Search Results (1,041)

Background: Plant-based protein supplementation in supporting muscle recovery following resistance exercise remains an area of growing interest, particularly among vegan athletes, as a potential alternative to animal-based proteins. This systematic review aimed to evaluate the effectiveness of plant-based proteins on recovery from resistance exercise-induced muscle damage in healthy young adults. Methods: A systematic and comprehensive search was administered in eight databases up to 1 May 2025, identifying 1407 articles. Following deduplication and screening, 24 studies met the eligibility criteria, including 22 randomized controlled trials and 2 non-randomized studies, with the majority from high income western countries. Results: Interventions primarily involved soy, pea, rice, hemp, potato, and blended plant protein sources, with doses ranging from 15 to 50 g, typically administered post resistance exercise. Outcomes assessed included muscle protein synthesis (MPS), delayed-onset muscle soreness (DOMS), inflammatory biomarkers, muscle function, and fatigue. The review findings reaffirm that single-source plant proteins generally offer limited benefits compared to animal proteins such as whey, particularly in acute recovery settings, a limitation well-documented consistently in the literature. However, our synthesis highlights that well-formulated plant protein blends (e.g., combinations of pea, rice, and canola) can stimulate MPS at levels comparable to whey when consumed at adequate doses (≥30 g with ~2.5 g leucine). Some studies also reported improvements in subjective recovery outcomes and reductions in muscle damage biomarkers with soy or pea protein. However, overall evidence remains limited by small sample sizes, moderate to high risk of bias, and heterogeneity in intervention protocols, protein formulations, and outcome measures. Risk of bias assessments revealed concerns related to detection and reporting bias in nearly half the studies. Due to clinical and methodological variability, a meta-analysis was not conducted. Conclusion: plant-based proteins particularly in the form of protein blends and when dosed appropriately, may support muscle recovery in resistance-trained individuals and offer a viable alternative to animal-based proteins. However, further high-quality, long-term trials in vegan populations are needed to establish definitive recommendations for plant protein use in sports nutrition. Full article

Background/Objectives: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country’s population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. Methods: Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). Results: The review identified three domains of factors and the ways in which each factor shapes older adults’ virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). Conclusions: This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts. Full article

Refugees experience disproportionately high rates of sleep disturbances due to trauma, displacement, and resettlement stressors. Sleep health is critically linked to both physical and mental well-being, yet remains an underexplored area of intervention for refugee populations. This systematic review aimed to (1) identify interventions implemented to improve sleep health among refugees, (2) assess their effectiveness, and (3) evaluate the extent of cultural adaptation in their design and implementation. A comprehensive search of peer-reviewed literature from 2004 to 2024 identified nine studies focused on adult refugees in high-income countries. Interventions included psychoeducation, music-assisted relaxation, guided imagery, and nightmare-focused therapies. Several demonstrated improvements in sleep quality, insomnia severity, and nightmare frequency. Music-based interventions and sleep health education stood out as accessible, non-stigmatizing strategies that may be particularly well suited to refugee contexts. However, cultural adaptation emerged as the most significant gap. Using the 4-Domain Cultural Adaptation Model (CAM4)—which assesses adaptation across context, content, delivery, and engagement—most studies showed only surface-level modifications. Few incorporated community voices, and none validated sleep assessment tools for cultural relevance. Future research should prioritize co-creation with refugee communities to ensure interventions are not only evidence-based, but also culturally grounded, trusted, and sustainable across diverse refugee populations. Full article

