Background: Polyphenols—bioactive compounds abundant in plant-based foods—are increasingly recognised for their capacity to modulate the gut microbiota. As the gut microbiome plays a central role in metabolic regulation, immune function, and disease prevention, understanding how specific polyphenol subclasses influence microbial diversity and functionality remains essential. Despite growing evidence of their benefits, the precise effects of flavonoids, phenolic acids, and anthocyanins on gut microbial composition are not yet fully clarified. Objective: This study aimed to evaluate the impact of dietary polyphenols on gut microbiota composition and function, with a particular focus on the abundance of Bifidobacterium, a key beneficial genus associated with metabolic and immune health. It was hypothesised that polyphenol-rich interventions were associated with increases in Bifidobacterium abundance and enhance overall microbial diversity. Design: A systematic review and meta-analysis were conducted following PRISMA guidelines. Human intervention studies published between January 2015 and February 2025 were retrieved from PubMed, Scopus, and Web of Science. A predefined PICO framework guided study selection. Twenty-two studies were synthesised using thematic analysis, and four of these were eligible for quantitative meta-analysis. The meta-analysis was performed in R (version 4.4.1) using the metafor and meta packages, calculating standardised mean differences (SMD) under a random-effects model to account for heterogeneity. Extracted data included study design, population characteristics, polyphenol subclass, intervention type, microbiome assessment method, and key outcomes. Results: Across the 22 reviewed studies, polyphenols—particularly flavonoids and phenolic acids from foods such as berries, grape pomace, and green tea—consistently increased beneficial microbial taxa including Bifidobacterium, Faecalibacterium, and Lactobacillus. These microbial shifts were associated with improved metabolic markers, reduced inflammation, and enhancements in gut barrier integrity. Polyphenol-rich dietary patterns also showed benefits in conditions such as NAFLD, prediabetes, and depression. However, findings were influenced by interindividual variability, short intervention durations, and inconsistent methodologies. The meta-analysis revealed a significant positive effect of polyphenol intake on Bifidobacterium abundance (SMD = 0.81; 95% CI: 0.18–1.44; p = 0.0114), corresponding to a moderate-to-large effect size. Substantial heterogeneity (I² = 77.4%) suggested considerable variation in intervention types, dosage, study design, and microbiome analysis methods. Conclusions: Polyphenol-rich diets were associated with increased Bifidobacterium abundance and favourable modulation of gut microbiota composition, supporting their potential as a nutritional strategy to enhance gut and metabolic health. However, interstudy variability highlights the need for more standardised, long-term, and mechanistically focused human trials. Future research should incorporate multi-omics approaches, personalised nutrition frameworks, and consistent microbiome analysis methods to better understand the pathways linking polyphenol intake and host health outcomes.

Background/Objectives: Although numerous studies have examined associations between screen time and early language development, less is known about how screen exposure interacts with developmental stage, digital content quality, and parental mediation across childhood and adolescence, particularly with respect to pragmatic communication. This study aimed to address these gaps by examining the joint associations of screen time, content composition, and parental mediation with multiple linguistic and pragmatic domains across a broad age range. Methods: A cross-sectional study was conducted with 286 Romanian participants aged 5–19 years, grouped into four developmental stages. Measures included daily screen time, proportion of educational versus recreational content, parental mediation practices, and standardized assessments of vocabulary, verbal fluency, grammatical competence, and pragmatic communication. Analyses included descriptive statistics, Pearson correlations, 4 × 3 factorial ANOVAs (age group × screen-time category), and multiple linear regression. Results: Higher levels of screen exposure were consistently associated with lower performance across all linguistic and pragmatic domains (r = −0.19 to −0.28, all p < 0.01). Participants viewing >2 h/day showed significantly weaker outcomes than those with ≤1 h/day, particularly in semantic and phonemic fluency and pragmatic communication (p < 0.001). Educational content correlated positively with linguistic scores, whereas recreational content showed negative associations. Parental mediation emerged as a significant positive predictor. In the regression model (R² = 0.42), age (β = 0.47), parental mediation (β = 0.21), and educational content (β = 0.18) predicted better linguistic performance, while screen time (β = −0.29) predicted lower performance. Conclusions: The findings indicate that associations between digital media use and linguistic and pragmatic performance vary across developmental stages and contextual factors. Rather than screen time alone, digital content quality and parental mediation are associated with differences in communicative performance. These results highlight the value of a nuanced, developmentally informed perspective when considering children’s digital media environments.

