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Search Results (3,698)

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18 pages, 640 KiB  
Article
Suicidal Ideation, Lifestyle Factors, and Burnout Syndrome Among Spanish Professionals in Implant Dentistry: A Survey-Based Cross-Sectional Observational Study
by Ángel-Orión Salgado-Peralvo, Naresh Kewalramani, Eugenio Velasco-Ortega, José López-López, Álvaro Jiménez-Guerra, Loreto Monsalve-Guil, Jesús Moreno-Muñoz, José-Luis Rondón-Romero, Iván Ortiz-García and Enrique Núñez-Márquez
J. Clin. Med. 2025, 14(15), 5486; https://doi.org/10.3390/jcm14155486 (registering DOI) - 4 Aug 2025
Abstract
Background: Burnout syndrome (BS) is an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed. Although there are underlying causes associated with personal attributes, it is generally linked to external factors within the work environment. The aim of [...] Read more.
Background: Burnout syndrome (BS) is an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed. Although there are underlying causes associated with personal attributes, it is generally linked to external factors within the work environment. The aim of the present study was to investigate the impact of lifestyle factors on BS and its dimensions, as well as on suicidal ideation among Spanish professionals dedicated to implant dentistry. Methods: A cross-sectional observational study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. An electronic survey based on the Maslach Burnout Inventory—Human Services Survey (MBI–HSS) was distributed to members of the Spanish Society of Implants. The data were analysed using descriptive statistical methods. Results: A total of 305 participants (20.9%) responded to the questionnaire. Notably, 10.8% of the professionals reported experiencing suicidal thoughts, a factor significantly associated with the presence of BS. The lifestyle factors associated with BS included the following: not engaging in aerobic exercise for at least 30 min per day (p < 0.05), not having hobbies that facilitate mental disconnection from work (p < 0.001), not following a balanced diet (p < 0.0001), having an insufficient social life (p < 0.0001), and experiencing suicidal ideation (p < 0.01). Conclusions: The surveyed dentists generally reported having healthy lifestyle habits. Nevertheless, one in ten professionals acknowledged having experienced suicidal ideation at some point, highlighting a concerning association with BS. Full article
(This article belongs to the Special Issue Mood Disorders: Diagnosis, Management and Future Opportunities)
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13 pages, 235 KiB  
Article
Motivations of Sports Volunteers at Mass Endurance Events: A Case Study of Poznan
by Milena Michalska, Mateusz Grajek and Mateusz Rozmiarek
Sports 2025, 13(8), 255; https://doi.org/10.3390/sports13080255 - 1 Aug 2025
Viewed by 150
Abstract
Sport volunteering plays an important role in achieving the goals of sustainable development by supporting the social dimension of sustainability, fostering social integration, and promoting a healthy lifestyle. However, there is a lack of systematic research in Poland on the motivations of sport [...] Read more.
Sport volunteering plays an important role in achieving the goals of sustainable development by supporting the social dimension of sustainability, fostering social integration, and promoting a healthy lifestyle. However, there is a lack of systematic research in Poland on the motivations of sport volunteers, particularly in the context of mass endurance events. This study employed a quantitative, cross-sectional design involving 148 sport volunteers engaged in mass endurance events in Poznan, Poland. To measure motivation, the Polish adaptation of the VMS-ISE scale was used. Data analysis was conducted using one-way analysis of variance (ANOVA). The results showed that volunteer motivations were relatively homogeneous regardless of gender and education level, with the exception of passion for sport, which was significantly stronger among men (p = 0.037). Significant differences were found based on place of residence: residents of medium-sized cities demonstrated the highest motivation for personal development (p < 0.001), whereas individuals from rural areas exhibited stronger patriotism, a greater need for interpersonal interaction, and a higher valuation of external rewards (p < 0.05). The motivations of sport volunteers in Poland are complex and sensitive to environmental factors. Understanding these differences allows for better alignment of recruitment and volunteer management strategies, which can enhance both the effectiveness and sustainability of volunteer engagement. It is recommended to develop volunteer programs that take into account the demographic and socio-cultural characteristics of participants. Full article
34 pages, 434 KiB  
Article
Mobile Banking Adoption: A Multi-Factorial Study on Social Influence, Compatibility, Digital Self-Efficacy, and Perceived Cost Among Generation Z Consumers in the United States
by Santosh Reddy Addula
J. Theor. Appl. Electron. Commer. Res. 2025, 20(3), 192; https://doi.org/10.3390/jtaer20030192 - 1 Aug 2025
Viewed by 198
Abstract
The introduction of mobile banking is essential in today’s financial sector, where technological innovation plays a critical role. To remain competitive in the current market, businesses must analyze client attitudes and perspectives, as these influence long-term demand and overall profitability. While previous studies [...] Read more.
