Search Results (375)

Background: Dry Eye Disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability and inflammation. Cyclosporine A, an immunomodulator, and Diquafosol sodium, a mucin secretagogue, represent two distinct therapeutic pathways. However, current evidence directly comparing their clinical efficacy is inconsistent. This meta-analysis aimed to compare treatment outcomes and efficacy between 0.05% Cyclosporine A and 3% Diquafosol sodium in patients with moderate-to-severe DED. Methods: In January 2026, we conducted a systematic search of PubMed, Scopus, Web of Science, and the Cochrane Library for randomized controlled trials directly comparing 0.05% Cyclosporine A to 3% Diquafosol sodium in adult patients with moderate-to-severe DED. For the meta-analysis, we used R 4.5.0 with R Studio 2024.12.1+563. Results: We included six RCTs with a total of 859 patients. No significant differences were found between Cyclosporine A and Diquafosol sodium in Tear Break-Up Time (TBUT) at 4, 8, or 12 weeks. Cyclosporine A showed a suggestive greater improvement in Schirmer test scores at 4 weeks (SMD = 0.35, 95% CI 0.07 to 0.63). A modest benefit in symptom scores favoring Diquafosol sodium was observed at 12 weeks (SMD = 0.23, 95% CI 0.06 to 0.41). Subgroup analysis suggested this symptomatic benefit may be more pronounced in patients with severe disease, although subgroup interaction tests were not statistically significant. There were no significant differences in corneal or conjunctival staining at any time point. The risk of adverse events did not differ significantly between treatments. Conclusions: Early improvement in tear production showed a potential benefit for Cyclosporine A, while longer-term symptomatic relief showed a potential benefit for Diquafosol sodium, with suggestive evidence in severe disease. However, these findings should be interpreted cautiously, given the methodological limitations and inconclusive TSA evidence for several outcomes. Future large-scale, standardized trials with extended follow-up are warranted to confirm these findings. Full article

The Jabal Ali Marine Sanctuary, Dubai, is one of the most important marine protected areas (MPAs) in the UAE. The Arabian Gulf is characterised by extreme environmental conditions, including high temperatures and hypersaline waters. These conditions, combined with increasing anthropogenic pressures from coastal development projects such as desalination plants, energy plants and the Palm Jebel Ali development, may influence the pelagic ecosystems of MPAs. This study examined seasonal variability in phytoplankton communities and environmental conditions between summer (June 2017) and winter (December 2017), with particular emphasis on the interactions between temperature-driven stratification, hypersaline conditions, and phytoplankton community structure, abundance, and diversity. The AZTI (AZTI Tecnalia Marine Research Centre) Marine Biotic Index indicated predominantly “Good” to “High” ecological status of the pelagic ecosystem, indicating favourable environmental conditions. Potentially harmful algal bloom taxa, including Pseudo-nitzschia and Dinophysis, were detected at low abundances. Summer surveys recorded higher total species richness (44 vs. 34 species) and greater phytoplankton abundance (mean 68.6 vs. 49.8 cells/L) compared to those in winter. Diatoms dominated the assemblages in both seasons, accounting for 62–69% of the recorded species, while distinct spatial zonation patterns reflected habitat heterogeneity. The observed seasonal and spatial variability highlight the importance of incorporating temporal and spatial dimensions into management strategies. As the first pelagic phytoplankton assessment conducted in an MPA, this study provides important baseline data for understanding phytoplankton ecology in one of the world’s most environmentally extreme marine ecosystems. The findings contribute to evidence-based management under increasing climate change and anthropogenic pressures. However, because sampling was limited to the two principal climatic seasons, the study characterises inter-seasonal variability rather than a complete annual succession cycle. Additional surveys during spring and autumn are recommended to fully resolve seasonal succession dynamics. Overall, the findings support the continued protection of the sanctuary as an important biodiversity reservoir and a potential reference site for assessing marine ecosystem responses to environmental conditions. These findings are directly relevant to the environmental sustainability agenda of the Dubai 2040 Urban Master Plan, which prioritises the protection and expansion of the emirate’s nature reserves and the safeguarding of marine and coastal biodiversity. By establishing the first pelagic phytoplankton baseline for the sanctuary, this study provides an evidence base for monitoring and managing marine protected areas in line with this long-term framework. Full article

