Search Results (19,294)

(1) Background: The COVID-19 pandemic presented unprecedented challenges for people with multiple sclerosis (PwMS) in Oman, necessitating targeted healthcare planning and patient support. This study aimed to investigate the impact of COVID-19 on MS management and disease course, incidence, and outcomes of COVID-19, psychosocial and mental health effects of the pandemic, and demographic and clinical predictors of the effects related to COVID-19 among Omani PwMS. (2) Methods: This cross-sectional study was conducted from January to April 2021. Adult (18–60 years) Omani PwMS completed a structured interview along with the Expanded Disability Status Scale (EDSS) and World Health Organization Well-being Index (WHO-5). Clinical data on relapses and disease-modifying therapies and adherence were analyzed. The data was statistically analyzed. (3) Results: Of 104 PwMS (73.1% female), 22.1% contracted COVID-19, with fatigue being the most reported symptom (87%). Female sex (p = 0.042), younger age (18–34 vs. 35–45 years; p = 0.014), diagnosis of COVID-19 (p = 0.037), and low current mental well-being scores (p = 0.021) predicted greater COVID-19-related effects. (4) Conclusion: These findings highlight the need to study the mental resilience of this subgroup of PwMS and provide them with targeted support during crises. 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 COVID-19 pandemic exacerbated mental illness, accelerated cognitive decline, and deepened social inequalities. In low and middle-income countries (LMIC) such as Panama, it is unclear as to whether, and to what extent, the pandemic lockdowns affected cognitive, mental, and physical health of older adults. This study investigated changes in cognitive function, mental health, and physical health in a sample of Panamanian older adults assessed before and during the pandemic, and examined whether sociodemographic variables were associated with cognition and mental health. Participants completed in-person interviews between 2018 and early 2020 and a follow-up telephone interview between February and May 2021. Repeated measures analyses showed no significant changes in cognitive function or depression; however, participants reported fewer chronic illnesses. Linear regression analysis indicated that higher cognitive function during the pandemic was associated with younger age, higher education, and having sufficient income. An attrition analysis compared participants who completed both interviews to those who were lost to follow-up, revealing that participants who dropped out of the study had lower socioeconomic status and greater impairment at baseline. These findings highlight the need for targeted support for vulnerable older adults during public health crises. 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

This study investigated the psychological factors related to the enjoyment of playing musical instruments among Chinese adults. Additionally, it verified a model that can predict enjoyment using psychological variables, demographic profiles, and variables related to music to provide useful information and knowledge for further studies and interventions. The participants were 416 male and female Chinese adults aged 20–68 years. Predictive models were examined using stepwise regression and decision-tree analyses. The results revealed that extraversion, conscientiousness, agreeableness, and hardiness were positively correlated with the enjoyment of playing musical instruments, whereas the behavioral activation system (BAS) and behavioral inhibition system (BIS) showed negative correlations. Stepwise regression analysis revealed that fun-seeking accounted for the greatest variance in enjoyment in playing musical instruments. Fun-seeking, agreeableness, openness, self-directedness, and conscientiousness accounted for approximately 27.2% of the variance in enjoyment in playing musical instruments among Chinese adults. The decision-tree model included enjoyment of music class in childhood, self-directedness, age, experience playing musical instruments, experience growing up in a family that enjoys music, extraversion, and agreeableness. These findings suggest that psychological variables such as fun-seeking and agreeableness may play a more important role in Chinese adults’ enjoyment of playing musical instruments. 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/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

CR is a cornerstone of secondary prevention for cardiovascular disease, offering well-established benefits across mortality, hospital readmission, functional capacity, and quality of life. Despite Class I guideline endorsements and decades of supporting evidence, CR remains vastly underutilized, particularly among women, racial and ethnic minorities, older adults, and individuals in low-resource settings. This review synthesizes the current evidence base for CR, with emphasis on disease-specific benefits across different cardiovascular diseases, and highlights recent data on its role in expanding populations, including patients with HFpEF, older adults, patients with advanced heart failure, and those undergoing transcatheter interventions. We also examine persistent barriers to CR access and participation, including system-level and referral limitations, as well as patient-level disparities by age, sex, race and ethnicity, and socioeconomic status. Building on this, we explore innovative delivery models and recent policy initiatives such as hybrid programs and reimbursement reform, all designed to expand access, promote equity, and modernize CR delivery. The findings underscore the need for continued investment, advocacy, and innovation to ensure equitable access to CR and its life-saving benefits across the full cardiovascular care continuum. Full article