The introduction of mobile banking is essential in today’s financial sector, where technological innovation plays a critical role. To remain competitive in the current market, businesses must analyze client attitudes and perspectives, as these influence long-term demand and overall profitability. While previous studies have explored general adoption behaviors, limited research has examined how individual factors such as social influence, lifestyle compatibility, financial technology self-efficacy, and perceived usage cost affect mobile banking adoption among specific generational cohorts. This study addresses that gap by offering insights into these variables, contributing to the growing literature on mobile banking adoption, and presenting actionable recommendations for financial institutions targeting younger market segments. Using a structured questionnaire survey, data were collected from both users and non-users of mobile banking among the Gen Z population in the United States. The regression model significantly predicts mobile banking adoption, with an intercept of 0.548 (p < 0.001). Among the independent variables, perceived cost of usage has the strongest positive effect on adoption (B=0.857, β=0.722, p < 0.001), suggesting that adoption increases when mobile banking is perceived as more affordable. Social influence also has a significant positive impact (B=0.642, β=0.643, p < 0.001), indicating that peer influence is a central driver of adoption decisions. However, self-efficacy shows a significant negative relationship (B=0.343, β=0.339, p < 0.001), and lifestyle compatibility was found to be statistically insignificant (p=0.615). These findings suggest that reducing perceived costs, through lower fees, data bundling, or clearer communication about affordability, can directly enhance adoption among Gen Z consumers. Furthermore, leveraging peer influence via referral rewards, Partnerships with influencers, and in-app social features can increase user adoption. Since digital self-efficacy presents a barrier for some, banks should prioritize simplifying user interfaces and offering guided assistance, such as tutorials or chat-based support. Future research may employ longitudinal designs or analyze real-life transaction data for a more objective understanding of behavior. Additional variables like trust, perceived risk, and regulatory policies, not included in this study, should be integrated into future models to offer a more comprehensive analysis. Full article
24 pages, 6020 KiB  
Article
Seasonal Patterns of Preterm Birth During the COVID-19 Pandemic: A Retrospective Cohort Study in Romania
by Paula Trif, Cristian Sava, Diana Mudura, Boris W. Kramer, Radu Galiș, Maria Livia Ognean, Alin Iuhas and Claudia Maria Jurca
Medicina 2025, 61(8), 1398; https://doi.org/10.3390/medicina61081398 - 1 Aug 2025
Viewed by 160
Abstract
Background and Objectives: Preterm birth and stillbirth are primary adverse pregnancy outcomes. Research during the COVID-19 pandemic revealed reductions in preterm birth in some countries, while stillbirth rates increased or remained unchanged. These findings suggest the presence of preventable risk factors associated with [...] Read more.
Background and Objectives: Preterm birth and stillbirth are primary adverse pregnancy outcomes. Research during the COVID-19 pandemic revealed reductions in preterm birth in some countries, while stillbirth rates increased or remained unchanged. These findings suggest the presence of preventable risk factors associated with changes in physical activity and lower exposure to community-acquired infections due to lockdown measures, altered social interaction patterns or reduced access to antenatal care. Assessing seasonal variation may offer insights into whether lifestyle changes during the COVID-19 lockdown period influenced preterm birth rates. Materials and Methods: This retrospective cohort study used data from the electronic medical records of Bihor and Sibiu counties. Preterm deliveries (<37 weeks) and stillbirths during the COVID-19 pandemic (2020 and 2021) were compared with the corresponding pre-pandemic (2018 and 2019) and post-pandemic (2022 and 2023) period. Preterm birth rates during summer and winter in the pre-pandemic, pandemic, and post-pandemic years were analyzed. A comparison with rates during strict lockdown was made. Results: Out of 52,021 newborn infants, 4473 were born preterm. Preterm birth rates remained stable across all three periods (p = 0.13), and no significant seasonal pattern was identified (p = 0.65). In contrast, stillbirth rates increased notably during the strict lockdown period, with the median incidence almost doubling compared to other periods (0.87%, p = 0.05), while remaining unchanged during the rest of the pandemic (p = 0.52). Conclusions: Our study found that preterm birth rates remained unaffected by the pandemic and lockdown periods, while stillbirths increased significantly during the strict lockdown. These findings highlight the importance of maintaining access to timely antenatal care during public health emergencies to prevent adverse perinatal outcomes. Full article
(This article belongs to the Special Issue Advances in Obstetrics and Maternal-Fetal Medicine)
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23 pages, 511 KiB  
Article
Dietary Acrylamide Exposure and Its Correlation with Nutrition and Exercise Behaviours Among Turkish Adolescents
by Mehtap Metin Karaaslan and Burhan Basaran
Nutrients 2025, 17(15), 2534; https://doi.org/10.3390/nu17152534 - 1 Aug 2025
Viewed by 237
Abstract
Background/Objectives: Acrylamide is a probably carcinogenic to humans that naturally forms during the thermal processing of foods. An individual’s lifestyle—especially dietary habits and physical activity—may influence the severity of acrylamide’s adverse health effects. This study aimed to examine the relationship between adolescents’ dietary [...] Read more.
