Search Results (2,462)

Background/Objectives: Obesity-associated non-alcoholic fatty liver disease (NAFLD) drives systemic metabolic stress and accelerates chronic kidney disease, yet the mechanistic links remain unclear. Mitochondrial dysfunction has emerged as a central mediator of obesity-induced organ injury. Here, we investigated renal mitochondrial remodeling in a rat model of obesity-associated NAFLD (Ob-NAFLD) and examined the effects of metformin. Methods: Female Zucker rats (obese fa/fa and lean Fa/Fa) were fed an AIN-93G diet for eight weeks, followed by 10 weeks of metformin treatment in designated groups. Kidney tissues were analyzed using biochemical assays, immunoblotting, blue native PAGE, in-gel activity assays, and histological evaluation. Results: In Ob-NAFLD rats, renal ATP levels were elevated despite reduced electron transport chain (ETC) Complex III and increased Complex V expression, reflecting compensatory ATP synthase hyperactivity uncoupled from efficient oxidative phosphorylation. Mitochondrial dynamics were disrupted such that inhibitory phosphorylation of DRP1 was reduced, promoting fission, and total OPA1 expression was decreased with a shift in short-to-long isoform balance, indicating impaired fusion and cristae remodeling. Notably, ATPase inhibitory factor 1 (IF1), a checkpoint that limits ATP synthase overdrive, remained stably expressed, suggesting an adaptive ceiling or failed protective control under chronic metabolic stress. Metformin partially alleviated bioenergetic stress by lowering ATP and modestly restoring Complex III, yet ETC imbalance and structural remodeling persisted, revealing the limitations of metabolic modulation alone. Conclusions: These findings position entrenched mitochondrial dysregulation as a mechanistic bridge linking obesity-driven liver disease to kidney injury. Therapeutic strategies combining metabolic interventions with targeted restoration of ETC coordination, mitochondrial dynamics, and regulatory checkpoints such as IF1 may be required to fully restore renal mitochondrial health and prevent the progression of metabolic kidney disease. Full article

Low health literacy is associated with risky alcohol use among young people, particularly those exposed to social and environmental factors that normalize drinking. In digital contexts, innovative and engaging interventions are needed to strengthen alcohol-preventive competencies among hazardous drinkers. This study evaluated the effectiveness of an online health literacy promotion program integrating artificial intelligence (AI) and gamification in improving health literacy and alcohol-preventive behaviors among hazardous-drinking vocational students. A quasi-experimental two-group pre-test–post-test design with a 1-month follow-up was conducted among 114 first-year Higher Vocational Certificate students aged 18–20 years in Bangkok, Thailand. Participants were assigned to an intervention group (n = 57) or a comparison group (n = 57). The intervention group received the ALC Literacy Program, while the comparison group received standard educational materials on alcohol prevention. Data were analyzed using descriptive statistics, chi-square tests, independent t-tests, and two-way mixed-design repeated-measures ANOVA with Bonferroni post hoc comparisons. At baseline, no significant between-group differences were observed. After the intervention and at 1-month follow-up, the intervention group showed significantly greater improvements in both health literacy and alcohol-preventive behaviors than the comparison group (p < 0.001). Large interaction effect sizes were observed for health literacy (partial η² = 0.623) and alcohol-preventive behaviors (partial η² = 0.622). These findings indicate that the ALC Literacy Program was effective in enhancing health literacy and strengthening alcohol-preventive behaviors among hazardous-drinking vocational students. This intervention may represent a potentially useful digital health promotion approach for alcohol prevention in educational settings. Full article

