Search Results (49,650)

Objectives: Individuals with type 2 diabetes (T2D) remain at high cardiovascular disease (CVD) risk. The pan-immune-inflammation value (PIV) integrates circulating neutrophils, monocytes, platelets, and lymphocytes but does not capture albumin-related nutritional and inflammatory reserve. We investigated associations between the PIV-to-albumin ratio (PIVA) and incident CVD, cardiovascular mortality, and disease progression in individuals with T2D. Methods: This prospective study included 15,355 UK Biobank participants with T2D and no baseline CVD. PIVA was calculated from peripheral blood cell counts and serum albumin and was natural log-transformed. Fine–Gray competing-risk and cause-specific Cox models were used to evaluate incident CVD and cardiovascular mortality. Multi-state models characterized transitions from T2D to CVD and death. We also examined nonlinear associations, renal biomarker mediation, joint associations with the CVD polygenic risk score and triglyceride–glucose index, sensitivity analyses, and external validation of cardiovascular mortality in the National Health and Nutrition Examination Survey. Results: During median follow-ups of 12.94 years for incident CVD and 14.49 years for cardiovascular mortality, 4829 incident CVD events and 514 cardiovascular deaths occurred. Each 1-unit increase in lnPIVA was associated with higher risks of incident CVD (subdistribution hazard ratio [sHR], 1.140; 95% confidence interval [CI], 1.088–1.194) and cardiovascular mortality (sHR, 1.449; 95% CI, 1.247–1.684). Associations were nonlinear. Higher lnPIVA was also associated with transitions from T2D to CVD, from T2D directly to cardiovascular death, and from incident CVD to cardiovascular death. Cystatin C explained a larger proportion of these associations than creatinine. Elevated lnPIVA identified excess cardiovascular risk across strata of genetic susceptibility and insulin resistance, and the findings were generally supported by sensitivity and external validation analyses. Conclusions: lnPIVA was associated with incident CVD, cardiovascular mortality, and adverse cardiovascular transitions in individuals with T2D. As an immune-inflammatory and albumin-based index, PIVA may help identify high-risk individuals beyond conventional cardiometabolic and genetic risk profiles. Full article

Background and Objectives: Tobacco smoking is associated with an increased risk of depression and anxiety symptoms, but it remains unclear whether this relationship differs according to the type of nicotine product used. The increasing popularity of heated tobacco products has created a need to better understand their association with mental health, particularly in comparison with combustible cigarettes. Therefore, this study aimed to compare the prevalence of depression and anxiety symptoms among combustible cigarette (CC) users, heated tobacco product (HTP) users, and non-smokers. Materials and Methods: A cross-sectional study was conducted among 497 adults. Participants were classified into three groups according to their tobacco-use status: combustible cigarette smokers, heated tobacco users, and non-smokers. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and anxiety symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7). Group differences were evaluated using hierarchical linear regression analyses adjusted for sociodemographic, health, and lifestyle factors. Results: Tobacco-use group significantly improved the model fit for PHQ-9 (ΔR² = 0.0575, p < 0.001) and GAD-7 (ΔR² = 0.0764, p < 0.001). In non-smokers, scores of depression were 3.48 lower than in CC users and 1.42 lower than in the HTP users’ group. In HTP users, these scores were 2.06 lower than in the CC users’ group. Anxiety scores were 3.71 lower in non-smokers than in CC users, and 1.29 lower than in the HTP users’ group. In the HTP users’ group, this score was 2.42 lower than in the CC users’ group. HC3 robust standard errors with 5000-sample BCa bootstrap confidence intervals and reduced-adjustment sensitivity analyses confirmed the primary pattern. Conclusions: Our study results showed that combustible cigarette users had the highest adjusted depression and anxiety scores, HTP users had intermediate scores, and non-smokers had the lowest. In both tobacco-using groups, greater product-specific nicotine dependence was associated with higher PHQ-9 and GAD-7 scores. Further interdisciplinary studies incorporating biomarkers of nicotine exposure, HPA axis function, inflammation, and oxidative stress are needed to clarify whether the observed differences reflect the characteristics of individuals who choose specific tobacco products or are partly attributable to product-specific effects. Full article

