Search Results (218)

Background: Identifying factors associated with cognitive impairment among older adults is critical. This study investigates both concurrent and longitudinal associations between sleep quality, sleep duration, and cognitive performance among older adults in China, with particular emphasis on the moderating role of fruit and/or vegetable intake (FVI), a factor rarely examined in previous research. Methods: We pooled five waves of a specially designed nationwide sample of adults aged 65 years or older (N = 64,690; mean age: 86.3 years; men: 43.5%) in 2005, 2008, 2011, 2014, and 2018 in China. Cognitive impairment was assessed by the Mini-Mental State Examination. Among the sample, 10.7% were cognitively impaired. FVI was dichotomized into frequent (almost daily) versus infrequent (other low frequencies). Sleep hours were grouped into short (≤6 h), normal (7–9 h), and long (≥10 h) durations. Both concurrent and cross-lagged analyses were performed after adjusting for a wide set of covariates (demographics, socioeconomic status, family/social connections, health practices, disability, self-rated health, and chronic conditions). Analyses were further stratified by gender, age group, and urban–rural residence. Results: When all covariates were present (the full model), good sleep quality was associated with 22% lower odds of the prevalence of cognitive impairment, whereas the long sleep duration was associated with 24% higher odds as compared with the normal sleep duration. Although the short sleep duration was not associated with the prevalence of cognitive impairment in the full model, it was associated with 8% higher odds of cognitive impairment when health condition was not controlled for. Interaction analyses revealed that frequent FVI buffered the adverse cognitive effects of poor sleep quality and both short and long sleep durations. Subgroup analyses further show similar patterns across subpopulations, with more pronounced protective associations in older women and the oldest-old. Conclusions: Good sleep quality, normal sleep durations, and frequent FVI jointly contribute to better cognitive functioning at older ages. While the observed relationships are largely concurrent rather than causal, promoting both healthy sleep and dietary habits may be important for cognitive health among older adults. Full article

Background: Insomnia is prevalent and difficult to treat safely over the long term. Given the role of the microbiota–gut–brain axis in melatonin and hypothalamic–pituitary–adrenal (HPA) regulation, and preclinical evidence for Limosilactobacillus fermentum PS150, we evaluated whether a heat-treated formulation (HT-PS150) could improve sleep and modulate endocrine/circadian markers in adults with poor sleep. Methods: In a randomized, double-blind, placebo-controlled trial, 84 adults aged 20–60 years with PSQI ≥ 5 and ISI < 22 were assigned to receive either placebo or HT-PS150 for eight weeks. Outcomes included patient-reported sleep (PSQI, ISI), anxiety/depression (GAD-7, PHQ-9), quality of life (QLESQ-SF), gastrointestinal symptoms (VAS-GI), wrist actigraphy (Fitbit Inspire 3), and sleep-relevant biomarkers measured from urine, saliva, and/or blood samples (melatonin, cortisol, orexin, serotonin, GABA, and/or norepinephrine). Repeated measures were analyzed using generalized estimating equations. An exploratory proportional regulation analysis classified individual biomarker changes as up- or down-regulated and compared proportions between study arms. Per-protocol analyses required ≥80% compliance. Results: Improvements in the primary outcomes, PSQI and ISI, were observed over time in both groups, while no significant group × time interactions were detected. In exploratory proportional analyses, a higher proportion of participants in the HT-PS150 group exhibited up-regulated nocturnal melatonin secretion and improved daytime plasma orexin levels, as well as a tendency toward greater reductions in nocturnal salivary cortisol compared with placebo. In subgroup analyses with higher baseline insomnia severity (ISI ≥ 8), HT-PS150 was associated with greater improvements in PSQI (notably sleep duration and efficiency) and reduction in anxiety (GAD-7) upon post hoc testing. Conclusions: Although group mean scores on sleep symptom scales did not differ significantly in the full cohort, HT-PS150 appeared to modulate sleep–wake regulation by enhancing nocturnal melatonin secretion, attenuating HPA-axis activity, and stabilizing wakefulness. Clinical benefits were most evident among participants with greater baseline symptom burden, suggesting potential utility in more symptomatic populations. Full article

