Search Results (748)

Background/Objectives. Patient-Reported Outcome Measures (PROMs) capture patients’ perspectives about their health status, quality of life, and medical care outcomes. LIMB-Q Kids is a validated PROM designed to assess health-related quality of life (HRQL) in children with lower limb differences. It evaluates physical, social, and psychological function; symptoms related to the leg, hip, knee, foot and ankle; leg-related distress, appearance, and school-related concerns. It has now been translated and culturally adapted from English to other languages. The aim of this study was to translate and culturally adapt LIMB-Q Kids to Hebrew. Methods. Following international guidelines, two independent forward translations from English to Hebrew were produced and reconciled into a single version. A backward translation was then compared with the original to identify discrepancies. This draft underwent cognitive debriefing interviews (CDIs) with 11 children (ages 8–15) having lower limb differences to assess comprehension and cultural relevance. Results. CDIs revealed general issues including lengthy or unclear text, high-level language, cultural unfamiliarity and duplication of descriptors. Specific to Hebrew, issues included gender inflections and the need for vowel diacritics to support younger, less proficient readers. Revisions to 14 items were made. Conclusions. A translation and cultural adaption (TCA) process led to a linguistically validated and culturally adapted Hebrew version of LIMB-Q Kids. It can now be used for the clinical follow-up of children with lower limb differences including pre- and post-operatively, and as an aid to decision-making for surgery. Full article

The term “image captioning” refers to the process of converting an image into text through computer vision and natural language processing algorithms. Image captioning is still considered an open-ended topic despite the fact that visual data, most of which pertains to images, is readily available in today’s world. This is despite the fact that recent developments in computer vision, such as Vision Transformers (ViT) and language models using BERT and GPT, have opened up new possibilities for the field. The purpose of this review paper is to provide an overview of the present status of the field, with a specific emphasis on the use of facial expression recognition and object detection for the purpose of image captioning, particularly in the context of fault-aware systems and Prognostics and Health Management (PHM) applications within Industry 4.0 environments. However, to the best of our knowledge, no review study has focused on the significance of facial expressions in relation to image captioning, especially in industrial settings where operator facial expressions can provide valuable insights for fault detection and system health monitoring. This is something that has been overlooked in the existing body of research on image captioning, which is the primary reason why this study was conducted. During this paper, we will talk about the most important approaches and procedures that have been utilized for this task, including fault-aware methodologies that leverage visual data for PHM in smart manufacturing contexts, and we will highlight the advantages and disadvantages of each strategy. The purpose of this review is to present a comprehensive assessment of the current state of the field and to recommend topics for future research that will lead to machine-translated captions that are more detailed and accurate, particularly for Industry 4.0 applications where visual monitoring plays a crucial role in system diagnostics and maintenance. Full article

The acceleration of industrialization and urbanization have led to the increasingly serious problem of waste gas pollution. Pollutants such as sulfur dioxide (SO₂), nitrogen oxides (NOx), volatile organic compounds (VOCs), ammonia (NH₃), formaldehyde (HCHO), and hydrogen sulfide (H₂S) emitted from industrial production, transportation, and agricultural activities have posed a major threat to the ecological environment and public health. Although traditional physical and chemical treatment methods can partially reduce the concentration of pollutants, they face three core bottlenecks of high cost, high energy consumption, and secondary pollution, and it is urgent to develop sustainable alternative technologies. In this context, probiotic waste gas treatment technology has become an emerging research hotspot due to its environmental friendliness, low energy consumption characteristics, and resource conversion potential. Based on the databases of PubMed, Web of Science Core Collection, Scopus, Embase, and Cochrane Library, this paper systematically searched the literature published from 2014 to 2024 according to the predetermined inclusion and exclusion criteria (such as research topic relevance, experimental data integrity, language in English, etc.). A total of 71 high-quality studies were selected from more than 600 studies for review. By integrating three perspectives (basic theory perspective, environmental application perspective, and waste gas treatment facility perspective), the metabolic mechanism, functional strain characteristics, engineering application status, and cost-effectiveness of probiotics in waste gas bioconversion were systematically analyzed. The main conclusions include the following: probiotics achieve efficient degradation and recycling of waste gas pollutants through specific enzyme catalysis, and compound flora and intelligent regulation can significantly improve the stability and adaptability of the system. This technology has shown good environmental and economic benefits in multi-industry waste gas treatment, but it still faces challenges such as complex waste gas adaptability and long-term operational stability. This review aims to provide useful theoretical support for the optimization and large-scale application of probiotic waste gas treatment technology, promote the transformation of waste gas treatment from ‘end treatment’ to ‘green transformation’, and ultimately serve the realization of sustainable development goals. Full article

