Search Results (60,743)

Chronic disease self-management (CDSM) is critical for improving health outcomes, particularly for individuals with low health literacy who face barriers in accessing and understanding medical information. This study examined the role of tailored digital health interventions in reducing stress and improving quality of life among individuals with chronic conditions. A multisite randomized controlled trial including 309 participants at baseline aged 40 to 90 years was conducted using a mobile app that provided self-management information at different literacy levels. Latent growth curve modeling (LGM) computed in Mplus was used to assess changes in stress over time and its impact on quality of life. The results indicated that successful tailoring of health information was significantly associated with reductions in perceived stress, which, in turn, predicted improvements in quality of life. These findings suggest that personalized digital interventions may enhance engagement with self-management strategies, alleviate psychological distress, and contribute to better overall well-being. This study highlights the importance of tailoring health content to users’ literacy levels and informational needs, underscoring the potential of mobile health solutions for improving CDSM. Future research should explore additional mechanisms underlying these effects and assess the long-term sustainability of digital interventions in diverse populations. These results provide valuable insights into optimizing mobile health applications to support individuals with chronic conditions. Full article

Background/Objectives: Emerging evidence suggests that gut microbiota composition is influenced by both age and sex and may contribute to dementia-related brain pathologies. However, comprehensive microbiome-based biomarker discovery stratified by these factors remains limited. Methods: We performed a metagenomic analysis of the gut microbiota of participants stratified by sex (female vs. male) and age (<75 vs. ≥75 years). Alpha diversity (observed operational taxonomic unit, Chao1, Shannon, and Simpson) and linear discriminant analysis effect size analyses were conducted to identify dominant taxa associated with Alzheimer’s pathology, vascular pathology, and dementia-related structural brain changes. Results: Females and non-elderly participants (aged < 75 years) exhibited higher gut microbial diversity, characterized by an increased abundance of Bifidobacterium spp. and Blautia spp., whereas males and elderly participants (aged ≥ 75 years) exhibited increased levels of Bacteroides spp. and Bacteroidia, which have been associated with inflammation and dysbiosis. Several taxa, including Bifidobacterium spp. were consistently identified as potential protective biomarkers, while Bacteroides spp. was linked to a higher risk of dementia-related brain pathologies. Conclusions: Our findings demonstrate distinct age- and sex-specific differences in gut microbiota composition that may be closely associated with the pathophysiology of dementia-related brain pathologies. These results demonstrate that gut microbiota may serve as potential biomarkers for monitoring cerebrovascular conditions, potentially contributing to the development of personalized therapeutic strategies. Full article

The demand for polymer composite materials in the dental market is increasing every year. This rise is due to their excellent properties and ongoing technological advancements. The goal of this study was to develop new photoinitiators included in the liquid organic matrix, which is one of the main components of dental composites. Therefore, a series of compounds based on the indenoquinoxaline skeleton was synthesized, differing in the substituent. The spectroscopic properties of these compounds allowed their use as visible-light photoinitiators of radical polymerization in combination with (phenylthio)acetic acid. In addition to the polymerization kinetics, the lifetime and quantum yield of the triplet-state formation and the rate constants of its quenching by (phenylthio)acetic acid were determined. The durability of the designed composites was also assessed. Ageing tests included hydrothermal ageing, allowing for the determination of sorption, solubility, and mass change. Solutions imitating the oral cavity environment—distilled water, artificial saliva, n-heptane, and 3% acetic acid—as well as solutions containing pigments were used for these studies. Determination of the mass change and colour stability allowed for the assessment of how these materials react to long-term exposure in the oral environment. It was found that the solution simulating the natural oral environment has a significant impact on the hydrolytic stability and colour stability of the materials. Full article

