Search Results (392)

Background: Breastfeeding enhances infant and maternal health, but global breastfeeding rates remain suboptimal. Virtual reality (VR) emerges as a promising tool for breastfeeding education. The objective of this review was to assess the effectiveness of VR-based interventions on breastfeeding outcomes in pregnant and postpartum women. Methods: PubMed, Embase, Web of Science, Scopus, and CENTRAL were searched until 10 January 2026, for randomized controlled trials (RCTs) and quasi-experimental studies comparing VR-based interventions (immersive simulations, 360° videos, or head-mounted displays) with standard care or non-VR comparators in pregnant or postpartum women. Primary outcomes included breastfeeding self-efficacy, motivation, and breastfeeding technique (LATCH score). Secondary outcomes included exclusive breastfeeding rates, milk production, and maternal anxiety. Risk of bias was assessed using the RoB 2.0 and ROBINS-I tools for RCTs and non-RCTs, respectively. A random-effects meta-analysis was conducted, with results reported as mean differences (MD) or risk ratios (RR), along with 95% confidence intervals (CIs). Certainty of the evidence was assessed using the GRADE approach. Results: Five studies (4 RCTs and 1 quasi-experimental; n = 344) were included. VR improved prenatal breastfeeding self-efficacy (2 studies, MD: 13.93; 95% CI: 10.96–16.90), motivation (1 study, MD: 2.88; 95% CI: 1.66–4.10), and LATCH score (1 study, MD: 1.72; 95% CI: 1.37–2.07), and reduced time to breastfeeding initiation (1 study, MD: −22.4 min; 95% CI: −29 to −15.9), the certainty of evidence was low to very low for these outcomes. No significant effects were observed for postnatal self-efficacy, exclusive breastfeeding, or maternal anxiety. Formal assessment of publication bias could not be done. The small sample sizes for most outcomes, heterogeneity, the open-label nature of the trials, and the subjective nature of the outcomes should be considered when interpreting these results. Conclusions: VR-based interventions may improve process outcomes, such as prenatal breastfeeding self-efficacy, motivation, breastfeeding technique, and early breastfeeding initiation; the certainty of evidence is low to very low. Evidence for clinically important outcomes, including exclusive breastfeeding and maternal anxiety, remains inconsistent. Larger, well-designed RCTs are warranted before these interventions can be considered in routine practice. Full article

Background: Radiation dermatitis (ARD), particularly its most severe form, moist desquamation (MD), is a frequent and distressing complication of external beam radiotherapy (RT) in head and neck (H&N) cancer patients. Standard management often provides limited benefit for healing and symptom control. Silicone-based foam dressings, including Mepilex Lite and Mepilex Ag, may offer atraumatic adherence, moisture balance, and pain reduction. This study evaluated their real-world effectiveness for MD after conventional RT. Methods: Ten H&N cancer patients with clinically confirmed MD post-radiotherapy were prospectively followed until healing. Patients received Mepilex Lite or Mepilex Ag based on exudate level and infection risk, with dressings changed every three days. Patient- and healthcare provider-reported measures were collected throughout follow-up. The primary endpoint was time to MD resolution, defined as healing to grade 1 skin status. Secondary endpoints included changes in symptom burden, dressing tolerability and satisfaction, and adverse events. Results: Median age was 69 years (range 44–78). All wounds healed to grade 1, with a mean time of 8.6 days (SD 3.9). No infections or adverse events occurred. Pain, burning, and interference with daily activity decreased, and most patients reported improved comfort. Conclusions: In this small prospective cohort study, use of Mepilex dressings was associated with rapid healing, good tolerability, and improvement in patient-reported symptoms of acute radiation dermatitis. These findings suggest that Mepilex dressings may be a promising management option and warrant evaluation in larger comparative studies. Full article

