Search Results (10,756)

Background/Objectives: Conventional ketogenic diets, although effective for weight loss, often contain high total and saturated fat intake, which leads to increased low-density lipoprotein cholesterol (LDL-C). Thus, the Healthy Ketogenic Diet (HKD) was developed to address these concerns. It emphasizes calorie restriction, limiting net carbohydrate intake to 50 g per day, prioritizing unsaturated fats, and reducing saturated fat intake. However, adherence to the HKD remains a challenge in urban, time-constrained environments. Therefore, this pilot randomized controlled trial aimed to investigate the effects of Healthy Ketogenic Diet Ready-To-Eat (HKD-RTE) meals (provided for the first month only) versus HKD alone on weight loss and metabolic parameters among overweight adults. Methods: Multi-ethnic Asian adults (n = 50) with a body mass index (BMI) ≥ 27.5 kg/m² were randomized into the HKD-RTE group (n = 24) and the HKD group (n = 26). Both groups followed the HKD for six months, with the HKD-RTE group receiving HKD-RTE meals during the first month. Five in-person workshops and mobile health coaching through the Nutritionist Buddy Keto app helped to facilitate dietary adherence. The primary outcome was the change in body weight at 6 months. Linear regression was performed on the change from baseline for each continuous outcome, adjusting for demographics and relevant covariates. Logistic regression was performed on binary weight loss ≥5%, adjusting for demographics and relevant covariates. Results: In the HKD group, participants’ adherence to the 50 g net carbohydrate target was 15 days, while that in the HKD-RTE group was 19 days over a period of 30 days. Participants’ adherence to calorie targets was 21 days in the HKD group and 23 days in the HKD-RTE. The average compliance with the HKD-RTE meals provided in the HKD-RTE group was 55%. The HKD-RTE group experienced a greater percentage weight loss at 1 month (−4.8 ± 3.0% vs. −1.8 ± 6.2%), although this was not statistically significant. This trend continued up to 6 months, with the HKD-RTE group showing a greater percentage weight reduction (−8.6 ± 6.8% vs. −3.9 ± 8.6%; p = 0.092). At 6 months, the HKD-RTE group had a greater reduction in total cholesterol (−0.54 ± 0.76 mmol/L vs. −0.05 ± 0.56 mmol/L; p = 0.283) and LDL-C (−0.43 ± 0.67 mmol/L vs. −0.03 ± 0.52 mmol/L; p = 0.374) compared to the HKD group. Additionally, the HKD-RTE group exhibited greater reductions in systolic blood pressure (−8.3 ± 9.7 mmHg vs. −5.3 ± 11.0 mmHg), diastolic blood pressure (−7.7 ± 8.8 mmHg vs. −2.0 ± 7.0 mmHg), and HbA1c (−0.3 ± 0.5% vs. −0.1 ± 0.4%) than the HKD group (not statistically significant for any). Conclusions: Both HKD-RTE and HKD led to weight loss and improved metabolic profiles. The HKD-RTE group tended to show more favorable outcomes. Short-term HKD-RTE meal provision may enhance initial weight loss, with sustained long-term effects. Full article

This study applies Computational Fluid Dynamics (CFD) and mathematical modeling to examine uterine and umbilical arterial blood flow during pregnancy, providing a more detailed understanding of hemodynamic changes across gestation. Statistical analysis of Doppler ultrasound data from a large cohort of more than 200 pregnant women (in the second and third trimesters) reveals significant increases in the umbilical arterial peak systolic velocity ($PSV$) between the 22nd and 30th weeks, while uterine artery velocities remain relatively stable, suggesting adaptations in vascular resistance during pregnancy. By combining the Navier–Stokes equations with Doppler ultrasound-derived inlet velocity profiles, we quantify several key fluid dynamics parameters, including time-averaged wall shear stress ($TAWSS$), oscillatory shear index ($OSI$), relative residence time ($RRT$), Reynolds number ($Re$), and Dean number ($De$), evaluating laminar flow stability in the uterine artery and secondary flow patterns in the umbilical artery. Since blood exhibits shear-dependent viscosity and complex rheological behavior, modeling it as a non-Newtonian fluid is essential to accurately capture pulsatile flow dynamics and wall shear stresses in these vessels. Unlike conventional imaging techniques, CFD offers enhanced visualization of blood flow characteristics such as streamlines, velocity distributions, and instantaneous particle motion, providing insights that are not easily captured by Doppler ultrasound alone. Specifically, CFD reveals secondary flow patterns in the umbilical artery, which interact with the primary flow, a phenomenon that is challenging to observe with ultrasound. These findings refine existing hemodynamic models, provide population-specific reference values for clinical assessments, and improve our understanding of the relationship between umbilical arterial flow dynamics and fetal growth restriction, with important implications for maternal and fetal health monitoring. Full article