Background/Objectives: Acrylamide is a probably carcinogenic to humans that naturally forms during the thermal processing of foods. An individual’s lifestyle—especially dietary habits and physical activity—may influence the severity of acrylamide’s adverse health effects. This study aimed to examine the relationship between adolescents’ dietary and exercise behaviors and their dietary acrylamide exposure and associated health risks. Methods: This descriptive and cross-sectional study was conducted with 370 high school students in Türkiye. Data were collected using the Nutrition Exercise Behavior Scale (NEBS) and a retrospective 24-h dietary recall questionnaire. Acrylamide exposure was calculated based on food intake to estimate carcinogenic (CR) and non-corcinogenic (target hazard quotient: THQ) health risks and analyzed in relation to NEBS scores. Results: Findings indicated that while adolescents are beginning to adopt healthy eating and exercise habits, these behaviors are not yet consistent. Emotional eating and unhealthy food choices still occur. Higher acrylamide exposure and risk values were observed in boys and underweight individuals. This can be explained mainly by the fact that boys consume more of certain foods—especially bread, which contains relatively higher levels of acrylamide—than girls do, and that underweight individuals have lower body weights despite consuming similar amounts of food as other groups. Bread products emerged as the primary source of daily acrylamide intake. Positive correlations were found between NEBS total and subscale scores and acrylamide exposure and health risk values. Conclusions: The study demonstrates a significant association between adolescents’ health behaviors and acrylamide exposure. These results underscore potential public health concerns regarding acrylamide intake during adolescence and emphasize the need for targeted nutritional interventions to reduce risk and promote sustainable healthy behaviors. Full article
(This article belongs to the Section Nutrition Methodology & Assessment)
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18 pages, 3318 KiB  
Article
Indirect AI-Based Estimation of Cardiorespiratory Fitness from Daily Activities Using Wearables
by Laura Saldaña-Aristizábal, Jhonathan L. Rivas-Caicedo, Kevin Niño-Tejada and Juan F. Patarroyo-Montenegro
Electronics 2025, 14(15), 3081; https://doi.org/10.3390/electronics14153081 - 1 Aug 2025
Viewed by 182
Abstract
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 [...] Read more.
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
(This article belongs to the Special Issue Wearable Sensors for Human Position, Attitude and Motion Tracking)
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15 pages, 606 KiB  
Article
Assessment of the Physical and Emotional Health-Related Quality of Life Among Congestive Heart Failure Patients with Preserved and Reduced Ejection Fraction at a Quaternary Care Teaching Hospital in Coastal Karnataka in India
by Rajesh Kamath, Vineetha Poojary, Nishanth Shekar, Kanhai Lalani, Tarushree Bari, Prajwal Salins, Gwendolen Rodrigues, Devesh Teotia and Sanjay Kini
Healthcare 2025, 13(15), 1874; https://doi.org/10.3390/healthcare13151874 - 31 Jul 2025
Viewed by 154
Abstract
Introduction: Congestive heart failure (CHF), a complex clinical syndrome characterized by the heart’s inability to pump blood effectively due to structural or functional impairments, is a growing public health concern, with profound implications for patients’ physical and emotional well-being. In India, the burden [...] Read more.
