Search Results (28,630)

Asthma continues to affect millions of adults in the United States, with indoor environmental exposures playing a major role in symptom burden and control. Limited research has examined the combined influence of multiple household and environmental determinants on adult asthma morbidity, particularly in diverse states such as Texas. We analyzed pooled data from 1596 Texas adults with asthma who completed the Asthma Call-Back Survey between 2019 and 2022. Multivariable logistic regression models, adjusted for survey design and demographic covariates, were used to examine associations between household and environmental determinants and four morbidity outcomes: asthma attacks, recent symptoms, sleep difficulty, and limited activity due to asthma. Current smoking, lack of bathroom or kitchen ventilation, and absence of air purifier use were consistently associated with higher odds of morbidity. Protective associations were observed for homes without mold, rodents, or furry pets. Disparities were also evident, with older adults, women, and non-Hispanic Black respondents reporting greater morbidity. These findings highlight the importance of addressing modifiable exposures such as indoor smoking, ventilation, and allergen control within comprehensive asthma management strategies. Targeted interventions that combine environmental modifications with health education may help reduce asthma disparities and improve the quality of life for adults with asthma. Full article

Treatment of neuropathic pain (NP) remains a challenge in clinical practice because the current treatment approaches produce satisfactory pain alleviation in only 30% of patients. This necessitates developing novel drugs or repurposing existing medications intended to manage other diseases. When the repurposing intendance is chosen, similarity in the pharmacological properties should be hosted by the candidate drugs. Herein, this review sheds light on the mechanisms of certain centrally acting skeletal muscle relaxants (CMRs), specifically tolperisone. So far, data indicate that tolperisone displays voltage-gated sodium channel (VGSC) blocking properties with modulatory effect on voltage-gated calcium channels (VGCCs). These properties have led to recent preclinical research initiatives testing tolperisone in NP, resulting in positive outcomes. Furthermore, the review highlights the currently available VGSC blockers and proposes a strategy based on combining them with VGCC blockers that have been proven for the treatment of NP. This proposal is supported by the fact that tolperisone, in combination with pregabalin, has recently been shown to acutely halt NP. Full article

Eco-cities have become global initiatives in recent years. This paper aims to discuss the construction, evolution and future of eco-city movements in China, especially in areas with abundant ecological resources. Extant literature emphasizes that sustainable development is the purpose of an eco-city. However, in the spatial practice of ecological modernization, many European and American countries develop ecological construction at a slower pace, resulting in sustainable ecological outcomes. Those countries developed ecological practices at a smaller scale, aiming to achieve green towns with zero carbon emission. In contrast, the construction of China’s eco-cities typically involves building new cities in outer suburbs with a larger scale and faster speed. This has led to the rapid construction of so-called ecological cities without sustainable development. In this context, this paper starts from the perspective of political economy and conducts qualitative research on the Shanghai Dongtan Eco-city as a case study. It analyzes the motivation and practical measures of different actors by examining the planning, design and construction process of Dongtan Eco-city during 1998–2024. The results suggest that gaining national political priority through the intervention of international actors and foreign investment is the key to the local pilot ecological city project. This paper further analyzes the differences between the planning concept and the actual practice of Dongtan Eco-city, critically discussing the “Eco-city as the enclave of ecological technology.” This is driven by the integration of eco-city construction and the local government performance appraisal system. Consequently, the pursuit of economic returns redirected Dongtan’s sustainability experiment into a form of green-branded retirement real-estate development between 1998 and 2012. From 2012 to 2024, Chongming’s development model continued to evolve, as the project was reframed from a real-estate-led eco-city paradigm toward an “ecological island” agenda articulated in the language of sustainable development. Full article

Endometrial hyperplasia (EH) comprises a spectrum of abnormal proliferative changes in the endometrium, ranging from benign glandular overgrowth to lesions with substantial malignant potential. The importance of risk stratification and early identification is highlighted by the growing recognition of EH as a precursor to endometrial cancer. The main causes of EH, according to epidemiological research, include obesity, polycystic ovarian syndrome (PCOS), metabolic dysfunction, and extended exposure to unopposed estrogen. Emerging molecular markers, histological analysis, and imaging are all necessary for a proper diagnosis of EH because it might appear with vague clinical symptoms such as irregular uterine bleeding. Surgical intervention or progestin therapy are two possible management techniques for EH, depending on the lesion’s intricacy and the patient’s medical history, including fertility issues. Personalized therapy techniques and recent developments in molecular profiling have the potential to enhance patient outcomes by matching treatment to tumor biology and individual risk profiles. This review highlights the translational potential of molecular insights while synthesizing the most recent data on the epidemiology, risk factors, diagnostic techniques, and therapy of EH. A deeper comprehension of these elements is necessary to maximize treatment results and stop the development of endometrial cancer. Full article

