Search Results (5,559)

Background: Plant-based protein supplementation in supporting muscle recovery following resistance exercise remains an area of growing interest, particularly among vegan athletes, as a potential alternative to animal-based proteins. This systematic review aimed to evaluate the effectiveness of plant-based proteins on recovery from resistance exercise-induced muscle damage in healthy young adults. Methods: A systematic and comprehensive search was administered in eight databases up to 1 May 2025, identifying 1407 articles. Following deduplication and screening, 24 studies met the eligibility criteria, including 22 randomized controlled trials and 2 non-randomized studies, with the majority from high income western countries. Results: Interventions primarily involved soy, pea, rice, hemp, potato, and blended plant protein sources, with doses ranging from 15 to 50 g, typically administered post resistance exercise. Outcomes assessed included muscle protein synthesis (MPS), delayed-onset muscle soreness (DOMS), inflammatory biomarkers, muscle function, and fatigue. The review findings reaffirm that single-source plant proteins generally offer limited benefits compared to animal proteins such as whey, particularly in acute recovery settings, a limitation well-documented consistently in the literature. However, our synthesis highlights that well-formulated plant protein blends (e.g., combinations of pea, rice, and canola) can stimulate MPS at levels comparable to whey when consumed at adequate doses (≥30 g with ~2.5 g leucine). Some studies also reported improvements in subjective recovery outcomes and reductions in muscle damage biomarkers with soy or pea protein. However, overall evidence remains limited by small sample sizes, moderate to high risk of bias, and heterogeneity in intervention protocols, protein formulations, and outcome measures. Risk of bias assessments revealed concerns related to detection and reporting bias in nearly half the studies. Due to clinical and methodological variability, a meta-analysis was not conducted. Conclusion: plant-based proteins particularly in the form of protein blends and when dosed appropriately, may support muscle recovery in resistance-trained individuals and offer a viable alternative to animal-based proteins. However, further high-quality, long-term trials in vegan populations are needed to establish definitive recommendations for plant protein use in sports nutrition. Full article

To enhance regional flood control capacity, this study focused on the DX River section in Zhejiang Province. Unmanned vessel bathymetry was employed to obtain precise river cross-section data. A hydrodynamic model was established to simulate flood propagation processes and conduct flood routing analyses. Flood scenarios under 5-year, 10-year, and 20-year return periods were simulated to assess water level variations and overflow risks. The results indicate that under a 5-year flood, 19.5% of the right bank fails to meet flood control standards. This risk intensifies significantly with increasing return periods. Building on these findings, a flood optimal operation model was developed. The resulting coordinated strategy, which lowers the peak water level by 1.2 m during a 20-year flood, is sufficient to prevent overflow at the critical section and enhances regional flood control capacity. This is followed by dynamic gate regulation to match the outflow to the inflow. Dynamic regulation of spillway gates should then be implemented to achieve outflow rates commensurate with the incoming flood magnitude. This study demonstrates a robust workflow from high-resolution data acquisition to actionable operational rules, providing a transferable framework for mitigating flood risks in complex, regulated river systems. Full article

Refugees experience disproportionately high rates of sleep disturbances due to trauma, displacement, and resettlement stressors. Sleep health is critically linked to both physical and mental well-being, yet remains an underexplored area of intervention for refugee populations. This systematic review aimed to (1) identify interventions implemented to improve sleep health among refugees, (2) assess their effectiveness, and (3) evaluate the extent of cultural adaptation in their design and implementation. A comprehensive search of peer-reviewed literature from 2004 to 2024 identified nine studies focused on adult refugees in high-income countries. Interventions included psychoeducation, music-assisted relaxation, guided imagery, and nightmare-focused therapies. Several demonstrated improvements in sleep quality, insomnia severity, and nightmare frequency. Music-based interventions and sleep health education stood out as accessible, non-stigmatizing strategies that may be particularly well suited to refugee contexts. However, cultural adaptation emerged as the most significant gap. Using the 4-Domain Cultural Adaptation Model (CAM4)—which assesses adaptation across context, content, delivery, and engagement—most studies showed only surface-level modifications. Few incorporated community voices, and none validated sleep assessment tools for cultural relevance. Future research should prioritize co-creation with refugee communities to ensure interventions are not only evidence-based, but also culturally grounded, trusted, and sustainable across diverse refugee populations. Full article

