Search Results (2,011)

The demand for functional beverages is increasing as consumers seek options that offer health benefits, and plant-based beverages are gaining popularity for their associated advantages. The objective of this study was to optimize the formulation of a chickpea and hibiscus beverage to maximize flavor sensory acceptance, antioxidant capacity, and anthocyanin content using a mixture design and characterize the optimal formulation. An extreme vertices mixture design was employed, with fixed proportions of chickpea beverage (66.5%) and inulin (2%), while varying the proportions of hibiscus decoction, monk fruit, and cinnamon powder. Additionally, the Kano model was used to classify the beverage’s attributes. The optimized formulation consisted of 31.41% hibiscus decoction, 0.48% monk fruit, and 0.61% cinnamon powder, achieving 329.2 µmol ET/100 mL (antioxidant capacity), 3.567 mg C3GE/100 mL (anthocyanin content), and a flavor rating of 6.2. The Kano model classified good taste, functional properties, monk fruit sweetening, and chickpeas as attractive attributes, with functional properties obtaining the highest satisfaction index (0.88). These results demonstrate that employing a mixture design is an effective tool to enhance health-related aspects and consumer acceptance. Additionally, the incorporation of the Kano model provides a broader perspective on the development of functional beverages by identifying key attributes that influence product acceptance and market success. Full article

The increasing reliance on cloud services demands advanced security mechanisms to protect sensitive data and ensure robust access control. This study addresses critical challenges in cloud security by proposing a novel framework that integrates blockchain-based smart contracts to enhance authorization and authentication processes. Smart contracts, as self-executing agreements embedded with predefined rules, enable decentralized, transparent, and tamper-proof mechanisms for managing access control in cloud environments. The proposed system mitigates prevalent threats such as unauthorized access, data breaches, and identity theft through an immutable and auditable security framework. A prototype system, developed using Ethereum blockchain and Solidity programming, demonstrates the feasibility and effectiveness of the approach. Rigorous evaluations reveal significant improvements in key metrics: security, with a 0% success rate for unauthorized access attempts; scalability, maintaining low response times for up to 100 concurrent users; and usability, with an average user satisfaction rating of 4.4 out of 5. These findings establish the efficacy of smart contract-based solutions in addressing critical vulnerabilities in cloud services while maintaining operational efficiency. The study underscores the transformative potential of blockchain and smart contracts in revolutionizing cloud security practices. Future research will focus on optimizing the system’s scalability for higher user loads and integrating advanced features such as adaptive authentication and anomaly detection for enhanced resilience across diverse cloud platforms. Full article

Background/Objectives: The present study aimed to evaluate the oral health and patient satisfaction of flexible and non-metal clasp dentures (NMCD) compared to removable partial dentures (RPD) using a systematic review. Methods: The PICOS framework of this review was as follows: Do rehabilitations involving flexible dentures or NMCD have a similar success rate to those using RPD? Thus, the PICOS approach involves the following topics: (P) Population/Problem: partial edentulous adult patients; (I) Intervention: patients rehabilitated with flexible dentures or NMCD; (C) Comparison: patients rehabilitated with standard RPD; (O) Outcome: clinical parameters such as oral health, masticatory function, and patient satisfaction; and (S) Study Type: clinical trials and observational studies (cohort, case–control, and cross-sectional). No language restrictions were applied to the studies. The search strategy consisted of the following keywords in different databases: ((flexible) OR (nonmetal) OR (non-metal) OR (thermoplastic)) AND (denture). Only clinical trials and observational studies (cohort, case–control, and cross-sectional studies) from the last 15 years were included, and no language restrictions were applied. Studies that did not describe the denture material were excluded. Results: Of the 2197 potentially relevant records, 14 studies were included in the present review. Two studies reported retrospective results, while twelve reported a prospective evaluation. Considering the thermoplastic materials, five studies evaluated polyester, five polyamides, three polyacetals, and only one study evaluated polyetheretherketone (PEEK). Flexible dentures and NMCD demonstrated similar periodontal status and bone levels on abutment teeth to RPD after up to 12 months. Flexible dentures exhibited a higher degree of redness of the mucosa after 12 months. One study showed a lower maximum bite force for flexible dentures compared to RPD. No study has performed a clinical evaluation of mastication and chewing ability. Conclusions: Despite increased short-term patient satisfaction for flexible dentures and NMCD, there is weak evidence to support a similar clinical performance of flexible dentures and NMCD to RPD. Full article

