Search Results (195)

Objectives: This study aimed to identify anatomical and clinical predictors of moderate to high Obstructive Sleep Apnea (OSA) risk in a sample of university students, with an emphasis on sex-based differences. Methods: A cross-sectional study was conducted among 340 university students (148 males, 192 females) in Manizales, Colombia. Anthropometric measurements, anatomical features (neck circumference, Mallampati index, facial profile, molar Angle classification), and validated screening tools (STOP-BANG, Epworth Sleepiness Scale) were assessed. Multivariate logistic regression models were applied globally and stratified by sex to determine predictors of moderate/high OSA risk (STOP-BANG ≥ 3). Results: Males had significantly higher STOP-BANG scores, neck circumference, and prevalence of moderate/high OSA risk (23% vs. 3.1%), while females showed higher daytime sleepiness (p < 0.001). In the global model, neck circumference (OR = 0.57, p < 0.001) and Epworth score (OR = 0.86, p = 0.01) were significant predictors. In men, neck circumference (OR = 0.62, p < 0.001) and Angle’s molar classification (OR = 0.54, p = 0.04) were associated with risk. In women, neck circumference (OR = 0.35, p = 0.01) and daytime sleepiness (OR = 0.60, p = 0.03) remained significant. Conclusions: Easily accessible anatomical and clinical markers can help identify young adults at risk for OSA. Sex-specific screening approaches may enhance early detection strategies in university populations. Implementing these tools in clinical and educational settings may improve targeted prevention, facilitate timely referral to sleep specialists, and potentially reduce long-term health complications associated with undiagnosed OSA in emerging adults. Full article

Background: Prolonged sedentary behavior and associated obesity are recognized risk factors for poor health across the lifespan. Globally, data show that many children and adolescents aged 5 to 17 significantly increased their sedentary behaviors during the COVID-19 pandemic, failing to meet recommended physical activity levels and reporting increased smartphone use. While mobile devices and video games have been traditionally linked to physical inactivity, formats like exergaming, which combine gameplay with gross motor activity, offer potential to promote physical activity. However, many digital health tools for children are developed without incorporating feedback from key stakeholders and end-users (e.g., children, teachers, and guardians). Therefore, this paper, within the Walk around the Earth (E-Walk) project, describes a prospective study that aims (1) to identify the most influential factors or characteristics affecting engagement with and usability of a mobile application promoting physical activity among primary school students; (2) to develop a mobile application for children based on the identified factors and characteristics. Methods: This project will use a group concept mapping approach to identify the most influential features/factors/characteristics affecting engagement with and usability of an app. By involving primary stakeholders (e.g., children, teachers, guardians, and physical activity experts), the project seeks to align the app’s features with primary end-user needs and motivations. Following the app’s development, its effectiveness in increasing physical activity levels and reducing sedentary behaviors will be evaluated through a mixed-method design, incorporating anthropometric data, validated physical activity questionnaires (Physical Activity Questionnaire for Older Children (PAQ-C) and International Physical Activity Questionnaire (IPAQ)), and engagement metrics. Conclusions: The E-Walk project integrates participatory design with educational content and activity-based challenges, representing a multidimensional strategy for promoting health and learning in primary school students. Ultimately, this study contributes to the development of user-informed digital interventions that support sustainable behavioral changes, in line with broader goals of child well-being and digital health promotion. Full article

Background: Arthroereisis is a well-accepted and relatively easy procedure to treat the flexible flatfeet in children and adolescents. A mild calf-muscle shortening is not seldom an accompanying feature. The need for a gastrocnemius recession in addition to arthroereisis is controversial. Therefore, the objective of this study is to investigate the need for a gastrocnemius recession in mild cases of gastrocnemius shortening to improve ankle dorsiflexion in addition to arthroereisis. Methods: Twenty-seven patients (ages 9–15 years) who underwent arthroereisis for painful idiopathic flatfeet were included in this non-randomised retrospective study, approved by Friedrich-Alexander University, Erlangen-Nürnberg (22-86-Br). The gait data of 18 typically developed children in same age group was used as reference. Based on the intraoperative Silfverskjöld test, two groups could be identified in the collective, one with shortened of gastrocnemius who underwent gastrocnemius recession (FFGR) and one without (FF). A control group included 18 feet of 18 typically developing children. Outcomes were evaluated by comparing pre- and postoperative clinical assessments including pain scores, gait analysis using a multi-segmental foot model, and radiological imaging. The mean follow-up was 22.1 months, and statistical analysis included a two-factor ANOVA. Results: No statistically significant differences in anthropometric, clinical, and gait parameters were observed between the groups preoperatively. Improvements in ankle dorsiflexion and pain were seen in both groups without statistical significance. There was no loss of calf-muscle strength or ankle power. Conclusions: Arthroereisis effectively corrects an idiopathic flexible flatfoot and reduces pain in children and adolescents. The gastrocnemius muscle stretches following arthroereisis and therefore, no lengthening is necessary when mildly shortened. The major limitations of this study are its retrospective nature, non-randomisation, and small size of the study collective. Full article