Background: Adolescent tobacco, e-cigarette, and alcohol use are important public health concerns in China. However, the associations of specific types and cumulative exposure to childhood family violence with different substance use outcomes remain insufficiently understood. This study examined these associations among Chinese adolescents. Methods: We analyzed data from a cross-sectional school-based survey of 41,146 students aged 10–19 years conducted from October 2022 to March 2023 in a mountainous city in western Guangdong Province, China. Childhood family violence was assessed using the validated Chinese Family Violence Questionnaire and a cumulative exposure index. Descriptive analyses and logistic regression models were conducted, with adjustment for demographic and environmental factors. Results: The mean age of participants was 14.8 years, and 51.7% were female. Overall, 25.1% of adolescents reported at least one type of childhood family violence. Verbal insults (18.6%) and emotional neglect (16.3%) were the most frequently reported types and were consistently associated with tobacco, e-cigarette, and alcohol use (adjusted odds ratios [ORs] = 1.4–1.5, p < 0.001). A cumulative exposure pattern was also observed. Compared with adolescents reporting no childhood family violence, those exposed to three or more types had higher odds of tobacco use (OR = 3.81; 95% CI: 3.42–4.23), e-cigarette use (OR = 3.90; 95% CI: 3.39–4.48), and alcohol use (OR = 3.95; 95% CI: 3.59–4.35). Peer smoking and access to tobacco products were also significantly associated with substance use. Conclusions: Childhood family violence, particularly verbal insults and emotional neglect, was associated with adolescent tobacco, e-cigarette, and alcohol use. The findings highlight the importance of considering emotional maltreatment, cumulative adversity, peer influences, and access to tobacco products in future prevention research and practice. Full article

Oral squamous cell carcinoma (OSCC) frequently develops within chronically injured oral mucosa and may be preceded by clinically recognizable oral potentially malignant disorders (OPMDs), which provide an important window for cancer interception. This review examines how etiological exposures, persistent inflammation, and lesion-specific epithelial–stromal–immune interactions cooperate during the transition from mucosal injury to dysplasia, carcinoma in situ, and invasive OSCC. Major carcinogenic exposures, including tobacco, alcohol, and areca nut, are considered together with context-dependent contributors such as microbial dysbiosis, viral infection, and immune-mediated epithelial injury. At the molecular level, inflammation-driven oral carcinogenesis involves cytokine and chemokine amplification, oxidative and nitrosative stress, NF-κB and STAT3 activation, the COX-2/PGE₂ axis, genomic instability, field cancerization, epithelial–stromal crosstalk, angiogenesis, immune dysregulation, and epigenetic and non-coding RNA-mediated reprogramming. Emerging tools such as molecular risk assessment, liquid biopsy, optical imaging, spatially resolved profiling, and artificial intelligence-assisted models may improve identification of high-risk lesions, although most biomarkers require further prospective validation. Prevention should therefore integrate exposure control, biopsy-based diagnosis, local treatment when indicated, long-term surveillance, and trial-based precision strategies according to lesion risk, intervention window, and safety profile. This review supports a shift from lesion-centered management toward risk-adapted precision prevention in inflammation-driven oral carcinogenesis. Full article

Background: Unhealthy alcohol use may lead to arrhythmia and cardiomyopathy, but its impact on sudden death is not well understood. Objective: To investigate the association of unhealthy alcohol use with sudden death. Methods: We conducted a case-control study in Wake County, a large (~1 million inhabitants), diverse county in North Carolina. We screened and adjudicated victims of sudden, unexpected, out-of-hospital deaths in adults aged 18–64 years reported by emergency medical services between 2013 and 2015. We randomly selected sex- and age-matched control patients from a university health system from the same county and time period. Characteristics of sudden death victims and controls were ascertained via standardized chart reviews. Unhealthy alcohol use was identified via chart review and was defined as any evidence of excessive alcohol use, such as it being stated in the social history or medical history, alcohol abuse being listed as a possible contributor to death, or alcohol-related diagnoses. We used logistic regression to estimate odds ratios (ORs) for the association of unhealthy alcohol use and sudden death, adjusting for age, sex, race, and other psychiatric diagnoses, including depression, anxiety, schizophrenia, bipolar disorder, and substance use disorders other than tobacco and alcohol. We also calculated the E-value to estimate the impact of any unmeasured confounders. Results: We identified 399 sudden death victims, of whom 374 (94%) had alcohol use data available. Among these 374 included victims, 256 (68%) were male, and 239 (62%) were White, with a median age at death of 55 years (IQR 48, 60). The demographic characteristics of the 1114 matched controls were similar to those of sudden death victims. Unhealthy alcohol use was present in 115 (31%) sudden death victims and 27 (2%) controls. In analyses adjusted for demographics only, unhealthy alcohol use was associated with a higher incidence of sudden death, with an OR of 17.5 (95% CI 11.4, 27.8). When further adjusted for other psychiatric diagnoses, the OR was 11.2 (95% CI 7.1, 18.0). The calculated E-value was 21.8, meaning an unmeasured confounder would need to be associated with both unhealthy alcohol use and sudden death by 21.8-fold to explain away the observed OR. Conclusions: Unhealthy alcohol use was strongly associated with higher sudden death risk in working-age adults. Our calculated E-value indicates it is unlikely that any unmeasured confounders alone would account for the observed association. Our findings suggest that interventions to reduce unhealthy alcohol use may be an effective strategy to prevent sudden death in working-age adults. Full article