Background: Breast cancer remains a major public health challenge in Latin America, where access to personalized risk assessment tools is still limited. This study aimed to evaluate the implementation of a polygenic risk score (PRS)-based stratification model combined with remote genomic counseling in Colombian women with sporadic breast cancer and healthy women. Methods: In 2023, an embedded mixed-methods observational study was conducted in Medellín involving 1997 women aged 40–75 years who underwent clinical PRS testing. The intervention integrated PRS-based risk categorization with individualized risk factor assessment and lifestyle recommendations delivered through a remote counseling platform. Results: PRS analysis classified 9.7% of women as high risk and 46% as low risk. Healthier lifestyle patterns were significantly associated with lower PRS categories (p = 0.034). Physical activity showed a protective effect (OR = 0.60, 95% CI: 0.5–0.8), while prior smoking, elevated BMI, and sedentary behavior were associated with higher risk. The counseling model achieved high delivery (93%) and satisfaction (85%) rates. Qualitative insights revealed improved understanding of genomic risk and greater engagement in preventive behaviors. Only one new case of breast cancer was detected among intermediate-risk participants, with a diagnostic lead time of 12 months. Conclusions: These findings support the feasibility, acceptability, and potential impact of integrating PRS and genomic counseling in cancer prevention strategies in middle-income settings. Full article

Background and Objectives: Implantation of cardiac implantable electronic devices (CIEDs) is increasingly performed in elderly and comorbid patients, for whom minimizing perioperative complications—including pain and systemic drug use—is critical. Traditional local infiltration often provides insufficient analgesia. The ultrasound-guided PECS II block, an interfascial regional technique, offers promising analgesic benefits in thoracic wall procedures but remains underutilized in cardiac electrophysiology. Materials and Methods: We conducted a prospective, controlled, non-randomized clinical study including 106 patients undergoing de novo CIED implantation. Patients were assigned to receive either a PECS II block (n = 53) or standard lidocaine-based local anesthesia (n = 53). Pain intensity was assessed using the numeric rating scale (NRS) intraoperatively and at 1, 6, and 12 h postoperatively. Secondary outcomes included the need for rescue analgesia, procedural duration, length of hospitalization, and patient satisfaction. Results: Patients in the PECS II group reported significantly lower NRS scores at all time points (mean intraoperative score: 2.1 ± 1.2 vs. 5.7 ± 1.6, p < 0.001; at 1 h: 2.5 ± 1.5 vs. 6.1 ± 1.7, p < 0.001). Rescue analgesia (metamizole sodium) was required in only four PECS II patients (7.5%) vs. 100% in the control group within 1 h. Hospital stay and procedural time were also modestly reduced in the PECS II group. Patient satisfaction scores were significantly higher in the intervention group. Conclusions: The ultrasound-guided PECS II block significantly reduces perioperative pain and the need for additional analgesia during CIED implantation, offering an effective, safe, and opioid-sparing alternative to conventional local infiltration. Its integration into clinical protocols for device implantation may enhance procedural comfort and recovery. Full article

The study aimed to evaluate the role of government policies in reducing poverty in Palestine, testing their effectiveness and adequacy, and assessing the challenges associated with their implementation. The study also evaluated the satisfaction of poor families with government programs directed at them. To achieve the objectives of the study, the study followed the descriptive analytical approach, through the use of the quantitative approach, where a questionnaire was distributed to 447 poor families in the West Bank. The qualitative method was developed to study the content of all Palestinian government policies followed to reduce poverty. The results showed a decrease in the confidence of poor families in the adequacy and effectiveness of government policies used to combat poverty, in light of the rise in poverty rates (74.3% in 2024). Accordingly, the study recommends the need to enhance integration between social protection policies and economic development by adopting a comprehensive, innovative, and visionary approach that integrates the provision of resources and sustainable economic empowerment programs to achieve sustainable development goals better. Full article

