Search Results (2,276)

This study examines how transnational online continuing professional development (CPD) supports language instructors’ technological pedagogical content knowledge (TPACK) in transnational higher education (TNHE). To assess this development, an existing TPACK self-report instrument was adapted to reflect cross-border online delivery, platform-mediated assessment and feedback, and collaborative course preparation. Survey data were collected from instructors at University of Southampton partner institutions in China (n = 431). Using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), structural equation modeling (SEM), and paired-samples t-tests, the study examined the instrument’s measurement properties, the structural relations among knowledge domains, and changes over time. Results supported a stable four-factor structure—technological knowledge, content knowledge, pedagogical knowledge, and TPACK—with good model fit and acceptable reliability and validity. SEM showed that pedagogical knowledge and technological knowledge significantly predicted TPACK, whereas content knowledge did not directly predict it. Longitudinal analyses of matched pre–post responses (n = 172) indicated significant increases in technological knowledge, pedagogical knowledge, and TPACK after CPD participation, while content knowledge remained statistically stable. These findings suggest that routine online CPD is most responsive in strengthening instructors’ technology-related and pedagogical capacities, which in turn support integrative teaching competence in TNHE language teaching. Full article

Background/Objectives: Substance use disorder (SUD) in pregnancy is an increasingly complex public health challenge that is known to worsen maternal and neonatal outcomes. Rates of polysubstance use are steadily rising. The objective of this study was to assess the impact of co-occurring opioid and stimulant use disorder on adverse pregnancy outcomes (APOs) among inpatient pregnancy hospitalizations. Methods: We conducted a cross-sectional analysis of inpatient pregnancy hospitalizations for delivery admissions from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) from 2016 to 2020. ICD-10 codes were used to identify patients with opioid and stimulant use disorder and with APOs. APO was defined as a composite to include hypertensive disorders of pregnancy, antepartum hemorrhage, postpartum hemorrhage, preterm birth, and fetal growth restriction. Multivariable logistic regression analyses were undertaken to predict the likelihood of APOs among pregnancy hospitalizations with opioid use, stimulant use, or co-occurring (opioid and stimulant) use disorders. Sociodemographic covariates, including age, race and/or ethnicity, insurance payor type, and income level, were accounted for. Results: From 2016 to 2020, 32,602 delivery hospitalizations complicated by stimulant or opioid use disorder were identified. Of these admissions, 21,049 (64.6%) had opioid use disorder, 9472 (29.1%) had stimulant use disorder, and 2081 (6.4%) had co-occurring opioid and stimulant use disorder. In the entire cohort, the prevalence of APOs was significantly highest among pregnancy delivery hospitalizations with co-occurring opioid use and stimulant use disorder (1136/2081—54.6%, p < 0.001), as compared with opioid use disorder (8923/21,049—42.4%) or stimulant use disorder alone (4654/9472—49.1%). Rates of APOs increased in subsequent years for all cohort groups. Adjusting for relevant sociodemographic covariates, co-occurring opioid and stimulant use disorder was an independent predictor of APO (aOR 3.65; CI 95%, 3.34–3.99). In comparison, opioid use disorder and stimulant use disorder were independent predictors of APOs with a less strong correlation, aOR 2.22 (CI 95%, 2.16–2.29) and aOR 2.89 (CI 95%, 2.77–3.02), respectively. Conclusions: Patients with co-occurring opioid and stimulant use disorder have the highest exposure risk for APOs, acting as an independent predictor for APOs when adjusting for sociodemographic covariates. Full article

Vanillin is widely used in foods, but its poor water dispersibility and limited stability reduce its flavor performance during processing and storage. In this study, soy protein isolate (SPI) was used as a food-grade carrier to prepare soy protein isolate–vanillin (SPIV) complexes via a pH-shifting strategy. SPI and vanillin were first adjusted to pH 9.0, where SPI unfolded and vanillin was deprotonated and dispersed in the solution and then readjusted to pH 7.0 to form SPIV complexes. Vanillin was incorporated into SPI at different loading levels of 0.5, 1.0, 2.5, and 5.0 mg/mL, corresponding to 9–50 wt.% relative to SPI. The binding efficiency of vanillin decreased from 91.03 wt.% to 69.43 wt.% with increasing vanillin loading. Moderate loading preserved the globular morphology of SPI, whereas excessive loading (≥33.33 wt.%) induced vanillin nanocrystal formation and aggregation. Spectroscopic analyses and molecular docking indicated that vanillin interacted with soy proteins through a combination of covalent and noncovalent interactions. Compared with free vanillin, SPIV showed improved color, light, and thermal stability. Among the tested samples, SPIV2 exhibited the most favorable interfacial behavior and application performance, producing more stable emulsions and higher flavor scores in simplified beverage and soy milk models. These findings establish a loading-dependent structure–function relationship in SPIV complexes and provide practical guidance for the design of soy protein-based carriers for flavor stabilization and delivery. Full article

