Search Results (248)

Disability in basic and instrumental activities of daily living (BADL and IADL) reflects functional decline in older adults and can be associated with chronic conditions like type 2 diabetes (T2DM) and hypertension (SAH). This cross-sectional study utilized data from the 2013 and 2019 Brazilian National Health Surveys to investigate the associations between T2DM, SAH, and disability levels. Exposures were self-reported diagnoses and outcomes were classified as independent, moderate, or severe. Multivariable Poisson regression models, with robust variance estimates, estimated adjusted prevalence ratios (PRa), accounting for sociodemographic variables and the survey design. In 2013, the absence of diabetes and hypertension was associated with a lower prevalence (PRa = 0.70; 95% CI: 0.58–0.85) of moderate disability in BADL when compared with the presence of only one of the conditions. On the other hand, the coexistence of T2DM and SAH was associated with a higher prevalence (PRa = 1.39; 95% CI: 1.01–1.91). A similar result was found in 2019 with the addition that coexistence was also associated with a higher prevalence of severe disability in BADLs (PRa = 1.82; 95% CI: 1.59–2.07). For IADL, the absence of T2DM and SAH was associated with a lower prevalence of severe disability in 2013 and 2019 and a lower prevalence of moderate disability only in 2019. However, coexistence showed a higher prevalence in both degrees of disability and both years of the survey. These findings highlight the impact of T2DM and SAH on disability in older people. Therefore, it is crucial to develop targeted strategies for vulnerable subgroups to enhance functional independence in aging populations. Full article

Egg yolk immunoglobulin Y (IgY) possesses advantages such as low cost, easy availability, simple preparation, high antigen specificity, absence of drug residues, and compliance with animal welfare standards, making it an environmentally friendly and safe alternative to antibiotics. This research utilizes IgY antibody technology to develop a multivalent passive immune vaccine for major pathogenic bacteria in aquaculture. In this study, IgY antibodies against live Shewanella xiamenensis (LSX-IgY) and inactivated S. xiamenensis (ISX-IgY) were prepared by immunizing laying hens, and passive immunization protection experiments were conducted in Carassius auratus infected with S. xiamenensis and Aeromonas hydrophila. The passive immunization protection rates of LSX-IgY and ISX-IgY against S. xiamenensis were 63.64% and 72.73%, respectively, and the passive cross-protection rates against A. hydrophila were 50% and 71.43%, respectively. Further, C. auratus sera could specifically bind to S. xiamenensis or A. hydrophila in vitro, and the phagocytic activity of leukocytes was increased. LSX-IgY and ISX-IgY could reduce the bacterial load in the C. auratus kidneys. Meanwhile, they could significantly reduce the levels of antioxidant factors in serum and inhibit the mRNA expression of inflammation-related factors in the kidneys and spleens. Additionally, histopathology and immunofluorescence analysis showed that both IgY preparations preserved tissue integrity and reduced the expression of apoptosis factor (p53) and DNA damage factor (γH2A.X) of visceral organs, respectively. In summary, LSX-IgY and ISX-IgY can combat various bacterial infections, with no significant difference between the two. Additionally, inactivated bacterial immunization is more aligned with animal welfare standards for laying hens. Therefore, ISX-IgY is expected to serve as a multivalent vaccine against major aquaculture pathogens. Full article

