Search Results (626)

Hispanic populations in the U.S. have a high prevalence of type 2 diabetes and its complications. It has been proposed that interventions targeting multiple levels and domains of influence are needed to address health disparities, but more evidence is needed regarding the most effective approaches. We aimed to review the effects of non-pharmacological interventions on glycemic control among Hispanic persons with diabetes, overall and by level and domain of intervention. A systematic review (PubMed, Scopus, PsycInfo, CINAHL; 1985–2019) identified randomized trials reporting HbA1c outcomes for Hispanic populations. Article review, data extraction, and risk of bias assessment were completed by independent reviewers. Level and domain of intervention were assigned based on the National Institute on Minority Health and Health Disparities Research Framework. Random-effects meta-analyses estimated pooled effect sizes. Quality of evidence was rated based on the GRADE framework. Forty-eight trials met inclusion criteria, representing various Hispanic populations (n = 18 Mexican, n = 5 Puerto Rican, n = 1 Dominican, n = 4 multiple, n = 20 unspecified) and enrolling 9185 total participants. Overall, interventions decreased HbA1c by −0.32% (95% CI: −0.44% to −0.20%, I² = 68%, strength of evidence: moderate). Multi-level, multi-domain interventions decreased HbA1c by −0.41% (−0.61% to −0.21%, I² = 74%, strength of evidence: moderate). Few interventions addressed community (n = 3), society (n = 0), or physical/built environment (n = 1). Non-pharmacological interventions have modestly decreased HbA1c among Hispanic persons with diabetes. Multi-level, multi-domain interventions are promising, but more research is needed on interventions that target social and environmental structures. Full article

Background/Objectives: While the benefits of almond consumption in reducing levels of TC and LDL-C are well established, the effects on additional lipids that have emerged as important predictors of cardiovascular disease, such as ApoB and the ratio of ApoB:ApoA, are not well characterized. In this systematic review and meta-analysis, the effects of almond consumption on blood lipids were comprehensively assessed. Methods: On 12 May 2025, ProQuest Dialog™ was used to search ten literature databases (AdisInsight: Trials; Allied & Complementary Medicine™; BIOSIS Previews^®; CAB ABSTRACTS; Embase^®; Embase Preprints; Foodline^®: SCIENCE; FSTA^®; MEDLINE^®; National Technical Information Service). Randomized controlled trials at least 4 weeks in duration were included if the investigational product was almonds; the control was void of nuts/tree nuts; the subjects were adults without CVD; and blood lipid levels were assessed. Health Canada’s Quality Appraisal Tool for Intervention Studies was used to assess each study’s risk of bias. The mean difference in the effect for each parameter was pooled across studies in a random effects model, using the inverse of the variance as the weighting factor. Results: 36 publications (48 almond–control datasets) representing 2485 participants were included. Almond consumption significantly reduced LDL-C (−0.132 mmol/L; 95% CI: −0.190, −0.075 mmol/L; p < 0.001), TC (−0.160 mmol/L; 95% CI: −0.218, −0.101 mmol/L; p < 0.001), non-HDL-C (−0.204 mmol/L; 95% CI: −0.281, −0.127 mmol/L; p < 0.001), TC:HDL-C (−0.154; 95% CI: −0.246, −0.063; p = 0.001), LDL-C:HDL-C (−0.112; 95% CI: −0.199, −0.026; p = 0.011), ApoB (−4.552 mg/dL; 95% CI: −6.460, −2.645 mg/dL; p < 0.001), and ApoB:ApoA (−0.027; 95% CI: −0.046, −0.008; p = 0.006), with a borderline significant reduction in TG (−0.037 mmol/L; 95% CI: −0.079, 0.005; p = 0.085) and no effects on HDL-C, ApoA, or Lp[a]. The effects persisted when the analyses were limited to higher quality studies, except for the reduction in TG. Conclusions: Almond consumption improves levels of LDL-C, TC, non-HDL-C, TC:HDL-C, LDL-C:HDL-C, ApoB, and ApoB:ApoA, though dedicated clinical trials are needed to better understand effects on TG levels. Full article

