Search Results (17,354)

Background: Polyendocrine Metabolic Ovarian Syndrome (PMOS), previously known as Polycystic Ovary Syndrome (PCOS), is one of the most common endocrine disorders affecting women of reproductive age and represents a major cause of infertility worldwide. It is associated with hormonal imbalance, ovulatory dysfunction, and metabolic disturbances, all of which can significantly impair reproductive outcomes and quality of life. We aimed to investigate the metabolic and hormonal markers in infertile women who had PMOS in one of the rapidly developing Middle Eastern countries. Methods: This was a retrospective observational cohort study conducted at the Military Medical Specialist Center in Qatar (2019–2024). Data were extracted from patient medical records, including demographic characteristics, clinical presentation, hormonal profiles, metabolic parameters, and details of fertility treatment. Women aged 18–40 years diagnosed with PMOS according to the Rotterdam criteria were included. Correlation coefficient analysis was performed to assess the associations between PMOS-related factors. Patients were categorized by BMI (normal, overweight, and obese). Results: The mean age of patients was 31.9 ± 5.3 years, and 43.8% of patients were obese. Primary infertility was more frequent than secondary infertility (61.8% vs. 38.2%). Women with secondary infertility were significantly older and had higher body mass index (BMI) (p = 0.001 and p = 0.01, respectively). Insulin resistance was prominent (mean Homeostatic Model Assessment for Insulin Resistance [HOMA-IR] of 4.04) and increased significantly with the increase in BMI (p = 0.01). BMI showed positive correlations with serum levels of glucose, insulin, HOMA-IR, and testosterone. Hormonal parameters were largely comparable between infertility groups, except for lower FSH levels in secondary infertility (p = 0.04). The proportion of PMOS based on the HOMA-IR category was 5.6% (HOMA-IR < 1.0), 23.4% (HOMA-IR 1–1.99), 20.2% (HOMA-IR 2–2.99), and 50.8% (HOMA-IR > 3.00). In PMOS patients, there was a significant association between obesity and HOMA-IR, with each 1-unit increase in HOMA-IR associated with a 14% increase in odds (crude odds ratio 1.14; 95% confidence interval 1.02–1.28, p = 0.02). Also, obesity was associated with low LH/FSH (crude odds ratio, 0.67; 95% CI, 0.45–0.99; p = 0.04). Results: The mean age of patients was 31.9 ± 5.3 years, and 43.8% of patients were obese. Primary infertility was more frequent than secondary infertility (61.8% vs. 38.2%). Insulin resistance was prominent (mean HOMA-IR 4.04) and increased significantly across BMI categories (3.0 in normal-weight vs. 4.8 in obese women, p = 0.01). BMI was positively correlated with HOMA-IR (r = 0.17, p = 0.02) and testosterone levels (r = 0.18, p = 0.01). Secondary infertility became more frequent with increasing BMI (p = 0.02). Each 1-unit increase in HOMA-IR was associated with a 14% increase in the odds of obesity (OR 1.14, 95% CI 1.02–1.28, p = 0.02). Conclusions: Among infertile women with PMOS, obesity and insulin resistance were prominent metabolic characteristics. These findings support routine screening for insulin resistance, particularly in overweight and obese women, together with weight management and individualized fertility treatment based on BMI and metabolic profiles. Full article

Background/Objectives: Enteral nutrition (EN), delivered either exclusively (EEN) or partially (PEN) in combination with the Crohn’s Disease Exclusion Diet (CDED), represents an evidence-based dietary therapy for active Crohn’s Disease (CD), recommended in clinical guidelines. However, adherence to this therapy remains suboptimal among adult patients. This study aimed to explore the intention to repeat CDED & PEN alongside perceived factors affecting adherence to CDED & PEN in CD adult patients. Methods: A single-center, cross-sectional qualitative study was conducted between October 2025 and March 2026 at a private dietetic practice in Larissa, Greece. Semi-structured interviews were undertaken and analyzed using thematic analysis. Results: Out of the 88 patients screened, 15 adults with CD participated in semi-structured interviews. Four overarching themes emerged: (1) intention to repeat CDED & PEN, with all participants reporting willingness to repeat CDED & PEN in the event of future relapse; (2) barriers to CDED & PEN adherence, including challenges in social situations involving food; (3) facilitators of CDED & PEN adherence, such as improved symptom control and increased sense of security; and (4) dual factors affecting CDED & PEN adherence, whereby meal preparation demands, taste and variety, and social and environmental support acted as either facilitators or barriers against adherence depending on individual circumstances. Conclusions: Greek adults with CD showed strong willingness to reinitiate CDED & PEN during relapse. Addressing modifiable barriers, particularly dietary monotony and financial burden, alongside strengthening structured dietitian support and personalized dietary guidance, may help optimize adherence in clinical practice. Full article

