Search Results (26,615)

Background: Type 2 inflammatory diseases are among the most common chronic inflammatory conditions in childhood and represent a growing global health burden. Increasing evidence suggests that early-life nutritional exposures may influence immune programming and allergic disease development. This Position Paper aims to summarize the current evidence regarding the immunomodulatory role of polyunsaturated fatty acids (PUFAs), particularly omega-3 long-chain fatty acids, in the prevention of allergic diseases during early life. Methods: A scoping literature review and consensus process were conducted to map biological mechanisms and clinical evidence linking omega-3 PUFAs with allergic disease prevention. This document analyzed experimental, observational, and randomized controlled studies evaluating maternal prenatal/lactational omega-3 exposure. The clinical evidence was qualitatively appraised using study-design-specific Joanna Briggs Institute (JBI) Critical Appraisal Tools. Particular attention was given to immune modulation, inflammatory pathways, epithelial barrier function, gut microbiota interactions, and the ferroptosis–immune–metabolic axis. Results: Omega-3 PUFAs, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), exert immunomodulatory and anti-inflammatory effects through multiple mechanisms, including specialized pro-resolving mediator production, regulation of T-helper cell responses, cytokine modulation, maintenance of epithelial barrier integrity, and microbiota interaction. Emerging evidence also supports their involvement in oxidative stress and ferroptosis regulation. Current clinical evidence, particularly from higher-quality prenatal randomized trials and evidence syntheses, suggests that adequate maternal omega-3 intake during pregnancy and lactation may reduce the risk of respiratory allergic outcomes, especially wheezing and asthma, in selected offspring. Conclusions: Adequate omega-3 PUFA intake, such as 2 g/die, during critical windows of immune maturation may represent a valuable strategy for the primary prevention of allergic diseases. Current evidence most strongly supports supplementation during pregnancy and lactation, particularly in populations with low dietary omega-3 intake or increased allergic risk. Omega-3 supplementation should be considered within a broader multifactorial preventive approach aimed at promoting immune tolerance and reducing the future burden of allergic diseases. Full article

Bioelectrical impedance analysis (BIA) is a widely used technique in clinical and research settings because it provides non-invasive estimates of body composition. However, the quality of a measurement depends on more than the perceived accuracy and precision of numbers produced by a BIA device. This review considers BIA through the lens of metrology, defined as the science of measurement. It highlights several key factors that affect measurement quality. These include accuracy, precision, calibration, standardisation, and uncertainty quantification, all of which are essential for meaningful, clinically feasible BIA measurements. Applying prediction equations generated by the device outside their intended context, poor electrode placement, or uncalibrated devices can introduce bias, whereas biological variability can complicate the interpretation of bioimpedance results. The traditional emphasis on using a reference method for validation is considered along with clinical relevance, which is argued to be an equally important benchmark for evaluating measurement utility. We also present best practices and practical guidelines for improving measurement quality, interpretation, and integration into clinical workflows. By adopting a metrological mindset in clinical practice and treating BIA with the same rigour as other diagnostic tools, its utility in areas such as fluid management, nutrition, and preventive health can be further enhanced. Trustworthy decisions depend not only on the data itself but also on how it is measured, interpreted, and used. Full article

Viral hemorrhagic fevers (VHFs) are severe infectious diseases caused by RNA viruses of the families Arenaviridae, Filoviridae, Flaviviridae, and Hantaviridae, characterized by high morbidity, significant case fatality rates, and frequent diagnostic uncertainty in early disease stages. For military medical services, timely clinical recognition and laboratory confirmation are essential to guide patient management, prevent nosocomial transmission, and maintain operational continuity, particularly in endemic or resource-limited deployment settings. This review critically examines current diagnostic approaches to VHF-causative agents, emphasizing their use in clinical and field medical settings. The diagnostic process, from exposure through specimen collection, laboratory testing, and result interpretation is analyzed, including the use of molecular, serological, and antigen-based assays. Particular attention is given to deployable diagnostic platforms and their role in bridging the gap between frontline clinical suspicion and definitive laboratory confirmation. Biosafety requirements and infection prevention measures are discussed as integral components of clinical diagnostic workflows, aligned with guidance from the World Health Organization and the Centers for Disease Control and Prevention. Comparative analyses of virus-specific diagnostic timelines and laboratory requirements are presented to support differential diagnosis and clinical decision-making. Emerging technologies, including rapid molecular assays and genomic methods, are evaluated for their potential to improve early diagnosis and patient outcomes. This review highlights the central role of diagnostic readiness in clinical management of the VHFs and provides evidence-based considerations to support military clinicians facing high-risk febrile illnesses in operational environments. Full article

