Search Results (17,716)

Background/Objectives: Heart failure is a major global health problem. Among the available treatment options, cardiac resynchronization therapy (CRT) has been shown to improve both quality of life (QoL) and mortality; however, not all patients respond adequately. Our study aimed to identify echocardiographic parameters that predict a positive response to CRT. Methods: A total of 33 patients (10 women and 23 men) were prospectively recruited, all met the standard criteria for CRT implantation. Biochemical, clinical, QoL, 6 min walk test, and echocardiographic evaluations were performed prior to CRT implantation and reassessed after 6 months. A ≥15% reduction in left ventricular end-systolic volume was taken as the defining parameter of positive response. Based on response level, patients were divided into two groups: responders and non-responders. Results: Comparing the overall population before and after CRT, a positive impact was observed on biochemical, electrocardiographic, and echocardiographic parameters. Fourteen patients (42%) were classified as responders and nineteen (58%) as non-responders. Only two basal echocardiographic parameters showed significant baseline differences between groups: Global Longitudinal Strain (GLS) and the Kapetanakis index. ROC curve analysis showed that baseline GLS and Kapetanakis index had excellent discriminative ability for predicting CRT response. Also, binary logistic regression analysis identified the association of GLS and Kapetanakis index with CRT response. Finally, Rho Spearman analysis showed a positive correlation between the degree of response to CRT and the QoL, (ρ) of 0.663 with p = 0.001. Conclusions: Our findings confirm the overall clinical, biochemical, echocardiographic, and QoL benefits of CRT. In addition, two echocardiographic parameters proved to be potential response predictors. Full article

Background: Despite its crucial role in overall health, oral health is frequently overlooked within healthcare systems, partly due to the misconception that oral diseases are neither life-threatening nor directly disabling. This perception has led to an underestimation of the psychological, social, and economic burden associated with oral diseases. Τhe present study aimed to assess oral health status and oral health-related quality of life among dental patients attending a public Special Care Center in Greece. Methods: A cross-sectional study was conducted among 400 dental patients aged 18 years and older who visited a public Special Care Center for a routine check-up or a dental problem between September and October 2024. Data was collected through personal interviews and clinical examinations after informed consent was obtained. Oral health-related quality of life was evaluated using the Oral Health Impact Profile-14 (OHIP-14) and the Oral Impacts on Daily Performance (OIDP) questionnaires. Categorical variables were presented as absolute and relative frequencies, while quantitative variables were summarized as mean, standard deviation, median, minimum, and maximum. Normality was assessed using the Kolmogorov–Smirnov test. Bivariate analyses and multivariate linear regression models were performed, with statistical significance set at p < 0.05. Statistical analyses were conducted using IBM SPSS 23.0. Results: The majority of participants were female (56.3%) with a mean age of 50.4 years (SD = 14.9). Overall oral health-related quality of life was moderate (OHIP-14: Mean = 21.0, SD = 14.8; OIDP: Mean = 14.0, SD = 12.8). Patients who attended the center due to a dental problem reported significantly poorer oral health outcomes than those attending routine check-ups (p < 0.001). Poorer self-rated oral health, having ≥12 missing teeth, prosthetic restoration, and foreign nationality were significantly associated with worse oral health-related quality of life. Conclusions: Dental patients attending the Special Care Center demonstrated moderate oral health status, which was associated with psychological distress, physical disability, and social limitations. These findings underline the need for targeted public oral health interventions, especially for vulnerable population groups. Full article

The massive influx of pelagic Sargassum in the Caribbean poses a serious environmental, social, and economic problem, as the stranded biomass is often treated as waste and deposited in landfills. This literature review synthesizes recent research highlighting its potential for valorization in various industries, turning this challenge into an opportunity. Sargassum has low levels of protein and lipids. Still, it is particularly rich in carbohydrates, such as alginates, fucoidans, mannitol, and cellulose, as well as secondary metabolites, including phenolic compounds, flavonoids, pigments, and phytosterols with antioxidant and bioactive properties. These biochemical characteristics allow for its application in renewable energy (bioethanol, biogas, biodiesel, and combustion), agriculture (fertilizers and biostimulants), construction (composite materials, cement additives, and insulation), bioremediation (adsorption of heavy metals and dyes), and in the health sector (antioxidants, anti-inflammatories, and pharmacological uses). A major limitation is its high bioaccumulation capacity for heavy metals, particularly arsenic, which increases environmental and health risks and limits its direct use in food and feed. Therefore, innovative pretreatment and bioprocessing are essential to mitigate these risks. The most promising approach for its utilization is a biorefinery model, which allows for the sequential extraction of multiple high-value compounds and energy products to maximize benefits, reduce costs, and sustainably transform Sargassum from a coastal pest into a valuable industrial resource. Full article