Background/Objectives: To determine whether ESS provides superior clinical, radiologic, or perioperative outcomes compared with non-ESS surgical strategies in lumbar spondylolisthesis. Methods: We conducted a PRISMA-guided systematic review and meta-analysis comparing ESS with non-ESS strategies specifically for lumbar spondylolisthesis. PubMed, Web of Science, Scopus, and CENTRAL were searched from inception to December 2025, plus reference-list screening. Primary outcomes were mean change in VAS back pain, VAS leg pain, and Oswestry Disability Index (ODI); secondary outcomes included radiologic measures (disc height, lumbar lordosis angle, fusion rate) and perioperative outcomes (blood loss, operative time, length of stay, complications). Results: Eighteen studies (16 retrospective cohorts, 1 RCT, 1 case–control) involving 1200 patients with lumbar spondylolisthesis (2019–2025) were included. ESS showed no significant differences versus non-ESS in mean change in VAS back pain (13 studies; MD −0.07), VAS leg pain (14 studies; MD 0.08), or ODI (12 studies; MD 0.51). No statistically significant differences were detected in radiological outcomes (disc height, lumbar lordosis angle, and fusion rate). ESS was associated with reduced blood loss (MD −132.98) and shorter hospital stay (MD −2.86 days), with no difference in operative time (MD 3.96) or postoperative complications (RR 0.86). Subgroup analyses compared endoscopic fusion with MIS fusion, open fusion, and non-endoscopic decompression. Endoscopic versus MIS fusion showed lower blood loss (MD: −50.9 mL) and shorter hospital stay (MD: −1.4 days) but longer operative time (MD: +17.2 min), with no differences in clinical outcomes. Comparisons involving decompression and open fusion were limited by the small number of studies and should be considered exploratory. Conclusions: For lumbar spondylolisthesis, no statistically significant differences were detected between ESS and non-endoscopic approaches in pain, disability, radiologic outcomes, or complication rates, with potential perioperative advantages in blood loss and length of stay. However, these findings should be interpreted cautiously because the available evidence is predominantly retrospective, procedurally heterogeneous, and affected by substantial variation in follow-up duration. Full article

Background/Objectives: Diabetic retinopathy (DR) is a major microvascular complication of type 2 diabetes (T2D) and a leading cause of visual impairment. The relationships among Mediterranean diet adherence, dietary components, DR, and vision-related quality of life remain incompletely defined. This cross-sectional study evaluated Mediterranean Diet Score (MDS) as the primary dietary endpoint, individual MDS components as secondary endpoints, and micronutrient intakes as exploratory endpoints. Methods: In this single-centre study, 129 subjects with long-standing T2D were classified as no DR (NDR; n = 85), non-proliferative DR (NPDR; n = 36), or proliferative DR (PDR; n = 8). Dietary intake was assessed using a food frequency questionnaire and vision-related quality of life using the NEI-VFQ-25. Results: Subjects with DR had longer diabetes duration than those without DR (18 vs. 16 years, p < 0.01). Overall MDS did not differ by DR status, indicating a null finding for the primary dietary endpoint. In secondary analyses, lower legume consumption was observed among participants with DR and was associated with higher odds of DR in multivariable models. Participants with PDR showed poorer vision-related quality of life, although this finding was limited by the small PDR subgroup and high NEI-VFQ-25 scores in other groups. Exploratory analyses suggested associations between selected micronutrient intakes and NEI-VFQ-25 domains. Conclusions: Overall Mediterranean diet adherence was not associated with DR status. Secondary and exploratory findings should be considered hypothesis-generating and require confirmation in prospective studies. Full article

