Search Results (14,667)

The purpose of this narrative review is to examine women’s cognitive health and to highlight its association with four major pillars: (1) aging, (2) estrogen decline and loss, (3) diet, and (4) neuroinflammation, and their contribution to cognitive decline, with a focus on this combination to increase awareness and address the progression and potential amelioration of Alzheimer’s disease (AD). Often overlooked, estrogen decline during perimenopause and loss of estrogen production from the ovaries after menopause negatively influences almost every tissue and organ in the body, including the brain. This estrogen loss leads to inflammation, as can poor nutritional choices, both of which have a profound impact on short- and long-term health and can increase the risk of dementia, including AD. Thus, this overview covers the following four pillars (1) a brief background on cognitive decline and AD with aging, (2) the importance of and changes in estrogen with aging, (3) influence of dietary choices on overall well-being and brain health, and (4) the biochemical and molecular mechanisms by which this combination of factors may lead to neuroinflammation, resulting in cognitive decline and AD. Finally, this review briefly presents a hypothesis on whether women during perimenopause should be administered estrogen to span the transition into menopause to protect against cognitive decline and possibly ameliorate the risk of AD. This article is based on previously conducted studies and does not contain new data/results (studies) of human participants or animals performed by the authors. Full article

Background/Objectives: Federated learning (FL) offers a way for healthcare institutions to collaboratively train machine learning models without sharing sensitive patient data. This systematic review aims to comprehensively synthesize the ethical dimensions of FL in healthcare, integrating privacy preservation, algorithmic fairness, governance, and equitable access into a unified analytical framework. The application of FL in healthcare between January 2020 and December 2024 is examined, with a focus on ethical issues such as algorithmic fairness, privacy preservation, governance, and equitable access. Methods: Following PRISMA guidelines, six databases (PubMed, IEEE Xplore, Web of Science, Scopus, ACM Digital Library, and arXiv) were searched. The PROSPERO registration is CRD420251274110. Studies were selected if they described FL implementations in healthcare settings and explicitly discussed ethical considerations. Key data extracted included FL architectures, privacy-preserving mechanisms, such as differential privacy, secure multiparty computation, and encryption, as well as fairness metrics, governance models, and clinical application domains. Results: Out of 3047 records, 38 met the inclusion criteria. The most popular applications were found in medical imaging and electronic health records, especially in radiology and oncology. Through thematic analysis, four key ethical themes emerged: algorithmic fairness, which addresses differences between clients and attributes; privacy protection through formal guarantees and cryptographic techniques; governance models, which emphasize accountability, transparency, and stakeholder engagement; and equitable distribution of computing resources for institutions with limited resources. Considerable variation was observed in how fairness and privacy trade-offs were evaluated, and only a few studies reported real-world clinical deployment. Conclusions: FL has significant potential to promote ethical AI in healthcare, but advancement will require the development of common fairness standards, workable governance plans, and systems to guarantee fair benefit sharing. Future studies should develop standardized fairness metrics, implement multi-stakeholder governance frameworks, and prioritize real-world clinical validation beyond proof-of-concept implementations. Full article

