Search Results (529)

Background: Neonatal jaundice is common and can cause severe hyperbilirubinemia if untreated. The early identification of at-risk newborns is challenging despite the existing guidelines. Objective: This study aimed to identify the key maternal and neonatal risk factors for jaundice requiring phototherapy using machine learning. Methods: In this study hospital, phototherapy was administered following the American Academy of Pediatrics (AAP) guidelines when a neonate’s transcutaneous bilirubin level was in the high-risk zone. To identify the risk factors for phototherapy, we retrospectively analyzed the electronic medical records of 8242 neonates admitted between 2017 and 2022. Predictive models were trained using maternal and neonatal data. XGBoost showed the best performance (AUROC = 0.911). SHAP values interpreted the model. Results: Mode of delivery, neonatal feeding indicators (including daily formula intake and breastfeeding frequency), maternal BMI, and maternal white blood cell count were strong predictors. Cesarean delivery and lower birth weight were linked to treatment need. Conclusions: Machine learning models using perinatal data accurately predict the risk of neonatal jaundice requiring phototherapy, potentially aiding early clinical decisions and improving outcomes. Full article

Background: Spinal muscular atrophy type 1 (SMA1) is a severe neuromuscular disorder characterized by progressive muscle weakness and atrophy, including the muscles of the oral cavity and esophagus. Eosinophilic esophagitis (EoE), a chronic, allergic disease, presents with eosinophilic infiltration of the esophagus, leading to esophageal dysmotility. Feeding difficulties may occur in both conditions. So far, the coexistence of EoE and SMA1 has not been described; we present the first such case. Case presentation: The patient was a girl with SMA1 diagnosed shortly after birth, treated with nusinersen and onasemnogene abeparvovec, and fed a standard industrial diet through a gastrostomy. In her second year of life, she developed increasing symptoms: distress during feeding, regurgitation, vomiting, and weight loss. She was treated with proton pump inhibitors without clinical improvement. Gastroscopy was performed, revealing superficial epithelial damage with bleeding in the proximal esophagus. Histopathology showed chronic inflammation with up to 150 eosinophils per high-power field, microabscesses, spongiosis, and basal layer hypertrophy. The girl was diagnosed with EoE. Her diet was switched from a standard industrial formula to an amino acid-based formula, which led to marked clinical improvement, the resolution of symptoms, and appropriate weight gain. Conclusions: This case report highlights the challenges of diagnosing EoE in SMA1 patients and emphasizes the need for multidisciplinary approaches and further investigation of allergic manifestations in SMA1 patients. Full article

Tool wear modeling in CNC turning processes is critical for proactive maintenance and process optimization in intelligent manufacturing. However, traditional physics-based models lack adaptability, while machine learning approaches are often limited by poor interpretability. This study develops Kolmogorov–Arnold Networks (KANs) to address the trade-off between accuracy and interpretability in lathe tool wear modeling. Three KAN variants (KAN-A, KAN-B, and KAN-C) with varying complexities are proposed, using feed rate, depth of cut, and cutting speed as input variables to model flank wear. The proposed KAN-based framework generates interpretable mathematical expressions for tool wear, enabling transparent decision-making. To evaluate the performance of KANs, this research systematically compares prediction errors, topological evolutions, and mathematical interpretations of derived symbolic formulas. For benchmarking purposes, MLP-A, MLP-B, and MLP-C models are developed based on the architectures of their KAN counterparts. A comparative analysis between KAN and MLP frameworks is conducted to assess differences in modeling performance, with particular focus on the impact of network depth, width, and parameter configurations. Theoretical analyses, grounded in the Kolmogorov–Arnold representation theorem and Cybenko’s theorem, explain KANs’ ability to approximate complex functions with fewer nodes. The experimental results demonstrate that KANs exhibit two key advantages: (1) superior accuracy with fewer parameters compared to traditional MLPs, and (2) the ability to generate white-box mathematical expressions. Thus, this work bridges the gap between empirical models and black-box machine learning in manufacturing applications. KANs uniquely combine the adaptability of data-driven methods with the interpretability of physics-based models, offering actionable insights for researchers and practitioners. Full article

