Search Results (567)

Intelligent sheep behavior monitoring is vital for modern husbandry, but faces severe challenges in natural pastures due to high-density flock occlusion. Traditional 2D skeleton-based networks often suffer from depth ambiguity and feature collapse, misclassifying static tremors as dynamic displacement. To overcome this, we propose a robust multimodal dual-stream framework using skeletal and local visual fusion. The architecture features an upstream spatial perception stage utilizing YOLOv11m-Pose. To reduce annotation costs and improve robustness, we introduce an Active Hard-Example Mining mechanism, explicitly retaining difficult samples with severe overlapping or edge truncation. For downstream behavioral decisions, a multimodal dual-stream architecture processes the targets. The Spatio–Temporal Kinematic Stream employs a Kinematic Denoising Engine, incorporating a 1D Gaussian filter and displacement dead-zone gate to purify 2D coordinates before feeding them into a BiLSTM network. Concurrently, the Spatial Visual Stream uses a ResNet-50 backbone on cropped RGB patches to capture essential spatial context, addressing the limitations of pure coordinates. Finally, a weighted Softmax layer integrates both streams. Experiments on a complex real-world dataset validate this approach. A baseline kinematic-only model achieved just 69.05% overall accuracy and 68.18% walking precision. In contrast, our dual-stream fusion network achieved 93.26% overall accuracy, elevating walking precision to 97.14% and the eating F1-score to 94.29%. By effectively decoupling similar static and dynamic behaviors, this study demonstrates the indispensability of local visual features, establishing a high-precision baseline for smart livestock monitoring. Full article

Food is lost and wasted at different points in the food supply chain, causing serious environmental, social and economic implications. School lunches are a significant source of food waste at the consumption stage. This study, undertaken in the framework of the Interreg Central Europe project ‘foodCIRCUS’, investigates food preparation, consumption, and waste generation in six educational institutions (three primary schools and three kindergartens) in Wrocław, Poland. Monitoring was done during five consecutive days in each institution (October–December 2024), covering food produced and eaten as well as unserved food, serving leftovers, and plate waste for the main lunch components (soup, protein, starch, and vegetables). The main results give an overall amount of food waste of 236 g/meal planned, with a wastage level of 45%. This is higher than values reported in the literature and higher than the commonly cited global estimate of approximately 30% across the entire food supply chain. Most of the wastage occurred as plate waste (27% of the total food prepared), whereas unserved food constitutes 18%. Primary schools show higher levels of unserved food due to variability in meal uptake, whereas kindergartens show higher plate waste. Vegetables and certain starch-based dishes (groats) have the highest wastage levels. It can be concluded that both operational and behavioral factors cause food waste in school canteens. The national nutrition guidelines lead to a consistent overproduction of food in kindergartens and primary schools, both with their own kitchens and served by catering companies. Reduction strategies should focus on behavioral approaches such as nudging or awareness-raising and operational optimization (e.g., improved forecasting and portion control), as well as redistribution approaches for surplus. The national nutrition guidelines should be interpreted and implemented less strictly. Each pupil should be given the chance to eat portions according to the amounts based on the guidelines, but this does not mean that these amounts have to be prepared for all the pupils potentially attending lunch (as for many it is not their only nutrition source). Full article

