Search Results (161)

Objective: Self-assembled nanoparticles (SANs) naturally occurring in Traditional Chinese Medicine (TCM) decoctions are promising drug carriers due to their biocompatibility, but uncontrolled assembly often leads to poor stability, limiting transdermal permeability and industrial application. This study aimed to fabricate stable and uniform SANs from licorice by precisely regulating the controlled nanoprecipitation of its water- and alcohol-extracted components. The transdermal delivery efficiency and therapeutic efficacy of the SANs in the treatment of atopic dermatitis (AD) were evaluated. Methods: Licorice self-assembled nanoparticles (LD-SANs) were prepared by mixing water and ethanol extracts of licorice, followed by ethanol evaporation under reduced pressure to trigger nanoprecipitation. In vitro transdermal tests compared the delivery efficiency of six major bioactive compounds between LD-SANs and traditional licorice decoction (LD). The penetration mechanism was investigated via passive diffusion and cellular uptake studies. In an AD mouse model, the therapeutic effects and expression of tight junction (TJ) proteins (Occludin and Claudin-1) were assessed. Results: The average particle size of LD-SANs is 200 nm, and it is uniform and stable. LD-SANs significantly enhanced the delivery efficiency of all six bioactive compounds compared to LD. Mechanistic studies revealed a unique “dual-channel” penetration mechanism: the nanoscale size enabled passive diffusion through hair follicles, intercorneocyte lipid gaps, and skin appendages, while perifollicular antigen-presenting cells (APCs) actively recognized and internalized the nanoparticles, creating a cell-mediated active targeting route that collectively boosted skin accumulation. In the AD model, LD-SANs promoted the expression of Occludin and Claudin-1 in the epidermal granular layer, reinforcing intercellular barrier integrity. Conclusions: By combining “efficient penetration” and “barrier repair”, LD-SANs demonstrated notable therapeutic efficacy in AD. This work transforms a traditional decoction into a well-characterized, high-performance nanomedicine and offers a novel strategy for developing TCM-based transdermal delivery systems. Full article

Background: New psychoactive substances (NPS) represent an evolving component of global substance use patterns and may contribute to HIV transmission through both injection-related and sexual risk behaviors. In Kazakhstan, where HIV incidence has increasingly shifted toward sexual transmission, evidence on HIV testing among NPS users remains limited. This study examined behavioral, social, and structural factors associated with HIV testing in this population. Methods: A cross-sectional study was conducted among 1500 adults reporting NPS use across six regions of Kazakhstan. Data were collected using structured interviewer-administered questionnaires. The primary outcome was self-reported HIV testing (ever tested: yes/no). Independent variables included sociodemographic characteristics, substance use behaviors, sexual practices, peer communication about HIV, and structural access to prevention services. Univariable logistic regression with Bonferroni correction (p < 0.001) was used for variable screening. Multivariable logistic regression models estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC). Results: Overall, 86.7% of participants reported prior lifetime HIV testing. In the multivariable model (n = 1482), older age was associated with higher odds of testing (AOR 1.06 per year; 95% CI 1.04–1.08; p < 0.001). Compared with participants holding a bachelor’s degree or higher, those without a high school diploma had lower odds of testing (AOR 0.50; 95% CI 0.28–0.89). Injectable psychostimulant use was also associated with testing (AOR 1.40; 95% CI 1.21–2.01). Participants who never discussed HIV within peer networks were less likely to have been tested (AOR 0.69; 95% CI 0.49–0.97). Engagement with HIV prevention services (AOR 0.54; 95% CI 0.39–0.75) and use of prevention centers (AOR 0.63; 95% CI 0.45–0.87) were significantly associated with testing. The model demonstrated acceptable discrimination (AUC = 0.725). Conclusions: Lifetime HIV testing uptake among NPS users in Kazakhstan is high but influenced by educational attainment, peer communication, injection practices, and engagement with prevention services. Strengthening integration of prevention services and expanding peer-based outreach may improve equitable access to HIV testing in this population. Full article