Background/Objectives: Metabolic dysfunction-associated steatosis liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver related morbidity and mortality affecting 38% of the adult global population. As of now, there is no clear consensus on a standardized pharmacological treatment for MASLD; therefore, lifestyle interventions particularly diet and exercise remain the first-line approach for both prevention and management. Extra virgin olive oil (EVOO), the primary source of fat in the Mediterranean diet. (MD) is widely recognized as a key contributor to its well-documented health benefits. As a central component of this dietary pattern, EVOO has demonstrated promising therapeutic potential due to its high phenolic content. The primary aim of this review is to synthesize existing human studies examining the effects of olive oil primarily EVOO on key pathological features of MASLD. Methods: A systematic search of human clinical and observational studies was conducted across major databases. Key outcomes assessed include hepatic steatosis, inflammation, oxidative stress, fibrosis, liver enzymes, and anthropometric measures. Study quality was evaluated using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Results: This review included 25 high-quality studies, 12 of which assessed olive oil alone and 13 evaluated the MD emphasizing extra virgin olive oil (EVOO). EVOO-rich interventions consistently improved hepatic steatosis, liver enzyme levels (ALT, AST), and inflammatory markers in MASLD patients, particularly when paired with calorie-restricted or MD patterns. Benefits were dose- and type-dependent, with EVOO showing superior effects compared to refined olive oils. Modest improvements in lipid profiles and insulin resistance were observed. Longer study durations and higher EVOO intake (>30–50 g/day) yielded greater improvements. Findings suggest EVOO may exert beneficial effects on liver health through its anti-inflammatory and antioxidant properties. Future studies on EVOO’s role in MASLD should use well-characterized oils with known polyphenol and bioactive compound levels and include clear biomarkers of oxidative stress, inflammation, and liver health outcomes on humans. Overall, EVOO represents a promising, non-pharmacological strategy for MASLD prevention and management. Conclusions: Current evidence suggests that EVOO, particularly when rich in phenolic compounds, is a promising dietary strategy for managing MASLD due to its hepato-protective effects, especially within a Mediterranean diet framework. However, findings are limited by study heterogeneity and a lack of high-quality randomized controlled trials, highlighting the need for future research to refine optimal dosing, assess long-term outcomes, and clarify underlying mechanisms. Full article

Falls from height are a critical safety concern in the construction industry, underscoring the need for effective identification of high-risk worker behaviors near hazardous edges for proactive accident prevention. This study aimed to address this challenge by developing an improved action recognition model. We propose a novel dynamic spatio-temporal graph convolutional network (CoG-STGCN) that incorporates a center of gravity (CoG)-aware mechanism. The method computes global and local CoG using anthropometric priors and extracts four key dynamic CoG features, which a Multi-Layer Perceptron (MLP) then uses to generate modulation weights that dynamically adjust the skeleton graph’s adjacency matrix, enhancing sensitivity to stability changes. On a self-constructed dataset of eight typical edge-related hazardous behaviors, CoG-STGCN achieved a Top-1 accuracy of 95.83% (baseline ST-GCN: 93.75%) and an average accuracy of 94.17% in fivefold cross-validation (baseline ST-GCN: 92.91%), with significant improvements in recognizing actions involving rapid CoG shifts. The CoG-STGCN provides a more effective and physically informed approach for intelligent unsafe behavior recognition and early warning in built environments. Full article

Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases. Full article

The protective role of progesterone against estradiol-driven proliferation is essential for preserving endometrial homeostasis. However, the factors that influence the progesterone–estradiol (P4:E2) ratio remain poorly characterized. This study aimed to model this ratio using a machine learning approach to identify key hormonal, anthropometric, demographic, dietary, metabolic, and inflammatory predictors. In addition, it aimed to assess estradiol and progesterone as individual outcomes to clarify whether shared or divergent mechanisms underlie variation in each hormone. NHANES data were used to identify postmenopausal women (n = 1902). An XGBoost model was developed to predict the log-transformed P4:E2 ratio using a 70/30 stratified train–test split. SHAP (SHapley Additive exPlanations) values were computed to interpret feature contributions. The final XGBoost model for the log-transformed P4:E2 ratio achieved an RMSE of 0.746, an MAE of 0.574, and an R² of 0.298 on the test set. SHAP analysis identified FSH (0.213), waist circumference (0.181), and CRP (0.133) as the most influential contributors, followed by total cholesterol (0.085) and LH (0.066). FSH and waist circumference emerged as key predictors of estradiol, while total cholesterol and LH were the most influential for progesterone. By leveraging SHAP-based feature importance to rank predictors of the P4:E2 ratio, this study provides interpretable, data-driven insights into the reproductive hormonal dynamics of postmenopausal women. Full article

While personal thermal comfort is critical for well-being and productivity, it is often overlooked by traditional building management systems that rely on uniform settings. Modern data-driven approaches often fail to capture the complex interactions between various data streams. This pilot study introduces a high-accuracy, interpretable framework for thermal comfort classification, designed to identify the most significant predictors from a comprehensive suite of environmental, physiological, and anthropometric data in a controlled group of young adults. Initially, an XGBoost model using the full 24-feature dataset achieved the best performance at 91% accuracy. However, after using SHAP analysis to identify and select the most influential features, the performance of our ensemble models improved significantly; notably, a Random Forest model’s accuracy rose from 90% to 94%. Our analysis confirmed that for this homogeneous cohort, environmental parameters—specifically temperature, humidity, and CO₂—were the dominant predictors of thermal comfort. The primary strength of this methodology lies in its ability to create a transparent pipeline that objectively identifies the most critical comfort drivers for a given population, forming a crucial evidence base for model design. The analysis also revealed that the predictive value of heart rate variability (HRV) diminished when richer physiological data, such as diastolic blood pressure, were included. For final validation, the optimized Random Forest model, using only the top 10 features, was tested on a hold-out set of 100 samples, achieving a final accuracy of 95% and an F1-score of 0.939, with all misclassifications occurring only between adjacent comfort levels. These findings establish a validated methodology for creating effective, context-aware comfort models that can be embedded into intelligent building management systems. Such adaptive systems enable a shift from static climate control to dynamic, user-centric environments, laying the critical groundwork for future personalized systems while enhancing occupant well-being and offering significant energy savings. Full article

Background/Objectives: Prehabilitation is a multimodal intervention introduced in preparation for various surgical procedures. The most effective treatment for obesity is bariatric surgery. Physiotherapy during prehabilitation for bariatric surgery may be an effective method of functional capacity improvement. We aimed to evaluate the impact of an individual outpatient 12-week, exercise-based physiotherapy program featuring prehabilitation on functional status, exercise tolerance, everyday mobility, and fatigue among patients qualified for bariatric surgery. Methods: The completion of an individual outpatient 12-week, exercise-based physiotherapy program during prehabilitation was an inclusion criterion for the study group. Participants included in the study and control groups were assessed twice, after enrollment into the prehabilitation program (the first assessment) and after prehabilitation but before surgery (the second assessment). Both assessments involved functional tests (a six-minute walking test [6MWT], a timed up and go test [TUG], a chest mobility test, anthropometric measures, a mobility index [Barthel], and a modified Borg scale). The collected anthropometric data and values from the 6MWT were used to create original linear models. This study followed STROBE recommendations. Results: The study group and control group did not differ statistically in terms of their anthropometric data. Statistically significant results were obtained between the first and second assessments in both groups in terms of body weight and waist circumference. However, only the study group showed improved results in the TUG test (p = 0.0001) and distance in the 6MWT (p = 0.0005). The study group presented with the normalization of blood pressure (BP) after exertion in the second assessment (systolic BP p = 0.0204; diastolic BP p = 0.0377), and the 6MWT results were close to the norms. According to the original linear model used to predict performance in the 6MWT, the primary modifiable determinant of exercise tolerance was the participant’s weight, while gender served as a non-modifiable determinant. Conclusions: Exercise-based physiotherapy in prehabilitation was associated with improved functional capacity in patients preparing for bariatric surgery, contributing to the improvement in 6MWT results in relation to the norms as well as exercise tolerance. Body weight may be an independent factor determining distance in the 6MWT for patients undergoing prehabilitation for bariatric surgery. Full article

