Search Results (1,591)

Climate change and sea-level change (SLC) are intensifying flooding in U.S. coastal communities, with disproportionate impacts on Black and minority neighborhoods that face displacement, economic hardship, and heightened health risks. In Norfolk, Virginia, sea levels are projected to rise by at least 0.91 m (3 ft) by 2100, placing underserved neighborhoods such as Oakleaf Forest at particular risk. This study investigates the compounded impacts of flooding at both the building and urban scales, situating the work within the framework of the UN Sustainable Development Goals (UN SDGs). A mixed-method, community-based approach was employed, integrating literature review, field observations, and community engagement to identify flooding hotspots, document lived experiences, and determine preferences for adaptation strategies. Community participants contributed actively through mapping sessions and meetings, providing feedback on adaptation strategies to ensure that the process was collaborative, place-based, and context-specific. Preliminary findings highlight recurring flood-related vulnerabilities and the need for interventions that address both environmental and social dimensions of resilience. The study proposes multi-scale, nature-based solutions (NbS) to mitigate flooding, restore ecological functions, and enhance community capacity for adaptation. Ultimately, this work underscores the importance of coupling technical strategies with participatory processes to strengthen resilience and advance climate justice in vulnerable coastal neighborhoods. Full article

Background: Dietary habits established during young adulthood have long-term implications for health, and food choices among university students are strongly shaped by contextual factors. Institutional eating environments represent a relevant setting for promoting healthier dietary behaviors, yet limited evidence integrates students’ engagement with these settings, their food consumption patterns across contexts, and the individual decision-making processes underlying food choice. Methods: This cross-sectional study analyzed survey data from 1519 students enrolled at a large Italian university. Measures included sociodemographic characteristics, self-identified dietary style, engagement with the university canteen, consumption frequency of selected food categories across institutional and non-institutional contexts, and category-specific food-choice motivations. Data were analyzed using descriptive analyses, Borda count rankings, paired comparisons, and multiple linear regression models. Results: Clear contextual differences in food consumption emerged across all food categories, with consistently lower consumption frequencies within the university canteen compared to outside settings (all p < 0.001). The largest contextual gap was observed for fruit consumption (d = 0.94), with similarly pronounced differences for plant-based foods. Taste was the most salient decision-making factor across food categories (overall M ≈ 4.4), while health-related motives were more prominent for healthier foods and gratification for desserts. Across contexts, self-identified dietary style was the most consistent predictor of food consumption, explaining substantial variance for animal-based protein consumption (R² = 0.293 in the canteen; R² = 0.353 outside), whereas age and gender showed smaller, food-specific associations. Conclusions: The findings highlight institutional eating settings as distinct food environments in which individual dietary preferences are only partially expressed. Effective strategies to promote healthier eating among university students should move beyond generic approaches and integrate interventions targeting service-related engagement, category-specific choice architecture, and students’ dietary identities. Full article

Respiratory infections are a major public health threat. Significant global mortality is caused by influenza viruses, the new SARS-CoV-2 virus, and the Respiratory Syncytial Viruses (RSVs). Wastewater-based epidemiology (WBE) has recently emerged as a valuable tool for monitoring these pathogens, providing insights into their evolution, transmission patterns, and co-circulation within populations. This study aimed to track influenza viruses (A and B), the new SARS-CoV-2 virus, and the Respiratory Syncytial Viruses (RSVs) (type A and B) during the pandemic period (from October 2020 to October 2021) in a middle-size Spanish city (Valladolid) and its surrounding areas. Viral concentration was performed using an aluminum-based precipitation method, followed by RNA extraction and RT-qPCR quantification targeting the N1 and N2 regions of the SARS-CoV-2 nucleocapsid gene, the N gene for both RSV-A and RSV-B, and the M and non-structural protein genes for influenza A and B, respectively. The results demonstrated the utility of WBE in predicting increases in clinical cases of SARS-CoV-2, as evidenced by a high correlation (r > 0.5). For RSV-A, the findings aligned with previous studies. Interestingly, particularly considering the length and period of analysis, influenza A, influenza B, and RSV-B viruses were not observed during the study period. In addition, the prevalence of RSV-A decreased during the SARS-CoV-2 pandemic, likely due to the implementation of non-pharmaceutical interventions. In conclusion, this study reaffirms that WBE provides critical epidemiological insights, complements clinical surveillance, and supports public health authorities in making informed and timely decisions. Full article

Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings. Full article

Background/Objectives: Colorectal cancer (CRC) is associated with anorexia–cachexia syndrome, which negatively affects health-related quality of life (HRQoL). This study aimed to evaluate HRQoL and functional status in CRC patients undergoing chemotherapy who were eligible for oral nutritional supplementation (ONS). Methods: In this prospective, randomized study, 72 patients with stage II–IV CRC were enrolled (40 intervention group [IG], 32 control group [CG]). IG received ONS (2 × 125 mL/day, 600 kcal, 36 g protein) for 12 weeks, while CG received dietary counseling only. HRQoL was assessed every 4 weeks with the Functional Assessment of Anorexia/Cachexia Therapy (FAACT, version 4.0). Functional status was evaluated with the Karnofsky scale. Nutritional status was assessed using the Subjective Global Assessment (SGA), Nutritional Risk Screening (NRS-2002), and body mass index (BMI), and appetite was assessed on a visual analogue scale (VAS). Clinical Trial Registration: ClinicalTrials.gov, NCT02848807. Results: Mean FAACT score did not differ significantly between groups over 12 weeks (101.0 ± 22.8, 95% CI: 94.6–107.4 vs. 105.1 ± 21.4, 95% CI: 99.1–111.1; p = 0.06). However, the observed difference corresponded to an effect size at the lower bound of the moderate range. However, minimally important difference (MID) analysis demonstrated that clinically meaningful improvement was significantly more frequent in IG than in CG for global FAACT (32% vs. 8%; p = 0.03, OR = 5.50, 95% CI: 1.10–27.62, φ = 0.29), physical well-being (32% vs. 8%; p = 0.03, OR = 5.50, 95% CI: 1.10–27.62, φ = 0.29), and emotional well-being (38% vs. 4%; p = 0.002, OR = 14.86, 95% CI: 1.79–123.36, φ = 0.40). Functional well-being and anorexia/cachexia concerns showed favorable, but nonsignificant, trends (FWB improvement: 29% vs. 8%, p = 0.05, OR = 4.79, 95% CI: 0.95–24.27, φ = 0.26; ACS deterioration: 3% vs. 20%, p = 0.07, OR = 0.12, 95% CI: 0.01–1.11, φ = 0.28). HRQoL correlated positively with nutritional status, appetite, and functional performance, while Karnofsky scores remained stable in both groups. Conclusions: ONS did not significantly change the mean QoL scores at the group level but increased the proportion of patients achieving clinically meaningful improvement, particularly in the physical and emotional domains. These findings suggest that ONS may benefit selected patients who respond to nutritional interventions, underscoring the clinical relevance of individualized nutrition strategies in oncology. Full article

Background: A significant shortage of available organs for transplantation persists globally, with insufficient education on organ donation recognized as a key contributing factor. Allied health students, when equipped with accurate knowledge, have the potential to serve as advocates for organ donation, influencing public attitudes through their social networks. Enhancing their understanding may contribute to increased organ donation awareness and acceptance within the broader community. Methods: This study employed a quasi-experimental design to examine the effect of an educational intervention program on allied health students’ knowledge and attitudes toward organ donation and transplantation. A total of 150 allied health students were recruited through simple random sampling. Data were collected using a valid and reliable translated self-administered online questionnaire. Participants were divided into intervention and control groups. Descriptive statistics, independent sample t-tests, and one-way ANOVA were used for data analysis. Results: Following the intervention, the mean score of knowledge and attitudes in the intervention group (M = 41.09, SD = 2.57) was significantly higher than that in the control group (M = 40.29, SD = 2.40), with a t-value of −3.49 and a p-value of <0.001. These results indicate that the educational program had a statistically significant positive effect on participants’ knowledge and attitudes regarding organ donation and transplantation. Conclusions: The implementation of the educational intervention significantly improved allied health students’ knowledge and attitudes toward organ donation and transplantation. This suggests that targeted educational programs for future health professionals may be an effective strategy to promote organ donation awareness and address the shortage of organ donors. Full article

