Search Results (916)

Acute malnutrition affects 3.1% of children under five years of age in Amazonian communities in Peru, where limited access to health services constrains timely nutritional assessment. In this context, this study aimed to develop, implement, and evaluate NutriRadar, a mobile application for automated childhood nutritional classification based on the anthropometric standards of the World Health Organization (WHO). The application was developed using a waterfall software development methodology and implements the calculation of the Weight-for-Height Z-score (WHZ) from basic anthropometric variables (weight, height, age, and sex). NutriRadar was designed with offline functionality, deferred data synchronization, and compatibility with low-end mobile devices to support operational use in Amazonian settings. Field validation was conducted in two early childhood education institutions in Puerto Maldonado, Peru, and included anthropometric assessments of 75 children aged 3–4 years. The application demonstrated stable offline operation, response times suitable for clinical practice, and nutritional classification results equivalent to the WHO Anthro reference tool. NutriRadar represents a viable and reproducible digital automation solution for the operational application of a deterministic WHO anthropometric protocol, contributing to the reduction of operational errors and strengthening standardized nutritional assessment in resource-limited Amazonian contexts. Full article

The emergence of the Smart Cities paradigm and the rapid expansion and integration of Internet of Things (IoT) technologies within this context have created unprecedented opportunities for high-resolution behavioral analytics, urban optimization, and context-aware services. However, this same proliferation intensifies privacy risks, particularly those arising from cross-modal data linkage across heterogeneous sensing platforms. To address these challenges, this paper introduces a comprehensive, statistically grounded framework for generating synthetic, multimodal IoT datasets tailored to Smart City research. The framework produces behaviorally plausible synthetic data suitable for preliminary privacy risk assessment and as a benchmark for future re-identification studies, as well as for evaluating algorithms in mobility modeling, urban informatics, and privacy-enhancing technologies. As part of our approach, we formalize probabilistic methods for synthesizing three heterogeneous and operationally relevant data streams—cellular mobility traces, payment terminal transaction logs, and Smart Retail nutrition records—capturing the behaviors of a large number of synthetically generated urban residents over a 12-week period. The framework integrates spatially explicit merchant selection using K-Dimensional (KD)-tree nearest-neighbor algorithms, temporally correlated anchor-based mobility simulation reflective of daily urban rhythms, and dietary-constraint filtering to preserve ecological validity in consumption patterns. In total, the system generates approximately 116 million mobility pings, 5.4 million transactions, and 1.9 million itemized purchases, yielding a reproducible benchmark for evaluating multimodal analytics, privacy-preserving computation, and secure IoT data-sharing protocols. To show the validity of this dataset, the underlying distributions of these residents were successfully validated against reported distributions in published research. We present preliminary uniqueness and cross-modal linkage indicators; comprehensive re-identification benchmarking against specific attack algorithms is planned as future work. This framework can be easily adapted to various scenarios of interest in Smart Cities and other IoT applications. By aligning methodological rigor with the operational needs of Smart City ecosystems, this work fills critical gaps in synthetic data generation for privacy-sensitive domains, including intelligent transportation systems, urban health informatics, and next-generation digital commerce infrastructures. Full article

