Background/Objectives: In rural settings, work, family, and environmental conditions are closely intertwined, requiring Primary Health Care to recognize care needs arising from productive work and everyday family responsibilities. This study aimed to analyze overall and domain-specific levels of perceived workload related to agriculture/fishing and family involvement in the household among rural and small-scale fishing workers, examine associated factors, and discuss analytical implications for nursing care organization in Primary Health Care. Methods: This cross-sectional study was conducted in three island territories in Rio Grande, southern Brazil, following the STROBE guidelines. Data were collected using a structured questionnaire on sociodemographic, family, and occupational characteristics and the NASA Task Load Index (NASA-TLX), applied separately to assess workload related to agriculture/fishing and family involvement in the household. Results: The sample included 146 rural and small-scale fishing workers. Perceived workload could suggest high in both dimensions, with higher levels in agriculture/fishing (mean 84.0 ± 16.5; 89.7% high/very high) than in family involvement in the household (mean 76.1 ± 24.5; 75.4% high/very high). Agriculture/fishing workload perceived could suggest highest scores for overall effort level, temporal demand, and physical demand, whereas family involvement could suggest highest scores for performance-related workload and overall effort level. In the adjusted model, agriculture/fishing perceived workload may be associated with longer daily working time (b = 1.69; 95% CI: 0.82 to 2.56; p < 0.001) and shorter rest time during work (b = -0.05; 95% CI: -0.08 to -0.01; p = 0.011). Perceived workload related to family involvement in the household may be associated with monthly income up to two minimum wages (b = 19.90; 95% CI: 7.78 to 32.10; p = 0.001). The adjusted R2 values were 17.3% and 6.7%, respectively. Conclusions: Perceived workload appears to be related to high levels in both productive and family household contexts. The findings might contribute to providing analytical support for future discussions on nursing care organization in Primary Health Care, potentially by considering working conditions, family responsibilities, and territorial context when discussing care needs among rural and small-scale fishing workers.
Background/Objectives: Skin cancer is one of the most common diseases worldwide, with a high mortality rate. Due to its ability to metastasize, the disease can progress to more serious stages over time. This article proposes a hybrid model based on feature engineering that will play a critical role in the early diagnosis of the disease. Methods: The developed model in this paper utilizes the well-known Vision Transformer (ViT) and Convolutional Neural Network (CNN) models for feature extraction from images in the dataset, while the FT-Transformer, Excel Former, SAINT, GRANDE, PTaRL, and TabTransformer architectures are used for feature extraction from clinical data. Furthermore, this study was developed using a very large pool of classifiers, including 13 classifiers. Fine-tuning was applied to improve the performance of the developed model. Channel attention mechanisms were incorporated into the study to ensure that the proposed model focuses on the diseased area. The PAD-UFES-20 dataset was used during the experiments. Class weighting was applied to the proposed model to prevent class-based imbalance in the PAD-UFES-20 dataset. Results: Six distinct CNN and four distinct ViT models were compared to the developed model. The developed model achieved a highly competitive Area Under the Curve (AUC) rate of 96.41%. The study was conducted using a dataset containing both clinical and imaging data. Conclusions: The proposed model is thought to help dermatologists diagnose skin cancer.
Secondary autoimmune and inflammatory diseases (SAIDs) are underrecognized and poorly described after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The standardization of management is hindered by the scarcity of data on epidemiology, pathogenesis, and clinical outcomes. To improve the evidence base, we performed a retrospective multicenter EBMT database study of patients who underwent allo-HSCT between 2005 and 2019 for either hematological malignancy or severe aplastic anemia with available information on SAIDs. We included 129 cases of SAIDs and 14,617 controls. The 5-year incidence of SAIDs was 0.9% (95% confidence interval (CI): 0.7-1.1), and the 10-year incidence was 1.1% (95% CI: 0.9-1.3). The median time from allo-HSCT to the diagnosis of SAIDs was 442 days [interquartile range (IQR): 242-1082]. Overall survival after the onset of SAIDs was 83.4% (95% CI 74.6-89.3) at 2 years and 73.4% (95% CI: 62-82) at 5 years. In multivariate analysis, risk factors significantly associated with SAIDs were bone marrow failure (Hazard Ratio (HR): 3.41 [95% CI, 1.55-7.52], p = 0.002), female donor to male patient (HR 1.77 [95% CI, 1.15-2.73], p = 0.009), and the presence of chronic GvHD (HR 1.61 [95% CI, 1.04-2.51], p = 0.034). SAIDs after allo-HSCT are rare but clinically significant entities requiring further investigations, exploring treatment and prevention strategies, as well as improving diagnostic approaches.
Microneedle systems are a promising category of devices used for various applications, such as drug delivery and diagnostics, offering benefits, including but not limited to, painless administration and improved patient experience and compliance. When combined with nanotechnology, these systems can offer improved therapeutic performance. This article analyzed the patent landscape related to technologies combining microneedles and nanotechnology. Patent documents were retrieved from the Espacenet database up to 2024. After applying predefined inclusion and exclusion criteria, 932 patents were selected from an initial set of 1,368 documents. The patents were categorized according to application field, publication year, country, origin of the invention (academic, industrial, independent, or other), type of nanotechnology used, and target substance. The results revealed an increasing global patent activity related to the integration of microneedles and nanotechnology. The patents covered diverse therapeutic and preventive applications and demonstrated the incorporation of multiple nanosystems, microneedle formats, and bioactive compounds. It is notable that this technological association has a multidisciplinary nature and is increasingly relevant to drug delivery innovation. The diversity of approaches reflects the potential of combining nanotechnology with microneedle systems to address different challenges in a wide number of health-related fields. Overall, the patent landscape indicates a growing global interest in microneedlenanotechnology integration. The findings may support technological assessment, research planning, and the identification of collaboration opportunities between academia and industry.