This study analyzed the surface layer condition of X5CRNI18-10 stainless austenitic chromium–nickel steel test pieces after burnishing. Among the finishing operations, burnishing is an economical and low-environmental-impact process. In special cases, grinding can be replaced by burnishing, so the same roughness can be achieved with much lower environmental impact. The aim of this study is to analyze the roughness of a surface machined by diamond burnishing using Kraljic matrices. The technological parameters used during the burnishing tests were burnishing speed, feed rate, and burnishing force. The full factorial experimental design method was used to carry out the experiments. Using Kraljic matrices, the optimum burnishing force was determined to select the best value of the surface roughness, and the change in surface roughness was investigated using full factorial experimental design for different technological parameter combinations. A special improvement ratio formula was developed to evaluate the effectiveness of the burnishing process with respect to 2D and 3D roughness parameters. Full article

Background: Breastfeeding is the ideal source of nutrition for babies. Despite its benefits, breastfeeding practices and attitudes vary across cultures, influenced by societal norms, education, and personal experiences. This article shows the attitude differences among female students in Syria and Hungary and how sociocultural aspects impact their attitude towards breastfeeding. Methods: The questionnaire was a part of a multi-section questionnaire presented to 317 Syrian students and 303 Hungarian students. It assessed students’ attitudes towards breastfeeding through the Iowa Infant Feeding Attitude Scale (IIFAS). In addition to cross-tabulations, an exploratory data categorisation method, i.e., cluster analysis, was used in analysing the data. Results: Participants in both countries demonstrated strong agreement with statements highlighting the emotional and nutritional advantages of breastfeeding. In total, 67.2% of the participants disagreed with the idea that formula feeding is more convenient; similarly, 66.3% of them disagreed that breastfeeding causes fathers to feel emotionally excluded. Attitudes toward breastfeeding in public were more divided, reflecting the sensitivity of the topic and varying degrees of acceptance, with 48.7% of respondents disagreeing. Multivariate analysis demonstrated that nationality or age were significant predictors of belonging to various attitude clusters (SBM, SFF, FT): Syrian respondents and younger participants aged 21–30 years were more likely to belong to the Supporters of Breast Milk (SBM) cluster. In addition, paternal education level and urban residence also influenced feeding attitudes. Conclusions: This study shows the differences in attitude among Syrian and Hungarian female students, which is rooted in cultural diversity and its effect on individuals’ decisions. Full article

Background/Objectives: Despite high breastfeeding initiation rates nationwide, disparities in breastfeeding continuation among Black mothers remain a public health issue. The BreastFeed Iowa Black Immigrant Project aimed to improve breastfeeding rates among low-income Black immigrant mother-infant dyads in Johnson County, Iowa by exploring factors influencing breastfeeding retention and developing a framework for culturally sensitive breastfeeding interventions. Methods: Using a descriptive cross-sectional study design, we employed a convergent, parallel mixed-methods approach to explore factors that influence breastfeeding duration among Black immigrant mothers with children 0–2 years old. Nine focus group discussions (FGDs) were conducted on Zoom among 40 participants with a semi-structured guide on breastfeeding beliefs, experiences, and feeding practices. Additionally, a 22-item survey was administered to 33 participants. Results: Based on the survey, one out of five participants indicated that they were unable to breastfeed for as long as they had planned. The top five reasons why mothers stopped breastfeeding included having received formula from the Supplemental Nutrition Program for Women, Infants and Children; being sick and having to take medicine; the baby was hungry too often; the baby was sick and could not breastfeed; and not producing enough milk. The top five themes that emerged from FGDs as barriers to breastfeeding included lack of lactation support, knowledge gaps on breastfeeding benefits, perception of inadequate milk supply, lack of comfort with breast milk expression, and work-related barriers. Conclusions: The community needs assessment identified the elements needed to develop a culturally sensitive framework with targeted interventions to address breastfeeding barriers in the Black immigrant community. Full article

