Search Results (29,315)

Telemedicine is increasingly transforming pediatric cardiology by expanding access to specialized care, supporting early diagnosis, and improving longitudinal monitoring of children with cardiovascular disease. This narrative review summarizes current applications of digital health in pediatric cardiology, with emphasis on congenital heart disease, pediatric hypertension, and arrhythmia management. Tele-echocardiography represents one of the most established telehealth tools, enabling remote interpretation of fetal, neonatal, and pediatric echocardiographic images and improving referral appropriateness, particularly in peripheral or resource-limited settings. In infants with complex congenital heart disease, especially those with single-ventricle physiology during the interstage period, home monitoring programs using mobile applications, pulse oximeters, digital scales, and structured caregiver reporting may facilitate early recognition of clinical deterioration and reduce avoidable transfers. In non-congenital cardiovascular disease, home blood pressure monitoring can improve diagnostic accuracy by reducing white-coat effects and supporting repeated measurements in real-life settings. Smartphone-enabled electrocardiographic devices and wearable technologies may enhance detection of intermittent arrhythmias and strengthen outpatient management. Despite these advantages, challenges remain, including data fragmentation, limited pediatric validation of consumer devices, interoperability issues, privacy concerns, and socioeconomic disparities in technology access. Properly integrated telemedicine may promote more timely, equitable, and patient-centered pediatric cardiovascular care. Full article

Bacterial self-healing concrete has emerged as a bio-based strategy to enhance the durability of cementitious materials and reduce the environmental impact associated with premature infrastructure deterioration. Its functional principle relies on microbially induced calcium carbonate precipitation (MICP), through which bacterial metabolism promotes CaCO₃ deposition within cracks. However, self-healing efficiency cannot be explained solely by mineral precipitation capacity. Concrete is a restrictive microbial environment characterized by alkalinity, desiccation, osmotic stress, nutrient limitation and physical confinement. Therefore, effective crack sealing requires a coordinated sequence involving bacterial survival, sporulation, germination, metabolic reactivation, biofilm-associated mineral nucleation and localized biomineralization. This integrative narrative review synthesizes mechanistic, material and biosafety evidence on bacterial self-healing concrete, focusing on spore-forming bacteria such as Bacillus subtilis and related taxa, including Paenibacillus. The evidence indicates that stress tolerance, germination signaling, calcium handling, biofilm establishment and stability, and encapsulation-mediated microenvironmental control are key determinants of performance, but remain insufficiently integrated into materials-oriented studies. Large-scale implementation also requires preventive assessment of strain persistence, genetic stability, horizontal gene transfer, environmental microbiome interactions and life-cycle exposure scenarios. Bacterial self-healing concrete should therefore be understood as a living or bioactive material system whose responsible development depends on the integration of microbiology, molecular biology, materials science, civil engineering, environmental risk assessment, occupational health, and public health. Full article

Plant protein-derived bioactive peptides have attracted increasing interest as potential ingredients for health-promoting functional foods because of their reported cardiometabolic, antioxidant, anti-inflammatory, immunomodulatory, antimicrobial, gastrointestinal, and satiety-related activities. However, the field remains dominated by peptide discovery, in silico prediction, enzyme-inhibition assays, simulated digestion, and preclinical models, whereas successful translation into clinically supported and technologically viable food products is still limited. This review critically examines the gap between mechanistic promise and functional food implementation. It integrates evidence on plant protein sources, peptide-generation strategies, structure–activity relationships, gastrointestinal stability, intestinal transport, local gut activity, food-matrix interactions, processing effects, encapsulation, sensory constraints, human efficacy, regulatory substantiation, commercial feasibility, and consumer acceptance. Particular attention is given to the limited predictive value of isolated in vitro activity when peptides are exposed to digestion, epithelial barriers, complex food matrices, realistic processing conditions, and achievable dietary doses. The review also highlights that systemic absorption is not the only relevant pathway, as selected peptides may act locally within the gastrointestinal tract. Overall, the evidence indicates that peptide discovery should not be treated as the principal endpoint of research. Future progress will require translation-oriented development in which bioactivity, digestion stability, matrix compatibility, sensory quality, manufacturing reproducibility, realistic intake, human evidence, and regulatory credibility are evaluated as interdependent criteria. The most promising plant-derived peptides will therefore be those that retain sufficient activity and acceptability under real conditions of food production and consumption. Full article