In Directed Energy Deposition (DED), modeling the molten pool temperature field is crucial for precise temperature control, process optimization, and quality improvement. However, conventional numerical methods suffer from limitations such as high computational costs and poor transferability. This study proposes a physics-informed neural network with dynamic learning rate (DLR-PINN) model, which integrates transfer learning to enable rapid prediction of 3D temperature fields and dimensions of molten pools across process parameters. Its validity is verified by a finite element method (FEM) calibrated via single-track DED experiments. Results show that DLR-PINN exhibits superior convergence and stability compared to traditional PINN. Combined with transfer learning, training efficiency is significantly enhanced, with a single prediction taking only 10 s. Using the FEM as the benchmark, it achieves a mean absolute percentage error (MAPE) of 0.53% for temperature prediction, and MAPE of 3.69%, 2.48%, and 6.96% for molten pool dimension predictions, respectively. Sensitivity analysis of process parameters reveals that scanning speed has a significantly greater regulatory effect on molten pool characteristics than laser power. Additionally, the temperature field of the flat-top heat source is more uniform than that of the Gaussian heat source, which is more conducive to improving printing quality and efficiency. Full article

Background/Objectives: Acetyl-CoA carboxylase (ACC) inhibitors block the initial step of de novo lipogenesis and potentially ameliorate liver pathology in nonalcoholic fatty liver disease (NAFLD). However, increased expression of glycerol-3-phosphate acyltransferase 1 resulting from reduced PUFA may cause hypertriglyceridemia. This systematic review and meta-analysis assessed the efficacy and safety of dual ACC 1/2 inhibitors in adult NAFLD patients, either with or without metabolic dysfunction. Methods: Six databases were searched for randomized controlled trials (RCTs). The primary outcomes were changes in liver fat and fibrosis. Study quality was assessed using the RoB 2 tool. Pooled mean differences (MDs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a fixed-effects model. Results: Six RCTs comprising 655 participants were included; most had low risk of bias. Interventions included firsocostat, clesacostat, and combined regimens with semaglutide, selonsertib, and cilofexor or ervogastat. Compared with placeo, ACC inhibitor monotherapy significantly reduced liver fat (mean difference [MD]: −48.38; 95% CI: −58.54 to −38.22; p < 0.00001) and ALT (MD: −16.07; 95% CI: −24.97 to −7.17; p = 0.0004) but increased ALP (MD: 11.95; 95% CI: 6.98, to 16.92; p < 0.00001) and GGT levels (MD: 23.90; 95% CI: 12.58 to 35.23; p < 0.0001). Hypertriglyceridemia risk was markedly elevated (odds ratio [OR]: 10.33; 95% CI: 4.93 to 21.65; p < 0.00001). No significant improvement in fibrosis was observed by magnetic resonance elastography. Serious adverse events were infrequent, and overall treatment-emergent adverse events were comparable between groups; however, the incidence of hypertriglyceridemia was consistently more frequent with ACC inhibitors. Conclusions: Dual ACC 1/2 inhibitors reduce hepatic steatosis and ALT levels but do not improve fibrosis. Their consistent association with hypertriglyceridemia raises concerns regarding potential long-term cardiometabolic risks, particularly in NAFLD patients with metabolic dysfunction. Full article

