Search Results (60)

Background/Objectives: High sodium consumption increases the risk of hypertension and cardiovascular disease. Although food remains the primary source of intake, elevated sodium levels in drinking water can further contribute to excessive intake, particularly in populations already exceeding recommendations. This review examines the extent to which national drinking water standards account for sodium-related health risks and aims to inform discussion on the need for enforceable, health-based sodium limits. Methods: National standards for unbottled drinking water in 197 countries were searched for using the WHO 2021 review of drinking water guidelines, the FAOLEX database, and targeted internet and AI searches. For each country, data were extracted for the document name, year, regulatory body, regulation type, sodium limit (if stated), and rationale. Socio-geographic data were sourced from World Bank Open Data. A descriptive analysis was conducted using Microsoft Excel. Results: Standards were identified for 164 countries. Of these, 20% (n = 32), representing 30% of the global population, had no sodium limit. Among the 132 countries with a sodium limit, 92% (n = 121) adopted the WHO’s palatability-based guideline of 200 mg/L. Upper limits ranged from 50 to 400 mg/L. Only twelve countries (9%) cited health as a rationale. Three countries—Australia, Canada, and the United States—provided a separate recommendation for at-risk populations to consume water with sodium levels below 20 mg/L. Conclusions: Globally, drinking water standards give inadequate attention to sodium’s health risks. Most either lack sodium limits or rely on palatability thresholds that are too high to protect health. Updating national and international standards to reflect current evidence is essential to support sodium reduction efforts. Health-based sodium limits would empower communities to better advocate for safe water. Amid rising water salinity, such reforms must be part of a broader global strategy to ensure universal and equitable access to safe, affordable drinking water as a basic human right. Full article

The mud crab (Scylla paramamosain), also known as the mangrove crab, thrives in shallow mangrove forests, subtidal zones, and muddy intertidal habitats. It is a highly valuable species in the mangroves and estuaries of tropical regions and is in high demand in Vietnam’s coastal markets. This study provides a comprehensive analysis of the key factors influencing consumer behavior and purchasing decisions regarding mud crabs in Vietnam’s three largest cities: Can Tho City, Ho Chi Minh City, and Hanoi Capital. To achieve this, the research employs rigorous analytical methods, including Cronbach’s alpha reliability test, principal component analysis, and multivariate regression analysis, to identify the primary determinants of consumer behavior and purchasing preferences for fresh mud crabs. The multiple regression analysis reveals two key factors that significantly influence consumer choices: nutritional knowledge and convenience awareness. Most of consumers perceive fresh mud crabs as superior in quality, expecting them to offer greater freshness; higher levels of protein, amino acids, and minerals; as well as excellent flesh texture and enhanced palatability. Based on these findings, two strategic directions are proposed for the sustainable development of Vietnam’s crab industry: (1) improving the nutritional quality of crab products to align with consumer expectations for health benefits and (2) enhancing the distribution network and diversifying product offerings to improve accessibility and convenience for consumers. Full article

Antioxidants are critical components of the body’s defense system, providing protection against cell-damaging free radicals responsible for oxidative damage of biomolecules. Humans benefit from the consumption of plants with high antioxidant content, which have been shown to positively impact health. In plant physiology, antioxidants provide protection from biotic and abiotic stress, particularly during the development of seeds and germination. Peanut seeds and seed coats have been shown to contain several beneficial antioxidants and are a good source of phytonutrients. Seed coat color can vary greatly and impact the antioxidant capacity of the edible portion of the peanut. Additionally, the seed coat can provide bitter notes in products, affecting their palatability and potentially negating the beneficial properties of the antioxidants present. A total of 42 accessions from the Germplasm Resource Information Network (GRIN) with a variety of seed coat colors were obtained and analyzed for total antioxidant capacity to provide a baseline assessment of the distribution of antioxidants in kernel versus seed coats. The results demonstrated that seed coat color somewhat impacts antioxidant capacity, and 56–88% of the total antioxidant capacity resides in the seed kernel. Three control samples, not part of the germplasm collection, were roasted and prepared for analysis by the descriptive sensory panel. Seed coats were added back to the roasted paste in increasing proportion for analysis by the panel, and perceptions regarding bitterness and overall organoleptic properties were noted. Based on the results of this study, several accessions were selected and then planted for increase and potential crossbreeding with appropriate commercial cultivars. This information could be used to selectively add antioxidant capacity to peanut breeding programs to provide additional health benefits to consumers without compromising the sensory perception and desirability and peanut products in nutrition. Full article

