Search Results (783)

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is strongly correlated with the severity of obesity, and the extent of liver fibrosis is associated with a higher risk of liver-related complications, cardiovascular events, and overall mortality. Leptin circulating levels are directly correlated with the amount of adipose tissue. Aims: In the present study, we investigated the association between circulating leptin levels and liver steatosis and fibrosis. Methods: Eighty-six patients (41.7 ± 12.6 yrs, 35 men, 41%), naïve to medications, who attended the Nutrition Center for the Research and Care of Obesity and Metabolic Diseases at the National Institute of Gastroenterology “Saverio de Bellis” for weight management, were cross-sectionally evaluated. Demographic, anthropometric, clinical, and laboratory data were collected and analyzed. All patients underwent liver ultrasonographic assessment by FibroScan to diagnose liver steatosis (controlled attenuation parameter, CAP > 275 dBm) and fibrosis (liver stiffness measurement, LSM > 8.2 kPa). Results: Sixty-three individuals (73.3%) had liver steatosis, and 17 (19.8%) had liver fibrosis. The mean leptin levels were 22.3 ± 14.1 ng/mL, while the BMI and waist circumference were 36.7 ± 7.2 kg/m² and 114.5 ± 16.4 cm, respectively. CAP values exhibited no correlation with leptin (r = 0.09, p = 0.436), while a significant connection was seen between leptin and LSM (β = 0.065; p = 0.038). Specifically, for each unit increase in leptin, LSM values were varied by +0.065 units (p = 0.038). This association was independent of gender, age, insulin resistance, adiponectin, RBP4, and visfatin. This is the first study showing these results by using FibroScan assessment in patients naïve to medications. Conclusions: Circulating leptin concentrations are independently correlated with hepatic fibrosis in individuals with a BMI ≥ 25 kg/m². These findings indicate a function for leptin in promoting liver fibrosis; however, longitudinal studies are required to elucidate the causal nature of this interaction. Full article

Bioaerosol particles contribute to the reduced indoor air quality and cause various health issues, thus their concentration must be managed. Air cleaning is one of the most viable technological options for reducing quantities of indoor air contaminants. This study assesses the effectiveness of a prototype multi-stage air cleaner in reducing bioaerosol particle viability and concentrations. The single-pass type unit consisted of non-thermal plasma (NTP), ultraviolet-C (UV-C) irradiation, bipolar ionization (BI), and electrostatic precipitation (ESP) stages. The device was tested under controlled laboratory conditions using Escherichia coli (Gram-negative) and Lactobacillus casei (Gram-positive) bacteria aerosol at varying airflow rates (50–600 m³/h). The device achieved over 99% inactivation efficiency for both bacterial strains at the lowest airflow rate (50 m³/h). Efficiency declined with increasing airflow rates but remained above 94% at the highest flow rate (600 m³/h). Among the individual stages, NTP demonstrated the highest standalone inactivation efficiency, followed by UV-C and BI. The ESP stage effectively captured inactivated bioaerosol particles, preventing re-emission, while an integrated ozone decomposition unit maintained ozone concentrations below safety thresholds. These findings show the potential of multi-stage air cleaning technology for reducing bioaerosol contamination in indoor environments, with applications in healthcare, public spaces, and residential settings. Full article

Wearable sensors are used in gait analysis to obtain spatiotemporal parameters, with gait events serving as critical markers for foot and lower limb movement. Summarizing detection methods is essential, as accurately identifying gait events and phases are key to deriving precise spatiotemporal parameters through wearable technology. However, a clear understanding of how these sensors, particularly angular velocity and acceleration signals within inertial measurement units, individually or collectively, contribute to the detection of gait events and gait phases is lacking. This review aims to summarize the current state of knowledge on the application for both gyroscopes, with particular emphasis on the role of angular velocity signals, and inertial measurement units with both angular velocity and acceleration signals in identifying gait events, gait phases, and calculating gait spatiotemporal parameters. Gyroscopes remain the primary tool for gait events detection, while inertia measurement units enhance reliability and enable spatiotemporal parameter estimation. Rule-based methods are suitable for controlled environments, whereas machine learning offers flexibility to analyze complex gait conditions. In addition, there is a lack of consensus on optimal sensor configurations for clinical applications. Future research should focus on standardizing sensor configurations and developing robust, adaptable detection methodologies suitable for different gait conditions. Full article