Objective: Influenza and pertussis vaccines are recommended during pregnancy; however, uptake remains insufficient in many European countries, increasing the risk of preventable infections. Recent recommendations for maternal respiratory syncytial virus vaccination have been endorsed by scientific societies. This study evaluated maternal vaccination coverage, knowledge, attitudes, and factors influencing vaccine uptake among Lithuanian women. Methods: A retrospective cross-sectional online survey was conducted between 4 and 14 November 2025 in Lithuania among women aged 18–55 years with at least one previous pregnancy. The questionnaire contained 29 questions on sociodemographic characteristics, obstetric history, vaccination history, attitudes, and informational sources influencing decisions. Internal reliability was confirmed (Cronbach’s α = 0.83). Descriptive statistics were used to summarize the data. Associations between categorical variables were assessed using the Chi-square test or exact tests (Fisher’s exact or Fisher–Freeman–Halton). Binary and multivariable logistic regression analyses were performed to evaluate factors associated with self-reported vaccination uptake and the relationship between influenza and pertussis vaccination. Odds ratios with 95% confidence intervals were calculated. Statistical significance was set at p < 0.05. Results: A total of 241 women participated. Self-reported vaccination coverage during pregnancy was 28.7% for influenza, 43.8% for tetanus–diphtheria–pertussis, and 4.2% for respiratory syncytial virus. Physician’s recommendation was the strongest predictor: women advised to vaccinate were 17.0 times more likely to receive influenza, 16.5 times more likely to receive pertussis, while RSV vaccination occurred almost exclusively among women who reported receiving a physician’s recommendation. Higher uptake was associated with younger maternal age and university education. Reasons for declining vaccination were avoidance of medical interventions and concerns about safety or side effects. Conclusions: Maternal vaccination coverage in Lithuania remains low despite public funding and national recommendations. Strengthening provider communication, improving information strategies, and integrating vaccination counseling into routine antenatal care may increase uptake and enhance maternal and neonatal protection. Full article

Background: H007 is a novel selective AMP-activated protein kinase (AMPK) activator with demonstrated efficacy against hyperlipidemia; however, its oral bioavailability is limited by poor solubility and low intestinal permeability. This study aimed to develop a self-microemulsifying drug delivery system (SMEDDS) incorporating a H007–phospholipid complex (H007-PC) to improve both solubility and intestinal permeability. Methods: H007-PC-SME was prepared by integrating phospholipid complexes into an SMEDDS formulation. The formulation was optimized on the basis of emulsification efficiency, droplet size, and zeta potential, and was then evaluated for stability, in vitro drug release, and cellular uptake. Different H007 formulations were orally administered to golden hamsters to assess bioavailability, and a chylomicron flow blockade hamster model was used to evaluate lymphatic transport. Results: The optimized H007-PC-SME showed good stability, rapid self-emulsification, and improved drug solubility. Relative to ordinary H007 tablets, the relative bioavailability of H007-SME and H007-PC-SME was 376.65% and 464.62%, respectively, when calculated from M1 exposure, and 314.01% and 463.55%, respectively, when calculated from MP exposure. When evaluated in a cycloheximide model, H007-SME and H007-PC-SME increased the lymphatic transport fraction of M1 from approximately 0% to 22% and 54%, and that of MP from approximately 1% to 28% and 52% compared with ordinary H007 tablets. Conclusions: H007-PC-SME combines stable phospholipid complex formation with strong self-emulsification performance and effective drug dissolution. By overcoming the intrinsic limitations of the H007 active pharmaceutical ingredient and ordinary H007 tablets, this formulation improves membrane permeability and lymphatic transport, thereby enhancing oral bioavailability and therapeutic potential. The formulation shows good stability and acceptable in vitro biocompatibility under the tested conditions. The preparation process is straightforward, reproducible, and suitable for further pharmaceutical development. Full article

