Search Results (11,973)

Background/Objectives: We investigated the effect of weight misperception or dissatisfaction among individuals of normal BMI on their long-term weight changes. Methods: Data from the three follow-ups of the CoLaus|PsyCoLaus study (2009–2012, 2014–2017, and 2018–2021) conducted in Lausanne, Switzerland. Participants with a BMI < 25 kg/m² were eligible. Weight misperception/dissatisfaction was assessed by questionnaires. Weight change over a 5- or 10-year period was categorized as stable (±5 kg), loss (<−5 kg), or gain (>+5 kg). Results: Overall, 1826 (66.1% women, 55.9 ± 9.9 years) and 1089 (62.7% women, 61.2 ± 9.6 years) participants of surveys 2009–2012 and 2014–2017, respectively, were retained for analysis. Prevalence of weight misperception was 15.9% (95% CI: 14.2–17.6) and 11.5% (95% CI: 9.6–13.5) in 2009–2012 and 2014–2017, respectively. The corresponding values for weight dissatisfaction were 28.9% (95% CI: 26.8–31.0) and 20.9% (95% CI: 18.6–23.5). After multivariable analysis, participants with weight misperception/dissatisfaction had a higher likelihood (p < 0.05) of presenting with weight loss: for weight misperception, odds ratio and 95% CI: 2.29 (1.30–4.02) and 2.66 (1.24–5.69) for 2009–2012 and 2014–2017, respectively; the corresponding values for weight dissatisfaction were 2.02 (1.22–3.35) and 2.40 (1.23–4.65). No associations between weight misperception/dissatisfaction with weight gain were found. Conclusions: Our study found that weight misperception/dissatisfaction in normal-weight, middle-aged individuals was associated with weight loss over time. Full article

Background/Objectives: the assessment and prevention of fall risk is an essential component of healthcare, particularly for vulnerable populations such as older adults with or without diabetes. The use of objective and validated tools to assess balance, gait, and other risk factors enables healthcare professionals to make informed clinical decisions and design personalized prevention programs. An observational cross-sectional study was conducted with a probabilistic sample of older patients, with and without diabetes, attending a podiatric clinic (Valencia, Spain). Methods: fall risk was assessed using the Tinetti Scale and the FallSkip^® device, which measures posture (i.e., medial-lateral and anterior-posterior displacements), gait (vertical and medial-lateral ranges), turn-to-sit (time) and sit-to-stand (power) tests, total time and gait reaction time. Results: the results showed a significant association between the values obtained with FallSkip^® and the Tinetti Scale (p < 0.001), identifying the older individuals at high risk of falls. The “reaction time” parameter measured by FallSkip^® showed a significant difference between diabetic and non-diabetic patients (p < 0.05), as well as the balance score assessed by the Tinetti Scale (p < 0.05). Having experienced falls in the previous year had a strong (p < 0.001) significant influence on the results evaluated using both the Tinetti Scale and FallSkip^®. Among the FallSkip^® parameters in the multivariate analysis, the ‘Total Time (%)’ parameter significantly (p < 0.01, Exp(B) = 0.974 (CI 95%: 0.961–0.988) discriminates individuals with or without falls in the previous year. Conclusions: this study supports the usefulness of the FallSkip^® device as an objective, efficient, and easy-to-use tool for fall risk assessment in primary care settings. Full article

A series of 6:2 fluorotelomer ethoxylates (FTEOs) has been recently detected in human serum. Whether it has the potential to disrupt lipid metabolism in human populations remains largely unexplored. This study quantified serum concentrations of 6:2 FTEOs in 237 healthy Chinese adults, examined the gender- and age-specific differences in serum levels of 6:2 FTEOs, and investigated the associations between serum levels of 6:2 FTEOs and lipid profiles for the first time. Nine 6:2 FTEO homologues were detected in collected human serum, with detection frequencies of 22–81%. 6:2 FTEO8 and 6:2 FTEO9 were the more abundant 6:2 FTEO homologues in human serum, displaying the mean levels of 0.69 ng/mL (range < LOD–7.36 ng/mL) and 0.71 ng/mL (<LOD–8.12 ng/mL), respectively. Male participants had much higher (p < 0.05) mean serum levels of 6:2 FTEO6 (0.61 vs. 0.31 ng/mL), 6:2 FTEO7 (0.44 vs. 0.21 ng/mL), 6:2 FTEO8 (0.91 vs. 0.38 ng/mL), and 6:2 FTEO11 (0.35 vs. 0.18 ng/mL) than female subjects. Correlation analysis revealed a significantly positive relationship (p < 0.01) between the age of participants and human serum concentrations of 6:2 FTEO6–6:2 FTEO11. Multivariate linear regression identified significant positive associations between specific 6:2 FTEO homologues (e.g., 6:2 FTEO6, 6:2 FTEO8–6:2 FTEO10) and elevated total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. Full article