Avian influenza viruses (AIVs) are widely distributed and have a wide range of hosts. Recently, the number of cases of infection associated with the circulation of highly pathogenic avian influenza H5N1 2.3.4.4b has raised concerns about its high transmission capacity in birds and mammals. This study analyzed swabs from bird and mammal species from the coast of Paraná and the northwest region of São Paulo, Brazil, for the presence of AIV in animals that did not present clinical or histopathological lesions of infection that indicated the need for molecular characterization during monitoring. Of the 661 animals analyzed, three tested positive, two of which were birds (Sula leucogaster and Thalasseus acuflavidus) while one was a mammal (Otaria flavescens) (0.45%, CI 95%: 0.16-1.33). A complete genome sequence of H5N1 AIV was obtained from a brown booby (Sula leucogaster) from the Paraná coast (GISAID accession number: EPI_ISL_1897537). Our study reinforces the importance of continuous genomic surveillance, especially in AIV hosts that do not show signs of infection, to enhance the One-Health assessment approach.
The prevalence and impact of mental health challenges among racially and ethnically diverse populations have received growing attention in recent years. This study investigates the factors associated with mental health service utilization and unmet mental health care needs among minoritized adults in the United States. Drawing on data from the 2021-2022 National Health Interview Survey (NHIS), an annual survey of the U.S. civilian, noninstitutionalized population that understands public health conditions, this study included a sample of Asian, Black/African American, and Hispanic participants (N = 16,245). A secondary data analysis was conducted using a multinomial logistic regression framework to examine how predisposing, enabling, and need-based factors influence patterns of mental health service use, guided by Andersen's Behavioral Model of Health Services Use. Findings highlight persistent disparities, showing that Black and Hispanic individuals who reported living with disabilities were more likely to forgo mental health services due to cost. Additionally, Asian older adults were less likely to report receiving mental health services. Meanwhile, Asian young adults who had never been married and who experienced anxiety had the highest odds of delaying mental health care. Together, these findings underscore the importance of culturally responsive strategies to improve access and equity in mental health services for minoritized individuals with intersecting social identities, as well as the need to strengthen training for culturally competent providers with attention to cultural diversity, acculturation processes, language proficiency, and advocacy.
Background/Objectives: There is increasing interest in and evidence for the role of ultra-processed foods (UPFs) in cardiometabolic risk. We tested the hypothesis that UPF intake score derived from dietary history is associated with measures of insulin secretion and sensitivity in a family setting even when the process of type 2 diabetes is still to ensue. Methods: We used data from our well-characterized San Antonio Family Assessment of Metabolic Risk Indicators in Youth (SAFARI) study cohort of nondiabetic children (aged 6-17 years). Dietary history was assessed using the Block Food Frequency Questionnaire. Outcomes of interest were 19 clinically useful indexes of insulin secretion/sensitivity based on fasting and oral glucose tolerance test results. Since the SAFARI study employed a family study design, we used polygenic regression models that adjusted for complex interactions between age and sex and accounted for important comorbidities. Results: A total of 53.3% of daily energy intake was contributed by UPF. Of the 19 indexes tested for association with the UPF score, we found a statistically significant association with measures of insulin resistance and beta cell function and with three indexes based on the results of oral glucose tolerance test as follows: Matsuda index (β = -0.0962, p = 0.0262), insulinogenic index at 30 min (β = 0.1779, p = 0.0006) and disposition index at 30 min (β = 0.1538, p = 0.0061). Conclusions: Even in nondiabetic children there was a significant and independent association of UPF intake with insulin secretion and sensitivity. Future studies need to investigate this association in larger, longitudinal settings and in randomized trials controlling potential systematic errors.
Short-neck morphology remains a challenging problem in cervicofacial rejuvenation because conventional neck contouring techniques do not consistently improve neck length perception. To evaluate a dual-plane deep reduction neck lift combining complete platysma transection and vector-controlled platysma repositioning for improvement of cervical contour and neck length perception in short-neck patients. A retrospective cohort study included 167 consecutive patients who underwent deep-plane facelift combined with dual-plane deep reduction neck lift between May 2023 and June 2024. Ninety-five patients met the Auersvald criterion for short neck (neck-clavicle distance ≤24% of vertex-clavicle height) and were analyzed. The procedure combined deep neck reduction, hyoid fasciotomy, complete platysma transection, and differential repositioning of the cranial and caudal platysma segments. Outcomes included cervicomental angle, postoperative-to-preoperative anterior neck length ratio (PANL), FACE-Q assessment, blinded surgeon evaluation, and complications. The mean PANL ratio was 2.49 ± 0.11, demonstrating a significant increase in apparent cervical length (p < 0.001). All patients showed improvement in cervical contour. FACE-Q demonstrated high satisfaction, with 94.7% of patients reporting being very satisfied. Blinded evaluators reported a mean perceived age reduction of 16 years. Complications were limited to transient neuropraxia (4.3%) and sialoma (3.1%), with no permanent sequelae. Dual-plane deep reduction neck lift with vector-controlled platysma repositioning provides consistent improvement in cervical contour and neck length perception in selected short-neck patients, with high patient satisfaction and a favorable safety profile.