Background and Objectives: Infant feeding practices play a crucial role in shaping the oral microbiome, modulating inflammatory responses, and maintaining epithelial health during the first year of life. Breastfeeding promotes the growth of beneficial bacteria and supports a diverse, stable microbial community. In contrast, formula feeding is associated with increased colonization by potentially pathogenic bacteria, such as Staphylococcus and Escherichia coli, which may elevate the risk of infections, oral diseases, and inflammation. This study investigates the effects of breastfeeding versus formula feeding on oral bacterial growth, epithelial cell integrity, and interleukin-17 (IL-17) expression in infants aged 1–12 months. Materials and Methods: A total of 60 infants (30 breastfed and 30 formula-fed) were recruited from pediatric clinics in the Qassim region. Microbial cultures quantified bacterial colony-forming units (CFUs), and epithelial cell morphology was assessed through the microscopic analysis of mucosal scrapings. IL-17 concentrations were quantified from the oral mucosa through enzyme-linked immunosorbent assay. Statistical analyses, including t-tests and chi-square tests, compared bacterial loads, IL-17 levels, and indicators of epithelial health between groups. Adjustment for potential confounders was achieved through multivariate statistical analysis. Results: Formula-fed infants showed significantly higher IL-17 levels than breastfed infants (p < 0.001), indicating a stronger pro-inflammatory profile. Breastfed infants exhibited lower inflammation, improved epithelial health, and reduced cellular debris compared to formula-fed infants, who had higher bacterial loads. A significant correlation was found between epithelial health and bacterial clustering, with clearer epithelial cells associated with lower bacterial colonization. Conclusions: Formula feeding was associated with increased salivary IL-17 levels, greater bacterial colonization, and compromised epithelial integrity, indicating a heightened pro-inflammatory state and potential vulnerability to mucosal irritation or infection. Breastfeeding appeared to confer protective effects by promoting healthier microbial balance, epithelial integrity, and reducing inflammatory responses. These findings underscore the immunological and microbial benefits of breastfeeding in supporting oral health during infancy. Full article

Background: Diet is known to influence the composition of the gut microbiome. For patients who require enteral feeding, there has been a growing popularity of using blenderized tube feeds (BTFs) as an alternative to standard enteral formula (SEF). There is limited literature exploring the impact of BTFs on the gut microbiome. Methods: Twenty-eight patients 1 to 22 years of age who received their nutrition via gastrostomy tube for over 4 weeks were included and participants were divided into BTF and SEF groups. Demographics and clinical information were collected from the medical records, and all legal guardians completed a semi-structured interview using a questionnaire. 16SrRNA sequencing was used for bacteriome analysis. Results: Eleven patients in the BTF group and seventeen in the SEF group were included. No significant differences in the demographics were noted. Patients on BTFs had no emesis compared to seven (41%) in the SEF group, p = 0.02. There were no significant differences in other clinical characteristics and comorbidities. No significant differences in the gut microbiome between the groups were noted for alpha and beta diversities, richness, and evenness (at both genus and species levels). Differential abundance analysis showed only a few significant differences between the groups at all reported taxonomic levels. Conclusions: Patients on BTFs had a significantly decreased prevalence of emesis compared to the SEF group. No significant differences in the microbiome between the groups were noted for alpha and beta diversities, richness, and evenness. Prospective studies are recommended to verify our preliminary data and further evaluate the implications of our study results. Full article

Infants born to HIV-positive mothers remain at significant risk of HIV acquisition despite maternal adherence to antiretroviral therapy, cesarean delivery, and formula feeding. Our previous study reported that initiating early antiretroviral treatment at three days post-SIV infection resulted in approximately eighty percent of pediatric virologic remission. In this study, we investigated treatment outcomes in postnatally SHIV-exposed infant macaques when early intervention was delayed by two days, as well as the mechanisms underlying virologic control. The results showed that, although initiating treatment at five days post-exposure effectively suppressed viral replication, only one of the three infant macaques achieved a sustained state of virologic remission following analytical treatment interruption. Notably, this virus-controlled infant lacked detectable virus-specific immunity, including neutralizing antibodies, cytotoxic T cell responses, and antibody-dependent cellular cytotoxicity. These findings highlight the critical importance of early treatment initiation as a key determinant of virologic control in HIV-exposed, infected infants. This study provides valuable insights for guiding early pediatric HIV intervention strategies in clinical settings. Full article

