Search Results (25,965)

Large language models (LLMs) are transforming the medical landscape by enhancing access to information, diagnostics, treatment customization, and medical education, especially in areas like Gastroenterology. LLMs utilize extensive medical data to improve decision-making, leading to better patient outcomes and personalized medicine. These models are instrumental in interpreting medical literature and synthesizing patient data, facilitating real-time knowledge for physicians and supporting educational pursuits in medicine. Despite their potential, the complete integration of LLMs in real-life remains ongoing, particularly requiring further study and regulation. This review highlights the existing evidence supporting LLMs’ use in Gastroenterology, addressing both their potential and limitations. Recent studies demonstrate LLMs’ ability to answer questions from physicians and patients accurately. Specific applications in this field, such as colonoscopy, screening for colorectal cancer, and hepatobiliary and inflammatory bowel diseases, underscore LLMs’ promise in improving the communication and understanding of complex medical scenarios. Moreover, the review discusses LLMs’ efficacy in clinical contexts, providing guideline-based recommendations and supporting decision-making processes. Despite these advancements, challenges such as data completeness, reference suitability, variability in response accuracy, dependency on input phrasing, and a lack of patient-generated questions underscore limitations in reproducibility and generalizability. The effective integration of LLMs into medical practice demands refinement tailored to specific medical contexts and guidelines. Overall, while LLMs hold significant potential in transforming medical practice, ongoing development and contextual training are essential to fully realize their benefits. Full article

Background and Objectives: This scoping review evaluates the use of wearable sensor technologies for workplace safety and health monitoring in industrial settings. The aim is to synthesize evidence on the impact of these sensors and their application in high-risk environments. Materials and Methods: Following the PRISMA guidelines, a systematic search across four international electronic databases yielded 59 studies, of which 17 were included in the final review. The selection criteria involved studies that specifically utilized wearable sensors to monitor various health and environmental parameters relevant to industrial workers. Results: The analysis categorizes wearable technologies into five distinct groups based on their function: gas monitoring technologies, heart rate and physiological data collection, fatigue and activity monitoring, comprehensive environmental and physiological monitoring, and advanced sensing and data collection systems. These devices demonstrated substantial benefits in terms of early detection of health risks and enhancement of safety protocols. Conclusions: The review concludes that wearable sensor technologies significantly contribute to workplace safety by providing real-time, data-driven insights into environmental hazards and workers’ physiological status, thus supporting proactive health management practices in industrial settings. Further research is recommended to address the challenges of data privacy, sensor reliability, and cost-effective integration to maximize their potential in occupational health safety. Full article

Background: Intravenous thrombolysis is one of the most effective therapies for the treatment of acute ischemic stroke (AIS), with urokinase offering a cost-effective alternative to newer agents like alteplase and tenecteplase, especially in resource-limited settings. Methods: This review provides a comprehensive overview of the application of intravenous thrombolysis with urokinase for AIS in the clinical practice of stroke management, including the efficacy, safety, and cost-effectiveness of urokinase compared to other thrombolytic agents. Results: Urokinase, a first-generation thrombolytic drug, is a non-specific plasminogen activator that offers a cost-effective alternative. It has been used in clinical practice for over two decades to improve neurological outcomes in patients with AIS if administered within 6 h of ictus. Numerous studies have indicated that urokinase remains a viable option for patients who cannot access alteplase or tenecteplase because of economic constraints, time window limitations, availability, or other reasons. Conclusions: In low- and middle-income countries, urokinase is a cost-effective alternative thrombolytic drug. High-level evidence-based medical research is therefore urgently needed to confirm that urokinase is not inferior to new-generation thrombolytic drugs, and to assess whether it may even be superior in some patient populations. Full article

