143174 research outputs found
Sort by
Correction: Long COVID clinical evaluation, research and impact on society: a global expert consensus
No full textAgri-food waste to phenolic compounds: life cycle and eco-efficiency assessments
No full textThe increase in the consumption of food products and the management of food waste have endangered the sustainability of the food sector. The need to move forward on the European bioeconomy requires to evaluate waste valorization strategies, to convert a non-valorized resource into a high-added value production in the market. In this regard, the focus of this research article is the valorization of orange peel and tomato seed wastes to produce bioactive compounds, such as carotenoids. Various extraction technologies have been analyzed, from the most conventional (solvent extraction), to emerging alternatives (including ultrasound-assisted extraction, microwave-assisted extraction and subcritical water extraction), providing a total of seven scenarios. Life Cycle Assessment methodology has been used for assessing the environmental sustainability of all the scenarios, combined with techno-economic analysis to evaluate its feasibility and also to provide an eco-efficiency evaluation. The results show that energy optimization is key to improve the profiles obtained, as well as to increase production capacity, as it is directly related to both economic and environmental viability. In general terms, orange peel valorization scenarios with emerging technologies are the most profitable and suitable, given the higher benefits and lower impacts compared to tomatoe valorization. The research developed has shown that the recovery of bioactive compounds from unusable wastes from the food and agricultural sectors is effective, and the outcomes could be used as a guide to stakeholders and entrepreneurs to where to focus to enhance the potential of the tomato and orange harvesting and processing activities
Large-scale online assessment uncovers a distinct Multiple Sclerosis subtype with selective cognitive impairment
No full textCognitive impairments in Multiple Sclerosis (MS) are prevalent and disabling yet often unaddressed. Here, we optimised automated online assessment technology for people with MS and used it to characterise their cognitive deficits in greater detail and at a larger population scale
than previously possible. The study involved 4,526 UK MS Register members over three stages. Stage 1 evaluated 22 online cognitive tasks and established their feasibility. Based on MS discriminability a 12-task battery was selected. Stage 2 validated the resulting battery at scale, while Stage 3 compared it to a standard neuropsychological assessment. Clustering analysis identified a prevalent MS subtype exhibiting significant cognitive deficits with minimal motor impairment. Disability in this group is currently unrecognised and untreated. These findings underscore the importance of cognitive assessment in MS, the feasibility of integrating online tools into patient registries, and the potential of such large-scale data to derive insights into symptom heterogeneity
Non-invasive fluorescence sensing reveals changes in intestinal barrier function and gastric emptying rate in a first-in-human study of Crohn’s disease
No full textBackground:
Crohn’s disease is characterised by multifaceted changes in gut function, involving not just inflammatory effects but also alterations in gut barrier function and gastric motility. However, current diagnostic tools used to measure key gut functional parameters are invasive, unreliable or time-consuming. Thus, we applied a novel, non-invasive fluorescence sensing technology – transcutaneous fluorescence spectroscopy (TFS) – to investigate gut barrier function and gastric emptying in Crohn’s disease.
Objectives:
Our study aimed to validate TFS for non-invasive gastrointestinal (GI) diagnostics and to explore changes in gut barrier function and gastric emptying rate simultaneously in Crohn’s disease.
Design:
A cross-sectional study involving patients with Crohn’s disease and healthy individuals.
Methods:
We performed fluorescent measurements and lactulose:mannitol (L:M) tests in 38 Crohn’s disease patients and 20 healthy volunteers. We investigated multiple TFS-derived parameters as indicators of gut barrier function and gastric emptying rate. Using these parameters, we assessed differences between healthy volunteers, inactive Crohn’s patients and active Crohn’s patients, and calculated correlations between TFS and L:M values.
Results:
TFS-derived parameters revealed significantly increased intestinal permeability and delayed gastric emptying in patients with active Crohn’s compared to healthy controls. TFS trends showed encouraging alignment with those from the L:M test, suggesting potential concordance with established methods. No adverse events were reported.
Conclusion:
TFS enables rapid, non-invasive discrimination of Crohn’s patients from healthy volunteers and allows simultaneous assessment of gut barrier function and gastric emptying rate – two important aspects of GI function in Crohn’s disease. This implies potential for improved monitoring and diagnosis of Crohn’s disease (and other gut disorders) as well as more advanced study of gut function in health and disease.