Atherosclerosis seriously endangers human health. Quercetin has drawn attention for its potential anti-atherosclerotic pharmacological effects. This study aimed to comprehensively assess quercetin’s effect and potential mechanism in treating atherosclerosis through a systematic review and meta-analysis. Preclinical studies published before 20 January 2025 were searched for in databases including PubMed, Embase, Web of Science, CNKI, Wanfang, and VIP. The CAMARADES list was used to assess the quality of the included studies. Stata 12 was applied for overall effect, sensitivity, subgroup, and publication bias analyses. Time–dose interval analyses were conducted to explore how quercetin dose and dosing cycle affect intervention effects. Finally, trial sequential analyses were performed using TSA 0.9 software. A total of 22 studies involving 421 animals were included, with a mean methodological quality score of 7.73/10. Meta-analysis showed that relative to the control group, quercetin reduced aortic plaque area, adjusted lipids (lowered TC, TG, and LDL-C and raised HDL-C), downregulated adhesion factors (e.g., VCAM-1) and pro-inflammatory factors (e.g., IL-1β and IL-6), upregulated anti-inflammatory factor IL-10 and antioxidant enzymes (SOD, CAT) while decreasing MDA content, and regulated atherosclerosis-related targets (e.g., LXRα, SIRT1, and mTOR). Subgroup analyses found model establishment time and quercetin administration time affected aortic lesion areas, TC, and TG. Time–dose analysis indicated quercetin had better ameliorative effects on atherosclerosis at 25–100 mg/kg with an 8–10-week intervention. Quercetin significantly improves atherosclerosis and inhibits its occurrence and progression through multiple pathways, such as regulating lipid metabolism, anti-inflammatory effects, and counteracting oxidative stress. Based on current evidence, quercetin is a potential therapeutic agent for treating atherosclerosis. Full article

Background/Objectives: Suicide is the second leading cause of death among adolescents and young adults. Those suffering from psychiatric illnesses are at particular risk. Our study, conducted at an outpatient mental health facility in Northern Italy, aimed at delineating demographic and psychopathological features of youths aged 16–29 who attempted suicide and were referred to our community-based outpatient service. Methods: We identified 63 subjects, most of whom suffered from personality disorders, mood disorders, and schizophrenia spectrum disorders. Analysis of variance and post hoc pairwise comparisons were performed. Results: Inferential analysis yielded significant results in terms of age at index suicide attempt across diagnostic groups. Patients with personality disorders attempted suicide at a younger age (M = 18.70) compared to those with schizophrenia spectrum disorders (M = 23.64; η² = 0.32). Conclusions: Our findings highlighted the period of transition from adolescence to adulthood as a stress on the need of preventive approaches towards suicidality in young people in both clinical and non-clinical settings. Moreover, the difference of age at index suicide attempt across different diagnostic groups stresses the need for tailored clinical interventions based on the specific psychopathological trajectories and natural histories of the diseases. Full article