Sect. Tuberculata Chang in the genus Camellia (Theaceae Mirb.) is named after the “tubercle-like projections on the surface of the capsule and ovary”. Due to complex morphological variations in these taxon and insufficient field investigations, the interspecies relationships are unclear, the species’ definitions are vague, and the names are confusing. This is not conducive to the conservation and study of these species. Therefore, herein, we systematically explore the taxonomic status of five sect. Tuberculata species using morphological, pollen morphological, and molecular phylogenetic methods. The results showed that (1) the morphological characteristics of the flower, fruit, and leaves of C. anlungensis and C. leyeensis are similar. Furthermore, the pollen characteristics and pollen wall ornamentation show that there is no significant difference between the two species; (2) there are significant differences between C. acutiperulata and C. anlungensis in terms of leaf shape (elliptic vs. obovate), calyx characteristics (sepal apex pointed vs. sepal oblong), and fruit shape (subglobose folds with shallow verruculose vs. flat folds and verruculose protuberances with pronounced internal cleavage); (3) C. pyxidiacea and C. rubituberculata differ in flower color (white or light color vs. red) and fruit verrucae (obviously deeply cleft vs. shallowly uncracked); (4) a phylogenetic tree based on the chloroplast genome shows that C. anlungensis and C. leyeensis form a single clade (BS = 100%, PP = 1.0) and are on a different branch, with C. acutiperulata on clade II (BS = 100%, PP = 1.0), and C. pyxidiacea and C. rubituberculata clustered on different branches of clade I (BS = 99%, PP = 1.00). Considering the above results together, we propose that C. leyeensis should be treated as a homonym of C. anlungensis, and C. acutiperulata, C. pyxidiacea, and C. rubituberculata should be considered as separate species. Clarifying the taxonomic status of these five species not only advances our understanding of the significance and complexity of the systematic classification of the genus Camellia but also has important implications for diversity conservation and population genetics. Full article

Omega-3 polyunsaturated fatty acids (ω-3 PUFAs, n-3 PUFAs), including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA), are essential polyunsaturated fats primarily obtained from fatty fish and plant-based sources. Compelling evidence from preclinical and epidemiological studies consistently suggests beneficial effects of ω-3 PUFAs on bone health and healthy aging processes. However, clinical trials have yielded mixed results, with some failing to replicate these benefits seen in preclinical models. This contraindication is mainly due to challenges such as low bioavailability, potential adverse effects with higher doses, and susceptibility to oxidation of ω-3 fatty acids, hindering their clinical effectiveness. This review comprehensively discusses recent findings from a clinical perspective, along with preclinical and epidemiological studies, emphasizing the role of ω-3 PUFAs in promoting bone health and supporting healthy aging. Additionally, it explores strategies to improve ω-3 PUFA efficacy, including nanoparticle encapsulation and incorporation of specialized pro-resolving mediators (SPM) derived from DHA and EPA, to mitigate oxidation and enhance solubility, thereby improving therapeutic potential. By consolidating evidence from various studies, this review underscores current insights and future directions in leveraging ω-3 PUFAs for therapeutic applications. Full article

This paper reviews natural capital (NC) valuation approaches in the context of woodland, forest, and riparian ecosystems, emphasising the need for participatory methods to take priority over neoclassical economics approaches. Focusing on research carried out in Scotland, the study analyses findings according to a classification of natural capital initiatives that we have developed, building on ideas proposed by the UK ENCA initiative, a guideline proposed to help researchers and practitioners understand NC and take it into account in valuation, decision-making and policy. We have found that landscape-scale initiatives that address the relationships between people and place to inform value and decision-making beyond the economic (monetary) benefits generated by ecosystem services (ES) are becoming popular. For instance, recent methods employed to capture stakeholders’ non-utilitarian preferences include the use of participatory GIS mapping, scenario planning, and other participatory methods to identify, explore and quantify less tangible cultural ecosystem services (CES). The review shows that many studies provide information relevant to the formulation of a place-based NC approach, working towards the integration of contextual and relational values into land management decisions to help formulate management strategies that maximise ES delivery. Conversely, we have not found evidence of the integration of shared values arising from an eco-centric perspective of nature valuation into the more classical, instrumental value lens. Such an approach would help inform broader, overarching aspects of woodland and forest management that may foster more effective conservation and help to manage conflicts. Full article

