Search Results (16,926)

Epidemiological and clinical research on neurodegenerative diseases has shown that metabolic dysregulations increase the risk of developing Alzheimer’s Disease (AD). Many metabolic changes can be grouped into metabolic syndrome (MetS), which is defined as the presence of three or more risk factors, including insulin resistance, hyperglycemia, hypertension, central obesity, and dyslipidemia. These changes cause systemic effects that are crucial in triggering neuroinflammation and neurodegeneration, key factors in AD development. All these factors impair energy metabolism in peripheral tissues and the brain by decreasing glucose utilization, leading to alterations in O-GlcNAcylation, glycosylation, mitochondrial function, oxidative stress, chronic inflammation, synaptic dysfunction, autophagy impairment, and blood–brain barrier (BBB) dysfunction. However, these factors are modified and largely influenced by lifestyle choices. A newer perspective emphasizes that regular exercise is vital for maintaining brain metabolism as we age. Current evidence suggests that engaging in physical activity for individuals with metabolic syndrome reduces their risk of Alzheimer’s disease, enhances prognosis, and improves cognitive abilities. This review explores how metabolic syndrome relates to Alzheimer’s and highlights possible strategies for prevention and treatment. Full article

Background and Objectives: Stroke remains a major contributor to global morbidity and mortality, with substantial geographic variation in incidence and outcomes. Although declining trends in stroke incidence and mortality have been documented in several Western European populations, countries in Eastern Europe have historically experienced a disproportionately high cardiovascular disease burden. Comprehensive long-term evaluations assessing simultaneous trends in stroke attack rates, mortality, and case-fatality in Lithuania are limited. This study aimed to investigate 24-year trends (2000–2023) in stroke epidemiology among working-age residents of Kaunas city. Materials and Methods: Data were derived from the Kaunas population-based stroke registry and included individuals aged 25–64 years. Age-standardized attack rates, mortality rates, and case-fatality rates per 100,000 population were calculated using the World Health Organization standard population. Temporal trends were assessed using Joinpoint regression analysis to estimate annual percentage changes (APCs) with corresponding 95% confidence intervals (CIs). Analyses were stratified by sex, age group (25–54 and 55–64 years), and stroke subtype (ischemic and hemorrhagic). Results: During 2000–2023, overall stroke attack rates declined significantly in both sexes, with a more pronounced reduction observed among females. Stroke mortality decreased significantly among females over the entire study period, whereas no significant overall change was observed among males, largely due to increases during 2010–2021 that attenuated earlier and subsequent improvements. Case-fatality rates demonstrated no significant overall long-term trend in either sex but exhibited marked temporal variability, including significant increases during 2010–2021 followed by substantial declines after 2021. Age-stratified analyses confirmed significant reductions in attack rates across both age groups. Ischemic stroke incidence declined significantly in both sexes, while hemorrhagic stroke mortality decreased significantly among males and females. The period 2021–2023 was characterized by pronounced reductions in mortality and case-fatality across multiple subgroups. Conclusions: Over the past two decades, the stroke burden among working-age residents of Kaunas has declined substantially, particularly among females. Despite period-specific deteriorations, recent improvements underscore the impact of advances in stroke prevention and acute care. Sustained risk factor control and continued healthcare system development remain essential to maintain favourable trends. Full article