Background/Objectives: Periodontitis is a multifactorial chronic inflammatory disease influenced by behavioral, metabolic, and lifestyle-related factors. This study aimed to examine the associations of selected dietary habits, body mass index (BMI), physical activity, smoking, and oral hygiene behaviors with clinical periodontal parameters in a clinical sample of adults with periodontitis from northwestern Romania. Methods: This cross-sectional study included 204 adults with clinically diagnosed periodontitis. Sociodemographic characteristics, smoking status, physical activity, toothbrushing frequency, tooth mobility, and selected dietary habits were assessed using a structured questionnaire. Periodontal status was clinically evaluated using periodontal probing depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP), while BMI was calculated from anthropometric measurements. Descriptive and inferential statistical analyses were performed to evaluate associations between the investigated factors and periodontal parameters. Multivariable linear regression models were constructed separately for PPD, CAL, and BOP, simultaneously including age, sex, BMI, smoking status, physical activity frequency, toothbrushing frequency, tooth mobility, education level, and the assessed dietary habits. Results: In the fully adjusted multivariable analyses, fish consumption 1–3 times/week was independently associated with lower PPD, whereas sweets consumption 1–3 times/week was independently associated with higher PPD. Carbonated beverage and sweets consumption 1–3 times/week were independently associated with higher BOP. Although the multivariable model for CAL was statistically significant overall, none of the individual predictors included in the model reached statistical significance. BMI and physical activity frequency were not independently associated with PPD, CAL, or BOP after simultaneous adjustment for the other variables. Age group was significantly associated with CAL category (χ²(2) = 13.28, p = 0.001, Cramér’s V = 0.255), while educational level was significantly associated with toothbrushing frequency (χ² = 62.26, p < 0.001, Cramér’s V = 0.39). Conclusions: Selected dietary habits were independently associated with PPD and BOP after adjustment for demographic, anthropometric, lifestyle, and oral hygiene factors, whereas no individual predictor was independently associated with CAL in the fully adjusted model. BMI and physical activity were not independently associated with the periodontal parameters examined. These findings emphasize the multifactorial nature of periodontal status and suggest that specific dietary habits may be associated with different clinical dimensions of periodontal disease. However, causal relationships cannot be established due to the cross-sectional design of the study. Prospective studies using validated dietary assessment methods are needed to confirm these associations. Full article

Background: Otolaryngology conditions significantly influence public health globally, often posing challenges in accessing specialized ear, nose, and throat (ENT) services. Digital referral systems can facilitate access to specialized care while supporting resource allocation. This study analyzed ENT digital referrals through the digital referral system of the Saudi Medical Referrals Centre to describe utilization patterns across different ENT subspecialties. Methods: This retrospective cross-sectional study analyzed 50,514 ENT digital referrals across Saudi Arabia from January 2023 to December 2024. Crude population-based rates per 10,000 were calculated using national census data. Cross-tabulation tables were utilized to compare patient demographics, regional variables, and referral characteristics with ENT subspecialties. Results: ENT digital referral utilization over two years reached 15.70 per 10,000 population (7.38 in 2023, and 8.32 in 2024). Patients over 60 years showed the highest rates (42.17), followed by children aged 1–7 years (29.90). Females demonstrated a higher crude population-based rate (17.07 vs. 14.83) despite males comprising 57.76% of total referrals. General ENT services represented 59.49% of referrals, audiology services 32.92%, while specialized services showed lower volumes. Routine outpatient referrals predominated at 91.14%, and only 1.3% of total requests required intensive care beds. Most referrals were managed internally (93.75%) with overall acceptance rate reaching 89.41%. Conclusions: The findings demonstrate distinct age- and subspecialty-related utilization patterns within Saudi Arabia’s national ENT digital referral system, with the highest demand among older patients and young children. General ENT constituted the majority of referrals, while other specialized services appeared in smaller volumes. The predominantly outpatient, highly accepted, and internally managed referral patterns establish baseline metrics for national ENT subspecialty access. These findings outline nationwide coordination patterns of subspecialty care and support continued investment in digital health infrastructure for specialized care coordination. Full article