Virgin olive oil (VOO) is highly valued for its nutritional, sensory, and health-promoting properties, which are strongly influenced by olive fruit maturity and extraction technology. This study evaluated the combined effects of fruit ripening stage and extraction system on the yield, physicochemical characteristics, bioactive compounds, fatty acid composition, and sensory quality of virgin olive oil obtained from the Jordanian Nabali Baladi cultivar. Olive fruits were harvested at four maturity indices (MI-3, MI-4, MI-5, and MI-6) during the 2024/2025 harvest season and processed using industrial two-phase and three-phase centrifugation systems under identical malaxation conditions (28–30 °C for 45 min). Oil yield, physicochemical quality parameters, total phenolic content, pigment concentrations, fatty acid composition, and sensory attributes were determined using standard analytical methods. Fruit ripening significantly increased oil yield (p < 0.05), reaching 27.80% and 30.00% at MI-6 in the two-phase and three-phase systems, respectively. However, increasing maturity was associated with higher free acidity and peroxide values and with significant reductions in phenolic compounds, chlorophyll, carotenoids, and sensory quality. Oils extracted using the two-phase system consistently exhibited lower acidity, lower peroxide values, and significantly higher concentrations of phenolic compounds than those obtained using the three-phase system. Sensory analysis showed progressive declines in fruitiness, bitterness, and pungency with advancing maturity, particularly in oils produced by the three-phase extraction system. Significant interactions between ripening stage and extraction technology confirmed that oil quality depends on both biological and processing factors. Although delayed harvesting improved oil recovery, it adversely affected the nutritional and sensory quality of virgin olive oil. The two-phase extraction system better preserved bioactive compounds and overall oil quality than the three-phase system. Harvesting olives at intermediate maturity stages (MI-4) combined with two-phase extraction provides the most suitable strategy for achieving an optimal balance between oil yield and quality under Jordanian growing conditions. Overall, this study provides a scientific basis for integrating harvesting and processing decisions within a unified quality-management framework for virgin olive oil production. Full article

This systematic review analysed the role, opportunities and challenges of digital technologies in promoting physical activity among rural children and adolescents aged 10–18. By identifying and analyzing 10 eligible studies across four major databases between June 2016 and June 2026, the research classified the tools used into five categories: behaviour-monitoring technologies (like wearable activity trackers), educational technologies (digital learning platforms), communication and social media technologies, immersive technologies (virtual and augmented reality), and digital health technologies. The implications of these tools were examined in relation to physical education curricula and the development of healthy lifestyles. While the available evidence suggests that these technologies support rural youth by enhancing self-monitoring, increasing health awareness, improving access to educational resources, and creating context-specific opportunities for active engagement, the data reveals that evidence of sustained improvements in moderate-to-vigorous physical activity remains limited. Furthermore, implementation is heavily hindered by barriers such as the digital divide, limited technological infrastructure, inequalities in resource access, and the threat of sedentary behaviours associated with excessive screen time. Consequently, the findings underscore a need for coordinated educational and health strategies, offering practical recommendations to integrate these digital technologies within rural educational settings to foster long-term active lifestyles. Full article

Digital technologies seem to contribute to health promotion and disease prevention, allowing older people to benefit from targeted health interventions supported by digital resources. The current study aimed to develop a substantive theory focusing on the experiences of older people who use smartphone technology daily and its repercussions on healthy aging. This qualitative study employed Charmaz’s constructivist grounded theory approach. Purposeful and theoretical sampling was used to recruit 37 older Brazilian people from a community extension project that integrates nurses who offer personalized guidance and support using smartphone devices. Individual phone-call interviews and reflective journals were conducted between August 2022 and March 2023. Four interrelated theoretical categories emerged: (1) technological progress during the aging process; (2) technological learning using smartphones and participation in virtual groups; (3) expanding social and personal development through smartphone communication; and (4) virtual groups for older people on healthy aging. The core category “Experiencing guided smartphone use as a resource for healthy aging” portrays the individual, social and cultural aspects involved in the habits and attitudes that older people develop to promote independence and quality of life. This study offers valuable insights into the daily use of smartphones by older people, and its repercussions on individual and social issues that bring people and places closer together, expand the social network, and modify communication patterns. The findings indicate that older adults undergo changes and adaptations in their daily lives and in the dynamics of interpersonal relationships, and that using digital applications such as smartphones contradicts the stereotype of fragility or limited understanding associated with aging. The findings can also help with the implementation of policies and practices aligned with a more person-centred care approach. Full article