Diet quality, nutrition knowledge, and psychosomatic literacy—defined as the understanding of the interactions between diet, gut microbiota, and mental well-being—may shape weight-related behaviours in youth. This study used a cross-sectional design to integrate these domains with digital information pathways in Central–Eastern Europe. This study assessed diet quality, nutrition, and psychosomatic knowledge, supplement use, and health-information sources among Polish adolescents and young adults, with emphasis on age-related differences and the role of social media. A cross-sectional, anonymous online survey (October 2025–January 2026) was conducted in Poland (final analytical sample: n = 478; adolescents 15–19 years vs. young adults 20–30 years). Of 591 individuals who accessed the survey, 478 were included in the final analytical sample. Diet quality was estimated from FFQ data using KomPAN-derived indices (pHDI-10, nHDI-14, DQI). Nutrition knowledge (0–25 points), psychosomatic/gut–brain indicators, supplementation, and information sources were analysed using χ²/Fisher tests and Mann–Whitney U tests with effect sizes. The primary outcomes measured were dietary supplement use and excess body weight (BMI ≥ 25 kg/m²). Multivariable logistic regression examined predictors of supplement use and BMI ≥ 25 kg/m². Overall diet quality was low to moderate, with limited intake of whole grains, legumes, and fish, and common nutrition misconceptions. Social media was the most frequently indicated source of diet/supplement information and was independently associated with more frequent supplement use (OR = 2.29; 95% CI: 1.43–3.64). Adolescents reported lower whole-grain intake and more misconceptions than young adults. Predictors of BMI ≥ 25 kg/m² included male sex (OR = 2.46; 95% CI: 1.46–4.15), lower education, and lower nutrition knowledge, while age showed a non-linear positive association with excess body weight. Polish adolescents and young adults show gaps between declared pro-health attitudes and actual diet quality/competencies. Social media reliance appears particularly linked to product-oriented behaviours (supplementation). Prevention should strengthen nutrition and food safety education, digital health literacy, and professional guidance on supplementation, especially in adolescents. Our findings suggest that social media is a primary driver for dietary supplementation among Polish youth, more so than objective nutrition knowledge. While diet quality is linked to weight status, the relationship is complex. These results may inform future public health interventions targeting digital health literacy to promote balanced nutrition and safe supplementation practices. Full article

Introduction: Low back pain (LBP) is the leading cause of disability worldwide, with substantial variation in prevalence across regions. It is associated with a wide range of biophysical, psychological, social, and lifestyle factors, as well as comorbid conditions. Given its high impact, identifying population-level correlations of LBP is essential for informing prevention strategies. This study aimed to assess demographic, socioeconomic, lifestyle, and health-related factors associated with LBP in Hungary. Methods: A repeated cross-sectional analysis was conducted using secondary data from three waves of the European Health Interview Survey (EHIS) carried out in Hungary in 2009, 2014, and 2019. Results: The prevalence of LBP increased over the study period. Female sex, higher educational attainment, normal body mass index, non-smoking status, abstaining from alcohol, and good self-perceived health were associated with lower odds of LBP. In contrast, older age (≥65 years), unfavorable financial status, residence in socioeconomically disadvantaged regions, use of over-the-counter medications, and several chronic conditions were associated with higher odds. Conclusions: Reducing the impact of low back pain requires its integration into comprehensive public health frameworks that combine chronic disease management with consideration of socioeconomic inequalities at the population level. Full article

Background/Objectives: Previous cross-sectional studies investigated the associations of low handgrip strength (HS), a primary indicator of probable sarcopenia (PS), with biomarkers related to anemia. However, existing evidence is inconsistent, and data establishing causality remain limited. The present prospective study aimed to evaluate whether serum vitamin B12, folate, homocysteine (Hcy), and ferritin levels are associated with PS risk. Methods: This study analyzed data from 1930 adults aged 45–76 years who had normal muscle quantity at baseline. Serum biomarkers were assessed at baseline and PS defined by low HS was determined at 6-year follow-up. The modified Poisson regression method was employed to calculate multivariable risk ratios (RRs) and 95% confidence intervals (CIs). Results: Among all participants, PS risk was inversely related to serum vitamin B12 levels (p = 0.06), while it was lowest in the high-normal ranges of serum Hcy (12.1–15 μmol/L) and ferritin (101–200 ng/mL) levels. The RRs (95% CIs) for PS risk were 0.73 (0.60, 0.89) and 0.75 (0.64, 0.87) for high-normal Hcy and ferritin categories, respectively, compared with the lowest category. On examining the associations of elevated Hcy and ferritin levels with PS risk, age was identified as a significant modifier for elevated Hcy levels (>15 μmol/L) (p for interaction < 0.05); a reduced risk was observed in younger participants, whereas an increased risk was noted in older participants. Conclusions: These findings suggest that high-normal ferritin levels may be optimal for alleviating PS risk, irrespective of age, and that elevated Hcy levels could be detrimental for older adults in preventing PS risk. Full article