Paratuberculosis is a chronic zoonotic bacterial infection, primarily affecting ruminants. This review examines the disease in the Arabian Peninsula, focusing on distribution, molecular diversity, prevalence, and associated risk factors. Following PRISMA guidelines, a systematic search was conducted in PubMed, Scopus, and Web of Science. After duplicate removal and eligibility screening, data extraction, analysis, and quality assessment were performed. Pathogen sequences were retrieved from NCBI GenBank for phylogenetic analysis. The review included a total of 31 published articles from 1997 to 2025, of which 26 were used in the meta-analysis. Most studies (n = 12) were published between 2011 and 2015, predominantly from Saudi Arabia (n = 22), with no reports from Qatar, Bahrain, or Yemen. The majority of the studies involved camels and sheep (n = 16 on each species), followed by cattle (n = 9), goats (n = 7), humans (n = 2), and buffalo (n = 1). Phylogenetic analysis delineates two major clades—Type S and Type C—suggesting greater genetic diversity in Type S. The estimated pooled seroprevalence and pathogen prevalence in livestock ruminants were 8.1% and 22.4%, respectively. Herd-level estimated pooled seroprevalence was 26.9%. Small ruminants (19.3%) were more sero-prevalent than large ruminants (7.4%), with goats (28.7%) significantly (p < 0.01) more affected than sheep (21.5%), camel (9.8%), and cattle (6.6%). Clinical signs in ruminants included chronic diarrhea, emaciation, anorexia, alopecia, wry neck, and dehydration. The reviewed study patterns and findings suggest high pathogen diversity and a significant risk of transboundary transmission at the human–animal interface in this region. A One Health surveillance approach is crucial, particularly on farms with diarrheic and emaciated animals. Establishing a national surveillance plan and phased (short-, intermediate-, and long-term) control programs is essential to mitigate economic losses, limit transmission, overcome the cultural barrier, and protect public health. Full article

While modern power sources have improved process stability, real-time monitoring and feedback control remain essential for ensuring consistent weld quality under dynamic conditions. To address this need, a vision-based closed-loop control system was developed for pulsed Metal-Active Gas (MAG) welding. The system dynamically adjusts the welding speed based on real-time visual feedback in the welding process. Otsu thresholding combined with morphological operations was applied to molten pool images for brightness-based feature extraction. These features, representing the dynamic behavior of the molten pool, were incorporated into a feedback loop for real-time control. Without relying on complex model-based prediction or sensor fusion, the proposed method reduces fluctuations in weld bead geometry and lowers the occurrence of defects. The experimental results showed that, under optimized control conditions and after a steady welding state was achieved, the weld bead’s height deviation exhibited an average standard deviation of 0.08 mm, and a process stability rate of 92%. The combination of conventional hardware and straightforward image processing makes the proposed approach practical for industrial implementation. Full article

Multi-layer multi-pass welding plays an important role in manufacturing industries such as nuclear power plants, pressure vessel manufacturing, and ship building. However, distortion or welding defects are still challenges; therefore, welding monitoring and quality control are essential tasks for the dynamic adjustment of execution during welding. The aim was to propose a machine vision system for monitoring and surface quality evaluation during multi-pass welding using a line scanner and infrared camera sensors. The cross-section modelling based on the line scanner data enabled the measurement of distortion and dynamic control of the welding plan. Lack of fusion, porosity, and burn-through defects were intentionally generated by controlling welding parameters to construct a defect inspection dataset. To reduce the influence of material surface colour, the proposed normal map approach combined with a deep learning approach was applied for inspecting the surface defects on each layer, achieving a mean average precision of 0.88. In addition to monitoring the temperature of the weld pool, a burn-through defect detection algorithm was introduced to track welding status. The whole system was integrated into a graphical user interface to visualize the welding progress. This work provides a solid foundation for monitoring and potential for the further development of the automatic adaptive welding system in multi-layer multi-pass welding. Full article

This study empirically investigates the relationship between board composition, focusing on board size and board independence, and firm performance. It further examines how national governance quality moderates this relationship. Using a panel dataset of 1604 firms from 41 developed and emerging economies, the study employs pooled ordinary least squares (OLS) as the baseline regression method, alongside two-stage instrumental variable regression and system generalised method of moments (GMM) to address potential endogeneity concerns. Firm performance is measured using return on equity (ROE) and Tobin’s Q. Board size is captured by the number of directors on the board, while board independence is measured by the proportion of non-executive directors. The findings indicate that while board size and independence are positively associated with firm performance, the strength of these relationships weakens in countries with high governance quality. Our findings remain robust after controlling for dynamic endogeneity and unobserved time-invariant heterogeneity inherent in the corporate governance–performance nexus. Full article

