Search Results (16,880)

Background/Objectives: Randomized controlled trials (RCTs) are needed to evaluate the impact of food is medicine (FIM) programs, such as medically tailored groceries (MTGs) to treat hypertension among diverse populations. Partnerships between academic centers’ student-run organizations (SROs) and community-based organizations (CBOs) offer critical safety nets for historically underserved groups, positioning these organizations to effectively undertake FIM programs among populations disproportionately affected by hypertension. We conducted an unblinded pilot RCT whose objectives were to assess the feasibility and acceptability of an SRO-coordinated, CBO-partnered MTGs intervention targeting blood pressure (BP) and food insecurity (FI) in underserved groups. Methods: Adult Black/African American and Hispanic/Latinx patients in Durham, North Carolina, where essential hypertension and FI were randomized (parallel arm, computerized 1:1 ratio) to 12 weeks of home-delivered, hypertension-focused MTGs plus in-person nutrition education sessions with compensation (intervention) versus data collection sessions with compensation (control). We offered transportation, childcare, and home visits to facilitate session attendance. The primary outcomes were the eligibility, enrollment, and retention rates (feasibility), and the survey feedback from the participants and CBO partners (acceptability). The secondary outcomes included the changes in the mean BP and median FI score with associated 95% confidence intervals. Results: Medical record screening identified 1577 eligible participants. Of the 94 reached to confirm eligibility, 77 met the enrollment criteria, and 50 were randomized (82% post-screen eligibility, 65% enrollment). A conventional content analysis of 15 participant surveys and CBO partner feedback affirmed the acceptability, noting intervention components that enhanced the retention (e.g., home delivery, transportation support, home visits). Pre–post analyses of secondary outcomes for 13/25 intervention and 15/25 control participants completing ≥2 sessions ≥2 months apart were performed. The intervention was associated with an average change in systolic BP of −14.2 mmHg (−27.5, −4.5) versus −3.5 mmHg (−11.7, 5.9) in the control group. The FI scores improved by −2 (−2.2, −0.5) in the intervention group and −1 (−1.3, −0.2) in the control group. No adverse events were reported. Conclusions: SRO-CBO partnerships could be feasible and acceptable avenues for conducting FIM trials among underserved populations. This multi-component FIM approach enhanced the study equity by addressing the participants’ disease-related social needs and warrants expansion into a powered RCT. Full article

People, communities, and economies in small island developing states are extremely vulnerable to climate change, disasters, and other crises. Renewable energy can play an important part in building the resilience of these communities. Three case studies were conducted in Fiji (i.e., a grid-connected secondary school with roof-top solar PV and biogas, an off-grid community with solar home systems, and a farm that uses solar PV for irrigation) to demonstrate how renewable energy initiatives build community resilience. This study used the community resilience framework, RETScreen tool, information gathered from key informants’ interviews, and secondary data sources to conduct qualitative and quantitative analyses. It found that seven community assets, i.e., human, social, cultural, financial, natural, built, and political assets, are enhanced, leading to an increase in absorptive, adaptive, and transformative capacities for these communities. Furthermore, current research shows that human capital is one of the key instruments in the adoption of new innovative technologies. The results from this study can be used by decisionmakers to promote and implement similar technologies in communities, which not only provide clean electricity and clean cooking energy for climate change mitigation but also build community resilience. Full article

Since the early 1990s, Gaucher Disease has been a pioneering condition for home-based enzyme replacement therapy (ERT), marking a significant shift in patient care. Since then, many countries have adopted this approach. However, home ERT is not possible in all countries. Objectives: The aim of this article is to explore the implementation of home ERT for Gaucher disease, focusing on patient expectations, safety, compliance, economic benefits, and practical considerations. Methods: The PRISMA reporting protocol was followed, focusing on articles about home ERT for Gaucher Disease. Results: Twenty articles were analyzed in the review, revealing promising outcomes. Home ERT has consistently been shown to be safe, to improve patients’ quality of life, to reduce the utilization of hospital resources, and to pose no compliance issues. Conclusions: We believe it is essential to expand the availability of home ERT for Gaucher Disease to all countries where ERT is accessible. Based on the literature review, we present the conditions that must be met before starting home ERT programs. Full article