Distribution grids are essential to power systems, as they ensure the safe and reliable operation of power systems. It is important to forecast the operational status of each distribution transformer. Consequently, there is an urgent need to develop load forecasting models that exhibit robust generalization and exceptional accuracy. However, distribution transformers are numerous, exhibit strong inherent features. Single-device load samples are scarce, with widespread few-shot issues. Traditional models rely on massive amounts of data and computational resources, making it challenging to balance computational costs, generalization ability, and accuracy. To address these issues, this paper analyzes the inherent features of distribution transformers and fine-tunes large language models using parameter-efficient fine-tuning methods to reduce training costs while preserving their generalization capabilities and accuracy. Experimental results demonstrate that this method achieves significantly higher accuracy than baseline models in few-shot scenarios. Full article

Background: Preventing nutritional decline during hospitalisation is imperative in reducing the development of complications such as malnutrition and pressure injuries. However, existing malnutrition screening and assessment tools employ a reactive rather than proactive approach, using predictors to identify inpatients who are already malnourished instead of those at risk of developing hospital-acquired malnutrition. Therefore, this review aimed to identify key contextual and individual factors contributing to nutritional deterioration and their interrelatedness, and to inform strategies for preventing hospital-acquired malnutrition. Methods: A scoping review of five databases (Medline, CINAHL, Embase, All EBM Reviews and PsycINFO) up to June 2024 was conducted to include English-language studies that reported statistically significant risk factors for changes in nutritional status during hospitalisation. A directed acyclic graphing method was used to visualise the interlinkage between contextual and individual risk factors identified. PRISMA Extension for Scoping Reviews was followed in reporting. Results: Of 8215 retrieved abstracts, 51 studies were included. Four contextual (ward type; food service satisfaction; medical-related mealtime interruption; nutrition care collaboration) and four individual factors (nutritional status prior admission; hospital length of stay; multimorbidity; disease acuity) were found to significantly predict nutritional decline during hospitalisation and were closely interrelated. Conclusions: More contextual risk factors are modifiable, suggesting a need for organisational strategies to optimise collaborative nutrition care and improve patient satisfaction with hospital food services to promote early nutritional intervention, particularly within the first three days of admission and for inpatients with multimorbidity, high disease acuity, or pre-existing malnourishment. Full article

Background/Objectives: Clear aligners are increasingly prescribed for orthodontic treatment, primarily in adult patients; however, concerns have been raised that this treatment approach may negatively impact root length, especially in endodontically treated teeth. The present investigation aims to systematically synthesize available research addressing the potential effects of clear aligner orthodontic treatment on root length changes in endodontically treated teeth. Methods: Four electronic databases were searched until May 2025, and lists of references from relevant publications were screened to identify studies (randomized clinical trials, controlled clinical trials, and observational studies) written in the English language with no date restriction. Clinical studies comparing clear aligner orthodontic treatment in endodontically treated teeth versus vital pulp teeth in humans, using cone beam computed tomography or panoramic radiographs to evaluate root resorption, were assessed. Following study selection and data extraction, the risk-of-bias assessment was evaluated with the Newcastle–Ottawa tool for the observational studies. Results: A total of 173 studies were retrieved, and ultimately 2 observational cohort studies were included in the systematic review, encompassing 135 patients (69.6% female; with an average age of 22.5 years). The present review found an association between endodontic status and root resorption, with vital pulp teeth (VPT) exhibiting a greater degree of resorption compared to root canal treated teeth (RCT). Clear aligner (CA) orthodontic treatment resulted in less root resorption than fixed orthodontic appliances (FAs). Conclusions: Limited evidence indicates that clear aligner orthodontic treatment leads to a lower occurrence of root resorption and fewer cases of severe root resorption in endodontically treated teeth. Based on findings from studies comparing CAs to FAs, there is overall significantly greater resistance to root resorption in RCT than VPT, irrespective of the orthodontic treatment modality (CAs or FAs). Full article

