Search Results (6,342)

Background/Objectives: In Ontario, approximately 8% (11,000) of infants are born preterm (22–<37 weeks gestation) each year. Many of these infants are cared for in a Level II Neonatal Intensive Care Unit (NICU). Family Integrated Care (FICare), an innovative model of care, aims to facilitate the involvement of parents in the care of their infants in NICUs. The aim of this study was to gain a better understanding of the general and specific needs of Level II NICUs in Ontario prior to implementation of FICare. Methods: Using a cross-sectional study design, two surveys (leadership and site resources) were developed using the Consolidated Framework for Implementation Science Research’s innovation, inner setting, and outer setting constructs and distributed to Level II NICUs medical and nursing leaders. Results: The surveys were sent to 44 Level II NICUs in Ontario, of which 24 hospitals (55%) responded. Key facilitators to implementation of FICare in Level II hospitals in Ontario were leadership interest, availability of staff and parent volunteers, and existing policies to support implementation. The identified barriers were lack of financial resources for new initiatives, skepticism in FICare’s ability to save costs, need for tailored implementation due to variability in NICU characteristics, and the lack of environmental support for prolonged parental presence. Conclusions: This study has confirmed the interest of many Ontario level II NICUs in implementing FICare and variability in their readiness for implementation based on the identified facilitators and barriers. Full article

The article discusses the use of virtual reality (VR) as a tool for responsible tourism. Practical research was conducted in a group of 215 participants using VR headsets (Meta Quest Pro and HTC VIVE). Volunteers participated in a VR session using the Google Earth VR application. They visited two locations of their choice. The first was a place they had previously visited in real life, while the other was a location they had not visited but would like to. Participants completed a survey before and after the VR experience. In the survey, participants rated, among others, their level of satisfaction, willingness to visit given locations, and emotions accompanying the experience. The authors conducted a statistical analysis of the survey results. The scientific goal of the article was primarily to present a proposal for the use of virtual reality as an innovative tool supporting responsible tourism. The results confirmed a positive reception of VR experiences: average satisfaction ratings exceeded 4.0 on a 5-point scale, and positive emotions (most often +1 and +2 on a scale from −2 to +2) dominated among participants. Higher emotional valence was significantly correlated with satisfaction (ρ ≈ 0.434, p < 0.001) and with increased willingness to visit destinations (ρ ≈ 0.306, p < 0.001). Statistically significant differences were noticed in satisfaction level with visiting new places among groups of respondents with different tourism type preferences (people who prefer cultural or health tourism reported noticeably higher satisfaction with the VR experience than other respondents). The authors also conducted a discussion on how VR technology can be a tool supporting responsible tourism. Full article

Background: Population ageing is a global challenge, prompting ageing-in-place policies in Hong Kong to support community-dwelling older adults while reducing healthcare costs. Yet, their impact on health-related quality of life (HRQoL) remains underexplored amid Hong Kong’s long life expectancy and growing older population. Traditional surveys are costly and time-consuming, while routinely collected registration data offers a large, efficient source for health insights. This study uses enhanced administrative data to track HRQoL trajectories and inform policy. Methods: This is a prospective, open-ended longitudinal study, enrolling adults aged 50 or older from a collaborating non-governmental organization in Hong Kong’s Southern District. Data collection, started in February 2021, occurs annually via phone and face-to-face interviews by trained social workers and volunteers using a standardized questionnaire to assess individual (e.g., socio-demographics), environmental (e.g., social support via Lubben Social Network Scale-6), biological (e.g., chronic illnesses), functional (e.g., cognition via Montreal Cognitive Assessment), and HRQoL (e.g., EQ-5D-5L) factors. A secure online system links health and service use data (e.g., service utilization like community care visits). Analysis employs descriptive statistics, group comparisons, correlations, growth modelling to identify health trajectories, and structural equation modelling to test a revised quality-of-life framework. Sample size (projected 470–580 after two follow-ups from a 2321 baseline) is based on power calculations: 300–500 for latent class growth analysis (LCGA) class detection and 200–400 for structural equation modelling (SEM) fit (e.g., RMSEA < 0.06) at 80% power/α = 0.05, simulated via Monte Carlo with a 50–55% attrition. Discussion: This is the first longitudinal HRQoL study in Hong Kong using enhanced non-governmental organization (NGO) administrative data, integrating social–ecological and HRQoL models to predict trajectories (e.g., stable vs. declining mobility) and project care demands (e.g., increase in in-home care for frailty). Unlike prior cross-sectional or inpatient studies, it offers a scalable model for NGOs, informing ageing-in-place policy effectiveness and equitable geriatric care. Full article