Trial registration:
The clinical study reported in this article was registered with ClinicalTrials.gov prior to enrolment of the first participant. https://clinicaltrials.gov/study/NCT03434639 and Registration number: NCT03434639
Human-centric cognitive state recognition using physiological signals: a systematic review of machine learning strategies across application domains
No full textThis systematic review analyses advancements in cognitive state recognition from 2010 to early 2024, evaluating 405 relevant articles from an initial pool of 2398 records identified through five databases: Scopus, Engineering Village, Web of Science, IEEE Xplore, and PubMed. Studies were included if they assessed cognitive states using physiological signals and applied machine learning (ML) or deep learning (DL) techniques in practical task settings. The review highlights a pivotal shift from shallow ML to DL approaches for analysing physiological signals, driven by DL’s ability to autonomously learn complex patterns in large datasets. By 2023, DL has become the dominant methodology, though traditional ML techniques remain relevant. Additionally, there has been a move from neuroimaging to multimodal physiological modalities, with the decrease in neuroimaging use reflecting a trend towards integrating various physiological signals for more comprehensive insights. Cognitive state recognition is applied across diverse domains such as the automotive, aviation, maritime, and healthcare industries, enhancing performance and safety in high-stakes environments. Electrocardiogram (ECG) is the most utilised modality, with convolutional neural networks (CNNs) being the primary DL approach. The trend in cognitive state recognition research is moving towards integrating ECG signals with CNNs and adopting privacy-preserving methodologies like differential privacy and federated learning, highlighting the potential of cognitive state recognition to enhance performance, safety, and innovation across various real-world applications
ABO blood group antigens influence host-microbe interactions and risk of early spontaneous preterm birth
No full textThe mechanisms by which vaginal microbiota shape spontaneous preterm birth (sPTB) risk remain poorly defined. Using electronic clinical records data from 74,913 maternities in conjunction with metaxanomic (n=596) and immune profiling (n=314) data, we show that the B blood group phenotype associates with increased risk of sPTB and adverse vaginal microbiota composition. The O blood group associates with sPTB in women who have a combination of a previous history of sPTB, an adverse vaginal microbial composition and pro-inflammatory cervicovaginal milieu. In contrast, women of blood group A have a higher prevalence of vaginal Lactobacillus crispatus, a lower risk of sPTB, with sPTB cases showing no association with vaginal microbiota composition or inflammation. We found that cervicovaginal fluid contains ABH(O) glycans, and show variable binding to key vaginal bacteria. This indicates that cervicovaginal ABH(O) glycans influence microbiota-host interactions implicated in sPTB risk, suggesting a novel target for sPTB prediction and prevention
Timing and safety of anticoagulation reinitiation after intracranial haemorrhage in patients with mechanical valves: a meta-analysis
No full textBackground and aims. In patients with mechanical heart valves (MHV), anticoagulation (AC) interruption following intracranial hemorrhage (ICH) poses a clinical dilemma due to competing risks of ischemic complications and haemorrhagic recurrence. To date, the optimal timing for
resuming vitamin K antagonists (VKA) remains unclear. This meta-analysis aims to quantify the risks of ischemic stroke and recurrent ICH associated with VKA resumption in this population and explore the temporal risk dynamics.
Methods. We systematically searched PubMed, Embase, and Cochrane Library from inception to December 2023 for studies reporting ischemic or hemorrhagic outcomes in adults with MHV who experienced ICH and were considered for VKA resumption. Primary outcomes were ischemic stroke before AC resumption and recurrent ICH after AC resumption. Random-effects meta analyses were performed. Meta-regressions assessed whether timing of resumption influenced risk.
Risk trajectories were estimated using a model-based approach.
Results. Nine studies were included, comprising 435 MHV patients with confirmed ICH included
in the pooled analysis. Mean age ranged from 54.1 to 75 years; 31.3% were female. The pooled
incidence of recurrent ICH after AC reinitiation was 11.4% (95% CI: 8.2–15.6; I² = 0%), ischemic
stroke during AC suspension was 6.1% (95% CI: 4.1–8.9; I² = 0%), valve thrombosis occurred in
3.3% (95% CI: 1.9–5.6; I² = 0%), and mortality in 4.9% (95% CI: 2.0–11.5; I² = 37%). Meta regression demonstrated a significant inverse association between time to AC resumption and risk
of recurrent ICH (regression coefficient –0.039; 95% CI: –0.093 to 0.015; p = 0.13), corresponding
to an approximate 50% relative reduction in risk at 11 days post-ICH. No significant time dependent association was observed for ischemic stroke (coefficient –0.013; 95% CI: –0.065 to 0.039; p = 0.61).
Discussion. In patients with MHV who experienced an ICH, this meta-analysis found that resumption of anticoagulation was associated with a recurrent ICH rate of 11.4% and an ischemic stroke rate of 6.1% during anticoagulation suspension. Meta-regression suggested a lower risk of recurrent ICH with later AC resumption, with a potential risk reduction at approximately 11 days post-ICH. No time-dependent increase in ischemic stroke was observed. Limitations include the retrospective design of most studies and heterogeneous AC timing across cohorts
Travel-time accessibility and adaptive spatial planning solutions for the healthcare system
No full textEnsuring equitable healthcare access remains a significant challenge, particularly in rural areas where aging populations face increasing barriers due to facility closures. This study employs a GIS-based spatial network model to assess hospital accessibility, integrate road characteristics, and estimate travel times across all officially registered population nodes in a region. Analyzing disparities by age composition, we identify high-risk exclusion areas and propose an optimized model prioritizing vulnerable populations. Through four optimization scenarios, we evaluate the impact of hospital reductions on territorial accessibility. Findings reveal significant gaps, disproportionately affecting elderly and remote communities. Strategic hospital redistribution can enhance system efficiency and equity. This research highlights the value of GIS-based approaches in healthcare planning, providing data-driven strategies for optimizing hospital distribution and informing evidence-based policymaking
Evidence of a novel sublineage of Streptococcus agalactiae in elephants from zoo populations in Germany
No full textStreptococcus agalactiae research primarily centres on investigating human and bovine infections, although this pathogen also can be carried and cause infections in a wider range of animal species. Moreover, infections with S. agalactiae are posing significant health implications, and recent studies furthermore are highlighting a potential zoonotic risk. Despite the relatively frequent isolation of S. agalactiae from elephants, only a few reports document infections in wild and zoo populations. We performed a comparative genomic analysis of 24 elephant isolates from three different zoos in Germany to achieve a comprehensive characterization. Elephant isolates showed pronounced phylogenetic divergence from isolates of other host species, while also forming clusters based on zoo of origin and their genotypes (MLST profiles). Capsular serotypes could not be predicted for the majority of the isolates (n=20/24). Several genes, exclusively associated with the elephant host, may underlie the pathogen's capacity to improve its survival and virulence across varied ecological niches. This study not only deepens our understanding of S. agalactiae across diverse species and environments but also represents the first whole-genome sequencing characterization of S. agalactiae isolates from elephants, helping to expand our knowledge about infections in animals