Search Results (400)

Background: Globally, an estimated 1.4 billion people had hypertension in 2014, yet only just over 20% had controlled blood pressure, and about 580 million remained undiagnosed. Evidence indicates that salt substitutes facilitate meaningful blood-pressure reductions, yet their implementation remains restricted by social and healthcare constraints. The comparative effectiveness of alternative sodium-reduction interventions for elevated blood pressure remains unclear, limiting their introduction across diverse clinical and public health contexts. This study is registered with PROSPERO (CRD420251130153). Methods: We systematically searched PubMed, MEDLINE, and supplementary sources for randomised controlled trials (RCTs) published between 2000 and 2025. All behavioural sodium-reduction interventions among populations with elevated blood pressure, including hypertension, were included. The mean difference in systolic blood pressure (SBP) was the primary outcome, as evidence indicates that intensive control of SBP to levels below 120–130 mmHg is significantly associated with a reduced risk of major cardiovascular disease (CVD) and all-cause mortality. Network and subgroup pairwise meta-analyses were performed, with sensitivity analyses conducted to assess robustness of the findings and subgroup analyses used to explore clinical and public health factors influencing intervention effectiveness (clinical factors: blood pressure stage, trial duration, and medication status; public health factors: setting, implementation period, and country income level). Results: Of 10,404 records identified, 42 studies (46 trials, n = 46,771) were included. While the use of salt substitutes was ranked the most effective intervention in the network meta-analysis, with reductions of −6.78 mmHg (95% CI, −8.42, −5.14) compared to no intervention and −5.35 mmHg (95% CI, −7.89, −2.81) compared to conventional health education, self-monitoring devices and low-sodium diets, when combined with health education, demonstrated similar magnitudes of SBP reductions. Digital health education showed a larger point estimate for SBP reduction by −3.59 mmHg (95% CI −7.40 to 0.22) than conventional education (−1.43 mmHg; 95% CI −3.49 to 0.63), but both confidence intervals crossed zero, indicating no statistically significant difference. Subgroup analyses indicated that, except for trial duration, intervention setting, and country income level in specific intervention comparisons, clinical and public health factors did not generally account for differences in SBP reduction. No evidence of publication bias was observed, except between salt substitutes and no intervention and low-sodium diets and no intervention. Conclusions: Network meta-analysis ranked the use of salt substitutes as the most effective intervention, yet self-regulated interventions, such as low-sodium diets and self-monitoring devices, when combined with education-based sodium-reduction approaches, showed comparable point estimates for SBP reductions. Digital health education showed promise as a supportive adjunct to self-regulated interventions, although its effects were variable and require further quantification. These findings underscore the need for alternative sodium-reduction interventions supported by digital or conventional health education to improve blood pressure control. Health education on sodium reduction, including clinical counselling, should be viewed primarily as a complementary component that enhances other interventions. Full article

Background: Hyponatremia (serum sodium levels below 135 mEq/L) is the most prevalent electrolyte imbalance, with the syndrome of inappropriate antidiuresis (SIAD) being the most common cause among inpatients. Fluid restriction is the primary treatment for SIAD, yet its efficacy is inconsistent. A novel therapeutic approach involves the use of oral vaptans, such as tolvaptan (TLV), which are non-peptide antagonists of arginine vasopressin receptors. The recommended daily dose of TLV is 15 mg; however, the risk of overcorrection and osmotic demyelination syndrome must be considered. Methods: Consequently, a more cautious approach involving a 7.5 mg dose of TLV was studied in SIAD patients to determine its safety and efficacy compared with a 15 mg dose. Results: The findings of our investigation show that the results obtained from the two doses are highly similar. However, it is important to note that the risk of overcorrection was lower in the 7.5 mg TLV group than in the 15 mg group. Furthermore, a more gradual increase in serum Na was observed in the 7.5 mg group than in the 15 mg group after the most critical first 24 h. Conclusions: TLV therapy can be initiated with a 7.5 mg dose, with serum sodium levels monitored at 12 and 24 h to confirm or adjust the TLV dose as required. Full article