Background: Childhood obesity rates remain high in the United States, with long-term implications for physical and mental health. Emerging research suggests that caregiving arrangements, particularly those involving non-parental caregivers such as grandparents, may influence adolescent health behaviors, including diet and physical activity. This study examined whether caregiver type (parents-only, grandparents-only, or multi-generational households) during adolescence predicted dietary patterns and physical activity trajectories into young adulthood. Methods: Data were drawn from 6260 participants in the National Longitudinal Study of Adolescent to Adult Health (Add Health). Caregiver type was identified at baseline (Wave 1), and dietary intake and physical activity were assessed across four waves from adolescence (~age 15) to early adulthood (~age 29). We employed generalized linear models and linear mixed-effects models with multiply imputed data to examine changes in sedentary behavior, individual exercise, and team sport participation over time, controlling for age, sex, and race. Results: Overall dietary intake at baseline did not significantly differ by caregiver type (Wilks’ Λ = 0.998, p = 0.389); however, an exploratory comparison indicated lower dairy consumption in homes with a grandparent present (t(6258) = 1.995, p = 0.046). Trajectories of individual exercise differed significantly by caregiver type over time (Time × Caregiver interaction: F(6, 10,395.601) = 2.795, p = 0.010), with adolescents in grandparent-only households reporting higher individual exercise at Wave 1. Sedentary behavior trajectories also significantly differed by caregiver group over time (Wave × Caregiver interaction: F(6, 18,951.310) = 23.026, p < 0.001). Baseline nutrition was positively associated with individual exercise trajectories into young adulthood (Time × Nutrition interaction: F(2.961, 13,096.103) = 3.974, p = 0.012). Conclusions: Caregiver structure during adolescence appears to shape long-term physical activity patterns, albeit modestly. These findings highlight the need to consider diverse family configurations—particularly grandparent-led households—when designing public health interventions to promote adolescent nutrition and physical activity. Full article

Bridges are assets in every society, and their deterioration can have severe economic, social, and environmental consequences. Therefore, implementing effective asset management strategies is crucial to ensure bridge infrastructure’s long-term performance and safety. Roadmaps can serve as valuable tools for bridge asset managers, helping bridge engineers make informed decisions that enhance bridge safety while maintaining controlled life cycle costs. Although some bridge asset management roadmaps exist, such as the one published by the United States Federal Highway Administration (FHWA), there is a lack of structured research roadmaps that are both region-specific and adaptable as guiding frameworks for similar studies. For instance, the FHWA roadmap cannot be universally applied across diverse regional contexts. This study addresses this critical gap by developing a research roadmap tailored to Idaho, USA. The roadmap was developed using a three-phase methodological approach: (1) a comprehensive analysis of past and ongoing Department of Transportation (DOT)-funded research projects over the last five years, (2) a nationwide survey of DOT funding and research practices, and (3) a detailed assessment of Idaho Transportation Department (ITD) deficiently rated bridge inventory, including individual element condition states. In the first phase, three filtering stages were implemented to identify the top 25 state projects. A literature review was conducted for each project to provide ITD’s Technical Advisory Committee (TAC) members with insights into research undertaken by various state DOTs. Moreover, in the second phase, approximately six questionnaires were designed and distributed to other state DOTs. These questionnaires primarily covered topics related to bridge research priorities and funding allocation. In the final phase, a condition state analysis was conducted using data-driven methods. Key findings from this three-phase methodological approach highlight that ultra-high-performance concrete (UHPC), bridge deck preservation, and maintenance strategies are high-priority research areas across many DOTs. Furthermore, according to the DOT responses, funding is most commonly allocated to projects related to superstructure and deck elements. Finally, ITD found that the most deficient elements in Idaho bridges are reinforced concrete abutments, reinforced concrete pile caps and footings, reinforced concrete pier walls, and movable bearing systems. These findings were integrated with insights from ITD’s TAC to generate a prioritized list of 23 high-impact research topics aligned with Idaho’s specific needs and priorities. From this list, the top six topics were selected for further investigation. By adopting this strategic approach, ITD aims to enhance the efficiency and effectiveness of its bridge-related research efforts, ultimately contributing to safer and more resilient transportation infrastructure. This paper could be a helpful resource for other DOTs seeking a systematic approach to addressing their bridge research needs. Full article