Background: Due to the congested competition calendar and the high physical demands of elite basketball, the selection of effective recovery strategies is essential to optimize performance and reduce exercise-induced fatigue and muscle damage. This pilot study aimed to examine the acute effects of different nutritional and physical recovery strategies on exercise performance, muscle damage, and perceived fatigue and exertion in elite basketball players. Methods: Fifteen elite male basketball players participated in this pilot randomized crossover trial and completed four recovery conditions: cold-water immersion (CWI), active recovery (ACT), protein–carbohydrate supplementation (SUP), and placebo (PLA). Following a basketball-specific fatigue protocol, creatine kinase, countermovement jump performance, isometric strength, 10 m sprint, and 4 × 10 m shuttle run tests were assessed at baseline, immediately post-exercise, and 24 h post-exercise. Perceived fatigue and rate of perceived exertion were measured at baseline, immediately post-exercise, immediately after the recovery intervention, and 24 h post-exercise. Results: The three recovery methods attenuated the 24 h exercise-induced increase in CK compared with the placebo condition (p > 0.05). CWI, SUP and ACT decreased fatigue and RPE immediately after their application (p < 0.05), while PLA kept them elevated. CWI was associated with a significant improvement in 4 × 10 m SRT performance (p = 0.027). Conclusions: Nutritional supplementation and physical recovery strategies effectively attenuated exercise-induced muscle damage and fatigue in elite basketball players. However, CWI demonstrated the most pronounced acute benefits for physical performance recovery. Full article

Vitamin D insufficiency remains common in adults, and supplementation with cholecalciferol (vitamin D₃) is widely used to improve circulating 25-hydroxyvitamin D [25(OH)D]. At the same time, circular-economy strategies are increasingly applied to nutraceutical production, including the valorization of fish processing by-products as sources of lipid-soluble bioactives. However, clinical evidence directly comparing fish processing by-product-derived vitamin D₃ with conventional synthetic vitamin D₃ at commonly used nutritional doses remains limited. D-FISH is a single-center, randomized, double-blind, parallel-group, non-inferiority trial enrolling adults aged 18–60 years with a baseline plasma of 25(OH)D 20–40 ng/mL. Participants will be randomized (1:1) to receive either fish processing by-product-derived or synthetic vitamin D₃ at the same nutritional dose (600 IU once daily with the evening meal) for 12 weeks. The primary endpoint is the between-group difference in the change in plasma 25(OH)D from day 0 to day 84, assessed against a pre-specified non-inferiority margin of 5 ng/mL, with analyses conducted in full analysis and per-protocol populations. Secondary endpoints include markers of mineral metabolism (calcium, phosphorus, PTH), fasting lipid profile, anthropometrics, and tolerability/safety outcomes; early 25(OH)D kinetics will be explored at 72 h, day 7, and day 28. The study will inform biochemical non-inferiority and short-term tolerability but is not powered to evaluate clinical outcomes (NCT07127796). Full article

Lower-extremity peripherally inserted central catheters (PICCs) are used in critically ill adults when upper-extremity access is limited, yet real-world data on indications, dwell time, and device-related outcomes remain scarce. We retrospectively reviewed consecutive ultrasound-guided mid-thigh lower-extremity PICC placements performed under a standardized protocol (15 cm below the inguinal ligament; fixed 55-cm insertion depth) in an adult ICU and extracted indication patterns, catheter dwell time, removal reasons, and microbiological findings. Among 38 placements in 37 patients, difficult peripheral access was present in all cases; prolonged intravenous antibiotics were the predominant indication (34/38, 89.5%), followed by total parenteral nutrition (13/38, 34.2%) and vasopressor therapy (2/38, 5.3%). Median dwell time was 19.5 days (IQR 12–25; range 3–48). Catheters were most commonly removed due to death (15/38, 39.5%), discharge (13/38, 34.2%), or no longer being clinically indicated (8/38, 21.1%), while removal for suspected catheter infection/fever occurred in 2/38 (5.3%). A catheter-drawn culture was positive in 1/38 (2.6%; Candida albicans), whereas peripheral blood cultures were positive in 4/38 (10.5%). In this single-center retrospective descriptive cohort, standardized mid-thigh lower-extremity PICCs were used for prolonged venous access. Removals for suspected infection/fever evaluation were uncommon; however, CRBSI was not adjudicated and thrombosis surveillance was not performed. These findings describe local utilization patterns and support future comparative studies and stewardship-focused quality improvement. Full article