Objective: To examine the reliability, construct validity, and discriminative capacity of the Spanish version of the Economic Living Standards Index Short Form (ELSI_SF) in a sample of older adults in Spain. Methods: This analysis was conducted using baseline data from 133 participants (mean age = 66.2 years, SD = 5.6; 53.8% women) recruited from community health and social centers in the provinces of Cuenca, Albacete, and Toledo within the PEPE cohort. Participants completed the ELSI_SF (25 items), sociodemographic measures, the SF-12 Health Survey, and the International Fitness Scale (IFIS). Internal consistency was assessed using Cronbach’s alpha. Convergent validity was examined through correlations between ELSI_SF scores and education, occupation, physical and mental health, and perceived fitness. Discriminative ability for health-related variables was analyzed using ANOVA and partial η². The internal structure was explored using exploratory factor analysis (EFA) and subsequently examined against the original four-factor theoretical model using confirmatory factor analysis (CFA), based on polychoric correlations and estimation methods appropriate for ordinal data. Results: The mean ELSI_SF score was 23.0 ± 3.9, with most participants classified as having comfortable or good living standards. Internal consistency was acceptable for the total scale (α = 0.779), whereas the ownership restrictions (α = 0.441) and self-rating (α = 0.319) subscales showed low reliability. Significant associations were observed between the ELSI_SF total score and selected socioeconomic and health-related measures. Factor-analytic findings provided only partial support for the original four-domain structure. Although CFA showed favorable CFI, TLI, and RMSEA values, the elevated SRMR and instability of the self-rating factor warrant cautious interpretation of the factorial solution. Conclusions: The Spanish ELSI_SF provides preliminary psychometric evidence supporting the use of its total score among relatively socioeconomically advantaged older adults. However, limitations in subscale reliability, factorial stability, and the restricted socioeconomic variability of the sample preclude definitive validation across the full spectrum of material living standards. Further evaluation in larger, independent, and more socioeconomically heterogeneous samples, particularly including older adults experiencing material deprivation, is required. Full article

Background: Treatment Burden (TB) refers to the workload imposed on patients by healthcare-related tasks involved in the management of chronic conditions. Despite increasing evidence on this phenomenon, strategies for its reduction in older adults with multimorbidity remain poorly explored. Aim: To map the factors associated with treatment burden reported for older patients with multimorbidity and to derive implications for potential reduction strategies, regardless of the care setting. Methods: A scoping review was conducted applying the JBI methodology for scoping reviews and reported in accordance with the PRISMA-ScR checklist. The literature search was performed on PubMed, Scopus, and CINAHL; no restrictions on publication year or language were applied. All study designs were eligible if they reported factors associated with TB from which reduction strategies could be derived, in patients aged ≥65 years, or with a mean age ≥ 65 years, with multimorbidity or associated geriatric conditions. Results: Six studies met the eligibility criteria, all of which were observational in design, conducted between 2021 and 2025. Eleven potential strategies for TB reduction, inferred from observational findings, were identified and grouped into three areas: healthcare system and access to care, therapeutic regimen, and patient and psychosocial context. Conclusions: To our knowledge, this review provides the first structured mapping of potential TB reduction strategies specifically in the older population with multimorbidity. The identified strategies, derived by the authors rather than empirically tested, may exclusively inform the design of future interventional studies and offer healthcare professionals preliminary guidance for TB management in this population. Full article

