Search Results (31,797)

Background: Obesity is a multisystemic health problem causing chronic diseases like diabetes or cardiovascular diseases, but also reproductive dysfunctions like infertility in adults or altered puberty onset in children. Exercise is a recognized intervention to control or prevent energy imbalance, thus deeply contributing to metabolic health in physiological and pathological conditions. The kisspeptin system (KS), the main gatekeeper of reproduction and puberty onset in mammals, is also an upcoming “metabolic sensor”, linking energy homeostasis to reproductive ability both centrally and peripherally. Objectives: This narrative review aims at summarizing recent evidence from animal models and human studies on the role of the KS in energy homeostasis, with a focus on the upcoming role of the KS as a metabolic sensor able to modulate the functionality of the hypothalamus–pituitary–gonad axis in males as an adaptive response to exercise. Methods: PubMed and Scopus search (date: 2015–2025; keywords: kisspeptin and metabolism, male reproduction or exercise; kisspeptin and doping). Results and Conclusions: This review article illustrates the crucial role of the KS in linking energy homeostasis and male reproduction at the central and peripheral levels, and modulation of the KS by exercise in physiological and pathological conditions. Due to the large amount of data from animal models, knowledge gaps occur in the analysis of the relationship among KS, energy homeostasis, male reproduction and exercise in humans, particularly in the case of overtraining. Lastly, kisspeptin inclusion in the doping list is also discussed. Full article

Background: There is a worldwide increase in the prevalence of type 2 diabetes, and strategies for managing this condition include dietary interventions. These interventions include the use of a low-glycaemic index diet, high-fibre and prebiotic diets, and low-carbohydrate diets (LCDs), which improve glycaemic control, reduce the risk of diabetic complications, and promote health. However, the definition of LCDs varies across the literature, and the use of LCDs in managing people with diabetes is often seen as controversial. Therefore, the aim of this review is to examine current advances and future prospects in the use of LCDs in managing people with type 2 diabetes. Method: A systematic review of randomised controlled trials, which applied both the PRISMA and PICOS frameworks. Databases including MEDLINE, APA PsycInfo, Academic Search Premier, CINAHL Plus with Full Text, APA PsycArticles, and Psychology and Behavioural Sciences Collection were searched through EBSCOHost. The EMBASE database and reference list of articles were also searched for articles of interest. Two researchers conducted the searches independently from database inception to 28/04/25. However, based on the inclusion criteria, the year of publication of studies was restricted to articles published from 2021. The search terms were combined using Boolean operators (AND/OR), and duplicates were removed in EndNote. The articles were screened for eligibility based on inclusion and exclusion criteria by two researchers. Results: The findings identified that an LCD is significantly (p < 0.05) more effective in reducing glycaemic parameters compared to a usual diet, standard care, or a control diet in people with type 2 diabetes. Similarly, the effect of LCD was significant (p < 0.05) in reducing BMI in patients with type 2 diabetes compared with the control diet. However, an LCD did not appear to have a significant (p > 0.05) effect on lipid parameters compared to a control diet. Conclusion: This systematic review found that LCDs are significantly (p < 0.05) more effective in promoting glycaemic control than a usual diet, standard care, or a control diet in people with type 2 diabetes. In addition, LCDs can be an effective strategy for reducing BMI in individuals with type 2 diabetes, particularly when implemented as part of a structured, sustained dietary intervention. However, there was variability in the findings of the studies included with respect to glycaemic control and BMI. Furthermore, the impact of LCD on glycaemic control did not appear sustainable in the long term. LCDs did not have a significant (p > 0.05) effect on lipid parameters compared to a control diet. Full article