Background/Objectives: Pediatric drug administration is hindered by difficulties in swallowing conventional medications and the unpalatable taste of many drugs. Among diseases highlighting the need for improved pediatric delivery, tuberculosis (TB) stands out. One form of the disease is latent TB infection (LTBI), which is concerning in children. Effective LTBI treatment is crucial for prevention, with isoniazid (INH) widely used for its proven efficacy and safety. This study aims to develop innovative 3D-printed chewable gels containing INH for LTBI treatment. Methods: The gels were formulated using gelatin and carrageenan gum, sugar-free sweeteners, and flavoring. Two batches were prepared, and using 3D printing (3DP) with a semi-solid extrusion (SSE) module, chewable gels were produced. Rheological properties were measured to assess the feasibility of 3DP-SSE, evaluating the structural integrity and adequate fluidity of the formulation. The 3D-printed chewable gels were evaluated by visual, mass, and dimensional characteristics. In addition, the water activity, texture profile, INH and degradation product content, in vitro release, and taste-masking were investigated. Results: The optimized formulation maintained suitable rheological properties for 3DP-SSE, demonstrating consistent weight, dimensions, and stability after the process. The texture achieved a balance between printing parameters and shape maintenance, and the INH presented an immediate-release profile (>85% within 30 min). The chewable gels showed an improvement in palatability compared to conventional INH tablets. Conclusions: This innovative approach offers a promising solution for pediatric LTBI treatment, as it improves efficacy, medication acceptability, and on-demand access. Full article

In-hospital patients who are in the gynecologic oncology setting often suffer from malnutrition, which is one of the primary problems, the rate of which reportedly ranges from 28% to 70%. Malnutrition is a significant risk factor for immunosuppression, negatively impacting immune response and postoperative recovery capacity. At the time of the surgeries, due to their wide scope and aggressive treatments such as chemotherapy and radiotherapy, the situation becomes more serious. Those micronutrients taking part in immunonutrition, namely, arginine, omega-3 fatty acids, nucleotides, and antioxidants, have the potential to prevent inflammation, protect against infections, and promote healing after the surgery. Research has shown that immunonutrition can lower the risk of postoperative infection, promote the normal healing of wounds, and reduce the hospital stays of patients, as well as support malnutrition status during chemotherapy. This review is based on a literature search conducted in Medline, Scopus, Clinicaltrials.gov, Cochrane CENTRAL, and Google Scholar, with the last search date being November 2024. Some studies. found that perioperative immunonutrition decreases wound infections and affects some immune indexes in gynecologic oncology patients positively. However, factors such as non-compliant patients, high costs, and non-standard formulations can deter its wider use. Patient adherence drops postoperatively mainly due to nausea and decreased appetite, whereas the cost of enriched formulations acts as an economic barrier. Postoperative compliance drops from ~78% prior to surgery to ~28% due to nausea, anorexia, and chemotherapy. Additionally, cost remains a constraining factor since special formulas are 2–4 times that of normal nutrition. While immunonutrition reduces hospital stay (by ~2–3 days) and infection rate (by 25–40%), access is hindered by prohibitive initial costs and lack of insurance coverage. Approaches such as subsidized schemes, enhanced palatability, and cost–benefit analyses are required to increase adoption. In addition, the lack of standardized protocols makes the clinical community hesitant to adopt this approach. Immunonutrition is, despite these problems, still hoped to be the new adjunct to gynecologic oncology patients. In future studies, it is imperative to pay attention to the best formulations that produce the best outcomes and evaluate and implement guidelines that are based on evidence. Together, with these improvements, immunonutrition could very well be an integral part of perioperative care thus completing the process by which patients in intense treatments are benefited not only via treatment but also via quality of life. Full article

Alcohol use disorder (AUD) is a chronic relapsing disorder afflicting millions of people worldwide. Malnutrition is frequently associated with AUD, which could be the result of reduced nutritional intake and impairment in the absorption/metabolism of nutrients because of excessive alcohol drinking. Interestingly, the higher consumption of high calorie/palatable foods is reported in recovering alcoholics who stayed sober. However, it is unclear if the higher calorie or rewarding properties of these palatable foods accounted for the protective effect in these conditions. In the present study, we evaluated the palatable food intake in male and female alcohol-preferring (P-rats) and compared it to alcohol-non-preferring rats (NP-rats). Importantly, alcohol-preferring (P-rats) were selectively bred for a higher alcohol preference and are regarded as a well-characterized model of alcoholism. A group of P- and NP-rats received a high-fat diet (40% fat) on four separate days over a two-week period, and their 24 h caloric intake and change in body weight were recorded. Standard chow and water were available unrestricted to all groups for the entire duration of the study. Total caloric intake in both P- and NP-rats was significantly increased on HFD access days compared to chow-only days, an effect observed in both males and females. Further analysis revealed that the total caloric intake in the P-rats was significantly lower compared to the NP-rats, an effect more significant and pronounced in the female group of rats. Furthermore, body weight increase during this period was significantly lower in the P-rats than the NP-rats, an effect more significant and pronounced in the male group of rats. These data not only document the important differences in the palatable diet intake between alcohol-preferring and non-preferring rats and the sex differences but also highlight that a higher alcohol preference does not necessarily equate to a higher intake of high calorie/palatable food. Full article