Anthropogenic phosphorus (P) release from human activities continues to degrade freshwater systems, underscoring the need for effective and sustainable approaches to P removal and management. This study investigates steel slag–chitosan–nanoclay hydrogel composites as a waste-derived alternative to metal-doped biopolymer hydrogels for P removal from wastewater and stormwater. Steel slag aggregates (SSAs), a by-product of steel manufacturing, were incorporated into chitosan-based hydrogel matrices to produce composite sorbents derived from waste materials with potential for cost-effective application. Two formulations (SSA20 and SSA40) were synthesized and compared with a chitosan–nanoclay–iron (CH/NC/Fe) reference hydrogel. Phosphorus adsorption affinity was evaluated using a standardized 24 h batch protocol at environmentally relevant concentrations representative of municipal wastewater (10 mg P L⁻¹) and stormwater or agricultural runoff (1 mg P L⁻¹). The SSA40 composite exhibited the highest P adsorption affinity (Rd = 2.39 ± 0.22 L g⁻¹), outperforming both standalone SSA and the Fe-based hydrogel reference. Scanning Electron Microscopy and Energy-Dispersive X-Ray Spectroscopy (SEM–EDX) analyses revealed strong polymer–slag interactions and metal–phosphate associations, consistent with coupled adsorption and precipitation mechanisms. The SSA-based hydrogels also exhibited self-induced acidification (pH 3.3–4.2), enhancing phosphate uptake while providing intrinsic pH buffering. This study introduces a stable, waste-derived hydrogel composite and demonstrates a reproducible, environmentally relevant batch-testing approach for comparative evaluation of hydrogel phosphorus sorbents, supporting evidence-based strategies for sustainable phosphorus pollution control. Full article

Background/Objectives: Human papillomaviruses (HPVs) are the most common sexually transmitted viruses worldwide and are strongly associated with multiple cancers, including cervical cancer. In France, HPV prevention relies on a combination of organized cervical cancer screening and prophylactic vaccination; however, coverage remains below international targets. Methods: This narrative review summarizes recent advances in HPV prevention in France, with a focus on screening strategies, including the integration of high-risk HPV testing and vaginal self-sampling, as well as vaccination policies that now include both girls and boys, notably through school-based programs. Results: International comparisons, particularly with Australia and several European countries, are used to highlight successful strategies and transferable lessons that could enhance the effectiveness of French prevention efforts. The review also discusses persistent barriers to uptake, including social, organizational, and cultural factors, and considers opportunities to reduce inequalities in access to prevention. Conclusions: Overall, this work provides a comprehensive overview of the current landscape of HPV prevention in France and situates national efforts within a global public health context, offering insights for policy development and future research directions. Full article

This study examined lower secondary students’ self-reported use of generative artificial intelligence (GenAI) for schoolwork across four modalities (text, image, audio, and video), and tested how attitudes grounded in the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) relates to usage. A total of 312 grade 7–9 students from Slovenian primary schools participated in the study. The final analytic sample comprised 229 students (47.2% female; M_age = 13.2 years) who reported at least minimal familiarity with GenAI. Students completed an online questionnaire assessing frequency of tool use and five attitude components (teacher support, perceived usefulness, perceived ease of use, experience, and attitudes toward learning with GenAI). Text generation tools were used more frequently than image, audio, or video generation tools. Text tool use was higher among ninth graders than seventh and eighth graders. Text tool use correlated positively with perceived usefulness, perceived ease of use, and experience, and negatively with attitudes toward learning with GenAI. In multiple regression, only perceived usefulness uniquely predicted text tool use, with attitudes explaining 13.7% of variance. Findings indicate that GenAI uptake is currently text-centric and primarily associated with perceived usefulness/performance expectancy, while perceived teacher support (facilitating conditions) shows weak links to use. Full article