Background: Emerging evidence indicates that some individuals recovering from COVID-19 develop persistent symptoms, including fatigue, pain, cognitive difficulties, and psychological distress, commonly known as Long COVID. These symptoms often overlap with those seen in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME), underscoring the need for integrative, non-pharmacological interventions. This Phase II controlled trial aimed to evaluate the feasibility and preliminary efficacy of Heart Rate Variability Biofeedback (HRV-BF) in individuals with Long COVID who meet the diagnostic criteria for CFS/ME. Specific objectives included assessing feasibility indicators (drop-out rates, side effects, participant satisfaction) and changes in fatigue, depression, anxiety, pain, and health-related quality of life. Methods: Participants were assigned alternately and consecutively to the HRV-BF intervention or Treatment-as-usual (TAU), in a predefined 1:1 sequence (quasirandom assignment). The intervention consisted of 10 HRV-BF sessions, held twice weekly over 5 weeks, with each session including a 10 min respiratory preparation and 40 min of active training. Results: The overall drop-out rate was low (5.56%), and participants reported a generally high level of satisfaction. Regarding side effects, the mean total Simulator Sickness Questionnaire score was 24.31 (SD = 35.42), decreasing to 12.82 (SD = 15.24) after excluding an outlier. A significantly greater improvement in severe fatigue was observed in the experimental group (H = 4.083, p = 0.043). When considering all outcomes collectively, a tendency toward improvement was detected in the experimental group (binomial test, p < 0.0001). Conclusions: HRV-BF appears feasible and well tolerated. Findings support the need for Phase III trials to confirm its potential in mitigating fatigue in Long COVID. Full article

The global rise in urban-related health issues poses significant challenges to public health, particularly in cities facing socio-economic crises. In Lebanon, 70% of the population is experiencing financial hardship, and healthcare costs have surged by 172%, exacerbating the strain on medical services. Given these conditions, improving the quality and accessibility of green spaces offers a promising avenue for alleviating mental health issues in urban areas. This study investigates the psychological impact of nine urban public spaces in Beirut through a comprehensive survey methodology, involving 297 participants (locals and tourists) who rated these spaces using Likert-scale measures. The findings reveal location-specific barriers, with Saanayeh Park rated highest in quality and Martyr’s Square rated lowest. The analysis identifies facility quality as the most significant factor influencing space quality, contributing 73.6% to the overall assessment, while activity factors have a lesser impact. The study further highlights a moderate positive association (Spearman’s rho = 0.30) between public space quality and mental well-being in Beirut. This study employs a hybrid methodology combining Research for Design (RfD) and Research Through Designing (RTD). Empirical data informed spatial strategies, while iterative design served as a tool for generating context-specific knowledge. Design enhancements—such as sensory plantings, shading systems, and social nodes—aim to improve well-being through better public space quality. The proposed interventions support mental health, life satisfaction, climate resilience, and urban inclusivity. The findings offer actionable insights for cities facing public health and spatial equity challenges in crisis contexts. Full article

As autonomous driving technologies advance, the need for human-in-the-loop systems becomes increasingly critical to ensure safety, adaptability, and public confidence. This paper presents the design and evaluation of a context-aware immersive teleoperation interface that integrates real-time simulation, virtual reality, and multimodal feedback to support remote interventions in emergency scenarios. Built on a modular ROS2 architecture, the system allows seamless transition between simulated and physical platforms, enabling safe and reproducible testing. The experimental results show a high task success rate and user satisfaction, highlighting the importance of intuitive controls, gesture recognition accuracy, and low-latency feedback. Our findings contribute to the understanding of human-robot interaction (HRI) in immersive teleoperation contexts and provide insights into the role of multisensory feedback and control modalities in building trust and situational awareness for remote operators. Ultimately, this approach is intended to support the broader acceptability of autonomous driving technologies by enhancing human supervision, control, and confidence. Full article

Objectives: Pelvic tumor resections demand high surgical precision to ensure clear margins while preserving function. Although patient-specific instruments (PSIs) improve osteotomy accuracy, positioning errors remain a limitation. This study evaluates the feasibility, accuracy, and usability of a novel dual-function augmented reality (AR) system for intraoperative guidance in PSI positioning and osteotomy execution using a head-mounted display (HMD). The system provides dual-function support by assisting both PSI placement and osteotomy execution. Methods: Ten fresh-frozen cadaveric hemipelves underwent AR-assisted internal hemipelvectomy, using customized 3D-printed PSIs and a new in-house AR software integrated into an HMD. Angular and translational deviations between planned and executed osteotomies were measured using postoperative CT analysis. Absolute angular errors were computed from plane normals; translational deviation was assessed as maximum error at the osteotomy corner point in both sagittal (pitch) and coronal (roll) planes. A Wilcoxon signed-rank test and Bland–Altman plots were used to assess intra-workflow cumulative error. Results: The mean absolute angular deviation was 5.11 ± 1.43°, with 86.66% of osteotomies within acceptable thresholds. Maximum pitch and roll deviations were 4.53 ± 1.32 mm and 2.79 ± 0.72 mm, respectively, with 93.33% and 100% of osteotomies meeting translational accuracy criteria. Wilcoxon analysis showed significantly lower angular error when comparing final executed planes to intermediate AR-displayed planes (p < 0.05), supporting improved PSI positioning accuracy with AR guidance. Surgeons rated the system highly (mean satisfaction ≥ 4.0) for usability and clinical utility. Conclusions: This cadaveric study confirms the feasibility and precision of an HMD-based AR system for PSI-guided pelvic osteotomies. The system demonstrated strong accuracy and high surgeon acceptance, highlighting its potential for clinical adoption in complex oncologic procedures. Full article