Background/Objectives: Occupation shapes time use, physical demands, stress, and access to health resources, yet it remains an understudied axis of inequality among working women in low- and middle-income countries. This study assessed occupational-group disparities in lifestyle behaviors and adiposity levels among Peruvian working women. Methods: We conducted a pooled repeated cross-sectional analysis of ten Peruvian DHS/ENDES rounds from 2014–2019 and 2021–2024 among working women aged 18–49 years. The exposure was standardized occupational group, using professional/technical/managerial workers as the reference. Outcomes included five lifestyle behaviors and four adiposity indicators. Crude models estimated descriptive prevalence ratios (PRs) or beta coefficients; secondary adjusted models included age group, survey year, education, wealth, residence, natural region, and marital status. Results: A total of 40,726 women were included. Agricultural workers showed lower crude prevalences of almost-daily television viewing (PR 0.49; 95% CI 0.47–0.52), current smoking (PR 0.14; 95% CI 0.10–0.19), current alcohol use (PR 0.39; 95% CI 0.36–0.42), and heavy alcohol use (PR 0.17; 95% CI 0.12–0.27); these contrasts attenuated but generally persisted after adjustment. Insufficient fruit and vegetable intake exceeded 87% in all groups. Sales, domestic/household, services, and skilled manual workers had higher adjusted obesity than the reference group, with adjusted PRs ranging from 1.22 to 1.35. Conclusions: Occupation identifies relevant heterogeneity in lifestyle behaviors and adiposity levels among Peruvian working women. Lifestyle and adiposity profiles did not follow a simple social gradient, supporting occupation-specific strategies for noncommunicable disease prevention. Full article

Objective: The aim of this study was to evaluate associations between flavonoid intake at dinner versus breakfast and the odds of non-alcoholic fatty liver disease (NAFLD) using data from the National Health and Nutrition Examination Survey (NHANES). Methods: According to total flavonoids, flavonoids intake at breakfast and dinner, or flavonoids intake differences at dinner and breakfast (Δ = dinner-breakfast), we divided 3240 participants from the NHANES (2007–2010) into five groups. Logistic regression analyses were performed to examine associations between total flavonoids, flavonoid intake at breakfast and dinner or Δ flavonoids and NAFLD after the adjustment of several confounding factors. Dietary substitution models were used to estimate the association between replacing 5% of flavonoid intake at dinner with that at breakfast and the odds of NAFLD. Results: For total flavonoids intake and flavonoids intake at breakfast, when compared to the lowest quintile (Q1), participants in the highest quintile of total flavonoids intake had lower odds of NAFLD, with an adjusted odds ratio (OR) for NAFLD of 0.78 (95% confidence interval (CI): 0.61–0.98) and a p-trend of 0.076. Participants in the highest quintile of flavonoid intake at breakfast had an adjusted OR for NAFLD of 0.87 (95% CI: 0.69–1.09) and a p-trend of 0.035, also showing a trend toward lower odds of NAFLD. Conversely, for Δ flavonoids, participants in the highest quintile had higher odds of NAFLD, with an adjusted OR for NAFLD of 1.27 (95% CI: 1.01–1.60) and a p-trend of 0.093. When total flavonoid intake in participants remained constant, replacing 5% of dietary flavonoid intake at dinner with that at breakfast was associated with 7% lower odds of NAFLD. Conclusions: Higher flavonoid intake at breakfast than at dinner may be associated with lower odds of NAFLD. Future research should focus on the potential role of breakfast-timed flavonoid intake in preventing the onset of NAFLD. Full article

Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer and one of the leading causes of cancer-related mortality globally, with its incidence increasingly driven not only by viral hepatitis and alcohol-related etiologies but also by metabolic dysfunction-associated steatotic liver disease. Dietary intake can modify gut microbial activity and the production of microbial metabolites, which in turn may regulate hepatic immune signaling and metabolic pathways along the gut–liver axis. Microbiota-derived metabolites have emerged as important immunometabolic mediators linking dietary factors to hepatic immune responses and metabolic reprogramming. These metabolites, which have been shown to influence hepatic immune cell function and inflammatory signaling, include short-chain fatty acids, secondary bile acids, and tryptophan-derived indoles. Changes in the production and composition of these metabolites have been associated with immune dysregulation, chronic inflammation, and metabolic reprogramming that promote hepatocellular carcinoma development. This review highlights how diet–microbiota interactions reshape hepatic immunometabolism and discusses their potential translational relevance for prevention and therapeutic strategies in hepatocellular carcinoma. Full article

Background: Steatotic liver disease (SLD) and sarcopenia are lifestyle-related conditions for which prevention is critical. The phase angle, which is derived from impedance, reactance, and resistance values obtained via bioelectrical impedance analysis, has emerged as a potential marker of sarcopenia. Additionally, amino acids have been implicated in the pathogenesis of both SLD and sarcopenia. This epidemiological study investigated the association between SLD and sarcopenia in a general population cohort. Methods: This cross-sectional study included 281 participants with metabolic dysfunction-associated steatotic liver disease (MASLD), 72 with metabolic alcohol-associated liver disease (MetALD), and 54 with alcohol-associated liver disease (ALD). Associations between phase angle, Mac-2-binding protein glycosylation isomer (M2BPGi) as a marker of liver fibrosis, and serum amino acid levels were analyzed. Results: The phase angle was significantly higher in the MetALD group than in the MASLD and ALD groups. Multivariate analysis identified MASLD as an independent risk factor for a low phase angle compared with MetALD. M2BPGi levels were lower in MetALD than in MASLD, and M2BPGi showed a negative correlation with the phase angle. Furthermore, MetALD was characterized by lower serine and glutamine levels than MASLD, with serine demonstrating a negative correlation with the phase angle. Conclusions: Although the possibility of residual confounding factors cannot be excluded, the present study suggests that phase angle may serve as a sensitive marker for the early decline in muscle mass in patients with SLD, comparable to grip strength and skeletal muscle mass index. Full article

Background/Objectives: Excessive alcohol consumption induces hepatic injury primarily through cytochrome P450 2E1 (CYP2E1)-mediated reactive oxygen species (ROS) generation and disruption of redox homeostasis. This study investigated the hepatoprotective effects of the ethyl acetate fraction from Dendropanax morbifera leaves (DMLEAF) against ethanol-induced oxidative damage in vitro and in vivo. Methods: The protective mechanisms of DMLEAF were evaluated in HepG2 cells exposed to ethanol (400 mM, 24 h) and in an acute ethanol-induced liver injury mouse model. Cellular ROS levels, apoptosis, antioxidant enzyme activities, and nuclear factor erythroid 2-related factor 2 (Nrf2) translocation were assessed in vitro. Serum biochemical markers, histopathological changes, and hepatic CYP2E1 mRNA expression were analyzed in vivo. Results: In HepG2 cells, DMLEAF significantly reduced intracellular ROS levels and apoptosis, improving cell viability by up to 27.2% and reducing apoptosis by approximately 32%. DMLEAF also attenuated the ethanol-induced decrease in antioxidant enzyme activities (superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase) and promoted nuclear translocation of Nrf2. In mice, oral administration of DMLEAF significantly reduced serum alanine aminotransferase and aspartate aminotransferase levels, improved histopathological alterations, and suppressed hepatic CYP2E1 mRNA expression by 2.6-fold compared with ethanol-treated controls, while preventing the reduction in hepatic antioxidant enzyme activities. Conclusions: These findings suggest that DMLEAF mitigates alcohol-induced liver injury through suppression of CYP2E1-associated ROS production and activation of Nrf2-mediated antioxidant defense mechanisms. Full article

