Search Results (13,806)

Background: Social media, especially Instagram, spreads nutrition-related information that often lacks scientific rigor. Many women report feeling inadequately informed about women’s health by healthcare professionals, turning to social media, increasing exposure to misinformation. Objectives: The NutriWomen platform aims to assess the quality, methodological soundness, and credibility of nutritional health claims and dietary recommendations on Instagram targeting women across different life stages. Its goal is to develop a systematic and scientifically grounded evaluation framework to assess Instagram nutrition-related claims and the methodological quality and interpretability of their supporting evidence, and to translate the results into accessible outputs that help women make informed nutrition decisions across life stages. Methods: This study follows a five-stage design Stage 1 involves a retrospective content analysis of Instagram posts containing nutrition-related claims targeted at women, identified through the “Top posts” function and screened using predefined criteria. Stage 2 assesses information quality using a validated 14-item tool. Stage 3 evaluates the scientific accuracy of claims by formulating PI(E)CO(TS) questions, selecting key outcomes, retrieving evidence from PubMed and the Cochrane Database, and appraising systematic reviews with a modified AMSTAR-2 tool incorporating GRADE ratings, when available. Stage 4 develops the NutriWomen website platform to translate assessments into accessible visual summaries. Stage 5 conducts a mixed-methods study with peri-, meno-, and postmenopausal women to explore information needs and evaluate platform usability through focus groups. Conclusions: The NutriWomen platform will be the first website to systematically publish the results of evaluations assessing the scientific quality of nutritional health claims on Instagram targeted at women across different life stages. It will provide a replicable methodology, and a digital tool designed to empower women with trustworthy nutrition information, with the potential to enhance health literacy and promote better health outcomes. Full article

Belimumab, a human monoclonal antibody that works against B-cell activating factor (BAFF), has significantly advanced the management of systemic lupus erythematosus (SLE). Beyond the initial Phase III randomised controlled trials (RCTs) that demonstrated efficacy for belimumab as an add-on to non-biological standard therapy (ST) along with a favourable safety profile, more than 50 post hoc analyses of RCT data have provided additional insights into its clinical utility. These analyses have shown uniformly that belimumab increases the likelihood of achieving meaningful reductions in disease activity, sustained low disease activity, and improved health-related quality of life (HRQoL) outcomes, with more pronounced benefits in serologically active SLE. Studies focusing on organ-specific manifestations revealed that belimumab confers benefits across multiple SLE facets, with prominent effects on musculoskeletal and mucocutaneous symptoms. Along the same lines, post hoc analyses of the BLISS-LN trial demonstrated benefit from belimumab regarding multiple renal outcomes, including reduced renal flare rates, improved glomerular filtration rate, and improved histological findings in repeat kidney biopsies. Long-term extension studies and real-world evidence confirm its durable efficacy and safety, with continued reductions in overall disease activity, glucocorticoid use, and healthcare resource utilisation over several years. By exploring different efficacy endpoints, person-centred outcomes, disease trajectories, and characteristics across organ manifestations, this body of post-marketing evidence has not only enhanced our understanding of belimumab use in SLE but also constitutes a comprehensive framework for future clinical trial design and development of novel therapeutic strategies. The present review summarises key findings of post hoc analyses of RCTs and observational studies of belimumab. Full article

Continuous blood pressure (BP) measurement is essential for real-time hypertension management and the prevention of related complications. To address this need, a cuffless BP estimation technique utilizing biosignals from wearable devices has gained significant attention. This study proposes a feasibility approach that integrates microneedle array electrodes (MNE) for ECG acquisition with photoplethysmogram (PPG) sensors for cuffless BP estimation. The algorithm employed is a baseline multivariate regression model using PTT and RR intervals, while the novelty lies in the hardware design aimed at improving signal quality and long-term wearability. The algorithm’s performance was validated using the Medical Information Mart for Intensive Care (MIMIC) database, achieving a mean error range of ±5.28 mmHg for the SBP and ±2.81 mmHg for the DBP. Additionally, the comparison with 253 measurements from three volunteers against an automated sphygmomanometer indicated an accuracy within ±25%. Therefore, these findings demonstrate the feasibility of an MNE-based ECG with PPG for BP integration for cuffless monitoring of SBP and DBP in daily life. The MIMIC-based evaluation was performed to verify the feasibility of the regression model under ideal public-database conditions. The volunteer experiment, performed with the developed MNE-ECG hardware, served as a separate preliminary feasibility test to observe hardware behavior in real-world measurements. Full article