The Florida softshell turtle, Apalone ferox, is considered common and found in many different types of freshwater habitats throughout its range. However, despite its prevalence where it occurs, little is understood about the species’ life history and population dynamics due to difficulties with capture and long-term marking. Building on a foundational study of the Florida softshell turtle at Wekiwa Springs State Park (WSSP) from 2007 to 2012, we present findings from an extended 16-year mark–recapture study spanning from 2007 to 2023. A total of 31 sampling events were conducted with a median of two capture events per year. Sampling events were spread over a median of 5 days each year (range, 2–11 days), with a total of 88 capture days. One hundred and twenty individual A. ferox were captured over 225 encounters. We estimated an average population size of 135.6 individuals using an annual Schumacher–Eschmeyer ratio estimator. Using a state-space Jolly–Seber model, we estimated that 204 individuals entered the population over the 16 years (the superpopulation), while the average current population size was 40 individuals. The median survival probability was 0.884 but the median detection probability was 0.10, reinforcing the perceived difficulty with capturing A. ferox. The continued influx of new juveniles, recapture of these individuals as adults, and strong female bias support the possibility that the WSSP and Rock Springs greater ecosystem functions as a potential nursery habitat for the Florida softshell. Though population estimates dropped 20% following a two-year sampling gap owing to the COVID-19 pandemic, the population is currently growing slowly and highlights the value of continued, long-term monitoring of elusive freshwater turtle species. Full article

Background/Objectives: Oral diseases are highly prevalent in Hungary and driven in part by unhealthy beverage consumption, smoking, and other behaviors. No prior study has examined the impact of beverage consumption patterns on oral health in a representative Hungarian population. This study investigated the association between beverage intake, lifestyle factors, and oral health outcomes among Hungarian adults. Methods: Data were drawn from the 2019 Hungarian European Health Interview Survey, a nationally representative cross-sectional study. Oral health outcomes and key exposures, including beverage consumption, smoking, alcohol use, and sociodemographic variables, were self-reported. Associations were assessed using multiple logistic regression models. Results: Among 5425 adults, higher dairy intake was linked to less gum bleeding (odds ratio = 0.76; 95% confidence intervals [0.59–0.96]) and lower odds of teeth missing (0.63 [0.47–0.86]). Weekly juice intake reduced gum bleeding (0.62 [0.51–0.76]) and missing teeth (0.83 [0.71–0.96]). Daily soda was associated with more gum bleeding (1.94 [1.53–2.47]), caries (1.57 [1.27–1.94]), and poor self-perceived oral health (1.32 [1.10–1.59]). Alcohol (1–4 times/week) increased gum bleeding (1.38 [1.07–1.77]) and tooth mobility (1.47 [1.02–2.11]). Smoking raised odds for caries (1.42 [1.21–1.66]) and missing teeth (1.81 [1.55–2.10]). Conclusions: Increasing dairy and fresh juice intake while reducing sugar-sweetened and acidic beverages, alongside tobacco and alcohol control and routine oral health screening, are effective strategies for improving population oral health across all sociodemographic groups. Full article