Background: Asthma is a chronic inflammatory airway disease in which oxidative stress and antioxidant imbalance play a critical role in disease progression and therapeutic response. This study aimed to evaluate oxidative stress and antioxidant status in relation to asthma control levels. Methods: A total of 106 patients admitted to the Clinical Hospital of Pulmonary Diseases, Iași, between March and May 2024 were included in this study. Patients were classified into three groups based on asthma control: well-controlled (AB-TCG), partially controlled (AB-PCG), and uncontrolled asthma (AB-UCG). Demographic, biochemical, and hematological parameters were assessed, with attention to oxidative stress markers and antioxidant defenses. Results: The study population was predominantly female (75%), with a mean age ranging from 50.75 to 64.38 years, and the majority residing in rural areas (73–75%). The AB-UCG group showed significantly elevated inflammatory markers, including a white blood cell count of 9.33 × 10³/µL (p = 0.005) and eosinophil percentage of 4.20% (p = 0.03), compared with the other groups. This group also exhibited an unfavorable lipid profile, with increased total cholesterol (207.40 mg/dL) and triglyceride levels (157.21 mg/dL). Oxidative stress was notably higher in the AB-UCG group, as indicated by elevated malondialdehyde (MDA) levels (2.86 mmol/L) versus 2.35 mmol/L in the AB-PCG group (p < 0.005), along with decreased serum uric acid (4.64 mg/dL) and reduced glutathione (GSH) levels (275.41 µmol/L), leading to a lower GSH/GSSG ratio. Environmental exposures, including tobacco smoke and occupational chemicals, were associated with exacerbated oxidative imbalance. Conclusions: The findings highlight the critical involvement of oxidative stress and compromised antioxidant defenses in poorly controlled asthma. Biomarkers such as MDA, white blood cell count, eosinophil percentage, and the GSH/GSSG ratio may act as valuable tools for personalized asthma management and therapeutic monitoring. Full article

Amid globalization and rising global temperatures, dehydration has emerged as a critical issue, especially for children who are more vulnerable due to their higher body surface-to-weight ratio. The issue is even more concerning given that adequate water intake is important for cognitive development, particularly in children since brain development is critical during early years. This study addressed this challenge by, first, designing a smart hydration device based on the Theory of Inventive Problem Solving (TRIZ). Then, this study proceeded with prototyping and testing the smart hydration device to promote increased daily water intake among Malaysian children. The device demonstrated improved water consumption and increased drinking frequency among children. Additionally, the children displayed improved cognitive performance. However, this study was limited to a specific age group and the device requires adult supervision for charging. Therefore, further research is necessary to tackle these limitations. Nevertheless, this smart device represents a promising step forward in fostering better hydration habits among children. Full article

Background: Frailty is an important factor in the quality of life, because physical functions decrease with increasing frailty and cannot return to their previous state. This can lead to falls, hospitalization, dependency, and early mortality. However, the definition of and measurement tools for frailty remain unclear. Among these measurement tools, the frailty phenotype and frailty index are commonly used. In Korea, frailty is diagnosed using the Korean version of the FRAIL scale (K-FRAIL scale), which was developed using the frailty phenotype and frailty index. Objectives: The goals of this study were to compare the frailty phenotype and the K-FRAIL scale, and to identify measurement tools that can accurately diagnose frailty in Korea. Methods: Frailty was assessed in 40 older adults aged 65 years or older using the frailty phenotype and the K-FRAIL scale. Results: The prevalence of the frailty phenotype was observed in frail (7.5%), pre-frail (60%), and robust (32.5%) patients. In contrast, the K-FRAIL was observed in frail (0%), prefrail (22.5%), and robust (77.5%) patients. The mean score of the frailty phenotype was higher than the K-FRAIL score (p = 0.00). Conclusions: We identified a difference between the frailty phenotype and K-FRAIL. Collectively, these two measurement tools can provide different measurement frameworks depending on the measurement environment. Full article

Objectives: This study was aimed to identify risk factors for persistent air leak after chest tube placement for secondary spontaneous pneumothorax and to determine the optimal timing of treatment. Methods: We retrospectively analyzed 221 cases of secondary spontaneous pneumothorax in patients aged ≥50 years who were treated with chest tube drainage. Patients were categorized into the observation group or additionally treated group based on whether they received interventional treatment beyond chest tube drainage. Air leak resolution patterns were analyzed using hazard function analysis. Risk factors were evaluated using univariate and multivariate analyses. Results: Hazard function analysis revealed that the probability of air leak resolution decreased by approximately 50% within the first 5 days after the initiation of chest tube drainage, with only 33% of cases resolving by day 7. Beyond days 7–10, resolution probability stabilized at a minimal level. Multivariate analysis identified previous pneumothorax history (HR: 0.422, p = 0.007) and low geriatric nutritional risk index (GNRI) (HR: 2.521, p < 0.001) as significant independent risk factors for persistent air leak. Further analysis of early resolution (within 7 days) identified female sex (HR: 0.24, p = 0.003), absence of previous pneumothorax (HR: 0.21, p = 0.003), and higher GNRI values (HR: 1.04, p = 0.008) as positive predictors. Conclusions: Risk stratification based on pneumothorax history and nutritional status enables the optimization of the timing of intervention for persistent air leak. We recommend considering additional treatment between days 7 and 10 of chest tube drainage, with earlier intervention for high-risk patients. This approach may improve patient outcomes while avoiding unnecessarily prolonged conservative management. Full article