Background: Pain is a complex phenomenon characterized by unpleasant experiences with profound heterogeneity influenced by biological, psychological, and social factors. According to the National Health Interview Survey, 50.2 million U.S. adults (20.5%) experience pain on most days, with the annual cost of prescription medication for pain reaching approximately USD 17.8 billion. Theranostic pain nanomedicine therefore emerges as an attractive analgesic strategy with the potential for increased efficacy, reduced side-effects, and treatment personalization. Theranostic nanomedicine combines drug delivery and diagnostic features, allowing for real-time monitoring of analgesic efficacy in vivo using molecular imaging. However, clinical translation of these nanomedicines are challenging due to complex manufacturing methodologies, lack of standardized quality control, and potentially high costs. Quality by Design (QbD) can navigate these challenges and lead to the development of an optimal pain nanomedicine. Our lab previously reported a macrophage-targeted perfluorocarbon nanoemulsion (PFC NE) that demonstrated analgesic efficacy across multiple rodent pain models in both sexes. Here, we report PFC-free, biphasic nanoemulsions formulated with a biocompatible and non-immunogenic plant-based coconut oil loaded with a COX-2 inhibitor and a clinical-grade, indocyanine green (ICG) near-infrared fluorescent (NIRF) dye for parenteral theranostic analgesic nanomedicine. Methods: Critical process parameters and material attributes were identified through the FMECA (Failure, Modes, Effects, and Criticality Analysis) method and optimized using a 3 × 2 full-factorial design of experiments. We investigated the impact of the oil-to-surfactant ratio (w/w) with three different surfactant systems on the colloidal properties of NE. Small-scale (100 mL) batches were manufactured using sonication and microfluidization, and the final formulation was scaled up to 500 mL with microfluidization. The colloidal stability of NE was assessed using dynamic light scattering (DLS) and drug quantification was conducted through reverse-phase HPLC. An in vitro drug release study was conducted using the dialysis bag method, accompanied by HPLC quantification. The formulation was further evaluated for cell viability, cellular uptake, and COX-2 inhibition in the RAW 264.7 macrophage cell line. Results: Nanoemulsion droplet size increased with a higher oil-to-surfactant ratio (w/w) but was no significant impact by the type of surfactant system used. Thermal cycling and serum stability studies confirmed NE colloidal stability upon exposure to high and low temperatures and biological fluids. We also demonstrated the necessity of a solubilizer for long-term fluorescence stability of ICG. The nanoemulsion showed no cellular toxicity and effectively inhibited PGE2 in activated macrophages. Conclusions: To our knowledge, this is the first instance of a celecoxib-loaded theranostic platform developed using a plant-derived hydrocarbon oil, applying the QbD approach that demonstrated COX-2 inhibition. Full article

Objective: The objective of this study was to assess changes in body composition, with a specific focus on fat mass (FM) and fat-free mass (FFM), in obese adults with type 2 diabetes (T2D) treated with once-weekly (OW) subcutaneous (s.c.) semaglutide. Methods: This was a single-center, 12-month, real-world, ambispective study (6-month prospective and 6-month retrospective). Body composition parameters were assessed via segmental multifrequency bioelectrical impedance analysis (SMF-BIA). Results: A total of 117 patients with DM2, with a median age of 56 years, a median HbA1c level of 9.4%, and a median body weight of 102.5 kg, were included in the study. The median body weight, body fat mass, and visceral fat significantly decreased at 6 months, with values of −9.3, −7.5, and −1.8 kg, respectively. There were further reductions from 6 to 12 months, albeit at a slower rate. The median skeletal muscle mass significantly decreased at 6 months (−1.2 kg), although no further significant reductions were observed at 12 months. Conclusions: OW s.c. semaglutide for 12 months significantly improved body composition parameters, mainly at the expense of fat mass loss, with the preservation of skeletal muscle mass. These changes are clinically meaningful, since they impact general metabolic health and are associated with improvements in metabolic control and clinical parameters associated with renal and CV risks, as well as presumable improvements in quality of life. Full article

