Search Results (700)

Mental health conditions affect many young people in sub-Saharan Africa (SSA), where stigma is high and access to care is limited. Digital tools accessible on basic mobile phones offer a scalable way to promote mental health, but evidence on their effectiveness in SSA is limited. This study evaluated the reach, feasibility, acceptability, and knowledge outcomes of Digital MindSKILLZ, an interactive voice response (IVR) mental health intervention implemented in the Democratic Republic of Congo, Ghana, Nigeria, Rwanda, Uganda, and Zambia. Over seven months, 700,138 people called the platform, and 425,395 (61%) listened to at least one message. Of these users, 63.6% were under 25 and 68.3% were from rural areas. The three content branches—mental health information, mental health skills, and soccer quizzes—were accessed by 36.5%, 46.4%, and 50.9% of users, respectively. Among users who accessed the mental health branch of the intervention, the mean number of messages completed was 7.6 out of 18 messages. In a follow-up survey, 91% of users understood the content, 85% would recommend the intervention, and 38% found the mental health content most helpful. Average knowledge scores were 62%, with lower scores on common disorders and stigma. The intervention showed strong reach and acceptability, but content and implementation improvements are needed to boost engagement and retention. Full article

Neurodevelopmental disorders are one of the most prevalent conditions today, and among the limitations in activity and restrictions in the participation of children and their families, we find intervention in activities of daily living; therefore, research focused on outcome measurement is one of the most active lines, and after COVID-19, telerehabilitation has garnered special interest. Background/Objectives: The study objective was to evaluate the effectiveness of a mobile health (mHealth) application in improving the performance of activities of daily living in children with neurodevelopmental disorders. Methods: The study employed a quasi-experimental design with a control group, using a fully remote mHealth-based intervention. The instruments used were a sociodemographic ad hoc, Pediatric Evaluation of Disability Inventory Computer, Family Outcomes Survey, Family Confidence Scale, and System Usability Scale. The final sample consisted of 13 participants. Results: The mHealth intervention showed significant improvements in occupational performance in the experimental group, especially in the global score and in the Responsibility dimension of the PEDI-CAT. No relevant differences were observed in the CON-FAN and FOS scales between groups, although the latter showed improvements over time. The usability of the app was rated positively (SUS = 69.75). Conclusions: The developed application presents good usability for families of children with neurodevelopmental disorders, but to obtain better outcome measures, the intervention should combine face-to-face sessions and the use of mHealth, as well as employing the family-centered model. Full article

Public safety personnel (PSP), including correctional workers, firefighters, paramedics, police, and public safety communicators, are at increased risk for posttraumatic stress injury, yet face barriers in receiving timely support. Mobile health (mHealth) applications (apps) offer promising avenues for confidential, on-demand access to relevant information and support. The purpose of this study was to assess implementation of PeerOnCall, a new mHealth platform designed by and for PSP (the platform includes two parallel apps: one for frontline workers and one for peer support providers). A multi-site mixed methods implementation trial was conducted over 3−6 months in 42 public safety organizations across Canada. App usage trends were tracked through software analytics, and facilitators and barriers to app use were explored via interviews with organizational champions. Over 11,300 employees across 42 organizations were invited to use the PeerOnCall app over the trial period, with approximately 1759 PSP (15% of total) downloading the app. Variation within and across sectors was evident in app downloads and feature use. Approaches to communication (mode, timing, and messenger), and organizational culture related to mental health and help outreach affected uptake levels. PeerOnCall is a promising tool to facilitate access to peer support; however, culturally relevant strategies are needed to overcome barriers and integrate this tool into workplace practices. Full article

Purpose: This systematic review aims to evaluate the utility of mobile health (mHealth) applications in uro-oncology, hereafter referred to as mHealth apps, specifically examining their potential to improve patient care, symptom management, and communication in genitourinary cancer treatment. Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive systematic review was conducted focusing on mHealth applications for patients with genitourinary cancers. Results: The review analyzed 29 studies, which revealed that mHealth apps demonstrated potential in uro-oncology patient care. Key findings included effective symptom monitoring, enhanced decision support, and improved patient education. The applications were found to be feasible and well-accepted by patients. However, implementation challenges were identified, including technical barriers, variations in app quality, and unequal access to digital healthcare technologies. This review systematically categorized mHealth interventions into three functional domains—symptom management, decision support, and personalized care—and identified critical implementation barriers including digital inequity, high risk of bias, and app quality variability. Conclusions: Mobile health applications demonstrate promise in revolutionizing uro-oncology care. Future research should prioritize developing comprehensive applications that address a broader range of urological cancers, enhance patient–clinician communication, and undergo rigorous evaluation. Collaborative efforts among researchers, clinicians, and app developers are crucial to overcome existing limitations and maximize the potential of these innovative healthcare tools. Full article