Background/Objectives: Pre-analytical variation is a major challenge in metabolomics, yet most stability studies have focused on healthy volunteers and have overlooked the impact of disease and medication. To address this gap, we conducted a pilot study in systemic lupus erythematosus (SLE) to assess serum metabolite stability under delayed centrifugation. Methods: Peripheral blood from 10 SLE patients and 5 healthy controls (HC) was stored at room temperature for 1–24 h before processing and analyzed by untargeted LC-MS-based metabolomics. This design enabled direct evaluation of the effect of pre-analytical delay within the context of clinical heterogeneity. Results: Principal component trajectories showed reproducible temporal shifts in HC but dispersed patterns in SLE, indicating disease- and treatment-related influences. Linear mixed-effects models identified metabolites with condition-specific kinetics, including glucose, choline, glycerophosphocholine, and pyroglutamic acid. Mycophenolate intake was further associated with distinct AMP dynamics. Conclusions: These findings demonstrate that both disease state and medication reshape apparent metabolite stability, highlighting the need for strictly controlled sample handling and well-characterized clinical cohorts in metabolomics studies. Full article

Owing to the great demand for healthy ageing promotion, and the anti-ageing reputation of anthocyanins and amino acids, we aimed to assess the effect of anthocyanin- and anti-ageing amino acids-enriched pigmented rice innovation on age-related cognitive decline, facial wrinkles, and a cardiovascular risk, and explored its mechanisms and safety. A total of 90 male and female volunteers (45–65 years old) participated in a 3-arm randomized, double blinded, placebo-controlled parallel study for 12 weeks. They were randomly allocated to one of the following groups: placebo, “Zuper rice” (Zup) 2 g/day and “Zuper Rice” 4 g/day. Cognition, facial wrinkles, atherogenic index in plasma (AIP), telomere length, telomerase, oxidative stress and inflammatory markers, together with safety parameters, were assessed every 6 weeks until the end of the study and compared to the baseline data. A high dose of “Zup” improved cognition, facial wrinkles, AIP and oxidative stress, while a low dose of “Zup” improved cognition, telomere length, telomerase and inflammation. No toxicity signs were observed. Therefore, “Zup” is a potential healthy ageing promotion innovation which improves telomere length, telomerase activity and inflammation at a low dose, resulting in an improvement in cognitive decline and the suppression of oxidative stress. At a high dose, it gives rise to improvements in cognition, facial wrinkles and cardiovascular risk. Full article

Background/Objectives: Radotinib is a second-generation tyrosine kinase inhibitor (TKI) that has been used for treatment of chronic myeloid leukemia (CML). This study was performed for the first time to characterize the pharmacokinetics of radotinib, identify the factors contributing to pharmacokinetic variabilities and explore alternative dosing regimens. Methods: A total of 640 plasma concentration–time datapoints obtained from 47 participants were evaluated using nonlinear mixed-effects modeling to estimate pharmacokinetic parameters and evaluate covariate effects. The study population comprised 23 healthy volunteers (HVs) who received a single, oral dose of 400 mg radotinib and 24 CML patients who repeatedly received 300 mg twice daily. Based on the final population pharmacokinetic model, alternative dosing regimens to the current every 12 h regimen were explored using Monte Carlo simulations. Results: A two-compartment model with first-order absorption through transit compartments and first-order elimination incorporating a circadian rhythm effect best described radotinib pharmacokinetics. Disease status significantly affected apparent clearance; it was slower by 39.2% in CML patients compared with HVs (23.0 L/h versus 37.9 L/h), resulting in a longer terminal half-life (28.8 h versus 17.5 h). Age was negatively associated with volume of distribution in the central compartment, with an estimated slope of −0.0129 L/year. A 400 mg once-daily regimen was predicted to provide comparable systemic exposures to those of other TKIs with similar physiochemical and pharmacological properties to radotinib, and a 36% lower exposure than that of the current 300 mg twice-daily regimen. Conclusions: The model developed in this study adequately describes the population pharmacokinetics of radotinib and provides a basis for optimal, individualized radotinib therapy for patients with CML. Full article

