Search Results (455)

Sleep disorders and stroke are intricately linked through a complex, bidirectional relationship. Sleep disturbances such as obstructive sleep apnea (OSA), insomnia, and restless legs syndrome (RLS) not only increase the risk of stroke but also frequently emerge as consequences of cerebrovascular events. OSA, in particular, is associated with a two- to three-fold increased risk of incident stroke, primarily through mechanisms involving intermittent hypoxia, systemic inflammation, endothelial dysfunction, and autonomic dysregulation. Conversely, stroke can disrupt sleep architecture and trigger or exacerbate sleep disorders, including insomnia, hypersomnia, circadian rhythm disturbances, and breathing-related sleep disorders. These post-stroke sleep disturbances are common and significantly impair rehabilitation, cognitive recovery, and quality of life, yet they remain underdiagnosed and undertreated. Early identification and management of sleep disorders in stroke patients are essential to optimize recovery and reduce the risk of recurrence. Therapeutic strategies include lifestyle modifications, pharmacological treatments, medical devices such as continuous positive airway pressure (CPAP), and emerging alternatives for CPAP-intolerant individuals. Despite growing awareness, significant knowledge gaps persist, particularly regarding non-OSA sleep disorders and their impact on stroke outcomes. Improved diagnostic tools, broader screening protocols, and greater integration of sleep assessments into stroke care are urgently needed. This narrative review synthesizes current evidence on the interplay between sleep and stroke, emphasizing the importance of personalized, multidisciplinary approaches to diagnosis and treatment. Advancing research in this field holds promise for reducing the global burden of stroke and improving long-term outcomes through targeted sleep interventions. Full article

Cardiorespiratory fitness is a predictor of long-term health, traditionally assessed through structured exercise protocols that require maximal effort and controlled laboratory conditions. These protocols, while clinically validated, are often inaccessible, physically demanding, and unsuitable for unsupervised monitoring. This study proposes a non-invasive, unsupervised alternative—predicting the heart rate a person would reach after completing the step test, using wearable data collected during natural daily activities. Ground truth post-exercise heart rate was obtained through the Queens College Step Test, which is a submaximal protocol widely used in fitness settings. Separately, wearable sensors recorded heart rate (HR), blood oxygen saturation, and motion data during a protocol of lifestyle tasks spanning a range of intensities. Two machine learning models were developed—a Human Activity Recognition (HAR) model that classified daily activities from inertial data with 96.93% accuracy, and a regression model that estimated post step test HR using motion features, physiological trends, and demographic context. The regression model achieved an average root mean squared error (RMSE) of 5.13 beats per minute (bpm) and a mean absolute error (MAE) of 4.37 bpm. These findings demonstrate the potential of test-free methods to estimate standardized test outcomes from daily activity data, offering an accessible pathway to infer cardiorespiratory fitness. Full article

Obstructive sleep apnea (OSA) is a prevalent and heterogeneous sleep disorder associated with significant health and societal burdens. While continuous positive airway pressure (CPAP) remains the gold standard treatment, its limitations in adherence and patient tolerance have highlighted the need for alternative therapies. Positional therapy (PT), which targets apneas that occur predominantly in the supine position, has emerged as a promising option for individuals with positional OSA (POSA). This narrative review synthesizes the current literature on PT, examining its clinical indications, typologies, comparative efficacy with CPAP, oral appliances, and hypoglossal nerve stimulation, as well as data on adherence and barriers to long-term use. Traditional methods such as the tennis ball technique have largely been replaced by modern vibrotactile devices, which demonstrate improved comfort, adherence, and comparable short-term outcomes in selected POSA subjects. While PT remains inferior to CPAP in reducing overall AHI and oxygen desaturation, it performs favorably in terms of mean disease alleviation (MDA) and sleep continuity. Importantly, treatment effectiveness is influenced by both anatomical and non-anatomical traits, underscoring the need for accurate phenotyping and individualized care. PT should be considered within a broader patient-centered model that incorporates preferences, lifestyle, and motivational factors. Further research is needed to validate long-term efficacy, optimize selection criteria, and integrate PT into personalized OSA management strategies. Full article