Heavy metal contamination in mining-affected groundwater may pose potential risks to drinking water safety and human health. In this study, 25 groundwater samples, including 18 from Aquifer IV of the Cenozoic unconsolidated porous aquifer system and 7 from the Taiyuan Formation limestone karst aquifer, were collected from the Zhuxianzhuang Coal Mine, Huaibei Coalfield, China. The Heavy Metal Pollution Index (HPI), Metal Index (MI), Positive Matrix Factorization (PMF), and oral-ingestion health risk model were applied to assess metal contamination, source contributions, and human health risks. HPI values ranged from 8.0 to 37.5, with a mean of 21.5, indicating a low overall pollution level. In contrast, MI values suggested cumulative metal contamination, with higher mean values in Taiyuan Formation limestone karst groundwater (5.60) than in Aquifer IV groundwater (2.38). PMF identified two major factors, interpreted as a natural water–rock interaction source and a combined anthropogenic and mining-related source. Health risks were consistently higher in Taiyuan Formation limestone karst groundwater. Non-carcinogenic risks were higher for children and mainly controlled by As, whereas carcinogenic risks were higher for adults and mainly associated with Cr. These findings highlight the need for aquifer-specific monitoring and source control to reduce toxic metal exposure in coal mining areas. Full article

Bovine adenovirus (BAdV)-based vectors, particularly those derived from bovine adenovirus 3 (BAdV-3), are emerging non-human adenoviral platforms for veterinary vaccine development. Adenoviral vectors are attractive for vaccination because they mediate efficient transgene expression, remain largely episomal, and induce robust innate and adaptive immune responses. However, widely used human adenoviral vectors, especially human adenovirus 5 (HAdV-5), may be compromised by pre-existing anti-vector immunity, supporting the development of rare human serotypes and non-human adenoviral alternatives. BAdV-3 is the best-characterized BAdV for recombinant vector engineering and has been used to express heterologous antigens from bovine herpesvirus-1, bovine respiratory syncytial virus, influenza virus, and Mycobacterium tuberculosis. Available evidence indicates that BAdV-based vectors can induce humoral, cellular, and mucosal immune responses and support intranasal antigen delivery. Protective efficacy has been demonstrated in selected experimental models, including mice and ferrets for influenza and tuberculosis vaccine candidates, whereas cattle challenge evidence remains more limited and is primarily represented by BHV-1 gD-expressing BAdV-3 vectors. These features make BAdV vectors relevant to bovine respiratory disease control, livestock vaccination, and One Health-oriented vaccine preparedness. Nevertheless, the platform remains at an early developmental stage. Key gaps include limited target-species efficacy data, pre-existing BAdV immunity in cattle, vector shedding, recombination risk, genetic stability, producer cell optimization, manufacturing scalability, and regulatory feasibility. Full article

Diabetes mellitus continues to impose a substantial global health burden, underscoring the need for therapeutic systems capable of achieving precise, adaptive, and patient-friendly glycemic control. Conventional diabetes treatments, including repeated insulin injections and oral hypoglycemic agents, are often constrained by non-physiological drug release, poor adherence, systemic side effects, and the persistent risk of hypoglycemia. In this context, glucose-responsive nanomedicine has emerged as a promising platform for next-generation diabetes therapy by enabling self-regulated and glucose-triggered delivery of insulin and other antidiabetic agents. This review highlights recent advances in glucose-responsive nanomedicine, focusing on the principal sensing mechanisms, including glucose oxidase-based, phenylboronic acid-based, and lectin-mediated systems, as well as the nanoscale carriers engineered to support them, such as polymeric nanoparticles, nanogels, micelles, liposomes, and hybrid nanostructures. These smart platforms offer significant potential to improve drug stability, enhance targeting efficiency, reduce dosing frequency, and more closely mimic endogenous insulin secretion. The review further examines their emerging role in precision diabetes care, particularly in combination with continuous glucose monitoring technologies, wearable devices, and closed-loop therapeutic systems. Despite notable progress at the preclinical level, important barriers to clinical translation remain, including challenges related to biocompatibility, long-term safety, reproducibility, scalable manufacturing, and regulatory approval. Collectively, glucose-responsive nanomedicine represents a rapidly advancing and clinically relevant field with the potential to redefine diabetes management through intelligent and personalized therapeutic strategies. This review provides a focused overview of current developments, key translational challenges, and future directions toward clinical implementation. Full article