This study presents an integrated computational framework for quantifying industrial impacts on marine ecosystems through the combined assessment of multiple environmental quality indices. The Aquatic Water Quality Index (AWQI) and four diagnostic pollution indices, namely the Heavy Metal Pollution Index (HPI), Metal Index (MI), Degree of Contamination (C_d), and Pollution Index (PI), were applied across 23 offshore sites in Mesaieed Industrial City, Qatar, to establish a high-resolution baseline for evaluating the effects of industrial effluents and brine discharge. Multivariate statistical analyses, including Principal Component Analysis (PCA) and Cluster Analysis (CA), identified Cr, Pb, Mn, Ni, and Zn as the principal drivers of water quality variability, effectively distinguishing anthropogenic influences from natural background conditions. To enable rapid and automated marine environmental assessment, three machine learning models—Artificial Neural Networks (ANN), Random Forest (RF), and Decision Trees (DT)—were developed and evaluated for predicting the investigated indices. Model performance was assessed through rigorous training–testing validation and the Diebold–Mariano test. The results demonstrated that model selection significantly influences predictive accuracy. Among the evaluated algorithms, RF achieved the highest predictive performance for AWQI (R² = 0.88) and C_d (R² = 0.92), whereas ANN performed best for HPI (R² = 0.89), and DT yielded the most accurate predictions for MI (R² = 0.82). Despite the index-specific strengths of individual models, RF emerged as the most robust and generalizable approach, consistently providing superior performance across heterogeneous environmental datasets. The proposed framework advances marine water quality assessment from conventional descriptive monitoring toward a proactive, data-driven paradigm, offering a scalable and cost-effective decision support tool for environmental management, pollution mitigation, and evidence-based coastal governance in industrialized coastal regions. Full article

Seagrass meadows support critical coastal ecosystems, but corresponding species-level remote sensing data remain limited, particularly in the Arabian Gulf, where field spectral data for dominant taxa are extremely limited. We present the first multi-species spectral characterisation of three dominant seagrass species in the Kingdom of Bahrain—Halophila stipulacea (n = 46 spectra, 25 stations), Halodule uninervis (n = 34, 19 stations), and Halophila ovalis (n = 17, 8 stations)—measured with an ASD FieldSpec^® 4 Hi-Res spectroradiometer (Malvern Panalytical, Malvern, UK; 350–2500 nm) from samples collected across 29 geographic stations (52 species–station sampling units). All sample counts reported here underwent quality control. Kruskal–Wallis tests with Benjamini–Hochberg (BH) correction, Jeffries–Matusita (JM) distance, Hedges’ g, and linear discriminant analysis (LDA) were used to characterise inter-species differences. H. ovalis was clearly distinguished from both co-occurring species: the Hd. uninervis–H. ovalis pair showed a discriminating window of 692–1394 nm (mean |g| = 1.31, BH q = 0.000046), and that for the H. stipulacea–H. ovalis pair was 700–1376 nm (mean |g| = 1.21, BH q = 0.000285); the JM distances were 1.60–1.67. A secondary shortwave-infrared discriminating window (1607–1755 nm; mean |g| = 0.90, BH q = 0.006) was also identified for the Hd. uninervis–H. ovalis pair. The H. stipulacea–Hd. uninervis pair showed meaningful geometric separation (JM = 0.994) but no individually significant wavelengths at the available sample size. ASentinel-2-proxy LDA achieved 85.6% overall accuracy (balanced accuracy = 87.3%; macro area under the curve = 0.917), outperforming a Landsat-proxy model by 20 percentage points. For each species, both a best-overall index and a visible-range alternative optimised for submerged satellite remote sensing are reported. The primary indices achieved balanced accuracies of 0.877–0.924; the visible-range alternatives achieved 0.818–0.907. Performance degraded substantially under noise (σ ≥ 0.002: −7.5 percentage points [pp]) and wavelength misregistration (±2–3 nm shifts caused losses of 5.5–15.7 pp), calling for stringent calibration requirements. These results constitute the first multi-species spectral library for Kingdom of Bahrain seagrasses, supporting Sentinel-2-based species mapping in the Arabian Gulf. Full article