Background: Vancomycin-resistant Enterococcus (VRE) bacteremia represents a major therapeutic and epidemiological challenge, particularly in regions with high antimicrobial resistance rates such as Southern Europe. Longitudinal local data are essential to guide infection control and antimicrobial stewardship strategies. This study aimed to evaluate temporal trends in incidence, management, and mortality of VRE bacteremia in a tertiary care center in Greece over a six-year period, including comparison before and after the coronavirus disease 2019 (COVID-19) pandemic. Methods: This retrospective observational study included adult patients with VRE bacteremia at the University Hospital of Heraklion, Greece, from 2018 to 2023. Demographic and clinical data, such as the Pitt Bacteremia Index (PBI), as well as microbiological, and treatment data were collected from patient records. Incidence was calculated per 10,000 patient-days. Comparisons were performed between survivors and non-survivors and between pre- and post-COVID-19 eras. Multivariate regression analysis was used to identify predictors of in-hospital mortality. Results: A total of 96 patients were included (mean age 68.6 ± 14.5 years; 56.3% male). The incidence of VRE bacteremia increased more than five-fold during the study period, from 0.242 cases per 10,000 patient-days in 2018 to a peak of 1.344 per 10,000 patient-days in 2022, remaining elevated in 2023 (1.001 per 10,000 patient-days). The overall in-hospital mortality was 54.2%. Non-survivors had significantly higher PBI scores compared to survivors (median 2.5 vs. 0, p = 0.005). In the multivariate analysis, higher PBI was independently associated with in-hospital mortality [odds ratio: 1.449 (95% confidence intervals: 1.166–1.801)]. Appropriate empirical therapy was administered in 41.7% of cases and was not significantly associated with survival. Post-COVID-19 patients were older (69.9 vs. 61.4 years, p = 0.0365), and antimicrobial regimens were more frequently adjusted according to susceptibility testing (55.7% vs. 18.2%, p = 0.0141), but mortality did not significantly differ between periods. Conclusion: VRE bacteremia incidence increased dramatically over the six-year study period in our tertiary center, with persistently high mortality exceeding 50%. Severity of illness at the diagnosis of bacteremia, as measured by the PBI, was an independent predictor of in-hospital mortality. Strengthened infection prevention measures, optimized antimicrobial stewardship, and early aggressive management are urgently needed to mitigate the growing burden of VRE bacteremia. Full article

Objective: This study evaluated the relationships between the development and clinical course of pressure injuries (PIs) and neurological status, nutritional risk, and laboratory parameters among patients admitted to a tertiary intensive care unit. Materials and Methods: The single-center, retrospective, observational study included 220 patients hospitalized in the intensive care unit for at least 5 days. On the day of admission, Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II), Braden, and Nutritional Risk Screening 2002 (NRS-2002) scores were assessed. Demographic characteristics, comorbidities, need for sedation and vasopressors, and laboratory parameters during the first 24 h (albumin, C-reactive protein, lactate, D-dimer) were analyzed. Factors independently associated with new PI development and clinical improvement were identified using binary logistic regression. Results: New PIs developed in 25% of patients. Patients with PI progression were older and had lower GCS and Braden scores, higher NRS-2002 scores, lower albumin levels, and higher D-dimer levels (p < 0.05). In multivariable analysis, low GCS (OR = 0.824), presence of comorbidity (OR = 2.327), and a high NRS-2002 risk level were independent predictors of new PI development. The model’s discriminative ability was acceptable (AUC = 0.756). Among patients with existing PIs, NRS-2002 score (OR = 0.450) and age (OR = 1.058) were independently associated with clinical improvement in an exploratory multivariable model. Conclusions: NRS-2002 was the only variable independently associated with both new PI development and the clinical improvement of existing lesions, underscoring the central role of nutritional risk assessment in ICU-based PI prevention and prognosis. Full article