Background: Parenteral iron is increasingly used to treat iron deficiency anaemia in patients with gastrointestinal cancer, particularly in the perioperative setting. However, concerns persist that intravenous iron could increase the risk of infection. We conducted a systematic review and meta-analysis to evaluate infectious complications and other relevant clinical outcomes after parenteral iron in gastrointestinal cancer. Methods: Embase, MEDLINE, CENTRAL and Scopus were searched from database inception to 20 February 2026, with additional records identified through citation searching. Comparative studies were eligible if they included adults with gastrointestinal cancer and compared parenteral iron with oral iron, placebo, no iron or standard care. Randomised and non-randomised comparative studies were included. The primary outcome was infection or infective complications. Secondary outcomes included length of hospital stay, hospital readmission and short-term mortality. Risk ratios (RRs) and mean differences (MDs) were pooled using random-effects models. Results: The search identified 2771 records. After removing 458 duplicates, 2313 records were screened, and 210 full texts were assessed. Fourteen comparative studies were included: four randomised controlled trials and ten non-randomised studies. Nine studies contributed to the primary infection analysis, including 899 patients receiving parenteral iron and 768 controls. Infection occurred in 126 patients in the parenteral iron group and 104 controls. Parenteral iron was not associated with an increased risk of infection (RR 1.07, 95% CI 0.71–1.62; p = 0.754; I² = 57%). Restriction to randomised trials also showed no significant increase in infection risk (RR 1.17, 95% CI 0.56–2.43). Thirteen studies reported length of stay, with no meaningful difference between groups (MD: −0.05 days, 95% CI: −0.66 to 0.57). Four studies reported hospital readmission, with no significant difference between parenteral iron and control (RR 0.76, 95% CI 0.35–1.64; p = 0.480; I² = 0%). Mortality analyses were event-limited, with no significant difference in 30-day mortality (RR 0.49, 95% CI 0.09–2.61) or 90-day mortality (RR 0.69, 95% CI 0.35–1.36). Conclusions: In patients with gastrointestinal cancer, parenteral iron was not associated with increased infection risk, prolonged hospital stay, higher readmission or increased short-term mortality. These findings provide reassuring evidence regarding the perioperative safety of parenteral iron, although confidence in the estimate is limited by observational evidence and heterogeneous definitions of infection. Full article

The detection and degradation analysis of subsurface microcracks in mural paintings remain challenging due to their inhomogeneous multilayered structure and complex deterioration mechanisms. In this study, we propose a multimodal stepwise method for three-dimensional characterization and cross-scale degradation analysis by integrating digital holography (DH), infrared thermography (IRT), acoustic excitation (AE), and molecular dynamics (MD) simulations. In the first step, an adjustable field-of-view (FOV) digital holographic system is developed to capture subsurface deformation under acoustic excitation, enabling high-resolution planar characterization of subsurface microcracks. Infrared thermography is then employed to estimate crack depth through an inverse thermal model, achieving full three-dimensional reconstruction of crack geometry. Based on the reconstructed structures, MD simulations are conducted to investigate the evolution of stress, bond breaking, and crack propagation under varying temperature and humidity conditions, with particular emphasis on water molecule migration and chemically induced degradation. The results demonstrate that environmental factors promote stress concentration and material embrittlement at crack tips, leading to secondary microcrack formation and progressive deterioration. Experimental aging tests show strong agreement with simulation results, validating the proposed methodology. This work establishes a unified “characterization–simulation–validation” paradigm, providing new insights into the mechanisms of mural degradation and offering a robust framework for non-destructive evaluation and preventive conservation of multilayer cultural heritage materials. Full article

Understanding the atomic-scale mechanisms of coal pyrolysis is essential for efficient coal utilization and carbon-neutral energy strategies, yet conventional computational approaches often struggle to balance between the high accuracy of quantum-chemical calculations and the efficiency of reactive force fields. To overcome this limitation, we proposed a multiscale computational framework integrating high-throughput density functional theory (DFT) calculations, ReaxFF-based configuration sampling, YARP reaction enumeration, and DPA3-based machine learning potentials (MLPs). Two coal-specific MLPs, DPA3-coal and DPA3-coal@dftb, were constructed and systematically benchmarked on both small molecular systems and larger C20–30 coal fragments extracted from MD simulations. DPA3-coal@dftb model demonstrated significantly improved accuracy over ReaxFF in predicting energies and atomic forces while maintaining good transferability. To balance computational efficiency and accuracy in large-scale simulations, the DPA3-coal model was employed to perform accelerated reactive molecular dynamics simulations of a Solomon-type bituminous coal molecule from 1600 to 2600 K. The simulations revealed temperature-dependent evolution of coke, tar, and gas products, including secondary condensation and deep-cracking processes at elevated temperatures. Higher-level DFT calculations further confirmed the thermodynamic consistency of key reaction pathways involving radical formation, H-transfer, recombination, and CO generation, indicating that coal-specific MLPs provide an effective atomistic tool for investigating mechanistic trends in coal pyrolysis. Full article