Building Information Modeling (BIM) has changed the landscape of the architectural, engineering, and construction (AEC) industry in recent decades. However, BIM is not well researched in most developing countries; in particular, few studies have addressed its adoption in Malawi. A non-probability, purposive sampling approach was adopted. A total of 143 questionnaires were completed. This research reveals that, while construction experts are aware of BIM, the level of uptake remains quite low. Architects in Malawi are the most knowledgeable, followed by land surveyors and then engineers. This research shows that most experts in Malawi are at level 1 of BIM usage, which is the first stage of BIM adoption and is characterized by the use of 3D models and output representation. Furthermore, the study results have shown that the Malawian AEC sector is currently succeeding at the modelling stage of maturity but is stalled by lack of collaborative frameworks, such as Integrated Project Delivery (IPD). Therefore, unless the industry shifts toward a unified Common Data Environment (CDE), advanced capabilities like clash detection will remain underutilized and disconnected from broader project success metrics. Statistical analysis has shown that the correlation analysis demonstrates a strong link (r = 0.75) between Integrated Project Delivery (IPD) and high BIM maturity, whereas traditional Design-Bid-Build methods show a critical misalignment with digital workflows. The study identifies high software costs and a lack of national standards as the primary barriers to adoption. Therefore, there is a need for robust sensitization to the benefits of BIM and training to improve its uptake in the context of Malawi’s construction industry. In order to advance Malawi’s BIM maturity, the research recommends a strategic shift toward integrated procurement models, the establishment of national BIM mandates, and the modernization of technical education to bridge the existing knowledge gap. Full article

Background: Childhood vaccination remains the cornerstone of public health strategies, substantially reducing global morbidity and mortality, yet suboptimal uptake persists in many settings. In South Africa, the challenge is evident, with persistent outbreaks of vaccine-preventable diseases. Addressing localised immunisation shortfalls requires elucidating the complex interplay of factors beyond conventional access barriers. This qualitative study provides context-specific insights into the behavioural and social drivers influencing childhood vaccination uptake among caregivers in Cape Town, South Africa. Methods: Utilising an exploratory qualitative research design, thematic analysis was applied to interview data (n = 25 caregivers) collected via a purposive sampling strategy designed to capture maximum variation in experiences within targeted low-uptake subdistricts. Interpretation of the data was systematically guided by the World Health Organization’s Behavioural and Social Drivers (BeSD) framework. The latter consists of four domains, namely, “Thinking and Feeling”, “Social Processes”, “Motivation”, and “Practical Factors”. Findings: Analysis across BeSD domains reflected a pattern of the intention–behaviour gap, where caregivers are motivated for vaccination but face structural and practical barriers affecting timely uptake. In the Thinking and Feeling domain, widespread conviction regarding the vital benefits of vaccination co-existed with significant anxiety concerning minor side effects (e.g., pain and fever), which sometimes precipitated missed subsequent appointments. Caregivers frequently accept immunisation as a social routine despite having limited knowledge of the diseases it prevents. Social Processes demonstrated that while decision-making authority rested primarily with mothers, compliance relied on the delegation of logistical responsibilities to extended family members. Critically, reports of poor communication, judgment, or negative attitudes among healthcare workers undermined trust and acted as barriers to sustained engagement. Within the Practical Factors domain, structural constraints frequently overshadowed high intent, with pervasive issues such as long waiting times and financial costs cited as the main reasons for missed appointments. Conclusions: Participants generally expressed strong acceptance of vaccination, but attainment of optimal coverage is constrained by systemic failures in patient–provider communication and persistent logistical barriers within the public healthcare delivery system. Strategic public health interventions must therefore move beyond addressing only attitudinal opposition to prioritise targeted efforts that mitigate structural constraints and reinforce personalised, empathetic communication to sustain caregiver confidence and adherence. Full article