Introduction: Congestive heart failure (CHF), a complex clinical syndrome characterized by the heart’s inability to pump blood effectively due to structural or functional impairments, is a growing public health concern, with profound implications for patients’ physical and emotional well-being. In India, the burden of CHF is rising due to aging demographics and increasing prevalence of lifestyle-related risk factors. Among the subtypes of CHF, heart failure with preserved ejection fraction (HFpEF), i.e., heart failure with left ventricular ejection fraction of ≥50% with evidence of spontaneous or provokable increased left ventricular filling pressure, and heart failure with reduced ejection fraction (HFrEF), i.e., heart failure with left ventricular ejection fraction of 40% or less and is accompanied by progressive left ventricular dilatation and adverse cardiac remodeling, may present differing impacts on health-related quality of life (HRQoL), i.e., an individual’s or a group’s perceived physical and mental health over time, yet comparative data remains limited. This study assesses HRQoL among CHF patients using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), one of the most widely used health-related quality of life questionnaires for patients with heart failure based on physical and emotional dimensions and identifies sociodemographic and clinical variables influencing these outcomes. Methods: A cross-sectional analytical study was conducted among 233 CHF patients receiving inpatient and outpatient care at the Department of Cardiology at a quaternary care teaching hospital in coastal Karnataka in India. Participants were enrolled using convenience sampling. HRQoL was evaluated through the MLHFQ, while sociodemographic and clinical characteristics were recorded via a structured proforma. Statistical analyses included descriptive measures, independent t-test, Spearman’s correlation and stepwise multivariable linear regression to identify associations and predictors. Results: The mean HRQoL score was 56.5 ± 6.05, reflecting a moderate to high symptom burden. Patients with HFpEF reported significantly worse HRQoL (mean score: 61.4 ± 3.94) than those with HFrEF (52.9 ± 4.64; p < 0.001, Cohen’s d = 1.95). A significant positive correlation was observed between HRQoL scores and age (r = 0.428; p < 0.001), indicating that older individuals experienced a higher burden of symptoms. HRQoL also varied significantly across NYHA functional classes (χ2 = 69.9, p < 0.001, ε2 = 0.301) and employment groups (χ2 = 17.0, p < 0.001), with further differences noted by education level, gender and marital status (p < 0.05). Multivariable linear regression identified age (B = 0.311, p < 0.001) and gender (B = –4.591, p < 0.001) as significant predictors of poorer HRQoL. Discussion: The findings indicate that patients with HFpEF experience significantly poorer HRQoL than those with HFrEF. Older adults and female patients reported greater symptom burden, underscoring the importance of demographic-sensitive care approaches. These results highlight the need for routine integration of HRQoL assessment into clinical practice and the development of comprehensive, personalized interventions addressing both physical and emotional health dimensions, especially for vulnerable subgroups. Conclusions: CHF patients, especially those with HFpEF, face reduced HRQoL. Key factors include age, gender, education, employment, marital status, and NYHA class, underscoring the need for patient-centered care. Full article
(This article belongs to the Special Issue Patient Experience and the Quality of Health Care)
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15 pages, 494 KiB  
Article
The Mediating Role of Physical Literacy in the Relationship Between e-Health Literacy and a Sustainable Healthy Lifestyle Among Adolescents
by Mehmet Akarsu, Mehmet Güllü, Gül Polat Günata, Aysel Kızılkaya, Savaş Aydın, Ecesu Özcan, Göktuğ Norman and Cihad Onur Kurhan
Healthcare 2025, 13(15), 1870; https://doi.org/10.3390/healthcare13151870 - 31 Jul 2025
Viewed by 213
Abstract
Background: It is well-established that, for adolescents to adopt sustainable healthy lifestyle behaviors, not only access to information but also the skills required to translate that information into action are critical. In this field, research that examines the relationship between e-health literacy and [...] Read more.
Background: It is well-established that, for adolescents to adopt sustainable healthy lifestyle behaviors, not only access to information but also the skills required to translate that information into action are critical. In this field, research that examines the relationship between e-health literacy and sustainable healthy lifestyle behaviors within the context of physical literacy is notably scarce. In this context, the aim of this study is to examine the effect of e-health literacy on a sustainable healthy lifestyle and to evaluate the mediating role of physical literacy in this relationship. Methods: A total of 835 adolescents from high schools across Türkiye voluntarily participated in this study. During the data collection process, the e-Health Literacy Scale, the Perceived Physical Literacy Scale, and the Healthy and Sustainable Lifestyle Scale were utilized. Data were analyzed using the JASP (version 0.18.3.0) software. Correlation analysis and structural equation modeling were conducted, and the bootstrap method (n = 5000) was employed for mediation analysis. Results: The effect of e-health literacy on a sustainable healthy lifestyle was found to be positive and statistically significant (β = 0.452, p < 0.001). Similarly, e-health literacy significantly predicted physical literacy (β = 0.755, p < 0.001), and physical literacy significantly predicted a sustainable healthy lifestyle (β = 0.310, p < 0.001). The mediating effect was also statistically significant (β = 0.234, p < 0.001). The model explained 32% of the variance in healthy lifestyle behaviors. Conclusions: The findings indicate that evaluating e-health literacy and physical literacy together provides a holistic approach to fostering sustainable healthy lifestyle habits among adolescents. It is recommended that intervention programs be structured to encompass both areas of competence. Full article
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14 pages, 2265 KiB  
Communication
Bioelectrical Impedance Assessment in a Patient with Breast Cancer: A Case Report on the Effect of Integrative Therapies on Cellular Homeostasis
by Graziella Marino, Giovanni Pace, Lucia Sabato, Marzia Sichetti and Marisabel Mecca
Nutrients 2025, 17(15), 2506; https://doi.org/10.3390/nu17152506 - 30 Jul 2025
Viewed by 125
Abstract
Background/Objectives: Since breast cancer (BC) survival rates have increased to 91% at 5 years and 80% at 15 years postdiagnosis, there is a growing awareness of the importance of addressing the long-term well-being of patients. Consequently, integrative oncology, which combines standard therapies [...] Read more.