Binge eating disorder (BED) is characterized by uncontrollable episodes of eating in a short period of time, with a subjective loss of control of overconsumption behavior. The role CB2 cannabinoid receptor (CB2R) plays in binge-like intake has not yet been identified. In this regard, the present study aims to evaluate the effect of the administration of CB2R agonist, antagonist, or both on binge-like intake of palatable food (PF) in adolescent mice. We used 35 C57BL6/J male mice of 30 postnatal days in this research; all animals were housed individually and had ad libitum access to a standard diet (SD) and water. Animals were evaluated for a total of 15 sessions of the Binge Eating Test (BET), which consisted of 1 h access to PF (chocolate sandwich cookies) according to intermittent diet protocol, with one-day access/one-day no-access. PF and SD caloric intake, as well as the PF binge index (defined as consuming ≥20% of total caloric intake per day during the 1 h access to PF), were analyzed. Mice were randomly assigned to one of the following treatment groups: (1) control; (2) vehicle; (3) HU308, selective CB2R agonist; (4) AM630, selective CB2R antagonist; (5) AM630+HU308 coadministration of antagonist and agonists of CB2R. All treatments were administered intraperitoneally before BET sessions. Our results show that HU308 significantly reduced binge-like intake of PF, while no significant differences were found in the rest of the groups. These results suggest that activation of the CB2R decreases the binge-like intake in adolescent mice and that chronic overconsumption in conditions of non-homeostatic feeding can be modulated by the CB2R. Furthermore, the activation of CB2R may also modulate reward pathways, reducing binge-like behavior, which could be further explored in future studies as a treatment for BED. Full article

Background and Objectives: Gingival recession is a common periodontal condition that can lead to aesthetic and functional problems if untreated, necessitating the development of effective root coverage techniques. The aim of this study was to compare two different root coverages for localized gingival recession on the lower anterior teeth using a partially de-epithelialized connective tissue graft (PE-CTG). Materials and Methods: This study included 18 patients (20 teeth) with lower anterior tooth recession. In the tPECTG group (seven patients, eight teeth), the recipient site was prepared with supraperiosteal tunneling. In the vPECTG group (11 patients, 12 teeth), the recipient site was prepared using the vestibular incision subperiosteal tunnel access technique. In both groups, partially de-epithelialized connective tissue was harvested from the hard palate using a high-speed handpiece diamond burr. The change in root coverage was evaluated based on vertical recession and keratinized tissue (KT) values before surgery and 6 months after surgery. Results: The mean root coverage was 89.01% across all cases, with the tPECTG and vPECTG groups achieving 87.85% and 89.78%, respectively. The average KT gain was 3.48 ± 1.37 mm, with the tPECTG group showing 3.94 ± 1.74 mm and the vPECTG group showing 3.17 ± 1.03 mm. No significant differences were found between the two groups for either parameter (p > 0.05). Conclusions: Within the limitations of this retrospective case series, vPECTG was as effective as tPECTG, but easier. Moreover, in both groups, the keratinized gingival width increased, and the mucogingival junction was maintained. Full article

Binge eating disorder (BED) is characterized by the rapid overconsumption of palatable food in a short amount of time, often leading to obesity. The endocannabinoid system (ECS), a system involved in palatable food intake, is highly expressed in reward-related brain regions and is involved in both obesity and BED. This study investigated differences in ECS expression between these conditions using male Wistar rats exposed to specific regimen over six weeks: a non-access group (NA) with a standard diet, a continuous access group (CA) with free-choice high-fat high-sugar (fcHFHS) diet modeling obesity, and an intermittent access group (IA) with intermittent fcHFHS access modeling BED. Food intake was measured, and brain tissues from the nucleus accumbens (NAc), dorsal striatum (DS), ventral tegmental area (VTA), and rostromedial tegmental nucleus (RMTg) were analyzed for ECS expression using qPCR and mass spectrometry. We identified differential ECS expression across palatable food access groups, with variations depending on the brain region (striatal or mesencephalic). Correlation analyses revealed ECS dysregulations dependent on the type (fat or sucrose) and quantity of palatable food consumed. Comparative network analysis revealed co-regulation patterns of ECS-related genes with specific signatures associated with each eating pattern, highlighting RMTg as a key region for future research in eating behavior. Full article

