Search Results (4,059)

Background: Cardiovascular-Kidney-Metabolic (CKM) syndrome involves interconnected cardiovascular, renal, and metabolic conditions. The dose–response relationship between physical activity and bidirectional CKM stage transitions remains unclear. Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS), cross-sectional analysis pooled 14,310 observations from 10,868 participants. Logistic regression with clustered robust standard errors accounted for intra-individual correlation. Longitudinal analysis (n = 3442) employed continuous-time multi-state Markov models with a 5-state structure (Stages 0–4). To evaluate physical activity effects, stages were regrouped into low-risk (Stages 0–2) and high-risk states (Stages 3–4) using a 2 × 2 transition intensity matrix. Physical activity was measured in MET-min/week and categorized into quartiles (Q1–Q4). Results: Compared with Q1, Q2, Q3, and Q4 were associated with 43.1%, 52.5%, and 53.1% lower risk of high-risk CKM stages, respectively. RCS analysis demonstrated nonlinear dose–response relationships between physical activity and CKM stage progression. Subgroup analyses showed more pronounced protective effects in older adults and single individuals. During 4-year follow-up, 31.6% experienced progression and 6.8% showed improvement. Stage 4 acted as a complete absorbing state without any reversal. Transition intensity analysis revealed that transitions between adjacent stages were notably higher than cross-stage transitions. The Q4 physical activity level significantly reduced transitions from low-risk to high-risk states (HR = 0.598, 95% CI: 0.459–0.777) and promoted transitions from high-risk to low-risk states (HR = 2.995, 95% CI: 1.257–7.134). Conclusions: Moderate-to-high physical activity effectively reduces CKM progression risk and promotes improvement, providing evidence for CKM prevention and management. Full article

Lignans are naturally occurring compounds found in a wide variety of plant species, including flaxseed, soybean, pumpkin seed, broccoli, sesame seed, and some berries. Lignans have been used for centuries in both food and traditional herbal medicine. Recently, numerous new lignans and lignan derivatives with diverse biological properties have been identified. Lignans are considered promising for human health due to their hydrogen-donating antioxidant activity together with their ability to complex divalent transition metal cations. They have demonstrated beneficial effects for cardiovascular disease, as well as in maintaining blood glucose levels, supporting cardiac health, promoting anti-obesity effects, decreasing the risk of renal diseases, enhancing brain function, improving skin and gut health, among others. This review explores the biosynthesis and biological effects of lignans, with a particular focus on their antihypertensive and anti-obesity properties, as well as the molecular mechanisms involved. It also highlights recent advances in sustainable lignan extraction techniques that are suitable for human use. The mechanisms underlying these bioactivities are thought to involve hormonal metabolism and availability, antioxidant action, modulation of angiogenesis, and more. However, further research is needed to fully elucidate the molecular pathways through which lignans exert their therapeutic effects. Overall, lignans from various plant sources hold significant potential for application in functional foods, dietary supplements, and pharmaceutical products aimed at preventing and managing a range of health conditions, including hypertension and obesity. Full article

The 2S LGBTQIA+ (Two-Spirit, Lesbian, Gay, Bisexual, Trans, Queer and/or Questioning, Intersex, Asexual, and additional sexually and gender-diverse self-identities) population often faces barriers to care in the context of cervical cancer screening. With the shift from primary cervical cytology (Papanicolaou test) to primary human papillomavirus (HPV)-DNA testing, it is crucial to examine these populations’ healthcare needs. An intersectionality framework with an anti-oppressive lens is needed to restructure a healthcare system whose systems have traditionally erased the care needs of diverse populations through colonial, racialized, and cis-heteronormative practices. Barriers to cervical screening in 2S LGBTQIA+ populations include stigma, discrimination, limited provider guidance and understanding, and high rates of physical, sexual, and medical trauma. Self-sampling for HPV is a less invasive alternative to traditional Pap tests with a high rate of acceptability. The option to self-sample may increase participation in cervical screening based on improved privacy, comfort, and feelings of empowerment. Organizational, psychosocial, and physical recommendations for practice are shared to create a welcoming environment that reflects the diversity of populations in all aspects of healthcare. Affirmative care aims to make clients feel safe and accommodated by prioritizing dignity and respect as essential elements of eliminating cervical cancer in 2S LGBTQIA+ populations. Full article