Tetanus is uncommon in dogs, which are considered relatively resistant to tetanospasmin, and detailed descriptions of the diagnostic evaluation of severe generalized cases remain limited. A 5.5-month-old intact male Miniature Schnauzer was presented four days after a puncture wound to the right pelvic limb. On admission the dog was alert but non-ambulatory, with generalized muscle rigidity, tremors, marked cervical hyperextension, hyperactive spinal reflexes, facial muscle spasms and dysphagia. Together with the wound history and rapid progression, these findings supported a presumptive diagnosis of generalized tetanus, clinically classified as Grade III. Serum collected before tetanus antitoxin administration contained no detectable antibodies against Clostridium tetani neurotoxin. Treatment comprised equine tetanus antitoxin, antimicrobials, multimodal sedation and muscle relaxation, enteral nutrition, intensive nursing and physiotherapy. Needle electromyography on day 10 showed increased insertional activity, positive sharp waves and fibrillation potentials, and continuous spontaneous motor unit activity. Despite patient young age and rapid disease progression, clinical improvement was evident from day 10, and the dog was discharged on day 16, ambulatory and eating voluntarily. This case highlights that severe generalized canine tetanus remains principally a clinical diagnosis, while serial neurological examination, clinicopathological monitoring and electromyography can strengthen diagnostic confidence, characterize disease progression and support clinical management. Full article

Background: Veterans with spinal cord injury (SCI) represent the largest single group of individuals with SCI nationwide. They have a high prevalence of obesity (76.7%) and cardiometabolic disease (57.5%). Time-restricted eating (TRE) involves eating within a consistent, daily window of ≤10 h and can improve cardiometabolic health. Here, we investigated the feasibility and acceptability of TRE among veterans with SCI and obesity and collected preliminary data on its cardiometabolic effects. Methods: We implemented a 6-week, single-arm trial of 10 h daily TRE among a convenience sample of 15 veterans with SCI and obesity. Results: Fourteen participants completed the trial. Among completers, TRE had high feasibility (83.0% adherence; mean window of 9.2 ± 1.5 h) and moderately high acceptability (50% planned to continue TRE post-trial and 79% would recommend TRE to a friend). TRE also improved several markers of glycemic control, including 24 h glucose levels (−7 ± 3 mg/dL, p = 0.02); Glucose Management Indicator (GMI), which estimates average HbA1c levels (−0.2 ± 0.1%, p = 0.02); and time in range (3.2 ± 1.6%, p = 0.02); and reduced time above range (level 1 hyperglycemia) (−2.0 ± 0.9%, p = 0.04). Half of participants reported improvements in aspects of physical or mental health, including mood, energy, and quality of life. Conclusions: TRE is both feasible and acceptable to veterans with SCI and obesity and has the potential to improve glycemic control. Larger trials are needed to test the effectiveness of TRE for reducing weight and improving cardiometabolic health in this high-risk population. Full article

Background: School-based sustainable and healthy diet (SHD) interventions often inadequately capture the multidimensional nature of sustainability, with socioeconomic and cultural dimensions frequently underrepresented. While digital interventions can facilitate the integration of multiple SHD components, maintaining user engagement remains a persistent challenge that can compromise intervention effectiveness. Digital serious games represent a promising intervention strategy that can address both limitations by delivering multidimensional SHD content through interactive and engaging learning, while enabling real-time behavioral monitoring. Objectives: To assess the feasibility, as well as the acceptability and user experience of “Sustainable ePlate”, a web-based serious game for multidimensional SHD educational interventions in schools, during school-based sessions. Methods: Sustainable ePlate integrates food-level sustainability indicators into a scaffolded nine-challenge serious game. Challenges are presented through the healthy eating plate structure, while addressing eight food-level sustainability indicators transformed into 1–5 ordinal game scores. A database of 138 food items was developed from publicly available LCA and TCA databases. The game design draws on established learning theories implemented through progressive challenge sequencing, tiered feedback, and social features. Feasibility was assessed in guided school sessions in Northern Greece using the eGameFlow questionnaire and system in-app metrics. Results: The assessment sample comprised n = 59 students from two secondary schools, of whom n = 57 completed the eGameFlow questionnaire. Mean overall enjoyment was 82.54 ± 16.33%. Mean session duration was 22.39 ± 12.68 min. Across all sessions, 6003 food selections were recorded, with 5179 correct and 824 incorrect placements, corresponding to an 86.27% placement accuracy rate. In-app metrics indicated strong technical feasibility, with all sessions completing the full game sequence. Behavioral metrics demonstrated active interaction, characterized by placement interval duration, hesitation times, and high placement accuracy. Conclusions: Sustainable ePlate demonstrated feasibility and a positive user experience as a school-based serious game for multidimensional SHD education, and as a research platform for capturing in-app behavioral metrics. Further studies are required to assess its educational effectiveness in improving knowledge, attitudes, and practices related to sustainable healthy diets through pre–post design interventions. Full article