Sepsis-induced myocardial injury is age-related and leads to increased mortality. Considering the importance of mitochondrial dysfunction in cardiac impairment, we aimed to investigate whether aging exacerbates the cardiac mitochondrial metabolic response to inflammation, thus leading to increased cardiac dysfunction in the elderly. Cecal ligation and puncture (CLP) was conducted in young adult (12–18 weeks) and aged (19–21 months) male C57BL/6 mice. Cardiac function was detected 20 h post-CLP. Additionally, cardiomyocytes isolated from young adult and aged male mice were used for assessments of mitochondrial respiratory function +/– TNFα or LPS. Protein levels of oxidative phosphorylation (OXPHOS), NADPH oxidase (NOX)2, NOX4, phosphor-STAT3 and STAT3 were determined in mouse hearts 24 h post-CLP and in cardiomyocytes following inflammatory stimuli. CLP significantly reduced cardiac contractility in both young and aged mice, with a higher incidence and greater severity of cardiac functional depression in the older group. Mitochondrial respiratory capacity was decreased in cardiomyocytes derived from aged mice, with increased susceptible to inflammatory toxic effects compared to those from young adult mice. The age-dependent changes were observed in myocardial OXPHOS complexes and NOX4. Importantly, CLP led to a significant increase in OXPHOS protein levels in the hearts of older mice, suggesting a possible compensatory response to decreased mitochondrial metabolic function and a greater potential for reactive oxygen species (ROS) generation. Our findings highlight that the response of aging-impaired mitochondria to inflammation may underlie the worsened cardiac functional depression in the aged group during sepsis. Full article

Objectives: The aim of the study was to investigate caries experience in correlation with self-reported oral health-related habits in a sample of blind and low-vision individuals in Croatia. Methods: The study is a part of the research in the “Project for Oral Health Promotion in Blind and Visually Impaired Persons” conducted at the Zagreb University School of Dental Medicine from 2014 to 2018. The final sample consisted of 85 adults: 42 females and 43 males; 50 blind and 35 low-vision individuals, age range 18–98. The assessment included dental examination and a questionnaire. Results: The median DMFT (Decayed, Missing, and Filled Teeth) index score was 17.0 (IQR = 12.5–22.0), with no significant difference between sexes or between blind and low-vision individuals. The occurrence of untreated caries was low (median D-component = 1.0), while the median F-component was 6.0. There was a significant increase in M-component and DMFT in older age groups. The number of untreated caries (D-component) was significantly correlated with consummation of soft drinks and smoking. Total DMFT did not correlate with frequency of tooth brushing, time since last dental visit, smoking, or level of education. Conclusions: This study revealed high caries experience among blind and visually impaired individuals that did not correlate with factors that normally influence oral health. Similar results were found in the control group, reflecting a 30-year post-war period without organized preventive care. The low number of decayed teeth reflects the availability of public dental care in Croatia; however, preventive care should be provided for both this vulnerable group and the general population. Full article