Background/Objectives: Since breast cancer (BC) survival rates have increased to 91% at 5 years and 80% at 15 years postdiagnosis, there is a growing awareness of the importance of addressing the long-term well-being of patients. Consequently, integrative oncology, which combines standard therapies with complementary approaches (nutrition, mind–body practices, and lifestyle modifications), has emerged as a patient-centred model aimed at improving symptom management, treatment adherence, and overall quality of life (QoL). This study aims to demonstrate how integrative therapies can benefit body composition, phase angle, and fluid and electrolyte balance through bioelectrical impedance analysis (BIA). Methods: This study considers a patient who underwent BC surgery and was enrolled in the AMICO clinic for anamnesis, as well as their oncological pathology data, assessment of QoL, and BIA. The breast surgeon specialising in integrative oncology therapies prescribed the patient curcumin and polydatin, moderate physical activity, a balanced diet, and Qigong sessions. The patient underwent monitoring through haematochemical analysis, BIA, and a QoL questionnaire, with follow-up every four months. Results: Between 4 and 12 months, fat mass (FM) and body mass index (BMI) markedly decreased, whereas fat-free mass (FFM), total body water (TBW), and skeletal muscle mass (SMM) increased progressively. Moreover, the improvements in the Na/K ratio and phase angle (PhA) suggest a shift toward better electrolyte and fluid balance and enhanced cellular integrity and membrane function. Equally outstanding were her psychological benefits in terms of mood, sleep, anxiety, and melancholy. Conclusions: Patient progress in body composition, metabolic function, pain management, and psychological status measured during the 12-month follow-up demonstrates the potential benefits of an integrative approach to supportive cancer care. Full article
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17 pages, 1264 KiB  
Article
An Emerging Longevity Blue Zone in Sicily: The Case of Caltabellotta and the Sicani Mountains
by Alessandra Errigo, Giovanni Mario Pes, Calogero Caruso, Giulia Accardi, Anna Aiello, Giuseppina Candore and Sonya Vasto
J. Ageing Longev. 2025, 5(3), 26; https://doi.org/10.3390/jal5030026 - 30 Jul 2025
Viewed by 144
Abstract
Blue Zones (BZs) are regions across the world associated with exceptional human longevity, where individuals routinely live into their 90s and beyond. These areas share distinct lifestyle and environmental factors that promote healthy aging. The established BZs include Sardinia, Okinawa, Ikaria, and Nicoya, [...] Read more.
Blue Zones (BZs) are regions across the world associated with exceptional human longevity, where individuals routinely live into their 90s and beyond. These areas share distinct lifestyle and environmental factors that promote healthy aging. The established BZs include Sardinia, Okinawa, Ikaria, and Nicoya, while several “emerging” BZs have been reported in various parts of the globe. This study investigates an area in Sicily for similar longevity patterns. Demographic data from the Italy National Institute of Statistics and local civil registries identify the municipality of Caltabellotta, home to approximately 3000 residents, and the nearby Sicani Mountains as a potential emerging BZ. The area exhibits a significantly higher prevalence of nonagenarians and centenarians compared to national and regional averages. Between 1900 and 1924, the proportion of newborns in Caltabellotta who reached age 90 and above rose from 3.6% to 14%, with 1 out of 166 individuals during this period reaching the age of 100. Historical, dietary, environmental, and sociocultural characteristics align with known BZ traits, including adherence to the Mediterranean diet, physical activity through agrarian routines, strong social cohesion, and minimal environmental pollution. A comparative analysis with the validated Sardinia BZ supports the hypothesis that this Sicilian area may represent an emerging longevity hotspot. Further multidisciplinary investigation is warranted to substantiate these findings. Full article
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16 pages, 1449 KiB  
Article
Cross-Lagged Relationship Between Adiposity and HOMA and Mediating Role of Adiposity Between Lifestyle Factors and HOMA Among in Mexican Health Workers
by Joacim Meneses-León, Amado D. Quezada-Sánchez, Mario Rojas-Russel, Diana I. Aparicio-Bautista, Rafael Velázquez-Cruz, Carlos A. Aguilar-Salinas, Jorge Salmerón and Berenice Rivera-Paredez
Nutrients 2025, 17(15), 2497; https://doi.org/10.3390/nu17152497 - 30 Jul 2025
Viewed by 211
Abstract
Background/Objectives: Unhealthy lifestyles are closely linked to insulin resistance (IR) and adiposity. However, the mediating role of adiposity in the relationship between lifestyle factors and IR is not yet fully understood. Mediation analysis may help clarify the role of adiposity in the [...] Read more.