Background: Oral ulceration with bone sequestration (OUBS) is an uncommon clinical lesion characterized by painful mucosal ulceration associated with exposed and necrotic bone in the oral cavity, often without known factors inducing osteonecrosis. Despite its potential for diagnostic confusion with more serious lesions, such as medication-related osteonecrosis, OUBS remains poorly understood and underreported. Objectives: To systematically review the literature on OUBS and identify its main clinical and radiographic characteristics to assist in early diagnosis and appropriate management. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted in the PubMed, Scopus, and Web of Science databases on 27 January 2024, to identify case reports, case series, and observational studies that described OUBS. Data extraction focused on demographic information, lesion location, clinical features, radiographic findings, possible etiological factors, management, and outcomes. The Joanna Briggs Institute (JBI) critical appraisal tools were utilized to assess the quality of the case reports and series. Data were synthesized narratively due to heterogeneity among studies. Results: Fifty-seven patients from 22 studies were included. The male-to-female ratio was 2.5:1, with most cases (71.9%) occurring in males. The mean age was 50.22 ± 11.49 years, with the highest incidence in patients aged 50–59 years (64.9%). Most cases were localized to the mandible (94.7%). Clinically, lesions were shallow ulcers (mean size: 0.75 ± 0.85 cm). Pain was the most common symptom (88.9%). Radiographs revealed no significant maxillary abnormalities, but some cases showed radiopaque areas in the mandible. Surgical interventions were most common (40.4%), with complete healing in 67.7% of cases within 4 weeks. Limitations include the predominance of case reports and series, which limits the strength of evidence. Conclusions: Recognizing OUBS can prevent misdiagnosis and unnecessary interventions. Further studies are needed to clarify its etiology and natural history. Registration: This review was registered on the PROSPERO database (registration number CRD42024541416). Full article

Background/Objectives:The co-occurrence of Attention-deficit/hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) is very common and worsens adaptive functioning. This systematic review evaluates both pharmacological and non-pharmacological interventions in this underserved population. Methods: Registered on PROSPERO (CRD42024526157), a systematic search was conducted on PubMed, Embase, and Web of Science until 5 April 2025. The review includes (a) pilot studies and RCTs, (b) participants aged <18 years, (c) diagnoses of ASD and ADHD based on DSM-IV/V or ICD-9/10, (d) at least one group receiving any intervention, and (e) publications in English, Italian, Spanish, or German. Newcastle Ottawa Scale tools for non-randomized studies and the Cochrane Risk of Bias Tools for randomized controlled trials were used to assess studies’ quality. Results: A total of 32 studies were included: 87.5% concerning pharmacological treatments. Specifically, methylphenidate (MPH, n = 11), atomoxetine (ATX, n = 11), guanfacina (n = 4), clonidine (n = 1), or atypical antipsychotics (n = 1) were examined. MPH and ATX were most frequently studied, with both showing positive effects in reducing ADHD core symptoms compared to placebo. ATX also reduces stereotyped behaviors and social withdrawal, although more withdrawals due to adverse events (AEs) were reported for ATX than MPH. Four studies (12.5%) examined non-pharmacological interventions, including treatment with virtual reality tools, digital platforms, educational animations, and biomedical protocols; improvements in emotion recognition, behavioral regulation, attention, and social functioning were found. Conclusions: While limited data prevent definitive conclusions, MPH and ATX appear to be relatively safe and effective on hyperactivity-impulsivity symptoms, even in individuals with ASD. Evidence on non-pharmacological treatments is limited, and further studies are needed to better establish their therapeutic potential. Full article

