed to determine whether postpartum mothers exhibit a uniform trajectory of postpartum emotional status (PES) changes or if distinct subgroups with differing trajectories of PES exist. Additionally, it investigated whether intensified tactile stimulation of the infant through Shantala massage influences maternal PES. Method: A quasi-experimental design with a matched control group was employed. Eighty women following their first physiological delivery volunteered to participate. The intervention involved applying intensified tactile stimulation to the infant via Shantala massage over a 12-week postpartum period. Maternal PES, divided into negative and positive emotional domains, was assessed using four standardized questionnaires. Results: Two opposing trajectories of PES change were identified: adverse and favorable. Intensified tactile stimulation was associated with improvement in maternal emotional status along both trajectories. Conclusions: PES changes do not follow a uniform course across all women; notably, those with a favorable trajectory often begin with more severe symptoms. Overlooking this distinction in diagnosis, prevention, and treatment may result in suboptimal care. The factors influencing PES trajectories remain unidentified but may affect clinical intervention outcomes. The Shantala massage intervention appears to slow the progression of emotional disorders in women with adverse PES changes and accelerate recovery in those with favorable changes. Implementation of this approach in clinical settings is recommended. Full article

Background and Objectives: Preterm birth and stillbirth are primary adverse pregnancy outcomes. Research during the COVID-19 pandemic revealed reductions in preterm birth in some countries, while stillbirth rates increased or remained unchanged. These findings suggest the presence of preventable risk factors associated with changes in physical activity and lower exposure to community-acquired infections due to lockdown measures, altered social interaction patterns or reduced access to antenatal care. Assessing seasonal variation may offer insights into whether lifestyle changes during the COVID-19 lockdown period influenced preterm birth rates. Materials and Methods: This retrospective cohort study used data from the electronic medical records of Bihor and Sibiu counties. Preterm deliveries (<37 weeks) and stillbirths during the COVID-19 pandemic (2020 and 2021) were compared with the corresponding pre-pandemic (2018 and 2019) and post-pandemic (2022 and 2023) period. Preterm birth rates during summer and winter in the pre-pandemic, pandemic, and post-pandemic years were analyzed. A comparison with rates during strict lockdown was made. Results: Out of 52,021 newborn infants, 4473 were born preterm. Preterm birth rates remained stable across all three periods (p = 0.13), and no significant seasonal pattern was identified (p = 0.65). In contrast, stillbirth rates increased notably during the strict lockdown period, with the median incidence almost doubling compared to other periods (0.87%, p = 0.05), while remaining unchanged during the rest of the pandemic (p = 0.52). Conclusions: Our study found that preterm birth rates remained unaffected by the pandemic and lockdown periods, while stillbirths increased significantly during the strict lockdown. These findings highlight the importance of maintaining access to timely antenatal care during public health emergencies to prevent adverse perinatal outcomes. Full article

This story began half a century ago with the discovery of an unusually high presence of tryptophan (Trp, W) in transthyretin (TTR), one of the three carrier proteins of thyroid hormones. With the Trp-rich retinol-binding protein (RBP), TTR forms a plasma complex implicated in the delivery of retinoid compounds to body tissues. W has the lowest concentration among all AAs involved in the sequencing of human body proteins. The present review proposes molecular maps focusing on the ratio of W/AA residues found in the sequence of proteins involved in immune events, allowing us to ascribe the guidance of inflammatory processes as fully under the influence of W. Under the control of cytokine stimulation, plasma biomarkers of protein nutritional status work in concert with major acute-phase reactants (APRs) and with carrier proteins to release, in a free and active form, their W and hormonal ligands, interacting to generate hot spots affecting the course of acute stress disorders. The prognostic inflammatory and nutritional index (PINI) scoring formula contributes to identifying the respective roles played by each of the components prevailing during the progression of the disease. Glucagon demonstrates ambivalent properties, remaining passive under steady-state conditions while displaying stronger effects after cytokine activation. In developing countries, inappropriate weaning periods lead to toddlers eating W-deficient cereals as a staple, causing a dramatic reduction in the levels of W-rich biomarkers in plasma, constituting a novel nutritional deficiency at the global scale. Appropriate counseling should be set up using W implementations to cover the weaning period and extended until school age. In adult and elderly subjects, the helpful immune protections provided by W may be hindered by the surge in harmful catabolites with the occurrence of chronic complications, which can have a significant public health impact but lack the uncontrolled surges in PINI observed in young infants and teenagers. Biomarkers of neurodegenerative and neoplastic disorders measured in elderly patients indicate the slow-moving elevation of APRs due to rampant degradation processes. Full article