This study investigates the production and economic feasibility of biochar for smallholder and family farms in Central Amazonia, with potential implications for other tropical regions. The costs of construction of a prototype mobile kiln and biochar production were evaluated, using small-sized biomass from acai (Euterpe oleracea Mart.) agro-industrial residues as feedstock. The biochar produced was characterised in terms of its liming capacity (calcium carbonate equivalence, CaCO_3eq), nutrient content via organic fertilisation methods, and ash analysis by ICP-OES. Field trials with cowpea assessed economic outcomes, as well scenarios of fractional biochar application and cost comparison between biochar production in the prototype kiln and a traditional earth-brick kiln. The prototype kiln showed production costs of USD 0.87–2.06 kg⁻¹, whereas traditional kiln significantly reduced costs (USD 0.03–0.08 kg⁻¹). Biochar application alone increased cowpea revenue by 34%, while combining biochar and lime raised cowpea revenues by up to 84.6%. Owing to high input costs and the low value of the crop, the control treatment generated greater net revenue compared to treatments using lime alone. Moreover, biochar produced in traditional kilns provided a 94% increase in net revenue compared to liming. The estimated externalities indicated that carbon credits represented the most significant potential source of income (USD 2217 ha⁻¹). Finally, fractional biochar application in ten years can retain over 97% of soil carbon content, demonstrating potential for sustainable agriculture and carbon sequestration and a potential further motivation for farmers if integrated into carbon markets. Public policies and technological adaptations are essential for facilitating biochar adoption by small-scale tropical farmers. Full article

This study estimates the prevalence of co-use of alcohol and cannabis, assesses the sociodemographic risk factors of co-use, and examines the associations between mental health and heavy episodic drinking (HED) and alcohol–cannabis co-use in Canada during the early years of the COVID-19 pandemic. Nine successive cross-sectional surveys, held from May 2020 to January 2022, of adults (aged ≥18 years) living in Canada were pooled for 9011 participants. The prevalence of co-use was calculated across sociodemographic groups. Logistic regressions were used to assess associations. Alcohol–cannabis co-use was associated with a greater likelihood of engaging in HED and experiencing symptoms of anxiety, depression, and loneliness. The prevalence of co-use of alcohol was different across sociodemographic groups. The highest prevalence was among TGD people (35.5%), followed by individuals aged 18–39 years (14.5%). Additionally, being TGD (aOR = 3.61, 95% CI 2.09–6.25), separated/divorced/widowed (aOR = 1.60, 95% CI 1.23–2.07), living in an urban area (aOR = 1.26, 95% CI 1.07–1.56), and having a high household income (aOR = 1.41, 95% CI 1.09–1.82) increased the likelihood of reporting alcohol–cannabis co-use. These findings underscore the fact that developing public health and clinical interventions for preventing and treating excessive alcohol or cannabis use must consider both alcohol and cannabis use patterns and should be tailored to the highest-risk TGD and young adults. Full article

Background: Cervical cancer poses a threat to the health of women globally. Adolescent girls are the primary target population for HPV vaccination, and guardians’ attitude towards the HPV vaccine plays a significant role in determining the vaccination status among adolescent girls. Objectives: This study aimed to explore the factors influencing guardians’ HPV vaccine acceptance for their girls and provide clues for the development of health intervention strategies. Methods: Combining the health belief model as a theoretical framework, a questionnaire-based survey was conducted. A total of 2157 adolescent girls and their guardians were recruited. The multivariable logistic model was applied to explore associated factors. Results: The guardians had a high HPV vaccine acceptance rate (86.7%) for their girls, and they demonstrated a relatively good level of awareness regarding HPV and HPV vaccines. Factors influencing guardians’ HPV vaccine acceptance for girls included guardians’ education background (OR = 0.57, 95%CI = 0.37–0.87), family income (OR = 1.94, 95%CI = 1.14–3.32), risk of HPV infection (OR = 3.15, 95%CI = 1.40–7.10) or importance of the HPV vaccine for their girls (OR = 6.70, 95%CI = 1.61–27.83), vaccination status surrounding them (OR = 2.03, 95%CI = 1.41–2.92), awareness of negative information about HPV vaccines (OR = 0.59, 95%CI = 0.43–0.82), and recommendations from medical staff (OR = 2.32, 95%CI = 1.65–3.25). Also, guardians preferred to get digital information on vaccines via government or CDC platforms, WeChat platforms, and medical knowledge platforms. Conclusions: Though HPV vaccine willingness was high among Chinese guardians, they preferred to vaccinate their daughters at the age of 17–18 years, later than WHO’s recommended optimal age period (9–14 years old), coupled with safety concerns. Future work should be conducted based on these findings to explore digital intervention effects on girls’ vaccination compliance. Full article