Background: Sickle cell disease (SCD) is associated with high physical and psychosocial burden among patients and their families. Hydroxyurea (HU) improves health-related quality of life by preventing SCD complications. Despite its availability, HU is underutilised in Tanzania. Perceived self-efficacy for appropriate medication use influences medication usage among individuals with chronic illnesses. We studied factors associated with caregivers’ perceived self-efficacy for appropriate use of HU and its association with HU usage among children with SCD in Dar-es-Salaam. Methods: We conducted a cross-sectional study from May to August 2023. We enrolled 374 caregivers of children with SCD from two regional and two national hospitals. We adapted the self-efficacy for appropriate medication use scale, a multidimensional perceived social support scale, and a patient health questionnaire for assessment of self-efficacy, social support, and depressive symptoms, respectively. Results: Three-quarters of caregivers had high perceived self-efficacy scores for medication use. Attending national hospitals, high social support, and absence of depressive symptoms were positively associated with perceived self-efficacy (adjusted beta coefficient aβ 2.3, 95% CI 0.5–4.2; aβ 9, 95% CI 7.1–10.9; and aβ 5.3, 95% CI 2.8–7.8, respectively). Caregivers with high self-efficacy were 5.3 times more likely to give HU to their children compared with those with low self-efficacy (incidence rate ratio 5.3, 95% CI 3.3–8.3). Conclusions: Hospital levels and psychosocial factors influence caregivers’ perceived self-efficacy for appropriate HU use. We recommend targeted interventions to enhance psychosocial support among caregivers to increase caregivers’ perceived self-efficacy and HU utilization among children with SCD in Tanzania. Full article

This study introduces a farm-to-fork quantitative risk assessment (QRA) model for invasive listeriosis from ready-to-eat diced cantaloupe. The modular model comprises seven stages—preharvest (soil and irrigation contamination), harvest (cross-contamination and survival), pre-processing (brushing), processing (flume tank washing, dicing and equipment cross-contamination), lot testing, cold-chain transport and retail growth, and consumer storage/handling. Each stage employs stochastic functions to simulate microbial prevalence and concentration changes (growth, inactivation, removal, partitioning, cross-contamination) using published data. In a reference scenario—good agricultural practices (soil barriers, no preharvest irrigation), hygienic processing and proper cold storage—the model predicts low lot- and pack-level contamination, with few packs >10 CFU/g and most servings below detection; the mean risk per serving is very low. “What-if” analyses highlight critical control points: the absence of soil barriers with preharvest irrigation can increase the risk by 10,000-fold; flume tank water contamination has a greater impact than harvest-stage cross-contamination; and poor consumer storage can raise the risk by up to 500-fold. This flexible QRA framework enables regulators and industry to evaluate and optimize interventions—from improved agricultural measures to targeted sampling plans and consumer guidance—to mitigate listeriosis risk from RTE diced cantaloupe. Full article

This study investigates L3 Spanish perception patterns among L1 Korean–L2 English bilinguals with varying L3 proficiency levels, aiming to test the applicability of traditional L2 perceptual models in multilingual contexts. We conducted two experiments: a cross-linguistic discrimination task and a cross-language identification task. Results revealed unexpected outcomes unique to multilingual contexts. Participants had difficulty reliably discriminating between cross-linguistic categories and showed little improvement over time. Similarly, they did not demonstrate progress in categorizing sounds specific to each language. The absence of a clear correlation between proficiency levels and the ability to discriminate and categorize sounds suggests that input distribution and language-specific activation may play more critical roles in L3 perception, consistent with the distributional learning approach. We argue that phoneme distributions from all three languages likely occupy a shared perceptual space. When a specific language is activated, the relevant phoneme distributions become dominant, while others are suppressed. This selective activation, while not crucial in traditional L1 and L2 studies, is critical in L3 contexts, like the one examined here, where managing multiple phonemic systems complicates discrimination and categorization. These findings underscore the need for theoretical adjustments in multilingual phonetic acquisition models and highlight the complexities of language processing in multilingual settings. Full article

