Search Results (20,495)

This study aimed to identify and evaluate the risk factors associated with Giardia spp. infection among generally hospitalized patients with various conditions specific to infectious diseases in Western Romania. A total of 312 patients, ranging in age from 2 months to 90 years and originating from both urban and rural settings, were included in the analysis. Fecal specimens were collected and analyzed using the Rapid-VIDITEST Crypto Giardia antigen test, a qualitative chromatographic assay for the detection of Giardia spp. Infection-related risk factors were assessed through a standardized questionnaire completed by adult patients or by the guardians of pediatric patients. The overall prevalence of Giardia spp. infection was 4.8%. Of the risk factors analyzed, only age demonstrated a statistically significant association with infection status (p < 0.05). Notably, the highest prevalence (12.5%) was recorded in the <1-year age group (2–11 months), with a marked decrease in prevalence observed among patients aged ≥60 years. Other evaluated risk factors—including area of residence, gender, contact with animals, pet ownership, hand hygiene after animal contact, type of housing (house or apartment), fruit washing practices, use of potable water, use of public transportation, international travel, and visits to playgrounds or swimming pools—did not show a statistically significant association with Giardia spp. infection among the study participants. The lack of statistical significance for several expected factors may be related to limited statistical power resulting from the low number of positive cases. These findings contribute to the current understanding of Giardia spp. transmission dynamics and may inform future research efforts aimed at elucidating relevant risk factors. Furthermore, the results may support the development of targeted public health interventions (focusing on infants and their caregivers) and prevention strategies. Full article

Background and Objectives: Recent research has highlighted the importance of examining risk factors and their complex interrelationships in the development of lower limb injuries. This study aimed to investigate the direct, indirect, and mediating effects of endogenous neuromuscular and psychological risk factors on the incidence of non-contact lower limb injuries in football players. Materials and Methods: A sample of ninety-seven male football players underwent a structured preseason, on-field assessment. Demographic characteristics, injury history, and athlete burnout were collected through standardized questionnaires. Preseason evaluations included assessments of lower limb flexibility; isometric strength assessment of hamstring, hip abductors, and quadriceps using a handheld dynamometer; hamstring and core endurance; and the single-leg triple hop for distance test. All non-contact lower limb injuries were prospectively recorded throughout the competitive season. Partial Least Squares Structural Equation Modeling (PLS-SEM) method was applied to examine both direct and indirect associations between preseason risk factors and injury incidence. Results: Lower limb strength asymmetries (path coefficient (PC) 0.293, p = 0.004) and previous injuries (PC 0.233, p = 0.015) exhibited the strongest direct effects on the occurrence of new non-contact lower limb injuries. In addition, age acted as a moderating factor, amplifying the effect of lower limb strength asymmetries on injury risk. Moreover, previous injuries demonstrated both direct and indirect effects on neuromuscular characteristics and perceived burnout. Core and hamstring endurance tended to influence new injuries indirectly through strength asymmetries and were significantly affected by hamstring strength (PC 0.248, p = 0.015) and prior injuries (PC −0.207, p = 0.029). Conclusions: Injury prevention strategies should prioritize the improvement of core and hamstring endurance and the reduction in lower limb Strength Asymmetries, particularly among older football players. Furthermore, individualized preventive interventions for athletes with a previous history of injury are strongly recommended. Full article