Background: Plant-based protein supplementation in supporting muscle recovery following resistance exercise remains an area of growing interest, particularly among vegan athletes, as a potential alternative to animal-based proteins. This systematic review aimed to evaluate the effectiveness of plant-based proteins on recovery from resistance exercise-induced muscle damage in healthy young adults. Methods: A systematic and comprehensive search was administered in eight databases up to 1 May 2025, identifying 1407 articles. Following deduplication and screening, 24 studies met the eligibility criteria, including 22 randomized controlled trials and 2 non-randomized studies, with the majority from high income western countries. Results: Interventions primarily involved soy, pea, rice, hemp, potato, and blended plant protein sources, with doses ranging from 15 to 50 g, typically administered post resistance exercise. Outcomes assessed included muscle protein synthesis (MPS), delayed-onset muscle soreness (DOMS), inflammatory biomarkers, muscle function, and fatigue. The review findings reaffirm that single-source plant proteins generally offer limited benefits compared to animal proteins such as whey, particularly in acute recovery settings, a limitation well-documented consistently in the literature. However, our synthesis highlights that well-formulated plant protein blends (e.g., combinations of pea, rice, and canola) can stimulate MPS at levels comparable to whey when consumed at adequate doses (≥30 g with ~2.5 g leucine). Some studies also reported improvements in subjective recovery outcomes and reductions in muscle damage biomarkers with soy or pea protein. However, overall evidence remains limited by small sample sizes, moderate to high risk of bias, and heterogeneity in intervention protocols, protein formulations, and outcome measures. Risk of bias assessments revealed concerns related to detection and reporting bias in nearly half the studies. Due to clinical and methodological variability, a meta-analysis was not conducted. Conclusion: plant-based proteins particularly in the form of protein blends and when dosed appropriately, may support muscle recovery in resistance-trained individuals and offer a viable alternative to animal-based proteins. However, further high-quality, long-term trials in vegan populations are needed to establish definitive recommendations for plant protein use in sports nutrition. Full article

The increasing prevalence of chronic metabolic diseases poses a significant challenge in the modern world, impacting healthcare systems and individual life expectancy. The World Health Organization (WHO) recommends that older adults (65+ years) engage in 150–300 min of moderate-intensity or 75–150 min of vigorous-intensity physical activity, alongside muscle-strengthening and balance-training exercises at least twice a week. However, nearly one-third of the adult population (31%) is physically inactive, which increases the risk of developing obesity, type 2 diabetes, cardiovascular diseases, hypertension, and psychological issues. Physical activity in the form of aerobic exercise, resistance training, or a combination of both is effective in preventing and managing these metabolic diseases. In this review, we explored the effects of exercise training, especially on respiratory and pulmonary factors, including oxygen consumption, pulmonary ventilation, and blood gas analyses among adults. During exercise, oxygen consumption can increase up to 15-fold (from a resting rate of ~250 mL/min) to meet heightened metabolic demands, enhancing tidal volume and pulmonary efficiency. During exercise, the increased energy demand of skeletal muscle leads to increases in tidal volume and pulmonary function, while blood gases play a key role in maintaining the pH of the blood. In this review, we explored the influence of age, body composition (BMI and obesity), lifestyle factors (smoking and alcohol use), and comorbidities (diabetes, hypertension, neurodegenerative disorders) in the modulation of these physiological responses. We underscored exercise as a potent non-pharmacological intervention for improving cardiopulmonary health and mitigating the progression of metabolic diseases in aging populations. Full article

Background/Objectives: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country’s population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. Methods: Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). Results: The review identified three domains of factors and the ways in which each factor shapes older adults’ virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). Conclusions: This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts. Full article

Background/Objectives: Melanoma is an aggressive skin cancer with increasing incidence worldwide. Dermoscopy has revolutionized early melanoma detection, but most studies have focused on the general adult population. This study aims to analyze dermoscopic and histological differences in melanoma across age groups, evaluating whether specific patterns vary between younger and older patients. Methods: This retrospective study included 285 histopathological confirmed melanomas diagnosed at the Dermatology Clinic of the University of Turin between November 2021 and April 2024. Patients were stratified by age (<40 vs. ≥40 years), and statistical analyses (Chi-square, logistic regression) assessed differences in dermoscopic, histopathological, and anatomical parameters. Results: Younger patients showed a higher prevalence of growth-related features (e.g., pseudopods, OR = 5.43; asymmetric globules, OR = 2.33) and a thicker Breslow index (mean = 1.05 mm). Older patients exhibited more regression-associated signs (scar-like depigmentation, OR = 0.15; peppering, OR = 0.39), greater lesion size, and solar elastosis. Dermoscopic regression significantly predicted histological regression, with age-stratified analysis revealing peppering as a predictor in younger patients (p = 0.015) and scar-like depigmentation in older ones (p = 0.012). Conclusions: Melanoma exhibits distinct dermoscopic features depending on patient age, with growth-associated patterns being more common in younger individuals and regressive patterns predominating in older patients. These findings highlight the importance of age-specific diagnostic considerations in melanoma detection, potentially improving early diagnosis and patient outcomes. Full article