Background: Commercial digital mental health platforms have expanded across the Gulf since 2020, yet cancellation in this delivery model remains understudied. We aimed to identify factors independently associated with session cancellation on a Saudi Arabic-language commercial platform and to determine whether they describe user or provider behaviour. Methods: We conducted a retrospective cohort analysis of 36,544 booked sessions from 21,904 unique users (October 2023–April 2026); the outcome was binary cancellation (cancelled vs. completed). Multivariable logistic regression with cluster-robust standard errors estimated adjusted odds ratios (aORs) for user, provider, and booking characteristics; secondary analyses decomposed cancellation by recorded initiator and modelled age, lead time, and calendar time flexibly. Reporting followed STROBE guidelines. Results: Crude cancellation was 25.6%. Cancellation was strongly patterned by visit type (follow-up aOR 0.26, 95% CI 0.21–0.32), lead time (≥8 days 2.10, 95% CI 1.90–2.33), session type (free 1.19, 95% CI 1.10–1.27), and provider specialty; age reduced odds modestly (aOR 0.90 per decade, p < 0.001) and gender was null (aOR 0.95, p = 0.119). Cause-specific models showed that the lead-time gradient reverses by initiator: at ≥8 days versus same-day, user-initiated cancellation was less likely (aOR 0.62, 95% CI 0.49–0.78), whereas provider-initiated cancellation was far more likely (aOR 4.75, 95% CI 4.23–5.35), and provider-specialty differences were confined almost entirely to provider-initiated cancellation. The very low adjusted odds for emergency sessions (aOR 0.17, 95% CI 0.13–0.23) reflect how emergency bookings are administratively coded on the platform rather than genuine behavioural non-adherence and are regarded as artefactual. Discrimination was moderate (apparent AUC 0.700, development sample). Conclusions: Cancellation reflected operational features of the booking, but its largest correlates—lead time, free-session status, and provider specialty—operate predominantly through provider-side scheduling rather than patient non-adherence. Full article

Background/Objectives: Hospital performance is a multidimensional construct that cannot be adequately assessed using isolated financial, clinical, organizational, or patient-reported indicators. This study aimed to develop and evaluate an Integrated Multidimensional Hospital Performance Assessment Framework combining organizational management, healthcare quality, patient satisfaction, and cost efficiency. Methods: An observational, descriptive, comparative study was conducted using data collected during 2018–2019 from two Romanian public hospitals with different organizational profiles: a multidisciplinary general hospital and a monospecialty hospital. Organizational, operational, financial, and clinical indicators were analyzed comparatively. Patient satisfaction was assessed in 184 hospitalized patients, including 130 from the general hospital and 54 from the monospecialty hospital, using a structured questionnaire with excellent internal consistency (Cronbach’s α = 0.92). Cost efficiency was estimated using Stochastic Frontier Analysis based on hospital expenditure, activity, resource utilization, case complexity, and quality-related variables. Results: Significant differences were identified between the hospitals in staff composition, bed occupancy, outpatient activity, case-mix complexity, surgical activity, healthcare quality, and financial performance. Patient satisfaction was generally high in both institutions, although several dimensions differed significantly, particularly overall satisfaction, waiting time, physician consultation, treatment received, and adherence to the prescribed medication schedule. The general hospital had a lower mean cost-inefficiency score than the monospecialty hospital (0.253 vs. 0.395), corresponding to higher estimated cost efficiency (0.747 vs. 0.605; p < 0.001). Conclusions: The proposed framework offers a comprehensive and practical approach to hospital performance assessment, and its application in two public hospitals provides a proof-of-concept demonstration of feasibility. Further multicenter studies are required for external validation and assessment of its generalizability across different hospital settings. Full article

