Search Results (1,161)

Background: The paucity of data on the epidemiology of chronic intestinal failure (CIF) in pediatric patients is a matter of particular concern. The objective of this article is to provide a comprehensive description of the epidemiology of CIF in Spain, encompassing its incidence, geographical distribution, underlying causes, and demographic and clinical characteristics. These findings are based on data collected from the multicentre REPAFI registry. Methods: This is a national, multicentre, ambispective cohort study including patients who initiated home parenteral nutrition (HPN) between January 2015 and January 2025. The data collected encompassed various demographic details, underlying diagnoses, the type of HPN utilized, and the nutritional status of the subjects at the commencement of HPN treatment. Results: The study included 163 patients (55.2% male) from 10 hospitals. The principal cause of CIF was short bowel syndrome (SBS) in 77.3% of cases, followed by severe motility disorders (12.9%), congenital enteropathies (CE) (5.5%), and other causes (4.3%). Among patients diagnosed with SBS, necrotizing enterocolitis was identified as the most prevalent underlying cause (32.5%). The most prevalent anatomical configuration was identified as type 2 (jejuno-colic anastomosis). A significant proportion, amounting to 62.7%, exhibited a lack of an ileocecal valve (ICV), while 23% demonstrated a residual bowel length (RBL) of less than 15 centimetres. The median RBL was 35 cm (IQR: 15.7–52.5). Patients diagnosed with SBS exhibited a lower gestational age and birthweight compared with the other groups (p < 0.05). Patients diagnosed with SBS and CE exhibited a lower mean age at the onset of HPN (p < 0.05). Furthermore, patients with CE exhibited the lowest weight-for-age Z-score at the initiation of HPN (p < 0.05). Conclusions: The present study provides the first epidemiological data on the state of pediatric CIF in Spain. The most prevalent cause of CIF was SBS, with a younger age at the initiation of HPN in comparison to other published studies. Patients with CE exhibited the most severe degree of malnutrition at the initiation of HPN. Full article

A combined Differential InSAR (D-InSAR) and Digital Elevation Model (DEM)-based analysis revealed that earthquake-triggered landslides significantly altered river morphology and intensified flooding in the Kota Belud catchment, Sabah, Malaysia. This 1386 km² catchment, home to about 120,000 people, has experienced a marked rise in flood events following the 4 June 2015 and 8 March 2018 earthquakes. Multi-temporal Sentinel-1 Synthetic Aperture Radar (SAR) data and a 30 m Shuttle Radar Topography Mission (SRTM) DEM, complemented by river network information from HydroBASINS, were integrated to map sediment redistribution and model flood extent. Upstream zones exhibited extensive coseismic landslides and pronounced geomorphic disruption. Interferometric analysis showed that coherence was well preserved over stable terrain but rapidly degraded in vegetated and steep areas. Sediment aggradation, interpreted qualitatively from patterns of coherence loss and increased backscatter intensity, highlights slope failure initiation zones and depositional build-up along channels. Conversely, downstream, similar sedimentary adjustments were detected immediately upstream of areas with repeated flood incidents. Between 2015 and 2018, flood occurrences increased over fivefold, and after 2018, they increased by more than thirteenfold relative to pre-2015 conditions. DEM-based inundation simulations demonstrated that channel shallowing substantially reduced conveyance capacity and expanded flood extent. Collectively, these results confirm that earthquake-induced landslides have contributed to reshaping the geomorphology and amplified flooding in the area. Full article

Despite notable progress in reducing childhood morbidity and mortality, achieving Sustainable Development Goal 3 remains a challenge in sub-Saharan Africa, where many children under five die before accessing formal healthcare services. This study explored the roles of the community in the implementation of the Integrated Management of Childhood Illness (IMCI) programme from the perspectives of caregivers and professional nurses. Using an interpretative phenomenological analysis design, 18 participants were purposively selected from four primary healthcare facilities. Data was collected through audio-recorded interviews, transcribed verbatim and analysed using the IPA framework. The findings underscore the critical role of community health workers (CHWs) within the Integrated Management of Childhood Illness (IMCI) framework, particularly in health promotion, child assessments and follow-up home visits. Support from early childhood development educators and community leaders further enhances these efforts. Nurses highlighted mobile health teams as vital for delivering integrated services, though challenges such as limited transport and inadequate training hinder CHWs’ effectiveness. Community-based care offers a cost-effective, accessible model in low-resource settings by leveraging local structures. Strengthening the connection between communities and formal health systems is essential. To sustain IMCI, investment in CHW-led initiatives, including training and logistical support, is recommended to improve service delivery and child health outcomes. Full article