Background/Objectives: Adults with intellectual disability are known to experience complex health needs, including an elevated presence of chronic conditions. Cardiovascular risk factors are a concern, yet the evidence base is fragmented, and the scope and focus of current research are not well understood. Methods: We conducted a scoping review to map the existing evidence on cardiovascular risk factors among adults with intellectual disability. The review included studies reporting on risk factor prevalence as well as participant characteristics (ethnicity, living arrangements, age, sex, and type of disability). Cardiovascular-related outcomes were extracted to clarify the health disparities documented in this population. Results: Searches of seven databases for studies published from 2013 onward yielded 15,598records, of which 85 met the inclusion criteria. Evidence was dominated by cross-sectional studies, with a few randomized controlled trials. Hypertension, Type 2 diabetes and obesity were commonly reported. Patterns appeared to reflect lifestyle, medication effects, genetic syndromes—particularly Down syndrome and Prader–Willi syndrome—and the severity of the disability. A notable share of the studies originated from the United Kingdom and the United States. Findings reveal a complex cardiovascular risk profile, emphasizing the need for tailored prevention and management. Conclusions: Adults with intellectual disability face a substantial burden of cardiovascular risk factors. Evidence on effective interventions remains limited, highlighting a need for targeted, evidence-informed approaches to improve cardiovascular health and long-term outcomes. Full article

Cyanotic congenital heart disease (CCHD) remains a major contributor to infant morbidity and mortality in the United States, yet the influence of maternal social determinants of health on risk is not fully understood. This study examined associations of maternal age, education, and race/ethnicity with the live birth prevalence of CCHD using recent national birth data from the Centers for Disease Control and Prevention (CDC) National Vital Statistics System (2022–2023). CCHD was identified from birth certificate records and analyzed as a binary outcome. Regression analyses were performed to evaluate relationships between maternal characteristics and CCHD occurrence. Overall, CCHD was a rare outcome with a modest decline in prevalence between the two years examined. Increasing maternal age was associated with higher odds of CCHD, while Latina ethnicity was associated with lower odds compared to the reference group. Other racial/ethnic categories and maternal education level were not significantly associated with CCHD risk in adjusted analyses. These findings suggest that certain maternal factors, particularly age and ethnicity, are associated with variation in the live birth prevalence of CCHD and underscore the need for further research into underlying environmental and structural contributors not captured in standard birth records. Full article

Modern agriculture depends heavily on machinery to maximize operational efficiency and, consequently, profitability, but the wear-and-tear on the mechanical components of machinery due to ageing can lead to reduced efficiency, more downtime, and higher maintenance expenses, thus raising the operative costs. These problems have been addressed by the use of specific lubricant additives for machinery; however, additives have known disadvantages, such as compatibility restrictions and environmental concerns, which represent critical issues especially in case of possible dispersion in the environment. Modern industry is always looking for techniques and solutions to increase efficiency and productivity, and this study investigates the possible advantages of employing nanotechnology in lubricant formulations. Amongst all possible substances, SiO₂ nanoparticles are increasingly promising as lubricant additives due to their unique properties, which include heat resistance, high levels of stability, and good biocompatibility. Moreover, biolubricants, derived from renewable sources, offer an environmentally friendly alternative to conventional lubricants. This article contributes to the field of agricultural technology by demonstrating the potential of SiO₂ nanoparticles in formulations of biolubricants thought to be used in agricultural machines. Key degradation parameters, including density, viscosity, total acid number (TAN), total base number (TBN), oxidation, and elemental composition, were systematically analysed. The results showed that SiO₂ nanoparticles mitigate viscosity loss and density increase, optimize TAN and TBN, reduce oxidation of the biolubricants by up to 17.7% at 1.00 wt% SiO₂, and stabilize elemental composition during ageing. Nanoparticles remained uniformly dispersed without sedimentation for over 30 days. This provides insights that can prevent machinery performance degradation over time, reduce lubricant changes, and suggest a more sustainable and environmentally friendly lubrication solution, thus promoting more sustainable industry. Full article