Food addiction (FA) is an emerging psychiatric condition that presents behavioral and neurobiological similarities with other addictions, and its early identification is essential to prevent the development of more severe disorders. The aim of the present study was to determine the ability of anthropometric measures, eating habits, symptoms related to eating disorders (ED), and lifestyle features to predict the symptoms of food addiction. Methodology: A cross-sectional study was conducted in a sample of 702 university students (77.3% women; age: 22 ± 6 years). The Food Frequency Questionnaire (FFQ), the Yale Food Addiction Scale 2.0 (YFAS 2.0), the Eating Attitudes Test (EAT-26), anthropometric measurements, and a set of self-report questions on substance use, physical activity level, and other questions were administered. A total of 6.4% of participants presented symptoms compatible with food addiction, and 8.1% were at risk for ED. Additionally, 26.5% reported daily smoking, 70.6% consumed alcohol, 2.9% used illicit drugs, and 29.4% took medication; 35.3% did not engage in physical activity. Individuals with food addiction had higher BMI (p = 0.010), waist circumference (p = 0.001), and body fat (p < 0.001) values, and a higher risk of eating disorders (p = 0.010) compared to those without this condition. In the multivariate logistic model, non-dairy beverage consumption (such as coffee or alcohol), vitamin D deficiency, and waist circumference predicted food addiction symptoms (R²_Nagelkerke = 0.349). Indeed, the machine learning approaches confirmed the influence of these variables. Conclusions: The prediction models allowed an accurate prediction of FA in the university students; moreover, the individualized approach improved the identification of people with FA, involving complex dimensions of eating behavior, body composition, and potential nutritional deficits not previously studied. Full article

Background/Objectives: Body Mass Index (BMI) is a widely used indicator of children’s nutritional status and helps identify risks of being underweight and overweight during development. Understanding how BMI classifications evolve over time is crucial for early intervention and public health planning. This study aimed to determine the scope and direction of changes in BMI classification among children between the ages of 6 and 10. Methods: This longitudinal study included 1026 children (497 boys and 529 girls) from Gdansk, Poland. Standardized anthropometric measurements were collected at ages 6 and 10. BMI was calculated and classified using international reference systems (IOTF and OLAF). BMI classification changes were analyzed using rank transformations and Pearson correlation coefficients (p < 0.05) to explore relationships between body measurements. Results: Most children (76.51%) retained their BMI classifications over the four-year period. However, 23.49% experienced changes, with boys more often moving to a higher BMI category (15.29%) and girls more frequently shifting to a lower category (14.03%). The prevalence of children classified as living with obesity declined between ages 6 and 10, while both overweight and underweight classifications slightly increased. Strong correlations were observed between somatic features and BMI at both ages. Conclusions: The stability of BMI classification over time underscores the importance of early identification and sustained monitoring of nutritional status. The sex-specific patterns observed highlight the importance of targeted health promotion strategies. In this context, incorporating dietary interventions—such as promoting balanced meals and reducing unhealthy food intake—could play a significant role in maintaining healthy BMI trajectories and preventing both obesity and undernutrition during childhood. Full article

Maintaining body symmetry in sports characterized by high lateralization is crucial for optimizing long-term athletic performance and mitigating injury risk. This study aimed to evaluate the extent of morphological asymmetry in anthropometric features among elite professional fencers. Additionally, the presence of functional asymmetry and its associations with morphological asymmetry were assessed. Thirty-two Polish adult female fencers, aged 18–33 yrs, were examined. Data collection involved a questionnaire survey, anthropometric measurements, calculation of anthropological indices, and assessment of functional asymmetry. For the 24 bilateral anthropometric features, small differences were found in seven characteristics: foot length, subscapular skinfold thickness, upper arm circumference, minimum and maximum forearm circumference, upper limb length, and arm circumference in tension. Morphological asymmetry index did not exceed 5%. Left-sided lateralization of either the upper or lower limbs was associated with significantly high asymmetry, specifically indicating larger minimum forearm circumferences in the right limb. Continuous, individualized monitoring of morphological asymmetry and its direction in athletes is essential, demanding concurrent consideration of functional lateralization. This ongoing assessment establishes a critical baseline for evaluating training adaptations, reducing injury susceptibility, and optimizing rehabilitation strategies. Deeper investigation of symmetry within non-dominant limbs is warranted to enhance our understanding. Full article