Protein misfolding and aggregation represent key pathological mechanisms in neurodegenerative and systemic amyloid disorders, yet disease-modifying therapeutic strategies remain limited. In recent years, plant-derived nanomaterials have attracted increasing attention as multifunctional platforms capable of interacting with misfolded proteins and modulating aggregation-related pathways. This review examines the evolution of research between 2015 and 2025 on plant-derived nanomaterials—including green-synthesized metallic nanoparticles, plant extracellular vesicles, and phytochemical-based nano-delivery systems—in the context of protein misfolding disorders. The available literature was analyzed to identify principal mechanisms of action, experimental models, and emerging therapeutic perspectives. Current evidence suggests that these nanomaterials may influence protein aggregation through direct molecular interactions, modulation of oxidative stress and neuroinflammatory responses, and enhancement of cellular protein clearance processes. However, the field remains characterized by methodological heterogeneity, limited standardization, and insufficient translational validation. By synthesizing recent developments, this review highlights key research trends, mechanistic gaps, and future directions necessary for advancing plant-derived nanomaterials toward biomedical applications targeting protein misfolding diseases.

Background/Objectives: Adequate hydration is essential for health; however, water consumption behaviors are influenced not only by physiological needs but also by hydration knowledge and perceptions of drinking water quality. Empirical evidence examining these factors in Eastern European populations remains limited. This study aimed to assess hydration knowledge, water consumption patterns, and attitudes toward drinking water quality among adults in Romania, and to examine their associations with daily water intake and water source preferences. Methods: A cross-sectional study was conducted between November 2024 and November 2025 among adults residing in Romania. Data were collected from 165 participants using an anonymous, self-developed, paper-based questionnaire administered in person to adult patients attending routine visits in four primary care clinics in Arad, Romania, using a convenience sampling approach. The questionnaire assessed sociodemographic characteristics, hydration knowledge, water consumption behaviors, and attitudes toward drinking water quality. Descriptive statistics, chi-square tests, correlation analyses, and multivariable linear and logistic regression models were applied to identify factors associated with daily water intake, adequate hydration (≥2 L/day), and bottled water consumption. Results: Hydration knowledge was moderate overall and was significantly associated with education level and gender. Higher hydration knowledge was positively correlated with daily water intake (r = 0.21, p = 0.006) and was independently associated with higher intake and adequate hydration (OR = 1.28, 95% CI: 1.10–1.49; p = 0.002). Greater trust in tap water was also positively associated with daily intake (r = 0.27, p = 0.001) and adequate hydration (OR = 1.31, 95% CI: 1.12–1.54; p < 0.001). Lower trust in tap water and stronger beliefs regarding bottled water were significant predictors of bottled water use as the primary drinking water source. Education level emerged as a consistent predictor across multiple hydration-related outcomes. Conclusions: Hydration knowledge and perceptions of drinking water quality are key, modifiable factors associated with water consumption behaviors. Educational strategies integrated into primary care and transparent communication regarding tap water safety may support adequate and sustainable hydration among adults.

Background/Objectives: Spinal alignment is a key determinant of biomechanical function and postural stability, particularly during periods of growth and development. Three-dimensional (3D) surface topography offers a non-invasive method for assessing spinal posture. This study aimed to evaluate spinal alignment parameters in a mixed adolescent and adult population, to investigate sex-related differences, and to analyze biomechanical relationships between spinal components. Methods: A total of 98 participants (aged 11–45 years) underwent 3D spinal surface topography assessment. Descriptive statistics were calculated for sagittal, coronal, and rotational parameters. Group comparisons between sexes were performed using independent samples t-tests. Pearson correlation analysis and linear regression were used to assess the relationships between spinal parameters. Logistic regression analysis was conducted to identify predictors of clinically relevant rotational asymmetry (surface rotation RMS > 6°). Results: Most participants exhibited near-physiological sagittal alignment, with thoracic kyphosis and lumbar lordosis within normal ranges. However, approximately 20% demonstrated clinically relevant rotational asymmetry. Female participants showed significantly higher rotational asymmetry compared to males (p = 0.008), while sagittal parameters did not differ significantly. Strong correlations were observed between thoracic kyphosis and cervical sagittal displacement (r = 0.77). Rotational asymmetry was negatively correlated with sagittal parameters and significantly predicted coronal imbalance (β = 0.38, p < 0.01; R² = 0.21). Conclusions: 3D surface topography provides a non-invasive method for assessing external postural alignment and surface-based asymmetries. Rotational asymmetry appears to represent a relevant component of spinal imbalance and is associated with coronal deviation within a multi-planar framework. These findings support the use of integrated biomechanical assessment in the evaluation of spinal alignment.

