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15 pages, 1507 KiB  
Article
Determination of Fumonisins B1 and B2 in Food Matrices: Optimisation of a Liquid Chromatographic Method with Fluorescence Detection
by Óscar Cebadero-Domínguez, Santiago Ruiz-Moyano, Alberto Martín and Elisabet Martín-Tornero
Toxins 2025, 17(8), 391; https://doi.org/10.3390/toxins17080391 - 5 Aug 2025
Abstract
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 [...] Read more.
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
(This article belongs to the Section Mycotoxins)
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24 pages, 3176 KiB  
Article
Influence of Seasonality and Pollution on the Presence of Antibiotic Resistance Genes and Potentially Pathogenic Bacteria in a Tropical Urban River
by Kenia Barrantes-Jiménez, Bradd Mendoza-Guido, Eric Morales-Mora, Luis Rivera-Montero, José Montiel-Mora, Luz Chacón-Jiménez, Keilor Rojas-Jiménez and María Arias-Andrés
Antibiotics 2025, 14(8), 798; https://doi.org/10.3390/antibiotics14080798 (registering DOI) - 5 Aug 2025
Abstract
Background/Objectives: This study examines how seasonality, pollution, and sample type (water and sediment) influence the presence and distribution of antibiotic resistance genes (ARGs), with a focus on antibiotic resistance genes (ARGs) located on plasmids (the complete set of plasmid-derived sequences, including ARGs) in [...] Read more.
Background/Objectives: This study examines how seasonality, pollution, and sample type (water and sediment) influence the presence and distribution of antibiotic resistance genes (ARGs), with a focus on antibiotic resistance genes (ARGs) located on plasmids (the complete set of plasmid-derived sequences, including ARGs) in a tropical urban river. Methods: Samples were collected from three sites along a pollution gradient in the Virilla River, Costa Rica, during three seasonal campaigns (wet 2021, dry 2022, and wet 2022). ARGs in water and sediment were quantified by qPCR, and metagenomic sequencing was applied to analyze chromosomal and plasmid-associated resistance profiles in sediments. Tobit and linear regression models, along with multivariate ordination, were used to assess spatial and seasonal trends. Results: During the wet season of 2021, the abundance of antibiotic resistance genes (ARGs) such as sul-1, intI-1, and tetA in water samples decreased significantly, likely due to dilution, while intI-1 and tetQ increased in sediments, suggesting particle-bound accumulation. In the wet season 2022, intI-1 remained low in water, qnrS increased, and sediments showed significant increases in tetQ, tetA, and qnrS, along with decreases in sul-1 and sul-2. Metagenomic analysis revealed spatial differences in plasmid-associated ARGs, with the highest abundance at the most polluted site (Site 3). Bacterial taxa also showed spatial differences, with greater plasmidome diversity and a higher representation of potential pathogens in the most contaminated site. Conclusions: Seasonality and pollution gradients jointly shape ARG dynamics in this tropical river. Plasmid-mediated resistance responds rapidly to environmental change and is enriched at polluted sites, while sediments serve as long-term reservoirs. These findings support the use of plasmid-based monitoring for antimicrobial resistance surveillance in aquatic systems. Full article
(This article belongs to the Special Issue Origins and Evolution of Antibiotic Resistance in the Environment)
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51 pages, 4099 KiB  
Review
Artificial Intelligence and Digital Twin Technologies for Intelligent Lithium-Ion Battery Management Systems: A Comprehensive Review of State Estimation, Lifecycle Optimization, and Cloud-Edge Integration
by Seyed Saeed Madani, Yasmin Shabeer, Michael Fowler, Satyam Panchal, Hicham Chaoui, Saad Mekhilef, Shi Xue Dou and Khay See
Batteries 2025, 11(8), 298; https://doi.org/10.3390/batteries11080298 - 5 Aug 2025
Abstract
The rapid growth of electric vehicles (EVs) and new energy systems has put lithium-ion batteries at the center of the clean energy change. Nevertheless, to achieve the best battery performance, safety, and sustainability in many changing circumstances, major innovations are needed in Battery [...] Read more.
