Search Results (10,243)

Background/Objectives: Dietary sweetener use is common among individuals with diabetes, yet little is known about the socioeconomic and dietary factors that influence the choice between caloric and artificial sweeteners in Central and Eastern Europe. This study examined the determinants of caloric and artificial sweetener use among adults with diabetes mellitus (DM) in Hungary. Methods: We conducted a cross-sectional analysis using frequency-based self-reported dietary measures of 542 adults with self-reported DM from the 2019 European Health Interview Survey (EHIS). Weighted descriptive statistics and multivariable logistic regression models were used to evaluate associations between sweetener use and sociodemographic, lifestyle, and dietary characteristics. Results: Overall, 28.0% of participants reported daily use of caloric sweeteners, and 45.2% reported daily use of artificial sweeteners. Higher educational attainment and healthier dietary patterns, including greater fruit and vegetable consumption, were associated with lower odds of caloric sweetener use. Individuals with lower fruit and vegetable intake, less frequent fruit juice consumption, and poor adherence to diabetic diet recommendations were more likely to use caloric sweeteners. In contrast, artificial sweetener use was strongly associated with daily fruit consumption, lower intake of fruit juice, and adherence to a diabetic diet. Vegetable intake showed a positive association with artificial sweetener use, which may reflect compensatory patterns in dietary self-management. Conclusions: Caloric and artificial sweetener use were associated with distinct socioeconomic and dietary profiles. Caloric sweetener use was linked to less healthy dietary behaviors, whereas artificial sweetener use appeared to be consistent with sugar-reduction strategies. These findings highlight the need for tailored dietary counseling that addresses both sweetener use and broader dietary patterns among individuals with diabetes in Hungary. Full article

Background and objectives: Increasing daily steps during weight management programs remains one of the most common recommendations; however, why, when and how many is still unclear. To clarify this, we aim to conduct a systematic review and meta-analysis. Methods: The study was conducted in adherence to the PRISMA guidelines on randomized controlled trials (RCTs), that included weight loss (WL) interventions based on lifestyle modification programs (LSMs), compared to “as usual care” considered as controls, to whom both daily steps and WL% were reported or retrievable at baseline (Time 0), end of WL phase (Time 1, WL1%), and weight maintenance phase (Time 2, WL2%), for both arms. Results: A total of 18 RCTs met the inclusion criteria and were included in the systematic review. Of those, 14 underwent meta-analysis and five main findings were revealed: (i) at baseline (Time 0), no significant difference was observed in mean daily steps between the LSM and controls (7280 vs. 7180, p = 0.336), reflecting a similar lifestyle between arms; (ii) at Time 1, the mean duration was 7.88 months (range = 3–12 months), and the LSM arm showed a significant increase in daily steps with respect to baseline (8454 vs. 7486 steps, p = 0.017) and a significant WL (WL1% = 4.39%, p < 0.001); (iii) at Time 2, the mean duration was 10.27 months (range = 3–24 months), and the LSM arm maintained the level of daily steps achieved by the end of WL phase (8241 vs. 8454 steps, p > 0.05), and also a significant WL% (WL2% = 3.28%, p = 0.001); (iv) the control arm showed no significant changes in daily steps and weight status at all times of assessment; and (v) the meta-regression showed in the LSM arm a positive relationship between daily steps at Time 1 (β = 1.33, p = 0.03) and Time 2 (β = 1.10, p = 0.02), both with WL2%. Conclusions: Our preliminary study results support that during LSM programs, patients should be encouraged to increase their daily steps during the WL phase, targeting approximately 8500 steps/day and maintaining these levels during the maintenance phase, since this strategy appears to be a useful behavioral approach associated with maintaining significant WL in the long term. Full article