As individuals with a cleft lip and palate (CLP) transition into adulthood, they face unique employment challenges related to income, job stability, and fewer career options. This study explored these challenges through two focus group discussions with 19 participants (aged 21–38), primarily women, to understand their employment experiences. Thematic analysis revealed the following three main themes: (1) physical factors, (2) psychosocial factors, and (3) overcoming employment challenges, with nine sub-themes including speech, hearing, appearance, health, childhood experiences, societal expectations, lack of self-confidence, communication improvement, and self-esteem building. The findings highlighted that physical and psychosocial factors significantly shape employment outcomes for CLP individuals. Difficulties with speech often hinder professional communication, while appearance concerns can reduce confidence in interviews and workplaces. To address these issues, the participants used strategies like targeted speech therapy and self-esteem building, which helped improve their communication and resilience. This study emphasises the need for targeted interventions such as specialised career counselling, access to assistive technologies, and inclusive workplace policies to support CLP individuals in overcoming employment barriers and achieving stable careers. Full article

Background/Objectives: Dental malocclusions are highly prevalent worldwide, negatively impacting patients’ quality of life and leading to complex, often costly, orthodontic treatments. In Romania, the economic status of patients and the limited public funding for orthodontic care significantly influence treatment accessibility and choices. Advanced technologies, such as mini-implants (MIs), offer improved anchorage and treatment efficiency but are often underutilized due to financial constraints and variability in clinical training. In this context, there are limited data regarding the use and preferences of MI among orthodontists in Romania. This study aims to explore the characteristics, preferences, and challenges of Romanian orthodontists in their use of MI systems. Methods: A survey was conducted between June and September 2024, targeting orthodontists across Romania. The questionnaire, distributed via social media platforms, consisted of 24 items addressing professional experience, MI system preferences, insertion methods, and complications. Statistical analyses were conducted using IBM SPSS Statistics 25. Fisher’s Exact Test and Pearson’s Chi-Square Test were employed to evaluate relationships between categorical variables. When appropriate, logistic binomial univariable regression models were applied to predict key dependent variables (e.g., MI placement zones, MI experience, and MI complications) based on independent variables such as specific MI system usage and frequency of MI usage. A significance threshold of α = 0.05 was used for all tests. Results: Out of 105 participants, 85.7% reported using mini-implants (MIs) in their orthodontic practice, with the Dual Top and Benefit systems being the most frequently used (60% and 43.3%, respectively). The interradicular area was the most common placement site (60%), while the palatal and retromolar regions showed significant correlations with the Benefit system (p = 0.008). Practitioners with more than 10 years of experience reported a significantly higher frequency of MI use (p = 0.001), with frequent use being observed in 60.9% of these practitioners. Complications were common, with MI mobility reported by 92.2% and soft tissue damage by 57.8%. The midpalatal area was significantly associated with higher complication rates compared to other sites (p < 0.001). The success rates of MI usage ranged from 76% to 100% in 57.8% of respondents, with higher success rates being associated with infrazygomatic placements (p < 0.05). Conclusions: MI usage is prevalent among Romanian orthodontists, with experienced practitioners utilizing them more frequently. Despite high success rates, common complications highlight the need for improved insertion techniques and post-operative care. Further research and training are recommended to optimize MI application and reduce complication rates. Full article

Old growth forests are increasingly rare but important carbon sinks which harbour rich biodiversity. Chronic browsing by the white-tailed deer (Odocoileus virginianus) is a threat to the sustainability of the services provided by these forests, particularly in northern temperate forests where deer numbers have increased in recent decades (driven by stricter hunting rules and reduced predation) and necessitating local monitoring of vegetation responses. The objective of this study was to determine the effects of deer exclusion on tree regeneration dynamics and soil nutrients in an old growth Carolinian forest. This was performed using exclusion fencing and tip-up mounds at McMaster Forest Nature Preserve and the Sheelah Dunn Dooley Nature Sanctuary in Hamilton Ontario. Tree regeneration was surveyed from thirty 1 m × 1 m quadrats within exclusion plots and another thirty quadrats from deer-browsed areas adjacent to the exclusion plots. Soil samples were taken from each quadrat to analyze browsing impacts on nitrate, phosphate and soil organic matter. Red oak (Quercus rubra) was planted at the top and base of tip-up mounds of varying heights and widths and monitored for deer access and browsing activity. Results show a significantly higher density of woody plants within exclosures compared to non-exclosures (p = 0.0089) and twice more abundance of highly palatable species within the exclosures. However, species richness (p > 0.05) and diversity (p > 0.05) were minimally impacted by deer browsing, showing a resilient old growth forest. Soil nitrate was consistently higher in the non-exclosures, while phosphate was consistently higher within deer exclosures. Finally, more seedlings survived at the top of mounds than the bases, showing the potential of tip-up mounds to be a natural method of deer exclusion and a critical avenue for restoring over-browsed forests. Full article