The rapid growth of electric vehicles (EVs) and new energy systems has put lithium-ion batteries at the center of the clean energy change. Nevertheless, to achieve the best battery performance, safety, and sustainability in many changing circumstances, major innovations are needed in Battery Management Systems (BMS). This review paper explores how artificial intelligence (AI) and digital twin (DT) technologies can be integrated to enable the intelligent BMS of the future. It investigates how powerful data approaches such as deep learning, ensembles, and models that rely on physics improve the accuracy of predicting state of charge (SOC), state of health (SOH), and remaining useful life (RUL). Additionally, the paper reviews progress in AI features for cooling, fast charging, fault detection, and intelligible AI models. Working together, cloud and edge computing technology with DTs means better diagnostics, predictive support, and improved management for any use of EVs, stored energy, and recycling. The review underlines recent successes in AI-driven material research, renewable battery production, and plans for used systems, along with new problems in cybersecurity, combining data and mass rollout. We spotlight important research themes, existing problems, and future drawbacks following careful analysis of different up-to-date approaches and systems. Uniting physical modeling with AI-based analytics on cloud-edge-DT platforms supports the development of tough, intelligent, and ecologically responsible batteries that line up with future mobility and wider use of renewable energy. Full article
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15 pages, 1216 KiB  
Article
Mathematical Modeling of Regional Infectious Disease Dynamics Based on Extended Compartmental Models
by Olena Kiseleva, Sergiy Yakovlev, Olga Prytomanova and Oleksandr Kuzenkov
Computation 2025, 13(8), 187; https://doi.org/10.3390/computation13080187 - 4 Aug 2025
Abstract
This study presents an extended approach to compartmental modeling of infectious disease spread, focusing on regional heterogeneity within affected areas. Using classical SIS, SIR, and SEIR frameworks, we simulate the dynamics of COVID-19 across two major regions of Ukraine—Dnipropetrovsk and Kharkiv—during the period [...] Read more.
This study presents an extended approach to compartmental modeling of infectious disease spread, focusing on regional heterogeneity within affected areas. Using classical SIS, SIR, and SEIR frameworks, we simulate the dynamics of COVID-19 across two major regions of Ukraine—Dnipropetrovsk and Kharkiv—during the period 2020–2024. The proposed mathematical model incorporates regionally distributed subpopulations and applies a system of differential equations solved using the classical fourth-order Runge–Kutta method. The simulations are validated against real-world epidemiological data from national and international sources. The SEIR model demonstrated superior performance, achieving maximum relative errors of 4.81% and 5.60% in the Kharkiv and Dnipropetrovsk regions, respectively, outperforming the SIS and SIR models. Despite limited mobility and social contact data, the regionally adapted models achieved acceptable accuracy for medium-term forecasting. This validates the practical applicability of extended compartmental models in public health planning, particularly in settings with constrained data availability. The results further support the use of these models for estimating critical epidemiological indicators such as infection peaks and hospital resource demands. The proposed framework offers a scalable and computationally efficient tool for regional epidemic forecasting, with potential applications to future outbreaks in geographically heterogeneous environments. Full article
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13 pages, 1060 KiB  
Article
Condition Changes Before and After the Coronavirus Disease 2019 Pandemic in Adolescent Athletes and Development of a Non-Contact Medical Checkup Application
by Hiroaki Kijima, Toyohito Segawa, Kimio Saito, Hiroaki Tsukamoto, Ryota Kimura, Kana Sasaki, Shohei Murata, Kenta Tominaga, Yo Morishita, Yasuhito Asaka, Hidetomo Saito and Naohisa Miyakoshi
Sports 2025, 13(8), 256; https://doi.org/10.3390/sports13080256 - 4 Aug 2025
Abstract
During the coronavirus 2019 pandemic, sports activities were restricted, raising concerns about their impact on the physical condition of adolescent athletes, which remained largely unquantified. This study was designed with two primary objectives: first, to precisely quantify and elucidate the differences in the [...] Read more.