Background/Objectives: The COVID-19 pandemic exposed global weaknesses in healthcare preparedness and highlighted the pivotal role of the World Health Organization (WHO) in coordinating responses and issuing technical guidance. Among these, the document “Rational use of personal protective equipment (PPE) for COVID-19 and considerations during severe shortages” (December 2020) aimed to standardize PPE use amid global scarcity. This study assessed the awareness, implementation, and perceived usefulness of this WHO guidance among Polish healthcare personnel and evaluated discrepancies between the WHO expectations and workplace realities. Methods: A cross-sectional, anonymous online survey was conducted between July and September 2025 among employees of 243 randomly selected healthcare facilities in Poland (constituting 20% of all hospitals). The original 24-item questionnaire covered the demographics, awareness and implementation of the WHO PPE guidelines, and perceptions of their effectiveness during and after the pandemic. Data were analyzed descriptively. Results: A total of 542 healthcare workers participated, predominantly nurses (56.8%) and physicians (12.2%), with 86.8% being female and 59.3% having over 20 years of experience. Most respondents (76.5%) reported familiarity with the WHO PPE document, and 63.1% confirmed its implementation in their institutions. Over two-thirds (68.0%) reported that the guidelines improved their sense of safety at work. The main barriers to implementation included staff shortages (52.9%) and insufficient local guidance (20.6%). In 2025, 52.3% continue to apply the WHO recommendations, and 70.8% believe they remain relevant in current practice. However, 80.2% indicated that the WHO guidance should be more closely adapted to local conditions. Conclusions: The WHO PPE guidance was widely recognized and reported as implemented by respondents from participating healthcare facilities, contributing to improved preparedness. Nonetheless, limited institutional support and inadequate local adaptation reduced implementation effectiveness. Future WHO recommendations should better align with national healthcare contexts to enhance preparedness for future crises. Full article

Background: Patients with catastrophic health conditions have continuously faced substantial out-of-pocket (OOP) costs for non-covered services despite universal health coverage in South Korea. In 2013, the National Health Insurance Service (NHIS) expanded coverage for four major catastrophic conditions—cancers, cardiovascular diseases, cerebrovascular diseases, and rare illnesses—aiming to strengthen financial protection for patients with catastrophic conditions. However, concerns remain that providers may respond by inducing more use of non-covered services, potentially offsetting reductions in patients’ financial burden. Methods: We evaluated the impact of the 2013 catastrophic coverage expansion on patients’ OOP spending for non-covered services using a quasi-experimental difference-in-differences design. Using nationally representative longitudinal healthcare expenditure data, the Korean Health Panel Survey (KHPS), from 2011 to 2016, we compared patients with the four targeted conditions to a control group with clinically comparable conditions. A two-part model was applied to separately estimate changes in the probability of incurring any non-covered OOP spending and changes in spending levels conditional on positive expenditures. We further examined whether effects differed by supplemental private health insurance (PHI) status. Results: We found that 7.3-, 5.2-, and 7.7-percentage-point decreases in annual probability of incurring any non-covered OOP spending for total, inpatient, and outpatient services, respectively, after policy implementation. Among patients with positive spending, OOP spending for total and inpatient non-covered services decreased by approximately 164 USD and 254 USD per year, while outpatient spending showed no statistically significant change. No statistically significant differential effects were also observed by PHI status. Conclusion: The catastrophic coverage expansion reduced patients’ exposure to and burden of non-covered OOP spending, indicating improved financial protection without evidence of compensatory increases in non-covered service use. These findings suggest that targeted benefit expansions for high-cost conditions can enhance financial equity within universal health systems. Full article

Diabetic foot complications represent a major global health burden and arise from a multifactorial interaction between neuropathy, ischemia, infection, and impaired wound repair. Increasing evidence suggests that, beyond traditional vascular and metabolic risk factors, endocrine dysregulation plays a central role in shaping vascular dysfunction and tissue vulnerability in patients with diabetes. This narrative review provides an updated overview of the endocrine–vascular axis in the development, progression, and healing of diabetic foot ulcers (DFUs), integrating evidence from experimental and clinical studies identified through targeted searches of PubMed, Embase, and Scopus. We examine how alterations in insulin signaling, relative glucagon excess, adipokine imbalance, dysregulation of stress hormones, and thyroid dysfunction interact with chronic hyperglycemia, dyslipidemia, mitochondrial dysfunction, and low-grade inflammation to impair endothelial homeostasis. These disturbances promote oxidative stress, reduce nitric oxide bioavailability, and compromise microvascular perfusion, thereby creating a pro-ischemic and pro-inflammatory tissue environment that limits angiogenesis, extracellular matrix (ECM) remodeling, immune coordination, and effective wound repair. By linking pathophysiological mechanisms to clinical relevance, this review highlights potential biomarkers of endocrine–vascular dysfunction, implications for risk stratification, and emerging therapeutic perspectives targeting metabolic optimization, endothelial protection, and hormonal modulation. Finally, key knowledge gaps and priority areas for future translational and clinical research are discussed, supporting the development of integrated endocrine-based strategies aimed at improving DFU prevention, healing outcomes, and long-term limb preservation in patients with diabetes. Full article