In this study, we investigate whether differences in sociodemographic and housing characteristics may lead to heterogenous reactions on water demand across households in the event of an unexpected shock. In this sense, we estimate a switching regression model for residential water usage in Gijón, Spain, between 2017 and 2021, exploiting the exogenous impact of the COVID-19 pandemic and various movement restriction phases. A rich dataset that integrates real data on water consumption and pricing, alongside reported household and housing characteristics, allows us to effectively control the heterogeneity of water consumers and test changes in marginal effects over time. Our findings reveal a significant increase in average water consumption coinciding with the onset of the pandemic. This increase in water usage was particularly pronounced among households with more members and those residing in older houses that also owned outdoor amenities such as gardens or swimming pools, among other socioeconomic and housing characteristics. Additionally, our study indicates that the price elasticity of water demand did not significantly differ from zero during the periods of the State of Alarm and the New Normal. This suggests that the implementation of movement restrictions and teleworking may have amplified households’ preferences and dependence on water, thus fostering increased water consumption. Furthermore, our results point towards unchanged residential information or knowledge of the expense of water services despite the time spent at home. Full article

Good sleep is essential for a healthy life. While airflow improves sleep in a hot environment, it may cause an excessive drop in body temperature because thermal-adaptive behavior is inactive during sleep. This study aims to propose an airflow control theory that prevents the excessive drop in body temperature while maintaining good sleep. The theory changes the heat transfer coefficient between the skin and the environment by the intensity of the fan operation to maintain a heat loss of 30 W/m² from a body with a skin temperature of 34.5 °C in a temperature-changing environment. We fabricated a ventilated sleep capsule in which this theory was embedded. Thermal manikin experiments were conducted to obtain the relationship between sensible heat transfer coefficients and the fan operating signal to establish control equations. We conducted a case study to evaluate whether the theory provided better sleep than sleeping with a regular fan running freely in homes in Ueda City, Japan, in one summer. Although the data used in the analysis were from only three subjects, the statistical analysis showed that sleeping in the ventilated sleep capsule provided better sleep, with a mean of 6% better sleep efficiency. Full article

Background: In this study, we describe a method by which a patient can independently assess their own periodontitis risk, for example, at home, with a mobile application. The aim of the study is to use active matrix metalloproteinase aMMP-8 mouth rinse cut-off 20 ng/mL point-of-care testing (POCT) and a polynomial function to reveal patients’ statistical risk of periodontitis. Methods: The polynomial function presented in this study was modeled with multiple logistic regression and the function estimates the risk of periodontitis using a probability measure. To investigate variables associated with periodontitis, we used data from adult patients visiting dental clinics in Thessaloniki, Greece. Results: The research results revealed that with appropriate information it is possible to obtain sufficient accuracy about a patient’s potential risk of periodontitis. The function for estimating risk of periodontitis is PERIORISK = (1 + e^{−(3.392×X1+0.002×X2+1.858×X3−9.151)})⁻¹, where X1 = aMMP-8 test result and tobacco smoking status, X2 = age × waist circumference and X3 = patient’s individual and parental history of diabetes. Conclusions: The prediction of periodontitis risk using an aMMP-8 test and a polynomial function seems to be a useful, non-invasive, safe-to-use and cost-effective tool for all people. Overall, in the model created, mouth rinse cut-off 20 ng/mL aMMP-8 test result, age, waist circumference, tobacco smoking status and patient’s individual and parental history of diabetes were found to be good factors explaining the risk of periodontitis. Full article