During the coronavirus 2019 pandemic, sports activities were restricted, raising concerns about their impact on the physical condition of adolescent athletes, which remained largely unquantified. This study was designed with two primary objectives: first, to precisely quantify and elucidate the differences in the physical condition of adolescent athletes before and after activity restrictions due to the pandemic; and second, to innovatively develop and validate a non-contact medical checkup application. Medical checks were conducted on 563 athletes designated for sports enhancement. Participants were junior high school students aged 13 to 15, and the sample consisted of 315 boys and 248 girls. Furthermore, we developed a smartphone application and compared self-checks using the application with in-person checks by orthopedic surgeons to determine the challenges associated with self-checks. Statistical tests were conducted to determine whether there were statistically significant differences in range of motion and flexibility parameters before and after the pandemic. Additionally, items with discrepancies between values self-entered by athletes using the smartphone application and values measured by specialists were detected, and application updates were performed. Student’s t-test was used for continuous variables, whereas the chi-square test was used for other variables. Following the coronavirus 2019 pandemic, athletes were stiffer than during the pre-pandemic period in terms of hip and shoulder joint rotation range of motion and heel–buttock distance. The dominant hip external rotation decreased from 53.8° to 46.8° (p = 0.0062); the non-dominant hip external rotation decreased from 53.5° to 48.0° (p = 0.0252); the dominant shoulder internal rotation decreased from 62.5° to 54.7° (p = 0.0042); external rotation decreased from 97.6° to 93.5° (p = 0.0282), and the heel–buttock distance increased from 4.0 cm to 10.4 cm (p < 0.0001). The heel–buttock distance and straight leg raising angle measurements differed between the self-check and face-to-face check. Although there are items that cannot be accurately evaluated by self-check, physical condition can be improved with less contact by first conducting a face-to-face evaluation under appropriate guidance and then conducting a self-check. These findings successfully address our primary objectives. Specifically, we demonstrated a significant decline in the physical condition of adolescent athletes following pandemic-related activity restrictions, thereby quantifying their impact. Furthermore, our developed non-contact medical checkup application proved to be a viable tool for monitoring physical condition with reduced contact, although careful consideration of measurable parameters is crucial. This study provides critical insights into the long-term effects of activity restrictions on young athletes and offers a practical solution for health monitoring during infectious disease outbreaks, highlighting the potential for hybrid checkup approaches. Full article
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18 pages, 1376 KiB  
Article
The Effect of Short-Term Healthy Ketogenic Diet Ready-To-Eat Meals Versus Healthy Ketogenic Diet Counselling on Weight Loss in Overweight Adults: A Pilot Randomized Controlled Trial
by Melissa Hui Juan Tay, Qai Ven Yap, Su Lin Lim, Yuki Wei Yi Ong, Victoria Chantel Hui Ting Wee and Chin Meng Khoo
Nutrients 2025, 17(15), 2541; https://doi.org/10.3390/nu17152541 - 1 Aug 2025
Viewed by 210
Abstract
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 [...] Read more.
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
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12 pages, 1450 KiB  
Article
Application of AI Mind Mapping in Mental Health Care
by Hsin-Shu Huang, Bih-O Lee and Chin-Ming Liu
Healthcare 2025, 13(15), 1885; https://doi.org/10.3390/healthcare13151885 - 1 Aug 2025
Viewed by 136
Abstract
Background: Schizophrenia affects patients’ organizational thinking, as well as their ability to identify problems. The main objective of this study was to explore healthcare consultants’ application of AI mind maps to educate patients with schizophrenia regarding their perceptions of family function, social support, [...] Read more.