Background: Foam rolling is a popular self-myofascial release (SMR) technique, yet empirical evidence regarding its long-term impact on cycling endurance remains inconclusive. This study investigated the effects of chronic SMR on cardiorespiratory capacity, metabolic kinetics, and mechanical performance in road cyclists. Methods: We conducted a six-month randomized controlled trial (RCT) with 32 male recreational cyclists. Both an intervention group (IG) and a control group (CG) followed a standardized training protocol. The IG additionally applied a Blackroll^® foam roller immediately after cycling training sessions. Outcomes included maximum oxygen uptake (VO₂max), submaximal heart rate, lactate slope, and relative mechanical power (W/kg) at aerobic and anaerobic thresholds. Data were analyzed using linear mixed-effects models (LMM), with age included as a fixed-effect covariate to control for baseline imbalances between groups. Effect sizes were determined via marginal and conditional R². Additionally, model robustness was verified through Shapiro–Wilk tests and Q–Q plots of conditional residuals. Results: No significant effects were observed for VO₂max or submaximal heart rate. In contrast the IG demonstrated significant improvements in metabolic kinetics, evidenced by a reduced lactate slope (p = 0.004). Furthermore, foam rolling yielded a statistically significant positive effect on relative mechanical performance at both the aerobic (p = 0.031) and anaerobic (p = 0.007) lactate thresholds. Sensitivity analyses confirmed that these effects were independent of the age difference between groups. Conclusions: Foam rolling did not enhance all endurance-related variables but showed positive effects on metabolic kinetics and mechanical performance. While it did not shift systemic cardiorespiratory limits, SMR appeared to optimize performance through improved metabolic economy and mechanical efficiency, suggesting it is a valuable supplemental tool for recovery and long-term performance maintenance in cycling. Full article

Introduction: Maintaining adherence and access to antiretroviral treatment is basic for good management of people with HIV (PWH), while enhancing patient satisfaction. With the aim of shifting from drug-centered into patient-centered care and integrating care interventions into community settings, here we share an outpatient hospital pharmaceutical care implementation model for PWH. This model involves the delivery of medication through a community center, BCN-Checkpoint, using a proprietary app and coordinated with automated locker systems. Methods: During the pre-implementation phase the circuit was defined and seven steps were considered critical for successful implementation: (1) assignation of teams and roles; (2) adaptation of the self-developed app; (3) development of a patient journey map; (4) locker installation and system integration with data from the electronic records; (5) staff training; (6) review of data protection regulations; (7) simulation tests. A two-phase simulation—with fictitious users and with real ones—validated the system. The implementation phase included an initial pilot study, in which 46 patients were included in the project. Results: System uptake was high, with strong adherence to the dispensing pathway; only five discontinuations due to personal preferences or availability of alternative dispensing pathways. Several barriers to implementation emerged, primarily categorized into technical issues, process and operational challenges, coordination, and user-related difficulties. However, a communitarian setting, flexible attention times and protocols, and the strong intersectoral collaboration between specialists are believed to increase patient retention and overall satisfaction. Conclusions: The implementation of an outpatient dispensing hospital medication model using an app and automated locker systems is feasible, considering detail to procedures, timely adaptations, and staff training. Full article

Background: Canada’s cervical cancer elimination plan is challenged by suboptimal screening participation and rising incidence of cervical cancer over the past decade. Cytology, the primary cervical screening method in Canada, is being replaced with HPV testing, which offers superior sensitivity for detecting pre-cancerous lesions and supports initiating screening at age 25 or older and extending screening intervals to five years. Research has shown that women’s insufficient knowledge and negative attitudes toward HPV screening represent a significant barrier to screening uptake. Methods: We conducted a web-based national survey using Best–Worst Scaling (trade off utilities) to quantify women’s preferences for screening test modality, age of initiation, and screening intervals. We also assessed preferences for information sources, provider type, and communication methods. Underscreened individuals were oversampled. Results: Among adequately screened (N = 1778) and underscreened (N = 1570) individuals, preferences favoured co-testing (cytology plus HPV testing), initiating screening at age 21, and three-year screening intervals. Underscreened participants showed relatively higher preference for HPV self-sampling, and as opposed to adequately screened participants, preferred screening by a gynecologist rather than a family physician. Across groups, participants preferred receiving screening-related information and communication by email over postal mail. Conclusions: The misalignment between women’s preferences and current HPV test-based screening implementation plans requires immediate education interventions and modernized, user-preferred communication channels for cervical screening-eligible individuals in Canada. Full article