Complex bone and joint infections (BJIs) represent a major public health challenge because of their severity, functional consequences, and the complexity of their management. In 2008, France established a nationwide network of Referral Centers for Complex Bone and Joint Infections (CRIOAc), a pioneering organization based on specialized multidisciplinary team (MDT) meetings and comprehensive national territorial coverage. We conducted a nationwide descriptive study of the CRIOAc network, assessing its activity and evolution since its establishment, including organizational changes, funding mechanisms, scientific output, and academic activities. Data were extracted from the national CRIOAc information system, which prospectively records all cases discussed during MDT meetings. A descriptive bibliometric analysis of publications citing the seminal CRIOAc article was also performed. The network expanded from 8 coordinating referral centers at its inception to 32 accredited centers in 2024, providing nationwide coverage. It is governed by a National Scientific Committee representing all specialties and geographic regions. Since its creation, 64,859 patients have been managed within the network. The annual number of MDT meetings increased from 698 in 2011 to 1,760 in 2024, while the number of surgical admissions for BJI increased from 6,148 to 11,340 over the same period. The proportion of cases classified as complex remained stable at approximately 60-65%. The CRIOAc network has contributed to the development of national and international clinical guidelines, the establishment of a national inter-university diploma, the conduct of multicenter research projects, and the implementation of innovative phage-related anti-infective therapies. Bibliometric analysis demonstrates the growing international dissemination of the CRIOAc model. Eighteen years after its establishment, the CRIOAc network represents a pioneering and sustainable national model for the multidisciplinary management of complex BJIs, whose core principles are now supported by the international literature. Its mission has expanded beyond specialized clinical care to encompass research, education, and the evaluation of innovative therapeutic strategies. Further integration into European collaborative networks could strengthen its contribution to improving the management of complex bone and joint infections. IV; Retrospective study.
People with liver cirrhosis are at an increased risk of bacterial infections, with a high rate of complications and mortality. Adding albumin to antibiotics may reduce their occurrence. To assess the benefits and harms of intravenous administration of human albumin in people with liver cirrhosis and bacterial infections versus no intervention, placebo, or other intravenous fluids. We identified randomised clinical trials (RCTs) through electronic searches in the Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE, Embase, LILACS, Science Citation Index Expanded, and Conference Proceedings Citation Index-Science. We searched online clinical trial registries for unpublished or ongoing trials and checked reference lists for additional trials (latest search date: 20 August 2025). RCTs comparing albumin versus no intervention, placebo, or other intravenous fluids, in people with infection in cirrhosis. Critical outcomes: all-cause mortality, serious adverse events, and health-related quality of life. Among the important outcomes were kidney impairment, acute liver decompensation, acute-on-chronic liver failure, and septic shock. We used the Cochrane risk of bias (RoB) 2 tool. We used standard Cochrane methods. We meta-analysed outcome data at the longest follow-up. We presented dichotomous outcomes as risk ratios (RR) or odds ratios (OR), with 95% confidence intervals (CI), and a random-effects model. We assessed the certainty of evidence with GRADE. We used 0.25 minimal important difference and optimal information size to assess imprecision. We included 11 parallel-group RCTs (published between 1999 and 2022), with 1273 adults with cirrhosis and bacterial infections. One trial was a multicentre trial conducted in eight European countries, and ten were conducted in India, Spain, China, France, Egypt, and Taiwan. The trials' settings were clinics or university hospitals. Trial participants had spontaneous bacterial peritonitis (n = 388; five trials), infections other than spontaneous bacterial peritonitis (n = 477; four trials), and infections in different sites and sepsis-induced hypotension (n = 408; two trials). Intravenous albumin was compared with no intervention (eight trials) and other intravenous fluids such as plasmalyte, normal saline, or hydroxyethyl starch (three trials). All participants received antibiotics. The follow-up was four to 90 days. All trials provided data for intention-to-treat analysis. Below, we present only the outcome results displayed in our Summary of Findings tables. Risk of bias For overall risk of bias, most of the outcomes had some concerns or a high risk of bias. This was due to missing information regarding the randomisation process, deviations from the intended interventions, missing outcome data, measurement of the outcome, or bias in the selection of the reported result. GRADE We downgraded the evidence to low or very low due to risk of bias and imprecision, meaning that the evidence was either uncertain or very uncertain. This was mainly due to a high or unclear risk of bias or due to imprecision (wide confidence intervals crossing thresholds of interest, or optimal information size not reached). Albumin versus no intervention There may be little to no difference between albumin and no intervention regarding all-cause mortality (RR 0.80, 95% CI 0.53 to 1.20; I² = 45%; 8 studies, 845 participants; very low-certainty evidence), but the evidence is very uncertain. The evidence is also very uncertain about the effect of albumin on serious adverse events (RR 3.15, 95% CI 0.39 to 25.15; I² = 21%; 3 studies, 411 participants; very low-certainty