High-density micro-electrocorticography (μECoG) arrays offer precise spatial resolution with minimal invasiveness. This study employed a custom ultra-thin 64-channel μECoG array to investigate cortical activity in mice under chronic caffeine exposure. While caffeine is known to enhance short-term alertness, its long-term impact on sleep microarchitecture and brain connectivity is unclear. Continuous recordings from adult mice during baseline and recovery revealed that prolonged caffeine intake significantly reduced broadband power spectral density (PSD) and spindle power but increased interregional coherence and altered spindle duration and density. In contrast, six hours of sleep deprivation elevated PSD and coherence, mainly affecting sensorimotor and retrosplenial cortices. These findings validate the μECoG array’s functionality and demonstrate that post-chronic caffeine withdrawal lowers cortical oscillatory power yet enhances network connectivity, whereas acute sleep loss boosts global synchrony. This work clarifies how sustained caffeine use and sleep deprivation distinctly disrupt sleep homeostasis through different neural mechanisms. Full article

This narrative review of rapid eye movement (REM) focuses on its primary etiology and how it fits into the larger framework of neurophysiology and general physiology. Arterial blood flow in the retina may be sensitive to the full overlying ‘weight’ of its adjacent and contiguous vitreous humor caused by the humoral mass effect in the Earth’s gravitational field. During waking hours of the day, this ‘weight’ is continuously shifted in position due to changing head position and eye movements associated with ordinary environmental observations. This reduces its impact on any one point on the retinal field. However, during sleep, the head may maintain a relatively constant position (often supine), and observational eye movements are minimal, leaving essentially one retinal area exposed at the ‘bottom’ of each eye, relative to gravity. During sleep, REM may provide a mechanism for frequently repositioning the retina with respect to the weight it incurs from its adjacent (overlying) vitreous humor. Our findings were consistent with the intermittent terrestrial nocturnal development of ‘gravitational ischemia’ in the retina, wherein the decreased blood flow is accompanied metabolically by decreased oxygen tension, a critically important metric, with a detrimental influence on nerve-related tissue generally. However, the natural mechanisms for releasing and resolving gravitational ischemia, which likely involve glymphatics and cerebrospinal fluid shifts, as well as REM, may gradually fail in old age. Concurrently associated with old age in some individuals is the deposition of alpha-synuclein and/or tau in the retina, together with similar deposition in the brain, and it is also associated with the development of Parkinson’s disease and/or Alzheimer’s disease, possibly as a maladaptive attempt to release and resolve gravitational ischemia. This suggests that a key metabolic parameter of Parkinson’s disease and Alzheimer’s disease may be a lack of oxygen in some neural tissues. There is some evidence that oxygen therapy (hyperbaric oxygen) may be an effective supplemental treatment. Many of the cardinal features of spaceflight-associated neuro-ocular syndrome (SANS) may potentially be explained as features of gravity opposition physiology, which becomes unopposed by gravity during spaceflight. Gravity opposition physiology may, in fact, create significant challenges for humans involved in long-duration space travel (long-term microgravity). Possible solutions may include the use of artificial gravitational fields in space, such as centrifuges. Full article

Capacitive ECG (cECG) technology offers significant potential for improving comfort and unobtrusiveness in long-term cardiovascular monitoring. Nevertheless, current research predominantly emphasizes basic heart rate monitoring by detecting only the R-wave, thereby restricting its clinical applicability. In this study, we proposed an advanced cECG mattress system and conducted a systematic evaluation. To enhance user comfort and achieve more accurate cECG morphological features, we developed a multi-layered cECG mattress incorporating flexible fabric active electrodes, signal acquisition circuits, and specialized signal processing algorithms. We conducted experimental validation to evaluate the performance of the proposed system. The system exhibited robust performance across various sleeping positions (supine, right lateral, left lateral and prone), achieving a high average true positive rate (TPR) of 0.99, ensuring reliable waveform detection. The mean absolute error (MAE) remains low at 1.12 ms for the R wave, 7.89 ms for the P wave, and 7.88 ms for the T wave, indicating accurate morphological feature extraction. Additionally, the system maintains a low MAE of 0.89 ms for the RR interval, 7.77 ms for the PR interval, and 7.85 ms for the RT interval, further underscoring its reliability in interval measurements. Compared with medical-grade devices, the signal quality obtained by the cECG mattress system is sufficient to accurately identify the crucial waveform morphology and interval durations. Moreover, the user experience evaluation and durability test demonstrated that the mattress system performed reliably and comfortably. This study provides essential information and establishes a foundation for the clinical application of cECG technology in future sleep monitoring research. Full article