Background: The emergence of alternative methods of obtaining groceries since the COVID-19 pandemic has raised new concerns regarding food safety. In this study, we sought to evaluate these concerns by evaluating how the procurement method of ground beef impacts the microbial load in the beef, as this has not been thoroughly studied. Methods: Specifically, we compared beef samples obtained from in-store shopping, grocery delivery, and meal kit delivery services to determine if these new, more convenient methods of grocery shopping impact the total microbial load or Escherichia coli present in the beef. We homogenized a total of 65 beef samples and plated dilutions on trypticase soy agar, MacConkey agar, and CHROMagar. Results: We found that in-store samples had the highest microbial load with an average of 5.06 log CFU/g, while grocery delivery samples resulted in an average of 4.76 log CFU/g and meal kit samples had an average of 4.23 log CFU/g when plated on TSA. This represents a 6.7-fold change between in-store samples and meal kit samples. These differences were not statistically significant (p = 0.1, ANOVA). When plated on MacConkey agar, in-store samples had a bacterial count at 3.0 log CFU/g, while grocery delivery samples had 2.99 log CFU/g and meal kit delivered samples had 3.05 log CFU/g. Suspected E. coli O157 colonies were detected using CHROMagar plates, as these plates function to change the coloration of positive E. coli O157 colonies to pink. Suspected E. coli O157 colonies were observed in three in-store samples, two grocery delivery samples, and one meal kit sample. After confirmatory agglutination testing, one meal kit sample was confirmed as E. coli O157. Conclusions: While trends suggest possible lower microbial contamination in delivery methods versus in-store shopping procurement, no statistical significance between methods was found. These findings indicate no significant changes in microbial loads in delivered ground beef, and the high variance suggests that all procurement methods still pose some level of risk. Full article

This study explores the potential utilization of bioactive glasses using different dopant ions and ketoprofen for both tissue ingrowth and local drug delivery. Four different compositions of vitreous powders were synthesized by the sol–gel combined with the emulsion method, in the presence of the ionic surfactant cetyltrimethylammonium bromide (CTAB), differing by dopant ions: SiO₂- P₂O₅-CaO-(ZnO-MgO). This study investigates the chemical–mineralogical, morphological, and structural characteristics, as well as the biological properties of vitreous materials obtained. X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR) data analysis confirmed the vitreous nature; scanning electron microscopy (SEM) micrographs correlate with the results of physical absorption with N₂, and the compositions used for the synthesis of the powders all showed for the samples with MgO lower porosity. Biological testing demonstrated biocompatible behavior towards osteoblast cells, (MG-63 type), inducing a slight acceleration of the mineralization phenomenon in the osteoid of the cells compared to the negative control, with cell viability for all the samples higher than 50%. Preliminary release analyses performed by UV–Visible spectroscopy showed a characteristic controlled release profile with prospects for a potential drug delivery system. The zinc–magnesium co-doped sample exhibits optimal performance in both osteogenic promotion and drug delivery, presenting potential for integrated bone repair and local drug administration. This study concludes that the synthesized bioglass exhibits promising characteristics for potential applications in tissue engineering with local drug delivery. Full article

Background: The increasing consumption of ultra-processed foods (UPFs) is concerning, given their negative impacts on environmental sustainability and human health. Evidence suggests a substantial presence of UPFs in health-promoting settings. However, the factors driving these procurement and service delivery decisions remain largely unexplored. Aim: To develop a conceptual model of the known and potential system drivers of UPFs in hospital food services. Methods: Dietitians from purposively sampled Australian hospitals participated. Group model-building workshops followed pre-established scripts from the system dynamics literature. A series of causal loop diagrams identifying drivers of UPF supply in hospitals was developed using model-building software. Primary and secondary drivers were derived inductively from participants and cross-checked against transcripts to produce the consolidated model. Results: The model presents six primary drivers (hospital menu and nutrition standards, food procurement and contracts, cost, standardisation for quality control, shelf life, and convenience) and nineteen secondary drivers that together explain the increased supply of UPFs in hospitals. Feedback loops were apparent, with drivers mutually reinforcing one another. Conclusions: Complex and interconnected drivers explain the increasing supply of UPFs in hospitals. Findings should inform future strategies to build sustainable food systems through improving food provision and reducing UPF supply in hospitals. Full article