Background: The impact of Long-Term Non-Invasive Ventilation (LT-NIV) on patient-relevant outcomes has yet to be clearly established in types 2 and 3 Spinal Muscular Atrophy (SMA). Objectives: The current study aimed to assess LT-NIV effect(s) on tracheostomy-free survival and the need for hospitalization. Its secondary aim was to identify patient characteristics that can be considered risk factors for an unsatisfactory response to treatment. Design: This study is a retrospective analysis of long-term outcomes in types 2 and 3 SMA patients receiving home LT-NIV. Methods:Patients and interventions: Eighteen types 2 and 3 SMA patients who were receiving home LT-NIV between 1 January 1990 and 31 March 2025 were included. Primary study endpoint: The endpoint comprised a composite of tracheostomy-free survival time and hospitalization rate. Results: Twelve patients (66.7%) had a positive response to LT-NIV (group A); the response was unsatisfactory in the remaining 6 (33.3%) (group B). Tracheostomy-free survival time was significantly reduced in the latter compared to the former [66 (range: 2–172) vs. 280 (range: 67–407) months; p = 0.010] and the hospitalization rate was significantly higher [0.35 (range: 0.06–1.44) vs. 0.07 (range: 0.00–0.18) episodes/yr; p = 0.007]. A correlation was found between an unsatisfactory response to LT-NIV and treatment initiation following an episode of acute respiratory failure (OR: 7.90; 95% CI, 0.99–123.2; p = 0.051). Conclusions: LT-NIV has a positive impact on tracheostomy-free survival and hospitalizations in types 2 and 3 SMA patients. The risk of an unsatisfactory response appears to be higher when the treatment is initiated in clinically unstable patients. Full article

Objectives: This study aimed to evaluate how non-invasive ventilation (NIV) and high-flow nasal cannula therapy (HFT) versus conventional oxygen therapy (COT) affect neural ventilatory drive during exercise in patients with severe chronic obstructive pulmonary disease (COPD). Methods: We conducted an experimental, controlled study with one arm and three different conditions for the same cohort. After initial testing on conventional oxygen therapy (COT), patients exercised under NIV and HFT in sequential days and a random order. Participants: Twenty patients (mean age 60 years old (SD 3.9), 6 female) with severe COPD (30% women) on home NIV as a bridge to lung transplantation were enrolled in this study, with a mean FEV₁ of 19.78% predicted and marked hyperinflation. Protocol: Participants performed constant-load cycling exercises at 75% maximum tolerated workload under three conditions: COT, NIV, and HFT. Neuro-respiratory drive (NRD) was measured using surface parasternal and sternocleidomastoid electromyography, and mixed ANOVA was performed to analyze repeated measures across conditions. Results: In total, 20 patients were included in this study. NIV demonstrated superior performance, with 60% lower NRD compared to COT (488.81 µV vs. 1180.63 µV, p < 0.05). HFT showed intermediate effects (807.8 µV). NIV also achieved greater reduction in respiratory rate (4.2 breaths/min), lower perceived exertion (Borg score decrease: 1.8 points), and more pronounced CO₂ reduction (5.3 mmHg) compared to both COT and HFT. Conclusions: NIV significantly reduces NRD during exercise in severe COPD patients compared to HFT and COT. This supports its use as a valuable adjunct to pulmonary rehabilitation in severe COPD. Full article

A very important issue in urban agglomerations is the proper management of green waste while reducing its negative impact on the environment. One potential solution is the utilization of green biomass—originating from the maintenance of parks, squares, and home gardens—for the production of compost and compost-based pellets as organic fertilizers. The aim of this study was to produce compost-based pellets intended for fertilization purposes from compost derived from green waste and conifer sawdust, and to analyze their mechanical and chemical properties. Ten variants of pellets with different compost-to-sawdust ratios were evaluated. Compost-based pellets exhibited the highest initial mechanical strength; however, their resistance to external loads decreased over time, whereas the best long-term stability was observed in pellets containing 50% sawdust. The seasoning process influenced the stabilization or improvement of the mechanical properties of certain mixtures. Chemical analyses showed that compost-based pellets contained the highest concentrations of nutrients (N, P, K), while increasing the proportion of sawdust reduced their fertilizing value. No exceedances of permissible heavy metal limits were detected. The results confirm the suitability of compost-based pellets made from green biomass as a sustainable alternative to mineral fertilizers, supporting the principles of the circular economy. Full article