Background/Objectives: In Kuwait, a marked decline in the number of quality nurses has been observed; however, the factors underpinning their intention to leave have never been investigated. This study aimed to determine the prevalence of turnover intention among quality nurses in Kuwait, describe the reported reasons for leaving, and explore the organizational and personal experiences underlying their intentions. Methods: A sequential explanatory mixed-methods design was used. The quantitative phase involved a total population survey of all eligible quality nurses working in public hospitals (n = 65), using a structured questionnaire that included demographic characteristics, the Turnover Intention Scale (TIS-6), and literature-informed reasons for leaving. Descriptive analyses and non-parametric group comparisons (Mann–Whitney U and Kruskal–Wallis H tests) were conducted. The qualitative phase comprised in-depth semi-structured interviews with seven nurses who voluntarily reported an intention to leave and agreed to explain and contextualize the quantitative findings. Interview data were analysed using inductive thematic analysis informed by phenomenological principles. Results: The mean turnover-intention score was 21.7 (SD = 3.9), exceeding the TIS-6 scale midpoint of 18. Overall, 54 of 65 participants (83.1%; 95% CI: 72.2–90.3%) scored above the TIS-6 midpoint of 18, consistent with the original developer’s scoring guidance for a desire to leave. The most frequently reported reasons for leaving were low salary (60.0%), stressful or unsupportive work environments (49.2%), and lack of recognition (44.6%). The qualitative findings expanded these results by illustrating how organizational factors were manifested in practice through poor communication, lack of managerial support, role ambiguity, blame culture, verbal mistreatment, emotional exhaustion, and perceived inequity. Three overarching themes were identified: organizational and workplace factors, compensation and benefits, and personal reasons. Predictable morning duty also emerged as a factor that participants perceived as supporting their willingness to remain in their roles. Conclusions: Turnover intention among quality nurses in Kuwait was reported primarily in relation to organizational and work-related factors rather than demographic characteristics. The qualitative findings contextualized the high turnover-intention scores by illustrating participants’ workplace experiences. These findings suggest that strengthening organizational support, clarifying professional roles, promoting equitable management practices, and reviewing remuneration structures might contribute to improving retention among quality nurses. Full article

Background/Objectives: To evaluate classification of improvement and agreement of walking-ability improvement criteria derived from outcome measures of walking capacity and performance among inpatients with spinal cord injury (SCI). Methods: Retrospective analysis of admission and discharge data from adults with SCI in the single-centre database from years 2020 to 2023: Six-minute Walk Test (6MWT), Ten-metre Walk Test (10MWT), Walking Index for Spinal Cord Injury; selected items of Spinal Cord Independence Measure (SCIM-III), and Functional Independence Measure; Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI) Walking Mobility subscale. Twenty-three criteria for assessing walking-ability improvement including distribution-based change threshold (DBCT) and provisional milestones for in-home or in-the-community walking (derived from stroke population) and/or related independence were evaluated. Proportion of patients who progressed according to each criterion and agreement between criteria were calculated. Results: Data from 281 individuals were analysed (median 2 months since SCI). Improvement in SCIM-III Mobility Categories was achieved in 47%. Estimated DBCT of 6MWT (69 m) was exceeded in 46%, and DBCT of 10MWT at comfortable speed (CS) in 42% of participants. Forty-two percent of participants improved in provisional Walking Ability Categories (WACs) based on 6MWT or 10MWT_CS, 39% on SCIM-III-Stairs criterion, and 36% on the SCI-FAI criterion. Conclusions: The estimated DBCT and the WACs for 6MWT and 10MWT_CS are promising criteria to assess improvement in walking capacity after rehabilitation in patients with SCI; however, they require prospective validation against patient-centred and real-world mobility anchors. SCIM-III Mobility Categories and Stairs are recommended for assessing improvement in walking-related independence, and the SCI-FAI criterion for walking performance in everyday life. Full article

Background/Objectives: Older adults residing in long-term care facilities (LTCFs) are at increased risk of poor oral health because of functional dependence and limited access to professional oral healthcare. Although oral healthcare education programs for care workers improve knowledge and performance, evidence of their effects on residents’ biological oral health outcomes remains limited. This study evaluated the effects of a care worker-centered oral healthcare program on oral inflammatory status in LTCF residents using salivary interleukin-1 beta (IL-1β) as an objective biomarker. Methods: A single-group pretest–posttest quasi-experimental study was conducted in two LTCFs in the Republic of Korea. Forty care workers completed a structured oral healthcare education program and provided daily oral healthcare to residents for 4 weeks. Saliva samples were collected before and after the intervention, and salivary IL-1β concentrations were measured using enzyme-linked immunosorbent assay. Changes in IL-1β concentrations were analyzed using the Wilcoxon signed-rank, Mann–Whitney U, and Kruskal–Wallis tests. Results: Thirty-seven residents completed the study. Median salivary IL-1β concentrations significantly decreased from 19.33 pg/mL (interquartile range [IQR], 11.49–34.66) at baseline to 10.78 pg/mL (IQR, 0.65–33.64) after the intervention (Z = −3.764, p = 0.001). Greater reductions were observed among residents with greater functional dependence, whereas limited communication ability or oral care refusal was associated with minimal improvement. Conclusions: A care worker-centered oral healthcare program significantly reduced salivary IL-1β concentrations among older adults residing in LTCFs. Findings support care worker training and highlight the use of salivary IL-1β as an objective biomarker for evaluating oral healthcare interventions. Full article