As global obesity rates rise, cardiovascular diseases increase, and stress-related issues become more severe. This increases the public awareness of health and exercise. However, existing spinning fitness equipment lacks personalized customization for individual needs. To address this, we developed a smart customizable spinning system that enables health monitoring, central computation, flywheel, voice interaction, notification, and query subsystems. Users can set fitness goals based on their personal needs, monitor workout data via sensors, and utilize voice interaction and control to track their exercise status in real time. The system notifies users of workout progress through a buzzer and message queuing telemetry transport, while the Web interface provides access to past workouts and health records. Additionally, the system supports bilingual functionality (Chinese and English), allowing users to operate it in their preferred language, enhancing global usability. Full article

Objectives: Accumulating clinical evidence from experimental and observational studies with humans suggests that edible mushrooms may have beneficial effects on markers of brain health. This study examined the effects of daily consumption of fresh Agaricus bisporus (cremini mushrooms) exposed to ultraviolet (UV) light on indices of anxiety, depression, mood, cognitive function, and well-being in middle-aged and older adults. Methods: Over a 6-week period, adults (n = 41 (19 M/22 F), age 43 ± 11 y; BMI 29.8 ± 5.9 kg/m², mean ± SD) without severe depression, cardiovascular disease, or Type 2 Diabetes consumed two daily servings (168 g/d wet weight) of cremini mushrooms intended to provide 400 IU/serving (800 IU/d) of vitamin D₂ (n = 20) or 2 tsp/d of breadcrumbs (control, n = 21). Assessments conducted at baseline and week 6 included General Anxiety Disorder-7 (GAD-7), Beck’s Depression Inventory (BDI-II), Patient Health Questionnaire (PHQ-9), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Profile of Mood States (POMS), and Medical Outcomes Study 36-Item Short-Form Health Survey Version 2 (SF36v2). Results: Consuming UV light-exposed mushrooms did not improve brain health outcomes. Independent of mushroom consumption, over time, there were improvements in immediate memory (RBANS), language (RBANS), and depression (BDI-II and PHQ-9). Conclusions: There were no differences observed between groups in the investigated indices of brain health. However, improvements over time were observed in Beck’s Depression Inventory and the Immediate Memory and Language domains in the RBANS, independent of mushroom consumption. Overall, consuming 2 servings/d of UV-exposed mushrooms for six weeks may not improve indices of brain health. Full article

Parental attitudes play a crucial role in shaping children’s language development. Language attitudes within families and parental beliefs about communicating with young children are under-researched, particularly in Estonia. This study aims to investigate language attitudes in Estonian-speaking families regarding communication with children under three years old. Using data collected via a web-based questionnaire from 246 Estonian families, the article addresses the following questions: How important do Estonian-speaking parents consider communication with young children during early stages of language development, including the pre-verbal period?; Do parents believe that speaking to young children should differ from communication with adults?; What specific features of child-directed speech (e.g., the use of diminutives) are known and applied by parents?; How do language ideologies about child-directed communication relate to socio-economic factors such as parental education, age, language skills, or residential environment (e.g., rural vs. urban)? The findings contribute to understanding the interplay between individual attitudes and beliefs in language strategies used with speaking with young children. Almost all parents considered speaking with children very important. Altogether, 58% of respondents answered that one should speak even with pre-verbal children, 67% reported that they use diminutives when speaking with children. Attitudes were more strongly expressed by individuals who indicated that they do not use a different register when speaking with children. Many respondents justified their perspective by emphasizing the importance of using normative and correct language with young children. Socio-economic status factors such as age, education, language skills, and residential environment did not appear to influence attitudes toward communicating with small children. Full article