This work presents the experimental evaluation of a robotic walker following the full implementation of its sensor and motorization system. The aging population and increasing mobility impairments drive the need for assistive robotic technologies that enhance safe and independent movement. The main objective was to validate the device’s behavior in real-use scenarios by assessing its stability, responsiveness, and accuracy in detecting user movement. Tests were carried out in straight-line walking and on paths involving directional changes, both with and without motor assistance, using a cohort of five test users. Principal Component Analysis (PCA) and t-SNE dimensionality reduction techniques were applied to analyze the inertial (IMU) and proximity (TOF) sensor data, complemented by motor control monitoring through wheel Hall sensors, to explore gait patterns and system performance. Additionally, synchronized measurements between the user’s and walker’s inertial units and Time-of-Flight sensors allowed the evaluation of spatial alignment and motion correlation. The results provide a foundation for future system adjustment and optimization, ensuring the walker offers effective, safe, and adaptive assistance tailored to the user’s needs. Findings reveal that the walker successfully distinguishes individual gait patterns and adapts its behavior accordingly, demonstrating its potential for personalized mobility support. Full article

Background: Epilepsy is a chronic neurological disorder frequently influenced by systemic inflammation, nutritional status, and comorbid conditions, which may worsen seizure outcomes. Given the increasing recognition of these factors in disease progression, this study aimed to investigate the relationship between the Modified Charlson Comorbidity Index (mCCI), inflammatory hematological parameters, and the prognostic nutritional index (PNI) with seizure frequency and clinical prognosis in patients with epilepsy. Methods: A total of 159 participants were enrolled between January 2021 and January 2023, including 53 healthy controls (mean age: 44 ± 14.2 years; female: 21, male: 32), 53 epilepsy patients without comorbidity (mean age: 33 ± 12.5 years; female: 28, male: 25), and 53 epilepsy patients with comorbidities (mean age: 56.2 ± 13.8 years; female: 22, male: 31). The participants were divided into three groups: 53 patients with isolated epilepsy, 53 patients with epilepsy and comorbid conditions, and 53 healthy individuals with no known diseases, matched for age and sex with the patient groups, who presented for routine check-ups. The mCCI was calculated for patients with comorbid epilepsy. Inflammatory hematological parameters and the PNI were assessed in all participants using previously obtained complete blood count data. Results: Inflammatory markers such as white blood cell count, neutrophil count, C-reactive protein (CRP), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and mean platelet distribution width (PDW) were significantly higher in epilepsy patients with comorbidities compared to other groups. Epilepsy patients with comorbidities had a higher seizure frequency compared to those without comorbidities (75.5% vs. 54.7%, p < 0.001). The PNI was lowest in epilepsy patients with comorbidities, showing a significant difference between all groups (p < 0.001). High comorbidity burden increased seizure risk by 4.56 times (95% CI: 1.30–16.01), each unit increase in the SII raised the risk by 1.13 times (95% CI: 1.08–1.19), and each unit decrease in the PNI increased the risk by 1.14 times (OR = 0.88, p < 0.001). Cerebrovascular disease and hemiplegia were also significant risk factors, increasing seizure risk by 4.15 and 4.48 times, respectively. Conclusions: Our study demonstrates that inflammatory hematological parameters, particularly SII and MCCI scores, are elevated in epilepsy patients and further increase with comorbidities. These markers are strongly associated with seizure occurrence, highlighting the prognostic significance of systemic inflammation and comorbidity burden in epilepsy. Given the frequent observation of low PNI values in patients with comorbid conditions, which may reflect compromised nutritional status, and given associations suggest a role in poor clinical outcomes, comprehensive management is essential. Monitoring the PNI and SII may help stratify high-risk patients for targeted nutritional and anti-inflammatory interventions. Full article