Background: Medical students are vulnerable to sleep disturbance and nocturnal eating behaviors that may jointly increase psychiatric and metabolic morbidity. Comprehensive sleep-eating evaluations in Turkish medical students remain limited. To determine the prevalence of poor sleep quality and night eating syndrome (NES) risk and to examine their cross-sectional associations with insomnia, anxiety, emotional eating, restless legs symptoms, chronotype, and lifestyle factors. Methods: This cross-sectional study, conducted from March to December 2023, included 265 medical students who completed validated instruments assessing sleep quality (Pittsburgh Sleep Quality Index [PSQI]), night eating syndrome (NES) risk (a score of ≥25 indicating high risk), insomnia severity, daytime sleepiness (Epworth Sleepiness Scale [ESS]), anxiety, emotional eating, Restless Legs Syndrome (RLS) symptoms, and chronotype. Group comparisons, Spearman’s correlation analyses, and multiple linear regression were conducted. Results: Poor sleep quality (PSQI > 5) affected 50.2% of participants, and high NES risk affected 14.7%. PSQI correlated with NEQ (r = 0.301; p < 0.001), insomnia severity (r = 0.538), anxiety, and emotional eating. Mean NEQ was higher in the poor-sleep group (18.67 ± 8.00 vs. 15.38 ± 6.36; p < 0.001; Cohen’s d = 0.455). Females had higher PSQI and ESS scores, anxiety, and emotional eating scores; high NES risk was numerically more frequent in males (18.6% vs. 11.8%; p = 0.175). RLS symptoms (score > 0) were present in 34.7% (mild 22.6%; moderate 7.9%; severe 4.2%). In the primary multivariable model (PSQI and sex), PSQI was the strongest independent correlate of NEQ (standardized β = 0.325; p < 0.001); sensitivity analyses showed stable PSQI estimates after additional covariate adjustment, whereas sex coefficients were non-significant and unstable across models. A secondary model excluding PSQI identified alcohol use as a significant lifestyle correlate (standardized β = 0.167; p = 0.014). R² = 0.148 for the full covariate model and R² = 0.108 for the primary model. Conclusions: Sleep disturbance and NES risk are prevalent and cross-sectionally associated in Turkish medical students. Poor sleep quality was the strongest independent correlate of night eating scores. Integrated campus screening targeting sleep, eating behavior, anxiety, and comorbid sleep symptoms may facilitate prevention and referral. Full article

Objective: This study assessed the prevalence of fear of cancer recurrence (FCR) and its clinical, treatment-related, and psychological correlates in breast cancer survivors without active disease. Materials and Methods: This cross-sectional study included 200 breast cancer survivors after curative treatment. FCR was assessed using the Fear of Cancer Recurrence Inventory–Short Form (FCRI-SF), with scores ≥ 13 indicating clinically significant FCR. Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and Depression (HADS-D) scores ≥ 8 indicated clinically significant symptoms. Associations with FCR were analyzed using logistic regression, with HADS-A and HADS-D evaluated in separate multivariable models because of their potential overlap. Results: The mean age was 55.6 ± 9.5 years; clinically significant FCR, anxiety, and depression occurred in 38.0%, 32.5%, and 38.0%, respectively. In univariable analysis, younger age, stage III disease, mastectomy, chemotherapy history, and high HADS-A and HADS-D were associated with FCR. In the HADS-A model, chemotherapy history (adjusted OR: 5.841; p = 0.006) and high HADS-A (adjusted OR: 7.828; p < 0.001) were independently associated with FCR, whereas increasing age was protective (adjusted OR: 0.855; p < 0.001). In the HADS-D model, mastectomy (adjusted OR: 6.265; p = 0.002), chemotherapy history (adjusted OR: 6.941; p = 0.001), and high HADS-D (adjusted OR: 14.343; p < 0.001) were independently associated with FCR, whereas increasing age was protective (adjusted OR: 0.836; p < 0.001). Conclusions: FCR is a major psychosocial concern among breast cancer survivors, particularly in younger patients, those with chemotherapy history, and those with greater psychological symptom burden. The association with mastectomy should also be considered, particularly in patients with depressive symptoms. Full article