Background: Pediatric Intensive Care Unit (PICU) outcome prediction is challenging, and machine learning (ML) can enhance it by leveraging large datasets. Methods: We built an ML model to predict PICU outcomes (“Death vs. Survival”, “Death or Morbidity vs. Survival without morbidity”, and “New Morbidity vs. Survival without new morbidity”) using the Trichotomous Outcome Prediction in Critical Care (TOPICC) study dataset. The model used the Light Gradient-Boosting Machine (LightGBM) algorithm, which was trained on 85% of the dataset and tested on 15% utilizing 10-fold cross validation. Results: The model demonstrated high accuracy across all dichotomies, with 0.98 for “Death vs. Survival”, 0.92 for “Death or New Morbidity vs. Survival without New Morbidity”, and 0.93 for “New Morbidity vs. Survival without New Morbidity.” The AUC-ROC values were also strong, at 0.89, 0.79, and 0.74, respectively. The precision was highest for “Death vs. Survival” (0.92), followed by 0.45 and 0.30 for the other dichotomies. The recalls were low, at 0.26, 0.31, and 0.34, reflecting the model’s difficulty in identifying all positive cases. The AUC-PR values (0.43, 0.37, and 0.20) highlight this trade-off. Conclusions: The LightGBM model demonstrated a predictive performance comparable to previously reported logistic regression models in predicting PICU outcomes. Future work should focus on enhancing the model’s performance and further validation across larger datasets to assess the model’s generalizability and real-world applicability. Full article

Prenatal exposure to air pollution is a major public health concern due to its potential to impair fetal brain development. This study examined whether maternal inflammatory and oxidative stress biomarkers mediate the association between trimester-specific air pollutant exposure during pregnancy and infant neurodevelopment at one year. We analyzed 87 mother–infant pairs from the OBESO perinatal cohort in Mexico City. Trimester-specific exposure to CO, PM₁₀, PM_2.5, SO₂, and O₃ was estimated using residential geolocation. Biomarkers were measured in the first and third trimesters by protocol, and intra-pregnancy change was calculated as Δ(3T–1T) for cytokines (IL-1β, IL-6, TNFα) and oxidative stress markers (malondialdehyde (MDA), protein carbonyls (PC), and total antioxidant capacity (TAC). Infant neurodevelopment at 12 months was assessed using Bayley-III. Exploratory mediation analyses were conducted, adjusting for gestational age at birth, pre-eclampsia, gestational diabetes, fetal growth restriction, marital status, mode of delivery, and infant sex; bootstrapping was applied to obtain robust estimates. Third-trimester CO exposure was associated with poorer receptive language (coef = 0.754, p = 0.02). PM_2.5 exposure showed direct effects on expressive language in the first (coef = 0.01, p = 0.04) and third trimesters (coef = 0.007, p = 0.015) in models including IL-1β. Third-trimester O₃ and SO₂ exposures were linked to lower expressive scores in models including TNFα (coef = 0.007, p = 0.02), MDA (coef = 0.008, p = 0.04), and PC (coef = 0.007, 95% p = 0.04). Meanwhile PM₁₀ exposure was associated with socio-emotional outcomes in models with IL-6 and TAC (coef = 0.003, p = 0.04). These findings indicate that maternal inflammation and oxidative stress biomarkers did not mediate the associations between prenatal air pollution exposure and infant neurodevelopment, and this study cannot elucidate their specific biological role in neurodevelopment. Full article

Background/Objectives: Children with Down syndrome (DS) present unique and multifaceted nutritional challenges arising from genetic, metabolic, and developmental factors. Despite growing interest in the health of individuals with DS, dedicated nutritional guidelines tailored to their specific needs remain lacking. This narrative review aims to summarize current scientific evidence on nutritional status, challenges, and therapeutic strategies in children with DS, with an emphasis on clinical implications and practical recommendations for healthcare professionals. Methods: A literature search was conducted across four databases (PubMed, Scopus, Web of Science, and Google Scholar) for English-language publications from 1993 to June 2025. Thirty-five peer-reviewed articles were included, comprising original studies, narrative reviews, and expert guidelines (e.g., the American Academy of Pediatrics [AAP], the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN], and the European Federation of Associations of Dietitians [EFAD]). The selection process followed the PRISMA protocol. Studies were categorized according to key themes: energy requirements, comorbidities, feeding difficulties, nutrient needs, and therapeutic interventions. Results: Children with DS typically exhibit lower basal metabolic rates and altered body composition (i.e., higher fat mass and reduced lean mass), which increase their risk of both obesity and nutrient deficiencies. Common comorbidities—such as hypothyroidism, celiac disease, and gastrointestinal or immune disorders—further complicate dietary management. Feeding difficulties, including sucking/swallowing impairments, food selectivity, neophobia, and delayed independence in eating, are prevalent and significantly affect diet quality. Key nutrients of concern include protein, omega-3 fatty acids, fiber, vitamins B12 and D, iron, and antioxidants. Although no official nutrition guidelines currently exist for this population, existing recommendations from pediatric and dietetic organizations provide partial guidance that can be adapted to clinical practice. Conclusions: There is an urgent need to develop evidence-based, population-specific dietary guidelines for children with Down syndrome. Clinical nutrition care should be individualized, multidisciplinary, and proactive, integrating regular assessments of growth, feeding abilities, and biochemical markers. Dietitians must play a central role in both early intervention and long-term management. Further research, particularly interventional studies, is essential to optimize dietary strategies and improve health outcomes in this vulnerable population. Full article