Background: Influenza poses a significant health threat to children under nine, who are at high risk of severe complications. Influenza vaccination is a key prevention strategy, but pediatric trials use heterogeneous safety and immunogenicity outcomes, follow-up windows, and dosing strata that hinder meaningful cross-trial comparison. Objective: To map how safety and immunogenicity outcomes are defined, collected, stratified, and reported across clinical trials of seasonal influenza vaccines in healthy children aged 6 months to 8 years, and to identify reporting patterns and gaps that limit cross-trial comparability. Methods: Studies were identified through a structured PubMed/MEDLINE search first conducted 20 April 2025 and last conducted June 2025, following JBI and PRISMA 2020 guidelines. We included clinical trials reporting at least one safety outcome in healthy children 6 months to 8 years old. Heterogeneity in outcome definitions, follow-up windows, and dose strata precluded meta-analysis; we conducted a narrative and per-study synthesis. Risk of bias was evaluated with RoB 2 for randomized trials and ROBINS-I (V2) for non-randomized studies following Cochrane guidance. Descriptive and visual syntheses were utilized. Results: Of 293 records, 20 studies comprising approximately [n = 12,267] pediatric participants met the inclusion criteria. All included studies evaluated inactivated, egg-based seasonal influenza intramuscular vaccines. Reporting windows and dose handling varied widely. Vaccine-related serious adverse events (SAEs) were rare (only four events, with reported SAEs happening in children 6–35 months old immunized with quadrivalent formulations; all SAEs resolved and did not result in participant withdrawal from the study). No SAEs were reported in children 3–8 years old. Immunogenicity outcomes are presented as reported by each trial, with baseline and post-vaccination sampling days reproduced; no cross-trial synthesis was performed. Conclusions: Seasonal, inactivated intramuscular influenza vaccines show a favorable safety and immunogenicity profile in healthy children 6 months to 8 years old. However, heterogeneous outcome definitions, variable safety follow-up windows, limited dose- and priming-specific reporting, and inconsistent immunogenicity schedules substantially constrain cross-trial comparability. Funding and Registration: Primary funding was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant HD109732). This review was registered in PROSPERO (registration number: CRD420251237499). Full article

Although smoking is the main risk factor for chronic obstructive pulmonary disease (COPD), about one-third of patients have never smoked. This phenomenon supports the idea of a distinct phenotype of the disease in never-smokers, influenced by genetic, infectious, socioeconomic, environmental, and occupational factors. The paper is based on a narrative review of recent literature on the etiology, clinical features, evolution, and therapeutic strategies of COPD in never-smokers, mainly through the analysis of published studies over the last 3 years. COPD in never-smokers occurs predominantly in women, the elderly, and individuals from rural areas or with poor socioeconomic status. Key risk factors include exposure to occupational or environmental pollutants, air pollution, previous respiratory infections, particularly due to pulmonary tuberculosis, and genetic predisposition, mainly through alpha-1 antitrypsin deficiency (A1ATD). Clinically, COPD in never-smokers is characterized by chronic cough and dyspnea, with less severe pulmonary functional impairment, slow progression, and lower prevalence of emphysema compared to smokers. Imaging often highlights bronchiectasis or post-infectious sequelae, and biological markers indicate a significant eosinophilic component. Thus, COPD in never-smokers is a distinct clinical entity with multifactorial pathogenesis and distinct clinical-functional characteristics. Prompt recognition of this form of disease is essential for prevention and adaptation of therapeutic strategies. A personalized multidisciplinary approach can improve disease prognosis and the quality of life for these patients. Full article

Astaxanthin (AX), a naturally occurring xanthophyll carotenoid, has attracted growing scientific interest due to its potent antioxidant, anti-inflammatory, and metabolic-regulatory properties. This review provides a critical appraisal of the current evidence regarding the nutraceutical potential of AX in muscle metabolism, exercise adaptation, and obesity management. Preclinical and clinical findings indicate that AX enhances lipid utilization, promotes mitochondrial biogenesis through AMPK activation, and improves endurance and muscle strength, particularly among older adults. Moreover, AX mitigates exercise-induced oxidative stress and muscle damage, thereby supporting recovery and physiological adaptation. In obesity models, AX reduces adipose tissue inflammation, improves insulin sensitivity, and modulates adipokine secretion, suggesting a multifaceted role in metabolic syndrome prevention. Despite robust preclinical data, human trials remain limited and often yield inconsistent outcomes, highlighting the need for well-designed, long-term clinical studies. Emerging evidence highlights the importance of optimized delivery strategies to enhance AX bioavailability and mitochondrial targeting. Nanoemulsions, liposomes, and lipid-based carriers improve stability, absorption, and tissue distribution, thereby potentiating AX’s effects on mitochondrial function and exercise adaptation. Overall, AX emerges as a promising nutraceutical candidate for enhancing muscle function, supporting exercise performance, and managing obesity-related metabolic disease, with delivery innovations representing a critical frontier for future translational applications. Full article