This study aimed to comprehensively investigate the impact of soybean β-conglycinin on broiler growth performance, nutrient utilization, allergic and inflammatory responses, intestinal barrier integrity, and cecal microbiota. A total of 168 newly hatched (1-day-old) Arbor Acres broilers with similar body weights were randomly divided into 6 treatment groups with 4 replicates of 7 broilers per replicate: the control group received a soybean-free basal diet, while the remaining five experimental groups were provided with diets supplemented with purified soybean β-conglycinin at the doses of 1%, 2%, 3%, 4%, and 5%. The results demonstrated that dietary 1–5% β-conglycinin supplementation significantly reduced the growth performance, nutrient utilization, and content of digestive enzymes in broilers (p < 0.05). Dietary 1–5% β-conglycinin supplementation also significantly increased the serum levels of histamine, β-conglycinin-specific IgY and IgM, TNF-α, and IL-6 and decreased IL-10 levels; the 3% group had the highest levels of histamine, TNF-α, and IL-6 and the lowest levels of IL-10 (p < 0.05). β-conglycinin supplementation significantly down-regulated the mRNA expression of tight junction proteins, MUC2 and IL-10, and up-regulated the expression of TNF-α and IL-6 in the small intestinal mucosa (p < 0.05). Furthermore, the Shannon and Simpson indices were significantly reduced by dietary 1–5% β-conglycinin administration (p < 0.05). The relative abundance of beneficial bacteria (Blautia, Lactobacillus, and Butyricoccus) was significantly decreased in all treatments (p < 0.05). Taken together, these findings suggest that β-conglycinin induces allergic and inflammatory responses, impairs intestinal barrier integrity, and alters the intestinal microbial balance, ultimately leading to reduced nutrient utilization and inhibited growth in broilers. Notably, our study demonstrated that dietary supplementation with 1% β-conglycinin already had various negative effects on broilers, and particularly supplemental 3% β-conglycinin induced serious allergic and inflammatory reactions. Therefore, in the present study, it is recommended that the inclusion level of β-conglycinin in broiler formula feed should not exceed 1%, i.e., the β-conglycinin content in the diet should not exceed 0.6% (converted from β-conglycinin purification purity). Full article

Background: Ischemic stroke (IS) is a severe condition with limited therapeutic options. Pyroptosis, a type of programmed cell death linked to inflammation, is closely associated with IS-related damage. Studies suggest inflammation aligns with the traditional Chinese medicine (TCM) concept of “fire-heat syndrome”. Huanglian Jiedu Decoction (HLJD), a TCM formula known for clearing heat and purging fire, has shown therapeutic effects on IS, potentially by regulating pyroptosis. Study design: Eight-week-old male mice were divided into six groups: sham operation, model, positive drug, and low-, medium-, and high-dose HLJD groups. After a week of adaptive feeding, mice received respective treatments for five days, followed by modeling on the sixth day, with samples collected 23 h post-perfusion. Analyses included multi-omics, physiology, histopathology, virtual drug screening, target affinity assessment, and molecular biology techniques to measure relevant indicators. Results: HLJD effectively mitigated IS-related damage, maintaining neurological function, reducing ischemic levels, protecting cellular morphology, inhibiting neuronal apoptosis, and preserving blood–brain barrier integrity. Bioinformatics of high-throughput omics data revealed significant activation of pyroptosis and related inflammatory pathways in IS. ScRNA-seq identified neutrophils, macrophages, and microglia as key pyroptotic cell types, suggesting potential therapeutic targets. Network pharmacology and molecular docking identified NLRP3 as a critical target, with 6819 ligand–receptor docking results. SPR molecular fishing, LC-MS, molecular dynamics, and affinity measurements identified small molecules with high affinity for NLRP3. Molecular biology techniques confirmed that HLJD regulates pyroptosis via the classical inflammasome signaling pathway and modulates the inflammatory microenvironment. Conclusions: Following IS, pyroptosis in myeloid cells triggers an inflammatory cascade, leading to neural damage. HLJD may inhibit NLRP3 activity, reducing pyroptosis and associated inflammation, and ultimately mitigating damage. Full article

Overfeeding, currently defined as providing excessive energy and nutrients beyond metabolic requirements, is a common yet often overlooked issue in the intensive care unit (ICU) setting. Understanding the factors contributing to overfeeding and implementing strategies to prevent it is essential for optimizing patient care in the ICU. Several factors contribute to overfeeding in the ICU, including inaccurate estimation of energy requirements, formulaic feeding protocols, and failure to adjust nutritional support based on individual patient needs. Prolonged overfeeding can lead to insulin resistance and hepatic dysfunction, exacerbating glycemic control, increasing the risk of infectious complications, and worsening clinical outcomes. Clinically, overfeeding has been linked to delayed weaning from mechanical ventilation, prolonged ICU stay, and increased mortality rates. Regular review and adjustment of feeding protocols, incorporating advances in enteral and parenteral nutrition strategies, are essential for improving patient outcomes. Clinicians must be proficient in interpreting metabolic data, understanding the principles of energy balance, and implementing appropriate feeding algorithms. Interdisciplinary collaboration among critical care teams, including dieticians, physicians, and nurses, is crucial for ensuring consistent and effective nutritional management. Overfeeding remains a significant concern in the ICU after discharge as well, implying further complications for patient safety and integrity. By understanding the causes, consequences, and strategies for the prevention of overfeeding, healthcare providers can optimize nutrition therapy and mitigate the risk of metabolic complications. Through ongoing education, interdisciplinary collaboration, and evidence-based practice, the ICU community can strive to deliver personalized and precise nutritional support to critically ill patients. Full article