Background/Objectives: In-hospital cardiac arrest (IHCA) remains a devastating event associated with high morbidity and mortality among general ward patients. While Rapid Response Systems (RRS) can help identify deteriorating patients, maintaining these systems in secondary hospitals is frequently hindered by severe fiscal and personnel constraints. Consequently, evidence regarding the real-world clinical effectiveness of artificial intelligence software as a medical device (AI-SaMD) for predicting deterioration in such resource-constrained settings remains limited. Methods: We conducted a retrospective analysis on a multicenter, staggered-implementation study evaluating 164,761 eligible adult general ward admissions across three secondary hospitals in South Korea. The intervention involved deploying an AI-SaMD (DeepCARS), which utilizes four routine vital signs to predict ward IHCA within 24 h. The primary outcome was ward IHCA. Secondary outcomes included in-hospital mortality and length of stay (LOS). Exploratory analyses investigated the mechanisms of clinical outcomes by evaluating lead-times to interventions, outcomes in sepsis subgroups, changes in care directives, and post-arrest neurological outcomes. Results: AI-SaMD implementation was associated with a 21% reduction in ward IHCA incidence (adjusted rate ratio 0.79; 95% CI, 0.65–0.96; p = 0.016) and a 15% reduction in in-hospital mortality (aRR 0.85; 95% CI, 0.79–0.90; p < 0.001), alongside significantly shorter hospital and intensive care unit LOS. These associations were also observed in patients with sepsis (IHCA aRR 0.71; 95% CI, 0.54–0.93; p = 0.013). Lead-times to critical care intervention and to antibiotic escalation were numerically shorter in the AI-SaMD group by 16.3 h (p = 0.066) and 2.6 h (p = 0.523); poor neurological outcome at discharge among ward IHCA cases was 85/108 (78.7%) in the AI-SaMD group versus 63/102 (61.8%) in the standard-care group (aRR 1.13; 95% CI, 0.99–1.33; p = 0.058); and the full-code death rate did not differ between groups (aRR 0.94; 95% CI, 0.76–1.15)—none of these additional analyses reached statistical significance. Conclusions: In secondary hospitals unable to operate an RRS due to fiscal limitations, implementation of an AI-SaMD as an additional informational layer was associated with lower ward IHCA and in-hospital mortality. The AI-SaMD may serve as an actionable and scalable additional safety layer for general-ward patients in resource-constrained environments where RRS infrastructure is not feasible. Although this was a multicenter, large-scale study, the present analysis was retrospective and quasi-experimental in design; rigorous randomized studies are needed to confirm these associations. Full article

Diabetes mellitus, particularly type 2 diabetes mellitus, is a growing global health burden characterized by chronic hyperglycemia and insulin resistance. Alpha-mangostin (AM), a xanthone from Garcinia mangostana pericarp, exhibits antioxidant, anti-inflammatory, and metabolic regulatory properties in preclinical models. We performed a systematic review and meta-analysis of controlled in vivo studies to assess AM’s anti-hyperglycemic effects. Fourteen studies (25 comparisons) in rodent models of diabetes or hyperglycemia were included. Primary outcome was blood glucose; secondary outcomes were glycated hemoglobin (HbA1c), insulin, and homeostatic model assessment of insulin resistance (HOMA-IR). Random-effects meta-analysis demonstrated that AM significantly reduced fasting blood glucose (mean difference (MD) = −8.75 mmol/L; 95% CI: −10.73 to −6.78; p < 0.001) and HbA1c (MD = −2.20%; 95% CI: −3.07 to −1.32; p < 0.001). AM did not significantly alter circulating insulin (Hedges’ g = 0.43; 95% CI: −0.62 to 1.49; p = 0.42) but improved insulin resistance as measured by HOMA-IR (MD = −0.90; 95% CI: −1.68 to −0.12; p = 0.02). Subgroup, sensitivity, and risk-of-bias analyses supported the robustness of the glucose-lowering association, although substantial between-study heterogeneity was present. Overall, this study provides preclinical evidence that AM exerts significant antihyperglycemic and insulin-sensitizing effects, supporting its potential as a multitarget metabolic modulator. Further standardized and mechanistically informed studies are warranted to facilitate translational progression. Full article