Aim: To evaluate the effect of a student-generated podcast intervention focused on maternal–child health topics on nursing students’ self-perceived knowledge, educational satisfaction, and gameful engagement. Introduction: Health education is essential for promoting healthy lifestyles and preventing disease, making the acquisition of effective communication skills vital for nursing undergraduates. While digital audio media and podcasts are increasingly popular pedagogical tools, traditional applications rely on passive listening. Student-generated podcast production represents an active learning approach that may enhance engagement, communication skills, and content synthesis. Design: Quasi-experimental study without randomization. Methods: The intervention was conducted across a 4-week framework comprising 8 contact hours of faculty guidance alongside independent teamwork. First-year nursing students organized into small collaborative groups (3–4 peers) received initial training on digital audio pedagogy, metadata, and production. Teams developed 5-to-7-min podcast capsules addressing eight evidence-based maternal–child health themes. Faculty provided structured formative checkpoints for script clinical validation and technical audio editing guidance. All completed podcasts were evaluated using a 100-point rubric assessing scientific accuracy (35%), communication clarity (25%), narrative engagement (20%), and technical quality (20%); thirty top-scoring episodes were selected for public radio broadcasting. Pre-and post-intervention self-administered questionnaires measured self-perceived knowledge across all eight topics, educational satisfaction, and gameful experience via the validated 27-item Gameful Experience Scale (GAMEX). Results: A total of 130 valid questionnaires were analysed at each assessment point. Self-perceived knowledge was higher at the post-intervention assessment across all eight topics (all Holm-adjusted p < 0.001). After Holm correction, general podcast satisfaction (adjusted p = 0.036), fulfilment of expectations (adjusted p = 0.036), recommendation to friends or family (adjusted p < 0.001), perceived importance of podcasting for maternal health (adjusted p = 0.036), and perceived ease of setting up a podcast (adjusted p = 0.005) remained statistically significant. Creative Thinking, Mastery, and the overall GAMEX score were nominally higher before multiplicity adjustment, but none remained statistically significant after Holm correction (adjusted p = 0.126, 0.234, and 0.158, respectively). Conclusions: Student-generated podcasting was associated with higher self-perceived knowledge and favourable appraisal on several educational outcomes. GAMEX differences were exploratory after Holm correction. Full article

Rising rates of obesity and diabetes have increased demand for sugar-free products, while consumers also seek natural colorants and foods offering functional health benefits. Sorghum leaves, an underutilized part of the plant, contain health-promoting polyphenolic compounds with bioactive and coloring properties. Incorporating sorghum leaf-derived polyphenols into foods may meet both producer and consumer interest in natural colorants and value-added ingredients. This study aimed to incorporate sorghum leaf polyphenol extracts into sugar-free gelatin candies. Four formulations were produced: artificial-low color, natural-low color, artificial-high color, and natural-high color candies. Instrumental texture was evaluated using firmness and springiness measurements. Water activity was recorded using a water activity meter. Color was assessed with a colorimeter. Total phenolic content (TPC) was measured using the Folin–Ciocalteu assay. Consumers’ (N = 105) acceptance of sensory properties was evaluated using 9-point hedonic scales, and purchase intent was measured before and after colorant source and sweetener informational messaging. Natural colorant formulations had significantly higher water activity than artificially colored candies. Instrumental firmness and springiness differed significantly (p < 0.05) across formulations. However, these differences did not significantly (p > 0.05) impact consumer texture preference. TPC increased with higher levels of sorghum leaf extract but did not increase bitterness ratings. After receiving educational information about the colorant sources, purchase intent for the naturally colored formulations significantly (p < 0.05) increased, exceeding that of artificially colored candies. These findings demonstrate that sorghum leaf polyphenols can be successfully incorporated into sugar-free gummy candies and are well accepted by consumers as a natural colorant. This work supports sorghum as a value-added food ingredient, creating new market opportunities for US sorghum farmers. Full article

The canine gut microbiome plays a key role in digestive, immune, and metabolic health and is increasingly recognized as an important indicator of overall animal well-being. Medicinal and Aromatic Plants are emerging as a promising approach to support intestinal balance through modulation of the gut microbiome. This pilot study evaluated the effects of Aloe vera, Artemisia annua, and Curcuma longa on the gut microbiome of healthy dogs. The study included eighteen healthy dogs, divided into an Experimental group (n = 9) and a Control group (n = 9). Dogs in the Experimental group received a daily combination of the three plants for 30 days, while Control dogs received microcrystalline cellulose as a placebo. Fecal samples were collected on Day 30 and analyzed using shotgun metagenomic sequencing. Differential abundance analysis revealed an enrichment of taxa associated with short-chain fatty acid production in the Experimental group, including Megasphaera elsdenii, Blautia, Butyricimonas, Bacteroides, and Phascolarctobacterium, together with a reduction in opportunistic and dysbiosis-associated taxa, such as Enterocloster bolteae, Anaerobiospirillum spp., and Stenotrophomonas maltophilia. Functional profiling showed a reduction in pathways related to virulence-associated mechanisms and iron siderophore systems, alongside an increase in pathways associated with GABA and putrescine metabolism and serine endopeptidase activity. Overall, these findings suggest that supplementation with these functional botanical ingredients may promote a more balanced and functionally beneficial gut microbiome in healthy dogs. Full article