Non-communicable diseases (NCDs) such as Diabetes Mellitus (DM) and Sickle Cell Disease (SCD) pose an escalating health challenge in Africa, underscored by diagnostic deficiencies, inadequate surveillance, and limited health system capacity that contribute to late diagnoses and consequent preventable complications. This review adopts a comparative framework that considers DM and SCD as complementary indicator diseases, both metabolic and genetic, and highlights intersecting diagnostic, infrastructural, and governance hurdles relevant to AI-enabled screening in resource-constrained environments. The study synthesizes epidemiological data across both African and high-income regions and methodically catalogs machine learning (ML) and deep learning (DL) research by clinical application, including risk prediction, image-based diagnostics, remote patient monitoring, privacy-preserving learning, and governance frameworks. Our key observations reveal significant disparities in disease detection and health outcomes, driven by underdiagnosis, a lack of comprehensive newborn screening for SCD, and fragmented diabetes surveillance systems in Africa, despite the availability of effective diagnostic technologies in other regions. The reviewed literature on ML/DL shows high algorithmic accuracy, particularly in diabetic retinopathy screening and emerging applications in SCD microscopy. However, most studies are constrained by small, single-site datasets that lack robust external validation and do not align well with real-world clinical workflows. The review identifies persistent implementation challenges, including data scarcity, device variability, limited connectivity, and inadequate calibration and subgroup analysis. By integrating epidemiological insights into AI diagnostic capabilities and health system realities, this work extends beyond earlier surveys to offer a comprehensive, Africa-centric, implementation-focused synthesis. It proposes actionable operational and policy recommendations, including offline-first deployment strategies, federated learning approaches for low-bandwidth scenarios, integration with primary care and newborn screening initiatives, and enhanced governance structures, to promote equitable and scalable AI-enhanced diagnostics for NCDs. Full article

The global rise in nursing home (NH) populations presents substantial challenges, as residents frequently experience physical and cognitive decline, low physical activity, and high fall risk. This study evaluates the effectiveness of the BeSt Age App, a tablet-based, staff-supported mHealth intervention designed to promote physical activity and prevent falls among NH residents. Primary outcomes were fall incidence and fall risk (assessed using Berg Balance Scale [BBS] and Timed Up and Go [TUG]); fear of falling was a secondary outcome. In a cluster-randomized controlled trial across 19 German NHs, 229 residents (mean age = 85.4 ± 7.4 years; 74.7% female) were assigned to an intervention group (IG) or control group (CG). The 12-week intervention comprised twice-weekly, tablet-guided exercise sessions implemented by NH staff. Mixed models and generalized estimating equations were used under an intention-to-treat framework. The IG showed significantly greater improvement in BBS scores than the CG (group × time: F(1, 190.81) = 8.25, p = 0.005, d = 0.22), while group × time changes in TUG performance, fear of falling, and fall incidence were nonsignificant. These findings demonstrate the feasibility of a staff-mediated mHealth approach to fall prevention in NH residents, showing significant improvements in BBS scores as one functional indicator of fall risk, while TUG, fall incidence and fear of falling showed no change. Full article

Carrots are exceptional sources of bioactive compounds with potential health benefits. This study investigated the relationship between the biodiversity of carrot cultivars (colour and size) and their potential chemopreventive properties. Four distinct carrot cultivars (orange, white, yellow, and purple) of normal and miniature sizes were comprehensively analysed for polyphenolic composition, bio-accessibility through in vitro simulated digestion, and in vitro antiproliferative activity against the HCT-116 colon cancer cell line. Our findings revealed that vegetable size influenced phytochemical composition more than vegetable colour, with mini purple carrots exhibiting exceptionally high polyphenolic concentrations and superior antiproliferative activity compared to orange, yellow, or white varieties. Notably, the bioaccessibility of bioactive compounds remained remarkably low across all samples, suggesting that these phytochemicals reach the colon in intact form, potentially enabling direct interaction with cancer cells. Interestingly, we found no direct correlation between total phenolic content and antiproliferative activity. In vitro cell cycle analysis revealed that mini purple carrot extracts induced S-phase arrest similar to the chemotherapeutic agent 5-FU, whereas other extracts caused G0/G1-phase arrest. The specific polyphenolic composition appears to be fundamentally important for bioactivity, with chlorogenic acid and diferulic acid-derivative isomer 2 potentially acting synergistically. These findings highlight the importance of carrot biodiversity in delivering functional foods with enhanced health-promoting properties, particularly for colorectal cancer prevention. Full article