Background/Objectives: Providing appropriate treatment for pediatric patients after traffic accidents remains a significant challenge. Furthermore, limited studies have validated the long-term effectiveness and safety of integrative Korean medicine treatment (IKMT) based on follow-up periods of 6 months or longer for pediatric patients. Methods: A retrospective chart review was conducted, focused on children aged 0–6 years who visited one of seven Korean medicine hospitals after traffic accident injuries and received IKMT between 1 January 2019 and 30 June 2023. The primary outcome was the Numeric Rating Scale (NRS) scores of chief complaints, and the secondary outcomes were quality of life, adverse events, and satisfaction with IKMT. Statistical analyses were conducted using paired t-tests and descriptive statistics, with a significance level of 5%. Results: Sixty-four participants were included in the retrospective chart review, and fifty-seven guardians responded to the surveys (mean age: 4.84 ± 1.26 years; mean duration of treatment: 19.20 ± 25.38 days). Among the immediate symptoms after the accidents, flashbacks and intrusive symptoms as well as nightmares and crying were the most common (50.9%). Following treatment, the NRS scores for flashbacks and intrusive symptoms and for nightmares and crying showed meaningful improvements from the time right after the accidents to the survey period. Follow-up confirmed that quality of life scores on all dimensions corresponded with those of healthy children. Nine adverse events were reported, and the participants fully recovered without the need for additional treatment. Furthermore, 91.2% of the survey respondents were satisfied with IKMT. Conclusions: IKMT was effective and safe for alleviating the post-accident symptoms in infants and young children aged 0–6 years involved in traffic accidents. Full article

Background: Patient care following botulinum toxin injections has long been guided by anecdotal instructions, often based on theoretical considerations. This study evaluates the necessity of extended post-treatment instructions by analyzing outcomes and satisfaction in patients who followed only a 10 min precaution protocol. Materials and Methods: A retrospective, multicentric study was conducted across six Italian centers, analyzing 5014 patients treated with botulinum toxin for upper facial wrinkles between 2015 and 2020. Outcomes included adverse effects—particularly upper eyelid ptosis—and patient satisfaction. Follow-up was performed at two weeks. Results: No cases of upper eyelid ptosis were observed. Among 4000 patients who attended follow-up, adverse effects occurred in only 5.99%, notably lower than rates reported in the literature. Of the 2010 patients who completed the satisfaction questionnaire, 90% reported being very satisfied. These findings support the safety of limiting post-treatment instructions to 10 min. Conclusions: Our findings indicate that omitting extended post-injection instructions does not negatively impact patient satisfaction or complication rates. Given the toxin’s rapid internalization and localized effect, extended behavioral restrictions may be redundant. However, the absence of a control group and lack of statistical analyses limit the strength of these conclusions. In addition, this is a short-term study. Future prospective, randomized trials are needed to develop evidence-based post-care protocols to optimize esthetic outcomes, patient safety, and long-term efficacy. Full article