Contemporary cities constitute both the primary site where the climate crisis manifests its most evident impacts and the privileged laboratory for testing strategies of adaptation and resilience. However, the growing emphasis on “climate neutrality” policies risks obscuring the social dimension of urban regeneration processes, thus generating new imbalances and forms of exclusion. This paper offers a critical reflection on the role of urban planning beyond climate neutrality, reorienting it towards a perspective of climate justice capable of integrating ecological transition goals with those of social and territorial cohesion. The research adopts a mixed-method approach, combining theoretical and documentary analysis with empirical case comparison, to investigate the relationship among urban regeneration, urban welfare, and spatial inequalities. The study aims to identify strategies for preventing climate gentrification, a phenomenon in which adaptation and mitigation measures—if not accompanied by adequate redistributive mechanisms—produce socio-spatial displacement effects that exclude the most vulnerable communities from the environmental benefits generated. The comparative analysis of two international case studies—Little Haiti (Miami) and the Green Corridors of Medellín (Colombia)—reveals two contrasting trajectories of the ecological transition: a regressive one, driven by market logics and real-estate valorization, and a progressive one, grounded in principles of equity, participation, and inclusive distribution of environmental benefits. Full article

Chronic diseases, characterized by their high prevalence and protracted course, represent a paramount challenge to global public health, necessitating effective, evidence-based preventive strategies. While functional foods are widely recognized for their potential, a comprehensive synthesis elucidating their multitargeted mechanisms within a “food-medicine homology” framework and a clear trajectory from broad-spectrum health promotion to targeted intervention remains lacking. This review bridges this critical gap by systematically evaluating the scientific evidence and application potential of functional foods, with a specific focus on key bioactive compounds—β-glucan, omega-3 polyunsaturated fatty acids (PUFAs), dietary fiber, and catechins. We provide a critical analysis of how these components orchestrate synergistic effects at molecular, cellular, and systemic levels to counteract core pathological processes, including oxidative stress, chronic inflammation, metabolic dysregulation, and gut microbiota imbalance. Our unique contribution lies in integrating the ancient wisdom of food-medicine homology with modern multi-omics and evidence-based research, thereby proposing a refined nutritional intervention paradigm. The review offers critical insights into the convergent actions of these bioactives, their dose-response relationships substantiated by clinical meta-analyses, and the emerging role of gut microbiota-derived metabolites. Furthermore, this review also explores the emerging evidence for synergistic interactions among these key bioactives, proposing that their combined use may yield amplified and more network-based protective effects against chronic diseases through complementary mechanisms, aims to develop integrated prevention strategies targeting both cardiometabolic and neurodegenerative diseases. The integrated prevention strategies systematically connect mechanistic insights into bioactive compounds, evaluates the strength of clinical evidence, and examines the implications for regulatory standards and societal acceptance, thereby bridging the gap between basic science, clinical application, and public health policy. The “mechanism-to-evidence-to-regulation” framework in this review links molecular insights with clinical validation and regulatory implications, offering a holistic perspective rarely addressed in existing literature. Full article