Background: Physical activity is essential for the physical and psychological development of children, contributing to both fitness and overall well-being. However, children with neurological conditions such as childhood absence seizures (CAE), a type of epilepsy characterized by brief episodes of impaired consciousness, may face barriers to participating in regular physical activities. This limitation can negatively affect their quality of life, motor coordination, and cognitive function. Despite this, there is limited research focusing on the physical activity levels of children with absence seizures in comparison to healthy children. Methods: This study aims to compare physical activity levels in children with absence seizures and healthy controls, using the Physical Activity Questionnaire for Children (PAQ-C), a validated tool for assessing children’s engagement in physical activity. The sample included 125 children with absence seizures and 125 healthy controls. The study also assessed anxious–depressive traits using the Children’s Depression Inventory (CDI-2) and the Multidimensional Anxiety Scale for Children (MASC-2). Additionally, seizure frequency and severity were documented for the seizure group, and the impact of different treatment regimens (levetiracetam, valproate, lamotrigine) was explored. Results: The results revealed that children with absence seizures exhibited lower physical activity levels compared to healthy children, although the difference did not reach statistical significance. Furthermore, they had higher scores for anxious–depressive traits. There were no significant differences in physical activity levels between the different treatment groups. The study also found that lower physical activity was correlated with poorer quality of life and increased psychological distress in the seizure group. Conclusion: Children with absence seizures face significant barriers to physical activity, which may be further compounded by psychological distress. These findings emphasize the need for targeted interventions to improve physical activity and address mental health concerns in this population. By enhancing physical activity levels and supporting psychological well-being, interventions can improve the quality of life and overall health of children with absence seizures. Additionally, the results highlight the importance of promoting inclusive physical activity programs for children with neurological conditions. Full article

Pummelo (Citrus maxima) is an ancestral species that has given rise to several major citrus varieties, such as sweet orange (C. x aurantium var. sinensis) and grapefruit (C. x aurantium var. paradisi). This species is also cultivated and its fruit consumed, particularly in Asia. Over the course of evolution, the allogamous reproduction of pummelos and the absence of asexual multiplication have contributed to its diversification. To assess its phenotypic diversity and the chemical composition of leaf and peel essential oils, genetic analysis using DNA markers is an essential prerequisite to ensure the identity and if varieties belong to this species. Fifty-eight accessions classified as grapefruits or pummelos were analyzed using 42 SSRs, 4 Indels, and 36 SNP markers. Based on the allelic composition of these markers, 20 cultivars were detected belonging to pummelos, 18 cultivars to grapefruits, and 11 were interspecific hybrids. The grapefruit inter-cultivar SSR diversity is null. The genetic origin of five interspecific hybrids is elucidated. The level of phenotypic diversity and of essential oil composition corroborate the modes of diversification, with high levels for those resulting from crosses and very low levels for the group of grapefruit mutants. Only the characteristics of breeding selection (pulp color, acidity and aspermia) are variable in grapefruits. In the composition of leaf essential oils (LEOs), nine profiles were detected in grapefruits based on variations in six compounds (neral, geranial, β-phellandrene, γ-terpinene, (E)-β-ocimene, and β-pinene). The seven interspecific hybrids involving pummelo as one parent show particular LEO profiles but without specific compounds, with the exception of p-cymenene which is present only in Wheeny. The diversity of peel essential oils in pummelos is lower, but variations in γ-terpinene, β-pinene, limonene, and myrcene make it possible to define seven profiles. With genetic verification the chemical and phenotypic diversity of the two species, pummelo and grapefruit, revealed in this study can be used as a reference for behavior in a specific environment. Full article

Background: Cervical foraminal bony stenosis (CFBS) is a common degenerative spinal condition that causes radicular pain and functional impairment in the upper extremities. Accurate and objective diagnosis of CFBS remains challenging due to the absence of standardized morphometric criteria. This study aimed to determine an optimal cut-off value for the cervical foraminal cross-sectional area (CFCSA) at the C5/6 level as a diagnostic indicator of CFBS. Methods: We conducted a retrospective case-control study including 154 patients aged 50 years or older with clinically and radiologically confirmed CFBS and 150 age-matched asymptomatic controls. Cervical spine magnetic resonance imaging (MRI) was performed in all subjects and CFCSA measurements were obtained from sagittal T2-weighted images using a standardized protocol. Group differences were analyzed using t-tests and diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Results: The mean CFCSA was significantly lower in the CFBS group (25.65 ± 7.19 mm²) compared to the control group (43.00 ± 8.38 mm²; p < 0.001). ROC analysis identified a CFCSA threshold of 33.02 mm² as the optimal cut-off point for predicting CFBS, yielding a sensitivity of 86.4%, a specificity of 86.7%, and an area under the curve (AUC) of 0.94 (95% CI: 0.91–0.96). Conclusions: These findings suggest that CFCSA is a robust and reproducible morphological parameter for evaluating foraminal stenosis. The proposed cut-off may enhance diagnostic accuracy and aid in clinical decision-making for patients presenting with C6 radiculopathy. However, given this study’s retrospective, single-center design, further validation through multicenter, prospective studies across multiple cervical levels is warranted. Full article