Importance: Lifestyle and supportive care interventions may improve treatment tolerance, long-term health behaviors, and survivorship outcomes among breast cancer patients receiving radiotherapy. Few randomized trials have integrated nutrition, exercise, stress management, and psychosocial counseling concurrently with radiotherapy and extended across survivorship. Objective: To evaluate the effects of a comprehensive lifestyle intervention (CompLife) initiated during radiotherapy and maintained for 12 months on body composition, fitness, quality of life, symptoms, and nutrition. Design, Setting, and Participants: Randomized clinical trial at a single cancer center. Eligible women were aged ≥18 years with stage II/III breast cancer scheduled for radiotherapy, BMI ≥ 24.5, and ≥2 lifestyle risk factors. Participants were randomized to CompLife or standard of care (SOC). Assessments occurred at baseline, end of radiotherapy, and 3, 6, and 12 months. The primary outcome of recurrence is ongoing; this report examines prespecified secondary outcomes. Interventions: CompLife included 6 weeks of in-person counseling integrating nutrition, physical activity, mindfulness, stress management, and psychosocial support; twice-weekly exercise, diet, and mind–body sessions during radiotherapy; and telehealth counseling for 12 months. SOC participants received standard educational materials. Main Outcomes and Measures: Secondary outcomes included visceral adipose tissue (VAT), weight, waist circumference, fitness (VO₂ max, strength), SF-36 Physical and Mental Component Summary scores, MD Anderson Symptom Inventory scores, mindfulness (FFMQ), and dietary fiber intake. Results: Ninety-five women were randomized (CompLife, n = 50; SOC, n = 45). CompLife participants had lower VAT at 3 and 6 months (e.g., 3 months: 118 vs. 141 cm²; p = 0.044) and greater improvements in VO₂ max at 3 (23.4 vs. 18.8 mL/kg/min; p = 0.025) and 6 months. SF-36 Physical scores improved to within population norms for CompLife at all follow-ups but remained below norms in SOC. CompLife participants reported fewer symptoms at 12 months (MDASI: 1.3 vs. 2.5; p = 0.014). Fiber intake was consistently higher in CompLife participants (20.5 g vs. 14.0 g; p < 0.001). The results should be interpreted with caution due to the large number of comparisons among the secondary outcomes. Conclusions and Relevance: A multidisciplinary lifestyle intervention delivered during radiotherapy and extended across survivorship produced clinically meaningful improvements in body composition, fitness, diet, and patient-reported outcomes. The findings suggest potential value in integrating structured lifestyle and psychosocial counseling into oncology care and warrant confirmation in larger multicenter trials with mature recurrence endpoints. Full article