Background: Mesenchymal stem cells (MSCs), multipotent and immune-regulatory cells derived from tissues such as bone marrow, dental pulp, and periodontal ligament, emerged as promising agents in regenerative dentistry. Their clinical applications include endodontic tissue regeneration, periodontal healing, and alveolar bone repair, addressing critical challenges in dental tissue restoration. Methods: A systematic review was conducted following PRISMA guidelines and registered in PROSPERO. We searched PubMed, Scopus, and Web of Science databases for open-access, English-language clinical trials and observational studies published from 2015 to 2025. Studies focusing on the application of MSCs in dental tissue regeneration were included based on predefined eligibility criteria. Results: Out of 2400 initial records, 13 studies met the inclusion criteria after screening and eligibility assessment. Most studies investigated MSCs derived from dental pulp and periodontal ligament for regenerating periodontal tissues and alveolar bone defects. The majority reported improved clinical outcomes; however, variations in MSC sources, delivery methods, sample sizes, and follow-up periods introduced methodological heterogeneity. Conclusions: MSCs show significant potential in enhancing bone and periodontal regeneration in dental practice. Nonetheless, the current evidence is limited by small sample sizes, short follow-up, and inconsistent methodologies. Future large-scale, standardized clinical trials are required to validate MSC-based regenerative therapies and optimize treatment protocols. Full article

High-quality end-of-life care (EoLC) is a critical yet often underemphasised component of oncology care. Several shortcomings in the delivery of EoLC for oncology patients in our centre during the COVID-19 pandemic were identified in our initial 2021 audit. In 2022, we introduced a care of dying patients proforma, an EoLC quality checklist, targeted education and training for staff, and an expanded end-of-life (EoL) committee. This re-audit aimed to review how these changes impacted on the care received by patients in a tertiary cancer centre. A second retrospective re-audit of patients who died between 11 July 2022 and 30 April 2023 was performed to assess quality of EoLC using the Oxford Quality indicators. A total of 72 deaths occurred over the audit period. Quality of EoLC improved significantly when compared to the initial audit (χ² (3, n = 138) = 9.75, p = 0.021). Exploration of patients’ wishes was documented in 48.8% and referral to pastoral care was documented in 68.3%, from 24.2% and 10.6%, respectively. The proportion of patients receiving poor EoLC reduced from 21.2% to 8.3%. Our study demonstrates the benefits of simple interventions, the importance of re-audit, and the role of ongoing interdisciplinary commitment to improving EoLC for our patients. Full article

Background: Enzymes secreted by the digestive glands are excreted from the body with urine, sweat and feces, and they are also removed from the blood due to their participation in the enzymatic provision of the secretion entering the gastrointestinal tract. Objective: The aim of this work was to analyze the activity of pepsinogen, amylase and lipase in the coprofiltrate of pregnant women in each trimester of pregnancy and in the postpartum period, taking into account the timing and type of delivery (term, premature, late delivery or cesarean section). Methods: Data from studies of non-pregnant (n = 45) and pregnant (n = 193) women were analyzed. The materials for preparation coprofiltrate were collected during delivery. Pepsinogen activity was determined by proteolytic activity at pH = 1.5–2.0 using the tyrosine spectrophotometric method, while amylase activity was determined by the amyloclastic method of Karavey, and lipolytic activity was determined by a unified kinetic method using olive oil as a substrate. Outcomes: A small amount of pepsinogen was excreted in the coprofiltrate, and while the level of its excretion increased after childbirth, it remained below the control values. At the same time, an increase in the amylolytic activity of the coprofiltrate was observed in all groups of pregnant women examined from the first to the third trimester of pregnancy. In pregnant women, multidirectional changes in lipase activity were observed depending on the timing and type of delivery. Conclusions: At the end of pregnancy, amylolytic activity increased in all women, and pepsinase activity decreased compared to the indicators of non-pregnant women. No reliable differences were found in the lipolytic activity of the coprofiltrate in pregnant women at the end of pregnancy and the indicators of non-pregnant women. Full article