Background/Objectives: Calcinosis cutis universalis is a rare and severe manifestation of dystrophic calcification, most associated with connective tissue diseases such as dermatomyositis, systemic sclerosis, and systemic lupus erythematosus. It is characterized by widespread deposition of calcium salts throughout the soft tissues, leading to pain, recurrent infections, restricted mobility, and significant impairment in daily functioning and quality of life. Management remains challenging due to the absence of standardized treatment guidelines with risks including delayed wound healing and recurrence. Adjunctive therapies may support symptom control in refractory cases. Conclusions: Management of calcinosis cutis universalis requires an individualized, multimodal strategy. Based on available evidence and expert opinion, a stepwise therapeutic decision-making algorithm integrating medical, minimally invasive, and surgical approaches is proposed to guide clinical practice and the variable efficacy of available therapies. This review aims to summarize current therapeutic strategies and to propose a pragmatic approach to clinical decision-making. Methods: A narrative review of the literature was conducted using PubMed and Google Scholar. The review focused primarily on calcinosis cutis universalis and severe or extensive forms of calcinosis cutis, with particular emphasis on surgical management and its integration with medical and minimally invasive treatments. Results: Pharmacological treatments—including bisphosphonates, calcium-channel blockers, tetracyclines, phosphate binders, probenecid, immunomodulatory agents, biologics, colchicine, sodium thiosulfate and JAK inhibitors—show heterogeneous and often partial efficacy, with more favorable responses in early or localized disease. Surgical interventions such as excision, curettage, CO₂ laser ablation, and reconstructive procedures provide meaningful symptomatic relief in selected patients but are associated. Full article

The valorization of dredged sediments represents a major environmental and logistical challenge, particularly in the context of forthcoming regulations restricting their marine disposal. This study investigates the potential of untreated dredged sediments as sustainable raw materials for geopolymer binder development, with the dual objective of sustainable sediment management and reduction in cement-related environmental impact. Dredged sediments from the Grand Port Maritime de Bordeaux (GPMB) were activated with sodium hydroxide (NaOH) and sodium silicate (Na₂SiO₃), both alone and in combination, with supplementary aluminosilicate and calcium-rich co-products, to assess their reactivity and effect on binder performance. A multi-scale experimental approach combining mechanical testing, calorimetry, porosity analysis, Scanning Electron Microscopy and Energy-Dispersive Spectroscopy (SEM–EDS), X-ray diffraction (XRD), Thermogravimetric Analysis (TGA), and solid-state Nuclear Magnetic Resonance (NMR) was employed to challenge the commonly assumed inert behavior of sediments within geopolymer matrices, to elucidate gel formation mechanisms, and to optimize binder formulation. The results show that untreated sediments actively participate in alkali activation, reaching compressive strengths of up to 5.16 MPa at 90 days without thermal pre-treatment. Calcium-poor systems exhibited progressive long-term strength development associated with the formation of homogeneous aluminosilicate gels and refined microporosity, whereas calcium-rich systems showed higher early age strength but more limited long-term performance, linked to heterogeneous gel coexistence and increased total porosity. These findings provide direct evidence of the intrinsic reactivity of untreated dredged sediments and highlight the critical role of gel chemistry and calcium content in controlling long-term performance. The proposed approach offers a viable pathway for low-impact, on-site sediment valorization in civil engineering applications. Full article

Parental perceptions of healthy eating often diverge from children’s actual diets, but this gap is poorly documented in Central Asia. We examined how parents’ priorities for key food groups relate to nutrient intakes in 390 urban children aged 1–6 years in Central Kazakhstan. In a cross-sectional study, parents completed a 24 h multiple-pass dietary recall and rated the importance of fats and sweets, meat and fish, dairy, vegetables and fruits, and bread and potatoes on 5-point scales. Nutrient intakes were calculated using software, compared with national DRIs, and analyzed using rank-based tests and Spearman correlations. Parents reported near-ceiling priority for restricting fats and sweets and consistently high priority for bread and potatoes, whereas vegetables, fruits, meat/fish, and dairy were rated moderately important, with dairy under-prioritized in 1–2-year-olds. On the recalled day, median intakes of fat, dietary fiber, vitamin C, and calcium were below national recommendations at all ages, and median intakes of iron, thiamine, and niacin were particularly low at 3–4 years, while sodium intake exceeded recommended levels; the 3–4-year group showed the most pronounced clustering of shortfalls. Prevalence estimates indicated that most children had intakes below recommendations for dietary fiber and calcium and above recommendations for sodium, underscoring population-wide nutritional imbalance. Across all scales, parental priorities showed only weak, non-significant associations with nutrient intakes (|r| < 0.11). These findings indicate a perception–intake gap and support interventions that ensure adequate fats, fiber, vitamin C, calcium, and bioavailable iron in preschool diets. Full article