Inland aquatic ecosystems, encompassing lakes, reservoirs, and ponds, serve as vital repositories of water resources and provide essential ecological, social, and cultural services. Water color, a key indicator of water quality, reflects the complex interactions among physicochemical, biological, and environmental drivers. Heilong Pool (HP) in Southwest China, which consists of a Clear Pool (CP) and a Turbid Pool (TP), has recently exhibited an anomalous reddish-brown “pumpkin soup” phenomenon in the CP, while the TP remains unchanged. This unusual phenomenon has raised widespread public concern regarding water resource security and its potential association with geological disasters. To elucidate the ecological and geochemical mechanisms of this phenomenon, we employed a multifaceted analytical approach that included assessing nutrient elements, quantifying heavy metal concentrations, analyzing dissolved substances, characterizing algal community composition, and applying δD-δ¹⁸O isotope analytical models. Our findings illustrated that while Bacillariophyta predominate (>79.3% relative abundance) in the algal community of HP, they were not the primary determinant of water color changes. Instead, Fe(OH)₃ colloidal particles, originating from groundwater–surface water interactions and controlled by redox environment dynamics periodically, emerged as the principal factors of the reddish-brown discoloration. The genesis of the “pumpkin soup” water coloration was attributed to the precipitation-induced displacement of anoxic groundwater from confined karst conduits. Subsequent exfiltration and atmospheric exposure facilitate oxidative precipitation, forming authigenic rust-hued Fe(OH)₃ colloidal complexes. This study provides new insights into the geochemical and hydrological mechanisms underlying water color anomalies in karst-dominated catchments. Full article

Background: Catheter ablation of the arrhythmogenic substrate has emerged as a promising therapeutic strategy for symptomatic Brugada syndrome (BrS). However, high-quality comparative evidence against conventional implantable cardioverter-defibrillator (ICD)-based management remains limited. Objectives: This meta-analysis aimed to evaluate the efficacy of catheter ablation in reducing ventricular fibrillation (VF) recurrence in symptomatic BrS compared to standard therapy. Methods: Medline, Cochrane Library, and Scopus were systematically searched through 1 June 2025. Study selection, data extraction, and quality assessment were independently conducted by three reviewers. Random-effects meta-analyses were used to pool risk estimates. Results: Three studies (two randomized controlled trials, one observational cohort; 130 symptomatic BrS patients) were included. Over a median follow-up of 3.9 years, catheter ablation was associated with a significantly lower risk of VF recurrence compared to standard therapy [risk ratio (RR) = 0.19, 95% confidence interval (CI) = (0.06, 0.60); I² = 36%, p for heterogeneity = 0.21], with no deaths reported in any group. A sensitivity analysis restricted to randomized trials confirmed similar findings in favor of ablation. Conclusions: Catheter ablation was associated with reduced VF recurrence compared to ICD therapy alone, supporting its potential role as first-line treatment in symptomatic BrS or as an alternative for patients who decline ICD implantation. Full article