The work presents a comprehensive analysis and costing of sugar beet cultivation in 2020–2022, for individual farms of the Lublin region. About 120 farms were analyzed. Based on this analysis, the criteria for a model farm were determined and adopted for the calculation of sugar beet production costs. ARIMA process modeling was performed, based on which forecasts were determined for several selected parameters. Customs tariffs introduced by the USA have a drastic impact on the economy. The effects of the COVID19 pandemic may also have a significant impact on the current market situation. Forecasting in the current geopolitical situation is very difficult because of the lack of stationarity of parameters. The financial result obtained by growers is mainly influenced by indirect costs absorbing 61.31% of total costs in 2020. In 2021 and 2022, indirect costs were 61.16% and 59.61% of production income, respectively. Among this group of costs, the largest share is accounted for by the costs of sowing services, sugar beet harvesting, and soil liming amounting from 14.27% to 15.92%. During the analyzed period, sugar beet cultivation remained profitable, with a production profitability index of 1.31 in 2020 and 2021, and 1.10 in 2022. The unit cost of production increased every year. In 2020, it was 14.27% and in 2021, it increased to 15.19%. The unit cost of production in 2022 was the highest, at 23.41%. Sugar beet cultivation is one of the profitable activities in agricultural production, but it is characterized by high production costs, which increased during the years analyzed (2020 to 2022), topping out at 90.87% of total revenue. The information and data presented in this study will be used in the development of a farmer-oriented application and will support the creation of an expert system for sugar beet growers. Cost forecasting will enable farmers to plan their production more effectively. Full article

Although organizational resilience is well established, refining the systematic quantitative evaluation of health systems resilience (HSR) remains an ongoing opportunity for advancement. Research either focuses on individual HSR indicators, such as social welfare policy, public expenditure, health insurance, healthcare quality, and technology, or broadly examines socio-economic factors, highlighting the need for a more comprehensive methodological approach. This study employed the Slacks-Based Measure (SBM) within Data Envelopment Analysis (DEA) to analyze efficiency by maximizing outputs. It systematically examined key HSR factors across countries, providing insights for improved policymaking and resource allocation. Taking a five-year (2016–2020) dataset that covered 55 to 56 countries and evaluating 17 indicators across governance, health systems, and economic aspects, the paper presents that all sixteen top-ranked countries with a perfect efficiency score of 1 belonged to the high-income group, with ten in Europe, highlighting regional HSR differences. This paper concludes that adequate economic resources form the foundation of HSR and ensure stability and sustained progress. A properly supported healthcare workforce is essential for significantly enhancing health systems and delivering quality care. Last, effective governance and the equitable allocation of resources are crucial for fostering sustainable development and strengthening HSR. Full article

For further investigation of the properties of the muon component in the core regions of extensive air showers (EASs), a new underground hodoscopic set-up with a total sensitive area of 22 m² was built at the Tien Shan High Mountain Cosmic Ray Station. The hodoscope is based on a set of large-sized scintillation charged particle detectors with an output signal of analog type. The installation ensures a (5–8) GeV energy threshold of muon registration and a ∼${10}^4$ dynamic range for the measurement of the density of muon flux. A program facility was designed that uses modern machine learning techniques for automated search for the typical scintillation pulse pattern in an oscillogram of a noisy analog signal at the output of the hodoscope detector. The program provides a ∼99% detection probability of useful signals, with a relative share of false positives below 1%, and has a sufficient operation speed for real-time analysis of incoming data. Complete verification of the hardware and software tools was performed under realistic operation conditions, and the results obtained demonstrate the correctness of the proposed method and its practical applicability to the investigation of the muon flux in EASs. In the course of the installation testing, a preliminary physical result was obtained concerning the rise of the multiplicity of muon particles around an EAS core in dependence on the primary EAS energy. Full article