Background/Objectives: “Ozempic face” is an aesthetic side effect associated with the use of the antidiabetic agent Ozempic (semaglutide), characterized by a prematurely aged and fatigued facial appearance due to rapid weight loss. Currently, treatment options for this condition are limited. In this study, we present our clinical experience with the BodyTite device, provided by InMode Italy S.r.l. (Rome, Italy). Materials and Methods: We report a case series involving 24 patients (19 women and 5 men, aged 27–65 years), treated with subdermal bipolar radiofrequency (Endotissutal Bipolar Radiofrequency) between 2023 and 2024. All patients underwent a minimum follow-up of 12 months. At the end of the follow-up period, patients rated their satisfaction on a from 0 to 10 scale, and an independent expert assessed the stability of clinical outcomes. Results: The majority of patients reported high satisfaction levels (≥8), which correlated with the independent expert’s evaluation of treatment efficacy and result stability. The only observed adverse event was transient cutaneous erythema. Conclusions: “Ozempic face” is an increasingly common side effect associated with newer classes of antidiabetic medications. Although these drugs offer significant metabolic benefits, the accompanying facial volume loss and aging are often poorly tolerated by patients. Our findings suggest that subdermal bipolar radiofrequency represents a safe, low-risk, and cost-effective therapeutic option for the aesthetic management of Ozempic face. Full article

Objectives: The objectives are to evaluate the influence of different maternal characteristics on ultrasound image quality and operator satisfaction, and to assess, preliminarily, a rating scale to stratify the difficulty level of ultrasound examination in early gestation. Methods: A multicentric observational study of ultrasound scans was carried out on singleton pregnant women undergoing routine gestational ultrasound at 11–14 weeks and 19–21 weeks of gestation at two Prenatal Care Centers in the Apulia region (Southern Italy). Inclusion criteria included the presence of one or more limiting features, i.e., obesity, retroverted uterus, myomas, previous abdominal surgery, and limited echo-absorption. Each woman was given an overall pre-echographic limiting score from 0 to 9. The outcome measure was the operator’s satisfaction with the examination, scored on a Likert scale. Nested linear regression models (raw, semi- and fully adjusted) were built for each of the two trimesters on the pre-ecographic limiting score (0–9 points) as dependent variables, with the operator’s satisfaction as the regressor. Results: The whole sample included 445 pregnant women. The two-center samples did not show statistically different baseline features. The operator’s satisfaction with the sonographic examination was significantly (and inversely) related to the pre-echographic limiting score, regardless of the mother’s age, the operator performing the ultrasound, the Hospital Center where the ultrasound examination was performed, and the duration of the sonographic examination. Conclusions: A number of maternal conditions need to be monitored for good ultrasound performance; using a specific rating scale to stratify the level of difficulty of the ultrasound examination at early gestation could represent a potentially useful tool, although it requires further validation. Full article

Respiratory diseases represent a persistent global health challenge, underscoring the need for intelligent, accurate, and personalized diagnostic and therapeutic systems. Existing methods frequently suffer from limitations in diagnostic precision, lack of individualized treatment, and constrained adaptability to complex clinical scenarios. To address these challenges, our study introduces a modular AI-powered framework that integrates an audio-based disease classification model with simulated molecular biomarker profiles to evaluate the feasibility of future multimodal diagnostic extensions, alongside a synthetic-data-driven prescription recommendation engine. The disease classification model analyzes respiratory sound recordings and accurately distinguishes among eight clinical classes: bronchiectasis, pneumonia, upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), asthma, chronic obstructive pulmonary disease (COPD), bronchiolitis, and healthy respiratory state. The proposed model achieved a classification accuracy of 99.99% on a holdout test set, including 94.2% accuracy on pediatric samples. In parallel, the prescription module provides individualized treatment recommendations comprising drug, dosage, and frequency trained on a carefully constructed synthetic dataset designed to emulate real-world prescribing logic.The model achieved over 99% accuracy in medication prediction tasks, outperforming baseline models such as those discussed in research. Minimal misclassification in the confusion matrix and strong clinician agreement on 200 prescriptions (Cohen’s $\kappa$ = 0.91 [0.87–0.94] for drug selection, 0.78 [0.74–0.81] for dosage, 0.96 [0.93–0.98] for frequency) further affirm the system’s reliability. Adjusted clinician disagreement rates were 2.7% (drug), 6.4% (dosage), and 1.5% (frequency). SHAP analysis identified age and smoking as key predictors, enhancing model explainability. Dosage accuracy was 91.3%, and most disagreements occurred in renal-impaired and pediatric cases. However, our study is presented strictly as a proof-of-concept. The use of synthetic data and the absence of access to real patient records constitute key limitations. A trialed clinical deployment was conducted under a controlled environment with a positive rate of satisfaction from experts and users, but the proposed system must undergo extensive validation with de-identified electronic medical records (EMRs) and regulatory scrutiny before it can be considered for practical application. Nonetheless, the findings offer a promising foundation for the future development of clinically viable AI-assisted respiratory care tools. Full article