This study investigates viscosity-enhancing and early-strength wet-mix shotcrete (VE-ESWS) incorporating a self-developed viscosity-enhancing and early-strength agent (VE-ES). Indoor tests combined with on-site spraying were performed to quantify the effects of the water/cement ratio (W/C) and VE-ES dosage on workability, strength, and durability. VE-ES had little influence on pumpability but substantially enhanced sprayability, reducing rebound rate to below 8%. Compressive and splitting tensile strengths peaked at W/C = 0.43–0.44 and a sand rate of 55%, whereas sand rates of 50% or 60% caused noticeable reductions. Durability (water permeability, freeze–thaw resistance, wet–dry sulfate attack, and carbonation resistance) of VE-ESWS was superior to that of the reference wet-mix shotcrete. Water penetration height could be controlled to about 5 cm when W/C was 0.42–0.43. During freeze–thaw cycling, mass loss rate increased initially and then decreased; slight apparent mass gains at later cycles were attributed to moisture uptake. VE-ES effectively reduced the compressive strength loss of VE-ESWS after sulfate attack, although the mass loss rate increased rather than decreased after 100 wet–dry sulfate attack cycles. The carbonation rate of VE-ESWS decreased with increasing VE-ES dosage. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) results corroborated accelerated hydration and pore-structure refinement. Based on combined indices, the recommended values are W/C = 0.42–0.44, and the VE-ES dosage = 7.5 kg/m³ within the studied ranges. This study could provide theoretical and technical support for the application of VE-ESWS in engineering practices. Full article

Nowadays, biowaste valorization is a key point in the circular economy. Digestate and compost from organic waste treatment can be used as nutrient-rich fertilizers. In Europe, the use of biowaste-derived fertilizers is promoted by the European Fertilizer Regulation (EU) 2019/1009, which requires verification of their biological stability through regulated indices; however, it is not clear whether the proposed indices and threshold values indicate the same level of stability and what correlations there are between them. This study compared four biological stability indices, namely Oxygen Uptake Rate (OUR), Self-Heating (SH), Residual Biogas Potential (RBP), and Dynamic Respirometric Index (DRI), which were tested on 50 samples of compost and digestate. Overall, the results revealed that most of the compost and digestate samples were quite far from European standards. On the contrary, the RBP test seemed to be less stringent than the other indices, since a much larger number of samples was closer to or in compliance with the established threshold. Data analysis using Pearson’s coefficients showed a strong linear correlation between the indices. Nevertheless, the linear regression predictive model based on experimental data demonstrated that the indices could not represent the same level of stability, providing poor consistency and variability in the predicted values and established threshold. In particular, the DRI test appeared to be more severe than the other aerobic indices. This work could provide valuable support in improving evaluation criteria and promoting a sustainable use of compost and digestate as organic fertilizers from a circular economy perspective. Full article

Dehumidification plays a vital role across industrial, commercial, and residential settings, where controlling moisture is essential for maintaining air quality, protecting materials, and ensuring comfort. Calcium chloride (CaCl₂) is a widely used, low-cost desiccant, but it suffers from a critical drawback: under humid conditions, particles tend to agglomerate, which reduces their ability to absorb water. In addition, when the salt dissolves in hydration water, its contact surface with moist air decreases, and corrosive liquid leakage can occur. Embedding CaCl₂ into hydrophilic porous matrices offers a solution by dispersing particles more effectively, preventing agglomeration, increasing the contact area, and retaining liquid within the pore network to suppress leakage. In this study, we introduce a novel approach for fabricating carbon-based foams impregnated with CaCl₂, produced through the thermal decomposition of glucose under self-induced pressure. These foams exhibit a composite architecture that integrates CaCl₂ and calcium carbonate, enabling controlled porosity through selective dissolution. Importantly, the in situ transformation of CaCl₂ into calcite refines the internal structure, improving both stability and acids absorption performance. FTIR confirmed the strong hydrophilicity of the foam walls, which enhances water vapor uptake while preventing leakage of saturated salt solutions. The carbon matrix further suppresses salt particle agglomeration during moisture absorption, resulting in high efficiency. These multifunctional foams not only capture water vapor and volatile acids but also show potential as phase change materials. Mechanical testing revealed tunable behavior among the fabricated foams, ranging from high-stiffness structures with superior energy absorption (e.g., C2) to more compliant foams with extended strain capacity (e.g., A2), illustrating their versatility for practical applications. Full article