Depression is a mental illness with hidden characteristics that affects human physical and mental health. In severe cases, it may lead to suicidal behavior (for example, among college students and social groups). Therefore, it has attracted widespread attention. Scholars have developed numerous models and methods for depression detection. However, most of these methods focus on a single modality and do not consider the influence of gender on depression, while the existing models have limitations such as complex structures. To solve this problem, we propose a symmetric-structured, multi-modal, multi-layer cooperative perception model for depression detection that dynamically focuses on critical features. First, the double-branch symmetric structure of the proposed model is designed to account for gender-based variations in emotional factors. Second, we introduce a stacked multi-head attention (MHA) module and an interactive cross-attention module to comprehensively extract key features while suppressing irrelevant information. A bidirectional long short-term memory network (BiLSTM) module enhances depression detection accuracy. To verify the effectiveness and feasibility of the model, we conducted a series of experiments using the proposed method on the AVEC 2014 dataset. Compared with the most advanced HMTL-IMHAFF model, our model improves the accuracy by 0.0308. The results indicate that the proposed framework demonstrates superior performance. Full article

In the context of the rapid growth of the Internet of Things and mobile health services, sensors and smart wearable devices are continuously collecting and uploading dynamic health data. Together with the long-term accumulated electronic medical records and multi-source heterogeneous clinical data from healthcare institutions, these data form the cornerstone of intelligent healthcare. In the context of medical data sharing, previous studies have mainly focused on privacy protection and secure data transmission, while relatively few have addressed the issue of incentive mechanisms. However, relying solely on technical means is insufficient to solve the problem of individuals’ willingness to share their data. To address this challenge, this paper proposes a three-party Stackelberg-game-based incentive mechanism for medical data sharing. The mechanism captures the hierarchical interactions among the intermediator, electronic device users, and data consumers. In this framework, the intermediator acts as the leader, setting the transaction fee; electronic device users serve as the first-level followers, determining the data price; and data consumers function as the second-level followers, deciding on the purchase volume. A social network externality is incorporated into the model to reflect the diffusion effect of data demand, and the optimal strategies and system equilibrium are derived through backward induction. Theoretical analysis and numerical experiments demonstrate that the proposed mechanism effectively enhances users’ willingness to share data and improves the overall system utility, achieving a balanced benefit among the cloud platform, electronic device users, and data consumers. This study not only enriches the game-theoretic modeling approaches to medical data sharing but also provides practical insights for designing incentive mechanisms in IoT-based healthcare systems. Full article

Antibiotic resistance is an escalating global health problem that calls for new types of treatments beyond standard antibiotics. This review examines how targeting bacterial metalloproteins, especially those involved in siderophore-driven iron uptake and manganese-based oxidative defense, could lead to more selective antibacterial drugs that are less toxic to humans. Recent research shows that metals and metal-containing compounds can act as antimicrobials, but many of their biological roles are still not well understood. By synthesizing current evidence, this article critically evaluates translational strategies targeting bacterial metalloproteins. These include siderophore–antibiotic conjugates, metal trafficking inhibitors, and catalytic metallodrugs. The review suggests that therapies using receptor-mediated uptake and guided by genomic data deserve priority in clinical development. The review also highlights unresolved challenges in selectivity, toxicity, and resistance mechanisms, offering a roadmap for future research. This review integrates evidence from multiple databases to provide a comprehensive framework for targeting bacterial metalloproteins, combining narrative synthesis with systematic methodology. Full article

The COVID-19 pandemic highlighted critical issues in health services and public policy, particularly in long-term care facilities across Canada. Failures in these facilities revolving around chronic underfunding, staffing shortages, inadequate infection control, and inconsistent regulatory oversight, underscore the need to rethink health service interventions, especially considering varying implementation contexts among provinces. The Ontario Long-Term Care COVID-19 Commission Final Report pointed to long-standing systemic issues as the primary causes of the sector’s failures. To explore this issue, a narrative review was conducted with findings indicating that the long-term care crisis in Canada cannot be solved by more privatization, regulation or efficiency measures, as these have contributed to the problem’s root causes. Ontario’s long-term care crisis stems from systemic misalignments in policy, structure and stakeholder dynamics, requiring a shift toward systems thinking and resident-centered care to build an equitable and sustainable long-term care sector. Ultimately, governments must lead a policy redesign that reflects shared responsibility, stakeholder interdependence, and public involvement, offering a model for broader healthcare reform. Full article