Background: Self-medication is the use of medicinal products to treat self-diagnosed disorders or symptoms without the prescription or supervision of a healthcare professional. There is a lack of data about self-medication knowledge, attitudes, and practices among pharmacy undergraduates in Malaysia. This study assessed the knowledge, attitudes, and practices among undergraduate pharmacy students in Penang regarding self-medication. Method: A descriptive cross-sectional study was conducted using a self-administered, web-based survey (Google Forms), which was completed and responded to by 203 undergraduate pharmacy students from Penang, Malaysia, between October and December 2023. Descriptive statistics were used to summarize the socio-demographic characteristics of the participants. Associations between the socio-demographic characteristics of the participants and the knowledge, attitudes, and practices regarding self-medication were assessed using a chi-square test. Regression analyses were carried out to determine whether the socio-demographic characteristics of the participants were associated with practices of self-medication. Results: A total of 203 of the undergraduate pharmacy students completed the questionnaire. More than half of the participants’ age ranged between 19 and 21 years old, the majority were females (77.3%), and 31.5% of the participants had family members employed in the healthcare sector. Most respondents showed good knowledge in a variety of domains: 97.5% acknowledged the potential for drug interaction with other medications, indicating a high awareness of proper self-medication practices. A positive attitude was found regarding participants’ attitudes toward self-medication, and 65.5% practiced self-medication, primarily for treating minor illnesses (75.9%). Common conditions included fever (83.3%), cough/cold/flu (76.8%), and headache (71.4%). Reasons for not self-medicating included the absence of illness (20.2%), lack of knowledge/prior experience (19.2%), and fear of using the wrong medication (18.7%). Only academic year level was the predictor of practicing self-medication within the last six months among the participants. Conclusions: Generally, the participants possessed good knowledge and positive attitudes toward self-medication. The study revealed no significant associations between demographic characteristics and knowledge or attitudes. Insights from this research contribute to understanding self-medication practices among pharmacy students in Penang, informing potential interventions to promote responsible self-medication practices. Full article

Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p < 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM. Full article

While the greatest risk factor for Alzheimer’s disease (AD) is aging, women are disproportionately affected by the disease. Interestingly, the hippocampus and cerebellum exhibit gender-specific cytoarchitecture differences, which are associated with AD, despite the absence of a role in animal reproductive behavior or hormonal signaling. This study investigates the potential association of sex differences associated with AD by interrogating cerebellar and hippocampal volume in preclinical (MCI) as well as clinical phases of AD compared to cognitively normal patients (CN) and in an animal model of AD, the streptozotocin (STZ)-induced sporadic AD model. In order to investigate putative changes in cerebellum and hippocampus in a rat model of AD, we used a STZ-induced sporadic AD model at three different time points (2, 4, and 8 weeks) after surgery in male and female rats. Previous studies have reported hippocampal-dependent changes as well as sex-dependent behavioral and signaling effects in the STZ animal model of sporadic AD while our current study showed involvement of cerebellum-mediated changes. To interrogate the role of cerebellar volume in AD progression within the human context, we analyzed data available through the Alzheimer’s Disease Neuroimaging Initiative (ADNI). In a cross-sectional analysis, we observed that levels of peripheral Glial Acidic Fibrillary Protein (GFAP) (astrocytic protein) were associated negatively with cerebellar and hippocampal volumes (β = −0.002, p-value = 0.04; β = −6.721, p-value < 0.0001) and were associated with sex specific differences in males. Our analysis identified that the effect on hippocampal volume was earlier in disease stage, reinforcing the relevance of longitudinal alterations of cerebellum and hippocampus volume over time. The STZ animal model of sporadic AD, corroborated the progressive changes in hippocampal volume and more minor and temporally delayed involvement of the cerebellum volume changes which were dependent on sex. This suggests that cerebellar involvement may be secondary to hippocampal neurodegeneration, and both regional differences were dependent on sex. Due to the association with GFAP, our findings may be due to network astrocyte connection spread regardless of primary pathology. Overall, our study uncovers a novel role for cerebellum in AD in a model and in the human context. Full article