Metabolic associated fatty liver disease (MAFLD), redefined from non-alcoholic fatty liver disease (NAFLD), is a global health concern driving the search for dietary interventions based on natural compounds. Phloroglucinaldehyde (PGA), a primary phenolic metabolite of the widely consumed anthocyanin cyanidin-3-glucoside (C3G) found in berries and other fruits, has emerged as a promising candidate due to its potential higher bioavailability than its parent compound. This study investigates the protective effects of PGA against high-fat diet (HFD)-induced MAFLD. Using both in vitro (LO2 cells) and in vivo (C57BL/6J mice) models, we found that PGA administration significantly attenuated body weight gain and hepatic steatosis, while reducing serum levels of TG, TC, liver transaminases (AST & ALT), and insulin resistance (p < 0.05). Further liver lipidomic profiling revealed that PGA supplementation specifically down-regulated 46 lipid species (p < 0.05), predominantly triglycerides characterized by long-chain and very-long-chain saturated fatty acids. Mechanistically, PGA enhanced the hepatic antioxidant capacity by increasing superoxide dismutase (SOD) activity (p < 0.05) and decreasing malondialdehyde (MDA) (p < 0.05) and exerted anti-inflammatory effects by reducing pro-inflammatory cytokines (IL-6, TNF, MCP-1) (p < 0.05) and endotoxin levels (p < 0.05). Correlation analyses further linked the down-regulated lipids to improvements in oxidative stress and inflammation. Our findings underscore that PGA, a key bioactive metabolite derived from dietary anthocyanins, alleviates MAFLD through its potent antioxidant and anti-inflammatory properties, highlighting its potential as a functional food ingredient or nutraceutical for metabolic health. Full article

Accurately determining actual energy consumption is essential for guiding technological developments in the transport sector, assessing vehicle development outcomes, and designing effective energy and climate policies. Although laboratory driving cycles such as the WLTP provide standardized benchmarks, they do not reflect the complex interactions between human behavior, environmental conditions, and vehicle dynamics under real-world operating conditions. This article presents an integrated framework for assessing long-term, actual energy carrier consumption in four main vehicle categories: internal combustion engine vehicles (ICEVs), hybrid electric vehicles (HEVs), hydrogen fuel cell electric vehicles (H2EVs), and battery electric vehicles (BEVs). The entire discussion here is based on the results of data analysis from natural operation using the so-called vehicle energy footprint. This framework provides a method for determining the average energy carrier consumption for each group of vehicles with the specified drivetrains. This information formed the basis for assessing the total energy demand for the operation of the analyzed vehicle types in normal operation. The simulations show that among mid-range passenger vehicles, ICEVs are the most energy-intensive in normal operation, followed by H2EVs and HEVs, and BEVs are the least. This study highlights the methodological challenges and implications of accurately quantifying energy consumption. The presented method for assessing energy demand in vehicle operation can be useful for manufacturers, consumers, fleet operators, and policymakers, particularly in terms of energy efficiency, emission reduction, and public health protection. Full article