Context: Planting forests is an important strategy to combat biodiversity loss and ecosystem service degradation, but its effects on biodiversity and ecosystem services remain uncertain. Objectives: This study aimed to investigate the restoration of plants along successional and environmental gradients in planted forests by examining how understory plant diversity (species richness, composition, functional diversity), functional diversity—the range of species’ traits influencing ecosystem functions and services and their environmental drivers—evolve in temperate plantations over time. Methods: We examined a total of 36 plots with different stand ages in Chongli District, China, and compared the differences in species richness, biodiversity, composition, and functional diversity across different successional stages and over time. We also analyzed the response mechanisms of species richness and functional diversity to environmental factors at both the local and landscape scales. Results and Discussion: Our results showed species diversity, species richness, and functional diversity tended to increase with time in most plots and stabilized after 45 years. Although species richness was lower in mature plots (>100 years), functional diversity was higher, and species composition was significantly differentiated. This trade-off reflects environmental filtering selecting for competitively dominant species with distinct functional traits, while continuous species turnover prevents compositional convergence. The increase in functional diversity was not directly related to the rise in species richness, but it depended on the relative dominance of several species with different functional characteristics in the ecosystem. Simulation analysis confirmed this pattern aligns with a Simpson’s index-driven trait complementarity mechanism. At the local scale, stand age was the most significant positive factor influencing species richness and functional diversity. Soil total nitrogen and organic matter only negatively affected species richness in interactions. At the landscape scale, landscape heterogeneity plays an important role in restoring functional diversity. Historical afforestation since the 1950s restricted comparisons to secondary forests, lacking primary forest baselines. Conclusions: The results suggest that the effects of the successional stage and multiscale environmental factors should be comprehensively considered in the restoration strategy of restored forests. Full article

The aim of the study was to verify the relationship between musculoskeletal pain of elite Polish goalball players and selected physique and posture characteristics. We examined 12 players. The mean age was 21.8 ± 6.0 years, and a mean training experience of 6.3 ± 3.4 years. Physique (body mass, body height, waist circumference, fat tissue, fat-free soft tissue) and posture (thoracic kyphosis and lumbar lordosis) and range of motion (in the thoracic and lumbar regions) were assessed. The incidences and locations of musculoskeletal pain were identified using the Nordic Musculoskeletal Questionnaire, covering the period from the last seven days (NMQ-7) and six months (NMQ-6). Due to the small group size, non-parametric tests (Spearman’s rank correlation) were used. The significance level was set at p < 0.05. Players were more likely to report musculoskeletal pain in the last six months than in the previous week. Pain reported in both NMQ6 and NMQ7 was most common in the wrists/hands and lower back, and, in NMQ6, also in the shoulders and ankles/feet. There were significant negative correlations of total NMQ7 with lumbar lordosis angle in the habitual standing position (R = −0.6; p = 0.04), trunk flexion (R = −0.8, p = 0.002), and trunk extension (R = −0.6; p = 0.03), and a positive correlation with thoracic kyphosis angle in trunk flexion (R = 0.8, p = 0.005). There was a statistically significant, inversely proportional relationship of thoracic kyphosis angle values in the habitual position (R = −0.58; p = 0.049) and thoracic kyphosis angle THA in trunk flexion (R = −0.6; p = 0.038) with time of disability. Relationships between some body posture parameters and musculoskeletal pain in the studied athletes were also noted. Full article

Epigenetic biomarkers offer promising potential for early identification and risk stratification of frail individuals susceptible to adverse cardiovascular outcomes. This scope review aimed to identify and evaluate epigenetic biomarkers concurrently associated with frailty and increased cardiovascular risk, potentially facilitating more precise patient stratification and treatment decisions. A two-stage literature search was performed using PubMed, Scopus, Web of Science, and Embase databases from the year 2000 through 27 December 2024. Stage 1 identified studies reporting epigenetic biomarkers associated with frailty in blood-derived human samples. Stage 2 assessed cardiovascular relevance by screening the frailty biomarkers identified in Stage 1 for their documented association with cardiovascular diseases. Two independent reviewers conducted screening, data extraction, and risk-of-bias assessments, resolving disagreements via a third reviewer. The primary outcomes were the association of biomarkers with frailty severity and cardiovascular risk. Key epigenetic biomarkers identified included microRNAs (particularly miR-21, miR-146a, miR-451, and miR-92a) and DNA methylation markers (LINE-1 methylation, epigenetic clocks like GrimAge and DunedinPACE, and possibly novel, emerging clocks like DNAmCVDscore and the Smoking Index). Due to specificity limitations, these biomarkers are most promising when used collectively as part of multimarker panels rather than individually. Future research should validate multimarker panels, explore novel biomarkers, and assess clinical integration to optimize precision medicine in frail cardiovascular populations. Full article