Background: Sustaining long-term lifestyle change remains a major challenge in preventive health. Epigenetic clocks offer a dynamic, modifiable measure of biological ageing that may enhance motivation when returned to individuals. Objectives: This study had two aims: (1) to evaluate whether personalised health reports integrating epigenetic age, polygenic cancer risk scores, and lifestyle metrics could motivate sustained behavioural change; and (2) to examine variability across epigenetic clock generations to inform the selection of a suitable model for participant feedback. Methods: A total of 178 adults were recruited via the Graham Fulford Charitable Trust community testing programme, and 91 completed a one-year follow-up survey assessing behavioural, psychological, and knowledge-related outcomes. DNA methylation data from 140 samples were used to compare 14 epigenetic clocks across four generations. Results: Most participants reported positive lifestyle changes, including feeling healthier (72.5%), increased physical activity (60.4%), and improved diet (47.3%). Gains were also observed in health knowledge (63.7%) and psychological well-being (31.9%). Epigenetic clock comparisons revealed substantial heterogeneity across models. Zhang2019-BLUP was selected as a stable and interpretable measure of biological age that can be readily communicated to participants, supporting empowerment and improved health literacy, rather than serving only as a risk prediction metric. Conclusions: Personalised biomarker feedback including epigenetic age combined with lifestyle and wearable data can support self-reported improvements in health-related behaviours. Community-based delivery through trusted local networks proved effective. The marked variation between epigenetic clocks highlights the importance of selecting models designed for clear communication when used in public-facing health interventions. Full article

Background: The global burden of mental disorders continues to escalate, necessitating scalable, evidence-based interventions. Artificial intelligence (AI)-delivered health promotion programs represent a promising approach to addressing treatment gaps by targeting the neuropsychological mechanisms that underlie mental health outcomes. This meta-analysis synthesizes evidence on the effectiveness of AI-delivered interventions in improving executive function, emotion regulation, and clinical outcomes across diverse populations. Methods: A systematic search identified 186 studies (n = 22,755 participants) published between 2020 and 2025. Random-effects meta-analyses estimated pooled effect sizes (Hedges’ g, calculated as between-group standardized mean differences with small-sample correction [J = 1 − 3/(4df − 1)]) for primary outcomes. Between-study heterogeneity was quantified using I² and τ² statistics. To address dependency among effect sizes from studies reporting multiple outcomes, robust variance estimation (RVE) was employed. Subgroup analyses examined intervention modalities, delivery formats, and clinical populations. Moderator analyses explored sources of heterogeneity, including publication year, sample size, intervention duration, control condition type, risk-of-bias rating, geographic region, and AI sophistication tier, and mediational models tested putative therapeutic mechanisms. Results: AI-delivered interventions demonstrated a significant overall effect on health outcomes (g = 0.68, 95% CI [0.58, 0.78]; τ² = 0.12; I² = 73.4%). Executive function outcomes showed moderate effects (g = 0.61, τ² = 0.08), with working memory improvements being strongest (g = 0.72). Emotion regulation outcomes demonstrated moderate-to-large effects (g = 0.61, 95% CI [0.51, 0.70], τ² = 0.006); formal subgroup pooled estimates by emotion regulation strategy were not calculated due to insufficient studies per strategy (k < 3 per category); individual study effect sizes ranged from g = 0.27 to g = 1.11. Among 41 studies examining neuropsychological mechanisms, convergent patterns suggested involvement of prefrontal neural circuits (DLPFC), enhanced alpha-band activity, and improved heart rate variability; however, formal mediation was tested in only 18 studies (9.7%). Among clinical populations, interventions for cognitive impairment yielded the largest effects (g = 1.02; this finding should be interpreted cautiously given modest cumulative sample size [n = 482], potential small-study effects [Egger’s p = 0.08], and trim-and-fill adjusted estimate of g = 0.85), followed by mental health conditions (g = 0.72), while other clinical populations showed smaller but significant improvements (g = 0.19). Mobile applications (g = 0.78) and chatbot-based interventions (g = 0.74) demonstrated the strongest effects among delivery formats. Among studies testing formal mediation, analyses suggested mindfulness (β = 0.42), decentering (β = 0.38), and cognitive reappraisal (β = 0.45) as processes associated with therapeutic outcomes. Conclusions: AI-delivered health promotion programs demonstrate significant effectiveness across executive function, emotion regulation, and clinical outcomes, though substantial heterogeneity (I² = 45–82%) indicates meaningful variability warranting attention to subgroup-specific effects. Given the diversity of intervention types included (chatbots, mobile apps, VR systems, neuromodulation), pooled estimates should be interpreted as characterizing the average effect across this heterogeneous landscape; subgroup-specific estimates provide more precise guidance for clinical decision-making regarding specific modalities. Effects are associated with convergent patterns of neuropsychological mechanisms, though mechanistic conclusions remain preliminary given that only 22% of studies (41/186) examined neuropsychological mechanisms, and formal mediation analyses were conducted in only 18 studies (9.7%); most of the mechanistic evidence is correlational rather than causal. Future research should establish standardized AI taxonomies, optimize adaptive algorithms, conduct adequately powered replication studies in populations with cognitive impairment, prioritize experimental mediation designs to establish causal pathways, and evaluate long-term maintenance effects with a minimum of 6–12-month follow-up periods. Full article