Background: Although the participation of children with autism spectrum disorder (ASD) in team sports presents challenges, group-based physical activities could offer specific benefits for their core symptoms. Therefore, the aim of this systematic review was to analyze the benefits of mini-basketball for children with ASD. Methods: A systematic review was conducted following PRISMA guidelines and was registered in PROSPERO (CRD420251144800). Four databases (Web of Science, SPORTDiscus, PubMed, and Scopus) were searched to select randomized controlled trials reporting the effects of mini-basketball interventions on children with ASD from their inception to August 2025. Results: Eight randomized controlled trials involving 436 participants (aged 3–12 years, 87.3% male) met the inclusion criteria. All studies were conducted in China using 12-week interventions (40–45 min, 2–5 days/week at moderate intensity). The quality was rated as good in two studies and fair in six. Five studies assessed social responsiveness, with four showing significant pre–post reductions in the experimental groups and all demonstrating superior outcomes versus those of the controls. One study reported significant reductions in repetitive behaviors, self-injurious behaviors, and restricted behaviors compared to that of the controls. Joint attention improvements were observed through eye-tracking measures, with increased fixation counts, shorter time to first fixation, and more accurate gaze shifts. Physical fitness benefits included improved shuttle run times and standing long jump performance. Finally, one study demonstrated better inhibition control and improvements in sleep quality, including increased sleep duration and efficiency. Conclusions: Mini-basketball interventions can improve social responsiveness and related outcomes in children with ASD. These findings support mini-basketball as a feasible, safe, and effective intervention that could be integrated with existing therapeutic approaches. Full article

Background/Objectives: Childhood obesity remains a critical public health concern in Greece, particularly among socioeconomically vulnerable groups. This study conducted a secondary analysis of five large-scale epidemiological datasets to examine the association between energy balance-related behaviours (EBRBs) and obesity in children in need. Methods: Data were compiled from five nationally or regionally representative studies (Genesis, ToyBox, Healthy Growth, ENERGY, and Feel4Diabetes) involving children aged 1–12 years. Stratified and subgroup analyses were performed to examine associations between weight status and EBRBs, including dietary habits, physical activity, and sedentary behaviour. Determinants of EBRBs were also analysed using the socio-ecological model framework. Results: Children in need demonstrated a higher prevalence of overweight and obesity compared to the general child population. Key risk factors for EBRBs included frequent consumption of sugar-sweetened beverages, sweet snacks, and high screen time. Protective behaviours associated with lower obesity risk included regular breakfast consumption, adequate sleep duration, and physical activity. Determinants of high-risk EBRBs were primarily interpersonal and, to a lesser extent, individual and community-level factors. Conclusions: These findings highlight the disproportionate burden of childhood obesity among vulnerable populations and identify modifiable behaviours and determinants that can inform targeted interventions. These results provide a robust evidence base to guide national public health policies, including the development of school- and community-based obesity prevention programmes aligned with the goals of Greece’s National Action Against Childhood Obesity. Prioritising children in need in such initiatives is essential to reduce health inequities and improve long-term health outcomes. Full article