Background: Tetrabenazine, a VMAT2 inhibitor used for hyperkinetic disorders, shows considerable pharmacokinetic variability due to extensive first-pass metabolism. Standardization of clinical trial conditions, including posture, may reduce variability and improve bioequivalence assessments. Objective: The aim of this study was to determine the impact of postural restriction on the pharmacokinetics of tetrabenazine and its active metabolite, dihydrotetrabenazine (HTBZ), under controlled conditions. Methods: A randomized, open-label, four-period replicate crossover study enrolled 72 healthy fasted adults who received a single 25 mg tetrabenazine dose under two conditions: 4 h semirecumbent posture versus unrestricted movement. Plasma drug concentrations were measured across 36 h using validated LC–MS/MS method. Pharmacokinetic parameters were estimated via non-compartmental analysis and compared with Wilcoxon signed-rank tests. Results: Postural restriction significantly increased tetrabenazine exposure (AUC_0–t: +16.4%, p < 0.0001) and half-life (p = 0.002), with a nonsignificant rise in C_max. For HTBZ, C_max decreased (−16.2%, p = 0.018), whereas AUC was unchanged. Parent-to-metabolite ratios increased by 24–29%. Replicate design analyses showed reduced intra-subject variability for tetrabenazine AUC with posture control (~24% vs. >28%). Simulation suggested that posture restriction could lower sample size requirements by 15–30% in two-period average bioequivalence trials. Conclusions: Maintaining a semirecumbent posture after dosing enhances tetrabenazine’s bioavailability, attenuates early metabolite formation, and reduces pharmacokinetic variability. Incorporating posture control into bioequivalence trial protocols may optimize study design, reduce participant exposure, and align with ICH-GCP ethical principles. Full article

Shear viscosity is the main property linked to the therapeutic effect of thickening products (TP) and can be reduced by the effect of salivary α-amylase during the oral phase and shear thinning during the pharyngeal phase of swallowing. The main aim of this study was to determine the time-effect salivary α-amylase. The study solutions were prepared with three types of TP: modified starch (MS), xanthan gum (XG), and mixture (MX), and two viscosity levels: 250 and 800 mPa·s at 50 s⁻¹. Five volunteers performed oral incubations from 5 to 60 s to assess the time-effect of α-amylase. The results revealed that MS-TP presented a sudden reduction in shear viscosity >99% at 5 s at both viscosity levels. In contrast, XG-TP showed only a slight reduction (1–20%) to α-amylase for all the time intervals. MX-TP viscosity exhibited a reduction of 25% for 250 and 13% for 800 mPa·s. The immediate and extreme reduction in shear viscosity of MS-TP in contact with α-amylase contrasted with the amylase resistance presented by TPs that contained XG. These findings improve the description of the full rheological behavior of TP and provide valuable insights into optimizing the choice of TP in the management of patients suffering from swallowing disorders. Full article