Pesticide residues from agriculture pose persistent threats to ecosystems and human health. Precipitation and surface runoff facilitate the transport of pesticide residues, leading to their subsequent accumulation in lakes and rivers. Microalgae-based bioremediation offers a promising and environmentally friendly approach for degrading and detoxifying these residues. This study employed liquid chromatography–mass spectrometry (LC-MS) to determine pesticide residues in various microalgal solutions. Using three-dimensional excitation-emission matrix (3D-EEM) spectroscopy and fluorescence regional integration (FRI), we quantified the dynamics of dissolved organic matter (DOM) and its relationship with pesticide degradation in the microalgal system. Over time, Tolypothrix tenuis exhibited the highest degradation rate for THX (95.7%), while Anabaena showed the most effective degradation for ATZ (53.8%). Based on structural analysis of degradation products, three potential degradation pathways for THX and ATZ under microalgae action were proposed. Moreover, the degradation process may also involve reactive oxygen species and intracellular enzymes. Hydroxylation and carboxylation were the primary reactions involved in THX degradation, leading to ring opening and subsequent mineralization. In ATZ, the initially removed groups included methyl and carbonyl groups, with the final products undergoing hydroxylation and subsequent mineralization to water and carbon dioxide. This study, conducted within the context of aquatic environmental protection, investigates the threat of pesticide residues to aquatic ecosystems. It further elucidates the associated environmental impacts and degradation mechanisms from a microalgal perspective. Full article

Since the COVID-19 pandemic, wastewater monitoring has become an additional tool in the surveillance of infectious diseases. Many EU countries put wastewater surveillance systems (WSS) in place to track SARS-CoV-2 and its variants and other pathogens, such as the influenza virus or Respiratory syncytial virus (RSV). In Germany, several research and pilot projects funded by the EU, the Federal Ministry of Education and Research, the Federal Ministry of Health, and projects at Federal State level have been launched in the last four years. In Germany, wastewater monitoring was not implemented as a public health tool before the COVID-19 pandemic, but in September 2022, it has been legally determined in the German infection protection act (Infektionsschutzgesetz, IfSG). As Germany is a federal state, competencies in epidemic management partly belong to the 16 federal states (“Länder”). In the federal states, the local health authorities at the county (“Kreise”) level also have specific risk management and communication competencies. Furthermore, WSS has been incorporated into the revised Urban Wastewater Treatment Directive (EU) 2024/3019. For this reason, the federal states and local health authorities play a pivotal role in successfully implementing wastewater monitoring as a supplementary component of disease surveillance in Germany. Between November 2021 and August 2022, the federal state of Thuringia, Germany, supported a pilot study to implement a surveillance system for SARS-CoV-2-RNA in wastewater of 23 wastewater treatment plants in 17 counties in Thuringia. Here, we describe the study design and the system behind the logistics and the planning, and we provide an overview of the options for involving the public health service. Furthermore, the possibilities for IT concepts and approaches to innovative AI solutions are shown. We also aim to explore the feasibility and potential barriers to further implementing wastewater surveillance as a supplementary public health tool in Thuringia. Full article

Sarcopenic obesity, characterized by skeletal muscle loss concurrent with adipose tissue accumulation, has emerged as a global health threat. Exercise is established as an effective intervention; however, the molecular mechanisms underlying its protective effects remain incompletely defined. This study investigated whether exercise mitigates high-fat diet (HFD)-induced sarcopenic obesity, and whether the mechanism was related to the activation of the adenosine monophosphate-activated protein kinase (AMPK)/Acetyl-CoA carboxylase pathway (ACC) pathway and the inhibition of ferroptosis. Cell experiments demonstrated that palmitic acid induced ferroptosis in C2C12 mouse myoblasts. Animal experiments confirmed that HFD promoted skeletal muscle ferroptosis in C57BL/6 mice, evidenced by iron metabolism imbalance (solute carrier family 39 member14 upregulation, ferroportin downregulation), impaired antioxidant capacity (reduced glutathione, superoxide dismutase, glutathione peroxidase 4), and elevated lipid peroxidation (increased malondialdehyde). Meanwhile, both flat treadmill running and uphill treadmill running may reverse these changes by activating AMPK/ACC phosphorylation, reducing non-transferrin iron uptake, enhancing iron export and storage, and improving antioxidant status, jointly inhibiting ferroptosis and attenuating muscle mass loss and lipid deposition. These findings confirm that ferroptosis acts as one of the key pathogenic drivers in sarcopenic obesity and suggests that exercise may improve sarcopenic obesity by activating the AMPK/ACC pathway and inhibiting ferroptosis. This study provides novel mechanistic insights into exercise-mediated regulation of iron-lipid metabolism crosstalk and informs targeted interventions for sarcopenic obesity. Full article