In vitro fertilization (IVF) exposes embryos to environmental stressors that can disrupt early development and confer long-term health risks, though the mechanisms remain poorly understood. Here, we tested the hypothesis that reducing incubation temperature during the first zygotic cleavage would promote long-term developmental stability in IVF-conceived offspring. Using a mouse model, we compared the long-term effects of standard (37 °C) versus reduced (35 °C) IVF culture temperature on energy balance, circadian rhythms, sleep architecture, and brain histone modifications. Although offspring from both IVF groups exhibited increased body mass without notable effects on glucose metabolism, significant disruptions in circadian rhythms and sleep–wake patterns were detected. The 37 °C group exhibited altered amplitudes in oxygen consumption rhythms and respiratory exchange ratios, as well as pronounced alterations in sleep–wake patterns, including reduced sleep duration and increased nighttime activity. The 35 °C group displayed intermediate phenotypes, substantiating the importance of optimizing embryo incubation parameters. These metabolic and behavioral changes were paralleled by altered histone modifications in the cerebral cortex of IVF offspring, suggesting an epigenetic basis for circadian misalignment. Our results identify disrupted circadian rhythm and sleep architecture as a novel mechanism contributing to metabolic dysfunction in IVF-conceived offspring. The partial mitigation of these effects through reduced culture temperature underscores the importance of optimizing IVF protocols to minimize long-term epigenetic and metabolic risks. Full article

Background: Burnout is a widespread concern across frontline professions, with healthcare, education, and emergency services workers experiencing particularly high rates of stress and emotional exhaustion. Passive artificial intelligence (AI) technologies may provide novel means to monitor and predict burnout risk using data collected continuously and non-invasively. Objective: This review aims to synthesize recent evidence on passive AI approaches for detecting stress and burnout among frontline workers, identify key physiological and behavioral biomarkers, and highlight current limitations in implementation, validation, and generalizability. Methods: A narrative review of peer-reviewed literature was conducted across multiple databases and digital libraries, including PubMed, IEEE Xplore, Scopus, ACM Digital Library, and Web of Science. Eligible studies applied passive AI methods to infer stress or burnout in individuals in frontline roles. Only studies using passive data (e.g., wearables, Electronic Health Record (EHR) logs) and involving healthcare, education, emergency response, or retail workers were included. Studies focusing exclusively on self-reported or active measures were excluded. Results: Recent evidence indicates that biometric data (e.g., heart rate variability, skin conductance, sleep) from wearables are most frequently used and moderately predictive of stress, with reported accuracies often ranging from 75 to 95%. Workflow interaction logs (e.g., EHR usage patterns) and communication metrics (e.g., email timing and sentiment) show promise but remain underexplored. Organizational network analysis and ambient computing remain largely conceptual in nature. Few studies have examined cross-sector or long-term data, and limited work addresses the generalizability of demographic or cultural findings. Challenges persist in data standardization, privacy, ethical oversight, and integration with clinical or operational workflows. Conclusions: Passive AI systems offer significant promise for proactive burnout detection among frontline workers. However, current studies are limited by small sample sizes, short durations, and sector-specific focus. Future work should prioritize longitudinal, multi-sector validation, address inclusivity and bias, and establish ethical frameworks to support deployment in real-world settings. Full article

Lunar dust remains one of the most critical unresolved challenges to long-duration lunar missions. Its sharp, abrasive, and electrostatically charged particles are easily inhaled and can penetrate deep into the lungs, reaching the bloodstream and the brain. Despite airlocks and HEPA filtration systems, dust will inevitably infiltrate lunar habitats and threaten astronaut health. We present a novel patent protected helmet design. This system uses a multilayered, synergistic mitigation approach combining mechanical and electrostatic defenses. The mechanical system delivers HEPA-filtered, ionized air across the user’s face, while the electrostatic barrier repels charged particles away from the respiratory zone. These two systems work together to prevent dust from entering the user’s breathing space. Designed for use inside lunar habitats, this helmet represents a potential solution to an unaddressed, life-threatening problem. It allows astronauts to eat, talk, and sleep while maintaining a protected respiratory zone and provides targeted inhalation-level protection in an environment where dust exposure is otherwise unavoidable. This concept is presented at Technology Readiness Level 2 (TRL 2) to prompt early engagement and feedback from the scientific and engineering communities. Full article