This study proposes a multi-source perceptual information fusion method to improve the accuracy and stability of dairy cow behavior monitoring. Existing machine vision approaches are often affected by lighting conditions, occlusion, and complex cowshed environments, while single wearable inertial measurement unit (IMU) devices may confuse similar behaviors such as eating, ruminating, standing, and lying. To address these limitations, a wireless collar was developed to synchronously collect nine-axis IMU data and ultra-wideband (UWB) ranging data in real time. Combined with manual behavioral observations, a dataset covering seven behaviors—eating, ruminating, standing, lying, drinking, sleeping, and lateral trunk contact—was constructed. By integrating neck-motion features extracted from the IMU data with spatial-distance features obtained from the UWB data, an IMU–UWB dual-branch fusion model was developed to automatically classify dairy cow behaviors. The results indicate that the proposed method can effectively reduce confusion among similar behaviors and improve the recognition of behaviors with limited samples. This approach enables more comprehensive assessment of dairy cows’ daily activities and health status, providing technical support for health monitoring, early disease warning, and intelligent dairy farm management. Full article

Background/Objectives: Obesity is a chronic, progressive, and relapsing disease that requires long-term, multidisciplinary management rather than episodic weight-loss treatment. Although novel incretin-based anti-obesity pharmacotherapies, including GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists, have markedly improved the clinical management of obesity, weight reduction alone does not fully capture treatment success. Body composition, lean mass preservation, physical function, nutritional adequacy, psychological well-being, adherence, and long-term weight-loss maintenance are increasingly recognized as essential therapeutic outcomes. This narrative review critically examines the role of lifestyle medicine as a co-therapeutic strategy during modern anti-obesity pharmacotherapy, with particular attention to physical activity, nutrition, behavioral support, and individualized monitoring. Methods: A narrative literature search was conducted in PubMed up to June 2026. The review included studies addressing adults with overweight or obesity and evidence related to anti-obesity pharmacotherapy, physical activity, nutrition, body composition, functional outcomes, eating behavior, quality of life, treatment tolerability, adherence, weight regain, and long-term maintenance. Results: Current evidence indicates that incretin-based therapies produce substantial and clinically meaningful weight loss, but pharmacological efficacy may be limited by reductions in lean mass, gastrointestinal adverse events, inadequate nutritional intake, treatment discontinuation, and weight regain after drug withdrawal. Physical activity should be considered a therapeutic component rather than only a tool for increasing energy expenditure, as aerobic exercise supports cardiometabolic health and cardiorespiratory fitness, while resistance training helps preserve muscle strength, bone health, and functional capacity. Nutritional strategies are equally important, particularly during appetite suppression, to maintain adequate protein, fiber, fluids, micronutrients, and diet quality. Behavioral factors, including sleep, stress, mood, stigma, self-regulation, and the food environment, may influence adherence and long-term outcomes. Conclusions: Novel anti-obesity drugs should not be viewed as replacements for lifestyle medicine but as powerful tools within an integrated chronic-care model. The goal of treatment should move beyond maximal body-weight reduction to durable improvements in body composition, metabolic health, physical function, nutritional status, quality of life, and weight-loss maintenance. Full article