Background: Thallium is a metal that is ubiquitous in our natural environment. Despite its potential for high toxicity, thallium is understudied and not regulated in food. The California Department of Public Health was alerted to a household cluster of elevated urine thallium levels noted among a mother (peak 5.6 µg/g creatinine; adult reference: ≤0.4 µg/g creatinine) and her three young children (peak 10.5 µg/g creatinine; child reference: ≤0.8 µg/g creatinine). Objectives: This case report identifies questions raised after a public health investigation linked a household’s thallium exposure to a commercially available food product. We provide an overview of the public health investigation. We then explore concerns, such as gaps in toxicological data and limited surveillance of thallium in the food supply, which make management of individual and population exposure risks challenging. Methods: We highlight findings from a cross-agency investigation, including a household exposure survey, sampling of possible environmental and dietary exposures (ICP-MS analysis measured thallium in kale chips at 1.98 mg/kg and 2.15 mg/kg), and monitoring of symptoms and urine thallium levels after the source was removed. We use regulatory and research findings to describe the challenges and opportunities in characterizing the scale of thallium in our food supply and effects of dietary exposures on health. Discussion: Thallium can bioaccumulate in our food system, particularly in brassica vegetables like kale. Thallium concentration in foods can also be affected by manufacturing processes, such as dehydration. We have limited surveillance data nationally regarding this metal in our food supply. Dietary reviews internationally show increased thallium intake in toddlers. Limited information is available about low-dose or chronic exposures, particularly among children, although emerging evidence shows that there might be risks associated at lower levels than previously thought. Improved toxicological studies are needed to guide reference doses and food safety standards. Promising action towards enhanced monitoring of thallium is being pursued by food safety agencies internationally, and research is underway to deepen our understanding of thallium toxicity. Full article

Background/Objectives: Avascular necrosis of the femoral head is a debilitating condition that, if left untreated, leads to progressive arthritis necessitating total hip replacement (THR). In the younger adult population, there is a drive towards joint-preserving procedures, particularly where alternative techniques such as core decompression or vascularised bone grafting are anticipated to fail. Proximal femoral osteotomy is a technique that aims to remove the necrotic segment from the weight bearing area. The presented review aims to examine the efficacy of this technique in the management of avascular necrosis of the femoral head, reporting both rates of conversion to total hip replacement and patient reported outcomes. Methods: This systematic review was conducted according to PRISMA guidelines. A search was conducted of PubMed, Ovid Medline, EMBASE, and the Cochrane Library using pre-defined search terms. Data were extracted, and descriptive data presented. Quality of each study was assessed using the NIH quality assessment tool for case series studies. Results: Fifty-three studies with data for 2686 osteotomies are presented. Progression of radiological arthrosis was present in 40% of cases, with 20.3% of patients having undergone conversion to THR at a mean of 75.4 months (range 20–132 months). Patient-reported outcome measures were recorded in 1416 patients, of which the Harris Hip Score was the most commonly utilised. This score improved from a mean of 58.3 to 84.4 at a mean follow-up of 102 months. Conclusions: Osteotomy represented a valid head-preserving technique in the armamentarium against avascular necrosis of the femoral head, with conversion to THR required in 20.3% of patients at 7 years. In those patients who did not require THR, PROMS were similar to the arthroplasty population. Full article

Background/Objectives: Cancer represents a significant health challenge, with high mortality and morbidity rates. Its diagnosis often triggers chronic stress, adversely affecting patient outcomes. Exercise has emerged as complementary therapy, enhancing treatment adherence and mitigating the side effects of chemotherapy. This study examines the effects of mild exercise during chemotherapy on patient anxiety. Methods: This prospective paired cohort study was conducted in the General Oncology Hospital of Kifisia “Agioi Anargyroi” in Athens, Greece. Adult cancer patients undergoing chemotherapy participated, excluding those with cognitive, hearing, or motor impairments, those who experienced side effects, or those who declined consent. Anxiety was measured before and after a 20-minute exercise routine performed during chemotherapy, using the Greek-translated State–Trait Anxiety Inventory (STAI). The exercise regimen included warm-up, full-body stretching, and cool-down exercises. Pre- and post-exercise scores were analyzed using the Wilcoxon signed-rank test. Results: Forty-five patients (20 women, 25 men; mean age 69.02 ± 10.62 years) with various cancer backgrounds participated. Pre-intervention anxiety levels were in the borderline “moderate” range, dropping post-exercise to the “low” range. Mean STAI scores decreased from 37.73 ± 13.33 to 32.00 ± 14.22 (p < 0.0001), with a medium-large effect size (Cohen’s d for paired samples = −0.646). No significant correlation was found between age and anxiety scores. Discussion: This study found a significant short-term reduction in anxiety, suggesting that incorporating mild exercise during chemotherapy may help in alleviating patient stress. The medium-to-large effect size supports the potential for meaningful short-term benefits. Conclusions: Incorporating mild exercise during chemotherapy may help reduce anxiety and psychological burden. These findings underscore the need for more comprehensive research in larger, more diverse populations to better understand the benefits of incorporating mild exercise during chemotherapy. Full article