Triterpenoid saponins from the Astragalus species possess valuable effects (cytotoxic, adjuvant, hepatoprotective, neuroprotective, antiviral, etc.). Some also have immunomodulatory activities. Astragalus glycyphyllos is distributed in Bulgaria and mainly accumulates cycloartane saponins. From the overground parts of the species, a triterpenoid cyloartane-type saponin (AGOS3) was isolated by different chromatographic techniques. A quantitative LC-MS method for the determination of the saponin was developed and validated. Further, the saponin was loaded in copolymeric micelles based on triblock copolymers of polyethylene oxide and polypropylene oxide (Pluronics). The LC-MS method was applied on the developed micelles to determine their loading degrees. Afterwards, the possible pharmacological effects of free and encapsulated in polymeric nanoparticles of triterpenoid saponin (1, 5, 10, 25, 50, and 100 µg/mL) were evaluated in isolated murine macrophages and lymphocytes in vitro. Free AGOS3 stimulated proliferation only at the highest tested concentrations (50–100 µg/mL), and the effect was more evident in isolated macrophages. Interestingly, AGOS3-loaded polymeric micelles caused concentration dependency and statistically significant increases in the proliferation of both isolated lymphocytes and macrophages, even at a lower concentration (10 µg/mL). These results could serve as the basis for further research on the immunomodulatory effect of this saponin. Full article

Background: Research into the pivotal role of potassium in chronic diseases and their comorbidities remains scarce. Our aim is to elucidate the relationship between potassium and chronic diseases, including comorbid conditions, and to provide evidence-based recommendations for potassium intake in patients. Methods: This study is anchored in a representative, population-based survey conducted in Zhejiang Province, China, in 2017, encompassing participants aged 18 to 69 years. Data collection included questionnaire responses, physical measurements, and biological samples, obtained through a multistage cluster random sampling method. A subset of 1496 participants provided complete 24 h urine samples. Results: The median age of the participants was 48.0 years (interquartile range [IQR] 24.0), with 51.1% being female, and hypertension was identified in more than one third (35.6%) of the participants. The prevalence of diabetes was approximately 9.0%, dyslipidemia was found in 34.2%, and microalbuminuria in 8.8%. The 24 h urinary excretion levels were 3613.3 mg/24 h (IQR 2161.7) for sodium and 1366.0 mg/24 h (IQR 824.9) for potassium, respectively. Potassium excretion exhibited an inverse relationship with blood pressure. Furthermore, a positive correlation was observed between potassium excretion and high-density lipoprotein cholesterol (HDL-C) levels, with an elevation of 0.03 mmol/L (95% confidence interval [CI] 0.00 to 0.05). In binary logistic regression analysis, individuals in the fourth quartile of potassium excretion (Q4) exhibited an odds ratio (OR) of 0.56 (95% CI 0.36–0.87) for hypertension compared to those in the first quartile (Q1). Urinary potassium excretion was inversely associated with low HDL-C levels, with Q4 individuals having 0.62 times the odds of having low HDL-C levels (OR, 0.62; 95% CI 0.39–1.00) compared to Q1. Conclusions: Potassium excretion demonstrated a direct negative correlation with certain comorbidities. This study underscores the pivotal role of potassium in the management of chronic diseases and associated comorbidities, thereby highlighting the significance of potassium in both public health initiatives and clinical practice. Full article

Viral infections in animals continue to pose a significant challenge, affecting livestock health, welfare, and food safety, and, in the case of zoonotic viruses, threatening global public health. The control of viral diseases currently relies on conventional approaches such as inactivated or attenuated vaccines produced via platforms with inherent limitations. Self-assembling ferritin nanocages represent a novel vaccine platform that has been utilized for several viruses, some of which are currently undergoing human clinical trials. Experimental evidence also supports the potential of this platform for developing commercial vaccines for veterinary viruses. In addition to improved stability and immunogenicity, ferritin-based vaccines are safe and DIVA-compatible, and can be rapidly deployed in response to emerging epidemics or pandemics. This review discusses the structural and functional properties of ferritin proteins, followed by an overview of the design and production of ferritin-based vaccines, the mechanisms of immune responses, and their applications in developing vaccines against animal and zoonotic viruses. Full article