Background: Fear of cancer recurrence (FCR) is a common, distressing concern among cancer survivors, with implications for psychological well-being and quality of life. Despite the proliferation of patient-reported outcome measures (PROMs) to assess FCR, consensus on the most valid and reliable instruments remains limited. Objective: To conduct a comprehensive psychometric evaluation of FCR PROMs developed or validated between 2011 and 2023, using the full COSMIN methodology. This review builds on earlier work by systematically appraising both newly developed and adapted instruments to inform evidence-based PROM selection for clinical and research use. Methods: This review followed the COSMIN 10-step procedure and PRISMA 2020 guidelines. Six databases were searched from January 2011 to December 2023. A search cut-off of 31 December 2023 was applied to align with COSMIN feasibility recommendations and ensure sufficient time and resources for full psychometric evaluation across all included PROMs. Eligible studies included adults diagnosed with cancer and reported on the psychometric evaluation of a self-reported, Likert-scale-based FCR PROM. PROMs were appraised across eight psychometric properties using COSMIN’s Risk of Bias checklist, criteria for good measurement properties, and modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) for evidence quality. Instruments were categorized as A, B, or C according to COSMIN’s recommendations. Results: Of the 34 PROMs evaluated across 32 studies, 28 achieved COSMIN Category A status, indicating sufficient psychometric quality for clinical or research use. Among the 19 FCRI and FoP-Q instruments validated in new cultural or population contexts, 15 received a Category A rating, reflecting strong cross-cultural performance. Short forms such as the FCRI-SF and FoP-Q-SF demonstrated consistent psychometric strength across French, English, Portuguese, and Asian-language versions. Of the 14 newly developed PROMs—including the CWS-6, FCR4/7, CARQ-4, and FCR-1—12 achieved Category A. The FCR-1 was the only single-item PROM to demonstrate responsiveness, supporting its use in both screening and longitudinal monitoring. For practical guidance, five PROMs (FCR-1, FCRI-SF, FoP-Q-SF, FCR-7, and CWS) emerged as the most strongly supported for clinical use. Conclusions: This review provides a comprehensive evaluation of contemporary FCR PROMs and highlights substantial progress in the development of valid, reliable, and culturally adaptable tools. The FCRI, FoP-Q-SF, and several newly developed short forms, such as FCR7, CWS, and particularly, the FCR-1, emerge as strong candidates for use in clinical screening and longitudinal assessment. These findings offer clear evidence-based guidance for instrument selection in research and survivorship care. PROSPERO registration: CRD42023453783. Full article

Background/Objectives: This study investigates disparities in physical fitness among Connecticut K-12 students post-COVID-19, highlighting persistent inequities across race, socioeconomic status, language proficiency, and dis/ability. Methods: Utilizing state-wide data from Connecticut’s EdSight portal, the research reveals a significant decline in student physical fitness compared to pre-pandemic levels, notably lagging behind academic recovery. Results: Findings underscore stark disparities, with marginalized groups such as students with disabilities, English learners, and racially minoritized students consistently performing lower than their peers. District-level analyses further illustrate pronounced inequities, where affluent, predominantly White districts achieved nearly four times higher fitness scores compared to economically disadvantaged, racially diverse districts. Conclusions: These disparities reflect systemic resource allocation issues and align with the framework of stratification economics, emphasizing structural inequities rather than individual deficits. The study advocates for equity-based funding, mandatory physical education monitoring, culturally responsive teaching practices, and systemic policy reforms to ensure equitable access to physical education resources and holistic student well-being. 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