Demand for mental health support has exerted unprecedented pressure on statutory services. Innovative solutions such as Green or Nature-Based Social Prescribing (NBSP) programmes may help address unmet need, improve access to personalised treatment, and support the sustainable delivery of primary services within a prevention model of population health. We piloted an innovative health economics-informed Social Return on Investment (SROI) analysis and forecast of a ‘Making Well’ therapeutic craft and horticulture programme for mental health between October 2021 and March 2022. Quantitative and qualitative outcome data were collected from participants with mild-to-moderate mental health conditions at baseline and nine-weeks follow-up using a range of validated measures, including the Short Warwick–Edinburgh Mental Well-being Scale, ICEpop CAPability measure for Adults (ICECAP-A), General Self-Efficacy Scale (GSES), and a bespoke Client Service Receipt Inventory (CSRI). The acceptability and feasibility of these measures were explored. Results indicate that the Making Well programme generated well-being-related social value in the range of British Pound Sterling (GBP) GBP 3.30 to GBP 4.70 for every GBP 1 invested. Our initial pilot forecast suggests that the programme has the potential to generate GBP 5.40 to GBP 7.70 for every GBP 1 invested as the programme is developed and delivered over a 12-month period. Despite the small sample size and lack of a control group, our results contribute to the evidence-base for the effectiveness and social return on investment of NBSP as a therapeutic intervention for improving health and well-being and provides an example of the use of health economic well-being outcome measures such as ICECAP-A and CSRIs in social value analysis. Combining SROI evaluation and forecast methodologies with validated quantitative outcome measures used in the field of health economics can provide valuable social cost–benefit evidence to decision-makers. Full article

Although age-related changes in the gut microbiome of pigs have been extensively studied, the dynamic patterns of fecal microbiota and SCFAs during the gestation-to-weaning period in sows remain poorly characterized. We aim to characterize the changes in fecal microbiota and SCFAs from pregnancy to weaning, and to investigate their associations with maternal weight gain during gestation. We systematically collected 100 fecal samples at four time points (day 30 of pregnancy (T1), 1–2 days before delivery (T2), day 10 after delivery (T3), and day 21 of weaning stage (T3)), and measured the body weight of sows at T1 (132 kg ± 10.8) and T2 (205 kg ± 12.1). The primary nutrient components of the diets during the gestation and lactation periods are summarized. All fecal samples were subjected to 16S rRNA gene sequencing. We found that a high proportion of crude fiber (bran) is a key feature of the gestation diet, which may affect enterotype shifts and gut microbial composition. Sows fed a high-fiber diet showed significant enrichment of gut microbiota, including genera such as Prevotellaceae_UCG-003, Prevotellaceae_NK3B31_group, and Prevotella_9 during the gestational period (LDA score > 2). Moreover, Eubacterium_coprostanoligenes_group (average relative abundance: 5.5%) and Lachnospiraceae_NK4A136_group (average relative abundance: 2.5%) were the dominant bacteria during the lactation stage. Fecal propionate and butyrate levels were lowest in late gestation, and propionate negatively and acetate positively correlated with body weight change (p < 0.05). Additionally, certain Prevotella taxa were associated with arachidonic acid metabolism and acetate production (p < 0.05). Our study identified key microbial communities across four stages from gestation to weaning and revealed that dietary patterns can shape the sow gut microbiota. Furthermore, we observed significant correlations between SCFAs and body weight change during pregnancy. These findings provide a scientific basis and theoretical support for future strategies aimed at modulating gut microbiota and targeting SCFAs to improve maternal health and productivity throughout the gestation-to-weaning period. Full article