Bufotalin (BT), a major active constituent of Chansu, has been found to possess multiple pharmacological activities. Although previous studies have shown that BT could inhibit the growth of glioblastoma (GBM), the safety of BT in vivo and the potential mechanism are still unclear. We conducted a systematic assessment to investigate the impact of BT on GBM cell viability, migration, invasion, and colony formation. Furthermore, in vivo results were obtained to evaluate the effect of BT on tumor growth. The preliminary findings of our study demonstrate the effective inhibition of GBM cell growth and subcutaneous tumor development in mice by BT, with tolerable levels of tolerance observed. Mechanistically, BT treatment induced mitochondrial dysfunction, bursts of reactive oxygen species (ROS), and subsequent cell apoptosis. More importantly, proteomic-based differentially expressed proteins analysis revealed a significant downregulation of integrin β4 (ITGB4) following BT treatment. Furthermore, our evidence suggested that the ITGB4/focal adhesion kinase (FAK)/extracellular signal-related kinase (ERK) pathway involved BT-induced apoptosis. Overall, our study demonstrates the anti-GBM effects of BT and elucidates the underlying mechanism, highlighting BT as a potential therapeutic option for GBM. Full article

Background/Objectives: Proximal humeral fractures (PHFs) are common, especially in the elderly, and account for 4% to 10% of all fractures, with women more often affected than men. Treatments include conservative methods, internal fixation and arthroplasty, with surgical approaches increasingly being used due to technological advancements. This study analyzes the evolution of PHF treatments in Italy from 2001 to 2022, using data from the Italian Hospital Discharge Records (HDRs) Database, and includes a stratified analysis by age and sex. Methods: Using HDR data from 2001 to 2022, records with ICD9-CM codes for proximal humeral fractures (812.0 and 812.1) among diagnoses were selected and categorized into three treatment groups: arthroplasty, fixation and conservative. Time series were analyzed with stratification by sex and age. Results: The extracted data included 486,368 records of PHFs, with 223,742 cases treated surgically (arthroplasty or internal fixation) and 262,626 treated conservatively; the average patient age was 66.6 years, with a higher proportion of women, especially among arthroplasty patients. Over time, the use of fixation and arthroplasty increased from 20% of treatments in 2001 to over 60% in 2022, with fixation becoming the most common treatment method by 2014 and arthroplasty significantly increasing among women, particularly in the 65–74 and 75–84 age groups. Conclusions: The study shows that in Italy, over the past two decades, treatment for PHFs has shifted from conservative methods to a preference for internal fixation and increasingly for arthroplasty, particularly among women and patients aged 65–84, reflecting evolving trends and technological improvements. Full article

This study aims to investigate how sustainability communication on social media, by retail fast-food chains, affects fast-food consumer behavior in terms of ascribed responsibility, felt obligation, and green values for the promotion of sustainable actions. Data-based evidence from fast-food customers in Malaysia established that sustainability communication increases the awareness of responsibility and moral obligation to behave sustainably. The findings of this study show that sustainability communication by retail fast-food chains leads to the improvement of the eco-conscious behavior of fast-food consumers. This relationship is mediated by psychological factors such as ascribed responsibility and felt responsibility and moderated by green values. The results of this study show that Malaysian customers who feel more responsible and obligated are likely to participate in sustainable behaviors. Furthermore, the high levels of green values enhance the impact of sustainability messages, meaning that sustainable communication can indeed change consumer behavior. This study supports the role of social media in improving the communication of sustainability and adapting the message to consumers’ values. These findings offer useful insights for fast-food firms that wish to enhance their sustainability initiatives and support the overall goals of sustainable development. This research also enhances the theoretical knowledge by incorporating both psychological and value-based factors into the model of sustainability communication, providing further insights into the effects of the factors on consumer behavior. This research thus offers a theoretical extension to the sustainability communication literature by considering psychological and value-based factors and offers practical implications for fast-food chains to enhance their sustainability communication and support sustainable development goals. Full article