Metabolic syndrome refers to a group of conditions that commonly occur together, including abdominal obesity, high blood pressure, elevated blood sugar, high triglyceride levels, and low high-density lipoprotein cholesterol (HDL). These factors collectively increase the risk of cardiovascular disease, diabetes, and cognitive impairment. Recent research has identified a connection between metabolic syndrome and cognitive disorders such as mild cognitive impairment and vascular dementia (VaD). Mulberry (Morus alba L.) is a natural source of bioactive compounds with antioxidant, anti-inflammatory, and lipid-regulating properties. This meta-analysis assessed the potential of mulberry extract as an adjunctive treatment for metabolic risk factors linked to vascular dementia. We systematically reviewed randomized controlled trials (RCTs) published up to May 2025 that compared mulberry extract to placebo or standard care in adults with metabolic disorders. Fifteen trials including 1202 participants met the inclusion criteria. The primary outcomes were fasting glucose, fasting insulin, liver enzyme levels, lipid profiles, and inflammatory markers such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP). The pooled results indicated that mulberry supplementation improved blood sugar control and lowered total cholesterol, low-density lipoprotein cholesterol (LDL), triglycerides, fasting blood glucose, glycosylated hemoglobin (HbA1c), homeostasis model assessment for insulin resistance (HOMA-IR), and inflammatory markers. Aspartate aminotransferase (AST) improved, whereas alanine aminotransferase (ALT) showed no significant change. Subgroup analyses revealed that greater benefits were associated with shorter treatment durations and doses below 500 milligrams per day. Furthermore, extracts from different parts of the mulberry plant showed varying effects on lipid and glucose metabolism. None of the included trials directly measured cognitive or neurovascular outcomes, so any potential neurovascular protection is inferred from changes in metabolic and inflammatory markers rather than demonstrated. In summary, these findings suggest that mulberry extract may be a promising complementary approach for managing metabolic risk factors in people at risk for VaD. However, further large-scale and rigorously designed studies are required to confirm its clinical benefits and to identify the most effective preparations. Full article

This study examines the relationship between attitudes toward artificial intelligence (AI) and AI dependency among Ecuadorian university students. A cross-sectional design was used, applying two validated instruments: the Artificial Intelligence Dependence Scale (DAI) and the General Attitudes Toward Artificial Intelligence Scale (GAAIS), with a sample of 540 students. Structural equation modeling (SEM) assessed how both positive and negative attitudes predict dependency levels. Results indicate a moderate level of AI dependency and an ambivalent attitudinal profile. Both attitudinal dimensions significantly predicted dependency, suggesting dual-use behaviors shaped by perceived utility and ethical concerns. Urban students reported higher dependency and greater sensitivity to AI-related risks, highlighting digital inequalities. Although the SEM model showed adequate comparative fit (CFI = 0.976; TLI = 0.973), residual indicators (RMSEA = 0.075) suggest further refinement is needed. This study contributes to underexplored Latin American contexts and emphasizes the need for equity-driven digital literacy strategies in higher education. Findings support pedagogical frameworks promoting critical thinking, ethical reasoning, and responsible AI use. The study aligns with Sustainable Development Goals 4 (Quality Education) and 10 (Reduced Inequalities), reinforcing the importance of inclusive, learner-centered approaches to AI integration. Full article

This systematic literature review pioneers the synthesis of cybersecurity challenges for automotive digital twins (DTs), a critical yet underexplored frontier in connected vehicle security. The notion of digital twins, which act as simulated counterparts to real-world systems, is revolutionizing secure system design within the automotive sector. As contemporary vehicles become more dependent on interconnected electronic systems, the likelihood of cyber threats is escalating. This comprehensive literature review seeks to analyze existing research on threat modeling and security testing in automotive digital twins, aiming to pinpoint emerging patterns, evaluate current approaches, and identify future research avenues. Guided by the PRISMA framework, we rigorously analyze 23 studies from 882 publications to address three research questions: (1) How are threats to automotive DTs identified and assessed? (2) What methodologies drive threat modeling? Lastly, (3) what techniques validate threat models and simulate attacks? The novelty of this study lies in its structured classification of digital twin types (physics based, data driven, hybrid), its inclusion of a groundbreaking threat taxonomy across architectural layers (e.g., ECU tampering, CAN-Bus spoofing), the integration of the 5C taxonomy with layered architectures for DT security testing, and its analysis of domain-specific tools such as VehicleLang and embedded intrusion detection systems. The findings expose significant deficiencies in the strength and validation of threat models, highlighting the necessity for more adaptable and comprehensive testing methods. By exposing gaps in scalability, trust, and safety, and proposing actionable solutions aligned with UNECE R155, this SLR delivers a robust framework to advance secure DT development, empowering researchers and industry to fortify vehicle resilience against evolving cyber threats. Full article