Veterinary drug residues in aquatic products are often overlooked, yet they pose significant environmental risks and potential threats to human health. In this study, a rapid and sensitive analytical method was developed for the simultaneous determination of nine commonly used macrolide antibiotics in largemouth bass (Micropterus salmoides) muscle using ultrahigh-performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS). Sample extraction was performed using 80% acetonitrile in water, followed by purification with Cleanert MAS-Q cartridges. Chromatographic separation was achieved on a Waters ACQUITY UPLC BEH C₁₈ column (50 mm × 2.1 mm; 1.7 μm), equipped with a Waters VanGuard^TM BEH C₁₈ guard column (1.7 μm), using a mobile phase consisting of 0.1% formic acid in water and 0.1% formic acid in acetonitrile. Mass spectrometric detection was conducted in positive electrospray ionization mode (ESI⁺) using multiple reaction monitoring (MRM). The method demonstrated excellent linearity in the concentration range of 0.2–30 ng/mL, with determination coefficients (R²) exceeding 0.9980 for all analytes. Average recoveries ranged from 89.3% to 108.4%, with intraday and interday relative standard deviations (RSDs) of 2.9–11.6% and 4.1–12.5%, respectively. The limits of detection (LOD) and quantification (LOQ) for largemouth bass muscle were determined to be 0.4 μg/kg and 2.0 μg/kg, respectively. The decision limits (CC_α) and detection capabilities (CC_β) ranged from 2.13 to 215.71 μg/kg and 2.22 to 231.42 μg/kg, respectively. The developed method was successfully applied to the quantitative analysis of macrolide residues in 20 largemouth bass samples collected from local markets. Full article

The growing use of mobile health (mHealth) technologies adds complexity and risk to the healthcare environment. This paper presents a multi-layered cybersecurity assessment of an in-house mHealth platform (PHGL-COVID), comprising a Docker-based server infrastructure, a Samsung Galaxy A55 smartphone, and a Galaxy Watch 7 wearable. The objective was to identify vulnerabilities across the server, mobile, and wearable components by emulating real-world attacks and conducting systematic penetration tests on each layer. Tools and methods specifically tailored to each technology were applied, revealing exploitable configurations, insecure Bluetooth Low Energy (BLE) communications, and exposure of Personal Health Records (PHRs). Key findings included incomplete container isolation, BLE metadata leakage, and persistent abuse of Android privacy permissions. This work delivers both a set of actionable recommendations for developers and system architects to strengthen the security of mHealth platforms, and a reproducible audit methodology that has been validated in a real-world deployment, effectively bridging the gap between theoretical threat models and practical cybersecurity practices in healthcare systems. Full article

Fumonisins, primarily produced by Fusarium spp. and Aspergillus section nigri, are common contaminants in maize, cereal grains, and other processed and derived products, representing a significant risk to food safety and public health. This study presents the development and optimisation of a high-performance liquid chromatography method with fluorescence detection (HPLC-FLD) for the quantification of fumonisin B1 (FB1) and B2 (FB2) in various food matrices. In contrast with conventional protocols employing potassium phosphate buffers as the mobile phase, the proposed method utilises formic acid, offering enhanced compatibility with liquid chromatography systems. An automated online precolumn derivatisation with o-phthaldialdehyde (OPA) was optimised through experimental design and response surface methodology, enabling baseline separation of FB1 and FB2 derivatives in less than 20 min. The method demonstrated high sensitivity, with limits of detection of 0.006 µg mL⁻¹ for FB1 and 0.012 µg mL⁻¹ for FB2, and excellent repeatability (intraday RSD values of 0.85% and 0.83%, respectively). Several solid-phase extraction (SPE) strategies were evaluated to enhance sample clean-up using a variety of food samples, including dried figs, raisins, dates, corn, cornmeal, wheat flour, and rice. FumoniStar Inmunoaffinity columns were the only clean-up method that provided optimal recoveries (70–120%) across all tested food matrices. However, the MultiSep™ 211 column yielded good recoveries for both fumonisins in dried figs and raisins. Additionally, the C18 cartridge achieved acceptable recoveries for both fumonisins in dried figs and wheat flour. Full article

