Search Results (46)

Background/Objectives: Daily caloric restriction (DCR) is a common dietary weight loss strategy, but leads to metabolic and behavioral adaptations, including maladaptive eating behaviors and dysregulated appetite. Intermittent fasting (IMF) may mitigate these effects by offering diet flexibility during energy restriction. This secondary analysis compared changes in eating behaviors and appetite-related hormones between 4:3 intermittent fasting (4:3 IMF) and DCR and examined their association with weight loss over 12 months. Methods: Adults with overweight or obesity were randomized to 4:3 IMF or DCR for 12 months. Both randomized groups received a matched targeted weekly dietary energy deficit (34%), comprehensive group-based behavioral support, and a prescription to increase moderate-intensity aerobic activity to 300 min/week. Eating behaviors were assessed using validated questionnaires at baseline and months 3, 6, and 12. Fasting levels of leptin, ghrelin, peptide YY, brain-derived neurotrophic factor, and adiponectin were measured at baseline and months 6 and 12. Linear mixed models and Pearson correlations were used to evaluate outcomes. Results: Included in this analysis were 165 adults (mean ± SD; age 42 ± 9 years, BMI 34.2 ± 4.3 kg/m², 74% female) randomized to 4:3 IMF (n = 84) or DCR (n = 81). At 12 months, binge eating and uncontrolled eating scores decreased in 4:3 IMF but increased in DCR (p < 0.01 for between-group differences). Among 4:3 IMF, greater weight loss was associated with decreased uncontrolled eating (r = −0.27, p = 0.03), emotional eating (r = −0.37, p < 0.01), and increased cognitive restraint (r = 0.35, p < 0.01) at 12 months. There were no between-group differences in changes in fasting appetite-related hormones at any time point. Conclusions: Compared to DCR, 4:3 IMF exhibited improved binge eating and uncontrolled eating behaviors at 12 months. This may, in part, explain the greater weight loss achieved by 4:3 IMF versus DCR. Future studies should examine mechanisms underlying eating behavior changes with 4:3 IMF and their long-term sustainability. Full article

Background/Objectives: Major depressive disorder (MDD) is a debilitating illness, and chronic stress is a contributing factor for depressive symptoms. However, despite intense research, the mechanisms of MDD remain substantially unidentified. Quercetin is a powerful flavonoid and could be used as a possible therapeutic strategy for depression. Acknowledging the potential benefits of quercetin, this study investigated its effect alone or in association with the standard drug tranylcypromine (TCP) in a rodent model of chronic restraint stress (CRS). Methods: Adult male rats were subjected to a CRS model consisting of an immobilization session of 4 h daily during 14 consecutive days. Quercetin (50 mg/kg, gavage) was administered for 45 days. TCP (10 mg/kg, gavage) was administered for 14 days. Behavioral tasks were conducted to assess locomotor functions, memory, anhedonia, depression-like behaviors, and anxiety-like behaviors. The activity, gene expression, and protein density of acetylcholinesterase (AChE) were investigated. Results: Behavioral tasks showed that the CRS model effectively induced stable behavioral changes. CRS did not alter locomotor function assessed by the open field test (OFT) or anhedonia behavior assessed by the sucrose preference test (SPT). CRS increased total fecal count, which was prevented by quercetin administration in rats. TCP and the association of quercetin and TCP increased the recognition index in comparison with the CRS group in the novel object recognition (NOR) test and improved the swimming and immobility times in comparison to stressed animals in the forced swim test (FST). All treatments were able to decrease the anxiety index assessed by the elevated plus maze (EPM) test. The activity, gene expression, and protein density of AChE were increased in the CRS model compared to control males. Overall, quercetin and TCP proved to reverse CRS-induced alterations in these parameters. Conclusions: Quercetin mitigated cognitive deficits, behavioral impairments, and neurochemical alterations induced by the CRS model, especially in association with TCP, supporting its potential as a promising therapeutic agent for depression. Full article