Background/Objectives: Unhealthy lifestyles are closely linked to insulin resistance (IR) and adiposity. However, the mediating role of adiposity in the relationship between lifestyle factors and IR is not yet fully understood. Mediation analysis may help clarify the role of adiposity in the relationship between lifestyle factors and IR. Therefore, we aimed to explore the bidirectional relationship between adiposity and IR, and to evaluate the relationship between lifestyle factors and adiposity-mediated IR in Mexican adults. Methods: A longitudinal analysis was conducted using data from the Health Workers Cohort Study, with measurements taken every six years from 2004 to 2018. This study included 1134 participants aged from 18 to 70 years. Lifestyle factors were assessed using a self-administered questionnaire. IR was assessed using the Homeostasis Model Assessment (HOMA). Adiposity was measured through body mass index (BMI), waist circumference (WC), and body fat proportion (BFP), and BMI was used as the marker indicator to set the metric of adiposity. We fitted structural equation models with a cross-lagged specification to examine the relationships between adiposity and ln(HOMA). In our analysis, we considered baseline adiposity and ln(HOMA) as mediators of the relation between lifestyle factors and future adiposity and ln(HOMA). Models were stratified by sex and adjusted by baseline age. Results: Results from the cross-lagged panel model showed that, for both men and women, adiposity predicted subsequent increases in HOMA (+5.3% IC95%: 1.8%, 9.0% in men; +6.0% IC95%: 4.2%, 7.8% in women). In men, baseline adiposity acted as a mediator between lifestyle variables (physical activity, tobacco consumption, and sleep duration) and HOMA. Conclusions: Our results suggest that understanding both the relationship between adiposity and HOMA and the mediating effects of adiposity is crucial for developing effective interventions to reduce IR in the Mexican population. Full article
(This article belongs to the Section Nutrition and Diabetes)
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25 pages, 4837 KiB  
Article
Multimodal Computational Approach for Forecasting Cardiovascular Aging Based on Immune and Clinical–Biochemical Parameters
by Madina Suleimenova, Kuat Abzaliyev, Ainur Manapova, Madina Mansurova, Symbat Abzaliyeva, Saule Doskozhayeva, Akbota Bugibayeva, Almagul Kurmanova, Diana Sundetova, Merey Abdykassymova and Ulzhas Sagalbayeva
Diagnostics 2025, 15(15), 1903; https://doi.org/10.3390/diagnostics15151903 - 29 Jul 2025
Viewed by 179
Abstract
Background: This study presents an innovative approach to cardiovascular disease (CVD) risk prediction based on a comprehensive analysis of clinical, immunological and biochemical markers using mathematical modelling and machine learning methods. Baseline data include indices of humoral and cellular immunity (CD59, CD16, [...] Read more.