Background/Objectives: Misinformation significantly impacts self-care behaviors and treatment outcomes in patients with type 2 diabetes mellitus (T2DM). We investigated the prevalence and content of diabetes-related misinformation among Thai patients with T2DM, examining the influence on cognitive attitudes and intentions to share such information. Methods: We employed a mixed-methods approach, conducting initial qualitative interviews with healthcare professionals and patients with T2DM to identify key misinformation themes. These themes guided the development of a validated questionnaire that was distributed to 107 patients with T2DM. Spearman’s correlation and multiple linear regression analyses were used to assess the relationships between misinformation exposure, attitudes, and sharing intentions. Results: Misinformation was categorized into four domains: medication side effects, alternative treatments, imbalanced lifestyle, and symptom perception. Exposure to misinformation ranged from 19.6% to 94.4%, with word of mouth identified as the primary source (81.18%). Misconceptions regarding symptom perception and alternative treatments were most prevalent. Information source, especially healthcare providers (β = 0.4); personal attitudes towards misinformation (β = 0.24); and exposure level (β = 0.46) significantly influenced the intention to share misinformation. Conclusions: This study highlights the need for targeted educational interventions to address widespread misconceptions in the management of T2DM, particularly those related to symptom perception and alternative treatments. Addressing these misinformation sources may be associated with improved self-management practices and could inform strategies aimed at enhancing patient outcomes. Full article

Background: In rapidly aging societies like Japan, socioeconomic status (SES) plays a critical role in shaping older adults’ health behaviors. Disparities in SES influence access to healthcare, engagement in health-promoting activities, and the adoption of digital health technologies. This narrative review synthesizes current evidence on how SES affects health behaviors among older adults and highlights challenges in promoting equitable and sustainable healthcare in aging populations. Methods: A PubMed search was conducted for English-language articles published up to May 2025 using the keywords “socioeconomic status”, “older adults”, and terms related to health behaviors. Studies were included if they focused on individuals aged 65 or older and examined associations between SES and healthcare use, digital health, complementary and alternative medicine (CAM), supplements, or lifestyle behaviors. Results: A total of 24 articles were identified. Higher SES—typically measured by income, education, and occupation—was consistently associated with an increased use of preventive services, digital health tools, CAM, and healthier lifestyle behaviors such as diet, physical activity, and sleep. In contrast, lower SES was linked to healthcare underuse or overuse, digital exclusion, and less healthy behaviors. Structural and regional disparities often reinforce individual-level SES effects. Comorbidity burden and shifting health perceptions with age may also modify these associations. Conclusions: SES is a key determinant of health behavior in older adults. Policies should focus on redistributive support, digital inclusion, and SES-sensitive health system strategies to reduce disparities and promote healthy aging in super-aged societies. Full article

The contemporary food environment is experiencing substantial transformations, and sustainability and the pursuit of novel ingredients have become pivotal factors in consumer decision-making and business strategy formulation. The emergence of alternative proteins has significant implications for sustainability, climate change mitigation and animal welfare, and can potentially promote the achievement of different United Nations Sustainable Development Goals. The spread of these novel foods requires significant attention, particularly concerning younger demographics, which are often considered to be more environmentally and ethically aware when making dietary choices. This study investigates the psychological and attitudinal factors that shape young consumers’ intention to consume plant-based, insect-based, and cultured meat alternative proteins, and verifies the existence of heterogeneous segments of consumers. To this purpose principal component analysis and k-means cluster analysis are employed using data from an online survey conducted in Italy, with a sample of 350 young consumers. The findings reveal that the intention to consume alternative protein sources is not particularly pronounced among the young consumers and differs according to the type of alternative protein. Three different profiles of young consumers were found: traditionalist (39% of the sample); enthusiastic (17%) and open-minded (44%). These segments differ significantly with respect to consumption intention, socio-demographic, lifestyle and psychological variables. The results provide useful insights for policymakers to design targeted interventions to encourage young consumers’ sustainable food choices. The findings could also be useful for marketers interested in investing in such innovations as they can benefit from an in-depth knowledge of this market segment. Full article