Groundwater is the main water source for irrigated agriculture, accounting for an increasing share of the domestic supply in the hyper-arid district of La Yarada Los Palos (Tacna, Peru); however, at the sector scale, concerns about arsenic, boron and salinity remain poorly quantified. Arsenic and boron were selected as target contaminants because of their naturally elevated concentrations associated with coastal and volcanic hydrogeological settings, and their well-documented implications for human health and irrigation suitability. This study reports a 12-month monitoring program (September 2024–August 2025) in three irrigated sectors, in which wells were sampled monthly and analyzed by inductively coupled plasma–mass spectrometry (ICP-MS) for total arsenic, boron, lithium and sodium, along with electrical conductivity, pH, temperature and total dissolved solids. The sector–month total arsenic means ranged from 0.0089 to 0.0143 mg L⁻¹, with 33 of 36 exceeding the 0.010 mg L⁻¹ drinking water benchmark recommended by the World Health Organization (WHO). Total boron ranged from 1.11 to 2.76 mg L⁻¹, meaning that all observations were above the 0.5 mg L⁻¹ irrigation guideline for agricultural use proposed by the United Nations Food and Agriculture Organization (FAO). A marked salinity gradient was observed from the inland Sector 1-BH (median Na ≈ 77 mg L⁻¹; EC ≈ 1.2 mS cm⁻¹) to the coastal Sector 3-LC (median Na ≈ 251 mg L⁻¹; EC ≈ 3.3 mS cm⁻¹), with Sector 2-FS showing intermediate salinity but the highest median boron and lithium levels. Spearman rank correlations indicate that sodium, electrical conductivity and total dissolved solids define the main salinity axis, whereas arsenic is only moderately associated with boron and lithium and is not a simple function of bulk salinity. Taken together, these results show that groundwater from the monitored wells is not safe for drinking without treatment and is subject to at least moderate boron-related irrigation restrictions. The sector-resolved dataset provides a quantitative baseline for La Yarada Los Palos and a foundation for future work integrating expanded monitoring, health-risk metrics and management scenarios for arsenic, boron and salinity in hyper-arid coastal aquifers. Full article

The field of electrochemical devices, encompassing energy storage, fuel cells, electrolysis, and sensing, is fundamentally reliant on the electrode materials that govern their performance, efficiency, and sustainability. Traditional materials, while foundational, often face limitations such as restricted reaction kinetics, structural deterioration, and dependence on costly or scarce elements, driving the need for continuous innovation. Emerging electrode materials are designed to overcome these challenges by delivering enhanced reaction activity, superior mechanical robustness, accelerated ion diffusion kinetics, and improved economic feasibility. In energy storage, for example, the shift from conventional graphite in lithium-ion batteries has led to the exploration of silicon-based anodes, offering a theoretical capacity more than tenfold higher despite the challenge of massive volume expansion, which is being mitigated through nanostructuring and carbon composites. Simultaneously, the rise of sodium-ion batteries, appealing due to sodium’s abundance, necessitates materials like hard carbon for the anode, as sodium’s larger ionic radius prevents efficient intercalation into graphite. In electrocatalysis, the high cost of platinum in fuel cells is being addressed by developing Platinum-Group-Metal-free (PGM-free) catalysts like metal–nitrogen–carbon (M-N-C) materials for the oxygen reduction reaction (ORR). Similarly, for the oxygen evolution reaction (OER) in water electrolysis, cost-effective alternatives such as nickel–iron hydroxides are replacing iridium and ruthenium oxides in alkaline environments. Furthermore, advancements in materials architecture, such as MXenes—two-dimensional transition metal carbides with metallic conductivity and high volumetric capacitance—and Single-Atom Catalysts (SACs)—which maximize metal utilization—are paving the way for significantly improved supercapacitor and catalytic performance. While significant progress has been made, challenges related to fundamental understanding, long-term stability, and the scalability of lab-based synthesis methods remain paramount for widespread commercial deployment. The future trajectory involves rational design leveraging advanced characterization, computational modeling, and machine learning to achieve holistic, system-level optimization for sustainable, next-generation electrochemical devices. Full article

