Search Results (3,169)

As society ages, there is a growing concern about the comfort and health of elderly people. Although populations around the world, including Slovenia, are rapidly aging, evidence that increasing longevity is being accompanied by an extended period of good health is scarce. An increasing number of older adults live with chronic diseases, functional limitations, or frailty. In 2025, Slovenia launched the project Systemic Approach to Frailty with a Focus on Pre-Frailty for Healthy and Hight-Quality Ageing, within the European Cohesion Policy Programme 2021–2027, aiming to address frailty through multidimensional and community-based interventions. In addition to presenting the project framework, this paper provides an analytical preliminary review of existing literature, critically reflecting on research gaps in the field. The main aim of this paper is to explore the possibilities for creating healthy living environments that support the prevention and management of frailty. The project’s core innovation lies in the integration of public health principles into urban planning and design through a structured, community-based approach and the use of the Living Environmental Assessment (OBO) Tool. This tool enables urban planners, municipalities, and local communities to collaboratively evaluate and co-design living environments (e.g., optimizing walkability, green space access, barrier-free design, and social amenities) to build resilience and independence among older adults. Designing inclusive, accessible, and health-promoting environments can help to prevent frailty and improve well-being across all age groups. Full article

Antioxidants, such as flavonoids, are influential secondary metabolites that play a significant role in regulating human health. Açaí, known for its potent antioxidant properties, has gained popularity in the nutritional field. However, there is a need for accurate methods to quantify its antioxidant capacity. Therefore, the goal of this investigation was to determine the total antioxidant capacity of frozen açaí pulp by applying the concept of the electrochemical quantitative index (EQI) using the cyclic voltammetry technique. The electrochemical response of ethanolic extracts obtained by a nonconventional ultrasound bath was investigated in the anodic region. The results clearly showed redox behavior at +0.37 V and +0.27 V (vs. Ag/AgCl) for the anodic and cathodic peaks, respectively, when evaluated by cyclic voltammetry at a glassy carbon (GC) electrode. By investigating a constant ethanolic extract concentration (0.2%) and analyzing the scan rate and supporting electrolyte effects, it was determined that the frozen açaí pulp extract presented an EQI of about 2.3 µA/V. Similarly, the concept of the EQI was extended to the use of the differential pulse voltammetry profile of a 0.2% ethanolic açaí extract on different supporting electrolytes, which showed that some experimental conditions needed improvement. Still, maintaining pH with a buffer solution in the anodic region is crucial to ensure reproducibility. The antioxidant capacity was also determined using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical assay to compare the electrochemical results. The Folin–Ciocalteu colorimetric test was applied to determine the total phenolic content of the extract. Full article

Background: Musculoskeletal disorders (MSDs) are a significant health problem associated with performing professional activities. The occurrence of pain often determines the type of work undertaken. Healthcare workers and public administration employees are occupational groups at risk of developing musculoskeletal disorders. The aim of this study was to compare the incidence and location of MSDs between two professional groups—healthcare and administrative workers—and to assess their impact on professional functioning. Methods: The study included 339 employees, comprising 188 healthcare workers and 151 administrative workers. An extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E) was used. Results: Healthcare workers experienced MSDs significantly more often than administrative workers, both in the past and in the last 12 months. MSDs in healthcare workers more often led to absenteeism, changes in duties, use of healthcare services, and medication use. The observed differences were statistically significant, particularly in the upper and lower limbs. Conclusions: Musculoskeletal disorders (MSDs) are a significant health problem among healthcare and administrative workers, but they affect healthcare staff much more frequently, especially in the upper and lower limbs. This results in higher sick leave rates, the need to modify duties, and more frequent use of treatment and painkillers. These differences may result from varying working conditions, age, and education, highlighting the need to implement preventive measures tailored to the specific characteristics of each professional group. Full article