Youth drug abuse is a persistent public health concern in China. Community-based drug rehabilitation (CBDR), the final three-year stage of China’s official rehabilitation system, aims to help people who use drugs (PWUD) reintegrate into society, but reintegration remains limited, particularly among young PWUD. This study explores the social reintegration challenges faced by young PWUD aged 18 to 35 during the CBDR stage in Guangzhou, China. Semi-structured interviews were conducted with 16 participants and analyzed using reflexive thematic analysis (RTA). Three themes were identified: stigma and relational struggles, socioeconomic marginalization and daily life disruption, and limitations of the CBDR service model. These challenges were not separate but reinforced one another, with difficulties in one domain spilling into others and narrowing the space in which reintegration could occur. These findings suggest that addressing the reinforcing linkages between stigma, economic hardship, and service limitations requires a more coordinated approach to CBDR service provision, one that integrates vocational support into relapse prevention, builds flexibility into surveillance procedures, and provides participants and their families with realistic, evidence-based information about the prospects of recovery. Full article

Background: Childhood oral hygiene behaviors are crucial to preventing oral diseases and can influence the development and progression of malocclusions. The World Health Organization (WHO) Oral Health Questionnaire is a standardized tool for assessing oral hygiene behaviors, oral health-related behaviors, and preventive dental awareness in children. Aim: This study aimed to assess oral hygiene behaviours and examine associations between WHO Oral Health Questionnaire variables and Angle malocclusion classes among children aged 6–9 years. Materials and Methods: This cross-sectional study included 90 children aged 6–9 years from the Pristina region, Kosovo. Data were collected using the WHO Oral Health Questionnaire for Children, which assessed oral hygiene habits, toothbrushing frequency, fluoride awareness, dental attendance, dietary behaviors, oral symptoms, and oral-health-related quality of life. Malocclusion was classified according to Angle classification into Class I, II, and III malocclusions with 3D intraoral scanners, Aerolscan 3. Descriptive statistical analysis, Chi-square (χ²) test, Spearman correlation analysis, and reliability analysis using Cronbach’s Alpha were performed using SPSS Statistics 23.0 (IBM Corp., Armonk, NY, USA) and Statistica 7.1 (StatSoft Inc., Tusla, OK, USA). Results: Most participants reported regular oral hygiene practices, with 46.7% brushing their teeth two or more times daily. However, limited awareness regarding fluoride-containing toothpaste was observed, as most children answered “don’t know” regarding fluoride use. Occasional toothache or oral discomfort was reported by 33.3% of participants, while 23.3% reported dissatisfaction with dental appearance. Difficulty biting hard foods was present in 34.4% of children. Reliability analysis of the Q10 section demonstrated moderate internal consistency (Cronbach’s Alpha = 0.500). Chi-square analysis demonstrated no statistically significant association between Angle malocclusion classes and WHO questionnaire variables (p > 0.05). The highest χ² value was observed for tooth-cleaning frequency (Q7) (χ² = 11.97; p = 0.152), although the association remained statistically non-significant. Psychosocial impact questions and oral health-related quality of life questions also demonstrated no statistically significant association with malocclusion classes. Conclusions: oral hygiene practices, preventative oral health practices, and oral health-related experiences were comparatively similar among children in different Angle malocclusion classes. Although there were no statistically significant correlations found between malocclusion classes and WHO questionnaire variables, the results show that some children have psychosocial concerns about their dental appearance and insufficient awareness of preventive oral health. The WHO Oral Health Questionnaire is a useful epidemiological tool for evaluating pediatric oral health behaviors and may help build youth orthodontic and preventive oral health policies. Full article