Background: Lung adenocarcinoma in non-smoking women represents a distinct clinical entity that cannot be fully explained by traditional exposure-centered carcinogenic models. Although ambient air pollution is a recognized risk factor, sex-specific vulnerability suggests the involvement of additional biological modulators shaping inflammatory, immune, and proliferative responses. Main body: In this conceptual review, we integrate epidemiological, experimental, and mechanistic evidence to propose a multisystem framework of lung carcinogenesis in non-smoking women. We delineate a central carcinogenic spine encompassing lung epithelial injury, chronic inflammation, growth factor signaling activation—particularly epidermal growth factor receptor (EGFR) pathways—and tumor microenvironment remodeling. Within this framework, three interacting domains function as biological modulators that amplify carcinogenic processes: chemosensory–neural–immune modulation, hormonal–endocrine signaling including estrogen–EGFR crosstalk, and psychosocial stress–hypothalamic–pituitary–adrenal (HPA) axis dysregulation. These domains converge through feedback mechanisms that reinforce systemic dysregulation and tumor-promoting microenvironments. Implications: This integrative model provides a biologically grounded perspective on female-specific vulnerability to lung adenocarcinoma and informs precision prevention, risk stratification, and ESG-informed public health strategies beyond conventional exposure reduction. Full article

Background/Objectives: Parental mental health challenges are associated with parenting difficulties and child mental health issues. Parenting interventions can support families; however, parents with mental health challenges face barriers to accessing parenting support, which is not consistently offered within adult mental health settings. Embedding technology-assisted parenting programs into these settings could provide accessible, holistic support. Partners in Parenting Kids (PiP Kids) is a digital parenting program designed to prevent child anxiety and depression, yet its suitability for parents with mental health challenges and fit within mental health services remains unclear. This study aimed to co-design and adapt PiP Kids for future implementation in an Australian adult mental health service. Methods: Parents who recently sought mental health support (n = 8) and service providers (n = 7) participated in co-design workshops to explore needs and preferences for a technology-assisted parenting program and iteratively develop a prototype. Parents (n = 3) trialled the online component of the prototype and participated in qualitative interviews to assess acceptability. Results: The adapted clinician-supported program was designed to facilitate (1) parent and clinician readiness for parenting support; (2) emotional and social support for parents and clinicians; (3) practical, personalised parenting knowledge; (4) parent-led empowerment; and (5) accessible, integrated support. Prototype clinician training was developed to strengthen the clinician-support component. Parents indicated initial acceptability of the online prototype while reiterating the value of including face-to-face support. Conclusions: This study co-designed an online, clinician-supported parenting program for future embedding within adult mental health settings. The findings highlight key considerations for developing and implementing technology-assisted interventions that promote family-focused care for parents seeking mental health support. Full article

The service tree (Sorbus domestica L.) fruits are rich in polyphenols, which exhibit promising therapeutic effects on bone health. This review summarizes the potential benefits of polyphenols identified in Sorbus domestica L. fruits, such as chlorogenic acid (CGA), protocatechuic acid (PCA), rutin, epicatechin, and naringin on bone biology and on bone-related diseases, including osteoporosis and diabetes mellitus. Current evidence suggests that the aforementioned polyphenols may modulate osteoblast and osteoclast activity, enhance mineralization, mitigate oxidative stress and inflammation, thereby supporting overall bone health. Specific studies highlight the anabolic and anti-resorptive effects of CGA, the osteoprotective potential of PCA, and the ability of rutin, epicatechin, and naringin to promote osteogenic differentiation and inhibit osteoclastogenesis. Although the exact mechanisms are still unclear, it is believed that these bioactive metabolites can act through a variety of signalling pathways and epigenetic mechanisms. Despite existing preclinical evidence, there is a significant gap in clinical trials evaluating the direct impact of polyphenols mentioned above on bone health in humans. Therefore, further research is needed to confirm their effectiveness in clinical settings. The therapeutic potential of the most common polyphenols from Sorbus domestica L. fruits has been evaluated by available in vitro and in vivo studies, which highlight their promising potential as dietary interventions to prevent bone loss and improve skeletal integrity in metabolic bone diseases. Based on available information, maximum health benefits may be achieved if mature Sorbus domestica L. fruits are consumed approximately two weeks after harvest or as unripe fruit-based fermented products. Full article