In the Arabian Gulf region, saltwater desalination is considered to be a significant process in producing clean water. This paper presents a sustainable, combined process for upgrading a Doha reverse osmosis (RO) plant in Kuwait. A pilot-scale microbial desalination cell (MDC) stack is proposed as a pre-treatment unit prior to the RO process in order to improve plant performance. A cost–benefit analysis is conducted for the combined system to emphasize the significance of the MDC–RO process. In RO, the expected energy consumption is 2.6–13 kWh per m³ of desalinated water, whereas using MDC can reduce this to about 0.52–5.3 kWh/m³. Moreover, this new technology using catalytic MDCs can help in improving electric current production and reducing the amount of rejected brine and membrane fouling in the RO process. The electric current is improved by reducing MDCs’ internal resistance using a reduced graphene oxide/polyaniline composite-coated stainless steel mesh cathode electrode. Layer-by-layer electro-deposition can be applied to achieve these coatings. An intermediate zeolite filter is proposed to mitigate RO membrane fouling. The combined system’s natural zeolite-membrane filter improves water purification. In this study, we assessed the combined MDC–RO process for upgrading the Doha plant’s performance in terms of quality, cost, and time. The suggested catalytic MDC, using efficient, low-cost materials as cathode electrodes with an equivalent daily cost of 0.01 USD/m³ and a desalination efficiency of about 40%, acts as an alternative to high-cost platinum metal electrodes. The results also indicate that the equivalent daily cost of energy consumption using the MDC process is about 0.03 USD/m³, whereas the investment cost is about 0.4 USD/m³ daily for one year of cell operation. Full article

Background/Objectives: A third-generation atypical antipsychotic drug, aripiprazole, is known to cross the placental barrier and pose negative consequences on placental growth and the normal development of the fetus. Although a few studies demonstrated these debilitating effects of aripiprazole, its skeletal effects remain unexplored. Therefore, this study was undertaken to evaluate the impact of prenatal aripiprazole exposure, administered at three different dose levels, on the ossification of the appendicular skeleton in 20-day-old rat fetuses. Methods: Forty pregnant Sprague–Dawley rats (n = 40) were assigned to four groups: control and three aripiprazole-treated groups receiving 3 mg/kg (LDA), 6 mg/kg (HDA), and 12 mg/kg (DHDA) daily from gestational days 6–19. Fetuses were delivered on gestation day 20, weighed, and processed for skeletal evaluation using Alizarin Red S staining. Ossification patterns of metacarpals, metatarsals, hip bones, long bones of the forelimb and hindlimbs from a total of 151 fetuses were analyzed and categorized as complete, delayed, or absent. Results: Aripiprazole exposure induced a dose-dependent reduction in the number of completely ossified skeletal bony centers (p < 0.01) with a highly significant reduction in the length of ossified portions of the long bones (p < 0.001). Histomorphometric analysis of Von Kossa-stained fetal femur sections revealed a significant decrease in the thickness of ossified cortical and trabecular bone with a statistically significant reduction in the length of hypertrophied chondrocytes of the growth plate cartilage in the aripiprazole-treated groups (p < 0.05). Conclusions: Prenatal exposure to aripiprazole leads to dose-dependent skeletal growth restriction and delayed ossification of the appendicular skeleton in rat fetuses. Future investigations should focus on the molecular mechanisms and consequences related to the prenatal impact of aripiprazole. Full article

The gut microbiota (GM) has become a key mediator of host health, with dietary manipulations promising ways of modulating the microbiome. This review focuses on the role of dairy bioactive (DB) compounds as precision modulators of intestinal microecology, including the whey proteins (WPs), including lactoferrin (LF), α-lactalbumin (LA), β-lactoglobulin, lysozyme (LZ), lactoperoxidase, glycomacropeptide (GMP), milk oligosaccharides (MOs), and bioactive peptides (BPs). This review compiles the existing evidence illustrating their dual-action mechanism through direct prebiotic activity and the promotion of beneficial taxa (Bifidobacterium, Lactobacillus, Faecalibacterium), along with selective antimicrobial activity and pathogen suppression. These compounds improve intestinal barrier integrity through tight junction (TJ) protein regulation, regulating short-chain fatty acid production, and modulating immune signaling pathways. Clinical evidence shows significant benefits in metabolism and inflammation among various populations. However, individual responses vary according to host factors such as enterotypes, FUT2 genotype, and baseline microbiota composition, suggesting the need for personalized intervention strategies. This review addresses critical knowledge gaps in dose–response relationships, long-term efficacy, and mechanistic pathways and suggests future directions for precision nutrition. By modifying molecular mechanisms in clinical applications, we have identified DB compounds as promising candidates for targeted modulation of the microbiota to optimize health and disease management. The review also brings together molecular mechanistic and clinically implementable, personalized dietary strategies, which have not been fully captured by previous reviews. It pinpoints gaps in knowledge related to dose–response characterization, long-term trial design, and multi-omics stratification that collectively define a new precision nutrition framework. In this approach, dairy-based intervention is planned for each person based on their microbial, genetic, and metabolic characteristics. Full article