Background: Iron deficiency remains a major nutritional challenge, partly due to the limited stability and bioavailability of conventional iron formulations in foods and during digestion. In this study, iron–protein microparticles (IP-MPs) based on bovine serum albumin (IA-MPs) and hemp protein (IH-MPs) were developed via coprecipitation and evaluated as food-compatible iron delivery systems. Methods: Iron–protein microparticles (IP-MPs) were fabricated by a coprecipitation technique. The stability of IP-MPs was investigated in a three-phase digestion model. The uptake of IP-MPs by Caco-2 cells as well as the Ferritin concentration in Caco-2 cells were investigated. Results: Particle morphology and size distribution were strongly dependent on the protein matrix, with hemp protein microparticles exhibiting greater size uniformity and higher stability under simulated gastric conditions. In a standardized in vitro gastrointestinal digestion model, both IP-MP formulations preserved iron predominantly in the bioactive Fe(II) state and remained sufficiently intact to reach the intestinal phase. Biocompatibility and iron uptake were assessed using Caco-2 cell monolayers. Neither formulation induced cytotoxic effects, while iron delivered via IP-MPs showed enhanced cellular uptake compared to a commercial iron supplement and ferrous sulfate. The amount of Fe(II) detected in the basolateral compartment of IH-MP and IA-MP samples (1.4 µg and 1.3 µg, respectively) was higher than that observed for Floradix^® samples (approximately 0.7 µg) and corresponded to about 25% of the total iron applied. Functional iron bioavailability, assessed by ferritin formation, was significantly higher for IP-MPs, with hemp protein microparticles yielding the strongest ferritin response. Conclusions: These results demonstrate that iron–protein microparticles, particularly those based on hemp protein, effectively improve iron stability during digestion and enhance cellular iron bioavailability, highlighting their potential for application in iron fortification and functional food systems. Full article

The study presents novel photocrosslinked hydrogels based on methacrylated chitosan and methacrylated gelatin/allyl-modified gelatin and compares their properties as drug delivery systems in wound healing applications. The polymers were selected due to their biocompatible, mucoadhesive, cell-interactive properties and flexibility in adjusting their structure, making them suitable candidates for applications that require tissue repair. A range of hydrogel formulations was obtained by modulating the ratio of modified chitosan to two distinct modified gelatins, with photocrosslinking performed using Irgacure 2959 as the photoinitiator. FT-IR analysis, SEM data, and swelling and mechanical properties confirmed the 3D networking and the compatibility between the hydrogel components. Allylic gelatin-based hydrogels present larger pores and a stronger pH-responsive swelling behaviour compared to methacrylated gelatin-based samples, reflecting the higher flexibility of allylic gelatin networks. The hydrogels release bacitracin during the first six hours, with a release profile that follows a non-Fickian diffusion mechanism. Cytocompatibility and wound healing potential were tested in the presence of human and mouse fibroblasts, cells with a pivotal role in the wound healing process. All formulated hydrogels exhibit antioxidant capacity and protein stabilization properties, which are attributed to the presence of chitosan in their composition. The cytocompatibility, in vitro wound healing, and biological properties of the obtained hydrogels, as well as the drug release results, confirm their suitability in wound healing applications. Full article