Background and Objectives: Depression is a multifactorial mental health disorder involving inflammation, oxidative stress, neuroplasticity deficits, and metabolic dysfunction. Emerging research suggests that vitamin K, beyond its classical roles in coagulation and bone metabolism, may influence neurobiological processes relevant to mood regulation. This systematic review evaluates the association between vitamin K and depressive symptoms and explores potential underlying mechanisms. Materials and Methods: A systematic search was conducted across PubMed, Scopus, Cochrane Library, ScienceDirect, and Google Scholar, following PRISMA 2020 guidelines. Eligible studies included human or animal research examining associations between vitamin K status (dietary intake or serum levels) and depression-related outcomes. Fourteen studies met the inclusion criteria: eleven observational studies, one randomized controlled trial (RCT), and two preclinical animal studies. Results: Most observational studies reported an inverse association between vitamin K intake or serum levels and depressive symptoms across diverse populations. One small RCT demonstrated modest improvements in depression scores following vitamin K2 (menaquinone-7) supplementation in women with polycystic ovary syndrome. Two preclinical studies using non-depression models reported behavioral improvements and reduced oxidative stress following vitamin K2 administration. Conclusions: While preliminary findings suggest a potential role for vitamin K in pathways relevant to depression, the current evidence is limited by cross-sectional designs, lack of isoform-specific analyses, and the absence of depression-focused preclinical models. Mechanisms including inflammation reduction, oxidative stress modulation, sphingolipid regulation, and vitamin K-dependent protein signaling (e.g., GAS6 and osteocalcin) were discussed based on indirect evidence and require further investigation in depression-specific contexts. Full article

Objective: Psychological resilience, defined as one’s self-reported ability to bounce back from stress, is understudied in young African American women (YAAW). Guided by community feedback, this study examined the associations between resilience and the following three constructs from Staudinger’s 2015 resilience and aging model: perceived stress, non-psychological resources, and psychological resources. We aimed to identify cultural resources that can enhance resilience in the face of unique stressors. Methods: A cross-sectional survey was administered to 512 self-identified YAAW aged 18–35 years. Resilience was measured by the Brief Resilience Scale, ranging from one to five, with higher scores indicating greater resilience. We employed linear regression to examine the relationships among stressors, resources, and resilience, and then used elastic net (EN) regularization to identify the resources most strongly associated with resilience after adjusting for age and stressors. Data were analyzed using SAS version 9.4. Results: YAAW with higher resilience experienced fewer stressors and reported greater access to both non-psychological and psychological resources. In the adjusted EN model, perceived stress (β = −0.16), internalized racism (β = −0.06), and adverse childhood experiences (β = −0.03) demonstrated the strongest associations with lower resilience. Conversely, improvisational skills (β = 0.23), (emotional stability or the absence of) neurotic personality traits, β = −0.22), presence of conscientious personality traits (β = 0.08), and not expressing anger to cope with discrimination (β = −0.04) had the strongest associations with higher resilience. Notably, high improvisation skills and low levels of neuroticism were identified as key resilience resources. Conclusion: Stress reduction techniques that focus on addressing racial trauma and highlight the health-promoting aspects of AA cultural identity, such as improvisation, may play an important role in fostering resilience among YAAW. Further research is needed to validate these findings and to help inform the development of effective intervention strategies in this group. Full article