The work presents a comprehensive analysis and costing of sugar beet cultivation in 2020–2022, for individual farms of the Lublin region. About 120 farms were analyzed. Based on this analysis, the criteria for a model farm were determined and adopted for the calculation of sugar beet production costs. ARIMA process modeling was performed, based on which forecasts were determined for several selected parameters. Customs tariffs introduced by the USA have a drastic impact on the economy. The effects of the COVID19 pandemic may also have a significant impact on the current market situation. Forecasting in the current geopolitical situation is very difficult because of the lack of stationarity of parameters. The financial result obtained by growers is mainly influenced by indirect costs absorbing 61.31% of total costs in 2020. In 2021 and 2022, indirect costs were 61.16% and 59.61% of production income, respectively. Among this group of costs, the largest share is accounted for by the costs of sowing services, sugar beet harvesting, and soil liming amounting from 14.27% to 15.92%. During the analyzed period, sugar beet cultivation remained profitable, with a production profitability index of 1.31 in 2020 and 2021, and 1.10 in 2022. The unit cost of production increased every year. In 2020, it was 14.27% and in 2021, it increased to 15.19%. The unit cost of production in 2022 was the highest, at 23.41%. Sugar beet cultivation is one of the profitable activities in agricultural production, but it is characterized by high production costs, which increased during the years analyzed (2020 to 2022), topping out at 90.87% of total revenue. The information and data presented in this study will be used in the development of a farmer-oriented application and will support the creation of an expert system for sugar beet growers. Cost forecasting will enable farmers to plan their production more effectively. Full article

Although organizational resilience is well established, refining the systematic quantitative evaluation of health systems resilience (HSR) remains an ongoing opportunity for advancement. Research either focuses on individual HSR indicators, such as social welfare policy, public expenditure, health insurance, healthcare quality, and technology, or broadly examines socio-economic factors, highlighting the need for a more comprehensive methodological approach. This study employed the Slacks-Based Measure (SBM) within Data Envelopment Analysis (DEA) to analyze efficiency by maximizing outputs. It systematically examined key HSR factors across countries, providing insights for improved policymaking and resource allocation. Taking a five-year (2016–2020) dataset that covered 55 to 56 countries and evaluating 17 indicators across governance, health systems, and economic aspects, the paper presents that all sixteen top-ranked countries with a perfect efficiency score of 1 belonged to the high-income group, with ten in Europe, highlighting regional HSR differences. This paper concludes that adequate economic resources form the foundation of HSR and ensure stability and sustained progress. A properly supported healthcare workforce is essential for significantly enhancing health systems and delivering quality care. Last, effective governance and the equitable allocation of resources are crucial for fostering sustainable development and strengthening HSR. Full article

Slow-release nitrogen fertilizers enhance crop production and reduce environmental pollution, but their slow nitrogen release may cause insufficient nitrogen supply in the early stages of crop growth. Mixed nitrogen fertilization (MNF), combining slow-release nitrogen fertilizer with urea, is an effective way to increase yield and income and improve nitrogen fertilizer efficiency. This study used urea alone (Urea) and slow-release nitrogen fertilizer alone (C/SRF) as controls and employed meta-analysis and a random forest model to assess MNF effects on crop yield and nitrogen partial factor productivity (PFPN), and to identify key influencing factors. Results showed that compared with urea, MNF increased crop yield by 7.42% and PFPN by 8.20%, with higher improvement rates in Northwest China, regions with an average annual temperature ≤ 20 °C, and elevations of 750–1050 m; in soils with a pH of 5.5–6.5, where 150–240 kg·ha⁻¹ nitrogen with 25–35% content and an 80–100 day release period was applied, and the blending ratio was ≥0.3; and when planting rapeseed, maize, and cotton for 1–2 years. The top three influencing factors were crop type, nitrogen rate, and soil pH. Compared with C/SRF, MNF increased crop yield by 2.44% and had a non-significant increase in PFPN, with higher improvement rates in Northwest China, regions with an average annual temperature ≤ 5 °C, average annual precipitation ≤ 400 mm, and elevations of 300–900 m; in sandy soils with pH > 7.5, where 150–270 kg·ha⁻¹ nitrogen with 25–30% content and a 40–80 day release period was applied, and the blending ratio was 0.4–0.7; and when planting potatoes and rapeseed for 3 years. The top three influencing factors were nitrogen rate, crop type, and average annual precipitation. In conclusion, MNF should comprehensively consider crops, regions, soil, and management. This study provides a scientific basis for optimizing slow-release nitrogen fertilizers and promoting the large-scale application of MNF in farmland. Full article