Smart home devices and home automation systems, which control features such as lights, blinds, heaters, door locks, cameras, and speakers, have become increasingly popular and can be found in homes worldwide. Central to these systems are smart home hubs, which serve as the primary control units, allowing users to manage connected devices from anywhere in the world. While this feature is convenient, it also makes smart home hubs attractive targets for cyberattacks. Unfortunately, the average user lacks substantial cybersecurity knowledge, making the security of these systems crucial. This is particularly important as smart home systems are expected to safeguard users’ privacy and security within their homes. This paper synthesizes eight prevalent cybersecurity challenges associated with smart home hubs through a systematic literature review. The review process involved identifying relevant keywords, searching, and screening 713 papers in multiple rounds to arrive at a final selection of 16 papers, which were then summarized and synthesized. This process included research from Scopus published between January 2019 and November 2024 and excluded papers on prototypes or individual features. The study is limited by scarce academic sources on open-source smart home hubs, strict selection criteria, rapid technological changes, and some subjectivity in study inclusion. The security of extensible smart home hubs is a complex and evolving issue. This review provides a foundation for understanding the key challenges and potential solutions, which is useful for future research and development to secure this increasingly important part of our everyday homes. Full article

Wastewater-based molecular epidemiology enables the surveillance of both symptomatic and asymptomatic individuals in a non-invasive, cost-effective, rapid, and early-detection manner. The use of wastewater analysis to monitor the prevalence of viral pathogens in a given population has increased significantly since the COVID-19 pandemic. These studies typically involve three main steps: viral concentration, nucleic acid extraction, and DNA/RNA quantification. However, the absence of a standardized methodology remains a major limitation, hindering result comparability across studies. Among the available viral concentration techniques, aluminum-based adsorption–precipitation is one of the most commonly used due to its simplicity, efficiency, and low cost. This study evaluates the robustness and variability of the viral concentration and nucleic acid extraction steps by implementing different process controls in wastewater samples across 122 independent experiments. Additionally, correlations between viral recovery efficiencies and relevant physicochemical parameters were also analyzed (n = 600). The results indicate that, despite the overall robustness of the method, the concentration step exhibits the highest variability (CV = 53.82%), which accounted for 53.73% of the overall variability. In addition, our results show that, on average, 0.65 logarithmic units were lost during the viral concentration step. Furthermore, viral recovery rates were influenced by seasonality and sample characteristics, while no significant correlation was observed with pH or conductivity. These findings highlight the importance of process controls, confirming the robustness of the methodology, and identifying key parameters that should be considered in future studies for improved data interpretation. Full article

Background/Objectives: Long-term effects of post-COVID-19 on several health outcomes remain unclear. We assessed PA and sedentary behaviour changes and explored behaviour-change factors twelve months post-COVID-19 in people with and without Long COVID. Methods: A prospective cohort study followed people treated for COVID-19 in different settings (home, hospital ward, intensive care unit) from twelve months to eighteen months post-COVID-19. Participants with and without Long COVID were identified. PA (Light PA-LPA, Moderate-to-Vigorous PA-MVPA, Steps·day⁻¹), sedentary time, functional capacity (six-minute walk test-6MWT), muscle strength (quadriceps maximal voluntary contraction-QMVC), dyspnoea (modified Medical Research Council scale-mMRC), fatigue, symptoms of anxiety and depression, and health-related quality of life-HRQoL were assessed. Results: Among 148 participants (58 ± 15 years, 54% male), 101 had Long COVID. All remained physically inactive. People with Long COVID significantly increased LPA (LPA_LongCOVID +28 [1; 55] min·day⁻¹; LPA_Controls +6 [−32; 45] min·day⁻¹), and decreased MVPA (MVPA_LongCOVID −4 [−7; −2] min·day⁻¹; MVPA_Controls −4 [−8; 1] min·day⁻¹) and sedentarism (Sedentarism_LongCOVID −47 [−89; −4] min·day⁻¹; Sedentarism_Controls −30 [−88; 28] min·day⁻¹). At eighteen months, higher proportions of individuals with Long COVID had impaired 6MWT (17% vs. 0%), reduced QMVC (25% vs. 6%), dyspnoea (24% vs. 0%), fatigue (67% vs. 13%), symptoms of anxiety (47% vs. 9%) and depression (26% vs. 0%) as well as poor HRQoL (50% vs. 6%). PA and sedentary behaviour changes at eighteen months were associated with dyspnoea and impaired QMVC at twelve months (LPA: mMRC ≥ 2: −41.56 [−129.30; 46.00] min·day⁻¹, Steps·day⁻¹: mMRC: −416.13 [−1223.83; 391.57]; QMVC ≤ 70% predicted: −1251.39 [−2661.69; 158.91], Sedentarism: mMRC ≥ 2: +47.21 [−90.57; 184.99] min·day⁻¹; 0.24 ≤ R² ≤ 0.32). Conclusions: PA and sedentary behaviour remain altered long after COVID-19, with people with Long COVID adjusting to fit lower PA levels, possibly driven by physical limitations and symptoms. Dyspnoea and muscle weakness may influence PA and sedentary behaviour. Full article