The Shatt al-Basrah Canal, a brackish artificial waterway in southern Iraq, experienced a fish mortality event in August 2021, raising serious environmental and socioeconomic concerns. This study documents field observations, photographic evidence, and in situ water-quality measurements collected during the event to characterize environmental conditions associated with the mortality and situate them within the context of long-term ecosystem degradation in the region. The event coincided with critically low dissolved oxygen concentrations (1–2.5 mg L⁻¹), elevated summer water temperatures (31.2–31.6 °C), high total ammonia nitrogen levels (1.88–2.2 mg L⁻¹), and brackish salinity (17.4–23 ppt), reflecting strong anthropogenic influence and limited hydrological flushing. These stressors occurred in areas receiving untreated wastewater inputs and affected both native and non-native fish species tolerant of estuarine conditions. Comparison with documented fish-kill events from Kuwait Bay and other parts of the northern Arabian Gulf indicates similar environmental settings characterized by hypoxia, organic enrichment, and summer thermal stress. The 2021 mortality event suggests how acute ecological deterioration may arise in chronically degraded brackish systems and underscores the need for continuous water-quality monitoring, improved wastewater treatment, and proactive management to reduce the risk of recurrent fish kills in Iraq’s vulnerable aquatic ecosystems. Full article

Aim: This study assessed the effects of a six-week educational intervention using an adapted “Snakes and Ladders” board game on hydration knowledge, behavior, and status among Tunisian elementary school children during physical education (PE) lessons. Method: A randomized controlled trial involving 207 children was conducted, with participants assigned to either the educational group (EG, n = 99) or the control group (CG, n = 108). The EG participated in six weekly 30-min board game sessions, while the CG continued regular activities. Knowledge of hydration was assessed using a validated questionnaire. Hydration status was monitored indirectly by the percentage change in body mass from pre- to post-PE session. Perceived thirst was evaluated using a 9-point scale, and hydration behavior was evaluated based on water consumption during PE lessons. Results: Following the intervention, the EG demonstrated a significant improvement in overall hydration knowledge (ΔMean = +0.30 ± 0.11 vs. −0.05 ± 0.08 in CG; p < 0.001). Water intake during PE sessions increased progressively from week 2 (83.6 ± 127.2 mL) to week 6 (311.2 ± 204 mL) in the EG, whereas it remained unchanged in the CG (p < 0.001). Body mass loss after PE sessions decreased significantly in the EG (−0.03 kg) compared with the CG (−0.16 kg; p < 0.001), and perceived thirst before and after PE sessions was markedly lower (Cohen’s d = 0.75–1.32). Conclusions. The six-week board-game intervention appeared effective in increasing hydration knowledge, promoting healthier drinking behaviors during PE, and improving indirect indicators of hydration status. These findings provide preliminary evidence for the feasibility and educational value of a gamified, low-cost approach to hydration promotion in schools. Further research should examine long-term retention, include objective hydration biomarkers, and evaluate applicability across diverse school settings and environmental conditions. Full article

Background: Acinetobacter baumannii (A. baumannii) is a critical-priority pathogen of major concern in healthcare settings. Colistin remains a last-resort antibiotic for multidrug-resistant (MDR) A. baumannii infections; however, resistance is increasingly reported worldwide yet remains understudied in Bahrain. Reliable detection methods and understanding clonal dissemination are essential for infection control. Objectives: This study aimed to (1) determine the rate of colistin resistance in 102 clinical A. baumannii isolates from Bahrain, (2) evaluate the diagnostic performance of the colistin agar test (CAT) and E-test against broth microdilution (BMD method), and (3) assess clonal relationships using BOX-PCR fingerprinting. Methods: 102 clinical isolates from multiple hospitals in Bahrain underwent susceptibility testing via the BMD method, CAT, and E-test; screening for mcr-1 to mcr-5 genes; and BOX-PCR DNA fingerprinting. Results: Colistin resistance was detected in 14.7% of isolates by BMD method, higher than regional and global averages. All resistant isolates were mcr-negative, suggesting chromosomally mediated resistance. CAT showed 86.7% sensitivity, 98.8% specificity, and a 13.3% very major error rate. The E-test failed to detect resistant isolates (very major error 100%). BOX-PCR revealed predominant clonal relatedness with intra- and inter-hospital spread. Conclusions: Colistin resistance in A. baumannii from Bahrain exceeds regional and global levels, likely driven by chromosomal mechanisms under selective pressure. The BMD method remains the gold standard for colistin testing, while CAT may serve as a screening tool requiring confirmation. Strengthened stewardship and infection control measures are vital to contain dissemination. Full article