Background/Objectives: Obesity-associated non-alcoholic fatty liver disease (NAFLD) drives systemic metabolic stress and accelerates chronic kidney disease, yet the mechanistic links remain unclear. Mitochondrial dysfunction has emerged as a central mediator of obesity-induced organ injury. Here, we investigated renal mitochondrial remodeling in a rat model of obesity-associated NAFLD (Ob-NAFLD) and examined the effects of metformin. Methods: Female Zucker rats (obese fa/fa and lean Fa/Fa) were fed an AIN-93G diet for eight weeks, followed by 10 weeks of metformin treatment in designated groups. Kidney tissues were analyzed using biochemical assays, immunoblotting, blue native PAGE, in-gel activity assays, and histological evaluation. Results: In Ob-NAFLD rats, renal ATP levels were elevated despite reduced electron transport chain (ETC) Complex III and increased Complex V expression, reflecting compensatory ATP synthase hyperactivity uncoupled from efficient oxidative phosphorylation. Mitochondrial dynamics were disrupted such that inhibitory phosphorylation of DRP1 was reduced, promoting fission, and total OPA1 expression was decreased with a shift in short-to-long isoform balance, indicating impaired fusion and cristae remodeling. Notably, ATPase inhibitory factor 1 (IF1), a checkpoint that limits ATP synthase overdrive, remained stably expressed, suggesting an adaptive ceiling or failed protective control under chronic metabolic stress. Metformin partially alleviated bioenergetic stress by lowering ATP and modestly restoring Complex III, yet ETC imbalance and structural remodeling persisted, revealing the limitations of metabolic modulation alone. Conclusions: These findings position entrenched mitochondrial dysregulation as a mechanistic bridge linking obesity-driven liver disease to kidney injury. Therapeutic strategies combining metabolic interventions with targeted restoration of ETC coordination, mitochondrial dynamics, and regulatory checkpoints such as IF1 may be required to fully restore renal mitochondrial health and prevent the progression of metabolic kidney disease. Full article

Background/Objectives: Declining masticatory function affects dietary variety, nutritional status, cognitive function, and health. Although factors related to chewing ability have been reported, the causes of temporal changes in masticatory kinematics in older adults remain unclear because prospective longitudinal data remain limited. Objectives: This follow-up study investigated factors associated with changes in masticatory movement in older adults requiring long-term care. Methods: Participants were 42 older adults residing in long-term care facilities. Survey items included mandibular kinematic data during rice cracker chewing and variables related to chewing, and the same assessment was performed two years after baseline. Relationships between changes in masticatory movement and other variables were examined, and factors associated with masticatory movement were identified using a linear mixed model (LMM). Results: A change in the number of cycles was significantly associated with the rate of change in the appendicular skeletal muscle mass index (ASMI). The rates of change in the number of linear motions and circular motion frequency were significantly associated with changes in the ABC Dementia Scale (ABC-DS). In the LMM results, cycle frequency remained associated with ASMI after adjustment for confounding factors, and both the number of circular motions and circular motion frequency were associated with ABC-DS. Conclusions: The findings suggest that masticatory movement in older adults requiring long-term care is influenced by skeletal muscle mass and cognitive function. In care facilities, interventions to maintain these factors are essential to help prevent dietary texture modifications among residents, while supporting nutrition, oral function, and health in this population. Full article

This research focused on the formulation of a health-oriented, clean-label food product fortified with encapsulated bioactive compounds from Sambucus nigra, Aronia melanocarpa, and Echinacea purpurea. To evaluate the protection of these sensitive compounds during production and storage, a comprehensive characterization was performed. This included basic physicochemical analyses, phenolic profiling, antioxidant activity tests, as well as rheological and textural measurements. Furthermore, sensory analysis, consumer evaluation, and microbiological stability during storage were assessed. Results from Scanning Electron Microscopy (SEM) and Fourier-Transform Infrared Spectroscopy (FTIR) analyses confirmed the structural integrity of the capsules post-processing. Additionally, the application of a starch–psyllium carrier ensured that the textural and rheological properties remained fully comparable to the control sample, preventing undesirable matrix alterations. Specifically, product hardness (1.17–1.23 N) and adhesiveness (8.17–8.94 N·s) were maintained at stable levels, while color alterations were minor and likely noticeable only to trained observers (ΔE* < 3.2). Microbiological evaluation demonstrated that the application of different formulated products effectively inhibited the growth of Gram-positive and Gram-negative bacterial strains, with inhibition rates increasing from 3.4 to 39.7%. Collectively, the experimental data demonstrate that encapsulation is a highly effective strategy for fortifying fruit-based systems with sensitive extracts, successfully maximizing bioactivity retention while maintaining high product quality and sensory appeal. Full article

The aviation industry is adopting liquid hydrogen (LH₂) for sustainable flight, requiring robust safety systems. This work is an example of adaptation of a Micro-Electro-Mechanical Systems (MEMS)-based structural health monitoring (SHM) system for LH₂ tanks, developed in the H2ELIOS project. It uses a multisensor approach that combines MEMS sensors to monitor vibration and acceleration, shape memory alloy (SMA) strain sensors for measuring tank expansion, and hydrogen leakage sensors to prevent false alarms. This SHM technology detects cracks and delamination of material and coating, enabling predictive maintenance via digital twins and ensuring structural integrity. Full article