Spaceflight imposes unique physiological stressors that profoundly disrupt immune regulation, including impaired lymphocyte activation, latent viral reactivation, and chronic low-grade inflammation. While structured exercise is the cornerstone countermeasure for musculoskeletal and cardiovascular health, current protocols rarely integrate immune endpoints into their design. This review aims to synthesize current evidence on the immunological effects of exercise in spaceflight and propose a novel framework for immune-focused physical activity guidelines tailored to long-duration missions. Evidence indicates that exercise intensity and modality critically determine immune outcomes. Acute strenuous exercise may transiently suppress immunity via cortisol and reactive oxygen species pathways, whereas chronic moderate-to-vigorous training enhances immune surveillance, reduces systemic inflammation, and supports T-cell and NK-cell function. Exerkines such as IL-15, IL-7, and irisin emerge as central mediators of exercise-induced immunomodulation, with potential applications for spaceflight countermeasures. Incorporating immune health into exercise guidelines represents a necessary paradigm shift for astronaut care. A structured framework—emphasizing aerobic, resistance, and HIIT modalities; moderate-to-vigorous intensity; daily training; immune biomarker monitoring; and integration with nutrition and sleep—can enhance resilience against infection, viral reactivation, and cancer risk. Immune-focused countermeasures will be essential to safeguard astronaut health and ensure mission success on future deep-space expeditions. Full article

Background and Objectives: The positive effect of health resort treatment on long COVID symptoms has been demonstrated. However, no previous study has considered therapy duration as a factor determining treatment effectiveness. Therefore, the objective of this study was to determine whether the duration of treatment predicts its effectiveness in individuals with long COVID. Materials and Methods: In this retrospective study, medical records of 119 individuals (68 women and 51 men; mean age 63.04 ± 8.61 years) undergoing health resort treatment for long COVID were analyzed. Participants were divided into two groups based on therapy duration: shorter (Group 1) and prolonged (Group 2). Dyspnea was assessed using the mMRC scale, physical performance with the SPPB, and functional status with the PCFS scale. Additionally, individuals rated symptom severity on 0–10 point scales. Results: Improvement in functional status was greater in individuals with a prolonged stay at the health resort (Group 1: 0.59 ± 0.66 points; Group 2: 1.41 ± 0.65 points; p < 0.001). Changes in the severity of most long COVID symptoms were significantly greater in patients who stayed longer. An extended stay at the health resort was associated with significant improvement in functional status (β = 0.033, p = 0.003) and in most long COVID symptoms, particularly sleep disorders (β = 0.112, p < 0.0001), memory disorders (β = 0.104, p < 0.0001), and headaches (β = 0.103, p < 0.0001). Conclusions: A prolonged stay in a sanatorium exerts a favorable effect on symptom severity in individuals with long COVID. Comprehensive health resort treatment of approximately four weeks is associated with improved functional status and alleviation of neuropsychiatric symptoms. Nevertheless, given the retrospective design of the present study, prospective research is required to validate these findings. Full article

Background: While sleep duration’s association with stroke is established, the combined influence of sleep onset time and duration on stroke subtypes remains inadequately explored. Since circadian biology links sleep onset timing to vascular risk via mechanisms operating independently of sleep duration, we quantified their joint contributions to the risk of stroke. Methods: In this population-based cross-sectional study, from 31 December 2021 to 31 March 2022, we recruited 8168 ischemic stroke cases, 3172 intracerebral hemorrhage cases, and 13,458 control participants across 152 survey centers in 28 counties in Hunan Province, China. Standardized computer-assisted interviews collected sleep parameters. Conjoint analysis identified protective sleep profiles. Results: Short sleep duration (<6 h) was consistently associated with elevated ischemic risk across all sleep onset times (p < 0.05 in all cases, i.e., sleep before 10 p.m. [odds ratio (95%CI): 1.886(1.606, 2.214)], 10–11 p.m. [1.740(1.336, 2.265)], 11 p.m.–12 a.m. [2.335(1.190, 4.581)], and after 12 a.m. [2.834(1.193, 6.728)]). A sleep duration of 6–8 h with a sleep onset time between 10 p.m. and 12 a.m. was associated with the lowest ischemic risk (p < 0.001 in all cases). Conversely, prolonged sleep (>8 h) with an early sleep onset time (<10 p.m.) increased ischemic risk (OR 1.194, 95% CI 1.090–1.308, p < 0.001), whereas a late sleep onset time (11 p.m.–12 a.m.) in long sleepers was protective (OR 0.580, 95% CI 0.352–0.956, p < 0.001). Similar trends were observed for ICH, though the effect sizes were attenuated. Conclusion: Sleep duration and onset time interact to influence stroke risk. Optimal cerebrovascular protection requires ≥6 h of sleep, ideally initiated between 10 p.m. and 11 p.m. These findings highlight sleep optimization as a potential modifiable target for high-risk populations. Full article