Background/Objectives: Psychophysiological insomnia is characterized by acquired sleep difficulties and/or a state of hyperarousal when falling asleep. This hyperarousal can develop and/or maintain insomnia. In contrast, mindfulness can reduce stress and improve sleep. This cross-sectional study aimed to assess the relationship between mindfulness traits (acceptance and awareness), pre-sleep arousal (cognitive and somatic) states, and insomnia symptoms. Methods: A sample of 464 non-clinical volunteers (352 females; mean age 27.89 ± 9.48 years) participated in this online cross-sectional study, completing the Philadelphia Mindfulness Scale (PHLMS), Pre-Sleep Arousal State (PSAS), and Insomnia Severity Index (ISI). Results: The acceptance component of mindfulness but not awareness negatively correlated with ISI, as well as PSAS subscales. In a mediation model, acceptance was associated with ISI both directly and indirectly, through associations with cognitive arousal and somatic arousal. Conclusions: This study suggests a possible mechanism by which mindfulness works to influence sleep processes. In particular, acceptance can reduce pre-sleep arousal, reducing the possibility of developing and/or maintaining insomnia symptoms. Full article

Maintaining an effective facial seal is critical for the performance of tight-fitting industrial respirators used in high-risk sectors such as mining, manufacturing, and construction. Traditional fit verification methods—Qualitative Fit Testing (QLFT) and Quantitative Fit Testing (QNFT)—are limited to periodic assessments and cannot detect fit degradation during active use. This study presents a real-time fit detection system based on embedded breath sensors and machine learning algorithms. A compact sensor module inside the respirator continuously measures pressure, temperature, and humidity, transmitting data via Bluetooth Low Energy (BLE) to a smartphone for on-device inference. This system functions as a multimodal biosensor: intra-mask pressure tracks flow-driven mechanical dynamics, while temperature and humidity capture the thermal–hygrometric signature of exhaled breath. Their cycle-synchronous patterns provide an indirect yet reliable readout of respirator–face sealing in real time. Data were collected from 20 healthy volunteers under fit and misfit conditions using OSHA-standardized procedures, generating over 10,000 labeled breathing cycles. Statistical features extracted from segmented signals were used to train Random Forest, Support Vector Machine (SVM), and XGBoost classifiers. Model development and validation were conducted using variable-size sliding windows depending on the person’s breathing cycles, k-fold cross-validation, and leave-one-subject-out (LOSO) evaluation. The best-performing models achieved F1 scores approaching or exceeding 95%. This approach enables continuous, non-invasive fit monitoring and real-time alerts during work shifts. Unlike conventional techniques, the system relies on internal physiological signals rather than external particle measurements, providing a scalable, cost-effective, and field-deployable solution to enhance occupational safety and regulatory compliance. Full article

Ultrasonic phased arrays have shown promise in generating virtual texture haptics through haptics feedback points. However, factors such as skin vibration speed, amplitude variations, acoustic interference, and energy loss can influence textural haptics. In this study, using Spatiotemporal Modulation (STM), virtual textures are produced through movement of the focal point. The acoustic field of the ultrasonic phased array as well as the stress and strain experienced by the skin during texture perception are simulated by numerical analysis. At the same time, psychophysical experiments are conducted by volunteers to evaluate these textures. The experimental results indicate that as the focal rotation frequency increases, regions closer to the center experience more significant shear wave effects, resulting in longer shear wave propagation, reduced tangential stress amplitude, and a larger affected area. Moreover, as the frequency of the shear wave interference shifts, it results in increasingly complex textural representations. Full article

Since the World Health Organization (WHO) launched its global network for age-friendly cities (AFC) movement in 2010, the number of participating cities and towns, as well as the body of literature focusing on this initiative has grown steadily. Nevertheless, few studies have directly examined how older adult volunteers are involved in AFC planning and initiatives for their municipalities. This study explores the experience of citizen volunteers, mostly older adults, engaging in local municipal-level age-friendly (AF) advisory committees as a part of the Age-Friendly Niagara (AFN) movement in Ontario, Canada. Since its conception as a grassroots movement in 2013, the AFN Network (AFNN) has expanded across the entire region, as each municipal government has appointed its local AF advisory committee or an equivalent, which consists of citizen volunteers, at least one councilor and one municipal staff member. Employing a qualitative multisite case study approach, we conducted focus groups with eight municipal AF advisory committees (or their equivalent) (n = 48, average age 69) to explore their roles, achievements and challenges. Our findings highlight the crucial role older adult volunteers play in their local AFC initiatives as they strive to co-produce and co-create sustainable age-friendly communities in collaboration with their municipal government. Full article