Sustainable diet transitions are required to protect human and planetary health, and consumers are important food systems actors who can foster positive changes. However, little is known about how consumers perceive the concept of sustainable diets. This study explored perceptions of sustainable diets across five high- and middle-income countries: Japan, Indonesia, Italy, Canada, and Mexico. Semi-structured interviews were conducted with 184 young adults (30–45 per country), and transcripts were analyzed using values coding to understand the values, attitudes, and beliefs that shape behaviours related to sustainable diets. Results revealed that defining “sustainable eating” was challenging for participants across all countries. While participants’ values regarding sustainable diets were often context-specific with marked differences across countries, common themes across countries included concern about food waste and packaging and the belief that sustainability should be the responsibility of all actors across the food system, not just the individual. These findings indicate that food policy should address both individual and systemic dimensions of food sustainability, specifically prioritizing strategies for waste and packaging infrastructure. Furthermore, public health strategies must be values-oriented and culturally tailored to ensure they resonate with local consumer priorities. Full article

Although probiotics are widely used in the food industry due to their health-promoting effects, their application is often limited by low stability and poor viability under processing, storage, and gastrointestinal conditions. Encapsulation has emerged as a promising strategy to address these issues, offering enhanced protection and controlled release of probiotic strains. This review summarizes recent advances in encapsulation techniques relevant to food applications, including spray drying, freeze drying, coacervation, and liposome formation, as well as novel approaches such as multilayer nanocoatings and dual-core systems. The use of natural biopolymers such as alginate, chitosan, and pectin, along with food-grade synthetic materials, has greatly improved the stability of probiotics in complex food matrices. Furthermore, emerging technologies such as cell-mediated coatings offer improved resistance to gastric acid and oxygen, enhancing probiotic survival through the gastrointestinal tract. These advances contribute to the development of functional foods with better health benefits. However, challenges remain regarding scalability, strain-specific encapsulation efficiency, and regulatory approval. Future research should focus on optimizing food-grade materials, exploring synergistic effects with bioactive compounds, and ensuring consistent performance across food systems. Full article

Objectives: Postpartum depression is a major global mental health concern, yet epidemiological evidence from the Baltic region remains limited. This study aimed to estimate the prevalence of depressive symptoms among postpartum women attending postpartum outpatient care in Latvia and identify associated sociodemographic and clinical factors. Methods: A cross-sectional study was conducted at the outpatient department of the largest maternity hospital in Latvia from May 2024 to June 2025. All women aged 18 years or older, who attended a routine postpartum gynaecological visit 4 to 6 weeks after delivery and screened positive on the Patient Health Questionnaire-9 (PHQ-9) (≥5 points), completed a sociodemographic and clinical questionnaire and the Edinburgh Postnatal Depression Scale (EPDS). Descriptive statistics were used in the study, and logistic regression was used to examine factors associated with postpartum depressive symptoms. Results: A total of 272 women aged 18 to 49 years (mean age 30.66 ± 5.59) participated. PHQ-9 results indicated that 43.02% of respondents met the threshold for a positive screen (≥5 points) and were included in the further analysis. Using a cut-off EPDS ≥11, the point prevalence of clinically significant depressive symptoms among women who screened positive on the PHQ-9 was 11.4%. In univariate analyses, postpartum depressive symptoms were most strongly associated with comorbid mental disorders (OR = 4.55; 95% CI 1.85–11.18; p = 0.001), caesarean section (OR = 3.05; 95% CI 1.18–7.92; p = 0.022), stress (OR = 2.49; 95% CI 1.04–5.94; p = 0.04) and obstetric complications (OR = 2.78; 95% CI 1.01–7.64; p = 0.048) during pregnancy. In the multivariate model, only three independent predictors remained: comorbid mental disorder (aOR = 9.54; 95% CI 2.72–33.49; p < 0.001) and caesarean section (aOR = 5.80; 95% CI 1.66–20.21; p = 0.006) were associated with higher odds of postpartum depression, while first-time motherhood was associated with a substantially lower likelihood of depressive symptoms (aOR = 0.14; 95% CI 0.04–0.49; p = 0.002). Sociodemographic characteristics, including age, education, employment, and income, were not significant predictors. Conclusions: The point prevalence of clinically significant depressive symptoms among Latvian postpartum women screening positive for depression appears similar to other European settings. Comorbid mental disorders and caesarean section were the strongest predictors of depressive symptoms, while primiparity showed a protective effect. Sociodemographic factors did not independently contribute to risk. As the first study of its kind in Latvia and conducted within a clinical setting that captures a large and diverse proportion of postpartum women, these findings highlight the context-specific nature of postpartum depression and underscore the need for further longitudinal research to inform effective screening and intervention strategies. Full article