Serious games and negotiation simulations such as the Phosphorus Negotiation Game (P-Game) are increasingly used to support sustainability-oriented education. To broaden accessibility, a smartphone-based version of the face-to-face P-Game was developed and is presented here. A comparative design integrating quantitative pre–post survey measures with analysis of open-ended responses was employed to examine self-reported knowledge gains and learning experiences among participants who completed the P-Game in face-to-face workshops and those who played the virtual version. Both formats were associated with significant increases in participants’ perceived understanding of phosphorus science and negotiation science/practice. Self-reported knowledge of phosphorus science increased by 92.3% (global face-to-face), 70.7% (Hungarian face-to-face), and 88.4% (online), with comparable gains observed in negotiation science and practice across groups. Qualitative findings complemented these results, indicating that while learning gains were broadly similar, the modes differed in experiential emphasis: face-to-face delivery elicited performance-oriented and socially embedded reflections, whereas the online format was more frequently described in terms of structured participation and reflective processing. User satisfaction with the virtual P-Game was high, reflected by a System Usability Scale (SUS) score above 80. Overall, the findings suggest that the virtual P-Game represents a viable and accessible complement to traditional face-to-face implementation, maintaining educational impact while extending reach. Further research with larger and more diverse participant samples is recommended to strengthen generalizability and explore long-term learning outcomes in sustainability contexts. Full article

Background/Objectives: Accurate determination of active pharmaceutical ingredient (API) particle size within dry powder inhaler (DPI) formulations is essential for ensuring effective pulmonary delivery but remains analytically challenging due to low API content and micronized particle size. Methods: In this study, scanning electron microscopy (SEM) coupled with energy-dispersive X-ray microanalysis (EDX) was used to directly identify and calculate the API particle size within several different commercial DPI products fit for purpose under regulatory constraints. The method exploits unique elemental markers inherent to each API, enabling reliable discrimination from excipients without prior sample modification or API extraction. Results: Large-area SEM–EDX mapping was used to localize API particles, followed by high-magnification imaging and confirmatory spot microanalysis. Particle sizes were manually measured for at least 50 API particles per formulation using image analysis software, and particle size distribution parameters were calculated from equivalent spherical diameters. Conclusions: The methodology was successfully applied to Spiriva^®, Anoro^® Ellipta, and Relvar^® Ellipta inhalation powders, revealing micronized APIs with distinct morphological features and verifying systematic application across products. Cross-validation against laser diffraction measurements of pure APIs demonstrated statistical equivalence, confirming the robustness and analytical utility of the proposed method for particle size assessment in DPI formulations. Full article

Introduction: Acute gallstone pancreatitis is a potentially severe disease associated with morbidity and mortality. Cholecystectomy is recommended to prevent recurrence. During pregnancy, surgical management is challenging, and in the post-partum period small gallstones may spontaneously disappear. Ursodeoxycholic acid (UDCA) is safe during the last 6 months of pregnancy and effective in dissolving small gallstones, although recurrence after discontinuation is common in the general population. The optimal strategy to prevent recurrent acute pancreatitis during and after pregnancy remains unclear. Methods: Between 2002 and 2017 we prospectively treated women with acute pancreatitis related to small gallstones (≤1 cm in diameter) during the last six months of pregnancy or within the first post-partum year who declined surgery. Patients received UDCA until stone dissolution. A patent cystic duct was confirmed by ultrasonography; after delivery, a non-contrast CT scan was performed to exclude calcified stones. Patients were followed for at least 6 years or until recurrence, with serial clinical and ultrasonographic examinations. Results: UDCA was associated with complete dissolution in 13/14 women within a mean ± SD of 7.77 + 3.1 months. One patient experienced gallstone recurrence 75 months after treatment discontinuation. Two patients developed recurrent pancreatitis (at 1 and 88 months respectively). Twelve women remained free of recurrence over a mean ± SD follow-up of 79.5 + 9.4 months. Discussion: This is an observational study in which we document that UDCA may facilitate the spontaneous dissolution of small gallstones after delivery and can be considered a bridge strategy during pregnancy when surgery is not feasible. However, this study cannot determine the additional benefit of UDCA over the spontaneous disappearance of stones observed after delivery because we had no control group. Cholecystectomy remains the standard of care post-partum. Medical therapy should be reserved for women who refuse surgery and it requires close ultrasonographic surveillance. The main strength of this study is the prospective long-term follow-up of a consecutive cohort with a rare condition. Limitations include the small sample size, missing control group and single-center design. Full article