Introduction: Cardiothoracic transplant surgery represents a critical intervention for patients with end-stage heart and/or lung failure. While advancements in surgical techniques and perioperative management have enhanced survival rates, these procedures remain associated with significant morbidity, extended hospitalizations, and complex recovery trajectories. Background/Objectives: Enhanced Recovery After Surgery (ERAS) protocols, originally developed for colorectal surgery, have shown promise in optimizing perioperative care across various surgical disciplines. However, their application in cardiac and thoracic transplantation is still emerging. This article evaluates recent advancements in ERAS protocols tailored to cardiac and thoracic transplant patients, focusing on preoperative, intraoperative, and postoperative interventions. Results: Evidence highlights the potential of ERAS to reduce complications, shorten hospital stays, and improve long-term outcomes. Key strategies include preoperative optimization through nutritional and psychosocial prehabilitation, intraoperative adoption of minimally invasive techniques and refined anesthesia practices, and postoperative protocols emphasizing opioid-sparing pain management, early mobilization, and nutritional recovery. Conclusions: This review identifies gaps in current research and offers recommendations for the broader implementation and standardization of ERAS protocols in cardiothoracic surgery, with emphasis on cardiothoracic transplantation, aiming to improve outcomes for this high-risk population. Full article

Wild edible plants represent an underexploited resource for enhancing agrobiodiversity and promoting more sustainable food systems. Urospermum dalechampii (Asteraceae) is a traditional Mediterranean wild edible species widely used in local cuisines, yet it remains marginal in modern horticulture. This review provides an overview of the current knowledge on the nutritional composition, phytochemical profile, biological activities, and agronomic potential of U. dalechampii. Available evidence indicates that its edible tissues are characterized by a favorable nutritional profile, including appreciable levels of dietary fiber, minerals, and beneficial fatty acids. Moreover, the species is a rich source of bioactive compounds—particularly phenolic acids, flavonoids, and terpenoids—which have been associated with antioxidant, anti-inflammatory, and antimicrobial activities. Recent studies have demonstrated the feasibility of domesticating U. dalechampii through both soil-based and soilless cultivation systems, including baby-leaf and microgreen production, thereby enabling controlled yields and reducing harvesting pressure on wild populations. Nevertheless, research on this species remains fragmented, and several knowledge gaps persist, notably the absence of standardized agronomic protocols, limited information on post-harvest management and safety, and potential market constraints related to bitterness and variability in product quality. Overall, U. dalechampii emerges as a promising candidate for sustainable horticulture and the development of functional foods. Full article

Patients with hepatocellular carcinoma (HCC) often sit at the crossroads of malignancy and chronic liver disease, where impaired hepatic reserve, systemic inflammation, and treatment-related stress accelerate loss of skeletal muscle mass and function. In this narrative review, we synthesize current evidence on the two-way relationship between sarcopenia and HCC management across curative and palliative settings. We outline key biological pathways—altered energy substrate use, amino acid imbalance, hyperammonemia-related signaling, and inflammatory and hormonal perturbations—that promote progressive muscle wasting, and we summarize how sarcopenia influences tolerance, complications, and outcomes of surgery, locoregional therapies, and systemic agents. We then translate the literature into practical supportive-care principles, including adequate energy and protein delivery, optimized meal distribution (including late-evening snacks), and selected supplementation alongside hepatic rehabilitation/exercise. Potential adjuncts discussed include branched-chain amino acids, L-carnitine, vitamin D, zinc, and other micronutrients. Because the available data are heterogeneous and largely derived from observational cohorts or extrapolated from cirrhosis populations, HCC-specific randomized trials and standardized intervention protocols remain limited. Therefore, nutritional and exercise recommendations should be individualized according to tumor stage, hepatic function, comorbidities, and treatment goals, and viewed as supportive guidance that requires confirmation in well-designed prospective studies. Full article