Overfeeding, currently defined as providing excessive energy and nutrients beyond metabolic requirements, is a common yet often overlooked issue in the intensive care unit (ICU) setting. Understanding the factors contributing to overfeeding and implementing strategies to prevent it is essential for optimizing patient care in the ICU. Several factors contribute to overfeeding in the ICU, including inaccurate estimation of energy requirements, formulaic feeding protocols, and failure to adjust nutritional support based on individual patient needs. Prolonged overfeeding can lead to insulin resistance and hepatic dysfunction, exacerbating glycemic control, increasing the risk of infectious complications, and worsening clinical outcomes. Clinically, overfeeding has been linked to delayed weaning from mechanical ventilation, prolonged ICU stay, and increased mortality rates. Regular review and adjustment of feeding protocols, incorporating advances in enteral and parenteral nutrition strategies, are essential for improving patient outcomes. Clinicians must be proficient in interpreting metabolic data, understanding the principles of energy balance, and implementing appropriate feeding algorithms. Interdisciplinary collaboration among critical care teams, including dieticians, physicians, and nurses, is crucial for ensuring consistent and effective nutritional management. Overfeeding remains a significant concern in the ICU after discharge as well, implying further complications for patient safety and integrity. By understanding the causes, consequences, and strategies for the prevention of overfeeding, healthcare providers can optimize nutrition therapy and mitigate the risk of metabolic complications. Through ongoing education, interdisciplinary collaboration, and evidence-based practice, the ICU community can strive to deliver personalized and precise nutritional support to critically ill patients. Full article

Inflammatory bowel disease (IBD), which includes Crohn’s Disease (CD) and Ulcerative Colitis (UC), is a chronic gastrointestinal (GI) disorder affecting 1 in 100 people in the United States. Pediatric IBD (PIBD) is estimated to impact 15 per 100,000 children in North America. Factors such as the gut microbiome (GM), genetic predisposition to the disease, and certain environmental factors are thought to be involved in pathogenesis. However, the pathophysiology of IBD is incompletely understood, and diagnostic biomarkers and effective treatments, particularly for PIBD, are limited. Recent work suggests that these factors may interact to influence disease development, and multiomic approaches have emerged as promising tools to elucidate the pathophysiology. We employed metagenomics, metabolomics- and metatranscriptomics-based approaches to examine the microbiome, its genetic potential, and its activity to identify factors associated with PIBD. Metagenomics-based analyses revealed pathways such as octane oxidation and glycolysis that were differentially expressed in UC patients. Additionally, metatranscriptomics-based analyses suggested enrichment of glycan degradation and two component systems in UC samples as well as protein processing in the endoplasmic reticulum, ribosome, and protein export in CD and UC samples. In addition, metabolomics-based approaches revealed patterns of differentially abundant metabolites between healthy and PIBD individuals. Interestingly, overall microbiome community composition (as measured by alpha and beta diversity indices) did not appear to be associated with PIBD. However, we observed a small number of differentially abundant taxa in UC versus healthy controls, including members of the Classes Gammaproteobacteria and Clostridia as well as members of the Family Rikenellaceae. Accordingly, when identifying potential biomarkers for PIBD, our results suggest that multiomics-based approaches afford enhanced potential to detect putative biomarkers for PIBD compared to microbiome community composition sequence data alone. Full article