Population aging is increasing demand for social services, and natural environments are increasingly recognized as health-promoting resources. Korea has institutionalized forest welfare as a national service system delivered through public facilities and a certified professional workforce. Its linkage with the statutory social service system nevertheless remains at an early stage, with few implementation frameworks grounded in the perspectives of those who would implement such a linkage. This study addressed that gap through a three-stage qualitative design—exploratory focus group interviews (FGIs), in-depth interviews with nine experts across four strata, and a follow-up FGI—with the data analyzed thematically. Experts converged on three target groups—socially isolated youth, middle-aged adults, and social workers—and showed that accessibility, though raised in every stratum, comprised four distinct barriers: psychological and informational, temporal and economic, organizational, and market-related. Social workers further occupied a dual position as both a channel for service dissemination and a population in need of the service. The resulting framework comprises three operational entities—support, delivery, and supply—across four dimensions: user characteristics, delivery system, service operation, and policy environment. Institutional foundations, target-group-differentiated accessibility, interagency collaboration, and a strengthened private supply base were identified as conditions for integration. By showing how a nationally institutionalized forest welfare system can be linked with statutory social services, the framework offers a reference for nature-based provision in other national contexts. Full article

Background/Objectives: Unhealthy diets and poor lifestyle choices can increase athlete’s risk of low energy availability (LEA) and its negative consequences. Conversely, optimal nutrition, such as the Mediterranean Diet (MedDiet), promotes health, recovery, and performance. This study evaluates MedDiet adherence among athletes and physically active individuals, exploring its relationship with nutrition knowledge (NK), dietary intake, eating behaviors, and sleep quality. Methods: This single-center observational study evaluated Italian healthy active adults/athletes (18–65 years) categorized into four performance Tiers. Validated questionnaires analyzed MedDiet adherence (MEDI-LITE), NK (GeSNK), eating behaviour (EAT-26 and TOS), sleep quality (PSQI), and physical activity (IPAQ). Dietary intake was estimated via a 7-day food diary. Body composition (skinfolds/BIVA), and resting energy expenditure (indirect calorimetry) were assessed. Results: Analysis included 169 participants (32.3 ± 11.9 years; 52.7% females; 56.8% Tier 1), practicing 2.0 ± 0.9 sports with 7.1 ± 3.7 h/week of training. Mean MEDI-LITE score was 10.6 ± 2.2 (moderate adherence) across all Tiers and was significantly, positively associated with NK (p = 0.002). Mean EA was 31.3 ± 8.6 kcal/kg FFM/day; sex-specific cut-offs revealed a substantial proportion of high-tier participants with low/suboptimal EA. Eating disorder risk and orthorexic tendencies were low, sleep quality was generally good; none significantly correlated with MEDI-LITE score. Conclusions: Higher NK was positively associated with MedDiet adherence. However, high-tier athletes showed low or suboptimal EA. Targeted nutrition education must integrate MedDiet principles with sport-specific fueling strategies, optimizing diet quality and energy adequacy. Full article

Background: Polypharmacy remains a significant challenge, often leading to adverse drug events and increased healthcare costs. One effective strategy to mitigate these risks is deprescribing, the systematic and intentional discontinuation or reduction of medications. Despite growing recognition of deprescribing’s importance, limited research has examined the impact of interprofessional education interventions on developing deprescribing competencies among healthcare professional students. This study aims to examine the perspectives of healthcare students, including student pharmacists, medical students, and nurse practitioner students, regarding their roles and responsibilities in the deprescribing process. Methods: Following completion of a Deprescribing Interprofessional Education Simulation activity (DIPE-SA), participants were invited to join focus groups. The study included students from the University of Tennessee Health Science Center (UTHSC) Colleges of Medicine, Nursing, and Pharmacy. Constructivist Grounded Theory (CGT) underpinned the qualitative research approach, informing the development of the study framework. Each focus group was facilitated by two researchers and recorded. Recruitment continued until saturation was achieved. Data were transcribed verbatim and analyzed for themes using Dedoose, qualitative analysis software. Results: A total of 19 participants attended four focus groups. Three major themes emerged and guided the development of the Roles–Collaboration–Communication (RCC) interprofessional framework. The first theme, roles, focuses on the unique responsibilities and functions healthcare professionals assume within the team and throughout the deprescribing process. The second theme, collaboration, emphasizes coordinated efforts and shared decision-making among members of the interprofessional healthcare team in deprescribing. Finally, the third theme, communication, highlights the importance of effective information and intention exchange, serving as both a mediator and connector, linking roles and collaboration, and ultimately enabling successful deprescribing. Conclusions: This study’s findings, together with the RCC interprofessional framework, demonstrate the interplay of roles, collaboration, and communication in medication management. The RCC framework highlights the value of dynamic team processes for achieving safe and effective deprescribing, which in turn improves patient care and health outcomes. Full article