Animal infectious diseases impose severe economic burdens on livestock industries, threaten wildlife populations, and compromise food security. Although vaccination remains the cornerstone of disease prevention, conventional vaccine platforms are often constrained by safety, efficacy, or manufacturing scalability. This narrative review provides a comprehensive analysis of the state of the art in herpesvirus-vectored vaccines for veterinary applications, focusing on five well-characterized alphaherpesviruses: Bovine herpesvirus type 1 (BoHV-1), Pseudorabies virus (PRV), Marek’s disease virus (MDV), Equine herpesvirus type 1 (EHV-1), and Duck enteritis virus (DEV). The intrinsic characteristics of herpesviruses, including large, stable genomes; the capacity for foreign gene insertion; broad host tropism; and the ability to elicit robust humoral and cellular immunity, are examined, and their performance is compared with that of traditional vaccine platforms. Key advances in vectored vaccine development are highlighted, from proof-of-concept studies to the creation of advanced multivalent constructs. These approaches demonstrate protective efficacy against a range of significant animal pathogens, including foot-and-mouth disease virus, porcine reproductive and respiratory syndrome virus, avian influenza virus, infectious bursal disease virus, and West Nile virus. The literature was identified through systematic searches of PubMed, Google Scholar, and Web of Science (1990–2026), followed by title/abstract screening and reference chaining. Future directions in vector engineering, mucosal delivery, and synthetic biology approaches are considered. Herpesvirus-vectored vaccines represent a versatile platform for enhancing animal health, supporting sustainable agriculture, and mitigating zoonotic risks. Full article

Background/Objectives: Dental fear and anxiety (DFA) in children can negatively affect oral health behaviors and dental care utilization. Family-related factors, particularly parental anxiety, parenting styles, and socioeconomic characteristics, may be associated with DFA. This study aimed to investigate the association between family-related factors and DFA among children aged 6–8 years in Jakarta, Indonesia. Methods: A cross-sectional study was conducted among 294 child–parent pairs recruited from 10 primary schools using multistage cluster sampling. Children’s DFA was assessed using the Children’s Fear Survey Schedule–Dental Subscale (CFSS-DS), whereas parental dental anxiety was measured using the Modified Dental Anxiety Scale (MDAS). Sociodemographic and family-related characteristics, including parenting styles, were collected using self-administered questionnaires. Data were analyzed using chi-square tests and multivariable logistic regression. Results: Overall, 34.7% of the children were classified as having DFA. Maternal employment was significantly associated with children’s DFA, with children of formally employed mothers having higher odds of DFA (aOR = 2.01, 95% CI: 1.05–3.85; p = 0.034). Parental dental anxiety was associated with children’s DFA. Children whose fathers and mothers reported high levels of dental anxiety had 4.68-fold (95% CI: 1.64–13.33; p = 0.004) and 2.50-fold (95% CI: 1.10–5.74; p = 0.029) higher odds of experiencing DFA, respectively. Dental drilling and injections were the most frequently reported fear-provoking stimuli. The final regression model explained 13% of the variance in children’s DFA. Conclusions: Parental dental anxiety and maternal employment were significantly associated with DFA among children aged 6–8 years. Family-centered preventive strategies and early identification of at-risk children may help reduce DFA and promote positive dental experiences and oral health outcomes. Full article

Background: Stroke-associated infection (SAI) is a common complication of acute ischemic stroke and is associated with adverse clinical outcomes. Contemporary prospective data from Southeast Asia remain limited. The primary objective was to determine the prevalence of SAI in patients with acute ischemic stroke. Secondary objectives were to identify associated clinical predictors and evaluate its relationship with in-hospital outcomes. Methods: This prospective observational cohort study included 390 adults with acute ischemic stroke admitted to a tertiary center between August 2024 and November 2025. SAI was defined as clinically diagnosed infection occurring within seven days of stroke onset using standardized criteria. Demographic, clinical, and treatment variables were collected. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Functional outcome at discharge was evaluated using the modified Rankin Scale (mRS). Multivariable logistic regression was performed to identify independent predictors of SAI. Results: SAI occurred in 75 patients, giving a prevalence of 19.2% (95% CI 15.3–23.1). Pneumonia was the predominant subtype (14.4%). On multivariable analysis, higher NIHSS score (adjusted OR 1.10 per point; 95% CI 1.05–1.14; p < 0.001) and mechanical thrombectomy (adjusted OR 3.02; 95% CI 1.11–8.26; p = 0.031) were independently associated with SAI. Patients with SAI had longer hospital stays (median 8 vs. 4 days, p < 0.001), poorer functional outcomes (81.3% vs. 24.8% with mRS 3–6, p < 0.001), and higher in-hospital mortality (17.3% vs. 1.0%, p < 0.001). Conclusions: Stroke-associated infection affected approximately one-fifth of patients with acute ischemic stroke and was strongly associated with stroke severity and adverse clinical outcomes. These findings support early risk stratification and targeted preventive strategies in acute stroke care. Full article