Background: Schizophrenia affects patients’ organizational thinking, as well as their ability to identify problems. The main objective of this study was to explore healthcare consultants’ application of AI mind maps to educate patients with schizophrenia regarding their perceptions of family function, social support, quality of life, and loneliness, and to help these patients think more organizationally and understand problems more effectively. Methods: The study used a survey research design and purposive sampling method to recruit 66 participants with schizophrenia who attended the psychiatric outpatient clinic of a hospital in central Taiwan. They needed to be literate, able to respond to the topic, and over 18 years old (inclusive), and they attended individual and group health education using AI mind maps over a 3-month period during regular outpatient clinic visits. Results: The study results show that patients’ family function directly affects their quality of life (p < 0.05) and loneliness (p < 0.05), satisfaction with social support affects quality of life and loneliness directly (p < 0.05), and satisfaction with social support is a mediating factor between family function and quality of life (p < 0.05), as well as a mediating factor between family function and loneliness (p < 0.05). Conclusions: Therefore, this study confirms the need to provide holistic, integrated mental health social care support for patients with schizophrenia, showing that healthcare consultants can apply AI mind maps to empower patients with schizophrenia to think more effectively about how to mobilize their social supports. Full article
(This article belongs to the Special Issue Applications of Digital Technology in Comprehensive Healthcare)
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19 pages, 9488 KiB  
Article
Proteus mirabilis from Captive Giant Pandas and Red Pandas Carries Diverse Antimicrobial Resistance Genes and Virulence Genes Associated with Mobile Genetic Elements
by Yizhou Yang, Yan Liu, Jiali Wang, Caiwu Li, Ruihu Wu, Jialiang Xin, Xue Yang, Haohong Zheng, Zhijun Zhong, Hualin Fu, Ziyao Zhou, Haifeng Liu and Guangneng Peng
Microorganisms 2025, 13(8), 1802; https://doi.org/10.3390/microorganisms13081802 - 1 Aug 2025
Viewed by 148
Abstract
Proteus mirabilis is a zoonotic pathogen that poses a growing threat to both animal and human health due to rising antimicrobial resistance (AMR). It is widely found in animals, including China’s nationally protected captive giant and red pandas. This study isolated Proteus mirabilis [...] Read more.
Proteus mirabilis is a zoonotic pathogen that poses a growing threat to both animal and human health due to rising antimicrobial resistance (AMR). It is widely found in animals, including China’s nationally protected captive giant and red pandas. This study isolated Proteus mirabilis from panda feces to assess AMR and virulence traits, and used whole-genome sequencing (WGS) to evaluate the spread of resistance genes (ARGs) and virulence genes (VAGs). In this study, 37 isolates were obtained, 20 from red pandas and 17 from giant pandas. Multidrug-resistant (MDR) strains were present in both hosts. Giant panda isolates showed the highest resistance to ampicillin and cefazolin (58.8%), while red panda isolates were most resistant to trimethoprim/sulfamethoxazole (65%) and imipenem (55%). Giant panda-derived strains also exhibited stronger biofilm formation and swarming motility. WGS identified 31 ARGs and 73 VAGs, many linked to mobile genetic elements (MGEs) such as plasmids, integrons, and ICEs. In addition, we found frequent co-localization of drug resistance genes/VAGs with MGEs, indicating a high possibility of horizontal gene transfer (HGT). This study provides crucial insights into AMR and virulence risks in P. mirabilis from captive pandas, supporting targeted surveillance and control strategies. Full article
(This article belongs to the Special Issue Antimicrobial Resistance and the Use of Antibiotics in Animals)
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13 pages, 906 KiB  
Systematic Review
Mobile Health Applications for Secondary Prevention After Myocardial Infarction or PCI: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Ioannis Skalidis, Henri Lu, Niccolo Maurizi, Stephane Fournier, Grigorios Tsigkas, Anastasios Apostolos, Stephane Cook, Juan F. Iglesias, Philippe Garot, Thomas Hovasse, Antoinette Neylon, Thierry Unterseeh, Jerome Garot, Nicolas Amabile, Neila Sayah, Francesca Sanguineti, Mariama Akodad and Panagiotis Antiochos
Healthcare 2025, 13(15), 1881; https://doi.org/10.3390/healthcare13151881 - 1 Aug 2025
Viewed by 215
Abstract
Background: Mobile health applications have emerged as a novel tool to support secondary prevention after myocardial infarction (MI) or percutaneous coronary intervention (PCI). However, the impact of app-based interventions on clinically meaningful outcomes such as hospital readmissions remains uncertain. Objective: To systematically evaluate [...] Read more.