Background: Obesity is a major public health issue in developed countries, primarily managed through dietary interventions and physical activity. Food portion sizes influence the estimation of energy intake, particularly through bites, of which characteristics remain insufficiently defined. This study investigates the variability in bite energy content. Methods: This observational study was conducted over 14 months. Thirteen types of packaged food were provided to 30 Italian healthy volunteers (mean age 26.8 ± 8.5 years) in a semi-naturalistic dietary feeding setting. Participants’ anthropometric measurements were recorded. A total of 1850 bites were weighed and 420 bites were assessed for volume and energy content. Results: Bite volume and mass explained bite energy content at different rates. The most influential anthropometric feature was waist circumference. Gender modified the association between waist circumference and bite characteristics; males showed increased bite volume, mass, and energy content as waist circumference increased, whereas females showed little or no association. Age was inversely associated with bite volume and mass, with younger participants having larger bites. Gender significantly influenced average bite size, with females showing lower values than males. The use of a fork was associated with higher bite volume, mass, and energy compared to a spoon. Food eaten with bare hands had lower mass but higher energy content compared to food eaten with a spoon. The variability in bite energy was considerably greater per bite than per gram, reflecting the combined influence of food texture, bite size, and cutlery used. Conclusions: Bite energy variability, influenced by intrinsic factors (gender, age, waist circumference) and extrinsic factors (cutlery, food texture), significantly impacts portion size effect. Future bite counters should consider these elements for accurate dietary assessment. Full article

Background: Urethral stricture disease involves fibrotic scarring that narrows the urethral lumen and can occur at any site. Sonourethrography (SUG) is increasingly used because it depicts both luminal anatomy and periurethral fibrosis, yet little is known about patient or lesion features that influence its diagnostic performance. Methods: We conducted a prospective single-center study of 170 men who underwent SUG before anterior urethroplasty between May 2016 and May 2021. Anthropometric data, comorbidities, and detailed ultrasonographic measurements were recorded and compared with intra-operative findings, which served as the reference standard. Accuracy was analyzed with Wald chi-square testing and Spearman correlation. Results: SUG length estimates matched intra-operative measurements in 139/170 strictures (81.8%). Length accuracy was higher in patients ≥ 60 years (89.2% vs. 77.0%, p = 0.03) and in those with type 2 diabetes (92.3% vs. 80.9%, p = 0.02) in conditions associated with pronounced spongiofibrosis that enhances echo contrast. Among stricture-specific factors, proximal location (63.6% vs. 84.5%, p = 0.01) and complete luminal occlusion (68.8% vs. 84.8%, p = 0.02) reduced precision, largely because deeper anatomy and absent saline flow hinder acoustic delineation. The Chiou ultrasonographic grade was the strongest determinant of performance; higher grades yielded clearer margins and better length estimation (p < 0.001). Conclusions: SUG is a reliable bedside technique for assessing anterior urethral strictures, but its accuracy varies with age, diabetes status, stricture site, degree of occlusion, and fibrosis grade. Recognizing these determinants allows clinicians to judge when SUG alone is sufficient and when complementary imaging or heightened caution is warranted. The findings support tailored imaging protocols and underscore the need for multi-center studies that include operators with diverse experience to confirm generalisability. Full article

Background/Objectives: Children with congenital adrenal hyperplasia (CAH) face significant risks of impaired growth and metabolic disturbances despite standard glucocorticoid therapy. This cross-sectional study aimed to evaluate growth outcomes, nutritional status, and associated factors among children with CAH treated in a Vietnamese tertiary pediatric center. Methods: We assessed 201 children aged 1.1–16.5 years in a tertiary pediatric center in Vietnam for anthropometric parameters, biochemical markers (calcium, phosphate, 25-hydroxyvitamin D), and clinical features. Growth status was evaluated using WHO standards, and bone age was assessed radiographically. Statistical analyses explored associations between growth outcomes and clinical, biochemical, and treatment-related factors. Results: Stunting was present in 16.4% of children, while 53.3% were overweight or obese. Bone age advancement occurred in 51.7% of cases. Vitamin D insufficiency or deficiency was detected in 85.6% of patients, and hypocalcemia was present in 85.1%. Overweight/obesity, vitamin D deficiency, and bone age advancement were associated with older age, prolonged corticosteroid therapy, higher androgen levels, and clinical features of treatment imbalance (e.g., Cushingoid appearance, hyperpigmentation). Female sex was significantly associated with higher rates of stunting. Conclusions: Growth impairment, nutritional deficiencies, and skeletal maturation disturbances are prevalent among children with CAH in Vietnam. Early identification of risk factors and the implementation of tailored management strategies that address both endocrine and nutritional health are crucial for optimizing long-term outcomes. Full article