Background: Heart failure (HF) patients with a ‘reduced’ ejection fraction (HFrEF) have several proven treatment options, but for those with a ‘preserved’ ejection fraction (HFpEF) there are very few. However, recent trials such as the EMPEROR-Preserved and DELIVER have shown that sodium-glucose cotransporter 2 (SGLT2) inhibitors significantly reduce HF hospitalization in HFpEF patients, and these are now supported by both Australian and international guidelines. Methods: We undertook a narrative review using a structured multi-database search (MEDLINE, Embase, CINAHL, Scopus) and key Australian sources (AIHW, ABS, Department of Health and Aged Care) without geographic or publication-year restrictions. Results: In Australia there were approximately 179,000 hospitalizations in 2020–2021 due to HF equating to a rate of 697 per 100,000 population. The age-standardized hospitalization rate for HF in remote and very remote areas was 1.8 times higher than in major cities. Likewise, since 2000 the prevalence of diabetes has nearly tripled, from 460,000 to 1.3 million. In remote areas, there were 47,600 diabetes hospitalizations in 2021–2022, with residents being 2.5 times more likely to be hospitalized for diabetes compared to those in major cities. Conclusions: In rural Australia, reducing preventable hospitalizations and premature mortality from heart failure and type 2 diabetes requires a stronger rural generalist and general practitioner workforce, improved access to essential medicines and telehealth, and equity-focused evaluation. Full article

Late-night feeding, defined in the present review as feeding after 8:00 pm when evening insulin secretion and sensitivity are low, is increasingly prevalent in Western society and is recognized as a disruptor of metabolic homeostasis. Yet health problems related to late-night feeding are largely ignored in time-restricted feeding studies that generally do not extend past an 8:00 pm feeding window. This paper proposes a novel cascade linking late-night hyperglycemia with sleep disturbances and nasal congestion mediated by renal sodium retention, increased plasma osmolarity, and stress hormone release by hypothalamic–pituitary–adrenal axis activation. The narrative describes the circadian decline in insulin sensitivity, which amplifies postprandial glucose surges following late-night feeding. Elevated glucose levels drive renal glucose reabsorption via sodium–glucose cotransporters, promoting sodium retention independent of insulin. Increased sodium retention raises extracellular osmolarity, activating hypothalamic osmoreceptors and stimulating the hypothalamic–pituitary–adrenal axis. Cortisol release promotes alertness, while fluid retention and mucosal edema contribute to nasal congestion and early waking. Supine fluid redistribution during sleep further exacerbates airway narrowing, increasing the risk of sleep fragmentation and obstructive sleep apnea. The present paper fills a gap in current time-restricted feeding literature by integrating renal, osmotic, and neuroendocrine pathways that may be overlooked as underlying mechanisms of dysregulated glucose control and hormone dysfunction. Reviewed evidence suggests that symptoms such as nocturnal congestion and sleep disruption are not merely incidental to late-night feeding but frame late night feeding as a risk factor with underlying physiological stressors that could contribute to cardiometabolic risk. Full article