Background: Mobile health applications have emerged as a novel tool to support secondary prevention after myocardial infarction (MI) or percutaneous coronary intervention (PCI). However, the impact of app-based interventions on clinically meaningful outcomes such as hospital readmissions remains uncertain. Objective: To systematically evaluate the effectiveness of smartphone app-based interventions in reducing unplanned hospital readmissions among post-MI/PCI patients. Methods: A systematic search of PubMed was conducted for randomized controlled trials published between January 2020 and April 2025. Eligible studies evaluated smartphone apps designed for secondary cardiovascular prevention and reported on unplanned hospital readmissions. Risk ratios (RRs) and 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup analyses were performed based on follow-up duration and user adherence. Results: Four trials encompassing 827 patients met inclusion criteria. App-based interventions were associated with a significant reduction in unplanned hospital readmissions compared to standard care (RR 0.45; 95% CI: 0.23–0.89; p = 0.0219). Greater benefits were observed in studies with longer follow-up durations and higher adherence rates. Improvements in patient-reported outcomes, including health-related quality of life, were also documented. Heterogeneity was moderate. Major adverse cardiovascular events (MACEs) were reported in only two studies and were not analyzed due to inconsistent definitions and low event rates. Conclusions: Smartphone applications for post-MI/PCI care are associated with reduced unplanned hospital readmissions and improved patient-reported outcomes. These tools may play a meaningful role in future cardiovascular care models, especially when sustained engagement and personalized features are prioritized. Full article
(This article belongs to the Special Issue Smart and Digital Health)
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20 pages, 1188 KiB  
Article
Consensus-Based Recommendations for Comprehensive Clinical Assessment in Prosthetic Care: A Delphi Study
by Frédérique Dupuis, Marion Pichette, Bonnie Swaine, Claudine Auger and Diana Zidarov
Prosthesis 2025, 7(4), 92; https://doi.org/10.3390/prosthesis7040092 (registering DOI) - 1 Aug 2025
Viewed by 120
Abstract
Background/Objective: The most effective strategy for addressing users’ prosthetic needs is a comprehensive clinical assessment that provides a holistic understanding of the individual’s symptoms, health, function, and environmental barriers and facilitators. A standardized evaluation form would provide guidance for a structured approach to [...] Read more.
Background/Objective: The most effective strategy for addressing users’ prosthetic needs is a comprehensive clinical assessment that provides a holistic understanding of the individual’s symptoms, health, function, and environmental barriers and facilitators. A standardized evaluation form would provide guidance for a structured approach to comprehensive clinical assessments of people with LLA. The objective of this study was to determine a list of relevant elements to be included in prosthetic evaluation for adults with lower limb amputation. Methods: Three independent focus group discussions were conducted with prosthetists (n = 15), prosthesis users (n = 11), and decision makers (n = 4) to identify all relevant elements that should be included in the clinical assessment of prosthetic services. The final content was then determined using the Delphi technique, with 35 panelists (18 prosthetists and decision makers, and 17 prosthesis users) voting in each round. Results: A total of 91 elements were identified through the focus group, of which 78 were included through the Delphi process. The identified elements are mostly related to the physical health of the prosthesis user (e.g., mobility, pain, and medical information), while others address personal or psychosocial aspects (e.g., activities of daily living, goals, and motivation) or technical aspects (prosthesis-related). Conclusions: Through a Delphi consensus, a list of relevant elements to be included in a prosthetic evaluation was generated. These results will inform the development of a standardized clinical prosthetic assessment form. This form has the potential to improve the quality of clinical evaluations, guide interventions, and enhance the well-being of prosthetic users. Full article
(This article belongs to the Section Orthopedics and Rehabilitation)
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17 pages, 482 KiB  
Article
Branched-Chain Amino Acids Combined with Exercise Improves Physical Function and Quality of Life in Older Adults: Results from a Pilot Randomized Controlled Trial
by Ronna Robbins, Jason C. O’Connor, Tiffany M. Cortes and Monica C. Serra
Dietetics 2025, 4(3), 32; https://doi.org/10.3390/dietetics4030032 - 1 Aug 2025
Viewed by 176
Abstract
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 [...] Read more.
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
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14 pages, 529 KiB  
Article
Nomophobia Levels in Turkish High School Students: Variations by Gender, Physical Activity, Grade Level and Smartphone Use
by Piyami Çakto, İlyas Görgüt, Amayra Tannoubi, Michael Agyei, Medina Srem-Sai, John Elvis Hagan, Oğuzhan Yüksel and Orhan Demir
Youth 2025, 5(3), 78; https://doi.org/10.3390/youth5030078 (registering DOI) - 1 Aug 2025
Viewed by 190
Abstract
The rapidly changing dynamics of the digital age reshape the addiction relationship that high school students establish with technology. While smartphones remove boundaries in terms of communication and access to information, their usage triggers a source of anxiety and nomophobia. The increase in [...] Read more.