Background: Hemodialysis (HD) patients frequently develop muscle wasting and chronic inflammation, conditions associated with functional decline and reduced quality of life (QoL). Nutritional strategies that provide targeted anabolic support without increasing nitrogen load may offer clinical benefits. The aim of this study was to evaluate the possible impact of a food for special medical purposes (FFSMP), composed of free-form branched-chain amino acids, β-hydroxy-β-methylbutyrate, and zinc, on muscle mass and strength, laboratory parameters, physical performance (PP), and QoL in HD patients. Methods: in this randomized double-blind crossover study, 24 adult HD patients received the FFSMP (10 g/day; two sachets) supplementation or placebo for 12 weeks, separated by an 8-week wash-out (protocol code RS 29.23). Measured outcomes included quadriceps rectus femoris thickness (QRFT) muscle, body composition analysis, inflammatory markers, oxidative stress indices, other routine biochemical parameters, PP, and QoL (SF-36 questionnaire). Results: FFSMP supplementation resulted in significant increases in QRFT and in fat-free mass percentage. Reductions in oxidative stress and inflammatory biomarkers were observed. Routine biochemical parameters remained stable, with the exception of a decrease in pre-dialysis urea. Functional performance measures did not differ between treatment periods. Improvements were noted in selected SF-36 domains, specifically energy/fatigue and general health. No major adverse events occurred during the study. Conclusions: In HD patients, this FFSMP produced favorable changes in markers of muscle mass and systemic inflammation without affecting short-term physical performance. These findings support the potential clinical utility of targeted amino acid supplementation in this patient population, highlighting the need for larger, longer-term trials. Full article

The informal street food sector serves as a vital component of urban economies in South Africa, providing affordable nutrition and employment. However, this industry struggles to comply with required health and safety practices and standards. This study protocol outlines a mixed-methods investigation into hygiene practices, regulatory compliance, and the intersection with business sustainability among informal food vendors in Johannesburg’s inner city. This study aims to investigate how vendors’ perceptions of health risks and benefits influence compliance behaviours and, in turn, how these behaviours impact operational efficiency, financial stability, and customer trust. Grounded in the Health Belief Model (HBM) and the Balanced Scorecard (BSC) framework, the research seeks to explore both behavioural drivers and performance outcomes associated with hygiene adherence. The study will employ structured stall observations, semi-structured vendor interviews, and customer surveys across high-density vending zones. Quantitative data will be analysed using descriptive and inferential statistics, while qualitative data will be thematically analysed and triangulated with observed practices. The expected outcome is to identify key barriers and enablers of hygiene compliance and demonstrate how improved food safety practices contribute to business resilience, customer trust, and urban public health. The findings aim to inform inclusive policy and innovative business support strategies that integrate informal vendors into safer and more sustainable food systems. Full article

Background/Objectives: Obesity is a multifactorial condition and a major public health challenge. Conventional treatment centers on caloric restriction, which is often unsustainable and may cause stigma and psychoemotional harm. This study aimed to describe the methodology and assess the effects of a multicomponent nutritional intervention not focused on caloric restriction on psychoemotional outcomes. Women were selected as the target population because of the higher prevalence of obesity-related psychoemotional distress, body dissatisfaction, and weight-related stigma in this group, as well as their greater vulnerability to the psychosocial impacts of weight-focused interventions. Methods: This randomised, parallel, open-label trial included 89 obese women from primary care in Viçosa, Brazil. The participants were allocated into three groups: Group 1 (Control), which received a personalised hypocaloric diet (from 500 to 1000 kcal/day); Group 2 (NutrirCom (NutrirCom is a multicomponent, person-centred nutritional intervention protocol that is not focused on caloric restriction, conceived by a group of researchers at the Federal University of Viçosa for the care of women with obesity in Primary Health Care. It integrates nutritional, psychoemotional, behavioural, and social strategies, with an emphasis on promoting eating autonomy, mental health, and quality of life through a humanised, integrated, and sustainable approach, aiming to enhance the effectiveness of health care delivery and clinical practice)), which received 10 individual NutrirCom-based sessions; and Group 3 (NutrirCom + Social Support), which combined individual NutrirCom sessions with monthly group meetings for social support. Randomisation was stratified by body mass index via Excel^® with concealed allocation. The six-month intervention assessed changes in stress, anxiety, depression, and self-compassion, along with anthropometric and metabolic markers. Results: All groups presented reductions in waist circumference, fasting glucose, and total body fat, with increased lean mass. Anxiety remained unchanged in Group 1 but decreased significantly in Groups 2 (p = 0.002) and 3 (p = 0.005). Only Group 2 showed a significant reduction in depression symptoms (p = 0.023). Self-compassion improved significantly in groups 2 and 3. Conclusions: NutrirCom is a low-cost, scalable, and human-centered intervention that integrates emotional, social, and nutritional aspects of care. This approach shows promise as a sustainable strategy for obesity treatment in primary health care. Registration: Brazilian Registry of Clinical Trials (ReBEC) (no. RBR-87wb8x5). Full article