In response to the growing complexity and uncertainty in real-world decision-making, this study introduces a novel framework based on the polytopic fuzzy tensor (PFT) model, which unifies the geometric structure of polytopes with the representational power of fuzzy tensors. The PFT framework is specifically designed to handle high-dimensional, imprecise, and ambiguous information commonly encountered in multi-criteria group decision-making scenarios. To support this framework, we define a suite of algebraic operations, aggregation mechanisms, and theoretical properties tailored to the PFT environment, with comprehensive mathematical formulations and illustrative validations. The effectiveness of the proposed method is demonstrated through a real-world application involving the evaluation of six pancreatic cancer treatment strategies. These alternatives are assessed against five key criteria: quality of life, side effects, treatment accessibility, cost, and duration. Our results reveal that the PFT-based approach outperforms traditional fuzzy decision-making techniques by delivering more consistent, interpretable, and reliable outcomes under uncertainty. Moreover, comparative analysis confirms the model’s superior ability to handle multidimensional expert evaluations and integrate conflicting information. This research contributes a significant advancement in the field of fuzzy decision science by offering a flexible, theoretically sound, and practically applicable tool for complex decision problems. Future work will focus on improving computational performance, adapting the model for real-time data, and exploring broader interdisciplinary applications. Full article

Background: The Transformative, Resilient, and Youth-Led/Driven (TRY) Gym, a school-based co-creative mental health training programme, is grounded in the Positive Youth Development (PYD) approach. It seeks to improve adolescents’ mental health and well-being by strengthening their resilience and competence. Additionally, it prepares them to deliver peer-led mental health activities, promoting mental wellness and fostering a stigma-free, supportive environment. Methods: This study evaluated the programme using a mixed-method design. In total, 94 students from eight secondary schools in Hong Kong were recruited, with 80 participating in the evaluation. Results: Five outcomes showed significant improvements from baseline to the post-implementation phase, including social competence, cognitive competence, emotional competence, resilience, and mental well-being. Common features were identified across interviews, which may possibly account for the significant results and participants’ improved mental health. Conclusions: The TRY Gym programme’s fidelity was demonstrated by its completion, which included high participant responsiveness, and a co-creative and youth-driven approach in the project. In addition, the positive outcomes of the programme underscore its effectiveness in improving mental health among adolescents by imparting mental health knowledge and providing opportunities for participants to apply learnt techniques in everyday life situations. Full article

Intangible cultural heritage (ICH) is deeply embedded in everyday social life, yet its officially recognized spatial distribution reflects both the independent influences of cultural traditions, development trajectories, and governance practices, and the complex interactions among them. Focusing on 494 national-level ICH items across ten categories in Jiangsu(J), Zhejiang(Z), and Shanghai(H), this study adopts a social-geographical perspective to examine both the spatio-temporal evolution and the driving mechanisms of ICH recognition in one of China’s most developed regions. After rigorous verification of point-based ICH locations, we combine kernel density estimation and the average nearest neighbor index to trace changes across five batches of national designation, and then employ the univariate and interaction detectors of the Geodetector model to assess the effects of 28 natural, socioeconomic, and cultural-institutional variables. The results show, first, that ICH exhibits significant clustering along river corridors and historical cultural belts, with a persistent high-density core in the Shanghai–southern Jiangsu–northern Zhejiang zone and a clear shift over time from highly concentrated to more dispersed and territorially balanced recognition. Second, human-environment factors—especially factors such as urban and rural income and consumption; residents’ education and cultural expenditures; and public education and cultural facilities—have far greater explanatory power than natural conditions, while different ICH categories embed distinctively in urban and rural socio-economic contexts. Third, bivariate interactions reveal that natural and macroeconomic “background” variables are strongly amplified when combined with demographic and cultural factors, whereas interactions among strong human variables show bivariate enhancement with diminishing marginal returns. In summary, these findings enrich international debates on the geography of ICH by clarifying how recognition processes align with regional development and social equity agendas, and they provide a quantitative basis for category-sensitive, place-based strategies that coordinate income policies, public cultural services, and the joint safeguarding of tangible and intangible heritage in both urban renewal and rural revitalization planning. Full article