Substance use disorders (SUDs) remain a major public health concern and contribute substantially to compromised quality of life, mortality, and healthcare burden. In the United States alone, millions of individuals are affected by alcohol use disorder (AUD), tobacco use disorder (TUD), and opioid use disorder (OUD), with many cases complicated by co-existing anxiety and stress-related disorders. Piper methysticum G. Forst (kava), a traditional South Pacific plant preparation, has gained attention for its anxiolytic, sedative, and sleep-promoting properties. Its pharmacological effects are primarily attributed to a set of lipophilic compounds known as kavalactones, which have been reported to modulate GABA_A receptor activity, dopaminergic and adrenergic signaling pathways, monoamine oxidase-B activity, cannabinoid receptor type 1 activity, and voltage-gated ion channels. Peer-reviewed literature was identified through searches of PubMed, NIH resources, and other scientific databases using terms related to kava, kavalactones, addiction, anxiety, stress, insomnia, and SUDs. Both clinical and preclinical studies were reviewed, including investigations of neurotransmitter systems and addiction-related signaling pathways. The current literature suggests that the strongest rationale for kava use exists in AUD, where anxiety and stress are established contributors to relapse. Evidence supporting kava use in TUD and OUD is largely theoretical, while concerns regarding hepatotoxicity, cytochrome P450 interactions, product variability, and additive risk remain important barriers to its clinical application. In summary, current evidence does not support kava as a replacement for established therapies, while its unique pharmacological profile warrants further investigation as a potential adjunctive treatment for withdrawal and relapse in SUDs. Full article

Vitamin D is a fat-soluble vitamin, considered a prohormone, that plays a fundamental role in calcium absorption and reabsorption, as well as the modulation of inflammatory response in infectious conditions such as COVID-19. A literature search was conducted in scientific databases and official sources, selecting studies published in the last 10 years in Spanish and English related to vitamin D and COVID-19; studies unrelated to the nutritional approach were excluded to reduce bias and ensure a rigorous and reproducible analysis. It was observed that the probability of contracting COVID-19 increases as the D3 hypovitaminosis prevalence increases. In Mexico, the relevance of vitamin D deficiency or supplementation in this disease has been controversial. Some studies claim that vitamin D supplementation could be a protective factor. According to the National Health Survey in Mexico (Ensanut), the Mexican population has significant deficiencies in this vitamin, contributing to an unfavorable diagnosis, particularly for children and pregnant women, as it is considered a deficiency in the blood when it is below 30 ng/mL and insufficiency when below 20 ng/mL, making these deficiencies important risk factors in the development of COVID-19 severe cases. Nevertheless, the use of vitamin D as an adjuvant agent in the treatment of COVID-19 can represent one of the main options for public health, providing therapeutic properties and health benefits. Full article