Background: This study presents an innovative approach to cardiovascular disease (CVD) risk prediction based on a comprehensive analysis of clinical, immunological and biochemical markers using mathematical modelling and machine learning methods. Baseline data include indices of humoral and cellular immunity (CD59, CD16, IL-10, CD14, CD19, CD8, CD4, etc.), cytokines and markers of cardiovascular disease, inflammatory markers (TNF, GM-CSF, CRP), growth and angiogenesis factors (VEGF, PGF), proteins involved in apoptosis and cytotoxicity (perforin, CD95), as well as indices of liver function, kidney function, oxidative stress and heart failure (albumin, cystatin C, N-terminal pro B-type natriuretic peptide (NT-proBNP), superoxide dismutase (SOD), C-reactive protein (CRP), cholinesterase (ChE), cholesterol, and glomerular filtration rate (GFR)). Clinical and behavioural risk factors were also considered: arterial hypertension (AH), previous myocardial infarction (PICS), aortocoronary bypass surgery (CABG) and/or stenting, coronary heart disease (CHD), atrial fibrillation (AF), atrioventricular block (AB block), and diabetes mellitus (DM), as well as lifestyle (smoking, alcohol consumption, physical activity level), education, and body mass index (BMI). Methods: The study included 52 patients aged 65 years and older. Based on the clinical, biochemical and immunological data obtained, a model for predicting the risk of premature cardiovascular aging was developed using mathematical modelling and machine learning methods. The aim of the study was to develop a predictive model allowing for the early detection of predisposition to the development of CVDs and their complications. Numerical methods of mathematical modelling, including Runge–Kutta, Adams–Bashforth and backward-directed Euler methods, were used to solve the prediction problem, which made it possible to describe the dynamics of changes in biomarkers and patients’ condition over time with high accuracy. Results: HLA-DR (50%), CD14 (41%) and CD16 (38%) showed the highest association with aging processes. BMI was correlated with placental growth factor (37%). The glomerular filtration rate was positively associated with physical activity (47%), whereas SOD activity was negatively correlated with it (48%), reflecting a decline in antioxidant defence. Conclusions: The obtained results allow for improving the accuracy of cardiovascular risk prediction, and form personalised recommendations for the prevention and correction of its development. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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25 pages, 3167 KiB  
Article
A Sustainability-Oriented Assessment of Noise Impacts on University Dormitories: Field Measurements, Student Survey, and Modeling Analysis
by Xiaoying Wen, Shikang Zhou, Kainan Zhang, Jianmin Wang and Dongye Zhao
Sustainability 2025, 17(15), 6845; https://doi.org/10.3390/su17156845 - 28 Jul 2025
Viewed by 288
Abstract
Ensuring a sustainable and healthy human environment in university dormitories is essential for students’ learning, living, and overall health and well-being. To address this need, we carried out a series of systematic field measurements of the noise levels at 30 dormitories in three [...] Read more.
Ensuring a sustainable and healthy human environment in university dormitories is essential for students’ learning, living, and overall health and well-being. To address this need, we carried out a series of systematic field measurements of the noise levels at 30 dormitories in three representative major urban universities in a major provincial capital city in China and designed and implemented a comprehensive questionnaire and surveyed 1005 students about their perceptions of their acoustic environment. We proposed and applied a sustainability–health-oriented, multidimensional assessment framework to assess the acoustic environment of the dormitories and student responses to natural sound, technological sounds, and human-made sounds. Using the Structural Equation Modeling (SEM) approach combined with the field measurements and student surveys, we identified three categories and six factors on student health and well-being for assessing the acoustic environment of university dormitories. The field data indicated that noise levels at most of the measurement points exceeded the recommended or regulatory thresholds. Higher noise impacts were observed in early mornings and evenings, primarily due to traffic noise and indoor activities. Natural sounds (e.g., wind, birdsong, water flow) were highly valued by students for their positive effect on the students’ pleasantness and satisfaction. Conversely, human and technological sounds (traffic noise, construction noise, and indoor noise from student activities) were deemed highly disturbing. Gender differences were evident in the assessment of the acoustic environment, with male students generally reporting higher levels of the pleasantness and preference for natural sounds compared to female students. Educational backgrounds showed no significant influence on sound perceptions. The findings highlight the need for providing actionable guidelines for dormitory ecological design, such as integrating vertical greening in dormitory design, water features, and biodiversity planting to introduce natural soundscapes, in parallel with developing campus activity standards and lifestyle during noise-sensitive periods. The multidimensional assessment framework will drive a sustainable human–ecology–sound symbiosis in university dormitories, and the category and factor scales to be employed and actions to improve the level of student health and well-being, thus, providing a reference for both research and practice for sustainable cities and communities. Full article
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25 pages, 3545 KiB  
Article
Combined Effects of PFAS, Social, and Behavioral Factors on Liver Health
by Akua Marfo and Emmanuel Obeng-Gyasi
Med. Sci. 2025, 13(3), 99; https://doi.org/10.3390/medsci13030099 - 28 Jul 2025
Viewed by 256
Abstract
Background: Environmental exposures, such as per- and polyfluoroalkyl substances (PFAS), in conjunction with social and behavioral factors, can significantly impact liver health. This research investigates the combined effects of PFAS (perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), alcohol consumption, smoking, income, and education [...] Read more.