This study presents a cradle-to-grave Life Cycle Assessment (LCA) and cost analysis of next-generation low-temperature district heating networks based on water-condensed electric booster heat pumps. The research, conducted within the ENEA Portici Research Center framework, evaluates multiple case studies to assess environmental and economic sustainability. The system boundaries include heat generators (geothermal heat pump, solar thermal, and photovoltaic–thermal hybrid), network configurations (tree vs. ring), supply temperatures (25 °C vs. 45 °C), and renewable electricity shares (0–100%). Environmental impacts were quantified using the Environmental Footprint 3.1 method, focusing on key indicators such as climate change, resource use, and human toxicity. The results show that supply temperature is a critical factor: 45 °C scenarios lead to notably higher impacts, while network configuration has only marginal effects. Among generation technologies, the photovoltaic–thermal system proved the most sustainable, despite higher investment costs, whereas the solar thermal system displayed the largest environmental burden but lower costs. Geothermal systems showed intermediate performance, with notable impacts from mineral resource use. Renewable electricity integration consistently improved environmental outcomes, reducing climate change impacts by up to 10%. Storage system comparison revealed lithium iron phosphate (LFP) batteries as the most advantageous solution for electrical storage, and phase-change materials (PCM), particularly Rubitherm15, as the most environmentally favorable option for thermal storage, although traditional water tanks remain more cost-effective. Overall, the study highlights the crucial role of renewable integration and temperature optimization in enhancing the eco-efficiency of low-temperature district heating networks, providing guidelines for future sustainable design and deployment. Full article

Background/Objectives: The ReCODE (Reversal of Cognitive Decline) protocol, a precision medicine program for patients with Alzheimer’s disease (AD), has demonstrated promising results in improving cognitive function. However, its impact on mood, specifically depressive symptoms, has been less explored. Depression is highly prevalent in individuals with mild cognitive impairment and AD, shares common risk factors (e.g., systemic inflammation), and negatively affects quality of life and disease trajectory. This study evaluated whether participation in the ReCODE program is associated with measurable improvement in depressive symptoms, as assessed by the Patient Health Questionnaire-9 (PHQ-9). Methods: This retrospective, observational analysis utilized de-identified data from 170 individuals diagnosed with mild to moderate AD enrolled in the ReCODE program. Participants received initial consultations and program orientation. Follow-up visits occurred 31 days post-enrollment, including further guidance on diet, lifestyle, medications, and supplements, along with mood assessment using the PHQ-9. Pre- and post-intervention PHQ-9 scores were analyzed using the non-parametric Wilcoxon signed-rank test. Results: Participants showed a statistically and clinically significant reduction in PHQ-9 scores. Improvement was observed across all baseline depression categories (mild, moderate, and severe). Critically, the proportion of participants scoring above the clinical threshold for depression decreased substantially following the intervention. Conclusions: These findings suggest that the ReCODE precision-medicine framework offers concurrent benefits for both mood and cognition. Extending prior work, our results indicate that the ReCODE program not only benefits cognitive and biological measures but also significantly alleviates depressive symptoms. While the results highlight ReCODE’s potential as a successful multifaceted therapeutic approach addressing both cognitive decline and mental health in Alzheimer’s disease, given the retrospective, uncontrolled design, the findings should be interpreted as associative and hypothesis-generating rather than causal. Full article