The peach fruit fly, Bactrocera zonata (Saunders) (Diptera: Tephritidae), is a climate-sensitive agricultural invader that threatens fruit production across the Arabian Peninsula, yet its realized climatic niche and future exposure under warming remain insufficiently resolved. We used Maximum Entropy (MaxEnt) modeling to quantify current and projected habitat suitability across the region (~3.2 million km²) under two Shared Socioeconomic Pathway scenarios (SSP1-2.6 and SSP5-8.5) for the 2050s and 2070s, based on 55 spatially filtered occurrence records and seven non-collinear environmental predictors, with sampling bias controlled using a Gaussian kernel density bias file. Model performance was robust, with mean training AUC of 0.922 ± 0.011 (SD) and mean TSS of 0.538 ± 0.115 (SD; range: 0.368–0.692), indicating moderate variability across replicates. Suitability was governed primarily by elevation, mean temperature of the driest quarter (Bio 9), mean diurnal temperature range (Bio 2), and precipitation of the coldest quarter (Bio 19), which together contributed over 97% of the model output, indicating strong climatic and topographic control on range persistence. Under present conditions, 790,714 km², or 28.38% of the study area, was suitable, concentrated in the southwestern highlands of Saudi Arabia and Yemen, the Omani mountain ranges, and coastal fringes of the Arabian Gulf and Gulf of Oman. Future projections showed a consistent net contraction of suitable habitat across all scenarios, from 7.4% under SSP1-2.6 in the 2050s to 28.0% under SSP5-8.5 in the 2070s. In all cases, contraction exceeded expansion, although the eastern Omani highlands remained a potential climatic refugium. These patterns indicate that warming is likely to reorganize rather than uniformly expand suitability, providing a spatial basis for climate-informed biosecurity, surveillance, and regional pest management. Full article

This study provides the first comprehensive assessment of microplastic (MP) contamination within oyster bed ecosystems of the Kingdom of Bahrain. Sediment, water, and oyster samples were collected from six sites representing diverse environmental conditions. Raman spectroscopy identified the presence of 12 distinct polymer types, with polypropylene (PP), polyurethane (PU), poly(ethylene terephthalate)/diamine/multi-walled carbon nanotube (PET/diamine/MWCNT), and fluorinated ethylene propylene (FEP) being the most prevalent. MPs occurred predominantly as fragments, films, and pellets, with black being the most common color across all matrices. MP abundances ranged from 750 to 1850 MPs/kg dry weight in sediments, 2100–9600 MPs/L in water, and 1.78–5.25 MPs/individual in oysters, with particles (<50 µm) most frequent in oyster tissues. Although spatial variation was evident across regions, detected polymers included types associated with known ecotoxicological risks. No significant correlation was observed between sediment grain size and MP abundance, suggesting that additional hydrodynamic or anthropogenic factors may influence MP distribution. Overall, this study provides critical baseline data on MP contamination in Bahrain’s marine environments and highlights the need for continued monitoring to assess potential risks to marine ecosystems and seafood safety. It also contributes to the limited understanding of MPs in the Arabian Gulf, informing future monitoring, conservation and policy initiatives that support long-term environmental sustainability. Full article

Reliable species-level information on elasmobranchs (sharks, rays, and skates) in the Arabian Gulf remains limited, despite these fish being among the most threatened marine vertebrates. Taxonomic uncertainty, driven by morphological similarities and incomplete reference datasets, continues to hinder accurate biodiversity assessments in the region. In this study, NADH dehydrogenase subunit 2 (NADH2) gene sequences were analyzed to assess the taxonomic status of elasmobranchs in United Arab Emirates waters, based on 182 specimens representing 31 species (15 sharks and 16 batoids) across 12 families. Shark lineages were consistently recovered and matched closely with published references, indicating a stable taxonomy. Batoids (rays), however, showed greater complexity, including misidentification among morphologically similar taxa, gaps in available reference sequences, and signs of possible cryptic diversity, reflecting persistent challenges in species identification and the need for more comprehensive molecular resources. Our findings highlight the value of genetic approaches in improving taxonomic resolution and establishing robust biodiversity baselines. Expanding reference databases, applying multi-locus genomic approaches, and broadening regional sampling will be essential to refining taxonomic frameworks and informing conservation management for elasmobranchs in the Arabian Gulf. Full article