Background: Sarcopenia is highly prevalent among hospitalized older adults and is associated with poor clinical outcomes. Multiple diagnostic criteria exist, but the comparative implications of different handgrip strength (HGS) thresholds and measurement tools are less explored. Objectives: This study aimed to assess the prevalence of sarcopenia, comparing the diagnostic yield of different HGS thresholds using two measurement instruments (dynamometer and vigorimeter) in hospitalized older adults. Design: This was a cross-sectional observational study. Setting: A tertiary geriatric hospital with acute, rehabilitation, and long-term care wards was included. Participants: A total of 376 hospitalized older adults with complete HGS and bioelectrical impedance analysis (BIA) data were recruited. Measurements: HGS was measured using both a hydraulic dynamometer and a pneumatic vigorimeter. Sarcopenia was defined using cut-offs from EWGSOP2, SDOC, and two DO-HEALTH-derived thresholds. Low muscle mass was identified using the fat-free mass index (FFMI) by BIA. Multivariate logistic regression was used to identify predictors of sarcopenia. Results: The prevalence of probable sarcopenia ranged from 68.1% to 89.4%, and confirmed sarcopenia from 39.6% to 50.3%, depending on the thresholds applied. Sarcopenic patients were older (86.1 ± 9.8 vs. 80.4 ± 11.0 years; p < 0.001), had lower BMI (20.7 ± 2.9 vs. 26.1 ± 4.8 kg/m²; p < 0.001), and were more frequently in long-term care (p = 0.014–0.043). Older age (OR 1.03–1.07 per year; p < 0.05) and lower BMI (OR 0.59–0.68 per kg/m²; p < 0.001) were independently associated with sarcopenia; sex and fall history were not. Conclusions: Sarcopenia prevalence was high and varied widely across diagnostic definitions and measurement tools, reflecting both methodological variability and the high vulnerability of hospitalized older adults. These findings highlight the need for standardized, context-adapted diagnostic strategies to guide timely intervention in high-risk hospitalized older adults. Full article

Influenza A viruses remain a persistent global health challenge due to their rapid antigenic evolution, zoonotic potential, and pandemic threat. Universal countermeasures targeting conserved viral components are urgently needed to enhance diagnostic, surveillance, and therapeutic capabilities. Here, we report the generation and characterization of a high-affinity monoclonal antibody (2D8 mAb) against the nucleoprotein (NP) of the H9N2 avian influenza virus, a subtype with increasing relevance to human infections. Importantly, 2D8 mAb exhibited robust cross-reactivity with a broad spectrum of influenza A viruses, including H1, H3, H5, H7, and H9 subtypes, while showing no cross-reactivity with unrelated viral pathogens. Epitope mapping identified its binding target as a highly conserved NP motif ³⁸RFYIQMCTEL⁴⁷, which is invariant across all major human influenza A lineages. Isotyping revealed 2D8 mAb to be of the IgG2b/κ subclass, with an exceptionally high titer (1:20,480,000) as determined by ELISA. Given the essential role of NP in viral replication and host adaptation, this antibody offers a powerful platform for next-generation diagnostic assays capable of detecting a wide range of human and zoonotic influenza A viruses using a single reagent. Moreover, it holds potential for guiding the design of universal antiviral strategies targeting structurally constrained regions of the influenza virus. Our findings provide a valuable resource for advancing pan-influenza A interventions, with direct implications for improving pandemic preparedness and strengthening global influenza surveillance in both clinical and public health settings. Full article

Aflatoxin M₁ (AFM₁), a hydroxylated metabolite of aflatoxin B₁ (AFB₁), is a potent hepatotoxic and carcinogenic compound frequently detected in milk and dairy products. Its thermal stability and resistance to processing make it a persistent public health concern, especially in regions prone to fungal contamination of animal feed. This review integrates bibliometric mapping (2015–2025) with toxicological and mitigation perspectives to provide a comprehensive understanding of AFM₁. The bibliometric analysis reveals a sharp global rise in research output over the last decade, with Iran, China, and Brazil emerging as leading contributors and Food Control identified as the most prolific journal. Five research clusters were distinguished: feed contamination pathways, analytical detection, toxicological risk, regulatory frameworks, and mitigation strategies. Toxicological evidence highlights AFM₁’s mutagenic and hepatocarcinogenic effects, intensified by co-exposure to other mycotoxins or hepatitis B infection. Although regulatory limits range from 0.025 µg/kg in infant formula (EU) to 0.5 µg/kg in milk (FDA), non-compliance remains prevalent in developing regions. Current mitigation approaches—adsorbents (bentonite, zeolite), oxidation (ozone, hydrogen peroxide), and biological detoxification via lactic acid bacteria and yeasts—show promise but require optimization for industrial application. Persistent challenges include climatic variability, inadequate feed monitoring, and heterogeneous regulations. This review emphasizes the need for harmonized surveillance, improved analytical capacity, and sustainable intervention strategies to ensure dairy safety and protect consumer health. Full article