Bullying and victimization are prevalent in school and sport settings, yet they are rarely examined concurrently. This study explored the relationships between school and sport bullying among youth athletes, assessing whether demographic and sport-related factors are associated with these behaviors across contexts. Participants included 189 youth athletes (aged 8–15 years) from Central Macedonia, Northern Greece. They completed a demographic survey and the Bullying and Victimization Questionnaire twice, assessing both school and sport environments. A multivariate analysis of variance (MANOVA) evaluated the effects of gender, educational level, sport type, and contact classification, followed by regression analyses. Results showed that educational level yielded a significant multivariate effect, with secondary school students reporting higher involvement in school bullying, sport bullying, and sport victimization. Crucially, regression analyses revealed that school-context bullying and victimization were the strongest factors associated with corresponding behaviors in sports. Additionally, team sport participation was associated with sport victimization, while demographic factors were related to school bullying perpetration. These findings demonstrate the interconnected nature of bullying between school and sport environments, emphasizing the critical need for coordinated, multi-contextual prevention strategies among educators and coaches. Full article

Background: Metabolic syndrome (MetS) is a cluster of pathologies (obesity, dyslipidemia, insulin resistance, hypertension) that affects over one quarter of old adults. MetS is a condition that markedly increases the susceptibility of various organs to dysfunctionality and is associated with the development of oxidative stress. The existing guidelines point out that exercise is highly advantageous for patients with MetS. However, there is a need for specific guidance and clinical evidence. Objective: This study aimed to investigate the effects of a moderate aerobic exercise program on older women without and with MetS. Methods: A total of 120 women aged 60–70 years old were recruited and divided into two groups: healthy old women (HOW, N = 60) and old women with MetS (OW-MetS, N = 60). Anthropometric values, biochemical parameters and markers of oxidative damage were evaluated before and after moderate aerobic exercise. Exercise was performed five days per week for three months (64 sessions). Each exercise session consisted of 40 min and included the following: (a) five minutes of warm-up exercise; (b) ten minutes of flexibility exercise with resistance using own weight and coordination; (c) twenty minutes of moderate-intensity aerobic exercise (heart rate max between 60% and 70%); and (d) five minutes to cool down/stretching with respiratory techniques. Results: A significant decrease in anthropometric variables was generated by the exercise program [waist circumference 4.35 cm (p < 0.05) in OW-MetS, body fat −1.55, −1.39% (p < 0.05) and muscle mass 0.8, 1.1% (p < 0.05) in HOW and OW-MetS, respectively]. The exercise program resulted in beneficial changes in all biochemical parameters in both groups. Importantly, HOMA values showed a significant decline of −0.85 and −6.17 in HOW and OW-MetS, respectively. Furthermore, oxidative stress was present in the OW-MetS group, which was reduced by the exercise program, resulting in a decrease in protein damage [formazan 45% and 42% in HOW and OW-MetS respectively] and an increase in antioxidant defenses (thiol groups 36%, 99% and GPx 55%, 20% in HOW and OW-MetS, respectively). Conclusions: The data of this study show that moderate aerobic exercise may be potentially useful in treating and preventing MetS in older patients. Full article