Junction temperature is considered a critical parameter that can directly affect the reliability and power handling capabilities of semiconductor devices. Effective thermal management, particularly under high-surge-current conditions, is therefore essential to maintain a lower junction temperature in order to enhance device performance and prevent device failure. Among various thermal management strategies, packaging technology plays an important role in optimizing junction temperature and enhancing the robustness of the device. In this article, a comparative analysis of high-power diodes is performed by investigating their junction temperature behavior and surge current handling capability. Moreover, an insulated module diode and a press-pack diode with pressure contact technology (PCT), both with identical specifications and power ratings, are selected for analysis. A 10 ms half-sine surge current waveform generator is developed both experimentally and in simulations to replicate realistic surge events. Experimental measurements of the forward voltage drop across varying surge levels are used to analyze device failure behavior. In addition, electro-thermal simulations are also employed in PSIM 2025.0 software to estimate and compare the temperature. Furthermore, this study enables practical insights into device thermal performance, robustness, and surge current handling capabilities, enabling a performance comparison between the two packaging technologies. Full article

Background: Biomedical device-associated infections pose major challenges in surgical care, particularly in hernia repair where polypropylene (PP) meshes and sutures are prone to bacterial colonization and biofilm formation. The limitations of antibiotic resistance and toxicity warrants the need of developing innovative antibacterial strategies. Methods: We developed a composite coating of hydroxypropyl methylcellulose (HPMC) and zinc oxide nanorods (ZnO NP) synthesized via thermal decomposition. This coating was applied to PP meshes and sutures to enhance anti-adhesive properties. The study evaluated surface hydrophilicity through water contact angles, estimation of Zn²⁺ ions using inductively coupled plasma–mass spectrometry (ICP-MS), and long-term efficacy over six months. Safety was assessed via systemic toxicity studies in murine models. Results: The ZnO NPs exhibited potent antibacterial efficacy, achieving up to 99.999% killing against Klebsiella pneumoniae. When applied as an HPMC-ZnO coating, PP meshes and sutures demonstrated enhanced hydrophilicity, reducing water contact angles by ~41° and facilitating prevention of bacterial adhesion. The coated meshes inhibited bacterial attachment by 83% (Escherichia coli), 60% (Pseudomonas aeruginosa), 99.6% (K. pneumoniae), and 99% (Staphylococcus aureus). Similarly, coated sutures reduced adhesion by 67–96% across these strains. Long-term storage studies showed retained antibiofilm efficacy for up to six months. In vivo assessments indicated negligible systemic toxicity of ZnO NPs in murine models. Conclusions: Collectively, these findings highlight HPMC-ZnO NPs coatings as a safe, durable, and effective strategy to functionalize PP-based meshes and sutures, reducing the risk of surgical site infections and demonstrating the potential for broader biomedical applications. Full article

Background: Molar–Incisor Hypomineralization (MIH) represents a developmental enamel defect of systemic origin, typically affecting the first permanent molars and often the incisors. Within the limitations of this study, several associations were observed between perinatal factors and MIH-related outcomes. However, most of these connections were not retained in adjusted analyses. Febrile illness during the first year of life showed a significant association with hypersensitivity. Methods: A structured 30-item questionnaire was distributed to mothers of 50 children diagnosed with MIH between February and March 2024. Data was analyzed using chi-square tests, with p < 0.05 considered significant, and univariate and multivariate logistic regressions at 95% confidence interval. Clinical diagnosis followed the Weerheijm (EAPD) criteria. Results: Maternal medication during pregnancy (antibiotics, antiepileptics, asthma drugs) was significantly associated with preterm birth (p = 0.01). Low birth weight correlated with tooth eruption disorders (p = 0.009) and perinatal complications such as hypoxia and respiratory distress (p = 0.0001). Fluoride application demonstrated a protective effect against discolorations (p = 0.005), caries (p = 0.002), and hypersensitivity (p = 0.01). In the multivariate model, febrile illness during the first year of life may be associated with hypersensitivity in MIH-affected teeth (aOR = 5.71, 95% CI: 1.01–32.27, p = 0.049). Conclusions: Maternal medication and perinatal complications, particularly low birth weight, were associated with MIH occurrence. Preventive strategies emphasizing maternal health, early screening, and remineralization-based therapies can mitigate long-term oral health impacts. Full article