Background: Persistent Postural-Perceptual Dizziness (PPPD) is a chronic vestibular disorder characterized by dizziness, instability, and visual hypersensitivity. Vestibular Physical Therapy (VPT) is commonly used, but its efficacy remains uncertain due to limited and heterogeneous evidence. Objective: This systematic review and meta-analysis aimed to evaluate the effectiveness of VPT in reducing dizziness and improving balance in individuals with PPPD. Methods: A systematic search of MEDLINE and PEDro was conducted in January 2025. Studies were selected following PRISMA guidelines and included if they assessed VPT interventions in patients diagnosed with PPPD. Risk of bias was assessed using the PEDro scale and the modified Newcastle–Ottawa Scale. The meta-analysis focused on pre- and post-intervention changes in Dizziness Handicap Inventory (DHI) scores using a random-effects model. Results: Six studies met the inclusion criteria. VPT significantly reduced DHI scores (pooled Hedges’ g = 1.60; 95% CI: 0.75–2.45), indicating a moderate to large improvement. Additional outcomes included improvements in postural control (e.g., mini-BESTest and posturography) and psychological well-being (anxiety and depression questionnaires). However, high heterogeneity (I² = 92%) was present across studies. Conclusions: VPT may improve dizziness and balance in PPPD, though evidence is limited. Further high-quality trials with standardized protocols are needed. Full article

Objectives: To evaluate the association between antidepressant use and the risk of venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism (PE), through a systematic review and meta-analysis of observational studies. Methods: A comprehensive literature search was conducted in Medline, Embase^®, and Web of Science^® up to December 2024. Eighteen studies (cohort, case-control, and nested case-control designs) meeting inclusion criteria were analyzed. Study quality was assessed using the Newcastle–Ottawa Scale. Pooled relative risks (RR) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses were performed based on recency of antidepressant use, VTE onset type (first vs. recurrent), and VTE subtype (PE). Results: Antidepressant use was associated with a significantly increased risk of VTE (RR = 1.22; 95% CI: 1.12–1.32; p < 0.001). Subgroup analyses revealed a stronger association for recent use (within 90 days), first-onset VTE, recurrent VTE, and PE. Heterogeneity was high (I² = 87.92%), but sensitivity analysis confirmed result robustness. No publication bias was detected. Conclusions: This meta-analysis indicates a modest but statistically significant increase in the risk of VTE associated with antidepressant use, particularly among recent users, individuals experiencing either first-time or recurrent VTE, and those with PE-type events. These findings highlight the importance of individualized VTE risk assessment when initiating antidepressant therapy. Full article

Background and Objectives: Dual-task training (DTT) is an innovative therapeutic approach that involves the simultaneous application of two tasks, which can be motor, cognitive, or a combination of both. Children with cerebral palsy (CP) often exhibit impairments in balance, motor skills, and gait, conditions that may be amenable to improvement through DTT. The aim of this study was to determine the effectiveness of DTT in enhancing balance, walking speed, and gross motor function-related balance in children with CP. Materials and Methods: In accordance with PRISMA guidelines, a comprehensive systematic review with meta-analysis (SRMA) was conducted. Electronic databases like PubMed Medline, Scopus, Web of Science, CINAHL, and PEDro were searched up to March 2025, with no language or publication date restrictions. Only randomized controlled trials (RCTs) examining the effectiveness of DTT on balance, gross motor function, and walking speed in children with CP were included. The methodological quality and risk of bias of the included RCTs were assessed using the PEDro scale. Pooled effects were calculated using Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI) within random-effects models. Results: Eight RCTs, providing data from 216 children, were included. Meta-analyses suggested that DTT was more effective than conventional therapies for increasing functional (SMD = 0.65; 95% CI 0.18 to 1.13), dynamic (SMD = 0.61; 95% CI 0.15 to 1.1), and static balance (SMD = 0.46; 95% CI 0.02 to 0.9), as well as standing (SMD = 0.75; 95% CI 0.31 to 1.18; p = 0.001) and locomotion dimensions (SMD = 0.65; 95% CI 0.22 to 1.08) of the Gross Motor Function Measure (GMFM) and walking speed (SMD = 0.46; 95% CI 0.06 to 0.87). Subgroup analyses revealed that a motor–cognitive dual task is better than a motor single task for functional, dynamic, and static balance and standing and locomotion dimensions for the GMFM. Conclusions: This SRMA, including the major number of RCTs to date, suggests that DTT is effective in increasing balance, walking and gross motor function-related balance in children with CP. Full article