The Otukpo Burnt Brick Factory has remained dormant for more than three decades despite repeated government interventions. In this context, the present study investigates the suitability of soils from Otukpo, Benue State, Nigeria, for unfired brick production and as supplementary cementitious materials (SCMs). Four representative samples (OT1–OT4) were subjected to X-ray fluorescence (XRF), thermogravimetric analysis (TGA), particle size distribution (PSD), X-ray diffraction (XRD), unconfined compressive strength (UCS), cube strength, shrinkage, and water absorption tests. The results revealed high reactive oxide contents (SiO₂ + Al₂O₃ + Fe₂O₃ > 93%) with low SO₃ and moderate loss on ignition (~6%), thus indicating strong pozzolanic potential. PSD residues on the 45 µm sieve ranged from 6.8 to 17%, which is well below the ASTM C618 limit of 34%. XRD confirmed quartz and kaolinite as dominant phases. Strength activity indices showed that only OT3 and OT4 exceeded Nigerian (NIS 693:2007) and Indian (IS 1725:2023) standards when stabilized with 5 wt.% cement or sodium hydroxide; while OT1 and OT2 were below these thresholds. Water absorption values for OT3 (18.69%) and OT4 (19.04%) marginally satisfied Indian standards but failed Nigerian requirements, which is reflective of high porosity. Linear shrinkage (~14%) met IS 1498 marginally, and pH values (6.14–6.34) were consistent with lateritic soils. Overall, OT3 and OT4 demonstrated promise for low-energy SCMs and unfired brick applications, though they must be restricted to non-load-bearing uses unless further stabilization is applied. Full article

Soda saline–alkaline soils have seriously restricted the sustainable development of agriculture in the Songnen Plain, China. Applying soil amendments has proven to be an effective remediation strategy for these sodic soils; however, conventional amendments face limitations, including prolonged remediation periods and the potential to cause secondary pollution upon misapplication. In this study, we combined three different amendments and applied them as four distinct treatments—citric acid + nano-silica (CS), citric acid + nano-silica + humic acid (CSH), nano-silica + humic acid (SH), and citric acid + humic acid (CH)—with no amendment used as the control (CK). The effects of these treatments on improving the soda saline–alkali soil was evaluated using a field positioning experiment. The results indicate that, compared to the CK treatment, applying the amendments significantly increased the concentrations of available phosphorus (AP) (9.19% to 44.43%) and organic matter (SOM) (3.53% to 16.48%) while decreasing alkalinity and salinity indicators (pH, EC (electrical conductivity), ESP (exchangeable sodium percentage), SAR (sodium adsorption ratio), and TA (total alkalinity)) and soil alkali stress ions (water-soluble and exchangeable Na⁺, CO₃²⁻, and HCO₃⁻). The partial least squares path modeling analysis (PLS-PM) demonstrated that the application of the amendments improved soil quality by changing its alkalinity and ion composition, thereby increasing the maize yield (from 3.01% to 9.80%). Full article

The advancement of smart packaging technology demands high-performance and sustainable sensing materials. While starch is a biodegradable natural polymer, its inherent high crystallinity restricts charge transport capability. This study developed a novel smart sensing film by incorporating ellagic acid-derived blue, fluorescent carbon dots (CDs) into phosphate starch (PS), which is rich in phosphorus. The effects of silver ions (Ag⁺), sodium carboxymethyl cellulose (CMC), and CDs on the film properties were systematically investigated. Results indicate that CDs act as flexible nano-crosslinkers, forming hydrogen bonds with PS molecular chains and effectively balancing strength and toughness—achieving a tensile strength of 5.1 MPa and an elongation at break of 24.1%. Phosphorus, in synergy with CDs, facilitates an efficient dual conduction pathway for ions and electrons: phosphate groups enable ion transport, while the conjugated carbon cores of the CDs provide electron transport channels. This synergistic effect significantly reduces the film’s electrical impedance from 6.93 × 10⁶ Ω to 1.12 × 10⁶ Ω (a reduction of 84%) and enhances thermal stability, increasing the char residue from 1.1% to 18.3%. The PS/CDs composite film exhibits a strong linear current response to pH in the range of 2–7 (R² = 0.9450), and shows enhanced discrimination between fresh orange juice (pH = 3.38) and spoiled orange juice (pH = 2.68), with a current change of 0.62 × 10⁻⁵ A. Moreover, the film exhibits strong blue fluorescence at 427 nm, with an intensity that shows a pronounced pH-dependent response. This study elucidates the mechanism by which phosphorus and CDs synergistically enhance the sensing performance of starch-based films, offering a new strategy for developing high-performance starch-based materials for smart packaging. Full article