Obesity in women of reproductive age is a major issue. It is associated with reduced fertility and an increased risk of obstetric and perinatal complications. Bariatric surgery is the most effective treatment for severe obesity, leading to substantial weight reduction, improvement of metabolic disorders, and enhanced fertility. Consequently, an increasing number of women are becoming pregnant after undergoing bariatric surgery. The aim of this paper is to review current recommendations and research data regarding the care of women after bariatric surgery in the periconceptional and perinatal periods, as well as throughout pregnancy, delivery, and the postpartum period. Research suggests that pregnancy after bariatric surgery is associated with a lower risk of gestational diabetes, hypertension, preeclampsia, and fetal macrosomia compared with pregnancies in women with similar baseline BMI (body mass index) who have not undergone surgical treatment. At the same time, an increased risk is observed for low birth weight, maternal micro- and macronutrient deficiencies, and complications characteristic of bariatric procedures, such as dumping syndrome or intra-abdominal hernias. Most scientific societies recommend postponing pregnancy planning for 12–18 months after surgery and using effective contraception, preferably methods that do not require gastrointestinal absorption. Regular monitoring of laboratory parameters, individually tailored supplementation, and interdisciplinary care are essential for the safe management of pregnancy after bariatric surgery. In particular, care should include achieving a stable body weight before conception, monitoring of nutritional status, verifying proper weight gain during pregnancy, and considering alternative methods for gestational diabetes screening (e.g., glycaemic monitoring instead of oral glucose tolerance testing) due to the risk of dumping syndrome. Appropriate preparation for pregnancy and proper management throughout its course allow for reducing the risk of perinatal complications. Bariatric surgery itself is not a contraindication to vaginal delivery. Full article

In semi-arid regions, sustainable groundwater management for irrigation is critical for agricultural productivity and food security. This study presents an integrated methodological framework combining hydrochemical characterization, machine learning (ML) modeling, and explainable artificial intelligence (XAI) to predict the Irrigation Water Quality Index (IWQI) in the Ain Oussera plain, Djelfa Province, Algeria. A total of 191 groundwater samples were collected from November 2023 to September 2024 and analyzed for major ions and physicochemical parameters. Multiple irrigation suitability indices were calculated, including Sodium Adsorption Ratio (SAR), Sodium Percentage (Na%), Magnesium Hazard (MH), Permeability Index (PI), Residual Sodium Carbonate (RSC), Soluble Sodium Percentage (SSP), and Kelly’s Ratio (KR). Five ML models were developed and evaluated for IWQI prediction: Random Forest, Gradient Boosting, XGBoost, K-Nearest Neighbors, and Support Vector Regression. Results showed that 55% of groundwater samples exhibited low to no restrictions for irrigation use, while 19% required high to severe restrictions. The XGBoost model demonstrated superior performance, with the highest R² (0.95) and the lowest RMSE (3.22) among all tested algorithms. SHAP (SHapley Additive exPlanations) analysis provided a transparent interpretation of model predictions, identifying electrical conductivity and Sodium Adsorption Ratio as the most influential parameters affecting IWQI, while chloride, sodium, total hardness, and magnesium had minimal impact. Spatial mapping using Inverse Distance Weighting (IDW) interpolation in ArcGIS 10.8 revealed considerable spatial variability in water quality throughout s the plain. This research addresses a critical gap in North African groundwater management by integrating ML predictive capabilities with XAI transparency, providing water resource managers and agricultural stakeholders with interpretable, data-driven tools for sustainable irrigation planning in water-stressed semi-arid environments. Full article

Background and Objectives: Venous thromboembolic disease (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cause of morbidity and mortality worldwide and imposes a substantial financial burden on health systems due to both the direct and indirect costs of acute management and long-term complications. This systematic review aimed to assess patient satisfaction with anticoagulation therapy for VTE and to highlight potential differences according to the type of anticoagulant. The review focused on factors influencing the patient experience, such as perceived efficacy, ease of use, adverse effects, and health-related quality of life. Materials and Methods: A systematic review, without quantitative meta-analysis, was conducted in accordance with PRISMA 2020 guidelines. Articles were identified through searches in major databases (PubMed, Scopus, Cochrane Library and others) using keywords including “patient satisfaction”, “anticoagulation”, “venous thromboembolic disease”, and “quality of life”. In total, 21 studies published between 2009 and 2025 met the inclusion criteria. The studies assessed patient satisfaction with different types of anticoagulation, including vitamin K antagonists (VKAs), direct oral anticoagulants (DOACs), and low-molecular-weight heparin (LMWH) injections. Results: Across the included studies, patients generally reported higher levels of treatment satisfaction with DOACs compared with VKAs, mainly due to the absence of routine laboratory monitoring and fewer dietary restrictions. However, satisfaction varied according to age, sex, and clinical status. In specific patient populations, such as those with cancer-associated thrombosis, factors including fewer drug–drug interactions and perceptions of safety with LMWH appeared to influence treatment choice and satisfaction. Adverse effects, particularly bleeding, were identified as major drivers of dissatisfaction. Several studies suggested that higher treatment satisfaction was associated with better adherence, while quality of life appeared to improve in patients treated with DOACs in comparison with VKAs. Conclusions: Patient satisfaction is a critical component of successful VTE management. Overall, DOACs appear to be associated with higher treatment satisfaction than traditional therapies such as VKAs, although further high-quality research is needed to individualise anticoagulation strategies. Systematic incorporation of patient-reported satisfaction into clinical decision-making and into international guidelines may improve adherence, enhance quality of life, and ultimately increase the effectiveness of anticoagulation therapy. Full article