Molar pregnancy (MP) is a gestational disorder resulting from abnormal fertilization, leading to atypical trophoblastic proliferation and the formation of a complete or partial hydatidiform mole. This condition represents the most common form of gestational trophoblastic disease (GTD) and carries a significant risk of progression to gestational trophoblastic neoplasia (GTN). Although rare in high-income countries, MP remains up to ten times more prevalent in low-income and developing countries, contributing to preventable maternal morbidity and mortality. This narrative review provides an updated, practical overview of the clinical presentation, diagnosis, treatment, and follow-up of MP. A key focus is the challenge of early diagnosis, particularly given the increasing frequency of first-trimester detection, where classical histopathological criteria may be subtle, leading to diagnostic errors. The review innovates by integrating advanced diagnostic methods—combining histopathology, immunohistochemistry using p57Kip2, Ki-67, and p53 markers, along with cytogenetic analysis—to improve diagnostic accuracy in early gestation. The central role of referral centers is also emphasized, not only in facilitating timely treatment and access to chemotherapy, but also in implementing standardized post-molar follow-up protocols that reduce progression to GTN and maternal mortality. By focusing on both advanced diagnostic strategies and the organization of care through referral centers, this review offers a comprehensive, practice-oriented perspective to optimize patient outcomes in GTD and address persistent care gaps in high-burden regions. Full article

Objective: This study aimed to develop a performance evaluation index system for a district-level public hospital in Chongqing, China, based on Diagnosis-Related Groups (DRGs), to provide a benchmark for performance assessment in similar hospitals. The system was constructed using a literature analysis, the Delphi method, and the Analytic Hierarchy Process (AHP) to identify and weight relevant indicators. Results: The evaluation system consists of three primary indicators and eighteen secondary indicators. Key secondary indicators include the Case Mix Index (CMI), cost consumption index, low-risk group mortality rate, the proportion of patients with three- or four-level surgeries at discharge, and the proportion of medical service revenue to medical income. In 2020, significant improvements were observed in several indicators, such as a decrease in the low-risk group mortality rate to 0% and increases in the proportion of patients with three- or four-level surgeries and CMI by nearly 10% and 13%, respectively. Conclusions: This study successfully developed a comprehensive and scientifically sound performance evaluation index system for a district-level public hospital in Chongqing. The system has proven effective in objectively assessing inpatient medical care performance and providing valuable guidance for improving healthcare services in similar settings. Full article

Background: The advances in cancer diagnosis and treatment have significantly improved survival rates in pediatric patients, with five-year survival now exceeding 80% in many high-income countries. However, these life-saving therapies often carry long-term consequences, including impaired fertility. The reproductive health of childhood cancer survivors has emerged as a key issue in survivorship care. Objective: This narrative review aims to examine the gonadotoxic effects of cancer treatments on pediatric patients, evaluate fertility preservation strategies in both males and females, and provide guidance on the long-term monitoring of reproductive function post treatment. Methods: A comprehensive literature review was conducted using PubMed, including randomized trials, cohort studies, and clinical guidelines published up to March 2024. The keywords focused on pediatric oncology, fertility, and reproductive endocrinology. Studies were selected based on relevance to treatment-related gonadotoxicity, fertility preservation options, and follow-up care. Results: Radiotherapy and alkylating agents pose the highest risk to fertility. Postpubertal patients have access to standardized preservation techniques, while prepubertal options remain experimental. Long-term effects include premature ovarian insufficiency, azoospermia, hypogonadism, and uterine dysfunction. The psychosocial impacts, especially in female survivors, are profound and often overlooked. Conclusions: Fertility preservation should be discussed at diagnosis and integrated into treatment planning in pediatric patients with cancer. While options for postpubertal patients are established, more research is needed to validate safe and effective strategies for younger populations. A multidisciplinary approach and long-term surveillance are essential for safeguarding future reproductive potential in childhood cancer survivors. Full article