Epoxy resins used in reactors are prone to cracking and failure due to mechanical vibration, thermal stress, and ultraviolet radiation. Improving their resistance to damage is important to extend the service life of reactors. This investigation develops a self-healing imidazole-cured epoxy resin for reactors using epoxy microcapsules and amine microcapsules prepared by electrospraying-interfacial polymerization (ES-IP) microencapsulation technique. Firstly, this investigation studies the feasibility of using double nozzles for simultaneous spraying to improve the preparation of small-sized microcapsules. After successful synthesis, the healing performance of self-healing imidazole-cured epoxy based on the microencapsulated epoxy-amine chemistry was studied, focusing on the influence of the ratio, concentration, and size of the two microcapsules on the healing efficiency, and further exploring the thermal stability of the self-healing performance. The addition of microcapsules to the mechanical properties was also investigated. Results show that the double-nozzle technique can prepare microcapsules with controllable sizes (20~200 μm). The self-healing imidazole-cured epoxy exhibits high self-healing performance, reaching 100% at the optimal ratio with 10.0 wt% 50~100 μm microcapsules. Although the added microcapsules reduce the tensile strength of the material, they improve its high-temperature aging resistance. The above investigation is significant for developing self-healing fiber-reinforced epoxy-based composite materials for reactors. Full article

Calcium aluminate cement (CAC) offers rapid strength development, chemical durability in harsh environments, and high-temperature resistance, but its long-term performance may be compromised by the conversion of metastable hexagonal hydrates into stable cubic phases. Concurrently, recycling spent fluorescent lamp glass (SFLG) is limited because of its residual mercury content. This study investigates the use of manually (MAN) and mechanically (MEC) processed SFLG as partial CAC replacements (up to 50 wt.%). Both SFLG types had irregular morphologies with mean particle sizes of ~20 µm and mercury concentrations of 3140 ± 61 ppb (MAN) and 2133 ± 119 ppb (MEC). Moreover, the addition of SFLG reduced the initial and final setting times, whilst MEC waste notably extended the plastic state duration from 20 min (reference) to 69 min (50 wt.% MEC). Furthermore, strength development was accelerated, with SFLG/CAC mortars reaching peak strengths at 7–10 days versus 28 days as in the CAC reference. CAC and 15 wt.% SFLG mortars showed strength loss over time by reason of their phase conversion, whereas mortars with 25–50 wt.% SFLG experienced significant long-term strength gains, reaching ~60 MPa (25 wt.%) and ~45 MPa (35 wt.%), respectively, after 365 days, with strength activity indexes (SAI) near 90% and 70%, respectively. These improvements are attributed to the formation of strätlingite (C₂ASH₈), which stabilized hexagonal CAH₁₀ and mitigated conversion to cubic katoite (C₃AH₆). Mercury leaching remained below 0.01 mg/kg dry matter for all mixes and curing ages, classifying the mortars as non-hazardous and inert under Spanish Royal Decree 646/2020. The results suggest that SFLG can be safely reused as a sustainable admixture in CAC systems, enhancing long-term mechanical performance while minimizing environmental impact. Full article

Aim: The aim of this preliminary study was to explore the visual attention in children with ADHD using eye-tracking, and to identify a relevant quantitative proxy of their attentional control. Methods: Twenty-two children diagnosed with ADHD (aged 7 to 12 years) and their 24 sex-, age-matched control participants with typical development performed a visual sustained-fixation task using an eye-tracker. Fixation stability was estimated by calculating the bivariate contour ellipse area (BCEA) as a continuous index of gaze dispersion during the task. Results: Children with ADHD showed a significantly higher BCEA than control participants (p < 0.001), reflecting their increased gaze instability. The impairment in gaze fixation persisted even in the absence of visual distractors, suggesting intrinsic attentional dysregulation in ADHD. Conclusions: Our results provide preliminary evidence that eye-tracking coupled with BCEA analysis, provides a sensitive and non-invasive tool for quantifying visual attentional resources of children with ADHD. If replicated and extended, the increased use of gaze instability as an indicator of visual attention in children could have a major impact in clinical settings to assist clinicians. This analysis focuses on overall gaze dispersion rather than fine eye micro-movements such as microsaccades. Full article