Objective: To review and synthesize the current literature of clinical trials that investigated the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in people with obstructive sleep apnea (OSA). Method: MEDLINE, EMBASE, Cochrane Library, and PsycINFO were searched for randomized controlled trials (RCTs) in which GLP-1RAs were used to treat people diagnosed with OSA. This systematic review and meta-analysis complied with PRISMA 2020 guidelines and was registered on PROSPERO (CRD42024537280). A random effects model was used for meta-analysis to assess changes in OSA as measured by the apnea–hypopnea index (AHI) compared to continuous positive airway pressure (CPAP) or placebo controls. The standardized mean difference (SMD) and risk ratio (RR) were computed for continuous and binary outcomes. Variability between studies, risk of bias, subgroup analysis, and leave-one-out analysis were completed. Results: Five studies were included (N = 1023; 511 GLP-1RA and 512 control). Two trials used tirzepatide and four studies used liraglutide as the GLP-1RA. Six studies showed a decrease in AHI with an SMD of −14.5 events per hour (95%CI = −24.73 to −4.21; I² = 96.3%). When compared to placebo, GLP-1RA treatment had a significant reduction in AHI (SMD = −0.69; 95%CI = −1.10 to −0.26; p = 0.001; I² = 88.0%). When compared to CPAP, no significant difference in the reduction of AHI was found. No evidence of publication bias was found. Compared to control, there was no significant difference in serious adverse events (RR = 0.89; 95%CI = 0.50 to 1.57; p = 0.68; I² = 20.93%). Conclusions: People with psychiatric disorders may also experience comorbid OSA that can impact their quality of life, which may perpetuate psychiatric symptoms of depression. GLP-1RAs may provide therapeutic potential in the treatment of OSA in addition to their cardioprotective effects. Current studies are limited by small sample sizes, lack of blinding, and short duration. Future studies will require further investigation in long-term efficacy and safety. Full article

Background: Published studies have documented the association between sunshine duration and depression symptoms; however, the evidence regarding the long-term effects and potential mechanisms remains insufficient. This study aimed to examine the association between sunshine duration and incident depression and to explore potential mediating pathways. Methods: A total of 336,805 participants from the UK Biobank were included in the study. Meteorological exposures were estimated using the bilinear interpolation approach and time-weighted method. The association between sunshine duration and incident depression was examined through the time-dependent Cox proportional hazard model and generalized propensity score model. Vitamin D, calcium, immune biomarkers, an aggregated inflammation score (INFLA-score), and sleep pattern were selected as the potential mediators. Causal mediation analysis was employed to elucidate underlying mediating effects. Results: With a median follow-up of 13 years, 13,862 cases of incident depression were identified. Sunshine duration demonstrated a negative association with the incident depression. The effects were stronger among the elderly, alcohol consumers, individuals who spent less time outdoors, and those who were less physically active. Vitamin D, calcium, INFLA, neutrophils, and monocytes emerged as the top five contributors of immune biomarkers to the natural indirect effect. The combined mediating effect of top five biomarkers and sleep pattern accounted for 30% of the total effect of sunshine duration on the incident depression. Conclusion: Our study suggests that longer sunshine duration might mitigate depression through vitamin D-related metabolism, inflammation, and sleep pattern. It may serve as an effective natural antidepressant, particularly for the elderly, alcohol consumers, less outdoor spenders, and those who were less physically active. Full article