Background: Influenza is a major health threat to the elderly in China. Despite this, influenza vaccination rates still remain low and vary across regions that have different funding policies. In this study, we compare the vaccination status and influencing factors among older adults under the free, partial reimbursement, and self-paid vaccination strategies. Methods: Three cities with free, partial reimbursement, and self-paid influenza vaccination policies were selected. A cross-sectional, anonymous survey was then conducted. A total of 2265 elderly individuals aged 60 years and above were recruited using probability proportionate to size sampling. A standardized questionnaire was used during face-to-face interviews to collect data regarding the influenza vaccination status and influencing factors. The statistical analyses included chi-square tests, a multivariate logistic regression, and random forest models. Results: Among the 2265 participants (free policy region: n = 426; partial reimbursement region: n = 633; self-paid region: n = 1206), vaccination rates during the 2023–2024 season were significantly higher in the free policy region (53.29%) than in the partial reimbursement (20.85%) and self-paid (13.60%) regions (p < 0.001). The intention to vaccinate for the 2024–2025 season was also highest in the free policy region (68.78%), followed by partial reimbursement (47.71%) and self-paid (37.15%) regions (p < 0.001). This result demonstrated the same trend as the vaccination behavior. Cues to action (e.g., healthcare worker or family member recommendations) positively influenced vaccinations across all of the regions. In the self-paid region, perceived barriers, such as vaccine cost and side effect concerns, significantly reduced both behaviors and the next-season intention to vaccinate. Healthcare worker recommendations were key positive factors, while misconceptions and costs were major barriers to vaccination. Conclusions: Vaccination rates varied significantly across regions with different influenza vaccine subsidy policies. The free policy region demonstrated the highest coverage rate, while the self-paid region exhibited the lowest, suggesting that financial policies are a key determinant of vaccination uptake. Furthermore, free vaccination policies were associated with improved influenza vaccine knowledge among the elderly. Analysis of other influencing factors revealed that healthcare workers’ recommendations played a crucial role across all policy regions, though their impact on current-season vaccination behavior and next-season vaccination intention differed by subsidy context. Further studies are needed to explore the best approaches for optimizing region-specific subsidy strategies for promoting influenza vaccination among the elderly in China. Full article

Introduction: Mpox emerged as a multi-country outbreak in 2022 and disproportionately affected gay, bisexual, and other men who have sex with men (GBMSM). Stigma is known to exacerbate health crises by discouraging testing, treatment, and vaccination. This review aimed to explore stigma associated with Mpox among GBMSM from July 2022, when mpox was declared a public health emergency of international concern. Methods: The PICO framework guided this narrative review. A search was conducted across the following databases from inception to June 2025: PubMed/MEDLINE, Embase, CINAHL, and Web of Science. The literature had to be empirical, peer-reviewed research that focused on mpox-related stigma in GBMSM. Results: Forty-seven studies were included in this review. The following themes were derived: (1) healthcare experiences, (2) media influence, (3) internalised and anticipated stigma, (4) public health messaging, (5) community responses, and (6) psychosocial impact. Healthcare experiences were marked by anticipated discrimination; many GBMSM delayed testing or vaccination for fear of being disclosed or labelled promiscuous. This was especially apparent in contexts where same-sex relationships are criminalised, leading some men to self-medicate or seek clandestine services. Media analyses revealed that social and traditional platforms often amplified blame and homophobia, though community-led counter-messaging helped shift narratives. Internalised and anticipated stigma resulted in shame, concealment of symptoms, avoidance of care, and heightened anxiety. Public health messaging that framed mpox as a behaviour-linked rather than identity-linked risk was more acceptable, and flexible vaccination strategies (e.g., offering less conspicuous injection sites) increased uptake. Stigma contributed to psychosocial distress and may have impeded outbreak control. Conclusions: Mpox-related stigma among GBMSM operates at individual, community, and structural levels, echoing patterns from the HIV era. Effective mitigation requires rights-based, destigmatising communication, culturally competent care, and collaboration. Addressing stigma is vital to controlling future outbreaks and ensuring equitable healthcare access. Full article