Fruits are widely consumed for their rich array of vitamins, minerals, and health-promoting compounds. However, their high perishability due to elevated moisture content often results in significant postharvest losses. To tackle this global challenge, drying represents one of the oldest preservation strategies. In the last decade, advances in drying strategies have led to the emergence of combined drying techniques. This critical review synthesises the existing literature on combined drying techniques for fruit preservation, focusing on publications from the Scopus database. The integration of bibliometric analysis with VOSviewer yielded 67 journal articles and an evaluation of global research trends, geographic contributions, and network visualisation. From a mechanistic perspective, combined drying techniques enhance fruit quality and drying performance while minimising energy consumption and production costs, thereby promoting global sustainability. However, various challenges hamper their broader acceptance, including the high upfront investment, a lack of legislative backing, and technical difficulties that prevent large-scale deployment. This dual approach (bibliometric and systematic review) highlights these challenges and proposes future research directions for combined drying techniques for fruits. Full article

Background: Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive and affective symptoms. Objectives: This study aimed to examine the acute effects of Resistance Training (RT) and Pilates on pain, functional impact, flexibility, and health-related quality of life in individuals with FM. Methods: In this randomized crossover pilot study, eight adults (7 females, 1 male; mean age: 48.5 ± 8.2 years) with a clinical diagnosis of FM participated. Each participant performed both RT and Pilates sessions in a randomized order. Outcomes were assessed at baseline and 24 h post-intervention using the Fibromyalgia Impact Questionnaire (FIQ), the 36-Item Short Form Health Survey (SF-36), the Visual Analog Scale (VAS) for pain, and the Wells sit-and-reach test (WELLS). Data were analyzed using two-way repeated-measures ANOVA and paired t-tests, with effect sizes (η²p and Cohen’s d) and 95% confidence intervals (95% CI). Statistical significance was set at p < 0.05. No formal sample size calculation was performed. Results: Participants presented a mean body mass index (BMI) of 27.4 ± 4.1 kg/m² and time since diagnosis of 6.2 ± 3.1 years. Within-subject variations were observed following both interventions. FIQ scores decreased at 24 h after both RT and Pilates sessions (RT: 52.21 ± 18.61; Pilates: 45.50 ± 18.63; p = 0.038, η²p = 0.42, 95% CI [−12.5, −1.2]). Conclusions: Both Resistance Training and Pilates acutely reduced overall disease impact in individuals with fibromyalgia, with Pilates promoting superior acute gains in posterior chain flexibility. Full article

The interest in dietary prebiotics in rabbit production has increased as a consequence of the search for natural alternatives to antibiotic growth promoters. This study was conducted to evaluate the individual and combined effects of gum Arabic and mannan oligosaccharides on growth performance, physiological health, meat quality and cecal bacterial populations of growing New Zealand White rabbits. Eighty rabbits (5 weeks of age) were randomly allocated to four dietary treatments, for a period of 8 weeks: basal diet (control), basal diet supplemented with gum Arabic (2 g/kg), mannan oligosaccharides (2 g/kg) or their combination (2 + 2 g/kg). The dietary supplementation significantly improved the final body weight, body weight gain, feed conversion ratio, carcass yield, serum protein profile, selected serum biochemical indicators related to hepatic and renal status, lipid profile, antioxidant status, immune response, meat quality and cecal microbial balance as compared to the control group. The combined treatment always produced the best improvements with better growth performance, less abdominal fat, higher antioxidant enzyme activity, higher immunoglobulin concentrations, better water-holding capacity and cooking characteristics of meat, higher populations of beneficial Lactobacillus and lower Escherichia coli counts. The combined treatment produced the most favorable responses for several measured variables, although the magnitude and statistical significance of the response varied among traits. These findings suggest that GA and MOS may have potential as dietary supplements for modulating selected productive, physiological, meat-quality, and cecal bacterial parameters in growing rabbits. Full article