evidence) and about whether it may reduce the risk of kidney impairment (RR 0.51, 95% CI 0.28 to 0.93; I² = 45%; 7 studies, 768 participants; very low-certainty evidence). The evidence is either uncertain or very uncertain about the effect of albumin on acute liver decompensation (RR 1.87, 95% CI 0.36 to 9.81; I² not applicable; 1 study, 118 participants; very low-certainty evidence), on acute-on-chronic liver failure (RR 0.86, 95% CI 0.43 to 1.73; I² not applicable; 1 study, 118 participants; low-certainty evidence), and on septic shock (RR 1.07, 95% CI 0.41 to 2.76; I² not applicable; 1 study, 118 participants; low-certainty evidence). Albumin versus other intravenous fluids The evidence is very uncertain about the effect of albumin on all-cause mortality (RR 1.05, 95% CI 0.85 to 1.29; I² = 0%; 3 studies, 428 participants; very low-certainty evidence). Albumin may increase serious adverse events (Peto OR 9.25, 95% CI 2.66 to 32.18; I² not applicable; 2 studies, 408 participants; very low-certainty evidence), but the evidence is very uncertain. There may be little to no difference between albumin versus other intravenous fluids for kidney impairment (RR 0.77, 95% CI 0.53 to 1.10; I² = 0%; 2 studies, 120 participants; very low-certainty evidence), but the evidence is very uncertain. Albumin may reduce the risk of septic shock (RR 0.91, 95% CI 0.85 to 0.97; I² = 0%; 2 studies, 408 participants; low-certainty evidence), but the evidence is uncertain. No trial reported data on quality of life, acute liver decompensation, or on acute-on-chronic liver failure. Seven trials were without for-profit support, one trial declared partial private funding, and three trials did not declare sources of support. We identified three ongoing trials. Due to the very low certainty and low certainty of evidence, we are either uncertain or very uncertain about the effect of albumin, compared with no intervention, on all-cause mortality, serious adverse events, kidney impairment, acute liver decompensation, acute-on-chronic liver failure, and septic shock. Due to very low certainty of evidence, we are very uncertain about the effect of albumin, compared with other intravenous fluids, on all-cause mortality or kidney impairment. The evidence is also very uncertain whether albumin increases serious adverse events. Due to low-certainty evidence, we are uncertain whether albumin reduces septic shock. No trial in this comparison reported data on acute liver decompensation and acute-on-chronic liver failure. Data on health-related quality of life were lacking. Though clinically relevant, we could not assess the effect of albumin in regard to the site and stage of infection due to insufficient data. We lack trials in children. None. Protocol available via 10.1002/14651858.CD014636.
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While functional mobility is known to deteriorate with age, the specific mechanisms driving this decline, along with potential differences between men and women, are not fully established. Therefore, the present study applied a moderated mediation framework to investigate whether lower limb strength and body mass index (BMI) mediate the relationship between aging and functional mobility, and to explore if sex acts as a moderator in these relationships. A cross-sectional design was used to evaluate 408 independent older adults (mean age: 71.9 ± 3.9 years; 273 females and 135 males). Assessments included the Timed Up and Go (TUG) for functional mobility, the 30 s Chair Stand for leg strength, alongside BMI calculations. Direct and indirect pathways were subsequently evaluated using a moderated mediation analysis. Lower limb strength and BMI significantly predicted functional mobility in both sexes (p < 0.05), with no significant moderation in the indirect pathways. Regarding conditional effects, advancing age predicted poorer functional mobility in females (p = 0.008) but not in males (p = 0.141), independent of the mediators. Strength and BMI appear to be correlates of functional mobility. However, since the age-by-sex interaction term was not statistically significant, the potential sex-specific direct effect of age must be interpreted with caution. While these findings hint at possible subtle differences in aging trajectories, future research is needed to confirm whether interventions for older women require addressing factors beyond strength and body composition.
In modern sows, litter size often exceeds the number of functional teats. Therefore, many farms retain surplus piglets within the litter. The present study evaluated the effect of cross-fostering biological litters with up to two surplus piglets relative to functional teats, allowing piglet replacement until day three of lactation. Females were selected (n = 201) at farrowing and evenly distributed among treatments: +0 (number of piglets equal to functional teats), + 1 (one surplus piglet), and + 2 (two surplus piglets). Biological litters were formed three to 12 h after farrowing (day 0). Piglets that died or were removed (low viability) during the first three days of life were weighed and replaced. Piglets in the + 2 group tended to have lower immunocrit values than those in the + 0 group (P = 0.06). Although the + 2 group exhibited the highest overall piglet loss rate across lactation (P ≤ 0.01), litter sizes in the + 1 and + 2 groups were larger than those in the + 0 group (P < 0.01). Piglets in the + 2 group also had reduced average daily gain compared with piglets in the + 0 and + 1 groups (P < 0.01). Facial and joint injuries were more frequent in the + 1 and + 2 groups on D5 (P < 0.01). No differences among treatments were found in udder injury scores, number of functional teats, sow body condition at weaning, daily milk production, or subsequent reproductive performance (P ≥ 0.10). Cross-fostering litters with up to two surplus piglets increased the number of piglets weaned without impairing sow performance, although individual piglet growth and early lesions were negatively affected.