Saudi Vision 2030 seeks to improve social sustainability in the Kingdom through comprehensive economic and social reforms. This study investigates whether these reforms are associated with changes in subjective well-being (SWB), commonly understood as individuals’ experienced quality of life. Using Gallup World Poll data from 2013 to 2023 on Cantril ladder scores and affect balance in Saudi Arabia, we find increases in SWB following the implementation of Vision 2030 reforms, particularly for the affective component of SWB. While positive changes in SWB are observed across the entire population, the gains in affective well-being are especially pronounced among women. Blinder–Oaxaca decompositions show that improvements are associated with enhanced community basics, followed by greater income sufficiency, improved perceptions of social life, and an increased sense of personal freedom. Full article

Background/Objectives: Undernutrition and intestinal parasitic infections are critical public health problems in low-income countries, with adverse effects on child growth and increasing anaemia. Madagascar, with a high prevalence of these factors, lacks comprehensive studies analysing their interaction. This study aimed to assess the nutritional status, the prevalence of anaemia, and the occurrence of intestinal parasitic infections among children and adolescents in three southern regions of Madagascar. Methods: A cross-sectional, prospective study of 289 children and adolescents (10–18 years) from three schools located in Antsoamadiro, Fianarantsoa, and Toliara was conducted. Sociodemographic, anthropometric, and haemoglobin concentration data, as well as faecal samples, were collected. Nutritional status was assessed by Nutrimetry, combining Height-for-Age and BMI-for-Age indicators. Stool samples were analysed by optical microscopy and molecular methods. Results: Nutricode 1 (short stature/stunting + thinness/wasting) was significantly more frequent in Toliara. Nutricode 1 was also significantly more prevalent in males than females. Anaemia affected 57.8% of participants and was significantly associated with Nutricode 1. The overall parasitism rate was also associated with Nutricode 1. Trichuris trichiura and Ascaris lumbricoides significantly increased the risk of stunting, wasting, and Nutricode 1. Co-infection with Trichuris trichiura + Giardia duodenalis was significantly associated with wasting and Nutricode 1. This co-infection was also related to the presence of anaemia, as was moderate-intensity infection with T. trichiura. Conclusions: There is a high co-burden of undernutrition, anaemia, and parasitic infections in southern Madagascar. These findings highlight the urgency of implementing comprehensive health programmes combining parasite control, nutritional support, and iron supplementation adapted to regional realities. Full article

Iron deficiency (ID) is the most prevalent micronutrient deficiency globally, affecting approximately one in four individuals, with a particularly high burden among children, women of reproductive age, and populations in low- and middle-income countries. It contributes significantly to the global burden of disease, with consequences ranging from impaired cognitive and motor development in children to increased risks during pregnancy, including low birth weight, preterm delivery, and maternal mortality, as well as reduced physical performance and quality of life in adults. ID often precedes iron deficiency anemia (IDA), though clinical and functional impairments—such as cognitive deficits, immune dysfunction, and fatigue—can occur even in the absence of anemia. Despite its widespread nature, challenges remain in precisely defining, diagnosing, and treating ID effectively. Advances in diagnostic tools allow for earlier detection, while novel therapeutic strategies, including updated oral dosing regimens and modern intravenous iron formulations, offer improved efficacy and tolerability. These approaches are particularly valuable in minimizing gastrointestinal side effects and enhancing patient adherence. This review is based on a comprehensive literature search conducted primarily through PubMed and Scopus, emphasizing studies published within the past 10–15 years. It is thematically structured to explore the epidemiology, health consequences, diagnostic complexities, and therapeutic developments related to ID. It highlights the multifactorial nature of ID and underscores the urgent need for early identification, targeted interventions, and updated clinical guidelines to reduce the long-term health and societal impacts of this preventable and treatable condition. Full article