This study applied time-series modeling using autoregressive integrated moving average (ARIMA) to compare the growth performance of tilapia broodfish in pond and recirculating aquaculture systems (RAS) from June 2023 to May 2024. Descriptive statistics showed a higher mean percentage weight gain under RAS (26.69%) than pond culture (23.75%), although monthly variability in the RAS dataset was influenced by an outlier, which may be attributed to influential exogenous factors rather than water-quality parameters. Normality, stationarity, and autocorrelation diagnostics confirmed that both datasets were appropriate for ARIMA modeling without differencing. Multiple ARIMA models were evaluated based on RMSE, MAPE, MAE, AIC, BIC, and residual behavior; ARIMA (1,0,1) emerged as the best fit for both systems. Forecasting up to May 2028 revealed stable long-term growth patterns, with RAS consistently showing slightly higher forecasted growth compared to pond culture, although the difference remained small in absolute terms. Predictions remained within model-generated 95% confidence intervals; however, these results indicate internal model consistency rather than independent validation of predictive accuracy. The findings highlight that RAS offers more consistent and slightly superior growth performance, supporting its potential for optimized broodfish production. Recommendations emphasize adopting RAS for enhanced growth predictability and improved management in tilapia aquaculture. Full article

The global burden of hypertension continues to rise, highlighting an urgent need for effective therapeutic strategies. Angiotensin-converting enzyme (ACE) is central to blood pressure regulation, but commonly used synthetic ACE inhibitors often have adverse side effects, spurring the search for safer natural alternatives. The aim of this study was to investigate Yanbian cattle hemoglobin as a novel precursor for ACE inhibitory peptides. The <1 kDa fraction was identified as exhibiting the highest inhibitory activity through the systematic screening of hydrolysates across multiple molecular weight ranges. LC-MS/MS analysis identified 1980 peptides, of which four were selected for further experiments. Solid-phase synthesis confirmed that NFGYDL exhibited the strongest ACE inhibition (IC₅₀ = 54.95 μM). Inhibition kinetics showed FHDYL acted as a mixed-type inhibitor, DLGHF and NFGYDL as competitive inhibitors and GFHLD as a non-competitive inhibitor. Molecular dynamics simulations validated the stable binding of these bovine blood-derived peptides to the ACE complex. HUVEC functional assays demonstrated that four peptides significantly increased angiotensin II-induced nitric oxide production and endothelin-1 levels, suggesting their potential antihypertensive activity. These findings suggested that bovine blood is a promising natural source of ACE-inhibitory peptides and holds potential for application as a functional component in functional foods targeting hypertension management. Full article