Virtual-reality exposure therapy (VRET) is an emerging treatment for psychiatric disorders that enables immersive and controlled exposure to anxiety-provoking stimuli. Recent developments integrate real-time physiological monitoring, including heart rate (HR), electrodermal activity (EDA), and electroencephalography (EEG), to dynamically tailor therapeutic interventions. This systematic review examines studies that combine VRET with physiological data to adapt virtual environments in real time. A comprehensive search of major databases identified fifteen studies meeting the inclusion criteria: all employed physiological monitoring and adaptive features, with ten using biofeedback to modulate exposure based on single or multimodal physiological measures. The remaining studies leveraged physiological signals to inform scenario selection or threat modulation using dynamic categorization algorithms and machine learning. Although findings currently show an overrepresentation of anxiety disorders, recent studies are increasingly involving more diverse clinical populations. Results suggest that adaptive VRET is technically feasible and offers promising personalization benefits; however, the limited number of studies, methodological variability, and small sample sizes constrain broader conclusions. Future research should prioritize rigorous experimental designs, standardized outcome measures, and greater diversity in clinical populations. Adaptive VRET represents a frontier in precision psychiatry, where real-time biosensing and immersive technologies converge to enhance individualized mental health care. Full article

The Atlantic chub mackerel (Scomber colias) is a nutritionally valuable species with potential for inclusion in school canteens. This study aimed to develop and evaluate mackerel-based products processed through marination, vacuum packaging, and sous-vide cooking. Following collective interviews with school canteen staff to assess acceptability and logistical suitability, the preferred variants—raw, marinated, and sous-vide marinated fillets—were subjected to a 49-day refrigerated storage trial, during which physicochemical and microbiological parameters were monitored. Results showed that sous-vide processing significantly improved product stability, with enhanced water retention, reduced microbial growth (mesophile and psychrophile abundances below 7 log CFU/g up to day 21 vs. day 7 in raw and marinated fillets), and lower levels of spoilage indicators such as TVB-N, kept within acceptable limits of 25–35 mg N/100 g until day 28 of storage. Although sous-vide fillets showed slightly higher lipid oxidation (TBARS of 11.52 mg MDA/kg vs. 8.82 and 6.94 mg MDA/kg in marinated and raw fillets), they maintained superior texture and water retention. Overall, sous-vide proved highly effective in preserving the quality and extending the shelf-life of mackerel fillets, supporting its application in institutional food services as a strategy to promote healthier eating habits among children. Full article

Occupational burnout is ubiquitous yet still debated as a disease entity. Previous reviews surveyed multiple biomarkers but left their neural substrate unclear. We therefore asked: What, if any, reproducible magnetic-resonance signature characterises burnout? Following PRISMA principles adapted for mechanistic synthesis, two reviewers searched PubMed, Scopus, Google Scholar, ResearchGate and Cochrane from January 2000 to May 2025 using “MRI/fMRI” AND “burnout”. After duplicate removal and multi-stage screening, 17 clinical studies met predefined inclusion criteria (English language, MRI outcomes, validated burnout diagnosis). In total, ≈1365 participants were scanned, 880 with clinically significant burnout and 470 controls. Uniform Maslach Burnout Inventory thresholds defined cases; most studies matched age and sex, and all excluded primary neurological disease. Structural morphometry (8/17 studies) revealed consistent amygdala enlargement—predominantly in women—and grey-matter loss in dorsolateral/ventromedial prefrontal cortex and striatal caudate–putamen, while hippocampal volume remained unaffected, distinguishing burnout from PTSD or depression. Resting-state and task fMRI (9/17 studies) showed fronto-cortical hyper-activation, weakened amygdala–ACC coupling, and progressive fragmentation of rich-club networks, collectively indicating compensatory executive overdrive and global inefficiency. Two longitudinal cohorts and several intervention sub-studies demonstrated partial reversal of cortical thinning and limbic hyper-reactivity after mindfulness, exercise, cognitive-behavioural therapy, neurofeedback, or rTMS, underscoring plasticity. Across heterogeneous paradigms and populations, MRI converges on a coherent, sex-modulated but reversible brain-networkopathy that satisfies objective disease criteria. These findings justify early neuro-imaging-based triage, circuit-targeted therapy, and formal nosological recognition of burnout as a mental disorder, with policy ramifications for occupational health and insurance parity. Full article