Background/Objectives: Children who suffer from congenital heart defects (CHDs) have a decreased ability to perform physical exercise and consequently have a decrease in their functional capacity. The main causes of this decrease in functional capacity have been related on the one hand to residual hemodynamic defects and, at the same time, to a situation of physical deconditioning due to inactivity, as well as problems in lung function, especially the presence of restrictive patterns that influence the amount of O₂ insufflated (decreased maximum VO₂), consequently generating a deficient maximum O₂ consumption and maximum work rate. This represents an important prognostic value, since it constitutes an independent predictor of death and hospitalization. This study aims to determine the benefits obtained regarding respiratory function, exercise capacity, and quality of life after implementing a hospital-based cardio-respiratory rehabilitation program compared to a home-based Cardio-respiratory Physical Activity Program in patients with intervened CHDs. Methods: This is a randomized controlled trial on the effectiveness of two different rehabilitation programs on respiratory function, exercise capacity, and quality of life in patients with CHDs conducted at the Child Cardiology and Congenital Heart Disease Unit of the University Hospital Complex of A Coruña (CHUAC). There will be two groups: Cardio-respiratory rehabilitation group program conducted in a face-to-face format at the hospital (n = 26) and a study group that follows a home-based Cardio-respiratory Physical Activity Program (TELEA) (n = 26). The measurement variables will be respiratory function, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), maximum expiratory flow (PEF), the Tiffeneau index (FEV1 /FVC), forced expiratory flow (FEF25%, FEF50%, FEF75%, FEF25–75%), exercise capacity (peak VO₂), and the quality of life of these children and their families. Conclusions: The implementation of cardiac and pulmonary rehabilitation programs in children with CHDs is essential to improve their quality of life, exercise tolerance, and socialization. These programs optimize life expectancy and promote integration, being crucial for their physical and emotional well-being Full article

Engagement in behaviors of concern (BoCs) by adults with intellectual and developmental disabilities (IDDs) living in small residential group homes can negatively impact the health, safety, and quality of life of the individuals themselves and others living and working in the home. Little is known about the societal cost of BoCs. The objective of this study was to quantify the cost of BoCs for residents, residential group homes, and public and healthcare services in terms of different behaviors. This descriptive study used incident and monthly behavior-tracking reports collected from small residential group homes for six months prior to implementing a social problem-solving intervention aimed at decreasing BoCs. The mean cost per BoC incident per resident was USD 80 ± 601. Health and safety incidents had the highest cost, followed by begging. BoCs impose costs on small residential group homes, public and healthcare services, and residents themselves. Full article

Diabetic foot syndrome is a multifactorial disease involving different etiological factors. This syndrome is also insidious, due to frequent lack of early symptoms, and its prevalence has increased in recent years. This justifies the remarkable attention being paid to the syndrome, although the problem of effective early screening for this syndrome, possibly at a patient’s home, is still unsolved. However, some options appear available in this context. First, it was demonstrated that the temperature measurement of the foot skin is an interesting approach, but it also has some limitations, and hence a more effective approach should combine data from temperature and from other sensors. For this purpose, foot skin conductance or bioimpedance measurement may be a good option. Therefore, the aim of this study was to review those studies where skin conductance/bioimpedance measurement was used for the detection of diabetic foot syndrome. In addition, we performed a meta-analysis of some of those studies, where a widely used device was exploited (SUDOSCAN^®) for foot skin conductance measurement, and we found that skin conductance levels can clearly distinguish between groups of patients with and without diabetic neuropathy, the latter being one of the most relevant factors in diabetic foot syndrome. Full article

Type 2 diabetes is a serious health problem worldwide. Metformin as the first-line drug in diabetes treatment mainly inhibits glucose production in the liver. Diabetes is often accompanied by other diseases, so patients may take many medications at the same time and have trouble controlling the therapy. This, in turn, may result in medications being stored in different, sometimes random places in the patient’s home where elevated temperatures or long-term exposure to solar radiation are possible. In this study, we aimed to analyze whether the total hemispherical reflectance and emittance values of metformin extended-release tablets would distinguish tablets stored correctly from those stored inconsistently with the manufacturer’s recommendations. Unexpired and expired extended-release tablets containing 750 mg metformin were tested. Unexpired tablets were analyzed in two ways i.e., 15 randomly selected tablets were stored as recommended (day 0), and the 15 next tablets in the blister were stored on a windowsill, where they were exposed to daylight for several hours during the day in mid-spring 2024 for 20 days (day 20). Total hemispherical reflectance (THR) was measured within seven spectral ranges from 335 nm to 2500 nm with a 410-Solar Reflectometer while emittance was analyzed within six spectral infrared ranges from 1500 nm to 21 microns with an ET 100 emissometer. The day 0 tablets showed the highest THR values in five spectral ranges from 400 to 1700 nm compared to expired and day 20 tablets. In the further infrared ranges, from 1.5 to 21 microns, unexpired tablets on day 0 had the lowest reflectance compared to day 20 tablets and expired tablets. This means that a greater amount of IR beam was absorbed by this type of tablet. Therefore, higher emittance was demonstrated by day 0 tablets than by other analyzed tablets. In addition, the emittance values for day 0 tablets decreased with increasing temperature. In conclusion, the storage of metformin extended-release tablets under unfavorable conditions may affect the physical structure of this drug form, which is manifested by changes in the reflectance and directional and hemispherical thermal emittance. Full article