Background/Objectives: Urinary incontinence (UI) remains a common and distressing complication following radical prostatectomy (RP). This prospective observational study aimed to assess the effectiveness of structured pelvic floor rehabilitation and to identify clinical and surgical predictors of continence recovery. Methods: A total of 182 patients undergoing RP received standardized physiotherapist-guided pelvic floor muscle training (PFMT), including supervised sessions before and after surgery, as well as individualized home exercise programs. UI severity was evaluated using a 1 h pad test and a four-level UI stage classification at three time points. The primary outcomes were changes in UI stage and the achievement of full continence, defined as a pad test result ≤2 g. Results: Following three rehabilitation sessions, 80.2% of patients regained full continence. Preoperative PFMT (β = −1.27, p = 0.0061) and shorter time to rehabilitation (β = −0.04, p = 0.0026) were associated with greater improvement in continence outcomes. Patients treated with robot-assisted RP showed a higher probability of continence recovery compared to those undergoing laparoscopic RP, particularly in the presence of moderate to severe baseline incontinence. Higher baseline urinary leakage significantly decreased the odds of treatment success (β = −0.01, p = 0.0001). ISUP grade and extraprostatic extension were not independently associated with outcomes. Conclusions: Despite the absence of a control group, this study demonstrates the effectiveness of structured and personalized pelvic floor rehabilitation in improving post-RP continence. Early initiation and preoperative training should be prioritized to optimize recovery in routine clinical practice. Full article

The integration of 3D printers into food production represents an unprecedented innovation, envisaging applications from the industry to missions in space to home cooking, with no geographical or sectoral limits. Extrusion food 3D printers are designed to use ‘food inks’ that must be produced from raw materials possessing a range of suitable characteristics (viscosity, elasticity, and others) that make them printable. Not all food matrices possess such characteristics, and additives are often needed to formulate food inks, which must also adapt to the complexity of the 3D model to be printed. Initially, mainly food matrices such as potatoes, chocolate, cereal, and legume flours and soluble-fiber-rich additives were tested with this new technology, with promising results. In recent years, alternative food matrices (e.g., based on insects, algae, cultured meat, and food waste) have begun to be experimented with, as 3D printing appears to be a suitable way to exploit their potential. This review aims to highlight recent studies that have investigated the development of innovative food ink formulations and trace a picture of the new food raw materials that are being tested for 3D food printing, the opportunities they represent, their nutritional properties, safety, and technological challenges. This review considered a total of 46 papers, selected from 330 papers published in the last 8 years (2018–2025) on the generic subject of 3D food printing. Full article

The aim of this retrospective study was to identify the influencing factors of prolonged evacuation among home-visit psychiatric nursing services patients affected by the 2024 Noto Peninsula Earthquake. We examined the associations between demographic factors, mental illness-related factors, living environment factors, and evacuation status. We also visualized evacuation routes using a geographic information system and analyzed their characteristics. We used data from medical records of patients using a single home-visit psychiatric nursing provider in northern Noto, Ishikawa Prefecture, Japan, an area severely affected by the 2024 earthquake. The study population comprised 115 patients with a mean (standard deviation) age of 53.3 (16.8) years; 64 (55.7%) were women and 51 (44.3%) were men. The median (interquartile range) total number of evacuation days was 208 (192–213) days, and the median (interquartile range) length of stay at the initial shelter was 2.0 (2.0–3.0) days. Binomial logistic regression analysis, adjusted for sex and age, showed that factors associated with prolonged evacuation were an initial shelter stay of <23 days (odds ratio: 3.26, 95% confidence interval: 1.15–9.26; p = 0.026) and the initial shelter being a public shelter (odds ratio: 4.56, 95% confidence interval: 1.49–13.95; p = 0.008). Geographic information system spatial analysis showed that for the three participants with the highest number of evacuations, the total distance traveled (minutes) for evacuation was 884.1 km (678.9 min), 159.0 km (158.8 min), and 36.8 km (54.8 min). These findings suggest that initial evacuation behaviors and shelter selection may significantly affect evacuation duration among home-visit psychiatric nursing patients. Full article