Helicobacter pylori is a well-established causative agent of gastritis, peptic ulcers, gastric adenocarcinoma, and primary gastric lymphoma. It colonizes the human stomach and expresses numerous virulent factors that influence disease progression. Among these factors is the cytotoxin vacA gene, which encodes the vacuolating capacity of the cytotoxin and plays a key role in the bacterium’s pathogenic potential. This study investigated the allelic diversity of the vacA among H. pylori strains infecting patients in Jordan with various gastric conditions and examined potential associations between vacA s-and m- genotypes, histopathological and endoscopic findings, and the development of gastric diseases. Gastric biopsies were collected from 106 patients at two hospitals in Jordan who underwent endoscopic examination. The collected biopsies for each patient were subjected to histopathological assessment, urease detection using the Rapid Urease Test (RUT), a diagnostic test for H. pylori, and molecular detection of the vacA gene and its s and m alleles. The histopathology reports indicated that 83 of 106 patients exhibited gastric disorders, of which 81 samples showed features associated with H. pylori infection. The RUT was positive in 76 of 106 with an accuracy of 93.8%. Real-time polymerase chain reaction (RT-PCR) targeting the 16S rRNA gene confirmed the presence of H. pylori in 79 of 81 histologically diagnosed cases as infected (97.5%), while the vacA gene was detected only in 75 samples (~95%). To explore genetic diversity, PCR-amplified fragments underwent sequence analysis of the vacA gene. The m-allele was detected in 58 samples (73%), the s-allele was detected in 45 (57%), while both alleles were not detected in 13% of samples. The predominant genotype combination among Jordanians was vacA s2/m2 (50%), significantly linked to mild chronic gastritis, followed by s1/m2 (35%) and s1/m1 (11.8%) which are linked to severe gastric conditions including malignancies. Age-and gender-related differences in vacA genotype were observed with less virulent s2m2 and s1m2 genotypes predominating in younger adults specially males, while the more virulent m1 genotypes were found exclusively in females and middle-aged patients. Genomic sequencing revealed extensive diversity within H. pylori, likely reflecting its long-standing co-evolution with human hosts in Jordan. This genetic variability plays a key role in modulating virulence and influencing clinical outcomes. Comprehensive characterization of vacA genotypic variations through whole-genome sequencing is essential to enhance diagnostic precision, strengthen epidemiological surveillance, and inform targeted therapeutic strategies. While this study highlights the significance of the vacA m and s alleles, future research is recommended in order to investigate the other vacA allelic variations, such as the i, d, and c alleles, to achieve a more comprehensive understanding of H. pylori pathogenicity and associated disease severity across different strains. These investigations will be crucial for improving diagnostic accuracy and guiding the development of targeted therapeutic strategies. Full article

Previous research has found significant associations among childhood trauma, dissociation, and shame. Furthermore, the clinical literature suggests that dissociation may foster feelings of shame in individuals who were exposed to childhood trauma. The current study aimed to test the potential mediating effect of dissociation on the association between childhood trauma and shame. The study sample consisted of 763 adults (479 females, 62.8%) from the general Italian population, aged between 18 and 65 years (M = 31.31, SD = 13.29). Self-report instruments assessing childhood trauma, dissociation, and shame were administered to participants via an anonymous online survey. Structural equation modeling showed that childhood trauma was associated with increased levels of both dissociation and shame. Moreover, dissociation partially mediated the predictive association between childhood trauma and shame. These findings suggest that dissociation might heighten the tendency to unconsciously reenact self-devaluation and self-blame in individuals exposed to childhood trauma, increasing feelings of shame. Full article

Background/Objective: Executive functions (EFs) are essential in the daily management of arthritis, as they influence treatment adherence, decision-making, and the ability to cope with disease-related challenges. The objective of this study was to compare EFs alongside functional status and quality of life in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) and examine their associations with disease activity and clinical variables. Methods: In this cross-sectional study, 140 patients (70 RA, 70 PsA) were assessed using the Stroop-TBAG, Wisconsin Card Sorting Test (WCST), and Adult Executive Functioning Inventory (ADEXI). Functional status and quality of life were measured with the Health Assessment Questionnaire (HAQ) and WHOQOL-BREF, respectively. Correlations with disease activity (DAS28-CRP), age, and disease duration were examined. Results: RA patients had significantly higher disease activity and longer disease duration. They showed poorer performance on the Stroop Test (color–word time: 61.6 ± 14.8 vs. 52.4 ± 10.9 s, p < 0.001; errors: 3.2 ± 2.1 vs. 2.1 ± 1.5, p = 0.001), more WCST perseverative errors (p = 0.002), and higher ADEXI inhibition scores (13.9 ± 2.5 vs. 12.9 ± 3.0, p = 0.013). DAS28-CRP was correlated with EF impairments, disability, and poorer quality of life in RA (p < 0.05). In PsA, EFs remained relatively stable, although higher disease activity was associated with worse HAQ scores (p = 0.001). Treatment type was not linked to EF, but patients on combination therapy reported lower physical (p = 0.009) and psychological (p = 0.014) quality of life, along with higher HAQ scores (p = 0.016). Conclusions: This study revealed that patients with RA exhibit more pronounced executive dysfunction, along with lower ADL skills and quality of life compared to those with PsA. These findings highlight the need for multidimensional assessment strategies in inflammatory arthritis, especially in RA, where cognitive and functional outcomes are closely tied to clinical burden. Full article