Background: Infrared thermography and acute muscle fatigue are often correlated in sports medicine for assessing muscle health during and after exercise, but there are no known studies describing the response throughout exercise; therefore, this study aims to observe the variation in skin temperature (Tsk) during the execution of a maximal muscle fatigue protocol using concentric exercises in the triceps suralis. Methods: An open cross-sectional descriptive observational study of the posterior region of the leg (triceps suralis) was performed using 98 healthy subjects. Volunteers were subjected to a maximal fatigue protocol, with thermographic images analyzed at 25%, 50%, 75%, and 100% cumulative maximal fatigue. Results: Results showed a significant difference in time (p = 0.039; η²p = 0.026) and side (p =≤ 0.001; η²p = 0.120). Tukey’s post hoc analysis detected a significant difference in Tsk B between the R and L side (R, 30.3 ± 1.39 °C; L, 30.2 ± 1.39 °C), in Tsk at 25% (R, 30.2 ± 1. 27 °C; L; 30.1 ± 1.27 °C), in Tsk at 50% (R, 30.2 ± 1.29 °C; L, 30.1 ± 1.29 °C), and in Tsk at 75% (R, 30.3 ± 1.33 °C; L, 30.2 ± 1.33 °C). Conclusions: The results observed in this study show that infrared thermography is a valid tool for the measurement, analysis, and quantification of the tissue metabolic response of the muscular system, pre, during, and after exercise. Therefore, we believe that, for future studies, it would be interesting to find relationships between Tsk variations and other performance and metabolic variables. The focus on a single muscle and not directly measuring muscle activity are two limitations of this study. Full article

Isoprene, the most abundant endogenous hydrocarbon in human breath, is a promising biomarker for metabolic and cardiovascular diseases. In this paper, we present the detection of isoprene in exhaled breath using the off-beam Quartz-Enhanced Photoacoustic Spectroscopy (QEPAS) method. The sensor employs a homemade quantum cascade laser emitting at 11.03 μm. We use numerical simulations to evaluate the impact of interfering gases (CO₂ and H₂O) and optimize the laser modulation parameters. The limit of detection reached for 1 s acquisition time is close to 220 parts per billion in volume (ppbv) with a normalized noise equivalent absorption (NNEA) of $1.1\times {10}^{-8}{\mathrm{cm}}^{-1}·\mathrm{W}·{\mathrm{Hz}}^{-1/2}$. Breath measurements conducted on healthy volunteers reveal a significant increase in isoprene concentration from resting levels (~250–350 ppbv) to elevated levels (~450–650 ppbv) after moderate physical exercise. Full article

Background/Objective: This study aimed to evaluate the strain values (SVs) of masseter muscle activity in dentofacial deformities (DDs) using ultrasound elastography. Methods: The DD group consisted of 60 patients with dentofacial deformities with skeletal class II or III malocclusion, and the control group consisted of 26 volunteers with normal occlusion. The SVs and the cross-sectional area of the masseter muscle were measured using an ultrasonic elastography. These were measured at three functional positions: resting, mouth opening, and clenching. The SVs were statistically compared with the DD and control groups. Changes in the cross-sectional area and factors (patient status, skeletal morphology, and oral function) related to the SVs in the study group were statistically analyzed. Results: The SVs were significantly higher during clenching than in resting and mouth opening in both groups, although there was no correlation between the DD group and the control group. The cross-sectional area was larger during clenching, resting, and mouth opening. The resting SVs decreased as the masseter muscle cross-sectional area increased. The SVs of clenching increased with higher resting SVs and decreased with greater maximum mouth opening. Conclusions: The SVs measured by ultrasound elastography changed depending on functional mandibular movement and have the potential to evaluate the masseter muscle activity of dentofacial deformities. Full article