Introduction: Actinic cheilitis (AC) is a common precancerous condition affecting the lips, primarily caused by prolonged ultraviolet radiation exposure. Various treatment options are available. However, the optimal treatment approach remains a subject of debate. Objective: To summarize and compare practice-relevant interventions for AC. Materials and Methods: A pre-defined protocol was registered in PROSPERO (CRD42021225182). Systematic searches in Medline, Embase, and Central, along with manual trial register searches, identified studies reporting participant clearance rates (PCR) or recurrence rates (PRR). Quality assessment for randomized controlled trials (RCTs) was conducted using the Cochrane Risk of Bias tool 2. Uncontrolled studies were evaluated using the tool developed by the National Heart, Lung, and Blood Institute. The generalized linear mixed model was used to pool proportions for uncontrolled studies. A pairwise meta-analysis for RCTs was applied, using the odds ratio (OR) as the effect estimate and the GRADE approach to evaluate the quality of the evidence. Adverse events were analyzed qualitatively. Results: A comprehensive inclusion of 36 studies facilitated an evaluation of 614 participants for PCR, and 430 patients for PRR. Diclofenac showed the lowest PCR (0.53, 95% confidence interval (CI) [0.41; 0.66]), while CO₂ laser showed the highest PCR (0.97, 95% CI [0.90; 0.99]). For PRR, Er:YAG laser showed the highest rates (0.14, 95% CI [0.08; 0.21]), and imiquimod the lowest (0.00, 95% CI [0.00; 0.06]). In a pairwise meta-analysis, the OR indicated a lower recurrence rate for Er:YAG ablative fractional laser (AFL)-primed methyl-aminolevulinate photodynamic therapy (MAL-PDT) (Er:YAG AFL-PDT) compared to methyl-aminolevulinate photodynamic therapy (MAL-PDT) alone (OR = 0.22, 95% CI [0.06; 0.82]). The CO₂ laser showed fewer local side effects than the Er:YAG laser, while PDTs caused more skin reactions. Due to qualitative data, comparability was limited, highlighting the need for individualized treatment. Conclusions: This study provides a complete and up-to-date evidence synthesis of practice-relevant interventions for AC, identifying the CO₂ laser as the most effective treatment and regarding PCR and imiquimod as most effective concerning PRR. Full article

Background: Genetic polymorphisms in the cyclooxygenase-2 (COX-2) gene may contribute to individual susceptibility to periodontal disease. A meta-analysis assessed the association between three COX-2 single-nucleotide polymorphisms (SNPs) namely, −765 G/C (rs20417), −1195 G/A (rs689466), and 8473 T/C (rs5275), and the risk of CP. Methods: Following the PRISMA 2020 guidelines, we conducted a comprehensive search of five electronic databases and additional sources. The eligible studies were observational (case–control or cohort) with genotypic data comparing individuals with periodontal disease and periodontally healthy controls. Methodological quality was assessed using the Newcastle–Ottawa Scale (NOS), and the certainty of evidence was evaluated via the GRADE framework. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated under dominant genetic models. Results: Seven studies (n = 1467 participants) met the inclusion criteria. No eligible studies evaluated the 8473 T/C SNP. The meta-analysis of the −765 G/C variant revealed a significant association with periodontal disease (OR = 1.61; 95% CI: 1.12–2.32, p = 0.03; I² = 0%). For the −1195 G/A variant, the pooled OR was 1.86 (95% CI: 1.00–3.43, p = 0.05; I² = 35%), suggesting a borderline significant association. The certainty of evidence was graded as moderate for −765 G/C and low for −1195 G/A. Conclusions: The COX-2 −765 G/C polymorphism is significantly associated with increased CP risk, while the −1195 G/A variant shows a potential, though less certain, link. Larger, high-quality studies using standardized classifications are needed to confirm these associations. Full article