ADHD is a childhood neurodevelopmental disorder, but it can persist into adolescence and adulthood and become detrimental to the individual’s well-being. It is known that many individuals with ADHD manifest executive functioning problems that affect their adaptive functioning. In the evaluation phase, it is, therefore, useful to consider these aspects as well. The diagnosis of ADHD is purely clinical in adults: it is based on anamnesis and the completion of questionnaires on the history of symptoms and current symptomatology. In recent years, the tele-assessment has become a valuable and accessible tool for diagnostic framing and intervention planning; however, there are currently few tele-assessment tools that enable the in-depth analysis of young adults. In this study, a group of 34 young adults with ADHD was compared with 35 typically developing peers using a tele-assessment tool for executive functioning (TeleFE, Anastasis). This research can be considered a pilot study to evaluate the differences in these tasks between the two populations and open the possibility of standardizing the tool for young adults. The use of this tool to assess executive functioning in individuals with ADHD in this age group would enable clinicians to plan more individualized interventions. Full article

Background: Cerebral palsy (CP) is a lifelong neurodevelopmental disorder characterised by motor impairment and commonly associated with comorbidities such as cognitive, communicative, and behavioural difficulties. While the physical and functional aspects of CP have been extensively studied, the mental health needs of this population remain largely underexplored, particularly concerning suicidal ideation and self-injurious behaviours. The purpose of this review is to synthesise the existing literature on suicidality in individuals with CP, explore theoretical and clinical risk factors, and identify key gaps in the current evidence base. Methods: A narrative literature review was conducted focusing on studies addressing suicidal ideation, self-harm, or related psychiatric outcomes in individuals with CP. Additional literature on risks and protective factors was included to support theoretical inferences and clinical interpretations. Results: Only a limited number of studies addressed suicidality directly in CP populations. However, several reports document elevated rates of depression, anxiety, and emotional distress, particularly among adults and individuals with higher levels of functioning. Communication barriers, chronic pain, social exclusion, and lack of accessible mental health services emerged as critical risk factors. Protective elements included strong family support, inclusive environments, and access to augmentative communication. Conclusions: Suicidality in individuals with CP is a neglected yet potentially serious concern. Evidence suggests underdiagnosis due to factors such as communication barriers and diagnostic overshadowing. Future research should prioritise disability-informed methodologies and validated tools for suicidal ideation, while clinicians should incorporate routine, adapted mental health screening in CP care to ensure early detection and person-centred management. Full article

The market for plant-based alternatives to animal foods has increased rapidly in the past decade, mainly due to consumer demand. Little evidence is available regarding nutritional impacts, drivers, and barriers to using these products as substitutes for animal foods in real-life conditions. This pilot study followed 16 Danish adults (30 ± 11 years old; 11 females) for 4 weeks with substituting milk, cheese, and yogurt with plant-based analogues to dairy (PBADs) and assessed their drivers and barriers to applying the intervention with a mixed-method approach. PBADs are constantly compared to their animal counterparts, both regarding product characteristics, such as price and sensory properties, as well as cultural roles and subjective memories. The mixed methods showed dairy attachment, price, and taste were the main barriers to consuming PBAD, while changes in life and social circles were drivers (qualitative data). As for the liking of PBADs, plant-based yoghurt was the preferred intervention product (73.5/100, p < 0.05), followed by plant-based drinks (65.9/100), while plant-based cheese was the lowest rated (47.9/100, p < 0.05). As for dietary changes, a lower average intake of sugars, saturated fatty acids, cholesterol, calcium, phosphorus, and zinc was observed after the intervention. Additionally, this study describes the attachment of the study population to milk and dairy products. It shows that choosing dairy is beyond nourishment but is connected to tradition, culture, pleasure, memories, and a sense of belonging. In contrast, there is no history or attachment to PBADs. Full article