Aging-associated dyslipidemia and chronic low-grade inflammation contribute to atherosclerosis and cardiovascular risk. As a blend of long-chain aliphatic alcohols, policosanol from insect wax (PIW) has been documented to regulate lipid metabolism. However, the effects of PIW on atherosclerosis remain insufficiently characterized. In this study, ApoE^−/− mice fed a high-fat diet were concurrently administered PIW (75 and 150 mg/kg) for eight weeks. PIW was associated with weight gain reduction and improvement in lipid profile, particularly a decrease in triglycerides and total cholesterol. PIW also lowered circulating inflammatory biomarkers (IL-6, TNF-α, and C-reactive protein). Histopathological analyses revealed attenuated hepatic injury and reduced aortic lipid deposition and lesion features. In parallel, PIW reduced serum endothelin-1 and oxidized LDL levels and modulated aortic ET-1, MMP-9/TIMP-1 balance, and LOX-1/NF-κB-related protein signals. Notably, as PIW was administered concurrently with high-fat diet induction, these findings should be interpreted within a preventive intervention framework. Collectively, PIW help attenuate HFD-associated atherosclerotic features and hold promise as a functional food ingredient for cardiovascular health and healthy aging. Full article

Intimate partner violence (IPV) against women is recognized as a public health and human rights issue globally. Nigeria continues to experience a substantial burden of IPV. This study analyzed patterns and multilevel factors associated with violence against women in Nigeria, including emotional, physical, and sexual violence. This study analyzed data from 5458 women aged 15 to 49 years who participated in the 2024 Nigeria Demographic and Health Survey (NDHS). We computed multivariable binary logistic regression and Firth logistic regression (for relatively rare events). Women whose partners consumed alcohol had higher odds of experiencing emotional violence (AOR = 2.97), less severe physical violence (AOR = 3.11), severe physical violence (AOR = 3.22), and sexual violence (AOR = 2.07). Partner controlling behaviors, including restricting contact with family or friends, was also consistently linked to elevated IPV risk. Women living with a partner had higher odds of severe physical and sexual violence. Higher education and greater household wealth were associated with lower IPV outcomes. Our study provides practice-relevant evidence and policy implications, including the need for integrated prevention strategies that address behavioral risk factors, strengthen early screening for controlling behaviors, and promote women’s socioeconomic empowerment. Full article

Adolescent gambling is a growing public health concern as opportunities expand across both physical and digital environments. This study examined gender differences in on-site and online gambling among Finnish adolescents and assessed associations with school engagement, family context, peer activities, and co-occurring risk behaviors. Data were obtained from the European School Survey Project on Alcohol and Other Drugs (ESPAD), collected from Finnish adolescents aged 15–16 in 2024 (boys: n = 1706; girls: n = 1588). Associations with past-12-month gambling were analyzed using Rao–Scott’s chi-square tests, F tests, and multinomial logistic regression, examining gender interactions. Gambling was more common among boys than girls: 7% of boys had gambled on-site only, 3% online only, and 11% both during the past 12 months. Among girls, the corresponding proportions were 0–2%. Skipping school, spending leisure time with friends, risky sexual behavior, and problematic substance use were associated with increased odds of both gambling types, whereas parental control was associated with decreased odds. Problematic social media increased the odds of on-site gambling, while problematic gaming decreased the odds. Several associations with online gambling differed by gender. These findings support multi-level prevention targeting family, school, peer, and behavioral risk factors. Full article