The rapidly changing dynamics of the digital age reshape the addiction relationship that high school students establish with technology. While smartphones remove boundaries in terms of communication and access to information, their usage triggers a source of anxiety and nomophobia. The increase in students’ anxiety levels because of their over-reliance on mobile phone use leads to significant behavioral changes in their mental health, academic performance, social interactions and financial dependency. This study examined the nomophobia levels of high school students according to selected socio-demographic indicators. Using the relational screening model, the multistage sampling technique was used to select a sample of 884 participants: 388 from Science High School and 496 from Anatolian High School (459 female, 425 male, Mage = 16.45 ± 1.14 year). Independent sample test and One-way ANOVA were applied. Depending on the homogeneity assumption of the data, Welch values were considered, and Tukey tests were applied as a second-level test from post hoc analyses. Comprehensive analyses of nomophobia levels revealed that young individuals’ attitudes towards digital technology differ significantly according to their demographic and behavioral characteristics. Variables such as gender, physical activity participation, grade level and duration of smartphone use are among the main factors affecting nomophobia levels. Female individuals and students who do not participate in physical activity exhibit higher nomophobia scores. Full article
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21 pages, 1112 KiB  
Article
Associations Between Smoking, Stress, Quality of Life, and Oral Health Among Dental Students in Romania: A Cross-Sectional Study
by Adina Oana Armencia, Andrei Nicolau, Irina Bamboi, Bianca Toader, Anca Rapis, Tinela Panaite, Daniela Argatu and Carina Balcos
Medicina 2025, 61(8), 1394; https://doi.org/10.3390/medicina61081394 - 1 Aug 2025
Viewed by 202
Abstract
Students, particularly those in the medical field, are exposed to various stressors that can affect their health-related behaviors, including smoking habits, with implications for oral health and quality of life. Background and Objectives: to analyze the relationship between smoking, oral health, perceived [...] Read more.
Students, particularly those in the medical field, are exposed to various stressors that can affect their health-related behaviors, including smoking habits, with implications for oral health and quality of life. Background and Objectives: to analyze the relationship between smoking, oral health, perceived stress level, and self-assessed quality of life in a sample of dental students. Materials and Methods: The cross-sectional study included 338 students, who completed validated questionnaires and were clinically examined. Lifestyle was assessed using a smoking behavior questionnaire, stress levels were measured with the Student Stress Inventory (SSI), and quality of life was evaluated using the EQ-5D-5L instrument. The DMFT index was calculated to determine oral health status. Results: Among the 338 participating students, 53.8% were smokers. The lifestyle analysis revealed slightly higher average scores among non-smokers across all domains—social (3.26 vs. 3.09), attitudinal (2.75 vs. 2.97), and behavioral (3.82 vs. 3.49), but without statistically significant differences (p > 0.25). The mean DMFT score was 12.48, with no significant differences between smokers and non-smokers (p = 0.554). The SSI total score averaged 83.15, indicating a moderate level of perceived stress, again with no statistically significant differences between the groups (p > 0.05). However, slightly higher average stress scores among smokers may suggest the use of smoking as a coping mechanism. In contrast, quality of life as measured by EQ-5D-5L showed significantly worse outcomes for smokers across all five dimensions, including mobility (78.6% vs. 95.5%, p = 0.000) and self-care (93.4% vs. 100%, p = 0.001). Multivariable logistic regression identified smoking (OR = 1.935; p = 0.047) and moderate stress levels (OR = 0.258; p < 0.001) as independent predictors of oral health status. Conclusions: The results obtained suggest that smoking may function as a stress management strategy among students, supporting the relevance of integrating specific psychobehavioral interventions that address stress reduction and oral health promotion among student populations. Full article
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41 pages, 580 KiB  
Review
The Alarming Effects of Per- and Polyfluoroalkyl Substances (PFAS) on One Health and Interconnections with Food-Producing Animals in Circular and Sustainable Agri-Food Systems
by Gerald C. Shurson
Sustainability 2025, 17(15), 6957; https://doi.org/10.3390/su17156957 - 31 Jul 2025
Viewed by 139
Abstract
Per- and polyfluoroalkyl substances (PFAS) are synthetically produced chemicals that are causing a major One Health crisis. These “forever chemicals” are widely distributed globally in air, water, and soil, and because they are highly mobile and extremely difficult to degrade in the environment. [...] Read more.