Background/Objectives: The administration of parenteral medications is essential in managing acute arousal within the Behavioral Assessment Unit (BAU) of the emergency department (ED), where timely and effective intervention is critical. This study aims to evaluate current practices surrounding the use of parenteral medications for patients with acute agitation, focusing on adherence to protocols, medication safety, documentation accuracy, and patient outcomes. Methods: A retrospective analysis was conducted on 177 cases from December 2023 to February 2024. The study assessed the demographics, diagnoses, treatment protocols, and patient outcomes, with a particular emphasis on the use of parenteral medications such as benzodiazepines and antipsychotics. The relationship between medication administration and involuntary admission, mechanical restraint usage, and patient outcomes was also explored. Results: The majority of patients were aged between 21 and 30 years, and there was a predominance of male patients across both groups. Schizophrenia was the most common diagnosis, with a higher prevalence in the parenteral group (34%) compared to the oral-only group (24%), and personality disorders were more frequent in the parenteral group. Intramuscular (IM) medication administration was strongly associated with the use of mechanical restraint, with patients receiving IM medication being 35 times more likely to require restraint, emphasizing the link between more intensive treatment approaches and behavioral challenges. The most frequently administered medications were diazepam (40.6%) and olanzapine (36.5%), with olanzapine, droperidol, and diazepam most commonly used parenterally. Documentation of physical assessments prior to parenteral administration was present in most cases, though comprehensive evaluations such as ECGs were inconsistently performed. Conclusions: Parenteral medications, including benzodiazepines and antipsychotics, were effective in rapidly stabilizing patients, but the study emphasizes reducing dependency on mechanical restraints. Tailoring treatment to patient characteristics and employing alternative de-escalation strategies can improve safety and align with recovery-oriented care. This study highlights the need for evidence-based practices to optimize care and improve patient outcomes in ED settings. Further research is needed to explore long-term outcomes and refine non-coercive care approaches. Full article

Accurate prediction of vehicle damage in collision scenarios is crucial for enhancing road safety. However, traditional collision simulation methods are computationally intensive and time consuming. In this study, we proposed an intelligent damage prediction model that significantly reduces the computational time required for collision simulations by leveraging collision simulation datasets in conjunction with the random forest (RF) algorithm. A finite element model for vehicle collision simulation was first established. Subsequently, a dataset comprising 160 collision scenarios was generated by systematically varying the collision object, angle, offset, and speed, ensuring comprehensive coverage of vehicle damage data. The dataset was employed to construct an RF-based prediction model to estimate vehicle collision damage. Validation trials demonstrated that the proposed model achieved a mean absolute percentage error of 20.09% compared with 33.18% of a support vector machine regression (SVMR) model. The root-mean-square error of the proposed model was 33.94, whereas that of the SVMR model was 68.16. Compared with the SVMR model, the proposed RF model exhibited superior fitting performance, with reduced dispersion between the predicted and actual values. This enhanced model offers rapid damage prediction for trajectory planning systems and adaptive restraint systems in autonomous vehicles, ultimately contributing to enhanced road safety. Full article

Background: Language discordance occurs when the patient and the healthcare provider are not proficient in the same language. Language discordance in the critical care setting is a significant global issue because of its implications in the quality of care and outcomes of patients who do not speak the primary language of the country in which they receive healthcare. Studies show that language-discordant, critically ill patients have increased use of restraints during mechanical ventilation, increased length of stay, and more frequent complications. Communication challenges are magnified in the intensive care unit because of the medical complexity and frequent need for challenging conversations regarding goals of care. To address language-based disparities in critical care, numerous qualitative studies in recent years have attempted to understand the barriers that providers face when caring for language-discordant patients. Our systematic review is the first to analyze this developing body of literature and identify barriers for which solutions must be sought to ensure equitable care. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Embase, and Scopus from inception up to 20 February 2024. From among 2150 articles, nine articles were selected, which included eight qualitative studies and one cross-sectional study. Three studies were high quality, five were moderate quality, and one was low quality. Results: We found four major barriers to caring for language-discordant patients in the critical care setting. These included limitations in providers’ knowledge of best practices in professional medical interpreter use, challenges in navigating interpreters’ multiple roles, and limitations with different interpretive modalities and system constraints. These barriers caused clinicians distress due to clinicians’ desire to provide empathic care that respected patients’ autonomy and ensured patients’ safety and understanding. Conclusion: Interventions to increase providers’ knowledge of best practices, integrate interpreters into the critical care team, strategize the use of interpretation modalities, and address system-based barriers are needed to improve the care of language-discordant, critically ill patients worldwide. Full article