Background: Remnant cholesterol (RC) is highly associated with several chronic diseases. However, the relationship between RC and Metabolic syndrome (MetS) remains unclear. The study’s objective is to illustrate the relationship of RC to MetS. Methods: The data were collected from the Chinese Nutrition and Health Surveillance (2015–2017), which included personal, household and dietary information. A total of 65,618 residents aged 20 years or older from 31 provinces in mainland China were included in this study. RC was calculated by the equation RC = TC − (LDL-C + HDL-C). The criteria for MetS were based on the 2020 Chinese Type 2 Diabetes Prevention and Treatment Guidelines. Logistic regression models were used to analyse the relationship between RC and MetS and every MetS component. The receiver operating characteristic (ROC) curve was established to evaluate the accuracy of RC in identifying MetS, and the area under the curve (AUC) and the best threshold were calculated. Results: The weighted RC level of Chinese residents aged 20 years or older was 0.48 mmol/L. Participants with high RC levels were likely to be elderly, have a higher prevalence of MetS, higher total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), hba1c, and lower high-density lipoprotein cholesterol (HDL-C). Sex, body mass index (BMI), education status, household yearly income per capita, marital status, area of the country, residence location, smoking status, fruit intake and sleep time had statistical differences in the RC group (p < 0.05). The OR of MetS gradually increased with an increase in the RC quartile (p < 0.01), and higher quartiles of RC (Q4) suggested the highest MetS risk. The prevalence of each MetS component gradually increased with an increase in the RC quartile. The ROC curve found that to identify MetS, the AUC and best threshold of RC were 0.71 and 0.52 mmol/L, respectively. Conclusions: RC had a positive association with MetS and each MetS component. The accuracy in identifying MetS was higher in RC than in other indexes. The current study could provide new scientific evidence for the early prevention and control of MetS. Full article

Scientific knowledge has advanced in the implementation of safe and beneficial interventions for children and adolescents with cerebral palsy (CP). Although the importance of interdisciplinary interventions that integrate all components of the International Classification of Functioning, Disability and Health (ICF) into family-centered practices is widely recognized, this approach is not yet widely adopted. Instead, many programs remain focused on isolated domains. This study presents the theoretical and methodological foundation of TREINI, an interdisciplinary and family-centered program developed for children and youth with CP and other neurodevelopmental disorders. TREINI incorporates intervention strategies that address all ICF domains. It is grounded in the biopsychosocial model of health and utilizes principles based on the best evidence in pediatric rehabilitation, including intensive training, task-oriented training, and a naturalistic learning environment. Unlike traditional rehabilitation approaches, the care provided by the TREINI program is delivered through an intensive and interdisciplinary approach, by a team working collaboratively in a single location. In addition to including evidence-based interventions, the TREINI program features two innovative components: the “City of Tomorrow”, a naturalistic learning environment, and the “TREINI Exoflex” therapeutic suit, specifically designed to address deficiencies in the body functions and structures of children with CP and other neurodevelopmental disorders. This program has been carefully designed to support the process of neurological re-education and rehabilitation for children and adolescents with neuropsychomotor developmental delays. Full article

Time-series forecasting represents of one of the most challenging and widely studied research areas in both academic and industrial communities. Despite the recent advancements in deep learning, the prediction of future time-series values remains a considerable endeavor due to the complexity and dynamic nature of time-series data. In this work, a new prediction model is proposed, named C-KAN, for multi-step forecasting, which is based on integrating convolutional layers with Kolmogorov–Arnold network architecture. The proposed model’s advantages are (i) the utilization of convolutional layers for learning the behavior and internal representation of time-series input data; (ii) activation at the edges of the Kolmogorov–Arnold network for potentially altering training dynamics; and (iii) modular non-linearity for allowing the differentiated treatment of features and potentially more precise control over inputs’ influence on outputs. Furthermore, the proposed model is trained using the DILATE loss function, which ensures that it is able to effectively deal with the dynamics and high volatility of non-stationary time-series data. The numerical experiments and statistical analysis were conducted on five challenging non-stationary time-series datasets, and provide strong evidence that C-KAN constitutes an efficient and accurate model, well suited for time-series forecasting tasks. Full article