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and the dual GIP/GLP-1 co-agonist tirzepatide are increasingly prescribed for obesity and type 2 diabetes in populations enriched for binge-spectrum eating pathology. A recurring controversy asks whether these agents treat eating pathology or merely mask it. This critical narrative review argues that, posed as a simple binary, the question is under-specified, and reframes it around three problems. The central is a measurement problem: several intended effects of GLP-1 RAs are scored as improvement by eating-disorder instruments, creating a diagnostic blind spot. In the one disorder where a weight-acting drug has been tested against a placebo, efficacy on weight coincided with no effect on the psychological core—the dissociation that confounds measurement during GLP-1 RA therapy. The second is a phenotype problem: because BED subtypes already moderate response to drug versus psychological treatment, an agent acting on appetite and reward should not act uniformly, though this remains a hypothesis. The third concerns the post-discontinuation trajectory, and a therapy–harm asymmetry emerges across the spectrum. A factorial, phenotype-stratified trial with disorder-core endpoints and drug-free follow-up could resolve these questions; meanwhile, prudent practice combines uncontaminated pre-treatment screening, monitoring not reliant on confounded self-report, discontinuation planning, and integration with psychological care. Full article

Shanghai-style poached chicken is a traditional ready-to-eat (RTE) dish in Shanghai. The locally monitored data revealed that the contamination rates of three major pathogens, including Staphylococcus aureus, Listeria monocytogenes, and Salmonella, were 8.33%, with Salmonella being the most frequently detected (4.76%), followed by S. aureus (2.38%) and L. monocytogenes (1.19%). A semi-quantitative risk assessment identified Salmonella as the key pathogen, with a high-risk score of 52. An established growth model for Salmonella isolates on poached chicken was utilized within a Monte Carlo simulation framework, combined with consumption data, to estimate ingestion levels per day across three typical consumption scenarios. Compared with dine-in consumption (Scenario 1), ambient storage (Scenario 2) and refrigeration (Scenario 3) increased the probability of infection by approximately 4-fold and 2-fold, respectively. Sensitivity analysis revealed the initial contamination level as the primary risk determinant, highlighting the importance of strict environmental hygiene in processing. Overall, this study provides a quantitative risk assessment of poached chicken in Shanghai and offers scientific evidence for targeted interventions along the food chain. Full article

Artificial intelligence (AI) is increasingly being applied in healthcare, with growing relevance to clinical nutrition. This narrative review examines current and emerging uses of AI in nutrition care within the Nutrition Care Process framework, with attention to assessment, monitoring and evaluation, diagnosis, intervention, and clinical support tools. Current applications include AI-assisted dietary assessment using image recognition, wearable sensors, analysis of continuous glucose and other physiologic data for early risk detection, and support for malnutrition screening and diagnosis. AI is also being explored for identifying micronutrient deficiencies and complications of nutrient excess, as well as for screening and early intervention in eating disorders. In nutrition intervention, AI has potential to support personalized dietary planning, nutrition support in intensive care settings, behavioral interventions, and precision nutrition approaches such as digital twins. Additional applications include clinical decision support and documentation assistance. However, despite its usefulness, concerns about AI systems exist. Its performance depends on the quality of the data used to train it; it can introduce bias, and it can produce inaccurate or misleading outputs. In addition, overreliance on AI may also reduce clinician attentiveness and contribute to cognitive errors. For these reasons, AI should be regarded as a support tool rather than a replacement for human clinical care. Overall, AI offers substantial opportunities to improve the personalization, efficiency, and scalability of clinical nutrition practice, but its safe and effective implementation will require continued validation, careful oversight, and integration with clinical expertise. Full article