Polycaprolactone (PCL) is a synthetic biodegradable polymer widely used in biomedical research due to its flexibility, safety for use in the body, and FDA approval for medical use. Nevertheless, its inherent hydrophobicity and restricted bioactivity limit its direct utilization in the field of biomaterials. Efforts to overcome these limitations include, but are not limited to, surface modifications, coating, and the use of copolymers of PCL with hydrophilic polymers. Polydopamine (PDA), the oxidative polymerization product of dopamine, a naturally occurring biomolecule in living organisms, is a flexible, bioinspired coating that makes surfaces more hydrophilic and facilitates cell attachment by incorporating numerous catechol and amine functional groups, making it suitable for biomaterial applications. PCL nanofibers were coated with PDA in three concentrations of dopamine solutions (0.2, 2, and 20 mg·mL⁻¹). Then, gold nanoparticles (AuNPs) were deposited in situ using sodium borohydride reduction. Morphological, physicochemical, and electrical properties of both PDA-coated and AuNP-loaded PCL fibers were comparatively investigated. The PDA coating made the surface significantly more hydrophilic compared to PCL-only surfaces, and AuNP-loaded fibers exhibited an extremely hydrophilic character. The primary concern of this article, electrical conductivity, was found to increase by up to a hundredfold with PDA coating and by a thousandfold with loading of AuNPs. PDA coating or loading AuNPs onto PDA-coated electrospun PCL fibers can provide a wide range of applications in the field of biomaterials. Full article

Background/Objectives: Transdermal formulations are widely utilized in the pharmaceutical and cosmetic fields because they enable non-invasive administration and sustained local drug delivery. Conventional ex vivo skin permeation experiments using Franz diffusion cells have limitations in capturing the spatial and temporal dynamics of skin penetration. This study aimed to develop a confocal laser scanning microscopy (CLSM)-based approach to visualize and semi-quantitatively assess the penetration behavior of fluorescent dyes with differing lipophilicities. Methods: Four fluorescent dyes with different Log P values—Rhodamine B (Rho-B), Rhodamine 123 (Rho-123), Fluorescein Sodium (Flu-Na), and Nile Red (NR)—were formulated into lotion-based vehicles and applied to excised human abdominal skin. CLSM imaging was performed from 10 min to 240 min post-application. Fluorescence intensities were extracted from depth-resolved regions (R1–R4, 30-μm intervals) to examine penetration kinetics and distribution. Results: CLSM imaging demonstrated that Rho-B penetrated through stratum corneum and entered deep into the skin via the hair follicles. Rho-123 and Flu-Na exhibited intercellular and follicular penetration; however, Flu-Na showed only a slight increase in intensity over time; NR showed negligible penetration into the deeper layers. The results of our analysis indicated that moderately lipophilic substances such as Rho-B and Rho-123 diffused deeply into the skin via both transdermal and follicular routes, whereas highly hydrophobic or lipophilic substances remained in the superficial layers. Conclusions: The CLSM-based approach enabled spatially and temporally resolved, semi-quantitative evaluation of transdermal penetration in a single, non-destructive experiment. Although restricted to fluorescent probes, this approach provides a practical early-stage screening tool for comparing route-specific and time-dependent penetration behaviors of compounds with different lipophilicities. Full article

Background/Objectives: Linezolid is a first-in-class oxazolidinone antibiotic that exhibits activity against Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. However, its clinical use is often restricted because of hematological toxicities, particularly thrombocytopenia, in patients with renal impairment. That side effect is thought to result from the systemic accumulation of pharmacologically inactive metabolites generated by oxidative degradation and ring-opening of the morpholine, but the details remain unclear. In this study, we established a novel synthetic route for four linezolid metabolites (PNU-142618, 142300, 142586 and 173558). Methods: The four major metabolites, which are secondary or tertiary amines, were synthesized using the aniline derivatives protected with a 2-nitrobenzensulfonyl (Ns) group. Results: Application of this Ns strategy enabled selective N-alkylation, enabling efficient synthesis of the target metabolites. The desired metabolites containing a carboxylic acid group were obtained as their sodium salts. This is the first report on the synthesis of PNU-142618 and 173558. Conclusions: The established synthetic pathway provides access to four linezolid metabolites. The results facilitated the provision of compounds necessary for comprehensive pharmacokinetic and toxicological studies. Full article