Background: Sexually transmitted infections (STIs) remain a major public health concern among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA). Although routine STI screening is essential for early diagnosis and prevention, uptake among AGYW is often suboptimal and influenced by multiple individual and contextual factors. This study assessed factors associated with STI screening uptake among AGYW enrolled in HIV prevention programs in Namibia. Methods: A secondary analysis of anonymized programmatic data was conducted among AGYW aged 15–24 years who received services through the DREAMS project and REACH PHN activity between 2018 and 2024. Descriptive statistics, Chi-square tests, and multivariable logistic regression analyses were performed to identify factors associated with STI screening uptake. Results: A total of 26,689 AGYW were included in the analysis, of whom 97.2% were screened for STIs. STI screening uptake was significantly associated with district of residence, year of enrolment, inconsistent or no condom use, perceived risk of HIV infection, use of family planning, and having had sex under the influence of alcohol or drugs. AGYW who perceived themselves to be at risk of HIV and those using family planning methods had higher odds of STI screening, while those who reported sex under the influence of alcohol or drugs were less likely to be screened. Significant geographic disparities in screening uptake were also observed across districts. Conclusions: STI screening uptake among AGYW enrolled in HIV prevention programs in Namibia was high. While this may reflect the effectiveness of integrated, community-based service delivery models, the results should be interpreted with caution, as they are based on a convenience sample. However, behavioural and geographic disparities persist. Strengthening integrated sexual and reproductive health services, addressing substance-related barriers, and implementing targeted district-level interventions may further improve equitable access to STI screening among AGYW. Full article

Background: Birth defects remain a major global public health concern, particularly in low-resource settings where awareness and preventive practices are limited. Maternal knowledge, attitudes, and practices (KAP) are critical in the prevention and management of birth defects. This study explored contextual factors influencing maternal KAP using a mixed-methods approach in three rural districts of the Eastern Cape, South Africa. Methods: A convergent mixed-methods cross-sectional study was conducted among 72 mothers selected through purposive sampling. Quantitative data were collected using a structured questionnaire administered in English only, covering socio-demographic characteristics, obstetric history, knowledge, and preventive practices. Qualitative data were obtained through interviews exploring beliefs, perceptions, and cultural explanations of birth defects. Quantitative data were analysed using descriptive statistics and linear regression analysis to identify factors associated with birth defects, while qualitative data were thematically analysed to provide contextual understanding. Results: Most participants resided in the Amathole district (63.89%), followed by Alfred Nzo (18.06%) and Joe Gqabi (18.06%). Most women were aged between 20 and 35 years (52.78%), while 15.28% were younger than 20 years and 6.94% were older than 45 years. Over half of the respondents were single (55.56%), 34.72% were married, and the remainder were either separated (4.17%) or divorced (5.56%). Numerous participants had primary education (56; 77.78%), followed by secondary (11; 15.28%) and tertiary education (5; 6.94%). The majority were unemployed (56; 77.78%), while smaller proportions were employed (10; 13.89%) or engaged in other income-generating activities (6; 8.33%), indicating limited participation in formal employment among respondents. Nearly all participants (95.83%) had experienced pregnancy, with 70.83% reporting pregnancy-related complications. Only 2.78% reported having a child with a birth defect, while 90.28% reported a family history of birth defects. Knowledge of genetic causes was relatively high (69.23%), but awareness of modifiable risk factors was limited. Although 93.06% recognized alcohol use during pregnancy as harmful, fewer participants identified smoking or medication use (18.06%) and advanced maternal age (26.39%) as risk factors. Only 13.89% acknowledged the preventive role of antenatal care. Qualitative findings revealed strong cultural influence on perceptions of birth defects, with causes attributed to medical factors (38.89%), supernatural beliefs such as witchcraft or curses (18.06%), immoral behaviour (12.50%), and dietary taboos (11.11%). Traditional health-seeking behaviour was common, with 91.67% consulting traditional healers during pregnancy. Linear regression analysis identified significant predictors of birth defects, including family history (β = 1.36, p = 0.008), alcohol use during pregnancy (β = 1.13, p = 0.050), and inadequate antenatal care attendance (β = 0.99, p = 0.040). Advanced maternal age showed a weaker and non-significant association (β = 0.79, p = 0.080). Conclusions: The study highlights substantial gaps in maternal knowledge and the strong influence of cultural beliefs on birth defect prevention. Strengthening culturally sensitive health education, improving antenatal care services, and engaging traditional healers in community-based interventions are essential to improve maternal health outcomes in rural South Africa. Full article