Molar pregnancy (MP) is a gestational disorder resulting from abnormal fertilization, leading to atypical trophoblastic proliferation and the formation of a complete or partial hydatidiform mole. This condition represents the most common form of gestational trophoblastic disease (GTD) and carries a significant risk of progression to gestational trophoblastic neoplasia (GTN). Although rare in high-income countries, MP remains up to ten times more prevalent in low-income and developing countries, contributing to preventable maternal morbidity and mortality. This narrative review provides an updated, practical overview of the clinical presentation, diagnosis, treatment, and follow-up of MP. A key focus is the challenge of early diagnosis, particularly given the increasing frequency of first-trimester detection, where classical histopathological criteria may be subtle, leading to diagnostic errors. The review innovates by integrating advanced diagnostic methods—combining histopathology, immunohistochemistry using p57Kip2, Ki-67, and p53 markers, along with cytogenetic analysis—to improve diagnostic accuracy in early gestation. The central role of referral centers is also emphasized, not only in facilitating timely treatment and access to chemotherapy, but also in implementing standardized post-molar follow-up protocols that reduce progression to GTN and maternal mortality. By focusing on both advanced diagnostic strategies and the organization of care through referral centers, this review offers a comprehensive, practice-oriented perspective to optimize patient outcomes in GTD and address persistent care gaps in high-burden regions. Full article

The Research Integrity Risk Index (RI²), introduced as a tool to identify universities at risk of compromised research integrity, adopts an overly reductive methodology by combining retraction rates and delisted journal proportions into a single, equally weighted composite score. While its stated aim is to promote accountability, this commentary critiques the RI² index for its flawed assumptions, lack of empirical validation, and disproportionate penalization of institutions in low- and middle-income countries. We examine how RI² misinterprets retractions, misuses delisting data, and fails to account for diverse academic publishing environments, particularly in Indonesia, where many high-performing universities are unfairly categorized as “high risk” or “red flag.” The index’s uncritical reliance on opaque delisting decisions, combined with its fixed equal-weighting formula, produces volatile and context-insensitive scores that do not accurately reflect the presence or severity of research misconduct. Moreover, RI² has gained significant media attention and policy influence despite being based on an unreviewed preprint, with no transparent mechanism for institutional rebuttal or contextual adjustment. By comparing RI² classifications with established benchmarks such as the Scimago Institution Rankings and drawing from lessons in global development metrics, we argue that RI², although conceptually innovative, should remain an exploratory framework. It requires rigorous scientific validation before being adopted as a global standard. We also propose flexible weighting schemes, regional calibration, and transparent engagement processes to improve the fairness and reliability of institutional research integrity assessments. Full article

Background: Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) globally, linked to severe complications such as pelvic inflammatory disease and infertility. In the Brazilian Amazon, socioeconomic vulnerability and the absence of screening policies exacerbate risks, particularly among female sex workers (FSWs). Objective: This study aimed to determine the seroprevalence of anti-C. trachomatis IgG antibodies among FSWs in five municipalities of Pará State, Brazilian Amazon, and identify epidemiological factors associated with infection. Methods: A retrospective cross-sectional study (2005–2007) included 348 FSWs recruited via convenience sampling. Sociodemographic and behavioral data were collected through questionnaires, and blood samples were analyzed by ELISA for anti-C. trachomatis IgG. Statistical analyses included Fisher’s exact tests, odds ratios (ORs), and 95% confidence intervals (CIs), using SPSS 21.0. Results: Overall seroprevalence was 93.9% (327/348; 95% CI: 83.1–90%). Significant associations included a household income of 1–3 minimum wages (98.4%; p = 0.0002), sexual partners from the same region (98.8%; p = 0.0421), and age >42 years (96.3%). Most reported inconsistent condom use (43.7%), multiple monthly partners (54.6%), and illicit drug use (53.4%). Discussion: The extremely high seroprevalence reflects chronic C. trachomatis exposure, driven by socioeconomic deprivation and limited healthcare access. Comparisons with global data underscore the urgent need for screening policies, absent in Brazil for FSWs, and highlight the vulnerability of this population. Conclusions: The findings reveal an alarming burden of C. trachomatis exposure among Amazonian FSWs. Integrated strategies, including routine screening, sexual health education, and inclusion of FSWs in priority health programs, are critical to reduce transmission and associated complications. Full article