LexTALE has emerged as a popular measure of language proficiency in research studies. While it has been widely validated for L2 learners across multiple languages, its applicability to heritage language learners (HLLs)—who often show distinct language development from L2ers—has not been established. Here, we evaluate the Spanish version of LexTALE (LexTALE-Esp) as a predictor of writing proficiency among college-aged HLLs in the United States. We show that LexTALE-Esp scores significantly correlate with ACTFL-rated functional writing levels and outperform self-assessment as a predictor of proficiency. Our results suggest that, despite concerns about HLLs’ limited experience with written texts in the heritage language, vocabulary-based tasks capture core aspects of written language ability. These findings indicate that vocabulary-based tests like LexTALE-Esp capture proficiency-relevant lexical knowledge across speaker profiles and may tap into dimensions of both core and extended language competence. Full article

Background and Aims: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) delay gastric emptying, raising concerns about periprocedural safety in elective endoscopy. We aimed to evaluate the association between pre-procedural GLP-1 RA use and post-procedural complications such as aspiration pneumonia. Methods: In this retrospective cohort study, adults (18–89 years) undergoing outpatient esophagogastroduodenoscopy or colonoscopy within the HCA Healthcare network from 1 July 2021 to 31 March 2024 were identified. Patients were classified as GLP-1 RA users (n = 953) or non-users (n = 3289) based on home medication records. Primary outcomes included aspiration, post-procedural oxygen requirement, hypotension, hospitalization, ICU admission, length of stay, and all-cause inpatient mortality. Multivariable logistic and negative-binomial regression models, incorporating an interaction term for anesthesia type, were adjusted for age, sex, body mass index, ASA class, and key comorbidities. Results: No aspiration events were reported in either group. GLP-1 RA use was associated with lower odds of post-procedural oxygen requirement (OR 0.43, 95% CI 0.25–0.76), hospitalization (OR 0.73, 95% CI 0.39–1.36), and mortality (0.1 vs. 0.9%, p = 0.014), and a shorter hospital stay (IRR 0.54, 95% CI 0.40–0.71). Rates of hypotension and ICU admission were similar between both groups. In anesthesia-stratified analysis among GLP-1 RA users, those receiving MAC/MS had higher odds of hospitalization compared with GA (OR 1.87, 95% CI 1.23–2.85, p = 0.003), whereas other outcomes were not significant. Conclusions: Pre-procedural GLP-1 RA therapy was not associated with increased peri-procedural complications. Although hospitalization was more frequent with MAC/MS, this difference did not extend to other clinically significant outcomes. Further prospective studies are needed to clarify the clinical implications of anesthesia choice. Full article

As the demand for second-life lithium-ion battery applications continues to grow, efficient cell equalization has become essential to mitigate parameter inconsistencies and extend system longevity. Owing to their diverse origins and varying aging paths, second-life batteries exhibit significant parameter dispersion, which poses distinct challenges. In light of these issues, this paper presents a comprehensive review of passive, active, and dynamic equalization technologies. It analyzes the circuit topologies and control strategies associated with each method, with a particular focus on their applicability to second-life battery systems. Furthermore, emerging trends toward intelligent, modular, and adaptive equalization are discussed. Full article