Designing fire evacuation strategies for hospitals involves navigating complex infrastructure and accommodating the unique needs of patients, many of whom may have limited mobility or require specialized support during emergencies. This study examines critical egress parameters and their impact on evacuation efficiency in hospital environments, emphasizing configurations that can improve safety and reduce evacuation time. Although the inclusion of smoke effects in recent evacuation models is gaining traction, their combined impact with assisted evacuation scenarios in hospital settings remains underexplored. By integrating smoke propagation data into evacuation modelling, we analyze the effects of reduced visibility and smoke spread on egress routes and occupant behavior. Findings show that smoke effects significantly increase evacuation time estimates (around 50%) compared to traditional models (without accounting for smoke effects), highlighting the risk of underestimation in practical applications, particularly in regions where strict codal compliance is lacking. The study also reveals that stairway width, number, and location substantially affect evacuation times, with about 40% reduction achieved by increasing stairway width from 44 to 66 inches. Additionally, situational awareness enhancements, such as real-time information on fire location and safe exits, can improve evacuation efficiency by about 35%. For taller hospital buildings, the findings highlight the need for implementation of situational awareness in addition to optimized egress planning to achieve safe and efficient evacuation strategies. Full article

Accessing the built environment poses many challenges for people with disabilities, severely affecting their independence and quality of life. A panel of experts with a lived experience of disabilities co-designed a survey capturing the challenges in New Zealand’s public places. There were 319 survey respondents with impairments related to mobility (66.5%), vision (18.8%), hearing (5.0%), sensory processing and cognition (8.8%). They perceived sports stadiums as the least accessible venue, followed by bars, boutique shops and public toilets. The most accessible venues were supermarkets, libraries and shopping malls. The type of disability affected the main accessibility challenges. Significant outdoor barriers included uneven and cluttered paths, inadequate provision of curb cuts, seating and accessible parking spaces, and obscure wayfinding. Entrance barriers included heavy doors, complex access control, remote ramps and narrow, obscure entrances. Interior problems included cluttered paths and poor signage. The top priorities for improvement were simplifying layouts, keeping paths clear, and providing clear, inclusive signage, communication and assistance for people with varying impairments. Providing lower counters, better colour contrast, hearing loop facilities and better control of lighting and acoustics also improve accessibility. This research contributes novel experiential data from people with disabilities that is critical to achieving an inclusive built environment. Full article

Gold mineralisation at Ity (Ivory Coast) is spatially associated with skarns formed at contacts between carbonate-rich Birimian volcano-sedimentary rocks and felsic intrusions, whereas at Dahapleu, a nearby skarn-free prospect, gold occurs in structurally controlled shear zones. Gold occurs as native gold in pyrite or as a Bi–Te–Au–Ag telluride assemblage. Fluid inclusion data indicate that Ity formed through a hybrid model: a mesothermal orogenic gold system dominated by CO₂–CH₄ fluids at >350 °C, superimposed on earlier skarn mineralisation characterised by saline fluids. At Dahapleu, no skarn fluids were identified, but volatile-rich inclusions with more variable signatures (CO₂, CO₂–CH₄, CO₂–N₂) indicate metamorphic fluids circulating in convective, fault-related systems and recording distinct fluid–rock interactions. The Ity–Dahapleu mineralising system thus displays fluid inclusion characteristics typical of mesothermal orogenic gold systems, likely at higher temperatures than most West African Birimian deposits. Overall, the Ity system reflects a long-lived thermal anomaly driving fluid circulation and metal deposition, with successive favourable events: rapid exhumation of hot lithospheric crust, granite intrusion, and skarn formation, followed by shear deformation and hydrothermal activity. Full article

Pulse width modulation (PWM) allows for the real-time flow rate adjustment of spray nozzles without changing system pressure, indicating that PWM is a promising technology for improving the quality of pesticide applications. However, its effect on the droplet formation process is not yet fully understood. In this study, the effects of a PWM system on the droplet spectrum and velocity generated by different flat fan hydraulic nozzles were evaluated. The experiment was conducted via a spray simulator to test the impact of PWM technology under various operational conditions and flat fan nozzle types (standard, pre-orifice, and air inclusion). With the aid of a real-time particle analyzer and high-resolution imaging, the following variables were analyzed: volume median diameter (VMD), relative span, droplet velocity, and the percentage of volume composed of droplets with a diameter smaller than 100 µm. Four simulated working speeds (1.1, 1.7, 2.8, and 3.9 m s⁻¹), which were equivalent to four PWM valve duty cycles (35%, 42%, 71%, and 100%), respectively, were evaluated. The PWM system altered the droplet size, generally reducing the VMD in comparison to the conventional system. The relative span was not influenced by the PWM system’s duty cycle, although system activation increased droplet size heterogeneity in some nozzle types. The droplet velocity was generally slower using the PWM system in comparison with the conventional system, but higher duty cycles increased this parameter. Overall, the results of this study suggest that spray patterns are altered by PWM activation, and the traits of this behaviour depend on the spray nozzle type. Full article