Background: Environmental exposures, such as per- and polyfluoroalkyl substances (PFAS), in conjunction with social and behavioral factors, can significantly impact liver health. This research investigates the combined effects of PFAS (perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), alcohol consumption, smoking, income, and education on liver function among the U.S. population, utilizing data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). Methods: PFAS concentrations in blood samples were analyzed using online solid-phase extraction combined with liquid chromatography–tandem mass spectrometry (LC-MS/MS), a highly sensitive and specific method for detecting levels of PFAS. Liver function was evaluated using biomarkers such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), total bilirubin, and the fatty liver index (FLI). Descriptive statistics and multivariable linear regression analyses were employed to assess the associations between exposures and liver outcomes. Bayesian Kernel Machine Regression (BKMR) was utilized to explore the nonlinear and interactive effects of these exposures. To determine the relative influence of each factor on liver health, Posterior Inclusion Probabilities (PIPs) were calculated. Results: Linear regression analyses indicated that income and education were inversely associated with several liver injury biomarkers, while alcohol use and smoking demonstrated stronger and more consistent associations. Bayesian Kernel Machine Regression (BKMR) further highlighted alcohol and smoking as the most influential predictors, particularly for GGT and total bilirubin, with posterior inclusion probabilities (PIPs) close to 1.0. In contrast, PFAS showed weaker associations. Regression coefficients were small and largely non-significant, and PIPs were comparatively lower across most liver outcomes. Notably, education had a higher PIP for ALT and GGT than PFAS, suggesting a more protective role in liver health. People with higher education levels tend to live healthier lifestyles, have better access to healthcare, and are generally more aware of health risks. These factors can all help reduce the risk of liver problems. Overall mixture effects demonstrated nonlinear trends, including U-shaped relationships for ALT and GGT, and inverse associations for AST, FLI, and ALP. Conclusion: These findings underscore the importance of considering both environmental and social–behavioral determinants in liver health. While PFAS exposures remain a long-term concern, modifiable lifestyle and structural factors, particularly alcohol, smoking, income, and education, exert more immediate and pronounced effects on hepatic biomarkers in the general population. Full article
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42 pages, 914 KiB  
Review
Western Diet and Cognitive Decline: A Hungarian Perspective—Implications for the Design of the Semmelweis Study
by Andrea Lehoczki, Tamás Csípő, Ágnes Lipécz, Dávid Major, Vince Fazekas-Pongor, Boglárka Csík, Noémi Mózes, Ágnes Fehér, Norbert Dósa, Dorottya Árva, Kata Pártos, Csilla Kaposvári, Krisztián Horváth, Péter Varga and Mónika Fekete
Nutrients 2025, 17(15), 2446; https://doi.org/10.3390/nu17152446 - 27 Jul 2025
Viewed by 550
Abstract
Background: Accelerated demographic aging in Hungary and across Europe presents significant public health and socioeconomic challenges, particularly in preserving cognitive function and preventing neurodegenerative diseases. Modifiable lifestyle factors—especially dietary habits—play a critical role in brain aging and cognitive decline. Objective: This narrative review [...] Read more.
Background: Accelerated demographic aging in Hungary and across Europe presents significant public health and socioeconomic challenges, particularly in preserving cognitive function and preventing neurodegenerative diseases. Modifiable lifestyle factors—especially dietary habits—play a critical role in brain aging and cognitive decline. Objective: This narrative review explores the mechanisms by which Western dietary patterns contribute to cognitive impairment and neurovascular aging, with specific attention to their relevance in the Hungarian context. It also outlines the rationale and design of the Semmelweis Study and its workplace-based health promotion program targeting lifestyle-related risk factors. Methods: A review of peer-reviewed literature was conducted focusing on Western diet, cognitive decline, cerebrovascular health, and dietary interventions. Emphasis was placed on mechanistic pathways involving systemic inflammation, oxidative stress, endothelial dysfunction, and decreased neurotrophic support. Key findings: Western dietary patterns—characterized by high intakes of saturated fats, refined sugars, ultra-processed foods, and linoleic acid—are associated with elevated levels of 4-hydroxynonenal (4-HNE), a lipid peroxidation product linked to neuronal injury and accelerated cognitive aging. In contrast, adherence to Mediterranean dietary patterns—particularly those rich in polyphenols from extra virgin olive oil and moderate red wine consumption—supports neurovascular integrity and promotes brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) activity. The concept of “cognitive frailty” is introduced as a modifiable, intermediate state between healthy aging and dementia. Application: The Semmelweis Study is a prospective cohort study involving employees of Semmelweis University aged ≥25 years, collecting longitudinal data on dietary, psychosocial, and metabolic determinants of aging. The Semmelweis–EUniWell Workplace Health Promotion Model translates these findings into practical interventions targeting diet, physical activity, and cardiovascular risk factors in the workplace setting. Conclusions: Improving our understanding of the diet–brain health relationship through population-specific longitudinal research is crucial for developing culturally tailored preventive strategies. The Semmelweis Study offers a scalable, evidence-based model for reducing cognitive decline and supporting healthy aging across diverse populations. Full article
(This article belongs to the Section Nutrition and Public Health)
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