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition leading to declining lung function, dyspnea, and reduced quality of life. Pulmonary rehabilitation (PR) remains a cornerstone in COPD management; however, access remains limited, with less than 3% of eligible patients participating. Inspiratory muscle training (IMT), especially through novel methods like the Test of Incremental Respiratory Endurance (TIRE), offers a potential home-based alternative to traditional rehabilitation services. Despite growing interest, a key knowledge gap persists: few randomized trials have directly compared TIRE with threshold loading IMT over extended, largely unsupervised home-based periods while concurrently evaluating inspiratory muscle endurance and adherence. This randomized controlled trial aimed to evaluate the long-term efficacy of TIRE IMT compared to traditional threshold IMT and sham training in COPD patients. The study also assessed adherence to these home-based interventions, focusing on unsupervised periods without additional motivational support. Methods: A total of 52 COPD patients were randomly assigned to one of three groups: TIRE IMT, Threshold IMT, or Sham IMT. The study consisted of an 8-week supervised Phase I followed by a 24-week unsupervised Phase II. Training details: TIRE—session template set to 50% of the day’s maximal sustained effort; 6 levels × 6 inspirations (total 36) with preset inter-breath recoveries decreasing from 60 s to 10 s. Threshold IMT—spring-loaded valve set to 50% MIP (re-set at week 4); 36 inspirations completed within ≤30 min. Sham—valve set to minimal resistance (9 cmH₂O); 36 inspirations within ≤30 min. Primary outcomes included changes in maximal inspiratory pressure (MIP) and sustained maximal inspiratory pressure. Secondary outcomes focused on adherence rates and correlations with functional capacity. Results: Of the 52 participants, 36 completed the study. Participant details: TIRE n = 12 (mean age 60.9 ± 12.9 years), Threshold n = 12 (67.4 ± 6.9 years), Sham n = 12 (67.3 ± 8.7 years); overall 21/36 (58%) men; mean BMI 30.0 ± 7.5 kg/m². The TIRE IMT group demonstrated significantly greater improvements in MIP (31.7%) and SMIP compared to both the Threshold and Sham groups at 24 weeks (p < 0.05). Despite a decline in adherence during the unsupervised phase, the TIRE group maintained superior outcomes. No adverse events were reported during the intervention period. Conclusions: In this randomized trial, TIRE IMT was associated with greater improvements in inspiratory muscle performance than threshold and sham IMT. While adherence was higher in the TIRE group, it declined during the unsupervised phase. The clinical interpretation of these findings should consider the relatively wide confidence intervals and modest sample size. Nevertheless, the mean change in MIP in the TIRE arm exceeded a recently proposed minimal important difference for COPD, suggesting potential clinical relevance; however, no universally accepted minimal important difference exists yet for SMIP. Further adequately powered trials are warranted. Full article

Background/Objectives: High-risk human papillomavirus (HPV) is the principal etiological agent of cervical cancer, with distinct genotype-specific oncogenic potential. While HPV type 16 is most frequently implicated in carcinogenesis, the role of other genotypes and their interaction with sexually transmitted infections and cervico-vaginal dysbiosis is gaining recognition. This study aimed to assess the genotype-specific distribution of high-risk HPV among HPV-positive women from Southern Croatia and examine associations with age and co-infections with selected microbial pathogens. Methods: We conducted a retrospective cross-sectional study on 1211 HPV-positive women (out of 3098 tested) from Split and Dalmatia County between 2023 and 2024. Cervico-vaginal swabs were tested using molecular and culture-based methods for 14 high-risk HPV genotypes and several pathogens, including Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, Gardnerella vaginalis, and other microorganisms. In the analysis, each detected HPV genotype was also treated as a distinct line-level observation. Genotypes were grouped by phylogenetic and carcinogenic profiles, and statistical analyses—including chi-square tests and multinomial logistic regression—were performed to evaluate associations with age and co-infections. Results: Among high-risk HPV-positive women, the most frequently detected high-risk HPV genotypes were HPV 16 (23.3%), HPV 31 (22.4%), and HPV 51 (13.5%). Notably, HPV 18 was less prevalent (8.1%) and occurred at a similar frequency to HPV 58 and 68. Although younger age was significantly associated with high-risk HPV positivity (p < 0.001), no significant differences in HPV genotype group distribution were observed between age groups; however, C. trachomatis and Streptococcus agalactiae were significantly more prevalent in women aged ≤29 years (p < 0.001 and p = 0.029, respectively). Multinomial regression revealed that C. trachomatis was negatively associated with 16-related and lower-risk genotypes, while G. vaginalis showed a positive association with 16-related types. Conclusions: There is a complex interplay between high-risk HPV genotypes and microbial co-infections, which means the broader cervico-vaginal microbiome has to be considered in HPV risk assessment. The findings highlight the need for extended genotyping and microbial screening to inform regional prevention strategies. Full article