Human milk is the primary source of infant nutrition, although breastfeeding rates are declining today, and human milk is often replaced by animal milk-based infant formula. Infant formula is intended to replicate the composition of human milk, albeit significant differences remain in the physiological responses to breastfeeding and formula feeding in offspring. More research is needed on the composition of human milk and other milk types, especially regarding their lipid content. A comparative analysis of different milk samples was carried out in this study. The amount of omega-3 fatty acids, omega-6 fatty acids, and endocannabinoids was measured in human, cattle, and goat milk as well as in goat milk- and cow milk-based infant formulas using chromatography coupled to mass spectrometry. Significant differences between the human and animal milks were observed in the case of omega-6 fatty acid and endocannabinoid content, with higher omega-6 fatty acid and lower endocannabinoid levels in human milk than in animal milk samples and infant formulas. Goat milk shares the highest similarity to human milk in terms of the analyzed lipid species. However, our results indicate that the levels of the examined bioactive lipid species in human milk failed to be replaced by goat milk- and cow milk-derived infant formulas. Full article

Background/Objectives: Optimal feeding regimens for preterm neonates, including the role of multi-nutrient fortification, are unknown, leading to large practice variation in comparing different feeding regimens that include fortification and their impact on outcomes for preterm infants. Methods: Using a network meta-analyses design, two reviewers independently extracted data. A Cochrane CENTRAL, Medline, Embase, and CINAHL search was conducted for all studies published up to 27 June 2023. Randomized clinical trials of feeding regimens for preterm infants that included multi-nutrient fortification were included. Outcomes were mortality, necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), sepsis, periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), time to full enteral feeds, and the Bayley II MDI developmental score. Results: Fifty-nine studies were included. For mortality, NEC, and time to reach full enteral feeds, the top-ranked treatment class was the mother’s own milk with donor milk and a human-milk-based fortifier. For ROP and BPD, the top-ranked treatment class was mother’s own milk with a phosphorus fortifier. For sepsis, the top-ranked treatment class was mother’s own milk with formula. For PVL, the top-ranked treatment classes were mother’s own milk and mother’s own milk with donor milk and a bovine fortifier in the two disconnected networks. For the Bayley II MDI score, the top-ranked treatment class was mother’s own milk with formula and bovine fortification. Conclusions: Treatment rankings are consistent with the underlying hypothesis that increased mother’s own milk intake appears to be associated with better clinical outcomes. This review provides the first global view of interventions and highlights insufficient high-quality evidence to support or refute one fortification feeding regimen over another. Full article

Prolonged breastfeeding (BF), as opposed to artificial infant formula feeding (FF), has been shown to prevent the development of obesity later in life. The aim of our narrative review is to investigate the missing molecular link between postnatal protein overfeeding—often referred to as the “early protein hypothesis”—and the subsequent transcriptional and epigenetic changes that accelerate the expansion of adipocyte stem cells (ASCs) in the adipose vascular niche during postnatal white adipose tissue (WAT) development. To achieve this, we conducted a search on the Web of Science, Google Scholar, and PubMed databases from 2000 to 2025 and reviewed 750 papers. Our findings revealed that the overactivation of mechanistic target of rapamycin complex 1 (mTORC1) and S6 kinase 1 (S6K1), which inhibits wingless (Wnt) signaling due to protein overfeeding, serves as the primary pathway promoting ASC commitment and increasing preadipocyte numbers. Moreover, excessive protein intake, combined with the upregulation of the fat mass and obesity-associated gene (FTO) and a deficiency of breast milk-derived microRNAs from lactation, disrupts the proper regulation of FTO and Wnt pathway components. This disruption enhances ASC expansion in WAT while inhibiting brown adipose tissue development. While BF has been shown to have protective effects against obesity, the postnatal transcriptional and epigenetic changes induced by excessive protein intake from FF may predispose infants to early and excessive ASC commitment in WAT, thereby increasing the risk of obesity later in life. Full article