Background: The consumption of coffee has been widely debated regarding its effects on health. This study aims to analyze the correlations between daily coffee intake and sleep, blood pressure, anthropometric measurements, and biochemical markers in individuals with type 2 diabetes (T2D) and hypertension over a 12-month period. Methods: An observational study was conducted with 40 participants with T2D and hypertension, comprising 20 females and 20 males. Participants were monitored for their daily coffee consumption over a 12-month period, being assessed every 3 months. Linear regression was utilized to assess interactions and relationships between variables, providing insights into potential predictive associations. Additionally, correlation analysis was performed using Pearson’s and Spearman’s tests to evaluate the strength and direction of linear and non-linear relationships. Statistical significance was set at p < 0.05. Results: Significant changes were observed in fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body weight, body mass index, sleep duration, nocturnal awakenings, and waist-to-hip ratio (p < 0.05) over the 12-month study in both sexes. No significant differences were noted in the remaining parameters (p > 0.05). The coffee consumed by the participants was of the “traditional type” and contained sugar (2g per cup) for 100% of the participants. An intake of 4.17 ± 0.360 cups per day was found at baseline and 5.41 ± 0.316 cups at 12 months (p > 0.05). Regarding correlation analysis, a higher coffee intake was significantly associated with shorter sleep duration in women (r = −0.731; p = 0.037). Conversely, greater coffee consumption correlated with lower LDL cholesterol (LDL-C) levels in women (r = −0.820; p = 0.044). Additionally, a longer sleep duration was linked to lower FBG (r = -0.841; p = 0.031), HbA1c (r = -0.831; p = 0.037), and LDL-C levels in women (r = -0.713; p = 0.050). No significant correlations were observed for the other parameters in both sexes (p > 0.05). Conclusions: In women, coffee consumption may negatively affect sleep duration while potentially offering beneficial effects on LDL-C levels, even when sweetened with sugar. Additionally, a longer sleep duration in women appears to be associated with improvements in FBG, HbA1c, and LDL-C. These correlations emphasize the importance of a balanced approach to coffee consumption, weighing both its potential health benefits and drawbacks in postmenopausal women. However, since this study does not establish causality, further randomized clinical trials are warranted to investigate the underlying mechanisms and long-term implications—particularly in the context of T2D and hypertension. Full article

The growth of urban and industrial areas is accompanied by an increase in vehicle traffic, resulting in rising concentrations of various air pollutants. This is a global issue that causes environmental damage and risks to human health. The dataset presented in this research contains records with measurements of the air pollutants ozone (O₃) and carbon monoxide (CO), as well as meteorological parameters such as temperature (T), relative humidity (RH), and barometric pressure (BP). This dataset was collected using a set of low-cost sensors over a four-month study period (March to June) in 2024. The monitoring of air pollutants and meteorological parameters was conducted in a city with high industrial activity, heavy traffic, and close proximity to a petrochemical refinery plant. The data were subjected to a series of statistical analyses for visualization using plots that allow for the identification of their behavior. Finally, the dataset can be utilized for air quality studies, public health research, and the development of prediction models based on mathematical approaches or artificial intelligence algorithms. Full article