Background: Falls are a leading cause of injury, disability, and loss of independence among community-dwelling older adults. Although exercise-based interventions are widely recommended for fall prevention, the comparative effectiveness of different exercise modalities remains insufficiently synthesized. Methods: This systematic review was conducted in accordance with PRISMA 2020 guidelines. Randomized and controlled trials were identified through searches of PubMed, Scopus, Web of Science, and CINAHL, including studies involving adults aged ≥60 years who participated in balance-based, strength-based, multimodal, Tai Ji Quan, Otago Exercise Program, or perturbation-based reactive balance training interventions. Methodological quality was assessed using the Cochrane Risk of Bias 2 (ROB-2) tool. Due to substantial clinical and methodological heterogeneity across interventions and outcome measures, a narrative synthesis was undertaken. Results: Twenty-seven trials met the inclusion criteria. Exercise interventions consistently reduced fall incidence across studies. Tai Ji Quan interventions were associated with approximately 31–58% reductions in falls, the Otago Exercise Program with 23–40% reductions, and multimodal strength–balance training with 20–45% reductions. Perturbation-based reactive balance training demonstrated particularly strong effects on laboratory-induced falls, with reductions ranging from 50–75%. Functional outcomes also improved across intervention types, including faster Timed Up and Go performance, increased gait speed, improvements of approximately 1.2–2.5 points in Short Physical Performance Battery scores, 15–35% gains in lower-limb strength, and enhanced reactive balance responses. Longer-duration interventions (12–24 months) generally demonstrated sustained reductions in fall risk. Conclusions: Evidence from randomized and controlled trials indicates that structured exercise interventions, particularly Tai Ji Quan, the Otago Exercise Program, multimodal strength–balance training, and perturbation-based reactive balance training, are effective in reducing falls and improving balance, mobility, and strength in community-dwelling older adults. These findings support the use of targeted, evidence-based exercise programs as central components of fall-prevention strategies in older populations. Full article

Pigment gallstones represent a heterogeneous group of concretions, classically divided into black and brown types, whose morphology and microstructure offer critical clues about their underlying pathogenesis. Gallstone formation (lithogenesis) is a complex process triggered when the physicochemical equilibrium of bile is disrupted. Background/Objectives: The spicules observed on the surface of certain black pigment gallstones have traditionally been attributed to the branching capacity of cross-linked bilirubin polymers. However, a growing body of experimental and spectroscopic evidence suggests that inorganic calcium salts, particularly calcium carbonate and calcium phosphate, play a central role in the formation of the distinctive spiculated or “coral-like” architecture. Materials and Methods: In our study, we examined a case series of 1350 consecutive patients with gallstone disease, identifying 81 patients who presented with solitary black pigment stones. We systematically explored the association between high calcium content, specifically calcium carbonate, and the occurrence of spiculated morphology. Our analyses demonstrated a robust correlation between an elevated concentration of calcium carbonate and the presence of well-defined spicules. Results: These results support the hypothesis that mineral elements, rather than organic bilirubin polymers, act as crucial determinants of the peculiar crystalline structure observed in a significant subset of pigment stones. Spiculated stones, due to their small size and sharp projections, have a higher likelihood of migrating, increasing the risk of potentially life-threatening complications, such as acute cholangitis and gallstone pancreatitis. Conclusions: Our findings, consistent with recent advanced crystallographic analyses, underscore the importance of considering mineral composition in the diagnosis and management of cholelithiasis. Understanding the factors that drive calcium carbonate precipitation is essential for developing new preventive and therapeutic strategies, aiming to modulate bile chemistry and reduce the risk of calcium-driven lithogenesis. Full article