Introduction. Clival chordomas represent a rare but clinically significant subset of skull base tumors, characterized by a locally aggressive nature and a location in proximity to vital neurovascular structures. Surgical resection, often combined with adjuvant therapies, remains the cornerstone of clival chordoma treatment, and various approaches and techniques have evolved to maximize tumor removal while preserving neurological function. Recent advancements in skull base surgery, imaging, and adjuvant therapies have improved outcomes by reducing morbidity and thus enhancing long-term survival. Methods and Results. We have conducted a systematic review on PubMed/Medline following PRISMA guidelines regarding indications, the extent of resection (EOR), and complication rates. Then, we present three illustrative cases from our personal experience, which started 25 years ago with CVJ instrumentation procedures and 15 years ago with anterior decompressive transmucosal procedures performed with the aid of an operative microscope, an endoscope, and neuroradiological monitoring. Conclusions. Traditionally, the transoral approach (TOA) is the most frequently used corridor for accessing the lower clivus and the anterior craniovertebral junction (CVJ), without the need to mobilize or retract neural structures; however, it is associated with a high rate of complications. The endonasal approach (EEA) provides access to the anterior CVJ as well as to the lower, middle, and superior clivus, decreasing airway and swallowing morbidity, preserving palatal function, decreasing postoperative pain, and reducing the incidence of tracheostomy. The submandibular retropharyngeal approach (SRA) allows unique access to certain cervical chordomas, which is better suited when the lesion is located below the clivus and in the midline. Full article

Background: A new access technique was developed to reduce postoperative adverse events after the extraction of impacted maxillary wisdom teeth. Hence, this study aimed to assess the occurrence of adverse events after the extraction of maxillary impacted wisdom teeth using a traditional access (TA) or a new technique (NT). Methods: Two different surgical incision designs were used for bilateral wisdom tooth extractions in 30 patients. The traditional incision was performed distal to the second molar in the center of the tuberosity, followed by a buccal releasing incision. After the tooth extraction, the wound was secured by sutures. The new technique consists of an oblique incision from the distal palatal aspect of the tuberosity towards the buccal aspect of the second molar. After the tooth extraction, cyanoacrylate glue was used on the wound. Results: Lower pain was reported by patients at the site treated with the new technique (p < 0.01). Edema, postsurgical bleeding, and hematoma were similar in both groups. The surgical time was shorter for the new technique (p < 0.01). Conclusions: The new technique applied for the extraction of impacted maxillary wisdom teeth reduced postsurgical pain and the duration of surgery. Full article

Paediatric infectious diseases contribute significantly to global health challenges. Conventional therapeutic interventions are not always suitable for children, as they are regularly accompanied with long-standing disadvantages that negatively impact efficacy, thus necessitating the need for effective and child-friendly pharmacotherapeutic interventions. Recent advancements in drug delivery technologies, particularly oral formulations, have shown tremendous progress in enhancing the effectiveness of paediatric medicines. Generally, these delivery methods target, and address challenges associated with palatability, dosing accuracy, stability, bioavailability, patient compliance, and caregiver convenience, which are important factors that can influence successful treatment outcomes in children. Some of the emerging trends include moving away from creating liquid delivery systems to developing oral solid formulations, with the most explored being orodispersible tablets, multiparticulate dosage forms using film-coating technologies, and chewable drug products. Other ongoing innovations include gastro-retentive, 3D-printed, nipple-shield, milk-based, and nanoparticulate (e.g., lipid-, polymeric-based templates) drug delivery systems, possessing the potential to improve therapeutic effectiveness, age appropriateness, pharmacokinetics, and safety profiles as they relate to the paediatric population. This manuscript therefore highlights the evolving landscape of oral pharmacotherapeutic interventions for leading paediatric infectious diseases, crediting the role of innovative drug delivery technologies. By focusing on the current trends, pointing out gaps, and identifying future possibilities, this review aims to contribute towards ongoing efforts directed at improving paediatric health outcomes associated with the management of these infectious ailments through accessible and efficacious drug treatments. Full article