Background/Objectives: Conventional ketogenic diets, although effective for weight loss, often contain high total and saturated fat intake, which leads to increased low-density lipoprotein cholesterol (LDL-C). Thus, the Healthy Ketogenic Diet (HKD) was developed to address these concerns. It emphasizes calorie restriction, limiting net carbohydrate intake to 50 g per day, prioritizing unsaturated fats, and reducing saturated fat intake. However, adherence to the HKD remains a challenge in urban, time-constrained environments. Therefore, this pilot randomized controlled trial aimed to investigate the effects of Healthy Ketogenic Diet Ready-To-Eat (HKD-RTE) meals (provided for the first month only) versus HKD alone on weight loss and metabolic parameters among overweight adults. Methods: Multi-ethnic Asian adults (n = 50) with a body mass index (BMI) ≥ 27.5 kg/m² were randomized into the HKD-RTE group (n = 24) and the HKD group (n = 26). Both groups followed the HKD for six months, with the HKD-RTE group receiving HKD-RTE meals during the first month. Five in-person workshops and mobile health coaching through the Nutritionist Buddy Keto app helped to facilitate dietary adherence. The primary outcome was the change in body weight at 6 months. Linear regression was performed on the change from baseline for each continuous outcome, adjusting for demographics and relevant covariates. Logistic regression was performed on binary weight loss ≥ 5%, adjusting for demographics and relevant covariates. Results: In the HKD group, participants’ adherence to the 50 g net carbohydrate target was 15 days, while that in the HKD-RTE group was 19 days over a period of 30 days. Participants’ adherence to calorie targets was 21 days in the HKD group and 23 days in the HKD-RTE. The average compliance with the HKD-RTE meals provided in the HKD-RTE group was 55%. The HKD-RTE group experienced a greater percentage weight loss at 1 month (−4.8 ± 3.0% vs. −1.8 ± 6.2%), although this was not statistically significant. This trend continued up to 6 months, with the HKD-RTE group showing a greater percentage weight reduction (−8.6 ± 6.8% vs. −3.9 ± 8.6%; p = 0.092). At 6 months, the HKD-RTE group had a greater reduction in total cholesterol (−0.54 ± 0.76 mmol/L vs. −0.05 ± 0.56 mmol/L; p = 0.283) and LDL-C (−0.43 ± 0.67 mmol/L vs. −0.03 ± 0.52 mmol/L; p = 0.374) compared to the HKD group. Additionally, the HKD-RTE group exhibited greater reductions in systolic blood pressure (−8.3 ± 9.7 mmHg vs. −5.3 ± 11.0 mmHg), diastolic blood pressure (−7.7 ± 8.8 mmHg vs. −2.0 ± 7.0 mmHg), and HbA1c (−0.3 ± 0.5% vs. −0.1 ± 0.4%) than the HKD group (not statistically significant for any). Conclusions: Both HKD-RTE and HKD led to weight loss and improved metabolic profiles. The HKD-RTE group tended to show more favorable outcomes. Short-term HKD-RTE meal provision may enhance initial weight loss, with sustained long-term effects. Full article

This pilot, randomized, double-blind, placebo-controlled trial investigated the effects of branched-chain amino acids (BCAAs)—provided in a 2:1:1 ratio of leucine:isoleucine:valine—combined with exercise on fatigue, physical performance, and quality of life in older adults. Twenty participants (63% female; BMI: 35 ± 2 kg/m²; age: 70.5 ± 1.2 years) were randomized to 8 weeks of either exercise + BCAAs (100 mg/kg body weight/d) or exercise + placebo. The program included moderate aerobic and resistance training three times weekly. Physical function was assessed using handgrip strength, chair stands, gait speed, VO₂ max, and a 400 m walk. Psychological health was evaluated using the CES-D, Fatigue Assessment Scale (FAS), Insomnia Severity Index (ISI), and global pain, fatigue, and quality of life using a visual analog scale (VAS). Significant group x time interactions were found for handgrip strength (p = 0.03), chair stands (p < 0.01), and 400 m walk time (p < 0.01). Compared to exercise + placebo, exercise + BCAAs showed greater improvements in strength, mobility, and endurance, along with reductions in fatigue (−45% vs. +92%) and depressive symptoms (−29% vs. +5%). Time effects were also observed for ISI (−30%), FAS (−21%), and VAS quality of life (16%) following exercise + BCAA supplementation. These preliminary results suggest that BCAAs combined with exercise may be an effective way to improve physical performance and reduce fatigue and depressive symptoms in older adults. Full article