Inflammation is strongly related to the development of multiple chronic diseases, such as cardiovascular and autoimmune diseases, and is considered a crucial target for new therapeutic approaches, since it significantly impacts public health, contributes to high mortality rates, and decreases the quality of life. Conventional anti-inflammatory approaches are commonly used, but they present multiple limitations, such as undesirable side effects and low target-specificity. Medicinal plants and their bioactive phytochemical compounds have been studied in recent years and are considered promising alternatives to classical therapies. They are widely recognized for their capacity to modulate inflammatory pathways, regulate inflammatory responses, and consequently reduce inflammation and related symptoms. Although they are considered a good therapeutic alternative, their application in the human body is limited by certain characteristics, such as low solubility, which leads to rapid metabolism and excretion by the organism, significantly reducing bioavailability; for these reasons, the use of medicinal plants remains a biopharmaceutical challenge. Nanotechnology represents a promising tool in this context, since it can improve several characteristics of these compounds. By incorporating plant-derived compounds in nanosystems, considerable advantages, including sustained release, protection from degradation, an increase in the specificity to target tissues, and consequent reduction in toxicity, can be achieved. Thus, nanosystems promote more favorable therapeutic outcomes. This work aims to compile scientific evidence supporting the use of medicinal plants and their bioactive phytochemical compounds, incorporated in nanosystems, in inflammatory disorders. This review enlarges knowledge by integrating both in vitro and in vivo studies involving multiple medicinal plants and bioactive phytochemical compounds, describing their mechanisms of action and the nanosystems employed for drug delivery. In the future, the need for deeper mechanistic studies, the development of targeted and stimuli-responsive systems, and advancement toward clinically translatable, sustainable, and cost-effective plant-based nanotherapies is required. Full article

Volatile organic compounds (VOCs) play a central role in plant communication and ecology, acting as a chemical language that mediates interactions with other organisms and responses to environmental stimuli. Analyzing changes in the plant volatilome enables the effective differentiation between biotic and abiotic stresses. Consequently, monitoring VOC emissions offers valuable insights into plant signaling pathways and health status. These insights position this approach as a promising strategy for improving crop protection. Direct infusion (DI) online analytical techniques, such as proton transfer reaction mass spectrometry (PTR-MS) and adduct ionization mechanism mass spectrometry (AIM-MS), have been developed to detect and characterize VOCs in real time. Here, we evaluated the suitability of PTR-MS and AIM-MS for monitoring VOC emissions in pea plants (Pisum sativum L.). Comparative analysis revealed that AIM-MS, a recently developed technology, detected a higher number of distinct signals than PTR-MS. Annotation of detected and significant AIM-MS signals indicated a predominance toward those that were putative lipids-derived and amino acids-derived, whereas PTR-MS signals were primarily associated with putative phenolic compounds. These findings suggest that the newly developed AIM reactor offers a broader detection range and may enhance our ability to monitor plant VOC emissions. Consequently, AIM-MS emerges as a promising tool for the real-time assessment of pea plant health and stress responses. Further efforts are needed to improve the portability of DI-MS techniques and to integrate them with GC-MS techniques. Overall, these efforts will allow this technology to be exploited for plant protection in compromised environments. Full article