Background/Objectives: Parenteral nutrition (PN) supports patients unable to receive nutrients via the gastrointestinal tract, but it lacks the health-promoting natural bioactive compounds found in a typical oral diet. This study aimed to develop a human serum albumin-based intravenous delivery system for lutein (an antioxidant carotenoid with vision-supportive and hepatoprotective properties) as a PN additive. Methods: An albumin–lutein nanosuspension (AlbLuteN) was synthesized using a modified nanoparticle albumin-bound (nab^TM) technology and characterized physicochemically. The nanoformulation was added to four commercial PN admixtures to assess the supplementation safety throughout the maximum infusion period. Visual inspection and measurements of fat globules larger than 5 µm (PFAT5) and the mean hydrodynamic diameter (Z-average), zeta potential, pH, osmolality, and lutein content were performed to detect potential interactions and evaluate the physicochemical stability. Results: AlbLuteN consisted of uniform particles (Z-average of 133.5 ± 2.8 nm) with a zeta potential of −28.1 ± 1.8 mV, lutein content of 4.76 ± 0.39%, and entrapment efficiency of 84.4 ± 6.3%. Differential scanning calorimetry confirmed the amorphous state of lutein in the nanosuspension. AlbLuteN was successfully incorporated into PN admixtures, without visible phase separation or significant changes in physicochemical parameters. The PFAT5 and Z-average values remained within pharmacopeial limits over 24 h. No substantial shifts in zeta potential, pH, or osmolality were observed. The lutein content remained stable, with losses below 3%. Conclusions: AlbLuteN can be safely added to representative PN admixtures without compromising their stability. This approach offers a novel strategy for intravenous lutein delivery and may contribute to improving the nutritional profile of PN. Full article

Background/Objectives: Recent changes in obstetric practices and population demographics have prompted a re-evaluation of labor patterns. This study aimed to characterize labor patterns in a Greek pregnant population using ultrasound and compare them with established labor curves. Methods: A prospective cohort study was conducted at the Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, over a two-year period (December 2022 to June 2024). Transabdominal ultrasound was used to determine the fetal head position and transperineal ultrasound was used to measure angle of progression (AoP) and head–perineum distance (HPD) during labor. Maternal and labor characteristics, including body mass index (BMI), parity, labor duration, and mode of delivery, were recorded. Statistical analysis included mixed linear models to assess the relationship between AoP, HPD, and cervical dilatation. Results: In total, 500 parturients were included in this study. Women entered the active phase of labor approximately 5 h before delivery, with AoP increasing sharply and HPD decreasing rapidly at this point. Cesarean section (CS) cases showed a slower increase in AoP compared to vaginal deliveries (VDs), with CS cases having a mean AoP of 117.9° (95% CI: 111.6–124.2°) at full dilation, compared to 133.4° (95% CI: 130.6–136.2°) in VD. HPD values declined more slowly in CS cases, with a mean HPD of 45.1 mm (95% CI: 40.6–49.6 mm) at full dilation, compared to 36.4 mm (95% CI: 34.3–38.5 mm) in VD. Epidural analgesia was associated with steeper increases in AoP and decreases in HPD in the final 2.5 h before delivery, while oxytocin administration accelerated these changes in the last 3–4 h. The mean time to delivery was 3.19 h (95% CI: 2.80–3.59 h) when AoP reached 125° and 3.92 h when HPD was 40 mm (95% CI: 3.53–4.30 h). BMI in women who gave birth via CS was significantly higher compared to VD (32.03 vs. 29.94 kg/m², p-value: 0.008), and the total duration of labor was shorter in VD compared to CS and operative vaginal delivery (OVD) (8 h vs. 15 h, p-value < 0.001 and 8 h vs. 12 h, p-value < 0.001, respectively). Birthweight was also lower in VD compared to CS (3103.09 g vs. 3267.88 g, p-value: 0.05). Conclusions: This study provides the first ultrasonographic characterization of labor patterns in a Greek population, highlighting the utility of ultrasound in objectively assessing labor progression. Full article