Per- and polyfluoroalkyl substances (PFAS) are synthetically produced chemicals that are causing a major One Health crisis. These “forever chemicals” are widely distributed globally in air, water, and soil, and because they are highly mobile and extremely difficult to degrade in the environment. They cause additional health concerns in a circular bioeconomy and food system that recycles and reuses by-products and numerous types of waste materials. Uptake of PFAS by plants and food-producing animals ultimately leads to the consumption of PFAS-contaminated food that is associated with numerous adverse health and developmental effects in humans. Contaminated meat, milk, and eggs are some of the main sources of human PFAS exposure. Although there is no safe level of PFAS exposure, maximum tolerable PFAS consumption guidelines have been established for some countries. However, there is no international PFAS monitoring system, and there are no standardized international guidelines and mechanisms to prevent the consumption of PFAS-contaminated foods. Urgent action is needed to stop PFAS production except for critical uses, implementing effective water-purification treatments, preventing spreading sewage sludge on land and pastures used to produce food, and requiring marketers and manufacturers to use packaging that is free of PFAS. Full article
30 pages, 1737 KiB  
Review
Current Perspectives on Rehabilitation Following Return of Spontaneous Circulation After Sudden Cardiac Arrest: A Narrative Review
by Kamil Salwa, Karol Kaziród-Wolski, Dorota Rębak and Janusz Sielski
Healthcare 2025, 13(15), 1865; https://doi.org/10.3390/healthcare13151865 - 30 Jul 2025
Viewed by 275
Abstract
Background/Objectives: Sudden cardiac arrest (SCA) is a major global health concern with high mortality despite advances in resuscitation techniques. Achieving return of spontaneous circulation (ROSC) represents merely the initial step in the extensive rehabilitation journey. This review highlights the critical role of structured, [...] Read more.
Background/Objectives: Sudden cardiac arrest (SCA) is a major global health concern with high mortality despite advances in resuscitation techniques. Achieving return of spontaneous circulation (ROSC) represents merely the initial step in the extensive rehabilitation journey. This review highlights the critical role of structured, multidisciplinary rehabilitation following ROSC, emphasizing the necessity of integrated physiotherapy, neurocognitive therapy, and psychosocial support to enhance quality of life and societal reintegration in survivors. Methods: This narrative review analyzed peer-reviewed literature from 2020–2025, sourced from databases such as PubMed, Scopus, Web of Science, and Google Scholar. Emphasis was on clinical trials, expert guidelines (e.g., European Resuscitation Council 2021, American Heart Association 2020), and high-impact journals, with systematic thematic analysis across rehabilitation phases. Results: The review confirms rehabilitation as essential in addressing Intensive Care Unit–acquired weakness, cognitive impairment, and post-intensive care syndrome. Early rehabilitation (0–7 days post-ROSC), focusing on parameter-guided mobilization and cognitive stimulation, significantly improves functional outcomes. Structured interdisciplinary interventions encompassing cardiopulmonary, neuromuscular, and cognitive domains effectively mitigate long-term disability, facilitating return to daily activities and employment. However, access disparities and insufficient randomized controlled trials limit evidence-based standardization. Discussion: Optimal recovery after SCA necessitates early and continuous interdisciplinary engagement, tailored to individual physiological and cognitive profiles. Persistent cognitive fatigue, executive dysfunction, and emotional instability remain significant barriers, underscoring the need for holistic and sustained rehabilitative approaches. Conclusions: Comprehensive, individualized rehabilitation following cardiac arrest is not supplementary but fundamental to meaningful recovery. Emphasizing early mobilization, neurocognitive therapy, family involvement, and structured social reintegration pathways is crucial. Addressing healthcare disparities and investing in rigorous randomized trials are imperative to achieving standardized, equitable, and outcome-oriented rehabilitation services globally. Full article
(This article belongs to the Section Critical Care)
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