Objective: This systematic review and meta-analysis aimed to evaluate the effects of moisture control strategies (including wet-bonding techniques, universal adhesives, and etching type) on dentin bonding performance in restorative dentistry. Methods: A comprehensive literature search was conducted across PubMed, Scopus, and Google Scholar, following PRISMA guidelines. Only in vitro and ex vivo studies comparing wet- and dry-bonding protocols, using human dentin substrates, and reporting microtensile bond strength (μTBS) were included. The data were synthesized using a random-effects meta-analysis and the methodological quality was assessed using the MINORS tool. Certainty of evidence was evaluated using the GRADE framework. Results: Nine studies met the inclusion criteria, eight of which were included in this meta-analysis. The moisture control strategies significantly influenced the bonding outcomes, with ethanol and acetone wet bonding yielding higher μTBS and enhanced hybrid layer morphology. The universal adhesives performed effectively under both moist and dry conditions, although their performance varied by the adhesive composition and solvent system. The meta-analysis revealed a statistically significant advantage for hydrated dentin (SMD = +1.20; 95% CI: 0.52 to 1.86; p < 0.001), with the moist and ethanol-treated substrates outperforming the dry and over-wet surfaces. The long-term durability was better preserved with ethanol and acetone pretreatments and the adjunctive use of chlorhexidine. Conclusions: Moisture conditions influence dentin bond strength, but modern universal adhesives show consistent bonding performance across different moisture conditions. Solvent-wet-bonding protocols, particularly with ethanol or acetone, enhance the immediate and long-term performance. While the current evidence is limited by the in vitro designs and heterogeneity, the findings demonstrate protocol flexibility and highlight strategies to optimize adhesion in clinical practice. Future clinical trials are necessary to validate these approaches under real-world conditions. Full article

The proper development of groundwater resources is very important in many parts of the world. Its planning requires mathematical simulation of groundwater flows. Simulation can be either analytical or numerical. Analytical tools, when available, require fewer computational resources, but they are usually based on more assumptions, at the conceptual level, which restrict their applicability. In this paper, we aim to check the applicability of one-dimensional analytical solutions for groundwater flows through non-homogeneous aquifers, which are bound by two constant head and two impermeable boundaries and bear many zones of different transmissivities. These solutions are based on the stepwise inclusion of neighboring zones to larger ones, with equivalent transmissivity coefficients. We compare analytical results with numerical ones, obtained from a two-dimensional numerical model. We have selected the boundary element method (BEM) for this task. BEM is very versatile in solving steady-state groundwater flow problems, since discretization is restricted to external and internal field boundaries only. This feature fits perfectly with our research, which requires flow velocities at the boundaries only. Our research shows that analytical results can serve as upper and lower limits of total inflow. If the differences between the transmissivities of adjacent zones are small, they can be used in preliminary calculations too. Full article

Immigrant and mixed-status families comprise a growing population in the United States, facing numerous barriers to accessing essential health and social services. This study examines service access barriers within the unique context of New Mexico’s borderlands, where constitutionally protected bilingualism and welcoming local policies contrast sharply with restrictive federal border enforcement. Using a qualitative approach, we conducted five focus groups with 36 immigrant caregivers in Doña Ana County, New Mexico, with the objective of understanding the factors that facilitate and hinder immigrant families’ access to health, behavioral health, and social services in this socio-politically complex border environment. Thematic analysis revealed three overarching themes: (1) structural and organizational limitations, including language barriers and transportation challenges exacerbated by border checkpoints; (2) the persistence of “chilling effects” on service use despite a Democratic presidency and post-pandemic policy shifts; and (3) community-defined recommendations for improving service access. The findings demonstrate how federal immigration enforcement undermines local inclusion efforts, creating enduring barriers to service access even in historically bilingual, immigrant-friendly regions. The participants proposed specific solutions, including mobile service units and integrated service centers, that account for both geographic and socio-political barriers unique to border regions. These community-generated recommendations offer practical strategies for improving immigrant service access in contexts where local welcome and federal enforcement create competing pressures on immigrant families. Full article