Background/Objectives: Sexual dysfunction (SD) and broader sexual health problems are common after neurological disorders, yet interventional evidence is fragmented across conditions and outcomes. This umbrella review mapped and appraised systematic review-level evidence on interventions targeting SD and sexual health in neurological populations and qualified conclusions using certainty of evidence. Methods: PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, EBSCOhost, and Scopus were searched from inception to 27 November 2025. Two reviewers screened records, extracted data, assessed review quality with AMSTAR 2, and rated certainty across intervention–outcome pairings using a GRADE-informed approach that integrated review confidence and primary-study risk-of-bias as reported by the source reviews. Results: Twenty-six systematic reviews were included. Overall confidence was frequently limited (17/26 critically low and 6/26 low), with only a small subset rated moderate or higher. Evidence was most coherent for phosphodiesterase type 5 (PDE5) inhibitors improving erectile function in men with spinal cord injury, whereas most other interventions and outcomes were supported by low or very low certainty. Women were represented in 16/26 reviews, yet validated female sexual function outcomes were synthesized in 6/26 reviews and relationship/couple outcomes in 3/26; furthermore, 10/26 reviews restricted inclusion to men, and no review synthesized pediatric intervention trials. Conclusions: Evidence supports PDE5 inhibitors for improving erectile function in men with spinal cord injury, while evidence for other interventions and sexual health domains remains limited. Methodological limitations highlight the need for more inclusive trials, broader standardized outcomes, and longer follow-up within neurorehabilitation pathways. Full article

Sodium chloride is a chemical compound that humans use in large quantities, both for consumption and for applications in many areas. This article aims to present various aspects of salt: production, health, tourism, cultural, environmental, and finally, historical. It mainly discusses the operation of the brine graduation towers—the last ones preserved in the technological line at the salt production plant. The authors aimed to illustrate the advantages and challenges associated with salt and to present solutions to the existing problems. Full article

Background: Children with disabilities and special educational needs show heterogeneous developmental profiles that may be associated with executive functioning and family factors. This study examined functional developmental profiles in primary education and their associations with executive functions, behavioural indicators, and parental mental health. Methods: Participants were 106 children aged 6–12 years attending mainstream schools, including a subgroup with special educational needs. Parents completed the Developmental Profile-3 (DP-3) and a family mental-health record, while teachers completed the Screening of Emotional and Behavioural Problems in Children (SPECI) and Behaviour Rating Inventory of Executive Function-2 (BRIEF-2) based on structured ratings derived from daily interaction with the child. Correlational and regression analyses were conducted. Results: Executive functions—particularly working memory and planning/organisation—were consistently associated with global, adaptive, and social development. Parental overload showed negative associations with several developmental domains. Associations with behavioural indicators were modest. Conclusions: Developmental functioning in children with and without special educational needs is associated with executive functions and family factors as perceived by parents and teachers. Findings should be interpreted as relational and inform future assessment and inclusive educational planning. Full article

Nowadays, the population is subject to a lot of stress, being one of society’s most encountered problems affecting people all over the world. Being under a lot of stress for prolonged periods of time impacts the physical and mental health of individuals with effects on society as an economic burden. Cortisol is one of the main indicators of stress. Long-term exposure to this stress hormone can lead to severe medical conditions such as heart disease, lung issues, obesity, anxiety, or depression. In this context, the current review aims to provide a comprehensive overview of the most recent advances made in the development of versatile and efficient cortisol devices and biosensors capable of monitoring the cortisol levels in biofluids. Lately, both non-plasmonic (polymer-based sensors, optical sensors, electrochemical sensors) and plasmonic sensors (mono- and multiple-metallic nanoparticles-based sensors) have shown great results in cortisol detection. The work focuses on the advantages, remaining restrictions, and limitations in the field of cortisol biosensors from solution-based immunosensors to wearable and Lab-on-Skin monitoring devices, providing a better understanding of the fulfilled requirements and persisting challenges in the accurate detection and monitoring of the cortisol stress hormone. Full article