Background and Objectives: Intermittent fasting (IF) has emerged as a nutritional strategy capable of modulating circadian alignment, metabolic efficiency, and neuroendocrine regulation in individuals with obesity. Among the neurobiological mediators potentially involved, Orexin-A—a hypothalamic neuropeptide regulating arousal, appetite, and energy balance—may represent a key link between fasting patterns and metabolic homeostasis. This study aimed to evaluate the long-term metabolic and neuroendocrine effects of two intermittent fasting protocols, time-restricted feeding (16:8) and alternate-day fasting (5:2), compared with a hypocaloric Mediterranean diet used as a reference condition. Materials and Methods: Thirty adults with obesity (aged 20–40 years) were allocated to one of three dietary interventions—low-calorie Mediterranean diet, IF 16:8, or IF 5:2—based on habitual dietary patterns and followed prospectively for 12 months. Anthropometric parameters, metabolic indices, inflammatory markers (CRP, TNF-α, IL-6, IL-10), and circulating Orexin-A concentrations were assessed at baseline and at three-month intervals (T0–T3). Results: Both intermittent fasting protocols induced more rapid improvements in body mass index, adiposity, lipid profile, fasting glucose, and inflammatory markers compared with the Mediterranean diet. Among the IF strategies, the 16:8 regimen showed the most consistent and physiologically coherent pattern of adaptation, characterized by a progressive and sustained increase in Orexin-A levels. This response was strongly associated with enhanced metabolic flexibility, reduced systemic inflammation, and improved energy regulation over time. In contrast, the 5:2 protocol produced more variable metabolic and neuroendocrine responses, likely due to alternating cycles of marked caloric restriction and compensatory intake. Conclusions: Intermittent fasting, particularly the 16:8 time-restricted feeding protocol, appears to be an effective and sustainable chrononutritional strategy for obesity management. By reinforcing circadian organization, improving inflammatory balance, and activating orexinergic pathways, the 16:8 model emerges as a promising intervention to address key metabolic and neuroendocrine dysfunctions associated with obesity. Full article

Background/Objectives: Iron-deficiency anemia (IDA) is a common condition in children and is frequently attributed to nutritional causes. However, gastrointestinal (GI) pathology may be present even in the absence of overt GI symptoms. The diagnostic value of endoscopic evaluation in asymptomatic pediatric patients with IDA remains debated. This systematic review aimed to synthesize available evidence on endoscopic and histologic findings in asymptomatic children with IDA and to assess their clinical implications. Methods: A systematic review was conducted in accordance with the PRISMA 2020 guidelines, and the protocol was registered in PROSPERO. MEDLINE (via PubMed) and Scopus were searched for studies involving children and adolescents (0–18 years) with confirmed iron-deficiency anemia and no gastrointestinal symptoms who underwent endoscopic evaluation. Results: Six studies met the inclusion criteria, comprising a total of 455 pediatric patients. Upper GI endoscopy was the most commonly performed procedure. Clinically significant findings were frequently identified, including histologic features consistent with celiac disease, Helicobacter pylori-associated gastritis, and chronic inflammatory gastric changes. Histologic abnormalities were often present despite minimal or absent macroscopic endoscopic findings. The diagnostic yield of endoscopy was particularly high in older children and adolescents and in those with severe or refractory IDA. Conclusions: This systematic review demonstrates that asymptomatic children with IDA may harbor significant GI pathology detectable by endoscopic and histologic evaluation. These findings support the consideration of targeted endoscopic assessments in selected pediatric patients with unexplained or persistent IDA, even in the absence of GI symptoms. Full article