Wire Laser Additive Manufacturing (WLAM) has emerged as a promising alternative for the fabrication and repair of components subjected to severe wear conditions due to its high deposition rate, efficient material utilization, and localized thermal control. In this study, the WLAM process using DUR600 wire as the feedstock material for the deposition of abrasion-resistant coatings was investigated. The deposited specimens were characterized by optical emission spectroscopy (OES), X-ray diffraction (XRD), optical microscopy (OM), scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM/EDS), Vickers microhardness testing, and dry sand/rubber wheel abrasion testing in accordance with ASTM G65. The deposits exhibited a predominantly martensitic microstructure with retained austenite, as confirmed by XRD. Hardness values ranged from 749 to 817 HV, with an average of 783 ± 18 HV, while the average volumetric loss in the abrasive wear test was 150.26 mm3. This behavior was attributed to the presence of the martensitic matrix and retained austenite, whose combined effect directly influences the tribological performance of WLAM coatings produced using DUR600 wire.
To examine agreement between telephone and in-person administration of the Early Childhood Development Index 2030 (ECDI2030) survey. In this crossover study, we compared in-person ECDI2030 interviews with other modalities (primarily telephone-based interviews) selected at a country level in Brazil, Canada, India and Malawi. Eligible participants were primary caregivers of preschool-aged children (36-60 months old), with equal recruitment across child sex and urban and rural residence. The primary outcome was agreement in overall scores between in-person interviews and other tested modalities, assessed using paired t-tests and intraclass correlation coefficients. The analytical sample included 258 individuals, with 212 paired observations for in-person and telephone-based interviews. Pooled t-tests showed no significant differences in overall scores between the interview modalities. However, in-person interviews yielded slightly higher scores than telephone interviews for female children (mean difference: 0.23; Cohen's d diff: 0.22) and participants from India (mean difference: 0.47; Cohen's d diff: 0.44). Canadian participants had lower scores on the second assessment completed (mean difference: -0.27; Cohen's d diff: -0.36), regardless of modality. However, pooled and stratified intraclass correlation coefficients analyses indicated that these modalities were statistically similar, with values ranging from 0.89 to 0.93, which are values commonly categorized as good to excellent. This multinational, multicentre, crossover study shows high agreement between telephone and in-person administration of the ECDI2030 across economically, culturally and geographically diverse settings. Expanding administration modalities may improve feasibility, particularly in geographically dispersed populations and rural settings. Examiner la concordance entre des entretiens par téléphone et en personne dans le cadre de l’enquête sur l’Indice de développement de la petite enfance 2030 (ECDI2030). Cette étude croisée a comparé les entretiens en personne dans le cadre de l’ECDI2030 à d’autres modalités (principalement des entretiens téléphoniques) sélectionnées au niveau national au Brésil, au Canada, en Inde et au Malawi. Les participants éligibles étaient les principaux gardiens d’enfants d’âge préscolaire (âgés de 36 à 60 mois). Le recrutement de ces participants était équilibré selon le sexe de l’enfant et le lieu de résidence (urbain ou rural). Le critère de jugement principal était la concordance des scores globaux entre les entretiens en personne et les autres modalités d’entretien, évaluées à l’aide de tests t appariés et de coefficients de corrélation intraclasse. L’échantillon d’analyse comprenait 258 personnes, avec 212 observations appariées pour les entretiens en personne et les entretiens téléphoniques. Les tests t regroupés n’ont montré aucune différence significative dans les scores globaux entre les différentes modalités d’entretien. Cependant, les entretiens en personne ont généré des scores légèrement supérieurs à ceux des entretiens téléphoniques pour les enfants de sexe féminin (différence moyenne: 0,23; d diff de Cohen: 0,22) et les participants indiens (différence moyenne: 0,47; d diff de Cohen: 0,44). Les participants canadiens ont obtenu des scores plus faibles lors de la deuxième évaluation (différence moyenne: -0,27; d diff de Cohen: −0,36), quelle que soit la modalité d’entretien. Toutefois, les analyses des coefficients de corrélation intraclasse regroupés et stratifiés ont indiqué que ces modalités étaient statistiquement similaires, avec des valeurs comprises entre 0,89 et 0,93, qui sont généralement évaluées comme bonnes à excellentes. Cette étude multinationale, multicentrique et croisée présente une forte concordance entre les entretiens téléphoniques et en personne de l’ECDI2030 dans des contextes diversifiés sur les plans économique, culturel et géographique. L’élargissement des modalités d’entretien pourrait améliorer la faisabilité, en particulier dans les populations géographiquement dispersées et les milieux ruraux. Examinar la concordancia entre entrevistas