Kefiran, the extracellular polysaccharide produced from the Generally Recognized as Safe (GRAS) bacteria in kefir grains, with its well-documented functional and health-promoting properties, constitutes a promising biopolymer with a variety of possible uses. Its compatibility with other biopolymers, such as milk proteins, and its ability to form standalone cryogels allow it to be utilized for the fabrication of films with improved properties for applications in the food and biomedical–pharmaceutical industries. In the present work, the properties of kefiran films were investigated in the presence of milk proteins (sodium caseinate, native and heat-treated whey proteins, and their mixtures), alongside glycerol (as a plasticizer) and cryo-treatment of the film-forming solution prior to drying. A total of 24 kefiran films were fabricated and studied for their physical (thickness, moisture content, water solubility, color parameters and vapor adsorption), mechanical (tensile strength and elongation at break), and optical properties. Milk proteins increased film thickness, solubility and tensile strength and reduced water vapor adsorption. The hygroscopic effect of glycerol was mitigated in the presence of milk proteins and/or the application of cryo-treatment. Glycerol was the most effective at reducing the films’ opacity. Heat treatment of whey proteins proved to be the most effective in increasing film tensile strength, reducing, at the same time, the elongation at break, while sodium caseinates in combination with cryo-treatment resulted in films with high tensile strength and the highest elongation at break. Cryo-treatment, carried out in the present study through freezing followed by gradual thawing of the film-forming solution, proved to be the most effective factor in decreasing film roughness. Based on our results, proper selection of the film-forming solution composition and its treatment prior to drying can result in kefiran–glycerol films with favorable properties for particular applications. Full article

Background/Objectives: This study aimed to assess the long-term clinical performance of full-arch fixed restorations made of fiber-reinforced composite (FRC) supported by four ultra-short implants (4.0 × 5.0 mm) in patients with edentulous, atrophic mandibles. Methods: Ten patients were treated at Sapienza University of Rome and monitored over a 10-year period. Each case involved the placement of four plateau-design implants with a pure conometric connection and a calcium phosphate-treated surface. The final prostheses were fabricated using CAD/CAM-milled Trinia^® fiber-reinforced composite frameworks. Clinical parameters included implant and prosthesis survival, marginal bone level (MBL), peri-implant probing depth (PPD), and patient-reported outcome measures (PROMs). Results: Implant and prosthesis survival reached 100% over the 10-year follow-up. MBL data showed a minor bone gain of approximately 0.11 mm per 5 years (p < 0.0001). PPD remained stable under 3 mm, with a minimal increase of 0.16 mm over the same period (p < 0.0001). PROMs reflected sustained high patient satisfaction. No technical complications, such as chipping or framework fracture, were observed. Conclusions: Rehabilitation of the edentulous mandible with ultra-short implants and metal-free FRC prostheses proved to be a minimally invasive and long-lasting treatment option. The 10-year follow-up confirmed excellent implant and prosthetic outcomes, favorable peri-implant tissue health, and strong patient satisfaction. Nonetheless, further studies with larger sample sizes are needed to confirm these encouraging results and strengthen the clinical evidence. Full article

Many applications in health research involve the analysis of multivariate distributions of random variables. In this paper, we review the basic theory of copulas to illustrate their advantages in deriving a joint distribution from given marginal distributions, with a specific focus on bivariate cases. Particular attention is given to the Archimedean family of copulas, which includes widely used functions such as Clayton and Gumbel–Hougaard, characterized by a single association parameter and a relatively simple structure. This work differs from previous reviews by providing a focused overview of applied studies in biomedical research that have employed Archimedean copulas, due to their flexibility in modeling a wide range of dependence structures. Their ease of use and ability to accommodate rotated forms make them suitable for various biomedical applications, including those involving survival data. We briefly present the most commonly used methods for estimation and model selection of copula’s functions, with the purpose of introducing these tools within the broader framework. Several recent examples in the health literature, and an original example of a pediatric study, demonstrate the applicability of Archimedean copulas and suggest that this approach, although still not widely adopted, can be useful in many biomedical research settings. Full article