Noise pollution represents a significant environmental stressor that compromises the health and welfare of farm animals. While music enrichment has been suggested to mitigate stress, the specific mechanisms by which it protects against noise-induced immune damage remain poorly understood. This study investigated whether music can mitigate acute noise-induced injury to the bursa of Fabricius in broilers. A total of 175 male Arbor Acres broilers were randomly allocated into four groups: Control (C), Noise (N), Noise plus Music (NM), and Music (M). Starting on day 14, groups N and NM were exposed to daily acute noise exposure (115–120 dB for10 min), while groups NM and M received daily 6-h Mozart’s K.448 music enrichment. We evaluated the effects of short-term (by day 21) and long-term (by day 42) music intervention. Results showed that acute noise induced significant histopathological damage, oxidative stress, and apoptosis in the bursa. While short-term music intervention showed limited efficacy, prolonged music exposure significantly attenuated these injuries. Mechanistically, music suppressed the noise-activated NF-κB signaling pathway and reduced inflammatory cytokines (IL-1β, IL-6, and TNF-α). Concurrently, it inhibited mitochondrial-dependent apoptosis by modulating Bcl-2, Bax, Cyt-C, and Caspase-3. These findings provide experimental evidence that long-term music enrichment effectively alleviates noise-induced immune injury, suggesting a practical strategy for improving poultry welfare. Full article

Reclamation measures are essential tools for enhancing ecosystem functions and promoting ecological sustainability. This study focused on the Jiangnan mining area within the Muli coalfield in Qinghai Province, China. Four organic fertilizer reclamation treatments were established, namely, unfertilized control (CK, 0), low fertilizer (LF, consisting of sheep manure at 165 m³/ha and commercial organic fertilizer at 7.5 t/ha), medium fertilizer (MF, using 330 m³/ha of sheep manure and 15.0 t/ha of commercial organic fertilizer), and high fertilizer (HF, using 495 m³/ha of sheep manure and 22.5 t/ha of commercial organic fertilizer), with a natural meadow near the experimental site selected as a reference for evaluation. Through a field vegetation survey and indoor analysis, the primary productivity, water conservation, carbon cycle, nitrogen cycle, and phosphorus cycle of five ecosystem functions and ecosystem multifunctionality (EMF) were quantified, and the trade-off relationships among ecosystem functions were analyzed. The findings indicate the following: (1) Compared to the unfertilized control, organic fertilizer reclamation significantly enhanced all individual ecosystem functions and EMF, with the EMF value under the high-fertilizer treatment (EMF = 0.69) even exceeding that of the natural grassland (EMF = 0.60). (2) This intervention altered the original trade-off patterns (E_RMSD = 0.03), intensifying trade-offs among multiple ecological functions (E_RMSD = 0.09), whereas natural grassland exhibited the strongest trade-off intensity (E_RMSD = 0.26). In summary, while organic fertilizer reclamation effectively enhances the multifunctionality of alpine mining ecosystems, it also amplifies trade-off effects among ecological functions to varying degrees. Therefore, future long-term positioning observations are required to evaluate the ecological stability and sustainability of this restoration technology under extreme climatic conditions and to further explore reasonable grazing and mowing management plans in order to coordinate multiple ecological functions, thereby promoting the development of the reclamation ecosystem in alpine mining areas toward coordination and health. Full article