telefónicas y presenciales en el marco de la encuesta del Índice de desarrollo de la primera infancia 2030 (ECDI2030). En este estudio cruzado, se compararon entrevistas presenciales del ECDI2030 con otras modalidades (principalmente entrevistas telefónicas) seleccionadas a nivel nacional en Brasil, Canadá, India y Malawi. Los participantes elegibles fueron cuidadores principales de niños en edad preescolar (de 36 a 60 meses de edad), con un reclutamiento equilibrado según el sexo del niño y el lugar de residencia (urbano o rural). El resultado principal fue la concordancia de las puntuaciones globales entre las entrevistas presenciales y las otras modalidades de entrevista evaluadas, analizada mediante pruebas t pareadas y coeficientes de correlación intraclase. La muestra analítica incluyó 258 personas, con 212 observaciones pareadas correspondientes a entrevistas presenciales y telefónicas. Las pruebas t agrupadas no mostraron diferencias significativas en las puntuaciones globales entre las distintas modalidades de entrevista. Sin embargo, las entrevistas presenciales generaron puntuaciones ligeramente superiores a las entrevistas telefónicas en niñas (diferencia media: 0,23; d diff de Cohen: 0,22) y en participantes de India (diferencia media: 0,47; d diff de Cohen: 0,44). Los participantes de Canadá obtuvieron puntuaciones más bajas en la segunda evaluación realizada (diferencia media: -0,27; d diff de Cohen: -0,36), independientemente de la modalidad de entrevista. No obstante, los análisis agrupados y estratificados de los coeficientes de correlación intraclase indicaron que estas modalidades eran estadísticamente similares, con valores comprendidos entre 0,89 y 0,93, generalmente considerados entre buenos y excelentes. Este estudio multinacional, multicéntrico y cruzado muestra una elevada concordancia entre las entrevistas telefónicas y presenciales del ECDI2030 en contextos diversos desde el punto de vista económico, cultural y geográfico. La ampliación de las modalidades de entrevista podría mejorar la viabilidad, especialmente en poblaciones geográficamente dispersas y en entornos rurales. دراسة التوافق بين الإدارة عبر الهاتف والإدارة الشخصية لاستبيان مؤشر تنمية الطفولة المبكرة 2030 (ECDI2030). في هذه الدراسة المقارنة، قمنا بمقارنة المقابلات الشخصية لاستبيان ECDI2030 مع طرق أخرى (المقابلات الهاتفية بشكل أساسي)، تم تحديدها على مستوى كل دولة في البرازيل، وكندا، والهند، وملاوي. كان المشاركون المؤهلون هم مقدمي الرعاية الأساسيين لأطفال في سن ما قبل المدرسة (36 إلى 60 شهرًا)، مع مراعاة التوزيع المتساوي بين الجنسين ومكان الإقامة الحضري أو الريفي. كانت النتيجة الرئيسية هي التوافق في الدرجات الإجمالية بين المقابلات الشخصية والطرق الأخرى قيد الاختبار، وتم تقييمها باستخدام اختبارات t -tests المقترنة ومعاملات الارتباط داخل الفئة. شملت العينة التحليلية 258 فردًا، مع 212 ملاحظة مقترنة للمقابلات الشخصية وعبر الهاتف. أظهرت اختبارات t -tests المجمعة عدم وجود فروق ملموسة في الدرجات الإجمالية بين أساليب المقابلة. مع ذلك، حققت المقابلات الشخصية درجات أعلى قليلًا من المقابلات عبر الهاتف بالنسبة للأطفال الإناث (متوسط الفرق: 0.23؛ معامل كوهين: 0.22) والمشاركين من الهند (متوسط الفرق: 0.47؛ معامل كوهين: 0.44). وسجل المشاركون الكنديون درجات أقل في التقييم الثاني (متوسط الفرق: -0.27؛ معامل كوهين: -0.36)، بغض النظر عن أسلوب المقابلة. ومع ذلك، أشارت تحليلات معاملات الارتباط داخل الفئة المجمعة والمصنفة إلى تشابه إحصائي بين هذه الأساليب، حيث تراوحت القيم بين 0.89 و0.93، وهي قيم تُصنف عادةً على أنها جيدة إلى ممتازة. إن هذه الدراسة المقارنة متعددة الجنسيات ومتعددة المراكز، تُظهر توافقًا عاليًا بين إدارة ECDI2030 عبر الهاتف وعبر المقابلات الشخصية في أوضاع متنوعة اقتصاديًا وثقافيًا وجغرافيًا. قد يؤدي توسيع أساليب الإدارة إلى تحسين الجدوى، لا سيما في المناطق ذات الكثافة السكانية المتفرقة جغرافياً والأوضاع الريفية. 旨在检验电话与面对面访谈这两种《儿童早期发展指数 2030》(ECDI2030) 调查实施方式的一致性。. 在这项交叉研究中，我们将在巴西、印度、加拿大和马拉维实施的 ECDI2030 面对面访谈与在相应国家层面选择的其他访谈方式（主要是电话访谈）进行了比较。入选参与者是学龄前儿童（36-60 个月大）的主要照护者，同时基于儿童性别和城乡居住地进行了均衡招募。主要结局指标是面对面访谈与其他受试方式在总分方面的一致性，该一致性使用配对 t 检验和组内相关系数进行评估。. 分析样本包含 258 人，其中有 212 人被纳入了面对面访谈和电话访谈的配对观察。合并 t 检验结果显示，两种访谈方式的总分并无明显差异。但是，针对女童（均数差：0.23；Cohen’s ddiff ：0.22）和印度参与者（均数差：0.47；Cohen’s ddiff ：0.44）的面对面访谈得分略高于电话访谈。在第二次评估中，加拿大参与者在所有访谈方式下的得分均较低（均数差：−0.27；Cohen’s ddiff ：−0.36）。但是，合并及分层组内相关系数分析表明，这些访谈方式在统计学上具有相似性，其值介于 0.89 至 0.93 之间，而处于这个范围内的值通常被归入“良好至优秀”一类。. 这项跨国多中心交叉研究表明，在经济、文化和地理环境迥异的条件下实施的 ECDI2030 面对面访谈和电话访谈存在高度一致性。拓展调查实施方式可提高可行性，特别是在人口分布比较分散的地区和农村地区。. Исследовать согласованность результатов оценки популяции по показателю развития детей раннего возраста 2030 (ECDI2030), проводимой в телефонном режиме и при личном контакте. В этом перекрестном исследовании авторы сравнили проводимые лично анкетирования по ECDI2030 с опросами в других модальностях (в основном в телефонном режиме), выбранными на уровне таких стран, как Бразилия, Индия, Канада и Малави. В опросах участвовали в основном лица, осуществляющие уход за детьми дошкольного возраста (от 36 до 60 месяцев) с равным представительством в отношении пола детей и проживания их в сельской или городской местности. Основной результат показал, что общий балл анкеты является сопоставимым при личном анкетировании и проведении опроса в других модальностях; для оценки использовался парный t-критерий и коэффициенты внутриклассовой корреляции. Аналитическая выборка включала 258 лиц, при этом было проведено 212 парных наблюдений