Heavy metals are a major toxicological concern due to their adverse effects on human health, particularly in children exposed to contaminated areas. This study evaluated biomarkers of exposure in 253 children aged 6 to 12 from Magangue, Achi, and Arjona (Bolivar, Colombia), analyzing their relationship with neurotoxicity and hematological markers. The mean Pb concentrations at the study sites were 1.98 µg/g (Magangue) > 1.51 µg/g (Achi) > 1.24 µg/g (Arjona). A similar pattern was observed for Cd concentrations for Magangue (0.39 µg/g) > Achi (0.36 µg/g) > Arjona (0.14 µg/g). In contrast, Se concentrations followed a different trend for Arjona (0.29 µg/g) > Magangue (0.21 µg/g) > Achi (0.16 µg/g). The proportion of Se/Pb molar ratios > 1 was higher in Arjona (3.8%) than in Magangue (0.9%) and Achi (2.0%). For Se/Cd ratios, values > 1 were also more frequent in Arjona (70.7%), exceeding 20% in the other two locations. Significant differences were found among locations in red and white blood cell parameters and platelet indices. Neurotransmitter-related biomarkers, including serotonin, monoamine oxidase A (MAO-A), and acetylcholinesterase levels, also varied by location. Principal component analysis showed that Pb and Cd had high loadings on the same component as PLT, WBC, and RDW, and while Se loaded together with HGB, PDW, MCHC, MCH, and MCV, suggesting distinct hematological patterns associated with each element. Multiple linear regression analysis demonstrated a statistically significant inverse association between hair Pb levels and serotonin concentrations. Although MAO-A and Cd showed negative β coefficients, these associations were not statistically significant after adjustment. These findings highlight the potential impact of toxic element exposure on key hematological and neurochemical parameters in children, suggesting early biological alterations that may compromise health and neurodevelopment. Full article

Vitamin D is the only vitamin that is conditionally essential, as it is synthesized from precursors after UV light exposure, whilst also being obtained from the diet. It has numerous health benefits, with deficiency becoming a major concern globally, such that dietary supplementation has more recently achieved vital importance to maintain satisfactory levels. In recent years, measurements made from blood have, therefore, become critical to determine the status of vitamin D levels in individuals and the larger population. Tests for vitamin D have routinely relied on laboratory analysis with sophisticated equipment, often being slow and costly, whilst rapid immunoassays have suffered from poor specificity and sensitivity. Here, we have evaluated a new rapid immunoassay test on the market (Rapi-D & IgLoo) to quickly and accurately measure vitamin D levels in small capillary blood specimens and compared this to measurements made using the standard laboratory method of liquid chromatography and mass spectrometry. Our results show that vitamin D can be measured very quickly and over a broad range using the new method, as well as correlate relatively well with standard laboratory testing; however, it cannot be fully relied upon currently to accurately diagnose deficiency or sufficiency in individuals. Our statistical and comparative analyses find that the rapid immunoassay with digital quantification significantly overestimates vitamin D levels, leading to diminished diagnosis of vitamin D deficiency. The speed and simplicity of the rapid method will likely provide advantages in various healthcare settings; however, further calibration of this rapid method and testing parameters for improving quantification of vitamin D from capillary blood specimens is required before integration of it into clinical decision-making pathways. Full article

As the size of the elderly population increases, the need for an improved understanding of what leads to the age-related decline in physiological function continues to grow. SAMP8 mice were selected for their accelerated aging phenotype. The low levels of glyoxalase 1 (Glo1), the main enzyme that removes the reactive dicarbonyl methylglyoxal (MGO), in the cerebral cortex of SAMP8 mice prompted us to produce the first transgenic mice overexpressing Glo1 against the SAMP8 background, aimed at rescuing the accelerated aging phenotype. Selected health and biochemical endpoints were assessed in ten-month-old SAMP8 mice overexpressing Glo1. Glo1 overexpression increased median survival in males (21%) and females (4.6%), which was associated with better memory performance. Glo1 overexpression also increased synaptic markers (synaptophysin and SNAP25) as well as markers of mitochondrial function (NDUFB8, SDHB) and negative modulators of oxytosis/ferroptosis (NQO1, FTH1, and GPx4) in the cerebral cortex. For all parameters analyzed, the effect of Glo1 overexpression was more pronounced in males. Overall, the data support the beneficial effects of overexpressing Glo1 in multiple tissues, especially in SAMP8 males, suggesting a possible gender effect of MGO in aging. Both modulation of oxytosis/ferroptosis and mitochondrial metabolism warrant further investigation as potential mechanisms underlying the improved health span of Glo1 mice. Full article