Background: Survival among children and adolescents and young adults (AYA) with cancer has improved substantially over recent decades; however, dominant survivorship models remain reactive—activated post-treatment and anchored to static exposure- and organ-based screening. This design underuses the anticipatory window at diagnosis and overlooks environmental and social determinants that modulate outcomes across the life course. Methods: We narratively reviewed international frameworks including the Children’s Oncology Group (COG), the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG), the Pan-European Network for Care of Survivors after Childhood and Adolescent Cancer (PanCare) and the National Comprehensive Cancer Network (NCCN), and synthesized evidence on environmental determinants, exposomics, toxicogenomics, and implementation. Building on two decades of real-world practice, we describe the evolution from the Pediatric Environmental History (PEHis) to the Ambiomic Health Compass (AHC), integrating genomic, exposomic, geospatial, clinical, and biomonitoring layers into routine care. In this framework, survivorship is conceptualized as beginning at the time of cancer diagnosis (“day 0”). Results: PEHis operationalizes guideline-based care with structured environmental and social assessment, personalized plans, and community integration, contributing to improved survival, healthier behaviors, reduced treatment-related mortality and stronger oncology–primary-care coordination. AHC extends PEHis with dynamic risk recalibration, contextual alerts, targeted biomonitoring, and toxicogenomic interpretation, enabling anticipatory decisions from day 0. The manuscript summarizes the paradigm shift (current vs. Ambiomic models), the domain-specific expansion over existing guidelines, the core clinical/system tools, and time-bound metrics (12, 24, 60 months) to support implementation and evaluation. Conclusions: Survivorship should move upstream—from late surveillance to ambiomic, exposure-aware care beginning at diagnosis. Integrating advanced exposomics, mutational epidemiology, and explainable analytics can reduce preventable events and chronicity, enhance equity, and align pediatric oncology with planetary health. The PEHis–AHC continuum offers a scalable blueprint for next-generation survivorship programs in Europe and beyond. Ambiomic medicine does not replace precision medicine—it completes and extends it by integrating exposomics, social context, and anticipatory analytics from day 0. Full article

Smart Manufacturing Systems (SMSs) have evolved into intelligent, data-driven ecosystems that integrate cyber–physical systems, digital twins, and artificial intelligence to enhance efficiency, sustainability, and resilience. This review synthesises more than 250 recent studies across four domains: manufacturing technologies, systems management, sustainable production, and human–robot collaboration. In process optimisation, hybrid machine learning and genetic algorithms reduce surface roughness in machining by up to 35% and decrease energy use in additive manufacturing by 20–30%. In systems management, digital twins and reinforcement learning enable adaptive scheduling and predictive maintenance, increasing operational flexibility and reducing industrial downtime. Sustainability-oriented research shows that additive manufacturing can cut energy consumption by up to threefold compared with subtractive routes, while aluminium recycling and hot-forming processes lower life-cycle impacts. Furthermore, the integration of ISO 14001, ISO 50001, and ISO 14040 supports consistent environmental and energy performance assessment across sectors. Building on this evidence, the review critically examines recent developments in manufacturing technologies, systems management, sustainable practices, and human–robot collaboration, highlighting emerging paradigms such as explainable AI and human-centric design that strengthen safety, transparency, and resilience. Open challenges and research opportunities are outlined to guide future innovation toward intelligent, adaptive, and sustainable manufacturing systems. Full article