In the search for new antischistosomal 3-benzylmenadiones (benzylMDs), the screening of a library developed in our laboratory led to the identification of two regioisomeric analogues, the 2′,5′- and 3′,5′-dimethoxy-benzylMD—designated schistodiones A_2′,5′ and A_3′,5′—which were investigated for their activity against the platyhelminth Schistosoma mansoni and various protozoan parasites, bacteria, and fungi. Reported work has shown that benzylMDs act as prodrugs: their bioactivation undergoes a cascade of redox reactions within the parasite, generating multiple drug metabolites, e.g., the main benzoylmenadione (benzoylMD) intermediates, and reactive oxygen species that interfere with key metabolic pathways. Among the secondary metabolites, benzoxanthones have been identified as potential products generated along this oxidative pathway. The aim of the study was to synthetize methoxylated benzoxanthones, as putative metabolites generated from these antischistosomal benzylMDs. During the synthetic work, several difficulties arose, including the absence of starting reagents, the incompatibility of certain reactions with methoxy groups, the possible formation of several isomers, and the easy re-oxidation of sensitive intermediates. To overcome these obstacles, we developed a new retrosynthetic strategy using modified precursors: replacing methoxy groups with O-methylenemethoxy (OMOM) groups that are more stable in basic media, using aldehydes or aromatic esters as precursors, and replacing certain substituents with groups that are easier and less costly to introduce (chlorine or nitro). Selected metabolites (benzoylMDs, benzoxanthones) were then tested in parasite and cellular assays. Furthermore, benzoylMDs were tested as subversive substrates of S. mansoni thioredoxin-glutathione reductase (SmTGR) and selected drug metabolites were investigated in SmTGR modeling experiments. From a One Health perspective, these benzylMD derivatives pose limited environmental risk because their metabolites lack toxicity when encountered externally, as toxicity requires intracellular metabolic activation and localized formation of reactive intermediates in close proximity to their cellular targets inside parasites. Full article

Background: Clinical controversy persists regarding the optimal weight-bearing strategy for elderly patients following hip fractures. Whilst early unrestricted weight-bearing may improve functional outcome and reduce the risk of bed-related complications, concerns about implant stability and failure often lead clinicians to adopt restricted weight-bearing protocols. To address this, we conducted a systematic review and meta-analysis to identify the effects of unrestricted weight-bearing compared with restricted weight-bearing on clinical outcomes in this patient population. We hypothesized that unrestricted weight-bearing may be associated with lower all-cause mortality without increasing postoperative complications, reoperation rates or length of hospital stay (LOS). Methods: This systematic review was conducted based on a study protocol registered on the PROSPERO platform and reported strictly in accordance with the PRISMA guidelines. We included clinical studies involving patients aged ≥65 years with hip fractures undergoing surgical treatment that directly compared the effects of different postoperative weight-bearing strategies on outcomes. Patients were further classified into unrestricted and restricted weight-bearing groups according to the postoperative weight-bearing protocols reported in each study. The primary outcome was all-cause mortality. Secondary outcomes included postoperative complications, reoperation rates, and LOS. A random-effects model was used for meta-analysis. Dichotomous variables were expressed as risk ratios (RRs), continuous variables as mean differences (MDs), and study heterogeneity was assessed using the I² statistic. The certainty of evidence of each outcome was assessed by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Ten studies (one randomized controlled trial and nine cohort studies) were included with 5806 patients in total. Extra-capsular fractures (intertrochanteric/subtrochanteric fractures) were the most common, with 3694 patients, followed by femoral neck fractures, with 1929 patients. Unrestricted weight-bearing was significantly associated with lower long-term mortality compared with restricted weight-bearing (RR = 0.67, 95% CI 0.51–0.88, p = 0.004, I² = 34%; 95% PI 0.52–0.83), with an absolute risk difference of −0.10%. Short-term mortality did not differ significantly in the primary analysis (RR = 0.58, 95% CI 0.14–2.34, p = 0.44, I² = 70%; 95% PI 0.00–126.98). Furthermore, the corresponding absolute risk difference was only −0.03%. No significant differences were observed for short-term complications, long-term complications, reoperation risk, or LOS between the two groups (all p > 0.05). GRADE assessment showed low certainty of evidence for long-term mortality and short-term complications, and very low certainty of evidence for the remaining outcomes. Conclusions: This meta-analysis suggests that unrestricted weight-bearing may be a feasible postoperative rehabilitation approach in selected patients. However, the results should be interpreted with caution. Further well-designed prospective studies are required to confirm these findings. Full article