Osteoporosis is highly prevalent in postmenopausal women, causing chronic pain, fractures, and limited mobility that burden individuals and society. While resistance exercise benefits bone health, its role in osteoporotic bone injury healing and underlying mechanisms remain unclear. This study aimed to explore the effects of 10-week weight-bearing ladder climbing exercise on ovariectomy (OVX)-induced osteoporosis and subsequent bone injury healing, and to investigate whether these effects are associated with the myostatin (MSTN) and Wnt/β-catenin pathways. Fifty-four 12-week-old female SD rats were randomized into Sham, OVX, and OVX + EX groups. Rats in the OVX and OVX + EX groups underwent ovariectomy to induce postmenopausal osteoporosis, and those in the OVX + EX group received 10-week weight-bearing ladder climbing. After the exercise intervention, 6 rats in each group were sacrificed; the remaining rats underwent femoral midshaft drilling to establish bone injury. The improvement in osteoporosis was evaluated via Micro-CT, biomechanical tests, RT-qPCR for mRNA detection, and Western blot for measuring protein levels of MSTN and Wnt/β-catenin pathway-related molecules at post-exercise and 21 days post-injury. Bone healing was reflected by the bone volume fraction at the bone injury site detected via Micro-CT at 10 and 21 days post-injury. This exercise significantly enhanced muscle strength and improved femoral bone mineral density (BMD), trabecular microstructure, and biomechanical properties in OVX rats. Meanwhile, the level of MSTN in the OVX + EX group was decreased, the expression of its downstream signaling pathways was inhibited, and the mRNA and protein expressions of Wnt/β-catenin were upregulated. Moreover, 21 days after exercise intervention, the biomechanical properties and bone microstructure of the OVX + EX group were still significantly superior to those of the OVX group, and the aforementioned molecular regulatory effect remained. In addition, pre-conducted exercise was able to promote increases in bone volume fraction at the bone injury site 10 and 21 days after drilling, which was conducive to bone injury healing. Ten-week weight-bearing ladder climbing ameliorates OVX-induced bone loss and promotes osteoporotic bone repair via regulating the MSTN/ActRIIB/Smad3 and Wnt/β-catenin pathways, providing evidence for exercise as a safe non-pharmacological intervention. Full article

Background/Objectives: The Adhera^® Caring Digital Program (ACDP) is a digitally delivered intervention aimed at enhancing the mental and physical well-being of family caregivers of children with chronic conditions. Tailored for the context of childhood obesity, ACDP leverages the Adhera AI Precision Digital Companion to support caregivers in promoting effective treatment adherence and healthy behaviors at home. While children in this study received GLP-1 receptor agonist treatment as part of their obesity management, the ACDP was designed to empower caregivers through educational, behavioral, and emotional support tools. The aim of this study was to determine the relationship between engagement with the ACDP as a DHI and clinical outcomes in participants receiving GLP-1 receptor agonist treatment for obesity. Methods: This study analyzed data from approximately 40 pediatric patients receiving GLP-1-based pharmacological treatment for obesity and their caregivers enrolled in the ACDP. Caregiver engagement was assessed through a composite score derived from digital activity metrics and classified as low, medium, or high. Children’s clinical parameters (BMI, weight, fat mass %, muscle mass %, and waist circumference) were collected at baseline and Day 150. Biometric, physical activity, and sleep data were also collected through a wearable device, enabling continuous and objective monitoring of participants’ physiological and behavioral patterns in real-world conditions. Statistical analyses included paired comparisons, Pearson correlations, and group comparisons by engagement level. Results: Data from 40 pediatric participants and their caregivers were analyzed over 150 days. Observed changes over the time in children showed a reduction in waist circumference (−6.0%, p = 0.0056) and a modest decrease in BMI. Higher levels of caregiver engagement with the Adhera^® Caring Digital Program correlated with reduction in body fat (ΔFat% r ≈ 0.5, p = 0.091) representing the strongest correlation observed in the study, albeit not reaching statistical significance. From baseline to Day 150, significant improvements were observed across all clinical outcomes, including reductions in BMI (−4.51 kg/m²), body weight (−11.42 kg), body fat percentage (−5.63%), and waist circumference (−8.69 cm), alongside an increase in muscle mass (+4.47%) (all p < 0.0001). Conclusions: At the mid-point of the intervention, combined GLP-1 pharmacotherapy and the Adhera^® Caring Digital Program led to meaningful improvements in BMI, adiposity, and central obesity. While caregiver engagement was not significantly associated with short-term outcomes, observed trends suggest that digital support may provide complementary benefits to pharmacological treatment, warranting further evaluation at Day 300. Full article