The global production of electronic waste (e-waste) has increased due to the quick turnover of electronic devices, creating urgent problems for resource management and environmental sustainability. As a result, e-waste-derived materials (EWDMs) are being explored in pavement engineering research as sustainable substitutes in line with Sustainable Development Goals (SDGs), specifically SDG 9 (Industry, Innovation, and Infrastructure), 11 (Sustainable Cities and Communities), 12 (Responsible Consumption and Production), and 13 (Climate Action). Therefore, to assess global research production and the effectiveness of EWDMs in asphalt applications, this review combines scientometric mapping and systematic evidence synthesis. A total of 276 relevant publications were identified via a thorough search of Web of Science, Scopus, and ScienceDirect (2010–2025). These were examined via coauthorship structures, keyword networks, and contributions at the national level. The review revealed that China, India, and the United States are prominent research hubs. Additionally, experimental studies have shown that EWDMs, such as printed circuit board powder, fluorescent lamp waste glass, high-impact polystyrene, and acrylonitrile–butadiene–styrene, improve the fatigue life, Marshall stability, rutting resistance (up to 35%), and stiffness (up to 28%). However, issues with long-term field durability, microplastic release, heavy metal leaching, and chemical compatibility still exist. These restrictions highlight the necessity for standardised toxicity testing, harmonised mixed-design frameworks, and performance standards unique to EWDMs. Overall, the review shows that e-waste valorisation can lower carbon emissions, landfill build-up, and virgin material extraction, highlighting its potential in the circular pavement industry and promoting sustainable paving practices in accordance with SDGs 9, 11, 12, and 13. This review suggests that further studies on large-scale field trials, life cycles, and technoeconomic assessments are needed to guarantee the safe, long-lasting integration of EWDMs in pavements. It also advocates for coordinated research, supportive policies, and standardised methods. Full article

Concrete structures in western saline soil regions are subjected to extreme environments with coupled dry-wet cycles and high concentrations of erosive ions such as Cl⁻, SO₄²⁻, and Mg²⁺, leading to severe degradation of mechanical properties. This study employed a simulated accelerated, high-concentration solution (Solution A, ~8× seawater salinity) similar to the composition of actual saline soil to perform accelerated dry-wet cycling corrosion tests on ordinary C40 concrete specimens for six corrosion ages (0, 5, 8, 10, 15, and 20 months). For each age, three replicate cube specimens were tested per property. The changes in cube compressive strength, splitting tensile strength, prism stress–strain full curves, and microstructure were systematically investigated. Results show that in the initial corrosion stage (0–5 months), strength exhibits a brief increase (compressive strength by 11.87%, splitting tensile strength by 9.23%) due to pore filling by corrosion products such as ettringite, gypsum, and Friedel’s salt. It then enters a slow deterioration stage (5–15 months), with significant strength decline by 20 months, where splitting tensile strength is most sensitive to corrosion. Long-term prediction models for key parameters such as compressive strength, splitting tensile strength, elastic modulus, peak stress, and peak strain were established based on grey GM(1,1) theory using the measured data from 0 to 20 months, achieving “excellent” accuracy (C ≤ 0.1221, p = 1). A segmented compressive constitutive model that considers the effect of corrosion time was proposed by combining continuous damage mechanics and the Weibull distribution. The ascending branch showed high consistency with the experimental curves. Life prediction indicates that under natural dry-wet cycling conditions, the service life of ordinary concrete in this region is only about 7.5 years when splitting tensile strength drops to 50% of initial value as the failure criterion, far below the 50-year design benchmark period. This study provides reliable theoretical models and a quantitative basis for durability design and life assessment of concrete structures in western saline soil regions. Full article