The overall prevalence of dyslipidemia among adults continues to rise. However, limited attention has been devoted to the association between free sugar intake and dyslipidemia. This study aimed to explore the association between free sugar intake and dyslipidemia, as well as its subtypes, in Chinese adults. A total of 38,656 adults from the Chinese Food Consumption Survey (CFCS) and 3974 from the China Health and Nutrition Survey (CHNS) were included in the final analysis. Dietary intake data were collected by 24 h dietary recalls and the weighing of household foods and condiments. For the CHNS, multivariable Cox proportional hazards regression models were used to examine the association between free sugar intake and the risk of dyslipidemia and its subtypes. Restricted cubic spline (RCS) regression was used to evaluate the nonlinear relationship between free sugar intake and dyslipidemia. Stratified analyses and interaction tests were performed across key covariates to explore potential effect modifiers of the association between free sugar intake and dyslipidemia risk. For the CFCS, the mean free sugar intake among Chinese adults was 6.4 g/d. For the CHNS, a total of 1052 individuals were diagnosed with dyslipidemia, corresponding to an incidence rate of 26.5% during a total of 24,531 person-years of follow-up (median follow-up, 6.0 years) in the CHNS cohort. After multivariable adjustment, the risk of dyslipidemia was increased by 38% with >20 g/d free sugar intake (HR = 1.38, 95% CI: 1.04–1.84, p for trend = 0.006), with <5 g/d free sugar intake as a reference. For different subtypes of dyslipidemia, with <5 g/d free sugar intake as a reference, the risk of hypo-HDL-cholesterolemia and hyper-LDL-cholesterolemia was increased by 91% (HR = 1.91, 95% CI: 1.34–2.74, p for trend < 0.001) and 52% (HR = 1.52, 95% CI: 1.01–2.29, p for trend = 0.004) with > 20g/d free sugar intake, respectively. Stratified analyses demonstrated that the impact of high free sugar intake on the development of hypo-HDL-cholesterolemia and hyper-LDL-cholesterolemia was significantly amplified among urban residents and those with insufficient physical activity. While linear dose–response associations were observed between free sugar intake and the risk of dyslipidemia (p for nonlinearity > 0.05), a nonlinear, inverted U-shaped association emerged for hyper-LDL-cholesterolemia (p for nonlinearity = 0.007). Our study demonstrates that free sugar intake levels in Chinese adults were relatively low compared to the recommended intake level (<50 g/d) in the Chinese Dietary Guidelines 2022. Nevertheless, increased free sugar intake was positively associated with a higher risk of incident dyslipidemia, as well as incident hypo-HDL-cholesterolemia and hyper-LDL-cholesterolemia. Targeted nutrition education is recommended to promote balanced dietary patterns and enhance overall dietary quality, thereby effectively reducing the risk of dyslipidemia. Full article

Autonomous vehicles depend on heterogeneous sensing systems whose performance varies with range, illumination, weather, object material, traffic geometry, contamination, calibration quality, and cyber-physical interference. This PRISMA 2020 and PRISMA-S systematic review synthesized 65 peer-reviewed primary studies selected from 2143 records identified through four databases. After removal of 793 records before screening, 1350 titles and abstracts were screened; 273 full texts were assessed and 208 were excluded with documented reasons. The final evidence base covers cameras, LiDAR, radar, thermal and event cameras, GNSS/IMU localization, calibration, synchronization, multimodal fusion, adverse-weather perception, sensor-health monitoring, and fault-tolerant perception. No modality was universally superior: comparative performance depended on hardware generation, dataset, environmental severity, range, and metric. Direct evidence was strongest for component-level perception and controlled degradation, whereas health-conditioned fusion, ODD restriction, and minimum-risk behavior were supported mainly by partial experimental evidence and safety-oriented synthesis. The review therefore proposes, rather than claims to validate, a reliability-aware architecture that separates sensor health from task confidence, preserves uncertainty and provenance, adapts fusion, and constrains operation when residual evidence is insufficient. The review was retrospectively registered in PROSPERO on 30 July 2026 (CRD420261465869). Full article

Background/Objectives: Older adults residing in long-term care facilities (LTCFs) are at increased risk of poor oral health because of functional dependence and limited access to professional oral healthcare. Although oral healthcare education programs for care workers improve knowledge and performance, evidence of their effects on residents’ biological oral health outcomes remains limited. This study evaluated the effects of a care worker-centered oral healthcare program on oral inflammatory status in LTCF residents using salivary interleukin-1 beta (IL-1β) as an objective biomarker. Methods: A single-group pretest–posttest quasi-experimental study was conducted in two LTCFs in the Republic of Korea. Forty care workers completed a structured oral healthcare education program and provided daily oral healthcare to residents for 4 weeks. Saliva samples were collected before and after the intervention, and salivary IL-1β concentrations were measured using enzyme-linked immunosorbent assay. Changes in IL-1β concentrations were analyzed using the Wilcoxon signed-rank, Mann–Whitney U, and Kruskal–Wallis tests. Results: Thirty-seven residents completed the study. Median salivary IL-1β concentrations significantly decreased from 19.33 pg/mL (interquartile range [IQR], 11.49–34.66) at baseline to 10.78 pg/mL (IQR, 0.65–33.64) after the intervention (Z = −3.764, p = 0.001). Greater reductions were observed among residents with greater functional dependence, whereas limited communication ability or oral care refusal was associated with minimal improvement. Conclusions: A care worker-centered oral healthcare program significantly reduced salivary IL-1β concentrations among older adults residing in LTCFs. Findings support care worker training and highlight the use of salivary IL-1β as an objective biomarker for evaluating oral healthcare interventions. Full article