Background/Objectives: Cognitive and psychological factors, such as eating disorder psychopathology, irrational food beliefs, and internalized weight stigma, have not been sufficiently explored in the context of obesity treatment. This study evaluated the role of these variables as predictors of weight loss in patients with severe obesity following a brief intensive cognitive–behavioral therapy for obesity (CBT-OB) program. Methods: A total of 400 patients (mean BMI: 41.9 kg/m²; mean age: 55.9 years) participated in a 21-day residential CBT-OB intervention, followed by a 12-month follow-up assessment. The Eating Disorder Examination Questionnaire, Weight Bias Internalization Scale, and Irrational Food Beliefs Scale were administered at admission and discharge. Body weight was also assessed at the 12-month follow-up. Results: Of the participants, 371 patients (92.2%) completed the intensive CBT-OB program, and 310 (81.1%) attended the follow-up. On average, completers achieved 9% weight loss at follow-up, accompanied by a significant reduction in binge-eating episodes. Cognitive factors, including lower baseline eating concern, higher baseline weight concern, and greater improvement in irrational beliefs (specifically self-deception about eating and weight control), significantly predicted weight loss at 12 months. However, internalized weight stigma did not predict weight loss in this cohort. Conclusions: This study underscores the importance of targeting specific cognitive factors in obesity treatment to enhance long-term outcomes. Addressing irrational food beliefs and promoting flexible dietary restraint may improve weight loss and maintenance in individuals with severe obesity. Further research is warranted to refine cognitive–behavioral interventions for personalized obesity management strategies. Full article

Individuals with eating disorders often face difficulty accessing sufficiently intensive, recovery-focused treatment. Residential treatment may fill a gap in the spectrum of care, offering 24-h support in a more home-like environment than a hospital and using a holistic approach including individual and group psychological therapy, meal support, and lived experience staff. As residential treatment has not previously been examined in Australia, the current study aimed to document the development, treatment components, and structure of this first Australian residential service for eating disorders and provide a pilot of its treatment outcomes. Preliminary outcomes are included from a sample of 19 individuals from the first six months of admissions, including eating disorder symptoms, eating disorder-related impairment, anxiety, and depression. Significant pre- to post-treatment improvement was found in total eating disorder psychopathology, dietary restraint, eating concerns, body mass index, eating disorder-related impairment, and depression, but not from pre-treatment to a six-month follow-up. Pilot outcomes were positive at end-of-treatment but require further clinical evaluation to examine follow-up effects. Clinical insights are discussed from the establishment of this new treatment service, including recommendations for clinicians involved in the current roll-out of residential programs across Australia. Full article

Background: The emergence of COVID-19 profoundly influenced the dynamics within intensive care units, significantly altering the patient–family experience. As the pandemic unfolded, the longstanding practice of using physical restraints for patient safety persisted, introducing new challenges in healthcare settings. This study explored the ramifications of these enduring safety measures on family members of ICU patients during the pandemic, illuminating their lived experiences and the psychological impact of seeing their loved ones restrained. Objectives: To explore family members’ lived experiences with physical restraints in the ICU during COVID-19 and inform improvements in patient-centered care. Methods: Utilizing hermeneutic phenomenology, the study engaged ten family members in detailed interviews to gain an understanding of their experiences with ICU physical restraints during COVID-19. Conducted at a northeastern U.S. hospital, the collected narratives underwent thematic analysis within a sensemaking framework, yielding a profound understanding of family perspectives. Results: Family members faced challenges in understanding and coping with physical restraints, revealing a need for improved healthcare system support for family sensemaking and well-being. Conclusions: The study advocates integrating empathetic communication and family engagement into ICU care practices, underlining the importance of sensemaking during healthcare crises. Full article

This study investigates audiogenic epilepsy in Krushinsky-Molodkina (KM) rats, questioning the efficacy of conventional EEG techniques in capturing seizures during animal restraint. Using a wireless EEG system that allows unrestricted movement, our aim was to gather ecologically valid data. Nine male KM rats, prone to audiogenic seizures, received implants of wireless EEG transmitters that target specific seizure-related brain regions. These regions included the inferior colliculus (IC), pontine reticular nucleus, oral part (PnO), ventrolateral periaqueductal gray (VLPAG), dorsal area of the secondary auditory cortex (AuD), and motor cortex (M1), facilitating seizure observation without movement constraints. Our findings indicate that targeted neural intervention via electrode implantation significantly reduced convulsive seizures in approximately half of the subjects, suggesting therapeutic potential. Furthermore, the amplitude of brain activity in the IC, PnO, and AuD upon audiogenic stimulus onset significantly influenced seizure severity and nature, highlighting these areas as pivotal for epileptic propagation. Severe cases exhibited dual waves of seizure generalization, indicative of intricate neural network interactions. Distinctive interplay between specific brain regions, disrupted during convulsive activity, suggests neural circuit reconfiguration in response to escalating seizure intensity. These discoveries challenge conventional methodologies, opening avenues for novel approaches in epilepsy research and therapeutic interventions. Full article