Swarm unmanned surface vehicles (USVs) have been increasingly explored for maritime defense and security operations, particularly in scenarios requiring the rapid detection and interception of multiple attackers. The target detection reliability and defender–target assignment stability are significantly crucial to ensure quick responses and prevent mission failure. A key challenge in such missions lies in the assignment of targets among multiple defenders, where frequent reassignment can cause instability and inefficiency. This paper proposes a novel ETA-hysteresis-guided reinforcement learning (RL) framework for continuous multi-target hunting with swarm USVs. The approach integrates estimated time of arrival (ETA)-based task allocation with a dual-threshold hysteresis mechanism to balance responsiveness and stability in multi-target assignments. The ETA module provides an efficient criterion for selecting the most suitable defender–target pair, while hysteresis prevents oscillatory reassignments triggered by marginal changes in ETA values. The framework is trained and evaluated in a 3D-simulated water environment with multiple continuous targets under static and dynamic water environments. Experimental results demonstrate that the proposed method achieves substantial measurable improvements compared to basic MAPPO and MAPPO-LSTM, including faster convergence speed (+20–30%), higher interception rates (improvement of +9.5% to +20.9%), and reduced mean time-to-capture (by 9.4–19.0%), while maintaining competitive path smoothness and energy efficiency. The findings highlight the potential of integrating time-aware assignment strategies with reinforcement learning to enable robust, scalable, and stable swarm USV operations for maritime security applications. Full article

Equine theileriosis, caused by the protozoan parasite Theileria equi, represents a significant economic threat to the equine industry. In Xinjiang, China, an endemic area for this disease, systematic research on the genetic diversity of T. equi has been notably lacking. The aim of this study was to obtain molecular epidemiological data pertaining to the parasite in selected regions of Xinjiang, China, and analyze the genetic characteristics (including 18S rRNA, EMA-1, and COI genes) and genotype distribution patterns of isolates from these regions, providing a scientific basis for developing targeted prevention and control strategies. Blood samples were collected from 440 horses across four regions (Altay, Ili, Tacheng, and Urumqi) and subjected to PCR assays. Positive samples were sequenced for phylogenetic and haplotype network analyses, and genetic diversity indices were calculated. The overall infection rate of T. equi was 38.41% (169/440), with Tacheng having the highest prevalence (86.27%) and Altay the lowest (20.88%); these regional differences were statistically significant. Phylogenetic analysis identified two genotypes of the 18S rRNA gene: genotype E (predominant) and genotype A. All EMA-1 sequences clustered exclusively within genotype A. Notably, all COI gene sequences formed a monophyletic group, exhibiting closer genetic relationships to isolates from France and Senegal. This study presents the first comprehensive genotyping of T. equi in Xinjiang based on three target genes and constructs an associated haplotype network. The analysis identified 18S rRNA genotype E and EMA-1 genotype A as the predominant genotypes. Furthermore, the genetic diversity of T. equi was found to be higher in Urumqi than in the other regions studied. Full article

Background: Adolescence is a developmental period marked by heightened vulnerability to depressive symptoms. Although prior research highlights the significance of father presence in adolescent mental health, longitudinal evidence clarifying both its direct and indirect effects remains scarce. Methods: The present study used a three-wave longitudinal design to examine whether emotion beliefs and emotion regulation processes explain the link between father presence and depressive symptoms. Participants included 1074 Chinese adolescents (M_age = 16.06, SD = 0.43, girls = 52.89%). Results: Path models showed that higher perceived father presence predicted lower depressive symptoms over time. Emotion beliefs and cognitive reappraisal each served as significant mediators in this association. Moreover, a sequential pathway emerged that father presence predicted fewer maladaptive emotion beliefs, which in turn were associated with the use of cognitive reappraisal, ultimately reducing depressive symptoms. Conclusions: These findings shed light on the cognitive and regulatory processes through which paternal presence contributes to adolescent emotional adjustment and provide support for incorporating paternal emotional engagement and emotion socialization strategies into family-based prevention and intervention programs targeting adolescent depression. Full article