Background/Objectives: Antimicrobial consumption (AMC) surveillance and antimicrobial stewardship (AMS) constitute effective strategies to combat the increasing antimicrobial resistance rates worldwide. Post-Soviet countries (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan) implemented various elements of AMC surveillance and AMS to different extents. The limited quantity and quality of data from post-Soviet countries make it difficult to assess health system performance; therefore, this region is a blind spot in global AMR monitoring. This systematic review assesses and characterises AMC surveillance and AMS implementation in post-Soviet countries. Methods: Evidence was compiled via a search in PubMed, Google Scholar, Embase, CyberLeninka, and Scopus. The eligibility criteria included AMC surveillance- and AMS-related papers in human health within defined regions and timelines. Some literature from the official websites of international and national health organisations was included in the search. Results: As a result of the searches, screening, and critical appraisal, three peer-reviewed publications and 31 documents were selected for analysis. Eleven out of fifteen countries with updated national action plans for combating antimicrobial resistance have defined AMC surveillance and AMS as strategic objectives. All 15 examined countries submitted antimicrobial consumption data to international networks and reported the existence of approved laws and regulations on antibiotic sales. However, disparities exist in the complexity of monitoring systems and AMS implementation between high-income and low-income countries in the region. Conclusions: This review provides key insights into the existing AMC surveillance and AMS implementation in former Soviet countries. Although the approach of this review lacks quantitative comparability, it provides a comprehensive qualitative framework for national-level AMC surveillance and AMS system assessment. Full article

This paper presents a comprehensive model for detecting and addressing concept drift in network security data using the Isolation Forest algorithm. The approach leverages Isolation Forest’s inherent ability to efficiently isolate anomalies in high-dimensional data, making it suitable for adapting to shifting data distributions in dynamic environments.Anomalies in network attack data may not occur in large numbers, so it is important to be able to detect anomalies even with small batch sizes. The novelty of this work lies in successfully detecting anomalies even with small batch sizes and identifying the point at which incremental retraining needs to be started. Triggering retraining early also keeps the model in sync with the latest data, reducing the chance for attacks to be successfully conducted. Our methodology implements an end-to-end workflow that continuously monitors incoming data and detects distribution changes using Isolation Forest, then manages model retraining using Random Forest to maintain optimal performance. We evaluate our approach using UWF-ZeekDataFall22, a newly created dataset that analyzes Zeek’s Connection Logs collected through Security Onion 2 network security monitor and labeled using the MITRE ATT&CK framework. Incremental as well as full retraining are analyzed using Random Forest. There was a steady increase in the model’s performance with incremental retraining and a positive impact on the model’s performance with full model retraining. Full article

The livestock sector is a significant contributor to the economy and rural livelihoods, but it is exposed to high risk across the supply chain, which is detrimental and needs to be addressed for sustainable development. Therefore, this study aimed to identify the major risk mitigation strategies (RMSs) and associated factors that affect their adoption. This study conducted a comprehensive literature review to identify the eight major RMSs and prioritized them through an analytical hierarchical process (AHP). Thereafter, a multivariate probit (MVP) model was developed to identify the factors affecting the adoption of major RMSs. The primary RMSs are livestock insurance, vaccination of livestock, and advisory/extension services. Further, the multivariate probit regression analysis shows that ‘age’, ‘social category’, ‘economic status’, ‘educational level’, ‘income level’, ‘the total number of animals’, and ‘perceived risk of foot and mouth disease’ are significant factors that influence the adoption of RMSs. This study’s findings will be useful for livestock supply chain partners to mitigate the risks along the livestock supply chain. This research will also help policymakers to develop policies/plans for incorporating these RMSs by considering the influencing associated factors. Full article