Background and Objectives: Sarcopenia and frailty are associated with falls, disability, and functional decline in older adults. This review evaluated traditional Chinese mind–body exercise (TCMBE), including Tai Chi and Health Qigong, in adults aged 60 years or older with clinically defined sarcopenia or frailty. Materials and Methods: Randomized controlled trials identified through December 2024 from six English- and Chinese-language databases were synthesized. The analyses included physical performance and secondary outcomes and explored sarcopenia and frailty as study-level subgroups. Results: Twenty-two trials involving 1660 participants were included. TCMBE was associated with a shorter Timed Up and Go Test time (mean difference [MD], −1.17 s; 95% CI, −1.80 to −0.54; p < 0.01; I² = 74%), a higher Short Physical Performance Battery score (MD, 0.99 points; 95% CI, 0.58 to 1.40; p < 0.01; I² = 24%), and greater grip strength (MD, 2.02 kg; 95% CI, 0.58 to 3.47; p = 0.006; I² = 89%). The 6 min walk test estimate was borderline and imprecise (MD, 11.76 m; 95% CI, 0.10 to 23.43; p = 0.05; I² = 0%), and no clear overall effects were observed for gait speed, the 30 s chair stand test, sit-to-stand time, Berg Balance Scale score, muscle mass, depressive symptoms, or quality of life. Several analyses showed substantial heterogeneity, and some subgroup estimates were based on only one or two studies. Conclusions: Low-certainty evidence suggests that TCMBE may produce small improvements in TUGT performance, SPPB scores, and grip strength. Very-low-certainty evidence leaves its effects on gait speed and quality of life uncertain. Risk-of-bias concerns, heterogeneity, imprecision, and uncertain clinical significance limit confidence in the current estimates. The available evidence is insufficient to support routine implementation, and larger, rigorously conducted randomized controlled trials are needed. Full article

Background/Objectives: Postmenopausal aging is accompanied by progressive loss of skeletal muscle mass and increased abdominal adiposity, both of which may influence bone health through distinct mechanical and metabolic pathways. However, their independent associations with bone mineral density (BMD) at different skeletal sites remain incompletely characterized. This study investigated the independent associations of appendicular skeletal muscle mass index (ASMI) and waist circumference (WC) with site-specific BMD in postmenopausal women. Methods: This cross-sectional study included 345 postmenopausal women who attended a university hospital menopause clinic in Thailand. Body composition was assessed using multi-frequency bioelectrical impedance analysis, and ASMI was calculated according to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus criteria. WC was measured using standardized anthropometric procedures. BMD at the lumbar spine (L1–L4), total hip, and femoral neck was determined by dual-energy X-ray absorptiometry. Multivariable linear regression analyses were performed to evaluate the independent associations of ASMI and WC with site-specific BMD after adjustment for age, years since menopause, hormone replacement therapy use, osteoporosis medication use, calcium supplementation, vitamin D supplementation, and fracture history. Robust standard errors were used in the final models. Results: Higher ASMI was independently associated with higher BMD at the lumbar spine (standardized β = 0.362, p < 0.001), total hip (standardized β = 0.371, p < 0.001), and femoral neck (standardized β = 0.353, p < 0.001). WC was positively associated with total hip BMD (standardized β = 0.158, p = 0.006), whereas no statistically significant associations were observed at the lumbar spine (standardized β = 0.009, p = 0.899) or femoral neck (standardized β = 0.105, p = 0.092). Conclusions: ASMI was consistently associated with BMD across all measured skeletal sites, whereas the association between WC and BMD varied according to skeletal region. These findings support the complementary assessment of skeletal muscle mass and central adiposity for characterizing body composition and skeletal health in postmenopausal women. Full article