Background: Human papillomavirus (HPV) infection in pediatric populations is an emerging area of interest due to its potential role in early viral transmission and long-term oncogenic risk. The oral cavity may serve as a reservoir for high-risk HPV types; however, its prevalence in children remains under-investigated and unclear. The HOPE (Human papillomavirus Oral infection in PEdiatric population) project aims to assess the prevalence of oral HPV using an innovative salivary sampling method, also exploring the influence of social determinants on parental awareness and attitudes toward HPV vaccination. This paper presents the findings from a cross-sectional pilot study. Methods: This pilot investigation included a total of 70 children (0–14 years) who underwent an oral examination and non-invasive salivary sampling using the novel LolliSponge device. HPV detection was performed using INNO-LiPA^® HPV genotyping. Parents completed a questionnaire assessing socio-demographic factors and HPV-related knowledge. Associations between oral health status, social determinants, and HPV awareness were analyzed. Results: The LolliSponge device demonstrated excellent acceptability among the pilot population. The mean age at recruitment of the children thus far (8 years) appears to correlate with the absence of oral HPV infection. Regarding parental knowledge and attitudes, 51 out of the 70 respondents (72.9%, 95% CI: 62–83%) reported having heard of HPV; however, 94.3% (66/70) were unaware of its transmission routes, and 60% (42/70) did not know that it can cause cancer. Only 4 out of the 70 participants (5.7%) reported that their child had received the HPV vaccine. Lower awareness of the HPV vaccine was significantly associated with a lower educational level (p = 0.001), being married (p = 0.03), and having three or more children (p = 0.039). Awareness of the vaccine’s existence also varied significantly by parental occupation (p = 0.02). Conclusions: The pilot findings of the HOPE project highlight both the potential of innovative strategies for detecting oral HPV infection in children and critical gaps in parental knowledge and vaccine uptake. Preliminary data also reveal an age-related bias in HPV status, suggesting the need for further investigations in a larger cohort of younger children (<5 years). Full article

Frequent outbreaks of respiratory infectious diseases, driven by diverse pathogens, have long posed significant threats to public health, economic productivity, and societal stability. Respiratory infectious diseases are highly contagious, characterized by short incubation periods, diverse symptoms, multiple transmission routes, susceptibility to mutations, and distinct seasonality, contributing to their propensity for outbreaks. The absence of effective antiviral treatments and the heightened vulnerability of individuals with weakened immune systems make them more susceptible to infection, with severe cases potentially leading to complications or death. This situation becomes particularly concerning during peak seasons, such as influenza outbreaks. Therefore, early detection, diagnosis, and treatment are critical, alongside the prevention of cross-infection, ensuring patient safety, and controlling healthcare costs. To address these challenges, this review aims to identify a comprehensive, rapid, safe, and cost-effective diagnostic approach for respiratory infectious diseases. This approach is framed within the existing hierarchical healthcare system, focusing on establishing diagnostic capabilities at hospitals, community, and home levels to effectively tackle the above issues. In addition to PCR and isothermal amplification, the review also explores emerging molecular diagnostic strategies that may better address the evolving needs of respiratory disease diagnostics. A key focus is the transition from amplification technologies to amplification-free biosensing approaches, with particular attention given to their potential for home-based testing. This shift seeks to overcome the limitations of conventional amplification methods, particularly in decentralized and home diagnostics, offering a promising solution to enhance diagnostic speed and safety during outbreaks. In the future, with the integration of AI technologies into molecular amplification technologies, biosensors, and various application levels, the inclusively economic, rapid, and safe respiratory disease diagnosis solutions will be further optimized, and their accessibility will become more widespread. Full article