процесса анкетирования, который проводился как при личном контакте, так и в телефонном режиме. Объединенные t-критерии не показали значимой разницы в общих баллах анкетирования для разных модальностей. Однако при личном анкетировании были получены несколько более высокие баллы по сравнению со случаями, когда опрос проводился в телефонном режиме, если речь шла о девочках (средняя разница: 0,23; коэффициент Коэна d diff: 0,22), а также в тех случаях, когда анкетируемые были из Индии (средняя разница: 0,47; коэффициент Коэна d diff: 0,44). Участники из Канады имели более низкий результат по второму проведенному оцениванию (средняя разница: –0,27; коэффициент Коэна d diff: –0,36), независимо от модальности. Однако анализ объединенных и стратифицированных коэффициентов внутриклассовой корреляции показал, что эти модальности статистически сопоставимы (значения варьировались в пределах от 0,89 до 0,93, что обычно означает степень корреляции от хорошей до отличной). Это многонациональное, многоцентровое перекрестное исследование показало высокую степень согласованности результатов при проведении анкетирования по ECDI2030 методом личного контакта и в телефонном режиме в странах с разными экономическими, культурными и географическими условиями. Расширение используемых модальностей анкетирования может улучшить его практическую осуществимость, в частности в географически разбросанных популяциях и сельской местности.
This study investigated the initial absorption dynamics and ultrastructural responses of soybean leaf tissue to foliar application of zinc-based (Zn2+) nanofertilizer, using brightfield light microscopy, electron scanning and transmission microscopy (SEM and TEM), and Raman spectroscopy. Anatomically, no relevant structural changes were detected in the roots or stems in any of the treatments. However, leaves treated with ionic Zn2+ (T1) exhibited thickening of the palisade parenchyma with Zn2+ accumulation in the adaxial epidermis. Samples treated with T2 and T3 revealed epidermal precipitates and intracellular deposits within leaf cells, as evidenced by brightfield optical microscopy and Raman spectroscopy. These aggregates were absorbed and subsequently dissolved, being no longer observed at the 30 min time point. Ultrastructural analysis confirmed the presence of nanofertilizers within the vacuoles and cytoplasm, suggesting absorption and translocation of Zn2+, reinforcing the ability of nano-enabled materials to overcome biological barriers. Our results indicate that zinc-based (Zn2+) nanofertilizers can alter cellular features without evident short-term phytotoxicity. Theoretically, this study provides mechanistic insights into nanoparticle dissolution dynamics, biological barrier penetration, and subcellular compartmentalization pathways in crop plants. From an applied perspective, the rapid absorption (<30 min) and preferential organelle targeting suggest potential for precision nutrient delivery systems, though long-term and efficacy evaluations are required before agricultural deployment can be recommended.
Head and neck cancer (HNC) is associated with substantial morbidity, functional impairment, and represents a substantial socioeconomic burden worldwide. Although advances in surgery, radiotherapy (RT), and systemic therapies have improved oncologic outcomes, treatment-related toxicities frequently overlap with profound economic consequences for patients and caregivers. Financial toxicity (FT), defined as the objective financial burden and subjective financial distress associated with cancer care, has emerged as a clinically relevant determinant of treatment adherence, quality of life (QoL), and survival. In HNC, FT appears particularly critical during active treatment, when multimodal therapies, nutritional compromise, work interruption, transportation costs, and supportive care needs converge. This structured narrative review synthesizes current literature regarding FT during active treatment for HNC, focusing on conceptual definitions, measurement approaches, temporal dynamics, clinical and psychosocial consequences, and health system determinants. The review was conducted according to the Scale for the Assessment of Narrative Review Articles (SANRA) framework using searches of PubMed/MEDLINE, Scopus, Embase, and Google Scholar. Available evidence suggests that FT may emerge early during treatment and evolve dynamically throughout the care trajectory. Lower socioeconomic status, treatment intensity, work interruption, and limited social support have been reported in association with increased FT. FT has also been linked to worse health-related QoL, higher symptom burden, treatment interruptions, hospitalization, and reduced survival, although the limited number of studies and methodological heterogeneity preclude definitive conclusions. Emerging evidence suggests that FT may be partially modifiable through interventions such as financial counseling and patient navigation. Future research should prioritize prospective and interventional designs using standardized multidimensional instruments capable of capturing both objective and subjective domains of FT. Integrating routine FT assessment into supportive oncology workflows may help identify vulnerable patients and support more equitable, patient-centered HNC care.