As public concern for maritime safety grows, there is a pressing need to delve deeper into the root causes of maritime accidents and develop effective preventive strategies. Spatial-temporal analysis stands out as a powerful approach to pinpointing accident hot spots. While previous research has shed light on the spatial aspects of these incidents, a comprehensive understanding of their temporal dimensions remains elusive. This paper bridges this gap by leveraging the Space-Time Cube tool in conjunction with traditional Kernel Density analysis to chart the spatial-temporal dynamics of maritime accident hot spots. Focusing on the East China Sea, a region notorious for its high incidence of maritime accidents and home to numerous world-class ports, we present a case study that offers fresh insights. Data spanning from 1994 to 2020, sourced from the Lloyd’s List Intelligence (LLI) database, reveal the evolving landscape of maritime accidents in the area. Notably, since 2005, the Yangtze River Delta Region in China has emerged as a persistent hot spot for accidents, underscoring its significance in maritime safety discourse. Furthermore, our analysis from the 2010s detects a new hot spot expanding towards the southwest of Kaohsiung Port, China, signaling a burgeoning area of concern for maritime safety. While the Fujian coast of China has seen its share of accidents, it is not qualified as a hot spot zone. The Space-Time Cube proves to be an indispensable tool in unraveling the progression of maritime accidents, and our findings indicate that maritime accidents in certain areas may not be merely random occurrences but exhibit intricate patterns. Full article

Mitochondrial trifunctional protein (MTP) and long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiencies have been a part of the Slovenian newborn screening (NBS) program since 2018. We describe a case of early lethal presentation of MTPD/LCHADD in a term newborn. The girl was born after an uneventful pregnancy and delivery, and she was discharged home at the age of 3 days, appearing well. At the age of 4 days, she was found without signs of life. Resuscitation was not successful. The NBS test performed using tandem mass spectrometry (MS/MS) showed a positive screen for MTPD/LCHADD. Genetic analysis performed on a dried blood spot (DBS) sample identified two heterozygous variants in the HADHA gene: a nucleotide duplication introducing a premature termination codon (p.Arg205Ter) and a nucleotide substitution (p.Glu510Gln). Post-mortem studies showed massive macro-vesicular fat accumulation in the liver and, to a smaller extent, in the heart, consistent with MTPD/LCHADD. A neonatal acute cardiac presentation resulting in demise was suspected. We conducted a systematic literature review of early neonatal deaths within 14 days postpartum attributed to confirmed fatty acid oxidation disorders (FAODs), which are estimated to account for 5% of sudden infant deaths. We discuss the pitfalls of the NBS for MTPD/LCHADD. Full article

CD44, a pivotal cell surface molecule, plays a crucial role in many cellular functions, including cell-cell interactions, adhesion, and migration. It serves as a receptor for hyaluronic acid and is involved in lymphocyte activation, recirculation, homing, and hematopoiesis. Moreover, CD44 is a commonly used cancer stem cell marker associated with tumor progression and metastasis. The development of CD44 aptamers that specifically target CD44 can be utilized to target CD44-positive cells, including cancer stem cells, and for drug delivery. Building on the primary sequences of our previously selected thioaptamers (TAs) and observed variations, we developed a bead-based X-aptamer (XA) library by conjugating drug-like ligands (X) to the 5-positions of certain uridines on a complete monothioate backbone. From this, we selected an XA with high affinity to the CD44 hyaluronic acid binding domain (HABD) from a large combinatorial X-aptamer library modified with N-acetyl-2,3-dehydro-2-deoxyneuraminic acid (ADDA). This XA demonstrated an enhanced binding affinity for the CD44 protein up to 23-fold. The selected CD44 X-aptamers (both amine form and ADDA form) also showed enhanced binding affinity to CD44-overexpressing human ovarian cancer IGROV cells. Secondary structure predictions of CD44 using MFold identified several binding motifs and smaller constructs of various stem-loop regions. Among our identified binding motifs, X-aptamer motif 3 and motif 5 showed enhanced binding affinity to CD44-overexpressing human ovarian cancer IGROV cells with ADDA form, compared to the binding affinities with amine form and scrambled sequence. The effect of ADDA as a binding affinity enhancer was not uniform within the aptamer, highlighting the importance of optimal ligand positioning. The incorporation of ADDA not only broadened the XA’s chemical diversity but also increased the binding surface area, offering enhanced specificity. Therefore, the strategic use of site-directed modifications allows for fine-tuning aptamer properties and offers a flexible, generalizable framework for developing high-performance aptamers that target a wide range of molecules. Full article