Background: Liver transplantation is a life-saving procedure for patients with end-stage liver disease, yet the immunological consequences of surgical trauma in these patients are not fully understood. The liver plays a central role in immune regulation, and its dysfunction in HBV-related chronic liver disease may alter the systemic stress response to surgery. Aim: This study aims to evaluate the stress response to surgical trauma of patients undergoing living donor liver transplantation (LDLT) for HBV-related chronic liver disease in comparison to living liver donors (LLDs). Methods: This prospective study included 20 LDLT recipients with HBV infection and 20 LLDs who underwent living donor hepatectomy between August 2020 and February 2021. Specific biochemical markers (IL-1, IL-4, IL-6, IL-22, IFN-γ, TNF-α, TGF-β, GM-CSF, GLDH, and GalactB) were measured at designated intervals: preoperative day 0 (Preop), immediately after incision (Incision), post-hepatectomy (Hepatectomy), postoperative day 0 (POD0), POD1, and POD3 using enzyme-linked immunosorbent assay (ELISA). Routine hematological and biochemical parameters (WBC, HGB, PLT, RDW, MPV, PDW, AST, ALT, ALP, GGT, albumin, total bilirubin, plateletcrit, phosphorus, fibrinogen, and INR) were measured regularly at five predetermined times: Preop, POD0, POD1, POD2, and POD3. Results: Prior to LDLT, LDLT recipients had significantly lower levels of pro-inflammatory cytokines (IL-1, IL-6, TNF-α, IFN-γ) compared to LLDs (p < 0.05). However, following liver implantation, these cytokine levels increased significantly at POD0, POD1, and POD3 (p < 0.001). Specifically, IL-1 levels elevated from 0 in the preop period to 21.5 (97.5) in POD3, and IL-6 elevated from 0 in the preop period to 28.3 at POD3 (p = 0.056). Similarly, TNF-α and IFN-γ levels exhibited significant upward trends (p < 0.05). In contrast, cytokine levels in LLDs remained stable throughout the perioperative period, revealing no statistically significant variations (p > 0.05). Routine hematological and biochemical parameters demonstrated significant postoperative fluctuations in LDLT recipients, reflecting the metabolic and immune restoration process. Conclusions: These findings indicate that patients with HBV-related chronic liver disease exhibit a diminished stress response to trauma due to underlying immune dysregulation caused by chronic hepatic dysfunction. However, after LDLT, the stress response gradually normalizes, suggesting that liver transplantation not only restores hepatic function but also reestablishes immune homeostasis, potentially reducing infection risks and improving postoperative recovery. These findings emphasize the crucial role of the liver in regulating the body’s stress response to trauma and highlight the immunological benefits of LDLT in restoring immune homeostasis. Full article

End-of-life wind turbine blade accumulation is a growing global materials management problem and current industrial recycling routes for glass fiber-reinforced polymer composites remain limited in material recovery value. There is limited understanding on how to recover clean glass fibers while keeping thermal exposure and energy input low, and existing studies have not quantified whether very short isothermal thermal residence can still result in complete matrix removal. The hypothesis of this study is that a mild two-step thermochemical sequence can recover clean glass fibers at lower temperature and near zero isothermal dwell if pyrolysis and oxidation are separated. We used wind-blade epoxy-based GFRP in a step-batch reactor and combined TGA-based thermodynamic mapping, short pyrolysis at 425 °C, and mild oxidation at 475 °C with controlled dwell from zero to thirty minutes. We applied model-free kinetics and machine learning methods to quantify activation energy trends as a function of conversion. The thermal treatment of 425 °C for zero minutes in nitrogen, followed by 475 °C for fifteen minutes in air, resulted in mechanically sound, visually clean white fibers. These fibers retained 76% of the original tensile strength and 88% of the Young’s modulus, which indicates the potential for energy-efficient GFRP recycling. The activation energy was found to be approximately 120 to 180 kJ mol⁻¹. These findings demonstrate energy lean recycling potential for GFRP and can inform future industrial scale thermochemical designs. Full article

Electrifying port horizontal transportation is constrained by downtime and deadheading from fixed charging/swapping systems, large battery sizes, and the lack of integrated decision tools for life-cycle emissions. This study develops a carbon-efficiency-centered bi-objective optimization framework benchmarking Mobile Charging Stations (MCSs) against Fixed Charging Stations (FCSs) and Battery Swapping Stations (BSWSs). The framework integrates operational parameters such as charging power, range, dispatch, and non-operational mileage, along with grid carbon intensity, battery embodied emissions, and carbon-market factors. It generates Pareto fronts using the NSGA-II algorithm with real port data. Port horizontal transportation refers to the movement of goods within the port area, typically involving the use of specialized vehicles to transport containers short distances across the terminal. Results show that MCSs can reuse idle windows to reduce deadheading and infrastructure demand, yielding significant economic improvements. The trade-off between emissions and profitability is context-dependent: at low-to-moderate reuse levels, low-carbon and profitable solutions coexist; beyond a threshold of approximately 0.5–0.75, the Pareto fronts shift to high emissions and high profits, highlighting the context-specific advantages of MCSs for port-infrastructure planning. MCSs thus provide context-dependent advantages over FCSs and BSWSs, offering practical guidance for port infrastructure planning and carbon-informed policy design. Full article