This cross-sectional study investigated interactions among sugar-related dietary patterns (DPs), personality traits, and cognitive–behavioural and emotional functioning. The study involved working-age women aged 18–54. Data were collected between Winter and Spring of 2020/21. The survey was conducted using anonymised questionnaires. The ten-item personality inventory (TIPI-PL) was used to examine personality traits based on the Big Five personality trait model. A three-factor eating questionnaire (TFEQ-13) was used to measure the following eating behaviours: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). The KomPAN questionnaire collected the frequency of the intake. Dietary patterns (DPs) were derived by principal component analysis (PCA). A logistic regression (OR) was applied to verify the associations among the DPs, personality traits, and cognitive–behavioural and emotional functioning. Three DPs were identified: sweet-Western (SWDP), pro-healthy (PHDP), and dairy (DDP). Women with high conscientiousness were less likely, by 33%, to adhere to the upper tercile of the SWDP and 80% more likely to the upper tercile of the PHDP. Elevated CR intensity increased by almost twofold (OR: 1.93; p < 0.001) the likelihood of high adherence to the SWDP. The high intensity in the EE decreased by 37% (OR: 0.63; p < 0.01) the likelihood of increased adherence to the SWDP. Personality traits and eating behaviours significantly correlated with the extracted SWDP. Full article

In the context of global food security and the pursuit of sustainable agricultural development, fostering synergistic innovation in the seed industry is of strategic importance. However, the collaborative innovation process between seed companies, research institutions, and governments is fraught with challenges due to information asymmetry and bounded rationality within the research and development phase. This paper establishes a multi-agent evolutionary game framework, taking the breeding of salt-tolerant rice as a case study. This study, grounded in the theories of information asymmetry and bounded rationality, constructs a two-party evolutionary game model for the interaction between enterprises and research institutions under market mechanisms. It further extends this model to include government participation, forming a three-party evolutionary game model. The aim is to uncover the evolutionary trends in collaborative behavior under various policy interventions and to understand how governments can foster collaborative innovation in salt-tolerant rice breeding through policy measures. To integrate the impact of historical decisions on the evolution of collaborative innovation, this research employs a delay differential equation (DDE) algorithm that takes historical lags into account within the numerical simulation. The stability analysis and numerical simulation using the DDE algorithm reveal the risk of market failure within the collaborative innovation system for salt-tolerant rice breeding operating under market mechanisms. Government involvement can mitigate this risk by adjusting incentive and restraint mechanisms to promote the system’s stability and efficiency. Simulation results further identify that the initial willingness to participate, the coefficient for the distribution of benefits, the coefficient for cost sharing, and the government’s punitive and incentivizing intensities are crucial factors affecting the stability of collaborative innovation. Based on these findings, the study suggests a series of policy recommendations including enhancing the initial motivation for participation in collaborative innovation, refining mechanisms for benefit distribution and cost sharing, strengthening regulatory compliance systems, constructing incentive frameworks, and encouraging information sharing and technology exchange. These strategies aim to establish a healthy and effective ecosystem for collaborative innovation in salt-tolerant rice breeding. While this research uses salt-tolerant rice breeding as a case study, the proposed cooperative mechanisms and policy suggestions have universal applicability in various agricultural science and technology innovation scenarios, especially when research meets widespread social needs but lacks commercial profit drivers, underscoring the essential role of government incentives and support. Consequently, this research not only contributes a new perspective to the application of evolutionary game theory in agricultural science and technology innovation but also offers empirical backing for policymakers in advancing similar collaborative innovation endeavors. Full article