Background/Objectives: Acute sinusitis (AS) is a common infection of the upper respiratory tract that places considerable clinical and economic burden worldwide. Although frequently encountered in practice, the factors that predispose individuals to AS remain poorly understood. This study examined how different respiratory disorders and comorbidities influence the likelihood of developing AS, aiming to clarify its underlying risk profile. Methods: A longitudinal analysis was performed using electronic health records from the Clinical Center of the University of Debrecen Hospital. The study cohort (2007–2022) encompassed 37,164 observations. To evaluate the risk of AS progression, Log-Rank tests and Cox proportional hazards regressions were applied whilst adjusting for covariates. Results: The risk of developing AS was significantly higher among individuals with preceding respiratory conditions. Patients with common cold demonstrated a 2.3-fold increased risk of developing AS (95% CI [1.51–3.40]). Compared to those without such disorders, participants with acute bronchitis had a 2.5-fold higher hazard of AS (95% CI 1.90–3.26). The strongest association was observed for allergic rhinitis (HR = 4.04, 95% CI 3.18–5.13), followed by chronic sinusitis (HR = 3.10, 95% CI 2.13–4.51). Chronic obstructive pulmonary disease was also identified as a significant predictor for AS (HR = 1.62, 95% CI 1.04–2.52), whereas dental pathologies were associated with a modest protective effect (HR = 0.69, 95% CI 0.48–0.97). Conclusions: Patients with allergic rhinitis, chronic sinusitis, acute bronchitis, common cold, or chronic obstructive pulmonary disease have a markedly higher risk of developing AS. Clinicians should actively screen for these conditions when assessing patients with recurrent or severe sinus infections. Early recognition and management of underlying respiratory disorders may reduce AS episodes, promote symptom control, and lessen healthcare burdens. Future research should concentrate on precision medicine to leverage AS preventive and management strategies. Full article

Background/Objectives: Childhood overweight and obesity are influenced by family-level behaviors related to nutrition, physical activity, and daily routines. This study aimed to In contrast to screen time family nutrition and physical activity practices for overweight and obesity among children aged 6–17 years in Türkiye. Methods: A cross-sectional study was conducted with 214 children recruited from a community setting. Sociodemographic data and anthropometric measurements were collected, and family practices were assessed using the Family Nutrition and Physical Activity Scale–Turkish version (FNPA-TR). Binary logistic regression analyses were performed separately for overweight and obesity outcomes. Results: Healthier beverage choices were the only significant predictor of overweight, reducing the odds by 62%. Obesity was predicted by three FNPA domains: family meal frequency, family eating habits, and screen time. Frequent family meals and healthier eating habits were associated with lower obesity risk, whereas higher screen exposure increased the likelihood of obesity. Conclusions: Beverage choices, family meal patterns, eating habits, and screen exposure emerged as key behavioral predictors of unhealthy weight status in children. These findings highlight key family-centered prevention targets for pediatric nursing and public health, including promoting healthy beverage consumption, strengthening structured family eating routines, and reducing screen exposure in children. Full article

The promotion of clean cooking energy use (CCEU) in rural areas is a key part of energy transformation. At present, the understanding of the relationship between environmental regulation and household CCEU remains limited. We primarily focus on the “Air Pollution Prevention and Control Action Plan” (APPCAP), which is regarded as China’s strictest command-and-control environmental regulation. This provides us with a quasi-natural experimental setting in evaluating the impact of environmental regulation on rural households’ CCEU. Empirical results indicate that APPCAP has significantly promoted CCEU among rural households in China. The transmission of this effect occurs primarily through three channels, including non-farm employment, health awareness, and peer effects. A heterogeneity analysis reveals that the impact of APPCAP is more pronounced among vulnerable rural groups with lower education levels and lower income. Furthermore, households with smaller family sizes, heavier dependency burdens, and a male eldest child are more responsive to the APPCAP. Further analysis confirms the sustainability of the policy effects. These findings provide evidence for accelerating the energy transition in developing regions. Full article