Background/Objectives: Prebiotics, which are non-digestible compounds that selectively modulate gut microbiota, are recognized for their potential to promote host health. Although their bifidogenic effect is well documented, a systematic synthesis of how this microbial modulation translates into clinical gastrointestinal (GI) and metabolic outcomes across diverse populations is needed. This review aims to integrate mechanistic insights with clinical evidence to elucidate the pathway from prebiotic structures to tangible health benefits. Methods: This comprehensive narrative review details the structural properties of major prebiotics (e.g., inulin, FOS, and GOS) that govern their fermentation and the production of short-chain fatty acids (SCFAs). To evaluate clinical efficacy, an analysis of 22 randomized controlled trials from the past decade was conducted, focusing on human studies that utilized ISAPP-recognized prebiotics as the sole intervention. Results: The analysis confirms that prebiotic supplementation consistently increased the abundance of beneficial bacteria (e.g., Bifidobacterium and Lactobacillus) and SCFA production. These changes are associated with significant clinical improvements, including enhanced stool frequency and consistency, strengthened intestinal barrier function, and modulated immune responses. Benefits have been documented in healthy individuals, children, the elderly, and those with conditions such as constipation, metabolic syndrome, and antibiotic-associated dysbiosis. However, significant inter-individual variability in response was evident, and the study designs showed notable heterogeneity in prebiotic type, dosage, and duration. Conclusions: Prebiotics are effective modulators of gut health, driving clinical benefits through selective microbial fermentation and SCFA production. The documented heterogeneity and variability highlight the need for future research to focus on personalized nutritional strategies. Key priorities include standardizing intervention protocols, elucidating dose–response relationships, integrating multi-omics data to link taxonomy to function, and exploring novel applications such as synbiotic formulations and gut–brain axis modulation. Full article

The global prevalence of obesity continues to rise and is a significant risk factor for the onset and progression of cardiovascular diseases. Despite the development of new pharmacological therapies, novel strategies are being explored to mitigate the impact of this disease. Intermittent fasting (IF) is a nutritional intervention that has gained popularity and shows potential as an innovative approach to weight management. This study aims to compile scientific evidence on various aspects of fasting, including its physiological effects, the molecular and thermogenic mechanisms involved, and recommendations regarding nutritional strategies during the refeeding period within the eating window. We conducted a narrative review, analyzing evidence available from PubMed/MEDLINE based on studies related to intermittent fasting, thermogenesis, and their associated outcomes. Our results demonstrate the existence of three commonly used IF protocols: alternate day fasting (ADF), periodic fasting (PF), and time-restricted eating (TRE). In addition to its effects on weight loss, IF has demonstrated notable benefits for cardiovascular health, oxidative stress, and metabolic function. Moreover, the interaction between the central nervous system and brown adipose tissue provides an alternative mechanism for the molecular regulation of thermogenesis. Nutritional patterns adopted during intermittent fasting play a crucial role in optimizing outcomes, with particular emphasis on the intake of proteins, fiber, bioactive compounds, and essential fatty acids during the feeding window. In summary, current evidence indicates that intermittent fasting provides a biologically robust framework for studying energy balance and holds promise for developing targeted nutritional interventions. Full article