Coal-fired power plants equipped with selective catalytic reduction (SCR) and wet flue-gas desulfurization (WFGD) can co-control mercury, but performance is limited by incomplete upstream Hg⁰ oxidation and downstream re-emission. This study evaluated a 660 MW unit using gas-, liquid-, and solid-phase measurements and coordinated single-factor and coupled operating tests. Under baseline conditions, SCR Hg⁰ oxidation was 31.66%, WFGD Hg²⁺ capture was 73.79%, and net mercury removal was 31.08%, with a stack Hg^T concentration of 4.70 µg/Nm³. Coupled optimization increased SCR Hg⁰ oxidation to 69.76% and WFGD Hg²⁺ capture to 96.05%, reduced the re-emission index from 0.596 to 0.250, and raised net removal to 70.83%. SCR inlet temperature, equivalent space velocity, and catalyst health were the dominant upstream factors, while S(IV), oxidation–reduction potential (ORP), slurry pH, and oxidation air supply governed downstream stabilization. A practical operating window was identified near 340 °C, with a normalized stoichiometric ratio (NSR) of approximately 1.0, high ammonia injection uniformity, pH of 5.5–6.0, ORP of approximately 200 mV, and S(IV) of approximately 2 mmol/L. The results show that coordinated operation of existing SCR–WFGD equipment can substantially reduce stack mercury without dedicated mercury-control hardware, provided that NH₃ slip, SO₃-related risk, catalyst condition, and absorber stability are simultaneously constrained. Full article

Rising temperatures and the occurrence of heat waves due to climate change can increase the risk of various skin disorders. Moreover, elevated temperatures worsen oxidative damage and inflammation caused by other climate change stressors, such as UV exposure. Consequently, there is growing interest in innovative solutions to protect skin health from the effects of pollution and climate change stressors. Among natural cosmeceuticals, carotenoids are recognized for their antioxidant and anti-inflammatory properties. This study evaluated the thermoprotective effects of Hematococcus lacustris (the microalga formerly called Hematococcus pluvialis) extract (HLE), which is considered the richest natural source of carotenoid astaxanthin, against acute hyperthermia, which mimics the conditions of heat waves. In addition, we separately assessed the effects of HLE against UVA and hydrogen peroxide stress, complementing the antioxidant profile of the extract under study. The evaluation was conducted using in vitro tests on human HaCaT keratinocytes and the nematode Caenorhabditis elegans, which is a model organism sensitive to environmental stressors. The treatment of HaCaT keratinocytes with HLE counteracted the intracellular formation of reactive oxygen species and cytotoxicity induced by hyperthermia, UVA, and hydrogen peroxide exposure. Under the same experimental conditions, HLE also restored the impaired expression of stress-sensitive genes, such as matrix metalloproteinase-1, in HaCaT keratinocytes and promoted wound closure mimicking the process of re-epithelization. Lastly, experiments in C. elegans confirm that HLE reduces heat stress-induced oxidative damage and preserves motility, supporting a systemic protective effect consistent with dietary uptake of the extract. These findings suggest that HLE, rich in carotenoid astaxanthin, can protect keratinocytes against oxidative damage and cytotoxicity induced by thermal stress, indicating its potential role in mitigating thermal aging. Full article

Background/Objectives: Social determinants of health are implicated in metabolic dysfunction–associated steatotic liver disease (MASLD), yet longitudinal evidence on incident disease is scarce, and whether individual- and community-level determinants act independently remains unclear. The objective of this study was to examine whether individual food insecurity and neighborhood deprivation are independently associated with incident MASLD. Methods: In this retrospective cohort of 40,693 U.S. adults without baseline MASLD in the diverse NIH All of Us Research Program, food insecurity (two-item Hunger Vital Sign) and neighborhood deprivation (validated five-domain composite) were co-primary exposures, with incident MASLD ascertained from validated diagnostic codes. Proportional hazards models were adjusted for demographic, socioeconomic, and metabolic factors, including obesity. Results: Over 116,220 person-years, 1240 (3.0%) participants developed MASLD. Both associations remained significant after adjustment for demographic, socioeconomic, and major metabolic risk factors, including obesity (food insecurity adjusted hazard ratio [aHR] 1.32, 95% CI 1.13–1.53; neighborhood deprivation aHR 1.20, 95% CI 1.05–1.37). Unadjusted cumulative incidence was highest among participants with both exposures and lowest among those with neither. Findings were consistent across sensitivity analyses; the food-insecurity association remained when neighborhood disadvantage was specified with a census-based index. Conclusions: Food insecurity and neighborhood deprivation were independently associated with higher incidence of MASLD. Nutrition-focused, equity-oriented interventions warrant evaluation to reduce MASLD burden and advance health equity. Full article