This literature review examined the relationship between energy drink consumption and cardiovascular health in young people. Following PRISMA 2020, we searched Scopus for articles published from 2020 to 2025 and included 33 original studies after screening 133 records. Evidence from observational, clinical, and experimental research was synthesized into six themes: youth consumption; direct cardiovascular outcomes; composition and toxicity; animal or cellular experiments; perceptions and habits; and occupational or sociodemographic factors. Across studies, habitual intake was linked to acute blood-pressure rises, arrhythmias, endothelial dysfunction, and metabolic disturbances, sometimes within 24 h of a single can. Risks were amplified by high caffeine and taurine doses and by co-use with alcohol or intense exercise. Adolescents and young adults were most vulnerable, due to heightened sympathetic responses, frequent use under academic or work stress, and limited risk perception. Authors highlighted five actions: longitudinal research; tighter ingredient monitoring and transparent labeling; consumer education; protection of vulnerable groups; and clinical guidance for responsible use. These results were observed across regions and study designs. Overall, the findings indicate that unregulated energy-drink consumption is a preventable cardiovascular risk in youth, justifying the use of coordinated public-health measures, including curriculum-based education, marketing restrictions, ingredient oversight, and clinical screening to mitigate harm. Full article

Pathogenic variants in the PAK1 gene are linked to neurodevelopmental and neurodegenerative disorders by disrupting neuronal signaling and function. Despite increasing recognition, the mechanisms underlying these conditions remain incompletely understood, limiting therapeutic options. Here, we report a novel de novo PAK1 variant, c.396C>A (p.Asn132Lys), in a 5-year-old girl with Intellectual Developmental Disorder with Macrocephaly, Seizures, and Speech Delay (IDDMSSD). The patient presented with mild intellectual disability, delayed speech, macrocephaly, hypotonia, gait ataxia, autism-like behaviors, and focal epileptiform activity. Trio exome sequencing confirmed the variant as likely pathogenic, absent in her parents and population databases. This finding expands the phenotypic spectrum of PAK1-related disorders and underscores the critical role of the autoinhibitory domain in neurodevelopment. In addition, we performed a comprehensive literature review of PAK1 variants affecting both the autoregulatory and kinase domains, summarizing associated clinical features and pathogenic mechanisms. Our study highlights the importance of identifying PAK1 pathogenic variants for accurate diagnosis, refined genotype-phenotype correlations, and the development of potential targeted therapeutic strategies. By integrating novel case data with existing literature, this work advances understanding of PAK1-related neurodevelopmental disorders and supports the application of genetic analysis in rare pediatric NDD cases. Full article

In this article, the thermal and mechanical properties of mortars reinforced with polypropylene (PP) fibres have been studied. Particularly, the effect of polypropylene fibres’ addition on the thermal behaviour of fine-grained building mortars at high temperatures was studied using simultaneous thermal analysis. Two types of polypropylene fibres, differing in shape and size, were used as fillers. The thermal behaviour of cement mortar samples with and without fibres was described. Special attention was given to the thermal behaviour of fibre-reinforced cement mortars subjected to the high temperatures of 100 °C, 200 °C, 300 °C, 400 °C, 500 °C, and 600 °C. Comparative studies using simultaneous thermal analysis (STA) were also performed for non-heated samples (20 °C). The TG, DTG, and DTA curves were analysed to investigate the effects related to the dehydration and the decomposition of hydration and carbonation products. Compared to mortar samples without fibres, the results showed that the presence of polypropylene fibres contributes to an increase in the thermal stability of the samples. It has been proven that the impact of the type and amount of PP fibres in the tested range (1.8 kg/m³ vs. 3.6 kg/m³) on the thermal stability of specimens of tested cement composites was found not to be significantly visible. Next, extensive research was performed on the impact of fire environmental exposure on the variability in the strength parameters of the mortars. Tensile strength tests were conducted based on the standards specified by the Polish Committee for Standardization. The research material consisted of high-strength, fine-grained building mortars, modified by an original method with polypropylene fibres at concentration of 1.8 kg/m³, 3.0 kg/m³, and 3.6 kg/m³. For reference, ordinary mortars without fibres were used, as well. Tensile strength was evaluated for mortar samples, which were exposed to temperatures of 100 °C, 200 °C, 300 °C, 400 °C, 500 °C, and 600 °C, respectively. Special attention was paid to the thermal behaviour of cement mortars reinforced with polypropylene (PP) fibres, subjected to high temperatures. Based on the obtained test results, a detailed statistical analysis was developed, along with comprehensive temperature–parameter relationships, which could enable an approximate post-failure assessment of the mortar’s condition. The main outcomes of this paper include optimal fibre dosage, which is 3.6 kg/m³, identified optimal fibre type, namely F fibre, as well as plateau in tensile strength for temperatures between 200 °C and 400 °C for fibre-reinforced samples. Full article