In the U.S., extreme heat is the leading cause of weather-related fatalities. Farmers, ranchers and other outdoor workers who are exposed to the elements and engaged in strenuous physical activity are disproportionately impacted. This manuscript summarizes the number and severity of heat-related illnesses and injuries collected through the AgInjuryNews.org system, highlights their characteristics, provides recommendations for farmworkers and employers, and calls for future research. Heat-related illness cases from 2016–2024 were analyzed. Fourteen agricultural heat-related incidents covered by U.S. media were identified. Most incidents took place in June and July. A content analysis was conducted to identify news articles that included mention of prevention strategies, laws and regulations related to working conditions, or OSHA. Over half of the cases were from southern states. Eleven of the incidents involved male farmworkers, one involved a male farmer, and two involved first responders (gender unspecified). All of the farmer/farmworker incidents were single-victim fatalities. Seven articles mentioned prevention strategies, ten mentioned laws or regulations, and nine mentioned OSHA, often cursory. These findings suggest that media reports provide a limited and selective image of agricultural heat-related injuries, with coverage emphasizing fatalities and investigation information more often than prevention. Full article

Background: There is a high burden of influenza among individuals aged 50–64 years, with the highest rates of influenza infections other than children. The MF59-adjuvanted influenza vaccine (adjuvanted trivalent influenza vaccine [aTIV]/adjuvanted quadrivalent influenza vaccine [aQIV]) is designed to enhance response to vaccination among older adults. Among those aged ≥65 years, adjuvanted vaccine (aTIV/aQIV) has shown to be 14% more effective than standard (TIV/QIV) vaccines. This modeling study aimed to estimate the potential public health impact of aTIV/aQIV over standard influenza vaccines (TIV/QIV) among individuals aged 50–64 years over five influenza seasons. Methods: A static compartmental model was developed based on a Centers for Disease Control and Prevention model. Model inputs included vaccine effectiveness, vaccine coverage, population counts and disease burden estimates. Additional burden averted (symptomatic cases, outpatient visits, hospitalizations, intensive care unit [ICU] admissions, and deaths) was expressed as total incremental cases averted between the vaccines. Sensitivity analyses explored the influence of uncertainties in model input on the results. Results: Across the influenza seasons evaluated, on average each 5% increase in the relative vaccine effectiveness (rVE) of aTIV/aQIV vs. QIV prevented an additional 172,738 symptomatic illnesses, 74,277 outpatient visits, 1832 hospitalizations, 343 ICU admissions, and 105 deaths. This corresponds to an average seasonal incremental burden averted of 15.2%, with a range of 5.9% to 37.2%. Deterministic sensitivity analyses revealed the greatest variability was tied to rVE and burden estimates. Probabilistic sensitivity analyses results were normally distributed. Conclusions: Individuals aged 50–64 years could benefit from use of aTIV/aQIV over TIV/QIV, with an average increase in the number of influenza outcomes prevented of 15.2% per 5% improvement in vaccine effectiveness. Full article

Objectives: To determine if global epicardial adipose tissue (EAT) radiomics, derived from non-contrast coronary artery calcium (CAC) scans, improves acute coronary syndrome (ACS) prediction beyond traditional risk factors (TRFs) and Agatston score (AS) in individuals without angina. Methods: We retrospectively analyzed 2020 subjects without angina who underwent CAC scans from 2016 to 2019, among whom 76 patients developed acute coronary syndrome (ACS) during a follow-up period until December 2023. One-to-one propensity score matching (PSM) based on TRFs (age, sex, BMI, smoking, diabetes, hypertension, dyslipidemia) and Agatston score ranks (ASR) created 76 ACS and 76 matched non-ACS subjects. A radiomics model was built using 5-fold cross-validation on the matched cohort and tested on the entire unmatched cohort. Statistical tests included AUC comparison. Results: PSM effectively mitigated disparities of TRFs and ASR. The radiomics model achieved AUCs of 0.91 ± 0.01 and 0.89 ± 0.03 for the training and matched test sets, respectively, and 0.89 ± 0.03 on the unmatched cohort. The radiomics score significantly improved ACS prediction over TRF and CAC models (p < 0.001) in both matched and unmatched cohorts. Conclusions: Global EAT radiomic phenotypes from conventional CAC scan improve ACS risk stratification beyond TRFs and AS in individuals without angina. In contrast to PCAT on CCTA, our simple approach appears to be suitable for large-scale applications using preventative CAC scans. Full article