Background/Objectives: Ankylosing spondylitis (AS) is a chronic inflammatory disease frequently associated with acute uveitis (AU). Adalimumab, a monoclonal tumor necrosis factor (TNF) inhibitor, is widely used to manage AS and AU. While biologic tapering is recommended in stable AS, its impact on uveitis recurrence remains unclear. Methods: This real-world retrospective cohort study analyzed 65 AS patients with a history of AU who received adalimumab for ≥6 months. Time-dependent covariates, including the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), and adalimumab dosing interval, were incorporated into a logistic regression model using generalized estimating equations to identify risk factors for uveitis recurrence. Uveitis recurrence rates were compared among different dosing intervals: every 2 weeks (q2w), every 3 weeks (q3w), and every 4 weeks or longer (q4w+). Results: Among the 65 patients, 27 (41.5%) experienced a total of 50 AU flares during adalimumab treatment. Recurrence rates increased with dosing interval extension (1.5% for q2w, 3.6% for q3w, and 4.0% for q4w+; p = 0.036). In adjusted logistic analysis, the odds ratio (OR) for AU recurrence was significantly higher for q3w (OR = 3.766) and q4w+ (OR = 4.916) compared to q2w. Other factors, including age, sex, ESR, and BASDAI, were not significantly associated with uveitis recurrence. Conclusions: Extended dosing intervals of adalimumab in AS patients with prior AU may be associated with a higher prevalence of uveitis recurrence, even when axial symptoms remain controlled. Therefore, adalimumab spacing strategies should be implemented with caution in these patients to minimize the risk of uveitis recurrence. Full article

Background: Preterm birth is associated with increased risk for neurodevelopmental disorders. Although standardized tools such as the Bayley Scales of Infant and Toddler Development—Third Edition (BSID-III) are widely used for early developmental assessment, parent-report measures may offer complementary and cost-effective alternatives. The Developmental Profile 3 (DP-3) is a parent questionnaire with potential utility in preterm follow-up programs. Objective: To compare developmental outcomes of preterm infants at 12 months corrected age assessed using the BSID-III and the DP-3 questionnaires and to evaluate the agreement between these tools across cognitive, language-communication, motor, and social-emotional domains. Methods: Fifty-five preterm infants (mean GA = 30.3 weeks; mean BW = 1388 g) were assessed using both the BSID-III (administered by professionals) and the DP-3 (completed by parents) at 12 months corrected age. Mean scores were computed for each domain, and infants were assigned to the corresponding descriptive categories. The agreement between BSID-III and DP-3 scores was statistically evaluated. Results: Both instruments identified similar developmental trends, with motor development emerging as the most vulnerable domain for preterm infants. DP-3 scores were higher than BSID-III scores in virtually all domains, and absolute intraclass correlation coefficients showed a generally moderate agreement between measurements. The BSID-III identified significantly more infants at risk in the cognitive and social-emotional areas compared to the DP-3. Conclusions: The DP-3 showed fair convergence with the BSID-III, supporting its use as a complementary tool in preterm follow-up. Extending follow-up assessments into later developmental stages will be essential to more accurately determine the predictive validity of the DP-3. Full article