Background/Objectives: Many studies have investigated the Cognitive Acceleration through Science Education (CASE) programme, demonstrating its impact on students’ reasoning and learning development across different educational contexts. Likewise, numerous experimental investigations have employed the Solomon Four-Group Design (SFGD) to control for pretest sensitisation and improve the validity of intervention studies. However, despite the extensive use of both frameworks independently, no previous research has integrated them within a single study. The present research therefore combines the theoretical foundations of CASE with the methodological rigour of the SFGD to explore the influence of intervention outcomes under different pretest conditions on learners’ cognitive growth. Methods: This study examines differences associated with pretest sensitisation and the CASE programme among middle school students using a quasi-experimental research design. The study was conducted with 88 students divided into four groups, two experimental and two control, following the Solomon Four-Group Design to account for pretest sensitisation and its potential interaction with the treatment. Results: Statistical analyses revealed that the observed outcomes differed between pretested and non-pretested groups, with the pretested conditions showing larger post-test differences than the non-pretested ones. Conclusions: Rather than establishing causal effects, this study highlights key methodological considerations related to pretest sensitisation when evaluating cognitive acceleration interventions. The findings provide practical guidance for researchers and educators in designing, analysing, and interpreting classroom-based intervention studies where pretesting may influence observed outcomes. Full article

The construction industry significantly contributes to global sustainability challenges, producing 30–40 percent of global carbon dioxide emissions and consuming large amounts of natural resources. Pervious concrete has emerged as a sustainable alternative to conventional pavements due to its ability to promote stormwater infiltration and groundwater recharge. However, the absence of fine aggregates creates a highly porous structure that results in reduced compressive strength, limiting its broader structural use. Determining compressive strength traditionally requires destructive laboratory testing of concrete specimens, which demands considerable material, energy, and curing time, often up to 28 days—before results can be obtained. This makes iterative mix design and optimization both slow and resource intensive. To address this practical limitation, this study applies Machine Learning (ML) as a rapid, preliminary estimation tool capable of providing early predictions of compressive strength based on mix composition and curing parameters. Rather than replacing laboratory testing, the developed ML models serve as supportive decision-making tools, enabling engineers to assess potential strength outcomes before casting and curing physical specimens. This can reduce the number of trial batches produced, lower material consumption, and minimize the environmental footprint associated with repeated destructive testing. Multiple ML algorithms were trained and evaluated using data from existing literature and validated through laboratory testing. The results indicate that ML can provide reliable preliminary strength estimates, offering a faster and more resource-efficient approach to guiding mix design adjustments. By reducing the reliance on repeated 28-day test cycles, the integration of ML into previous concrete research supports more sustainable, cost-effective, and time-efficient material development practices. Full article

(1) Background: The use of wearable technology for assessing running biomechanics in field-based sports has increased in recent years. Inertial measurement units (IMUs) are low-cost, non-invasive devices capable of estimating spatiotemporal gait-related metrics during overground locomotion. This study evaluated the accuracy and concurrent validity of a foot-mounted IMU system for estimating sprinting kinematics. (2) Method: Twenty-five elite and sub-elite athletes completed four maximal 10-metre fly efforts, with their kinematics measured concurrently using a three-dimensional motion analysis system and IMUs. (3) Result: The foot-mounted IMU system’s root mean square errors for stride length and duration were 0.22 m and 0.04 s, respectively. Mean biases (95% level of agreement) were −0.67 $\mathrm{m} · {\mathrm{s}}^{-1}$ (−1.19; −0.14) for peak velocity, −0.51 $\mathrm{m} · {\mathrm{s}}^{-1}$ (−1.10; 0.09) for instantaneous velocity, and 0.17 $\mathrm{m} · {\mathrm{s}}^{-2}$ (−1.04; 1.37) for instantaneous acceleration. Stride length, duration, and cadence were −0.07 m (−0.36; 0.23), 0.02 s (−0.02; 0.06), and −4.64 strides $· {\min }^{-1}$ (−15.82; 6.53), respectively. (4) Conclusions: End users implementing this technology in research and practice should interpret this study’s findings relative to their analytical objectives, logistical resources, and operational constraints. Therefore, its adoption should be guided by the specific performance metrics of interest and the extent to which the system’s capabilities align with the outcomes the end user aims to achieve. Full article