In this study, we examined the role of intellectual humility (IH) as an antecedent of individual attitude toward sustainable tourism viewed from the lens of personality trait theory, virtue ethics theory, and regenerative tourism principles within a stakeholder framework. Data were collected via Qualtrics in an online survey of 233 adults in the United States. A series of confirmatory factor analyses (CFA) were applied to the data to test the measurement model. In addition, a bifactor CFA was found to have acceptable fit and appropriate in controlling for common method variance. A series of covariance-based structural equations models (SEMs) was estimated to test the hypothesized model while controlling for common method variance in addition to individual age and gender. Using the chi-square difference test for nested model comparison, we found that intellectual humility was a significant antecedent of the negative ecological impact of tourism (β = 0.14, p < 0.01) while its relationships with economic and social impacts of travel became non-significant after controlling for common method variance. Pro-social tendency, operationalized as HEXACO Honesty–Humility, was also a significant antecedent of the negative ecological impact (β = 0.17) and positive economic impact (β = −0.34) of tourism, after controlling for common method variance. Despite its limitations due to its cross-sectional design and use of self-report data in the U.S., this study was novel in introducing intellectual humility as an important virtue to be cultivated at the individual level to achieve a holistic approach to sustainable tourism, especially in shaping destination choices. In addition, the study highlights the need to detect common method variance in self-report data via bifactor CFA to avoid erroneous reporting of significant findings, hampering our collective research efforts to address climate change and its impact. Full article

In the United States, at least one in three adults has prediabetes, a condition categorized by blood glucose levels higher than normal but not high enough to be classified as type 2 diabetes. The Centers for Disease Control and Prevention (CDC) recommends a modest weight loss of 5–7%, a reduction in A1C by 0.2%, and at least 150 min of physical activity per week to prevent or delay the onset of type 2 diabetes in individuals with prediabetes. Eat Smart, Move More, Prevent Diabetes (ESMMPD) is a CDC-recognized lifestyle-change program for individuals with prediabetes or at high risk of developing type 2 diabetes. ESMMPD consists of 26 lessons delivered over the course of a year by trained Lifestyle Coaches using Zoom^TM. Participants are taught strategies to implement health-promoting behaviors related to healthy eating, physical activity, and mindfulness into their daily lives. The core components of the program are planning, tracking, and living mindfully. The aim of this article is to provide insights into the development, delivery, and core components of the ESMMPD program for public health practitioners. Full article

Tropical acidic soils exhibit inherently low fertility and reduced microbial activity, driven by low pH and accelerated organic matter mineralization, phosphorus (P) fixation, and aluminum (Al³⁺) and iron (Fe³⁺) toxicity. These constraints limit agricultural productivity, necessitating sustainable and low-cost soil amendments essential for improving the soil fertility in such regions. This study investigated the effects of biochar, kitchen stove ash (KSA), and their combined application on the soil chemical properties, nutrient dynamics, and microbial functions in a tropical acidic soil. The treatment included the unamended control and two doses of 0.25% w/w (B₁₀) and 0.5% w/w (B₂₀) corncob biochar, 0.03% w/w kitchen stove ash (A_sh), and 0.027% w/w commercial-grade calcium carbonate (L_ime). Each biochar dose was added alone or in combination with either ash (A_sh + B₁₀ and A_sh + B₂₀) or calcium carbonate (L_ime + B₁₀ and L_ime + B₂₀). After eight weeks of laboratory incubation at 20 °C, the soil pH, N and P bioavailability, microbial biomass, and extracellular enzyme activities were measured. The combined application of 0.5% w/w biochar with 0.03% w/w KSA (A_sh + B₂₀) resulted in the most significant improvements in all of the examined soil fertility indicators than the individual amendments. Specifically, the soil pH was increased by 40% (+1.9 pH units) compared with the unamended control. Available phosphorus, mineral nitrogen, and total potassium were increased by 49%, 22%, and 36%, respectively, compared with the unamended control. Regarding the microbial parameters, the A_sh + B₂₀-treated soil showed the highest microbial respiration (+56%), microbial biomass (+45%), and extracellular C- and N-cycling enzyme activities compared with the unamended soil. The ash supplied minerals (P, K, and Mg) provided a more beneficial effect on the soil’s nutrient content and microbial functions than the calcium carbonate. The study demonstrated that underutilized kitchen ash may supplement biochar’s liming and nutrient supply potentials, even at a lower application rate, to improve the fertility of weathered acidic soil. Full article