Background: The role of primary anastomosis in rectal cancer surgery remains debated, particularly due to concerns regarding postoperative morbidity. Evidence from randomized trials is limited, and observational studies are frequently affected by selection bias. Methods: We conducted a retrospective observational study including patients undergoing rectal cancer surgery with or without primary anastomosis. To reduce confounding, propensity scores were estimated using relevant clinical and oncologic covariates, and overlap weighting was applied to estimate treatment effects in a population with clinical equipoise. The primary outcome was any postoperative complication. Secondary outcomes included severe postoperative complications, reintervention, in-hospital mortality, and measures of healthcare resource utilization. Absolute risk differences (RDs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Stabilized inverse probability of treatment weighting was used as a sensitivity analysis. Results: A total of 173 patients were included. After overlap weighting, primary anastomosis was not associated with a statistically significant difference in overall postoperative complications compared with no anastomosis (RD +0.01, 95% CI −0.14 to +0.17). Severe postoperative complications were numerically more frequent in the primary anastomosis group, while reintervention rates were numerically lower; however, these differences did not reach statistical significance. In-hospital mortality was significantly lower among patients undergoing primary anastomosis (RD −0.08, 95% CI −0.16 to −0.02). No significant differences were observed in length of hospital stay or intensive care unit utilization. Conclusions: Postoperative outcomes after rectal cancer surgery appeared broadly comparable between patients managed with or without primary anastomosis after adjustment for measured baseline characteristics. These findings should be interpreted in the context of residual confounding and surgical selection, and support individualized decision-making rather than routine use of either restorative or non-restorative strategy. Full article

This study examines the multidimensional nature of poverty and its underlying local determinants within the Suri Sadar Sub-Division of Birbhum District, Eastern India, an area marked by sharp ecological and socio-economic contrasts. Adopting a mixed-method approach, the research integrates primary household survey data (2024-25) with secondary spatial datasets to construct a comprehensive analytical framework. The extent and intensity of multidimensional poverty were measured using the Alkire–Foster (AF) method, while the determinants were identified through a Binary Logistic Regression model. Findings reveal that multidimensional poverty in the region is deeply rooted in the intersection of human, environmental, and spatial factors rather than mere income deprivation. Approximately 26.8 per cent of households were found to be multidimensionally poor, with the western plateau blocks, i.e., Rajnagar, Khoyrasole, and Md. Bazar, showing the highest deprivation levels. Spatial poverty drivers include education, agriculture, and gender equality improvements. Policy implications emphasise the need for geographically tailored, multi-sectoral interventions that focus on human capability, investing in infrastructure, and promoting gender-inclusive development. By elucidating the localized dynamics of poverty, this research contributes to the broader discourse on spatial inequality and sustainable development in rural Eastern India, offering actionable insights for evidence-based regional planning and targeted poverty alleviation. Full article

Diabetes mellitus is a growing health concern that causes numerous complications. Glycation produces advanced glycation end-products (AGEs), which promote diabetic complications. Targeting glycation is a strategy for combating the progression of diabetic complications. Pioglitazone enhances insulin sensitivity in patients with type 2 diabetes mellitus, but its impact on glycation remains unclear. This study aims to evaluate whether pioglitazone can inhibit glucose-induced glycation of human serum albumin (HSA), using in vitro assays and in silico tools. Pioglitazone inhibited >70% of early glycation products and >75% of AGEs. The treatment also reduced free lysine modification and improved biochemical markers, including carbonyl and free thiol levels. Pioglitazone exhibited moderate binding affinity for HSA, with a binding constant of 10⁴ M⁻¹. The interaction between pioglitazone and HSA was both spontaneous and entropically favourable. Molecular dynamics simulations revealed that the HSA–pioglitazone complex remained quite stable, with RMSF, RMSD, SASA, R_g, and HSA’s secondary structure showing minimal changes throughout the simulation. The overall binding energy for HSA–pioglitazone complex formation was −30.06 ± 0.31 kcal mol⁻¹, as obtained from MD simulations. The findings suggest that pioglitazone likely interacts with glycation-prone regions of HSA, as indicated by spectroscopic and docking analyses, and contributes to the reduction of glycation. Full article