Interspecies variability in diabetes mellitus (DM) represents a critical challenge for translational medicine, as metabolic pathways, pancreatic architecture, and therapeutic responses differ substantially across animal models. This systematic review, conducted according to PRISMA 2020 guidelines, synthesized evidence from 86 eligible studies published between 2001 and 2025. Comparative data from rodents, dogs, cats, pigs, non-human primates, and humans were analyzed to identify species-specific patterns in insulin secretion, insulin resistance (IR), β-cell dysfunction, microbiota–metabolism interactions, and susceptibility to diabetic complications. Results indicate that spontaneous diabetes in dogs closely mirrors human type 1 diabetes (T1DM), whereas feline obesity-associated diabetes reflects key features of human type 2 diabetes (T2DM). Rodent models remain essential for mechanistic and genetic studies but show limited chronicity and lower predictive fidelity for long-term outcomes. Non-human primates exhibit the highest physiological similarity to humans, especially regarding β-cell structure and incretin response, supporting their role in advanced translational studies. Major limitations included methodological heterogeneity and inconsistent molecular reporting. Integrating spontaneous models with standardized protocols and multi-omics approaches enhances translational relevance and supports more accurate model selection in diabetes research. Full article

Despite being key partners in the supportive care of the cancer patient, family caregivers are often inadequately prepared for or supported to take on this critical role, subsequently putting their own wellbeing at risk and, by extension, that of the patient. Exercise interventions show promise in mitigating caregiver burden and improving health outcomes for both caregivers and patients; however, the interrelationship between family caregiver and care recipient has gone largely unexplored. Thus, we conducted a single-group pilot study to examine the feasibility and preliminary effectiveness of a 12-week dyadic exercise intervention. Of the 27 caregiver–patient dyads who consented, 21 (77.8%) completed the study, with participants completing an average of 23.1 (96.3%) of the prescribed exercise sessions, suggesting good adherence and study retention. All participants reported higher post-intervention levels of strenuous physical activity (p = 0.017), improved sit-to-stand repetitions (p = 0.004), and social functioning (p = 0.030) compared to baseline. Of note, caregivers reported higher post-intervention scores on the burden in relationship subscale of the Zarit Burden Interview relative to baseline (p = 0.043), suggesting an increase in perceived caregiver burden following the intervention. Overall, dyadic exercise interventions appear feasible and may confer certain physical and psychosocial benefits for both family caregivers and care recipients. However, such programs may also unintentionally exacerbate certain aspects of caregiver burden. Future research should aim to identify factors within dyadic exercise interventions that may contribute to increased caregiver burden, as well as strategies to help mitigate these effects. Full article

Background: Potential drug–drug interactions (pDDIs) present substantial challenges to medication safety during care transitions. Warfarin, with its narrow therapeutic index and extensive interaction profile, provides a strategic model for examining pDDIs at discharge. This study aimed to characterize the burden and determinants of major warfarin pDDIs among patients discharged from a tertiary-care hospital. Methods: This retrospective cross-sectional study analyzed electronic health records of 1667 patients discharged home on warfarin. Major pDDIs were identified using the Micromedex^® Drug Interaction database. Log-binomial regression was used to assess predictors of ≥1 major pDDIs, and generalized Poisson regression was used to model the number of pDDIs per patient. Results: Major warfarin pDDIs were identified in 81.6% (95% CI: 79.6–83.4%) of patients at hospital discharge. The burden was considerable: 35.1% (95% CI: 32.8–37.4%) of patients had one major pDDI, while 46.5% (95% CI: 44.1–48.9%) had two or more. Polypharmacy (≥5 concurrent medications) was the strongest predictor, associated with a higher risk of any major pDDI (adjusted risk ratio 1.72, 95% CI: 1.46–2.02) and nearly three times the burden of interactions per patient (adjusted incidence rate ratio (IRR) 2.87, 95% CI: 2.36–3.49). When modeled as a continuous variable, each additional discharge medication was associated with a 9% increase in predicted pDDI burden (IRR 1.09, 95% CI: 1.08–1.10). Conclusions: Using warfarin as a model for high-risk medication safety, major pDDIs were highly prevalent at hospital discharge, with polypharmacy as a significant predictor of both the presence and burden of interactions. These findings emphasize the importance of identifying polypharmacy-related pDDIs to reduce potential drug interaction risk during care transitions. Full article