A preservationist Christian sexual ethic affirms heterosexuality as the only normal and natural expression of wholeness in human intimacy, relationships, and lifestyle. However, revisionist critics would maintain that the central problem of the preservationist perspective is the perceived lack of a compelling verifier. A revisionist Christian ethic embraces homosexuality as an alternative form of wholeness in human relationships and lifestyle. Preservationist critics would maintain that the central problem of the revisionist perspective is the perceived lack of a compelling verifier. They would also identify an additional problem for the revisionist position, namely, the perceived problem of self-contradiction. It may seem to some that problems alleged for a particular side cannot be leveraged to the advantage of the opposing side in this debate. Moreover, even the external judgment that a problem exists for a perspective is disputed within that perspective. This may seem to lead to stalemate between the opposing perspectives. However, it may be that a verifier or vindicator exists for one of these perspectives that would commend that perspective as more acceptable than the other. A vindicator for a perspective need only to reinforce that perspective, while a verifier must be an empirically attested ground for the perspective. In this article, I will compare verifiers and vindicators on each side of the debate and inquire whether there is an ace to be found in any of these arenas. I find that a preservationist Christian sexual ethic speaks for itself when its vehicles of verification and vindication are addressed in dialogue with a revisionist perspective. My aim is to increase the possibility of moving the discussion forward in the debate over normative human sexuality. Full article

Background: With growing interest in healthy lifestyles, protein bars have gained popularity. However, many commercial bars contain excessive calories, sugar, and artificial additives that undermine their health benefits. This study aimed to develop a protein bar using natural ingredients with a balanced macronutrient profile. Method: The protein bar formulation used soy protein extract, a plant-based protein source, known for its complete amino acid profile but limited in methionine, which was complemented by oats to nutritionally balance this deficiency. A database was created to evaluate the cost-effectiveness of commercially available protein bars based on consumer feedback. The experimental bar was tested for nutritional value, shelf life, and physiological impact, using only natural ingredients for texture, flavor, and stability. Results: The experimental protein bar had higher protein and fiber content than a selected commercial bar but a shorter shelf life (7 days vs. 90 days) due to the absence of preservatives. The database helped identify target consumer groups and ensure the product was affordable and nutritionally effective. Conclusion: This study demonstrates that using natural, complementary ingredients can create a protein bar with a more balanced nutrient profile while avoiding harmful additives. The final product supports muscle protein synthesis through its high-quality protein content and promotes glycemic control and satiety via its fiber-rich, low-sugar formulation and metabolic processes, offering a healthier alternative to commercial options, with a focus on consumer health and cost-effectiveness. Full article

Background/Objectives: Recent decades have seen a remarkable westernization of diets and a decline in adherence to the Mediterranean diet (MD). This study examined the eating habits of a representative sample of Italian university students to identify the determinants of adherence to the MD and the most relevant actions to improve their well-being. Methods: The Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) and Sustainable Healthy Diet (SHED) index questionnaires were used to explore MD adherence as the primary outcome, and dietary behavior sustainability, respectively. Sociodemographic, anthropometric, and lifestyle information was also collected. Results: The final sample included 1434 subjects (18–24; 60% female). The median (IQR) KIDMED score was 6.0 (4.0–8.0) and 33% showed a high adherence to the MD. Having breakfast, eating fruit and vegetables at least once a day, consuming pasta or other grains almost daily, and using olive oil at home were among the most common positive aspects of students’ diets. However, regular consumption of fish, nuts, legumes, dairy products, and a second serving of fruit and vegetables was less prevalent. Having an active lifestyle, eating more plant products, and having more sustainable dietary behaviors in terms of the SHED index, were the main determinants of a high KIDMED score. Likewise, graduate students, daily consumers of plant-based meat alternatives, and students attending university canteens daily were more likely to adopt healthier diets. Conclusions: Future actions are crucial to create a food environment that facilitates healthy and sustainable dietary choices among young adults, such as improving the nutritional quality of processed products and regulating their promotion, as well as implementing initiatives to improve university food services and encourage the use of campus dining facilities. Full article

Neuropathic pain resulting from injury to the somatosensory nervous system affects approximately 6.9–10% of the general population and significantly impacts quality of life. Common presentations include burning, stabbing, tingling, or electrical sensations, occurring spontaneously or through hyperalgesia or allodynia. Treatment approaches follow a tiered system. First-line therapies include gabapentinoids (e.g., gabapentin, pregabalin), which target voltage-gated calcium channels; tricyclic antidepressants (e.g., amitriptyline, nortriptyline); and serotonin-norepinephrine reuptake inhibitors such as duloxetine. Second-line options encompass topical agents (e.g., 5% lidocaine, 8% capsaicin), opioid-like medications (e.g., tramadol, tapentadol), and adjunctive therapies including psychological therapies and lifestyle interventions. For refractory cases, third-line treatments include NMDA receptor antagonists (e.g., ketamine, dextromethorphan), cannabinoids, and botulinum toxin type A, though these have more limited clinical evidence. Procedural interventions such as spinal cord stimulation and transcutaneous electrical nerve stimulation provide alternatives when pharmacological approaches fail. Despite advances in treatment options, many patients remain undertreated, highlighting the need for individualized, multimodal approaches and continued research into the complex pathophysiology of neuropathic pain conditions. Full article