Urban heat islands (UHIs) are a growing sustainability challenge impacting public health, energy use, and climate resilience, especially in hot, arid cities like San Antonio, Texas, where land surface temperatures reach up to 47.63 °C. This study advances a data-driven, interdisciplinary approach to UHI mitigation by integrating Machine Learning (ML) with physical and socio-demographic data for sustainable urban planning. Using high-resolution spatial data across five functional zones (residential, commercial, industrial, official, and downtown), we apply three ML models, Random Forest (RF), Support Vector Machine (SVM), and Gradient Boosting Machine (GBM), to predict land surface temperature (LST). The models incorporate both environmental variables, such as imperviousness, Normalized Difference Vegetation Index (NDVI), building area, and solar influx, and social determinants, such as population density, income, education, and age distribution. SVM achieved the highest R² (0.870), while RF yielded the lowest RMSE (0.488 °C), confirming robust predictive performance. Key predictors of elevated LST included imperviousness, building area, solar influx, and NDVI. Our results underscore the need for zone-specific strategies like more greenery, less impervious cover, and improved building design. These findings offer actionable insights for urban planners and policymakers seeking to develop equitable and sustainable UHI mitigation strategies aligned with climate adaptation and environmental justice goals. Full article

Mangoes are an important part of Hainan’s tropical characteristic agriculture. In response to the requirements of building an ecological civilization pilot demonstration zone in Hainan, China, green and sustainable development will be the future development trend of the mango planting system. However, the economic benefits and environmental impact during its planting and management process remain unclear. This paper combines emergy, life cycle assessment (LCA), and economic analysis to compare the system sustainability, environmental impact, and economic benefits of the traditional mango cultivation system (TM) in Dongfang City, Hainan Province, and the early-maturing mango cultivation system (EM) in Sanya City. The emergy evaluation results show that the total emergy input of EM (1.37 × 10¹⁶ sej ha⁻¹) was higher than that of TM (1.32 × 10¹⁶ sej ha⁻¹). From the perspective of the emergy index, compared with TM, EM exerted less pressure on the local environment and has better stability and sustainability. This was due to the higher input of renewable resources in EM. The LCA results showed that based on mass as the functional unit, the potential environmental impact of the EM is relatively high, and its total environmental impact index was 18.67–33.19% higher than that of the TM. Fertilizer input and On-Farm emissions were the main factors causing environmental consequences. Choosing alternative fertilizers that have a smaller impact on the environment may effectively reduce the environmental impact of the system. The economic analysis results showed that due to the higher selling price of early-maturing mango, the total profit and cost–benefit ratio of the EM have increased by 55.84% and 36.87%, respectively, compared with the TM. These results indicated that EM in Sanya City can enhance environmental sustainability and boost producers’ annual income, but attention should be paid to the negative environmental impact of excessive fertilizer input. These findings offer insights into optimizing agricultural inputs for Hainan mango production to mitigate multiple environmental impacts while enhancing economic benefits, aiming to provide theoretical support for promoting the sustainable development of the Hainan mango industry. Full article

Rural roads are critical for connecting isolated communities to essential services such as education and health and administrative services, as well as production and market opportunities in low-income countries. More than 70% of movements of people and goods in Sub-Saharan Africa are heavily reliant on rural transport systems, using both motorised but mainly alternative means of transport. However, rural roads often suffer from poor construction due to the use of low-strength, in situ soils and limited financial resources, leading to premature failures and subsequent traffic disruptions with significant economic losses. This study investigates the use of rice husk ash (RHA), a waste byproduct from rice production, as a sustainable supplement to Ordinary Portland Cement (OPC) for soil stabilisation in order to increase durability and sustainability of rural roads, hence limit recurrent maintenance needs and associated transport costs and challenges. To conduct this study, soil samples collected from Mulungushi, Zambia, were treated with combinations of 6–10% OPC and 10–15% RHA by weight. Laboratory tests measured maximum dry density (MDD), optimum moisture content (OMC), and California Bearing Ratio (CBR) values; the main parameters assessed to ensure the quality of road construction soils. Results showed that while the MDD did not change significantly and varied between 1505 kg/m³ and 1519 kg/m³, the OMC increased hugely from 19.6% to as high as 26.2% after treatment with RHA. The CBR value improved significantly, with the 8% OPC + 10% RHA mixture achieving the highest resistance to deformation. These results suggest that RHA can enhance the durability and sustainability of rural roads and hence improve transport systems and subsequently improve socioeconomic factors in rural areas. Full article