Objective: Tranexamic acid (TXA) is widely used in rhinoplasty to minimize intraoperative bleeding and improve visualization; however, its effect on postoperative bleeding remains unclear. This study aimed to evaluate whether intravenous TXA reduces postoperative bleeding in patients undergoing primary or secondary rhinoplasty. Methods: A retrospective cohort study was performed using the TriNetX national research database to identify patients who underwent primary (CPT 30400, 30410, 30420) or secondary (CPT 30430, 30435, 30450) rhinoplasty from 2010 to 2023. Patients were grouped based on perioperative usage of intravenous TXA. Propensity score matching adjusted for demographics and coagulation disorders (ICD-10 D65–D69). The primary outcome was postoperative bleeding, including epistaxis, within one month of surgery. Results: Among 2586 patients who met inclusion criteria, 1293 (50%) received TXA. TXA recipients had a higher prevalence of bleeding risk factors, including prior use of antihemorrhagic medications (5.9% vs. 1.8%, p < 0.0001) and prolonged prothrombin time (20% vs. 16.1%, p = 0.032). TXA patients more frequently underwent concurrent septoplasty (29.7% vs. 21%, p < 0.0001). There were no significant differences observed in postoperative epistaxis or bleeding between cohorts. Similar postoperative bleeding rates despite these higher-risk characteristics suggest that TXA may have benefit in the mitigation of elevated bleeding risk in the treated cohort. Conclusions: TXA is preferentially administered to patients at higher risk of bleeding and during more complex, vascular procedures prone to increased blood loss. Prospective studies are needed to directly test whether TXA normalizes bleeding risk in higher-risk rhinoplasty patients. Full article

Background/Objectives: This systematic review examines neuroplasticity-informed approaches to learning under cognitive load, synthesizing evidence from functional imaging, brain stimulation, and educational technology research. As digital learning environments increasingly challenge learners with complex cognitive demands, understanding how neuroplasticity principles can inform adaptive educational design becomes critical. This review examines how neural mechanisms underlying learning under cognitive load can inform the development of evidence-based educational technologies that optimize neuroplastic potential while mitigating cognitive overload. Methods: Following PRISMA guidelines, we synthesized 94 empirical studies published between 2005 and 2025 across PubMed, Scopus, Web of Science, and PsycINFO. Studies were selected based on rigorous inclusion criteria that emphasized functional neuroimaging (fMRI, EEG), non-invasive brain stimulation (tDCS, TMS), and educational technology applications, which examined learning outcomes under varying cognitive load conditions. Priority was given to research with translational implications for adaptive learning systems and personalized educational interventions. Results: Functional imaging studies reveal an inverted-U relationship between cognitive load and neuroplasticity, with a moderate challenge in optimizing prefrontal-parietal network activation and learning-related neural adaptations. Brain stimulation research demonstrates that tDCS and TMS can enhance neuroplastic responses under cognitive load, particularly benefiting learners with lower baseline abilities. Educational technology applications demonstrate that neuroplasticity-informed adaptive systems, which incorporate real-time cognitive load monitoring and dynamic difficulty adjustment, significantly enhance learning outcomes compared to traditional approaches. Individual differences in cognitive capacity, neurodiversity, and baseline brain states substantially moderate these effects, necessitating the development of personalized intervention strategies. Conclusions: Neuroplasticity-informed learning approaches offer a robust framework for educational technology design that respects cognitive load limitations while maximizing adaptive neural changes. Integration of functional imaging insights, brain stimulation protocols, and adaptive algorithms enables the development of inclusive educational technologies that support diverse learners under cognitive stress. Future research should focus on scalable implementations of real-time neuroplasticity monitoring in authentic educational settings, as well as on developing ethical frameworks for deploying neurotechnology-enhanced learning systems across diverse populations. Full article