This paper is concerned with the sexual rights of homeless adolescents. After a brief presentation of the ethical foundation of these rights in the capabilities approach and noting the relevance of the concept of relational autonomy, an ethical analysis of a specific problem is performed, namely the risky sexual behavior of homeless adolescents. It is argued that although these young people have moral agency it is not fully developed and thus they cannot be held to the same standards of responsibility as are adults. Thus, we can see the importance of interventions that empower homeless youth to protect their own sexual health through risk-avoidance or harm reduction strategies. Full article

Background/Objectives: The Korean Survey for Cancer Survivorship (KSCS) aims to comprehensively assess cancer survivors’ health behaviors, quality of life (QoL), and socioeconomic challenges. This study evaluated the feasibility of the KSCS protocol and identified key factors influencing psychological health and QoL among cancer survivors. Methods: The nationwide survey targeted survivors diagnosed with breast, colorectal, liver, lung, stomach, prostate, and gynecological cancers who had completed active treatment within 1 to 10 years. The respondents were given the option to participate in the survey either online or in-person. The questionnaire has 229 questions, including internationally validated tools such as the EQ-5D-3L, PHQ-9, and GAD-7. Results: A total of 983 cancer survivors completed the survey (92.7% online, 8.3% in-person) and were categorized by post-diagnosis duration. Survivors diagnosed within 1–3 years reported higher rates of moderate-severe depression (11.4% vs. 8.3%), moderate-severe anxiety (5.9% vs. 5.1%), and poorest QoL (63.0% vs. 50.9%) compared to those diagnosed more than 5 years ago. Employment changes, such as loss of job, change of workplace, or work leave, were significantly associated with worse health outcomes, including higher rates of moderate-severe depression (OR = 4.39; 95% CI 2.43–7.96), moderate-severe anxiety (OR = 3.63; 95% CI 1.68–0.88), and having extreme QoL problems (OR = 6.37; 95% CI 2.03–20.00). Conclusions: The KSCS protocol is feasible for nationwide implementation and provides comprehensive data on health, psychological, and socioeconomic challenges among cancer survivors. Preliminary findings highlight employment’s critical role in cancer survivors’ well-being and the need for survivorship care that integrates socioeconomic and clinical factors. Full article

As in adults, urolithiasis is a significant health problem in children from an early age, having a very negative impact on health and quality of life and potentially leading to kidney function impairment. The occurrence of deposits in the urinary tract in a child is almost always the result of significant predisposing factors, including metabolic defects involving the kidney or the entire body (often inherited in a Mendelian fashion), urinary tract defects, or urinary tract infections. Among metabolic disturbances, idiopathic hypercalciuria, preceded by hypocitraturia, is the most common one. Any child with nephrolithiasis requires a careful metabolic evaluation, including blood tests, urinalysis, and, in many cases, molecular diagnosis. This narrative review presents the epidemiology, pathophysiology, and diagnostic process in children with nephrolithiasis. Special emphasis is put on pathophysiological pathways leading to metabolic kidney stone disease and metabolic diagnostic steps in children with urolithiasis, as metabolic disturbances are the most common cause of recurrent urolithiasis in Europe and North America. Nephrolithiasis should be treated as a symptom of renal or systemic disorders, and in every child, the cause of these disorders should be sought to prevent recurrence. Full article

Cardiovascular diseases (CVDs) have emerged as a common health problem. However, despite their prevalence, little progress has been made in their treatment. In recent years, neurotrophic factors (NTFs) have been discovered to exert cardioprotective functions for CVDs. NTFs can modulate vascular integrity, myocardial remodeling, angiogenesis, and autonomic regulation, playing the roles of maintaining cardiovascular homeostasis and influencing disease progression. Under pathological conditions, the supplement of NTFs can induce substantial adaptations to mitigate adverse cardiac responses. Several NTFs have been investigated in this regard. This review briefly elaborates on present insights into the expression, signaling pathways, and regulatory effects of NTFs on the development of CVDs, and also discusses emerging therapeutic strategies based on NTFs, ranging from exercise to advanced modalities including stem cell therapy, gene transfer, recombinant protein therapy and NTF mimetics, among which the mimetics and exercise interventions emerge as the most promising avenues for clinical translation. Full article