Gastroesophageal reflux disease (GERD) is a widespread condition that requires reliable and non-invasive diagnostic methods to minimize patient discomfort. This study presents a radiofrequency spectrophotometry sensor specifically designed to detect esophageal liquid flow and ionicity in real time without disrupting the patient’s daily life. The sensor operates by measuring dielectric properties and ionic conductivity through the thoracic plexus, eliminating the need for invasive probes or prolonged monitoring. A study conducted on 49 participants demonstrated the sensor’s ability to differentiate between various liquid media and identify beta dispersion relaxation as a biomarker for esophageal tissue damage, a key indicator of GERD progression. Additionally, alpha dispersion conductivity effectively distinguished reflux episodes, proving the sensor’s high sensitivity. Unlike traditional diagnostic techniques such as endoscopy or pH monitoring, this radiofrequency spectrophotometry sensor enables continuous, real-time reflux detection, allowing patients to maintain a normal lifestyle during assessment. The results validate its potential as an innovative alternative for GERD diagnosis and monitoring, with future research focused on clinical validation, optimization, and integration into long-term patient monitoring systems. Full article

Background/Objectives: Gestational diabetes mellitus (GDM) is a major pregnancy complication with rising global prevalence. The Mediterranean Diet (MD) has shown metabolic benefits, but total adherence scores may obscure meaningful variation in dietary quality. This study aimed to investigate whether specific dietary patterns, identified within the MD framework, and their glycemic load (GL) are associated with GDM risk. Methods: This prospective cohort is part of the BORN2020 longitudinal study on pregnant women in Greece; dietary intake was assessed using a validated food frequency questionnaire (FFQ) at two time points (pre-pregnancy and during pregnancy). MD adherence was categorized by Trichopoulou score tertiles. GL was calculated for food groups using glycemic index (GI) reference values and carbohydrate content. Dietary patterns were identified using factor analysis. Logistic regression models estimated adjusted odds ratios (aORs) for GDM risk, stratified by MD adherence and time period, controlling for maternal, lifestyle, and clinical confounders. Results: In total, 797 pregnant women were included. Total MD adherence was not significantly associated with GDM risk. However, both food-specific GLs and dietary patterns with distinct dominant foods were predictive. GL from boiled greens/salads was consistently protective (aOR range: 0.09–0.19, p < 0.05). Patterns high in tea, coffee, and herbal infusions before pregnancy were linked to increased GDM risk (aOR = 1.96, 95% CI: 1.31–3.02, p = 0.001), as were patterns rich in fresh juice, vegetables, fruits, legumes, and olive oil during pregnancy (aOR = 2.91, 95% CI: 1.50–6.24, p = 0.003). A pattern dominated by sugary sweets, cold cuts, animal fats, and refined products was inversely associated with GDM (aOR = 0.34, 95% CI: 0.17–0.64, p = 0.001). A pattern characterized by sugar alternatives was associated with higher risk for GDM (aOR = 4.94, 95% CI: 1.48–19.36, p = 0.014). These associations were supported by high statistical power (power = 1). Conclusions: Within the context of the MD, evaluating both the glycemic impact of specific food groups and identifying risk-associated dietary patterns provides greater insight into GDM risk than overall MD adherence scores alone. Full article