Background/Objectives: Mechanical alignment (MA) has traditionally been the reference alignment strategy in total knee arthroplasty (TKA), whereas kinematic alignment (KA) has emerged as an individualized alternative intended to approximate patient-specific knee anatomy. However, the relationship between postoperative mechanical-axis alignment and functional recovery remains incompletely understood. This study aimed to compare short-term functional outcomes and postoperative mechanical-axis alignment between MA and KA following primary TKA and to investigate the relationship between measured postoperative alignment parameters and functional outcomes. Methods: This single-center retrospective comparative cohort study included 120 patients who underwent primary unilateral TKA for end-stage knee osteoarthritis (KOA) between January 2022 and December 2024; 51 underwent MA and 69 underwent KA. Radiographic assessment included the hip–knee–ankle (HKA) angle, mechanical-axis deviation (MAD), residual varus deformity, and radiographic knee extension deficit. Functional outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Knee Society Score (KSS). Preoperative, postoperative, and change-from-baseline (Δ) functional scores were evaluated. Analysis of covariance (ANCOVA) was used to assess associations between alignment strategy and postoperative functional outcomes after adjustment for baseline functional scores and relevant covariates. Associations between postoperative radiographic parameters and functional outcomes were additionally assessed. Results: Both alignment groups demonstrated substantial preoperative-to-postoperative functional improvement. MA achieved postoperative HKA alignment closer to the neutral mechanical axis than KA (179.63 ± 1.23° vs. 178.24 ± 2.32°; p < 0.001; FDR-adjusted p < 0.001). Absolute HKA deviation from neutral was lower with MA (0.97 ± 0.83° vs. 2.42 ± 1.62°; FDR-adjusted p < 0.001), as was postoperative absolute MAD (5.19 ± 4.53 mm vs. 7.86 ± 6.76 mm; p = 0.011; FDR-adjusted p = 0.018). KA was associated with a higher unadjusted postoperative KOOS score than MA (84.04 ± 12.33 vs. 77.12 ± 15.65; p = 0.010), whereas postoperative WOMAC (p = 0.206) and KSS (p = 0.843) did not differ significantly between groups. Between-group differences in change from baseline were not statistically significant for KOOS (p = 0.227), WOMAC (p = 0.130), or KSS (p = 0.427). After multivariable adjustment, no statistically significant between-group associations were observed for postoperative KOOS (adjusted β = 2.42; 95% CI, −0.93 to 5.77; p = 0.155), WOMAC (adjusted β = −2.80; 95% CI, −6.73 to 1.14; p = 0.162), or KSS (adjusted β = 1.09; 95% CI, −2.05 to 4.24; p = 0.492). Associations between the postoperative radiographic parameters and functional outcomes were negligible to weak, with none remaining statistically significant after FDR correction. Conclusions: Both MA and KA were associated with substantial short-term functional improvement, with no significant between-group differences in the magnitude of improvement from baseline. MA achieved postoperative alignment closer to the neutral mechanical axis, while the higher unadjusted postoperative KOOS score observed with KA was not statistically significant after adjustment for baseline characteristics and potential confounders. No significant postoperative differences in WOMAC or KSS were observed. The generally weak associations between measured postoperative mechanical-axis parameters and functional outcomes suggest that mechanical-axis alignment alone may not adequately explain short-term functional recovery. Because patient-specific coronal alignment parameters and achievement of the individualized KA target were not quantitatively assessed, the present findings cannot determine whether restoration of patient-specific anatomy was associated with functional outcomes.