Intensive nitrogen (N) fertilization in greenhouse vegetable systems degrades soil structure and accelerates soil carbon (C) mineralization. Biochar application can alleviate these adverse effects by enhancing aggregate stability and mediating microbially driven nutrient cycling, yet its effects across aggregate fractions remain poorly understood. Here, we investigated how biochar (0, 20, 40 t ha⁻¹) and N interact to affect aggregate stability, C mineralization, nutrient status, and microbial properties in bulk soil and four aggregate classes (large macroaggregates: LMA, > 2000 μm; small macroaggregates: SMA, 250–2000 μm; microaggregates: MA, 53–250 μm; silt + clay: S + C, < 53 μm) in vegetable soil after a 60-day incubation. Results showed that biochar–N co-application increased mean weight diameter by 27.4–30.5% and elevated soil total organic C (TOC) in LMA by 9.11–12.0% and in MA by 8.77–20.2% relative to the N-only treatment. It also reduced β-glucosidase and oxidase activities, as well as fungal and G⁻-bacterial abundance. Biochar amendment suppressed TOC mineralization by 2.7–24.6% in bulk soil and aggregate fractions, while boosting potentially mineralizable C pools by 12.5–155.7%, and thereby increasing overall mineralization potential. Structural equation modeling revealed the size-dependent regulatory mechanisms underlying these observations. Aggregate stability directly inhibited CO₂ emissions in bulk soil and SMA, while the effects in MA and S + C fractions were mediated by shifts in nutrient stoichiometry and hydrolase activities. Our findings clarified the size-dependent mechanisms by which biochar–N co-application promoted soil C sequestration, providing a theoretical basis for the sustainable management of intensive vegetable systems. Full article

This study examines the historical and anticipated effects of climate change on essential hydroclimatic variables (temperature, precipitation, evapotranspiration, and soil moisture) in the Southeastern Anatolia Project (GAP) region of Türkiye, a semi-arid and agriculturally significant basin experiencing heightened water stress. The analysis employs a collection of CMIP6 Global Climate Models (GCM) and integrates three Shared Socioeconomic Pathways (SSP1-2.6, SSP2-4.5, and SSP5-8.5), utilizing statistical bias correction methods such as Delta Change, Quantile Mapping (QM), and Empirical Quantile Mapping (EQM) to improve the regional accuracy of the projections. The ACCESS-CM2 model, validated with data from Türkiye’s Meteorological General Directorate (MGM), was chosen for comprehensive spatial mapping, utilizing Inverse Distance Weighting (IDW) interpolation across seven temporal intervals encompassing past, present, and future periods. The findings indicate a steady increase in temperature and evapotranspiration, especially under high-emission scenarios, with temperature rises above +4 °C and considerable water losses anticipated by century’s end. Soil moisture exhibits a declining tendency, particularly in the southern and eastern regions, signifying increasing drought susceptibility. Precipitation patterns demonstrate significant spatial variability and rising uncertainty, with relative error (RE%) values increasing under SSP5-8.5. Historical data from 1963 to 2022 corroborate these conclusions, indicating a progressive shift towards a warmer and drier regional climate. These observations highlight the importance of climate adaptation strategies and water management in the GAP region. The research provides decision-makers a high-resolution, bias-corrected hydroclimatic dataset. Full article

Background: Tirzepatide is a novel therapeutic option for the management of metabolic disorders which has started to be implemented in routine practice. The study aimed to analyze the effectiveness of tirzepatide use and patient education in the field of healthy eating and weight loss, based on real-life data from the practice of a primary care physician, in metabolic syndrome (MetSyn) patients during a one-year follow-up period. Methods: This is a retrospective study based on real-life data of 118 MetSyn patients who were under the supervision of a general practitioner (GP). Analysis was conducted on 62 patients supported by trizepatide (2.5 mg for 4 weeks, then 5 mg for 4 weeks and 7 mg for 46 weeks) with dietary education and 56 patients that underwent dietary education with motivation only. Lipid profile, glucose level and blood pressure were assessed. Body Mass Index (BMI), waist-to-height ratio (WHtR), A Body Shape Index (ABSI), Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI) and Body Roundness Index (BRI) were calculated. The KomPAN^® questionnaire was used for dietary assessment and WHO Quality of Life-BREF for the quality of life assessment at 52 weeks. Results: Patients from both groups significantly reduced their body weight and WC and the values of the following indices: BMI, WHtR, ABSI, LAP and BRI. A significant increase in LDL cholesterol and triglyceride values was observed in both groups and a significant decrease in glucose level only in the group with tirzepatide combined with dietary modification. Energy value, energy density of food and nutrient intake did not differ between groups, while the intensity of beneficial nutritional features (pHDI-10) was low. Significant differences in patients’ QoL were observed, especially in the domain related to mental health (higher in trizepatide + diet group). Conclusions: Support in primary care by a physician was successful from a long-term perspective in the group using tirzepatide in combination with diet modification as well as in the group based on dietary modification only. The data do not indicate a significant advantage of any one approach for patients, prioritizing an individualized approach to treatment. Full article