Background: Type 2 diabetes (T2D) and overweight or obesity are strongly associated, with a high prevalence of these concomitant conditions contributing significantly to global healthcare costs. Given this burden, there is an urgent need for effective interventions. Mobile health (mHealth) technologies represent a promising strategy to address both conditions simultaneously. Objectives: This systematic review and meta-analysis aimed to evaluate the effectiveness of mHealth-based interventions for the management of adults with T2D and overweight/obesity. Specifically, it assessed the quantitative impact of these interventions on glycosylated hemoglobin (HbA1c), body weight, triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels. Methods: A systematic search was conducted in PubMed, Web of Science, and Scopus databases from inception to 9 July 2025. The inclusion criteria focused on randomized controlled trials (RCTs) using mHealth interventions in adults with T2D and overweight/obesity, reporting HbA1c or weight as primary or secondary outcomes. The risk of bias was assessed using the Cochrane Risk of Bias tool 2. A total of 13 RCTs met the inclusion criteria. Results: Meta-analysis indicated significant improvements after 6–12 months of intervention in HbA1c (MD −0.23; 95% CI −0.36 to −0.10; p < 0.001; I² = 72%), body weight (MD −2.47 kg; 95% CI −3.69 to −1.24; p < 0.001; I² = 79%), total cholesterol (MD −0.23; 95% CI −0.39 to −0.07; p = 0.004; I² = 0%), and LDL (MD −0.27; 95% CI −0.42 to −0.12; p < 0.001; I² = 0%). Conclusions: mHealth interventions are effective and scalable for managing T2D and obesity, particularly when incorporating wearable technologies to improve adherence. Future research should focus on optimizing personalization, engagement strategies, and long-term implementation. Full article

Radio frequency (RF)-based wireless systems are broadly used in communication systems such as mobile networks, satellite links, and monitoring applications. These systems offer outstanding advantages over wired systems, particularly in terms of ease of installation. However, researchers are looking for safer alternatives as a result of worries about possible health problems connected to high-frequency radiofrequency transmission. Using the visible light spectrum is one promising approach; three cutting-edge technologies are emerging in this regard: Optical Camera Communication (OCC), Light Fidelity (Li-Fi), and Visible Light Communication (VLC). In this paper, we propose a Multiple-Input Multiple-Output (MIMO) modulation technology for Internet of Things (IoT) applications, utilizing an LED array and time-domain on-off keying (OOK). The proposed system is compatible with both rolling shutter and global shutter cameras, including commercially available models such as CCTV, webcams, and smart cameras, commonly deployed in buildings and industrial environments. Despite the compact size of the LED array, we demonstrate that, by optimizing parameters such as exposure time, camera focal length, and channel coding, our system can achieve up to 20 communication links over a 20 m distance with low bit error rate. Full article

Background/Objectives: Patients undergoing open aortic and valvular surgery often experience postoperative deconditioning, yet research on the role of inpatient cardiac rehabilitation (CR) in this population remains limited. This study aimed to examine the effects of inpatient CR on muscle strength, mobility, psychological well-being, and quality of life in patients recovering from open aortic surgery. Methods: We conducted a retrospective study using the medical records of patients who participated in inpatient CR after open aortic surgery. Functional and psychological outcomes were evaluated using the Medical Research Council (MRC) sum score, Timed Up and Go (TUG) test, Five Times Sit-to-Stand test (5STS), Six-Minute Walk Distance (6MWD), Berg Balance Scale (BBS), Modified Barthel Index (MBI), Patient Health Questionnaire-9 (PHQ-9), and the EuroQol-5D (EQ-5D). Pre- and post-rehabilitation scores were compared to assess changes in functional status, mobility, and quality of life. A post-discharge satisfaction survey was also analyzed. Results: A total of 33 patients were included. Significant improvements were observed in MBI (p < 0.001), MRC sum score (p < 0.001), 6MWD (p < 0.001), BBS (p < 0.001), TUG (p = 0.003), 5STS (p < 0.001), EQ-5D (p = 0.011), and PHQ-9 (p = 0.009) following inpatient CR. Patients with lower baseline mobility (6MWD ≤ 120 m) exhibited greater improvement in MBI (p = 0.034). Of the 33 patients, 26 completed the satisfaction survey; most reported high satisfaction, perceived health improvements, and willingness to recommend the program. Conclusions: Inpatient CR following open aortic and valvular surgery resulted in significant gains in muscle strength, mobility, psychological health, and overall quality of life. Patients with greater initial impairment demonstrated especially notable functional improvement, supporting the value of tailored CR in this population. Full article