Background and Clinical Significance: Kidney transplantation remains the most effective method of renal replacement therapy. Living donor transplantation offers several advantages—reduced cardiovascular risk, better graft survival, and preemptive intervention. However, donor obesity is a growing concern, as it is usually associated with perioperative and long-term complications, which can affect donor eligibility. Bariatric surgery is a standard recommendation for patients with a BMI over 35 kg/m². There are limited data on the use of pharmacological agents for weight reduction in kidney donors. This case presents a successful conservative treatment with GLP-1 receptor agonist in an obese woman wishing to donate a kidney to her son. Case Presentation: We are presenting the case of a 63-year-old woman with grade II obesity who was initially denied being a kidney donor to her son because of her weight. Under these circumstances, she underwent comprehensive lifestyle modification in the cardio-obesitology clinic (caloric restriction, physical activity, and pharmacological treatment with liraglutide). During the 3-month follow-up, she decreased her BMI to 33.4 kg/m², and subsequent examinations confirmed no surgical contraindications to donating a kidney. Despite hematuria, biopsy and genetic testing revealed a benign carrier condition of Alport syndrome, which, without proteinuria or renal impairment, allowed successful kidney donation. Conclusions: This case demonstrates that conservative pharmacological treatment for body weight reduction with GLP-1 receptor agonists may be an alternative to bariatric surgery for selected obese kidney donor candidates. The presented case highlights the importance of a multidisciplinary and personalized approach. Full article

Background/Objectives: Diet quality and sleep regularity both influence cardiovascular disease (CVD) risk and may influence each other, but there is scarce evidence for their joint or interacting associations in relation to CVD. We assessed these associations in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: Participants free of CVD with valid diet and sleep measures in 2010–2013 were included and followed through 2020 for detection of incident CVD (188 events detected over 8.8 years among 1782 participants; 55% women). Sleep timing and duration regularity were assessed via the intra-individual SD of sleep onset time and duration across 5- to 7-day actigraphy. The Alternate Healthy Eating Index-2010 assessed diet quality. Sleep regularity and diet quality were dichotomized and cross-tabulated to estimate joint associations with CVD and to evaluate interaction via Cox proportional hazard models adjusting for potential confounders. Results: Participants with low diet quality and irregular sleep had higher CVD risk compared to those with high diet quality and regular sleep (adjusted HR [95% CI]: low diet quality + irregular sleep timing: 1.56 [1.03, 2.37]; low diet quality + irregular sleep duration: 1.70 [1.09, 2.67]). The joint associations were stronger than those for only one adverse behavior and similar to those for their combination. There was no evidence for additive or multiplicative interactions. Conclusions: Having irregular sleep and low diet quality confers the highest CVD risk compared to having neither or only one of these behaviors. These results underscore the importance of interventions targeting these unhealthy lifestyle behaviors, especially when they co-occur. Full article

Background: Irritable bowel syndrome (IBS) significantly impairs the lifestyle and quality of life of the global population. However, the underlying pathophysiological mechanisms remain largely elusive. While conventional pharmacological approaches show limited therapeutic efficacy, emerging microbiota-targeted dietary interventions present promising alternatives. Objectives: The present study aimed to elucidate the molecular mechanisms by which a synbiotic mitigates IBS and associated colonic dysfunctions in C57BL/6 mice. Methods: The mouse model was induced by a Citrobacter rodentium (C. rodentium) infection combined with water avoidance stress (WAS). Galacto-oligosaccharides (GOS) were identified as the optimal carbon source for the growth of Lactobacillus plantarum ZYC501 (L. plantarum ZYC501), leading to the establishment of the synbiotic formulation. Results: The 32-day synbiotic intervention, consisting of L. plantarum ZYC501 (1 × 10⁹ CFU/day) and GOS (10 g/L, w/w), significantly alleviated colonic transit dysfunction, visceral hypersensitivity, and anxiety-like behaviors in IBS mice. The synbiotic treatment significantly inhibited the expression levels of histamine, mast cell tryptase, and prostaglandin E2 (PGE2) (p < 0.05). The synbiotic also suppressed colonic inflammation by reducing the levels of lipopolysaccharide (LPS), TNF-α, and IL-6 (p < 0.05). Moreover, the synbiotic increased the expression of MUC2 and the production of short-chain fatty acids (SCFAs), including acetate, propionate, and butyrate (p < 0.05). In terms of gut microbiota modulation, the synbiotic reshaped the gut microbiota composition, increasing the abundance of Lactobacillus and Akkermansia while decreasing the levels of Helicobacter and Saccharibacteria. Correlation analysis further revealed a strong association among SCFAs, colonic inflammation, and the gut microbiota. Conclusions: In conclusion, the synbiotic composed of L. plantarum ZYC501 and GOS effectively alleviates IBS and associated colonic dysfunctions by modulating the gut microbiota, reducing mast cell hyperactivity, and enhancing colonic barrier integrity. These findings provide a theoretical basis for developing gut microbiota-targeted dietary interventions for the management of IBS and improvement in gut health. Full article