Coming from the “end of the world”, from the south of the planet, Pope Francis first challenged global consciousness with his Encyclical Letter Laudato Si’: On Care for Our Common Home, then turned the attention of the Church and people of good will to the Amazon region. The convening of the Synod of Bishops for the Pan-Amazon Region was an initiative deeply attuned to the climate crisis, one of the most pressing challenges of our time. Faithful to the Second Vatican Council and the spirituality of liberation, Francis invites the whole world to admire and recognize the Amazon region as a sacred mystery as well as to heed the voices of its poor communities, precisely those whose resistance has preserved the rainforest. Using an exploratory bibliographical methodology, this article aims to contribute to the reflection on how 21st-century Liberation Theology might address challenges, with an emphasis on the ecological crisis central to Pope Francis’s magisterium, particularly articulated in his Post-Synodal Apostolic Exhortation Querida Amazonia: To the People of God and to All Persons of Good Will. As a result, we tried to demonstrate that Francis, in Querida Amazonia, proposes that a Church with an Amazonian face, located in the heart of Latin America, without forgetting the feminine protagonism, should be an inspiration for integral conversion on the planet. Full article

The increasing adoption of smart home technologies introduces significant cybersecurity and forensic challenges. This necessitates a shift from traditional reactive digital forensics to a more proactive approach to safeguarding these environments. This research is situated within Saudi Arabia’s ambitious digital transformation, as outlined in Vision 2030, which promotes the development of smart cities and homes. The unique technological landscape and national initiatives in Saudi Arabia require tailored cybersecurity solutions. Existing models are often too theoretical, generic, or overly specialized, lacking practical validation and comprehensive integration for modern IoT ecosystems. There is a pronounced lack of a scalable, validated framework designed explicitly for proactive digital forensic readiness in smart homes. The study employs a mixed-methodology approach, combining a PRISMA systematic literature review with Design Science Research (DSR) to develop and validate the Smart Proactive Forensic Metamodel for Smart Homes (SPFMSH). The developed SPFMSH was tested against realistic cyberattack scenarios, including unauthorized access and intrusion, data exfiltration, and device hijacking by ransomware. In each scenario, the model demonstrated its capability to proactively detect threats, automatically preserve forensic evidence, and provide structured investigative timelines. This validation proved its effectiveness in transforming security incidents into forensically sound investigations within the Saudi smart home context. SPFMSH delivers a practical, holistic framework that addresses the limitations of previous models, moving beyond theory to offer an implementable solution. Its development is a significant step towards enhancing national cybersecurity resilience and supporting the secure adoption of smart home technologies in alignment with Saudi Vision 2030. Full article

Individuals post-stroke commonly experience impairments in upper extremity function that limit participation in valued activities. Task repetitive practice is an effective intervention strategy, but accurately monitoring adherence and movement quality in home programs remains a challenge. This pilot study investigates the reliability and validity of raw accelerometer data captured by a commercially available, wrist-worn activity monitor to assess upper extremity movement in healthy adults during task repetitive practice. Measures of duration, angular velocity, and acceleration were obtained from activity monitors worn by 25 healthy adults performing four functional tasks under varying conditions. Preliminary results indicate moderate to excellent within-session reliability in these three measures when compared across repeated trials of the same task, with one exception. Across all tasks, the duration measure consistently detected differences in exercise time between sets of 5, 10, and 20 repetitions at a comfortable pace. All three measures differentiated between 10 comfortable repetitions and 10 fast repetitions on three out of four tasks. These findings provide initial psychometric properties in a healthy population and further research is required to determine whether these properties remain robust in the presence of motor impairment. This work represents an early step towards developing approaches for monitoring home exercise programs that support stroke recovery. Full article

Background: Hyperphosphorylated tau accumulation and neurofibrillary tangles (NFTs) are hallmarks of tauopathies, including Alzheimer’s disease (AD), and are strongly associated with cognitive decline. The rTg4510 mouse model, which expresses mutant human tau (P301L), develops progressive tauopathy in the absence of amyloid-β pathology, providing a valuable tool for investigating tau-driven neurodegeneration. Previous studies have demonstrated spatial and object-recognition memory deficits at six months of age, which can be prevented by doxycycline (DOX)-mediated suppression of tau expression. However, it remained unclear whether non-spatial hippocampal learning, particularly temporal associative learning, would be similarly affected. Methods: We evaluated six-month-old rTg4510 mice with or without DOX treatment. To control for potential motor confounds, we first assessed spontaneous home cage activity. We then tested hippocampus-dependent non-spatial learning using two paradigms: trace eyeblink conditioning (500-ms trace interval) and contextual fear conditioning. Results: General motor function remained intact; however, rTg4510 mice without DOX treatment exhibited increased rearing behavior. These mice demonstrated significant deficits in trace eyeblink conditioning acquisition, with particularly clear impairment on the final day of training. Contextual fear conditioning showed milder deficits. Analysis of response peak latency revealed subtle temporal processing abnormalities during early learning. Two months of DOX treatment initiated at four months of age prevented these learning deficits, confirming their association with tau overexpression. Conclusions: Our findings demonstrate that rTg4510 mice exhibit deficits in non-spatial temporal associative learning alongside previously reported spatial and object-recognition impairments. Trace eyeblink conditioning serves as a sensitive behavioral assay for detecting tau-related hippocampal dysfunction, and the prevention of learning deficits by DOX treatment highlights its potential utility as a translational biomarker for evaluating tau-targeted interventions. Full article