Fluoride remains the keystone of evidence-based caries prevention by stabilizing the mineral balance at the tooth–biofilm–saliva interface. Contemporary understanding emphasizes a predominantly post-eruptive, topical mode of action where fluoride inhibits demineralization and accelerates remineralization. This interfacial catalysis is reinforced by pH-responsive calcium-fluoride-like reservoirs that release fluoride during acid challenges. While community water fluoridation confers population-level reductions, the most effective approach is sustaining low-level fluoride in the biofilm environment. Evidence confirms that toothpastes with 1000–1500 ppm fluoride provide a dose–response benefit in children, while 5000 ppm concentrations are indicated for high-risk scenarios such as root caries and xerostomia. Beyond physicochemical effects, fluoride modulates the oral microbiome by inhibiting bacterial enzymes and proton pumps, shifting community function toward a health-associated state without reducing overall diversity. In restorative dentistry, glass ionomer cements offer superior preventive effects against secondary caries compared to amalgam; however, marginal integrity, adhesive performance, and clinical technique, rather than fluoride release alone, remain the primary determinants of success. Despite well-known risks associated with high systemic intake, such as fluorosis, current evidence does not indicate genotoxic or adverse microbiome effects in humans from routine topical use of standard fluoride products at recommended preventive concentrations. Overall, fluoride’s cariostatic value rests on frequent, low-level exposures that maintain tissues in a repair-favoring state. Full article

Background: HIV/AIDS remains a major global public health challenge, with persistent regional disparities in burden and progress toward the UNAIDS 95–95–95 targets. This study assessed temporal trends in the HIV/AIDS burden in Kazakhstan, compared them with Central Asia and global patterns, and projected trends through 2030. Methods: We conducted a population-level analysis using Global Burden of Disease 2023 data, examining age-standardized rates (per 100,000) of incidence, prevalence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) from 2010 to 2023. Trends were quantified using percent change and average annual percentage change, with projections based on log-linear models. Results: Between 2010 and 2023, prevalence in Kazakhstan increased by 332.1% and incidence by 111.0%, contrasting with the decline in global incidence (−24.7%). Mortality decreased (−32.7%), along with DALYs (−28.8%) and YLLs (−37.1%), while YLDs increased by 135.5%, indicating a shift toward a chronic disease burden. In 2023, Kazakhstan had a lower overall burden than global estimates but showed steeper increases in incidence and prevalence. Age-specific analyses indicated the largest increases among adults aged 30–69 years. Under current trend assumptions, projections suggest continued growth in prevalence and incidence, with modest mortality declines through 2030, though these trajectories do not account for future changes in prevention coverage, treatment access, or policy. Conclusions: Kazakhstan is undergoing a transition toward a chronic HIV epidemic, underscoring the need to strengthen prevention, expand PrEP and testing coverage, and address structural barriers to achieve epidemic control. Full article

Background: Sedentary behavior is a major modifiable risk factor for chronic metabolic disorders, particularly type 2 diabetes mellitus (T2DM). Despite recommendations promoting regular physical activity (PA), adherence remains low. DIA/01 is a multidisciplinary study designed to promote healthy lifestyles for the prevention and management of T2DM, supporting healthcare systems. Methods: A total of 123 adults with T2DM diagnosed will be enrolled at the Diabetes Center of the University Hospital of Perugia throughout 2025. Inclusion criteria are age 25–80 years, ability to walk independently, being inactive, and BMI 18.5–40 kg/m². Exclusion criteria include severe cardiovascular, central nervous system, or musculoskeletal diseases contraindicating PA. Participants will be randomized into three groups: (1) standard care (SC); (2) SC plus theoretical PA counseling (TCPA); and (3) SC plus TCPA plus a 3-month supervised mixed exercise program. The assessment, conducted at baseline and at 6 and 12 months, includes total weekly PA (WPA) time, using IPAQ-SF and actigraphy. Moreover, glycated hemoglobin, sedentary time (ST), functional capacity, body composition, cardiometabolic risk factors, dietary adherence, perceived barriers and willingness to initiate PA, readiness to change, health-related quality of life, and sleep quality will be studied. This study is registered in the Clinical Trials Registry on 13 May 2026, with the identifier NCT07583355. Conclusions: Participants in groups (2) and (3) are expected to show greater improvements in WPA, reductions in ST, and favorable changes in metabolic and functional outcomes compared with SC. This approach may support long-term engagement in regular PA and contribute to improving the clinical management of T2DM. Full article