Background: The prevalence of overweight and obesity in Chinese school-aged children has continued to rise, posing significant health risks. Rational nutrition knowledge and dietary behaviors are important for obesity prevention and control. The ‘Know Your Food’ campaign aimed to promote nutritious diets and empower informed food choices among Chinese children and young people. This study aims to assess both the implementation and effectiveness of the campaign in primary school settings. Methods: The monitoring framework was designed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and consisted of a series of social media advocacy and school-based nutrition sessions. A monitoring system based on the RE-AIM model was developed to assess the impact of the campaign. Observational data on reach, effectiveness, adoption, implementation, and maintenance were collected through media tracking, self-reported questionnaires, and focus group discussions. Results: Between 13 May and 15 June 2022, the campaign gained 77.13 million views and 291,029 interactions from social media. The campaign garnered positive feedback as it reached a wide audience through traditional media, social media and school sessions. 94.7% of the respondents were willing to share campaign information. After the session, more than two thirds of the students reported behavior change, with 70.0% reporting eating five vegetables a day, 67.7% reporting drinking fewer sugary drinks, 74.0% reporting replacing snacks with fruits/nuts, 76.9% reporting doing exercises, and 78.0% reporting getting sufficient sleep. Conclusions: The ‘Know Your Food’ campaign was able to reach and engage the target audience, increasing nutrition knowledge, and influencing behavior change within the short observation window. The findings exemplify the implementation and effectiveness of this campaign and highlight the importance of using a comprehensive assessment framework to assess such nutrition campaigns. Full article

Background/Objectives: Obesity is associated with alterations in cognitive control processes that support performance monitoring and dietary self-regulation, but the neurocognitive markers most closely tied to body weight status in young adulthood remain unclear. Methods: Sixty-two young adults completed a modified Simon task while continuous electroencephalography (EEG) was recorded. Response-locked event-related potentials (ERPs) were quantified for error-related negativity (ERN) and error positivity (Pe). The association between body mass index (BMI) and ERP amplitudes was examined under three parameterizations: BMI as a continuous variable, BMI split into three categories (normal weight, overweight, obese), and BMI split into two median-matched categories. Results: Higher BMI was associated with reduced (less negative) ERN amplitude under continuous (r = 0.30, p = 0.016, and median-split, Cohen’s d = −0.69, p = 0.009) specifications, and at the level of a trend under the three-group classification F(2, 59) = 2.80, p = 0.069, η²p = 0.09. The association was most consistent for neutral trials, where it reached significance under the continuous (r = 0.32, p = 0.010) and three-group (F = 3.31, p = 0.043) specifications and approached significance under the median-split (d = −0.51, p = 0.051). The BMI-ERN association remained significant after adjustment for age, sex, cardiorespiratory fitness, physical activity, and trait impulsivity. In contrast, Pe amplitude did not differ as a function of BMI under any specification. In exploratory analyses that did not survive correction for multiple comparisons, Pe amplitude was positively associated with mindful eating disinhibition and negatively associated with UPPS-P Positive Urgency, independent of BMI. Conclusions: These cross-sectional findings indicate that elevated adiposity in young adulthood is associated with attenuated pre-conscious conflict and error monitoring (i.e., ERN), whereas conscious error awareness (i.e., Pe) is unrelated to body weight status. The exploratory Pe–trait associations are offered as hypotheses for future confirmatory work rather than as established effects. Full article

This study explores the behavioral intersection of nutritional health and environmental literacy among pre-service teachers within the national higher education context. Utilizing the Sustainable Healthy Diet Index (SHED Index) for the first time in Croatia, this research systematically examines the dietary habits, lifestyle choices, and socio-cultural patterns of future educators (N = 164) at the University of Split. The survey instrument evaluated the core SHED domains, Healthy Eating (HE) and Sustainable Eating (SE), alongside supplementary indicators monitoring food logistics, hydration, and waste management. Descriptive analysis revealed moderately high standardized overall SHED scores (M = 62.86), aligning with the original normative distribution. Notably, students achieved significantly higher descriptive sub-scores in the HE domain (M = 24.68) than in the SE domain (M = 18.06). Although domestic food consumption and circular recycling practices were well integrated, critical biospheric behaviors—such as reducing animal protein, consuming legumes, purchasing organic food, and composting—remain limited by cultural resistance and municipal infrastructure deficits. Furthermore, an independent t-test indicated no significant differentiation across study levels, highlighting a potential institutional stagnation throughout the five-year teacher education program. Regression analysis demonstrated that sustainable dietary choices appear to be strongly anchored in personal health concerns rather than biospheric altruism, with healthy eating emerging as the single strongest explanatory factor for of sustainable behavior. These findings indicate that to cultivate authentic ecological literacy in the future teaching workforce, higher education curricula require a systemic redesign that explicitly links sustainability to personal well-being through localized, experiential learning. Full article