Background: Displaced individuals endure challenges, including conflict, forced migration, family separation, human rights violations, limited access to essential services, and increased exposure to violence and abuse. These hardships significantly impact their mental health, often leading to heightened trauma-related symptoms. Methods: We used a cross-sectional correlational design in refugee camps, homes, and centers across Jordan and Spain. 200 refugees with confirmed status in the past ten years were recruited. Demographic data were collected via a demographic form, the PTSD-8 Inventory assessed traumatic symptoms, and data analysis included descriptive statistics, independent t-tests, one-way ANOVA, and Chi-square tests. Results: Most participants had a secondary education, were unemployed, and had low incomes. PTSD symptoms were prevalent, with rates of recurrent thoughts (63.5%), re-experiencing events (57.5%), nightmares (50.5%), sudden reactions (56.5%), activity avoidance (53.5%), avoidance of specific thoughts or feelings (56.5%), jumpiness (53.5%), hypervigilance (53.5%), feeling on guard (41.5%), and general avoidance (43.5%) rated from rarely to most of the time. All symptoms were significantly more frequent among refugees in Jordan than in Spain. Conclusions and Recommendations: Intrusive thoughts were more frequent among females, urban residents, and unemployed individuals. Avoidance behaviors were higher in married and unemployed individuals. Hypervigilance was more prevalent among females, married individuals, and those with lower incomes. Regionally, females and married individuals in Jordan exhibited more intrusive thoughts and avoidance. In Spain, intrusive thoughts and hypervigilance were more common among females and the unemployed. The findings highlight the urgent need for targeted mental health interventions, particularly in refugee camps like those in Jordan, where PTSD symptom rates were significantly higher. Programs should prioritize trauma-focused therapies, such as Cognitive Behavioral Therapy, while adopting gender-sensitive approaches to address the heightened vulnerability of women and unemployed individuals. Given the strong link between unemployment and symptom severity, livelihood support and vocational training should be integrated into psychosocial care. Policymakers in host countries like Jordan could benefit from adopting integration strategies similar to Spain’s, which may contribute to lower PTSD prevalence. Additionally, community-based awareness initiatives could improve early symptom recognition and access to care. Future research should explore longitudinal outcomes to assess the long-term impact of displacement and resettlement conditions on mental health. Full article

Reintroduction efforts of wildlife species seek to re-establish self-sustaining populations of targeted species within their historical ranges. Our study focuses on the Indian Grey Hornbill, which faced local extinction in the Gir National Park and Sanctuary, Gujarat, India. The last recorded direct sighting of the Indian Grey Hornbill in the study area dates back to the 1930s. Its presence gradually declined, leading to its eventual extinction in the region between 1950 and 1960. Since the declaration of Gir Forest as a sanctuary in 1965 and subsequently as a national park in 1975, habitat conditions have significantly improved. This positive trend created an opportunity for the reintroduction of the hornbills to establish a self-sustaining population. The reintroduction was conducted in two phases. During the first phase, twenty-eight birds were captured from known hornbill ranges within Gujarat, and five of them were equipped with PTT/GSM satellite transmitters. And in the second phase, twelve birds were captured, and six of them were fitted with PTTs to study their ranging patterns, habitat associations, and potential breeding activities. During the establishment or initial phase of reintroduction, the birds exhibited exploratory behaviour, resulting in larger home ranges (mean ± Standard Deviation, SD) (60.87 ± 68.51 km²), which gradually reduced to smaller home ranges (5.73 ± 10.50 km²) during later stages. Similarly, the daily and monthly distances travelled by the birds were significantly greater in the initial phase than in the later one. Nest site selection correlated significantly with girth at breast height (GBH) and tall trees. Our study provides essential information for hornbill reintroduction in the Gir landscape, aiding future conservation efforts for Indian Grey Hornbills. Full article