Aim: This study sought to clarify the therapeutic benefits and mechanisms of action of pomegranate seed oil (PSO) in instances of ischemia–reperfusion (IR) damage in the lower extremities. Materials and Methods: The sample size was determined, then 32 rats were randomly allocated to four groups: Control (C), ischemia–reperfusion (IR), low-dose PSO (IR + LD, 0.15 mL/kg), and high-dose PSO (IR + HD, 0.30 mL/kg). The ischemia model in the IR group was established by occluding the infrarenal aorta for 120 min. Prior to reperfusion, PSO was delivered to the IR + LD and IR + HD groups at doses of 0.15 mL/kg and 0.30 mL/kg, respectively, followed by a 120 min reperfusion period. Subsequently, blood and tissue specimens were obtained. Statistical investigation was executed utilizing Statistical Package for the Social Sciences version 20.0 (SPSS, IBM Corp., Armonk, NY, USA). Results: Biochemical tests revealed significant variations in total antioxidant level (TAS), total oxidant level (TOS), and the oxidative stress index (OSI) across the groups (p < 0.0001). The IR group had elevated TOS and OSI levels, whereas PSO therapy resulted in a reduction in these values (p < 0.05). As opposed to the IR group, TASs were higher in the PSO-treated groups. Histopathological analysis demonstrated muscle fiber degeneration, interstitial edema, and the infiltration of cells associated with inflammation in the IR group, with analogous results noted in the PSO treatment groups. Immunohistochemical analysis revealed that the expressions of Tumor Necrosis Factor-alpha (TNF-α), Nuclear Factor kappa B (NF-κB), cytochrome C (CYT C), and caspase 3 (CASP3) were elevated in the IR group, while PSO treatment diminished these markers and attenuated inflammation and apoptosis (p < 0.05). The findings demonstrate that PSO has a dose-dependent impact on IR injury. Discussion: This research indicates that PSO has significant protective benefits against IR injury in the lower extremities. PSO mitigated tissue damage and maintained mitochondrial integrity by addressing oxidative stress, inflammation, and apoptotic pathways. Particularly, high-dose PSO yielded more substantial enhancements in these processes and exhibited outcomes most comparable to the control group in biochemical, histological, and immunohistochemical investigations. These findings underscore the potential of PSO as an efficacious natural treatment agent for IR injury. Nevertheless, additional research is required to articulate this definitively. Full article

This paper developed an artificial intelligence home environment monitoring system by using the Android Studio development platform. A database was constructed within a server to store sensor data. The proposed system comprises multiple sensors, a message queueing telemetry transport (MQTT) communication protocol, cloud data storage and computation, and end device control. A mobile application was developed using MongoDB software, which is a file-oriented NoSQL database management system developed using C++. This system represents a new database for processing big sensor data. The k-nearest neighbor (KNN) algorithm was used to impute missing data. Node-RED development software was used within the server as a data-receiving, storage, and computing environment that is convenient to manage and maintain. Data on indoor temperature, humidity, and carbon dioxide concentrations are transmitted to a mobile phone application through the MQTT communication protocol for real-time display and monitoring. The system can control a fan or warning light through the mobile application to maintain ambient temperature inside the house and to warn users of emergencies. A long short-term memory (LSTM) model and a convolutional neural network (CNN) model were used to predict indoor temperature, humidity, and carbon dioxide concentrations. Average relative errors in the predicted values of humidity and carbon dioxide concentration were approximately 0.0415% and 0.134%, respectively, for data storage using the KNN algorithm. For indoor temperature prediction, the LSTM model had a mean absolute percentage error of 0.180% and a root-mean-squared error of 0.042 °C. The CNN–LSTM model had a mean absolute percentage error of 1.370% and a root-mean-squared error of 0.117 °C. Full article