In China, scenic and historic areas are protected areas which are highly integrated with natural and cultural resources. The study analyzed policies based on the theory of policy instruments using content analyses. The results demonstrated that China’s scenic and historic areas have experienced four phases of development: primary development (1980–1994), exploration and growth (1995-–2006), deepening and maturity (2007–2018), and integration and optimization (2019–2023). Policy intensity is trending upwards, and contemporary policy authority and restraints are insufficient. The policy instruments showed an imbalance, and are mainly environmentally-type, with only a few supply- and demand-type. Policy topics mainly include management and planning protection. The Chinese government has played a leading role, taking many restraining measures to quickly protect scenic resources. Stronger and more effective policies with more specific content will favor the protection of scenic and historic areas. In the future, financial input, international exchanges, and outsourcing services should be increased to promote the vital development of scenic and historic areas. Legislation, establishment, social participation, operation, and ticket systems must be comprehensive. Overall, the study provides theoretical support for further reforms of China’s scenic and historic areas and lessons for improving the conservation quality of the world’s protected areas. Full article

Patients with critical illnesses are at higher risk of comorbidities, which can include bone mineral density loss, bone turnover marker increase, and fragility fractures. Patients admitted to intensive care units (ICUs) have a higher risk of bone fractures. Since hypermetabolism is a characteristic of ICU patients, such patients are often rapidly affected by systemic deterioration, which often results in systemic wasting disease. Major risk factors for ICU-related bone loss include physical restraint, inflammation, neuroendocrine stress, malnutrition, and medications. A medical history of critical illness should be acknowledged as a risk factor for impaired bone metabolism. Bone loss associated with ICU admission should be recognized as a key component of post-intensive care syndrome, and further research that focuses on treatment protocols and prevention strategies is required. Studies aimed at maintaining gut integrity have emphasized protein administration and nutrition, while research is ongoing to evaluate the therapeutic benefits of anti-resorptive agents and physical therapy. This review examines both current and innovative clinical strategies that are used for identifying risk factors of bone loss. It provides an overview of perioperative outcomes and discusses the emerging novel treatment modalities. Furthermore, the review presents future directions in the treatment of ICU-related bone loss. Full article

Intense stress, especially traumatic stress, can trigger disabling responses and in some cases even lead to the development of posttraumatic stress disorder (PTSD). PTSD is heterogeneous, accompanied by a range of distress symptoms and treatment-resistant disorders that may be associated with a number of other psychopathologies. PTSD is a very heterogeneous disorder with different subtypes that depend on, among other factors, the type of stressor that provokes it. However, the neurobiological mechanisms are poorly understood. The study of early stress responses may hint at the way PTSD develops and improve the understanding of the neurobiological mechanisms involved in its onset, opening the opportunity for possible preventive treatments. Proteomics is a promising strategy for characterizing these early mechanisms underlying the development of PTSD. The aim of the work was to understand how exposure to acute and intense stress using water immersion restraint stress (WIRS), which could be reminiscent of natural disaster, may induce several PTSD-associated symptoms and changes in the hippocampal proteomic profile. The results showed that exposure to WIRS induced behavioural symptoms and corticosterone levels reminiscent of PTSD. Moreover, the expression profiles of hippocampal proteins at 1 h and 24 h after stress were deregulated in favour of increased inflammation and reduced neuroplasticity, which was validated by histological studies and cytokine determination. Taken together, these results suggest that neuroplastic and inflammatory dysregulation may be a therapeutic target for the treatment of post-traumatic stress disorders. Full article

Carbon concrete is a new, promising class of materials in the construction industry. This corrosion-resistant reinforcement material leads to a reduction in the concrete cover required for medial shielding. This enables lean construction and the conservation of concrete and energy-intensive cement manufacturing. Bar-type reinforcement is essential for heavily loaded structures. The newly developed helix pultrusion is the first process capable of producing carbon fiber-reinforced polymer (CFRP) reinforcement bars with a topological surface in a single pultrusion process step, with fiber orientation tailored to the specific loads. The manufacturing feasibility and load-bearing capacity were thoroughly tested and compared with other design and process variants. Approaches to increase stiffness and strength while maintaining good concrete anchorage have been presented and fabricated. Tensile testing of the helical rebar variants with a 7.2 mm lead-bearing cross-section was conducted using adapted wedge grips with a 300 mm restraint length. The new helix geometry variants achieved, on average, 40% higher strengths and almost reached the values of the base material. Concrete pull-out tests were carried out to evaluate the bond properties. The helix contour design caused the bar to twist out of the concrete test specimen. Utilizing the Rilem beam test setup, the helical contour bars could also be tested. Compared with the original helix variant, the pull-out forces could be increased from 8.5 kN to up to 22.4 kN, i.e., by a factor of 2.5. It was thus possible to derive a preferred solution that is optimally suited for use in carbon concrete. Full article