Background/Objectives: Given the high prevalence of obesity and abdominal obesity in Indigenous adults from Sonora (IAS) and its strong association with diet, this study evaluates the association of dietary inflammatory index (DII) with obesity and abdominal obesity and its indicators, such as body mass index (BMI) and waist circumference (WC), respectively. Methods: This cross-sectional study included data from 559 adults across two Indigenous populations (Seris and Yaquis) collected in two separate studies. Obesity and abdominal obesity were classified according to the definitions established by the World Health Organization and the International Diabetes Federation. The DII was calculated with data from population-specific food frequency questionnaires. Multiple linear regression was used to assess the association between the DII variable (expressed as both numeric and categorical) and BMI and WC, separately; multiple logistic regression was used to evaluate the association between obesity and abdominal obesity. Results: The prevalence of obesity and abdominal obesity was 34.1% and 78.2%, respectively. There was a positive association between the DII and BMI (DII as numeric: β = 0.53, p = 0.001; tertile3 of DII vs. tertile1: β = 1.86, p = 0.001) and WC (DII as numeric: β = 1.15, p = 0.002; tertile3 of DII vs. tertile1: β = 3.81, p = 0.005). Similar results were found for both types of obesity. Conclusions: Higher DII scores were associated with increased obesity indicators (BMI and WC) and a higher risk of obesity and abdominal obesity in IAS. Promoting anti-inflammatory diets represents a feasible approach for preventing non-communicable diseases. Full article

Chronic stress (CS) contributes to male infertility, reduced testosterone levels, and impaired semen quality. CS models induced by glucocorticoids, such as dexamethasone (DEX), negatively affect sperm parameters and testicular health, notably by promoting testicular apoptosis. While individual plant extracts have been studied for their ability to mitigate stress-induced reproductive dysfunction, the preventive effect of the Tri Garn Pis (TGP) polyherbal extract in DEX-induced CS (DexCS) has not previously been investigated. This study evaluated the effects of TGP extract on testicular function, sexual behavior, and sperm quality in DexCS male mice. Seventy-two ICR mice were randomly divided into six groups: control, DexCS, TGP (50, 100, and 200) + DexCS, and TGP200. Mice received TGP (50, 100, 200 mg/kgBW) for 14 days before DEX co-treatment for 28 days. Behavioral and reproductive assessments included depression-like behavior tests, sexual behavior, sperm quality, testicular histopathology, steroidogenesis proteins (AR, CYP11A1, StAR), and apoptosis markers (Hsp70, caspase-3, caspase-9). TGP extract—which is rich in phenolics and flavonoids with antioxidant activity—improved depressive behavior, sexual performance, testicular histology, and low sperm quality. TGP also upregulated testicular StAR expression while reducing caspase-3 and caspase-9 levels. TGP prevents testicular apoptosis, sexual dysfunction, and poor sperm motility induced by DexCS. Full article

With increasing life expectancy driven by rapid biomedical science advancement, reproductive longevity has become a key concept in women’s health. Preventing reproductive senescence is important not only to extend fertility potential but also to preserve endocrine health, enhance quality of life, and promote healthy aging. The end of ovarian function and fertility is symbolized by menopause, as the most eminent index of reproductive aging. Hormone replacement therapy (HRT) remains the mainstay for managing menopausal symptoms. However, as the use of HRT is often limited, there is a need for safe and effective alternatives. This narrative review summarizes current and emerging approaches targeting different stages of reproductive aging. Both hormonal and non-hormonal therapies for vasomotor and genitourinary symptoms are discussed alongside developing fertility preservation techniques, including oocyte vitrification, ovarian tissue cryopreservation, in vitro follicle maturation, and artificial ovary engineering. Furthermore, evolving and experimental ovarian regenerative strategies, such as stem cell transplantation, intraovarian platelet-rich plasma (PRP) injections, antioxidants, metabolic modulators, telomerase activators, and stem cell-derived extracellular vesicles, offer new prospects for delaying or reversing ovarian aging. Overall, personalized regenerative strategies and innovative solutions may reshape the future of women’s reproductive health and longevity. Full article