Since its discovery in higher plants, melatonin has attracted considerable attention for its antioxidant properties and its diverse roles in plant physiology and stress responses. However, its biosynthetic pathway remains only partially elucidated, particularly in horticultural crops of economic and nutritional importance, such as pepper (Capsicum annuum L.) fruits. In our previous work, we identified five genes encoding tryptophan decarboxylase (TDC), the first enzyme in the melatonin biosynthetic pathway in pepper. The present study expands on this by identifying and characterizing additional genes encoding enzymes involved in subsequent steps of the pathway, including four tryptamine 5-hydroxylase (T5H) genes, two serotonin N-acetyltransferase (SNAT) genes, three N-acetylserotonin O-methyltransferase (ASMT) genes, two caffeic acid O-methyltransferase (COMT) genes, and one N-acetylserotonin deacetylase (ASDAC) gene, representing a total of twelve newly identified genes. We further examined their expression in sweet pepper fruits and found that only nine of the identified genes are expressed in the fruit, with generally higher transcript levels during the unripe stages. Melatonin quantification in the California-type ‘Masami’ cultivar using UPLC with fluorescence detection (FD) revealed concentrations of 623 ng melatonin·g⁻¹ dry weight (DW) in green fruits and 431 ng melatonin·g⁻¹ DW in red fruits, consistent with the higher expression of melatonin biosynthetic genes in unripe fruit. Expression analysis of these genes by means of RNA-seq revealed differential modulation in response to exogenous melatonin treatments (20, 50, and 100 µM). To our knowledge, this is the first report demonstrating that exogenous melatonin regulates the expression of genes involved in its own biosynthetic pathway in sweet pepper fruits. Notably, treatment with 100 µM melatonin delayed ripening in these non-climacteric fruits, highlighting its potential biotechnological application for controlling fruit ripening and improving postharvest management. Full article

Opuntia ficus-indica (L.) Mill., also named Cactus pear, is a crop widespread in many countries with Mediterranean and subtropical climates, where it represents a valuable source of food. However, in southern Europe, this fruit market is limited to a few months, from summer to autumn. The possibility to extend the ripening period of fruit is represented by the special pruning of the first bloom flush and consequent new development of late flowers and fruits. Extending the cultivation period would allow farmers to maximize the crop’s potential, thereby extending the Cactus pear market season throughout much of the year. In this study, conducted in southern Sardinia (Italy), progressive pruning was applied with the aim of evaluating the fruit characteristics in relation to this type of cultivation, also considering the weather conditions during the experimental period. Morphological traits and physicochemical compositions of fruit picked in four harvests during two sampling seasons from August 2022 to March 2023, and from August 2023 to March 2024 were compared. According to principal component analysis (PCA), most of the observed characters showed significant differences among harvest periods but also between the two seasons of cultivation (year of cultivation: r = 0.722 on PC1), suggesting that the meteorological trend strongly modulated fruit traits. Some fruit qualities were partially lost during the winter months, such as juice acidity and total soluble solids (TSS). October was the month with the highest TSS levels (13.5 ± 0.25), followed by August, January and March. On the other hand, juiciness and fresh weight remained unchanged or even improved in fruit harvested out-of-season. As observed in the redundancy analysis (RDA) a contribution of 54% due to weather variability emerged. In Particular, TSS levels, pH and juice dry matter were associated with high temperatures, solar radiation, and wind intensity. Wind speed was also moderately linked with betalain content. Moreover, high relative humidity was associated with lower pH values, higher water content, and higher fruit fresh weight. A significant difference was found between the two years in betalains content (80.0 ± 3.7 µg·mL⁻¹ in 2022–2023 and 28.2 ± 2.5 µg·mL⁻¹ in 2023–2024). The breakdown in the 2023–2024 season was likely due to the strong heat wave of July 2023 (up to 47 °C), which caused their partial degradation. In light of seasonal variability, this work provides some useful insights for future management of Cactus pear, also considering the possibility of usefully extending the period of cultivation and harvesting. Full article