Background/Objectives: Among Enterobacterales, OXA-48-like-producing Proteus mirabilis strains have been scarcely detected. Herein, we characterized a bla_OXA-48-harbouring P. mirabilis strain recovered from Greece (Pm GR-1), while phylogenomics and comparative genomics analyses with previously published bla_OXA-48 carriers were also assessed. Methods: Characterization of Pm GR-1 was performed by the Vitek^® Compact and Mass Spectrometry systems, antimicrobial susceptibility testing, detection of beta-lactamases, multilocus-sequence typing (MLST), and whole-genome sequencing (WGS). In silico prediction of mobile genetic elements (MGEs), genomic islands (GIs), antimicrobial resistance genes (ARGs) and virulence factors (VFs), and phylogenetic, core-genome SNP and comparative genomics analyses were executed using bioinformatic tools. Results: Pm GR-1 was isolated from a urine sample of an outpatient in a Greek hospital. It exhibited a multidrug-resistant phenotype, being susceptible only to amikacin and ceftazidime/avibactam. It co-carried several beta-lactamase genes on the chromosome (bla_OXA-48, bla_CTX-M-14, bla_TEM-1) and a plasmid (bla_TEM-2) and several other ARGs, but also mutations associated with quinolone resistance in the DNA gyrase and topoisomerase IV subunits. It belonged to the international clone ST135 that has also been detected among OXA-48-producing P. mirabilis strains from Germany and the USA. Pm GR-1 was genetically related to those from Germany, sharing highly similar MGEs, GIs, ARGs and VFs, including the chromosomal bla_OXA-48 genetic structure, the O-antigen locus, the flagella locus, the MR/P fimbriae operon, and the urease gene cluster. Conclusions: To our knowledge, this is the first report from Greece of a bla_OXA-48-possessing P. mirabilis strain. The emergence of bla_OXA-48 among P. mirabilis strains of the international clone ST135 in different geographical regions is worrying. Close monitoring of these strains is required in One Health settings. Full article

Total Knee Arthroplasty (TKA) is a well-established surgical intervention for the management of end-stage knee osteoarthritis. While the procedure is generally successful, postoperative rehabilitation remains a key determinant of long-term functional outcomes. Traditional rehabilitation protocols, particularly those requiring in-person clinical visits, often encounter limitations in accessibility, patient adherence, and personalization. In response, emerging sensor technologies have introduced innovative solutions to support and enhance recovery following TKA. This review provides a thematically organized synthesis of the current landscape and future directions of sensor-assisted rehabilitation in TKA. It examines four main categories of technologies: wearable sensors (e.g., IMUs, accelerometers, gyroscopes), smart implants, pressure-sensing systems, and mobile health (mHealth) platforms such as ReHub^® and BPMpathway. Evidence from recent randomized controlled trials and systematic reviews demonstrates their effectiveness in tracking mobility, monitoring range of motion (ROM), detecting gait anomalies, and delivering real-time feedback to both patients and clinicians. Despite these advances, several challenges persist, including measurement accuracy in unsupervised environments, the complexity of clinical data integration, and digital literacy gaps among older adults. Nevertheless, the integration of artificial intelligence (AI), predictive analytics, and remote rehabilitation tools is driving a shift toward more adaptive and individualized care models. This paper concludes that sensor-enhanced rehabilitation is no longer a future aspiration but an active transition toward a smarter, more accessible, and patient-centered paradigm in recovery after TKA. Full article

Mineral waters from two tectonically active mountain systems within the Alpine-Himalayan orogenic belt, the Pamir and the Greater Caucasus (Elbrus region), were analyzed for ²²²Rn activity and ²³⁸U concentrations to establish correlations with geological conditions, physicochemical characteristics of water, and to assess the potential health risk associated with ²³⁸U and ²²²Rn. It was found that in mineral waters of the Pamir, the concentrations of ²³⁸U (0.004–13.3 µg/L) and activity of ²²²Rn (8–130 Bq/L) are higher than in the Elbrus area: 0.04–3.74 µg/L and 6–33 Bq/L, respectively. Results indicate that uranium mobility in water is strongly influenced by T, pH, and Eh, but is less affected by the age of host rocks or springs′ elevation, whereas radon activity in waters depends on the age of rocks, spring elevation, ²³⁸U content, and values of δ¹⁸O and δ²H in water. This study reveals fundamental geological distinctions governing uranium and radon sources in the mineral waters of these regions. Isotopic evidence (²²²Rn and ³He/⁴He) demonstrates crustal radon sources prevail in Pamir, whereas the Elbrus system suggests mantle-derived components. The U concentrations do not exceed 30 µg/L, and most water samples (94%) showed ²²²Rn activities below 100 Bq/L, complying with the drinking water exposure limits recommended by the World Health Organization and European Union Directive. However, in intermountain depressions of the Pamirs, at low absolute elevations (~2300 m), radon concentrations in water can increase significantly, which requires special attention and study. Full article