This paper addresses the problem of optimizing obesity, which has been a challenging issue in the last decade based on recent data revealed in 2024 by the World Health Organization (WHO). The current work introduces a new mathematical model of the dynamics of weight over time with embedded control parameters to optimize the number of obese, overweight, and comorbidity populations. The mathematical formulation of the model is developed under certain sufficient conditions that guarantee the positivity and boundedness of solutions over time. The model structure exhibits inherent symmetry in population group transitions, particularly around the equilibrium state, which allows the application of analytical tools such as the Routh–Hurwitz and Metzler criteria. Then, the analysis of local and global stability of the obesity-free equilibrium state is discussed based on these criteria. Based on the Pontryagin maximum principle (PMP), the deviation from the obesity-free equilibrium state is controlled. The model’s effectiveness is demonstrated through simulation using the Forward–Backward Sweeping algorithm with parameters derived from recent research in human health. Incorporating symmetry considerations in the model enhances the understanding of system behavior and supports balanced intervention strategies. Results suggest that the model can effectively inform strategies to mitigate obesity prevalence and associated health risks. Full article

Background/Objectives: The present study aimed to evaluate the oral health and patient satisfaction of flexible and non-metal clasp dentures (NMCD) compared to removable partial dentures (RPD) using a systematic review. Methods: The PICOS framework of this review was as follows: Do rehabilitations involving flexible dentures or NMCD have a similar success rate to those using RPD? Thus, the PICOS approach involves the following topics: (P) Population/Problem: partial edentulous adult patients; (I) Intervention: patients rehabilitated with flexible dentures or NMCD; (C) Comparison: patients rehabilitated with standard RPD; (O) Outcome: clinical parameters such as oral health, masticatory function, and patient satisfaction; and (S) Study Type: clinical trials and observational studies (cohort, case–control, and cross-sectional). No language restrictions were applied to the studies. The search strategy consisted of the following keywords in different databases: ((flexible) OR (nonmetal) OR (non-metal) OR (thermoplastic)) AND (denture). Only clinical trials and observational studies (cohort, case–control, and cross-sectional studies) from the last 15 years were included, and no language restrictions were applied. Studies that did not describe the denture material were excluded. Results: Of the 2197 potentially relevant records, 14 studies were included in the present review. Two studies reported retrospective results, while twelve reported a prospective evaluation. Considering the thermoplastic materials, five studies evaluated polyester, five polyamides, three polyacetals, and only one study evaluated polyetheretherketone (PEEK). Flexible dentures and NMCD demonstrated similar periodontal status and bone levels on abutment teeth to RPD after up to 12 months. Flexible dentures exhibited a higher degree of redness of the mucosa after 12 months. One study showed a lower maximum bite force for flexible dentures compared to RPD. No study has performed a clinical evaluation of mastication and chewing ability. Conclusions: Despite increased short-term patient satisfaction for flexible dentures and NMCD, there is weak evidence to support a similar clinical performance of flexible dentures and NMCD to RPD. Full article

The uMlazi River receives effluents from wastewater work before feeding the Shongweni Dam. However, local communities are consuming fish from this dam for protein supplements. This study was undertaken to investigate the metal concentrations in the water and sediment, the general health of Coptodon rendalli and Oreochromis mossambicus, and metal bioaccumulation. Sampling was conducted during the dry (July–August) and wet seasons (November and December) in 2021. Water was sampled using acid-pre-treated sampling bottles, whereas sediment was collected using the Van Veen grab at the inflow, middle, and dam wall. Fish were collected, and their tissues were digested using aqua regia. Metal concentrations were measured using inductively coupled plasma optical emission spectroscopy (ICP-OES). This data manuscript reports the physical parameters of the water and concentrations of antimony, arsenic, cadmium, copper, iron, manganese, lead, selenium, and strontium in the water and sediment from the Shongweni Dam. Moreover, the fish morphometric data and metal concentrations observed in the muscle are also presented. This data could be used as baseline information on metal concentrations in the Shongweni Dam. Moreover, it provides insight into the potential impact of wastewater effluents on metal increases in freshwater bodies. Full article