The harmonic equivalent method is a non-perturbative approach to nonlinear vibration issues, aiming to create linearly coupled systems from coupled vibrations. However, there is still much to be discovered about managing interconnected nonlinear components. This paper examines the nonlinear components of a fractal-connected system and offers suggestions. This paper explores insights into the principles and uses of nonlinear systems in science and engineering by investigating the dynamic behavior of a connected cubic–quintic damping fractal system analytically using an innovative approach to analytical examination. A two-scale transformation and reformulation of the system into fractal form simplify its governing equations for dynamic and stability analysis. Two analytical scopes are presented: one decouples nonlinear systems using weighted averaging functions, and the other converts even nonlinearities into odd terms using El-Dib’s frequency formulas for linear representation, enabling an equivalent linear representation of the system. The resilience of the decoupled system is verified by numerical simulations using Mathematica, which shows high agreement and minimal relative errors. It also accurately reflects dynamic behavior. Additionally, the work uses the bridging techniques of El-Dib and Elgazery to convert a linear damping fractal coupled system into a classical continuous-space form. A scaling fractal factor is made possible by re-expressing the fractal structure using pseudo-dimensional parameters. The linearly linked damping system has an exact analytical solution. The paper provides valuable insights into the design and control of coupled nonlinear oscillatory systems by validating analytical solutions through numerical simulations using Mathematica. Full article

Oral joint supplements (OJSs), specifically those containing glucosamine and chondroitin sulfate, are some of the most popular feed additives fed by horse owners. However, evidence of the efficacy of these nutraceuticals in vivo is lacking. To investigate the impacts of an OJS on equine lameness, 40 geldings (18 ± 7 yr) with chronic lameness and AAEP lameness grades between 2 and 4 (as scored by a veterinary sports medicine and rehabilitation specialist) were enrolled in the study. Horses were stratified by lameness grade, BCS, and weight, and then randomly assigned to receive a placebo powder or an OJS daily for 6 wks. Stride length measurements and lameness evaluations were performed every 2 wk. There was no effect of treatment or treatment-by-day interaction for stride length, though day affected both walk (p = 0.04) and trot (p < 0.01). Only day affected lameness grade, with the lowest average score on d28 (p = 0.04). There was no evidence of supplementation improving gait symmetry over time. As such, there is no evidence to support efficacy of the tested OJS when fed for 6 wk. These results emphasize the importance of well-controlled studies and support continued development of evidence-based management strategies for equine joint health. Full article

Ratoon rice is a unique cropping system that utilizes the regenerative capacity of rice tillers to achieve one sowing with two harvests in a single growing season, thus exhibiting great yield potential. However, the ratooning ability is often constrained by impaired root function after the first harvest. In this study, we established an integrated nutrient management (INM) strategy to enhance root growth and function, thereby improving nutrient use efficiency and yield. Compared with farmers’ conventional management (FCM), INM increased annual total yield by 7.8% and 13.9% and enhanced ratooning ability by 20.7% and 19.0% in 2024 and 2025, respectively. INM consistently maintained higher root biomass in both main and ratoon crops: by 26.9% and 54.0% in 2024, and by 44.8% and 26.0% in 2025. Root biomass was significantly and positively correlated with brown rice weight across both seasons, and was positively associated with ratooning ability. INM also promoted early root establishment after transplanting, increasing the white-root number by 105.7%, 175.0%, and 484.8% at 3, 5, and 14 days after transplanting (DAT), respectively. Meanwhile, the xylem sap exudation rate and root triphenyl tetrazolium chloride (TTC) reduction activity were increased by 37.4% and 64.5% relative to FCM. In the 2024 ratoon season, INM improved nutrient use efficiency, with partial factor productivity (PFP) of nitrogen (PFP_N), phosphorus (PFP_P), and potassium (PFP_K) increased by 371.0%, 59.3%, and 91.1%, respectively. Gene Set Enrichment Analysis (GSEA) revealed significant enrichment of gene sets involved in root growth, development, nutrient acquisition, and assimilation under INM, providing molecular evidence for root-mediated nutrient synergy. In summary, INM enhances root growth and function, promotes nutrient uptake and utilization, and consequently improves yield. These results offer a practical management strategy supported by physiological and transcriptomic evidence for boosting ratoon rice production via root-mediated nutrient synergies. Full article