Cervical range of motion (CROM) has been used in research and clinically for assessing cervical health. Gold-standard goniometers tend to be cumbersome. However, Inertial Measurement Units (IMUs) or vision-based alternatives demand frequent calibration and/or costly hardware; moreover, the subject is aware of being measured and there is a risk of breaching privacy. In response, we have developed a non-contact HPNet system for head pose estimation (HPE) that can use a rear-facing camera to quantify CROM accurately. A Re-parameterized Visual Geometry Group (RepVGG)-D2se model is employed as the backbone of the network, and a Spatial Feature Enhancement (SCFE) module is incorporated to improve feature extraction. HPNet was evaluated on the large-scale Carnegie Mellon University (CMU) Panoptic dataset, achieving a mean absolute error (MAE) of 3.48°, 3.22°and 3.34° for yaw, pitch and roll respectively. Inter-instrument reliability was excellent for all six cervical movements when compared with the research/clinical-grade CROM device, with intraclass correlation coefficients (ICCs) averaging 0.939. Bland–Altman plots confirmed close agreement between the two methods. Cervical movement trajectory curves further confirmed the concordance between the clinical device and our method. The system is fully automatic, requires only a rear-facing camera, effectively preserves patient privacy, and provides accurate cervical posture estimation. This technology may provide a basis for future applications in neck-disorder screening, remote health monitoring, and personalized musculoskeletal wellness management, although further task-specific clinical validation will be required. To date, HPNet has been validated primarily on a computer-based platform and has not yet been deployed on smartphones. Future work will focus on model lightweighting, mobile deployment, and cross-device adaptation to facilitate its practical implementation on mobile devices. Full article

Background and Objectives: Sarcopenia and frailty are associated with falls, disability, and functional decline in older adults. This review evaluated traditional Chinese mind–body exercise (TCMBE), including Tai Chi and Health Qigong, in adults aged 60 years or older with clinically defined sarcopenia or frailty. Materials and Methods: Randomized controlled trials identified through December 2024 from six English- and Chinese-language databases were synthesized. The analyses included physical performance and secondary outcomes and explored sarcopenia and frailty as study-level subgroups. Results: Twenty-two trials involving 1660 participants were included. TCMBE was associated with a shorter Timed Up and Go Test time (mean difference [MD], −1.17 s; 95% CI, −1.80 to −0.54; p < 0.01; I² = 74%), a higher Short Physical Performance Battery score (MD, 0.99 points; 95% CI, 0.58 to 1.40; p < 0.01; I² = 24%), and greater grip strength (MD, 2.02 kg; 95% CI, 0.58 to 3.47; p = 0.006; I² = 89%). The 6 min walk test estimate was borderline and imprecise (MD, 11.76 m; 95% CI, 0.10 to 23.43; p = 0.05; I² = 0%), and no clear overall effects were observed for gait speed, the 30 s chair stand test, sit-to-stand time, Berg Balance Scale score, muscle mass, depressive symptoms, or quality of life. Several analyses showed substantial heterogeneity, and some subgroup estimates were based on only one or two studies. Conclusions: Low-certainty evidence suggests that TCMBE may produce small improvements in TUGT performance, SPPB scores, and grip strength. Very-low-certainty evidence leaves its effects on gait speed and quality of life uncertain. Risk-of-bias concerns, heterogeneity, imprecision, and uncertain clinical significance limit confidence in the current estimates. The available evidence is insufficient to support routine implementation, and larger, rigorously conducted randomized controlled trials are needed. Full article