Background/Objectives: Congenital rubella syndrome (CRS) is an infection caused by rubella virus transmitted to the fetus during pregnancy, which can cause congenital hearing loss. Cochlear implant can be an effective therapy in patients with severe to profound bilateral hearing loss. The aim of this study was to evaluate the benefits of cochlear implantation in patients with profound hearing loss caused by congenital rubella syndrome. Methods: In total, 38 patients with profound hearing loss caused by intrauterine rubella virus infection were considered for cochlear implantation. Patients ranged in age from 8 to 72 years on the day of surgery, with a mean age of 27 years and median of 25 years (SD = 13.2). Preoperatively, all patients underwent pure-tone audiometry, and free-field speech audiometry was conducted in a quiet environment with the patient wearing a fitted hearing aid. Postoperatively, patients underwent pure-tone audiometry to assess residual hearing, and free-field speech audiometry was conducted when the patients had an active implant. Results: The average preoperative hearing threshold (averaged across the seven frequencies from 0.125 to 8 kHz) was 99.2 dB HL (SD = 6.79), while the average postoperative hearing threshold was 103.4 dB HL (SD = 5.74). Twelve months after the operation, patients achieved a WRS in quiet scores ranging from 10% to 90%, with an average of 59.1% and median of 70% (SD = 25.8). Conclusions: Rubella during pregnancy can lead to severe congenital defects, with sensorineural hearing loss being the most common. Cochlear implants appear to be an effective treatment for profound hearing loss caused by congenital rubella syndrome. Full article

This paper investigates the relationship between ball spin and linear speed in table tennis. This study uses a simple photodiode montage to introduce a methodology for measuring spin based on light reflection on the ball’s surface. Two optical-based measurement systems were developed to measure either the ball’s speed or spin. This paper describes sensor calibration and error estimation. Those systems measured ball kinetic parameters from nine young elite players (aged 15 ± 1.5 years) who volunteered to perform 4 exercises. Results showed a strong positive linear relationship between the ball’s speed and spin (r = 0.96, R² = 0.93, p < 0.001). The effect of exercise conditions on ball speed has been studied using a statistical test, ANOVA. Results showed a significant main effect of exercise conditions on ball speed (p < 0.05) with a very large effect size (η² = 0.82). The study revealed significant variations in linear speed based on the type of stroke (backhand, forehand) and the incoming ball’s spin (topspin, backspin), with topspin forehand strokes achieving higher speeds compared to backhand strokes. These findings provide valuable knowledge for players to enhance performance in a competitive environment. Full article

Climate change, marked by decreasing rainfall and increasing extreme events, represents a major challenge for water resources, particularly in semi-arid regions. To estimate aquifer recharge, it is essential to assess the fraction of precipitation contributing to groundwater recharge and to implement a water balance model. However, the limited number of rainfall stations has led researchers to rely on satellite and reanalysis rainfall products. The accuracy of these datasets is essential for reliable hydrological modeling. In this study, we evaluated five rainfall products—CHIRPS, ERA5_Ag, CFSR, GPM, and PERSIANN-CDR—by comparing them to ground measurements from gauging stations in the central Haouz region of Marrakech. The evaluation was conducted at three temporal scales: daily, monthly, and annual. Statistical metrics, including RMSE, MAE, NSE, Bias, and Pearson correlation, as well as classification metrics (accuracy, F1 score, recall, precision, and Cohen’s Kappa), and wavelet analysis, were applied to assess the accuracy of the products. The results identified ERA5_Ag and GPM as the most accurate products in capturing rainfall events. Nevertheless, ERA5_Ag showed a high bias. After applying the quantile mapping method to correct the bias, the product exhibited greater accuracy. The corrected datasets from these two products will be used to estimate recharge over the last 30 years, contributing to the development of a hydrogeological model for groundwater dynamics. Full article