Cancer therapy remains limited by drug resistance and poor selectivity, while inflammation-driven tumor progression further complicates treatment outcomes. Antimicrobial peptides (AMPs) have emerged as promising therapeutic alternatives due to their multifunctional properties. In this study, we investigated the anticancer and immunomodulatory activities of KI17, a rationally designed peptide derived from GL18, a peptide fragment identified from the talisin protein of Talisia esculenta. KI17 exhibited dose-dependent antiproliferative effects against murine and human melanoma (B16F10-Nex2, SK-MEL-2, A375) and cervical cancer (HeLa) cell lines, while displaying reduced cytotoxicity toward non-tumoral BV-2 microglial cells, resulting in a favorable selectivity index. Mechanistic analyses revealed that KI17 induces morphological alterations, mitochondrial dysfunction, caspase activation, and late-stage apoptosis, together with G0/G1 cell cycle arrest accompanied by accumulation of the Sub-G0 population, indicating coordinated regulation of cell death and cell cycle progression. KI17 effectively suppressed lipopolysaccharide (LPS)-induced microglial activation, markedly reducing pro-inflammatory cytokine and nitric oxide production without compromising cell viability. These biological activities are consistent with the peptide's optimized physicochemical features, including increased cationicity, amphipathicity, and α-helical folding. Overall, our findings demonstrate that KI17 combines selective anticancer activity with potent immunomodulatory effects, highlighting its potential as a bioinspired peptide for further preclinical development in cancer therapy.
Constipation is a frequent non-motor symptom in Parkinson's Disease (PD). Standard care includes dietary and lifestyle guidance or the use of laxatives. Diet represents a promising non-pharmacological approach, but its management in PD is complex and goes beyond simple dietary recommendations. This study protocol aims to examine whether nutritional counseling delivered by a dietitian is more effective than usual care in reducing constipation symptoms in PD patients. This 90-day randomized controlled superiority trial uses a parallel-group design. A total of 54 outpatients with PD without dementia and fulfilling the Rome IV criteria for functional constipation will be included. Baseline assessments comprise demographics, nutritional evaluation (anthropometric measurements and sarcopenia indicators), neurological assessment, and the Constipation Scoring System (CSS) scores. Participants will perform stool sample collection for microbiota analysis and will be requested to complete three 24-hour dietary recalls over the subsequent week. After baseline, participants will be randomly allocated to either the control group (usual care) or the intervention group (nutritional counseling delivered by a dietitian). At the first study visit, participants will deliver the stool sample and dietary recalls. The intervention will last for 90 days and will include one in person consultations and bi-weekly follow-up phone calls. Nutritional counseling will address four main topics: healthy eating, food processing, fiber and fluid intake, and levodopa interactions with diet. In addition, participants in the intervention group will receive an individualized diet plan. All baseline assessments will be repeated at the 90-day endpoint. The primary outcome is the change in weekly bowel movement frequency from baseline to day 90, measured through the stool diary. Secondary outcomes include CSS, changes in fecal gut microbiota, macronutrient distribution, diet quality, body composition and sarcopenia indicators. Trial registration number: NCT07213856.
Gliomas are the most common and aggressive primary brain tumours, with glioblastoma (GB) exhibiting a poor prognosis and limited therapeutic response. Dysregulation of intracellular ion homeostasis, particularly Ca2+ signalling, has emerged as a key contributor to glioma progression. The transmembrane BAX inhibitor motif-containing (TMBIM) protein family regulates intracellular Ca2+ flux and cell survival; however, their role in glioma remains incompletely understood. Gene expression and clinical data from TCGA, CGGA, and Rembrandt cohorts were analysed to assess the association between TMBIM1-6 expression, tumour grade, and patient survival. Correlation analyses identified TMBIM-associated gene networks, followed by functional enrichment to characterise underlying biological processes and molecular functions. The TMBIM family members segregated into two distinct groups with opposing clinical associations. TMBIM1, TMBIM4, and TMBIM6 were upregulated and associated with poor survival, whereas TMBIM2, TMBIM3, and TMBIM5 were downregulated and associated with increased survival. Functional enrichment analyses revealed two conserved gene expression programmes: TMBIM1/4/6 are linked to membrane trafficking, metabolic and bioenergetic adaptation, while TMBIM2/3/5 are associated with cell cycle regulation and chromosomal instability. These findings uncover a previously unrecognised functional divergence within the TMBIM family in glioma. This bipartite organisation highlights TMBIM proteins as potential prognostic markers and suggests that selective targeting of specific TMBIM subgroups may improve therapeutic strategies.