Background: Cutaneous warts, caused by HPV, are common, and conventional destructive treatments often fail to prevent recurrence. Intralesional immunotherapy offers a promising alternative. Specifically, purified protein derivative (PPD) and vitamin D have demonstrated efficacy; however, a direct comparison of their therapeutic value and safety profiles is needed. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to compare the efficacy and safety of intralesional PPD versus intralesional Vitamin D for cutaneous warts. Methods: A comprehensive search of PubMed, Scopus, CENTRAL, and Google Scholar was conducted for RCTs up to November 2025. Primary outcomes were the complete and partial clinical response rates of warts. Secondary outcomes included recurrence and adverse events. Risk ratios (RRs) with 95% confidence intervals (CIs) and p-values were pooled using STATA 19.5. Results: Seven RCTs involving 520 patients were included. The analysis found no significant difference in the rate of complete clinical response (RR: 1.07, 95% CI [0.95, 1.21]; p = 0.24) or partial clinical response (RR: 0.90, 95% CI [0.56, 1.46]; p = 0.68) between the two groups. Also, the two groups showed no significant difference in recurrence rate (RR: 1.14, 95% CI [0.48, 2.68]; p = 0.77). Regarding safety, PPD was associated with a significantly higher risk of injection site erythema (RR: 4.76, 95% CI [2.08, 10.93]; p < 0.001) and flu-like symptoms/fever (RR: 8.28, 95% CI [1.59, 43.18]; p = 0.01). Still, no significant differences were found for injection site pain (p = 0.12) or swelling (p = 0.68). Conclusions: With uncertain evidence, intralesional PPD and vitamin D demonstrate comparable overall efficacy in clearing cutaneous warts. However, PPD carries a higher risk of systemic adverse events (fever) and injection site erythema, with a more effective potential to clear distant warts. The choice between the two agents should be based on the clinical profile and patient preference. Full article

Background/Objectives: Physical activity and sedentary behaviour represent related yet distinct movement behaviours with potentially different behavioural, psychosocial, and lifestyle correlates. However, multinational evidence examining these behaviours within the Mediterranean lifestyle framework remains limited. This study investigated correlates of physical activity and sedentary behaviour among adults from Mediterranean and neighbouring countries participating in the MEDIET4ALL survey. Methods: Data were collected from 4010 adults (37.2 ± 15.4 years; 59.5% female) across 10 Mediterranean and neighbouring countries using a standardized multilingual e-survey. Physical activity was assessed using the short International Physical Activity Questionnaire (IPAQ-SF; MET-min/week), and sedentary behaviour was assessed by daily sitting time. Hierarchical multiple linear regression analyses were conducted separately for physical activity and sedentary behaviour. Exploratory bootstrapped mediation analyses examined whether life satisfaction (SLSQ) or social participation (SSPQ) mediated associations between MEDLIFE dietary dimensions and sitting time. Results: Higher physical activity was associated with more rural living environments, lower body mass index, more favourable smoking status, higher alcohol consumption, stronger adherence to Mediterranean dietary habits, longer sleep latency, higher stress, and greater social participation (β ≈ 0.05–0.11), whereas female sex, longer sleep duration, and higher anxiety were associated with lower physical activity (β = −0.04 to −0.23); the positive association with alcohol consumption should be interpreted cautiously in light of potential residual confounding. By contrast, sedentary behaviour was positively associated with higher education, higher body mass index, and more favourable smoking-status (β ≈ 0.04–0.09) and inversely associated with better self-reported health status, Mediterranean dietary consumption patterns, life satisfaction, and social participation (β = −0.04 to −0.07). Mediation analyses showed significant but small-magnitude indirect effects for the pathways linking MEDLIFE dietary consumption patterns and MEDLIFE dietary habits with sitting time through social participation (indirect β = −0.0032 and −0.0045, respectively), which should be interpreted with caution, whereas no significant indirect effects were observed through life satisfaction. Conclusions: Physical activity and sedentary behaviour are associated with different, though partially overlapping, lifestyle and psychosocial correlates within the MEDIET4ALL framework. Social participation may represent a modest behavioural pathway linking Mediterranean dietary dimensions with lower sitting time. Given the cross-sectional design, these findings should be interpreted as associative rather than causal, but they nonetheless reinforce the importance of integrated and context-sensitive lifestyle promotion strategies. Full article