Background: Fatty acid status during the perinatal period is important for optimal offspring growth and development. Objectives: We aimed to test the association between maternal fatty acid (FA) intake during the third trimester of pregnancy and the FA composition of placental phospholipids, a marker of maternal fatty acid status. Methods: This cohort study was performed on 54 mothers participating in the PREOBE study. Maternal dietary intake was assessed with prospective 7-day food diaries at 34 weeks of gestation. Placenta samples were collected immediately after delivery and phospholipid FA was quantified with established methods. Data were analyzed with Pearson correlations and linear regression models, with adjustment for confounding factors. Results: Total energy intake was 2019 ± 527 kcal/d (mean ± SD) and total fat intake of the mothers was 87 ± 35 g/day. Myristic, stearic, oleic, and α-linolenic acid intakes were modestly correlated with placental percentages, with r-values ≤ 0.33. Only docosahexaenoic (DHA) acid intake (%-energy, %-fat, and g/d) showed r-values > 0.4 for the correlation with placenta phospholipids. Intake of other fatty acids, including arachidonic acid, was not associated with the placenta percentage. Linear regression models considering confounders showed only dietary DHA intake significant associations. Total fat intake did not interfere with the association of DHA intake with placental incorporation. Conclusions: DHA and arachidonic acid are enriched in the placenta, but only placental DHA content seems modifiable by maternal dietary DHA intake. Full article

Background/Objectives: Curcumin, the principal bioactive component of Curcuma longa, is known for its anti-inflammatory, antioxidant, and neuroprotective properties. Despite its therapeutic potential, curcumin exhibits poor oral bioavailability due to low solubility, rapid metabolism, and limited gastrointestinal absorption. Various delivery systems have been developed to overcome these limitations. This study aimed to evaluate and compare the pharmacokinetic profile of AQUATURM®, a novel, water-soluble curcumin formulation, with that of a widely available commercial curcumin supplement. Methods: A randomized, double-blind, two-period crossover study was conducted in 12 healthy adult participants (6 male, 6 female; aged 20–45 years). Each participant received a single oral dose of either AQUATURM® or the comparator product, followed by a 7-day washout period before receiving the alternate treatment. Blood samples were collected at multiple time points over a 12-h period post-dosing. Plasma curcumin concentrations were quantified using ultra-performance liquid chromatography with tandem mass spectrometry (UPLC-MS/MS). Results: AQUATURM® achieved a significantly higher systemic exposure compared to the comparator, with a more than 7-fold increase in area under the curve (AUC_0–12h) and higher peak plasma concentrations (Cmax). AQUATURM® also maintained detectable curcumin levels for the full 12-h observation period, whereas levels from the comparator fell below quantification limits in most participants after 4 h. Conclusions: AQUATURM® significantly enhances curcumin bioavailability in humans compared to a standard curcumin formulation. These pharmacokinetic improvements support its potential for greater clinical efficacy and warrant further evaluation in therapeutic setting Full article

In recent years, advances in organ transplantation medicine have led to an increase in pregnancies and births following transplantation. Pregnancy after organ transplantation is considered high-risk, and its impact on both the recipient and the child must be carefully evaluated. In this review, we summarize the current landscape of pregnancy and childbirth after organ transplantation, with a particular focus on uterus transplantation (UTx). Traditionally, organ transplants have involved vital organs; however, UTx, developed for women with absolute uterine factor infertility, represents a novel approach. Although the number of births following UTx remains limited, it is expected to grow due to the international expansion of this procedure. Importantly, the concept of pregnancy and delivery following UTx is fundamentally different from that of other organ transplants. UTx is a life-enhancing, non-vital, and temporary transplant uniquely intended to enable the creation of new life. Pregnancy after UTx carries specific risks such as a higher incidence of miscarriage, preterm birth, hypertensive disorders of pregnancy, and gestational diabetes. All deliveries are performed via cesarean section, and conception is typically allowed after a relatively short period following transplantation, given the temporary nature of the graft and the goal to minimize recipient burden, with generally good neonatal outcomes. As pregnancies after both solid organ transplantation and UTx continue to rise worldwide, the development of standardized, organ-specific perinatal management strategies, particularly for UTx, is essential. Multidisciplinary collaboration will be critical to supporting these high-risk pregnancies and ensuring the best possible maternal and neonatal outcomes. Full article