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become first-line pharmacotherapy for eligible patients with type 2 diabetes mellitus and obesity. Soon after their broad uptake, spontaneous reports of suicidal ideation, depression, and anxiety prompted regulatory investigations and a contentious debate about the neuropsychiatric safety of the class. Objective: We aimed to synthesize emerging evidence on psychiatric adverse outcomes associated with GLP-1 RAs by integrating mechanistic, pharmacovigilance, observational, and regulatory data; to trace how the evidence and regulatory assessments evolved chronologically from initial signal detection toward subsequent controlled refutation; and to translate the current balance of evidence into practical clinical guidance. Methods: We conducted a narrative integrative synthesis of peer-reviewed pharmacovigilance studies, cohort and case–control analyses, systematic reviews and meta-analyses, mechanistic literature, and regulatory communications identified through targeted searches of the published record through early 2026. Results: Disproportionality analyses of spontaneous-reporting databases have generated modest, semaglutide-predominant signals for depression and suicidality, whereas liraglutide and tirzepatide have generally not. Anxiety signals parallel those for depression, and emerging data also indicate potential benefits for substance-use, binge-eating, and sleep-disordered breathing. In contrast, large propensity-matched cohort studies, a nationwide case–time–control analysis, an administrative-claims cohort exceeding two million users, and a meta-analysis of 91 placebo-controlled trials enrolling 107,910 participants found no increased risk and, in some analyses, lower risk of suicidal ideation. The principal exception is an amplified reporting signal among patients co-prescribed antidepressants or benzodiazepines, indicating effect modification by psychiatric vulnerability. Conclusions: The preponderance of controlled evidence has not demonstrated a causal relationship between GLP-1 RAs and suicidality or major psychiatric harm, a conclusion reflected in 2024–2026 regulatory determinations. Residual uncertainty persists for psychiatrically vulnerable subgroups, justifying continued individualized monitoring rather than restriction of access. Full article

Background: Muscle health decline is a major concern in postmenopausal women; however, most interventions have focused on exercise as an isolated component. It remains unclear whether embedding exercise within a broader lifestyle framework enhances muscle-related outcomes. Methods: A total of 100 postmenopausal women took part in this randomized controlled trial and were randomly assigned to three groups: Nordic walking combined with high-protein intake and time-restricted eating (NW+HP+TRE, n = 36), Nordic walking combined with time-restricted eating (NW+TRE, n = 33), and a control group (n = 31). The intervention lasted 12 weeks. The primary outcome was handgrip strength, and the secondary outcomes included physical performance (6 m gait speed and five times chair-stand time) and lean mass-related measures. Adherence to all intervention components was monitored throughout the study. Results: During the intervention, four participants did not complete the post-intervention assessment, resulting in 96 participants being included in the final analysis. Handgrip strength improved in both intervention groups, with the largest increase observed in the NW+HP+TRE group. Physical performance outcomes showed a similar pattern. In contrast, the NW+TRE group showed less favorable changes in lean mass-related measures, whereas the control group showed minimal overall changes. Adherence to Nordic walking, time-restricted eating, and protein intake was high in the intervention groups. Conclusions: A Nordic walking-based integrated lifestyle intervention was associated with a more favorable overall pattern of change in muscle strength, physical performance, and lean mass-related outcomes in postmenopausal women. These findings should be interpreted as differences between intervention packages rather than as evidence for the isolated effect of any single lifestyle component. Further research is needed to examine the long-term sustainability of such interventions and to clarify the contribution of individual components. Full article