Objectives: Hepatitis E virus (HEV) infection is associated with severe hepatitis and high mortality rates, yet vaccination coverage remains suboptimal. Investigating public preferences for HEV vaccination is critical for developing targeted prevention strategies. This study employed a discrete choice experiment (DCE) to quantify attribute preferences and willingness-to-pay (WTP) for HEV vaccination among Chinese residents (in Shaanxi Province, for example), aiming to inform evidence-based immunization policy optimization. Methods: A cross-sectional survey recruited 3300 participants using stratified random sampling. The vaccine attributes—protective efficacy, duration of protection, and out-of-pocket cost—were identified using a systematic literature review and expert consultation. A comparative analysis of preference characteristics was conducted using conditional logit (Model 1) and mixed logit (Model 2) regression models. Population heterogeneity in vaccination preferences was further analyzed using the conditional logit framework, with marginal WTP estimated using parameter coefficients. Results: Among 3199 valid responses, duration of protection (Model 2: 10-years; β = 0.456, p < 0.001) and out-of-pocket cost (Model 2: 2000–3000 CNY; β = −0.179, p < 0.001) significantly influenced vaccination decisions. Preference heterogeneity was observed: women of childbearing age prioritized longer protection (10 years; β = 0.677, p < 0.001) and were sensitive to the cost of 1000–2000 CNY (β = 0.169, p = 0.011), while urban residents valued extended protection more than rural counterparts. Conclusions: Protection duration emerged as the primary determinant of HEV vaccination preference. Policy recommendations include implementing tiered pricing strategies and targeted health education campaigns emphasizing long-term protection benefits to enhance vaccine uptake and affordability. Full article

Artificial intelligence (AI) is revolutionarily shaping the entire landscape of medicine and particularly the privileged field of radiology, since it produces a significant amount of data, namely, images. Currently, AI implementation in radiology is continuously increasing, from automating image analysis to enhancing workflow management, and specifically, pediatric neuroradiology is emerging as an expanding frontier. Pediatric neuroradiology presents unique opportunities and challenges since neonates’ and small children’s brains are continuously developing, with age-specific changes in terms of anatomy, physiology, and disease presentation. By enhancing diagnostic accuracy, reducing reporting times, and enabling earlier intervention, AI has the potential to significantly impact clinical practice and patients’ quality of life and outcomes. For instance, AI reduces MRI and CT scanner time by employing advanced deep learning (DL) algorithms to accelerate image acquisition through compressed sensing and undersampling, and to enhance image reconstruction by denoising and super-resolving low-quality datasets, thereby producing diagnostic-quality images with significantly fewer data points and in a shorter timeframe. Furthermore, as healthcare systems become increasingly burdened by rising demands and limited radiology workforce capacity, AI offers a practical solution to support clinical decision-making, particularly in institutions where pediatric neuroradiology is limited. For example, the MELD (Multicenter Epilepsy Lesion Detection) algorithm is specifically designed to help radiologists find focal cortical dysplasias (FCDs), which are a common cause of drug-resistant epilepsy. It works by analyzing a patient’s MRI scan and comparing a wide range of features—such as cortical thickness and folding patterns—to a large database of scans from both healthy individuals and epilepsy patients. By identifying subtle deviations from normal brain anatomy, the MELD graph algorithm can highlight potential lesions that are often missed by the human eye, which is a critical step in identifying patients who could benefit from life-changing epilepsy surgery. On the other hand, the integration of AI into pediatric neuroradiology faces technical and ethical challenges, such as data scarcity and ethical and legal restrictions on pediatric data sharing, that complicate the development of robust and generalizable AI models. Moreover, many radiologists remain sceptical of AI’s interpretability and reliability, and there are also important medico-legal questions around responsibility and liability when AI systems are involved in clinical decision-making. Future promising perspectives to overcome these concerns are represented by federated learning and collaborative research and AI development, which require technological innovation and multidisciplinary collaboration between neuroradiologists, data scientists, ethicists, and pediatricians. The paper aims to address: (1) current applications of AI in pediatric neuroradiology; (2) current challenges and ethical considerations related to AI implementation in pediatric neuroradiology; and (3) future opportunities in the clinical and educational pediatric neuroradiology field. AI in pediatric neuroradiology is not meant to replace neuroradiologists, but to amplify human intellect and extend our capacity to diagnose, prognosticate, and treat with unprecedented precision and speed. Full article