Search Results (330)

Obesity is currently recognized as a global epidemic and contributes to numerous health complications. It is strongly associated with poor dietary habits, including the widespread availability and consumption of high-calorie foods. We conducted a narrative review of publications from major biomedical databases addressing obesity treatment and public-health interventions. One of the strategies for managing obesity is lifestyle modification—balanced diet and regular physical activity—supported by pharmacological and psychological treatment, and, in selected patients, metabolic and bariatric surgery. Beyond patient-level care, public-health-oriented measures should be considered, including taxation of sugar-sweetened beverages, restriction on advertising of unhealthy foods, regulation of the school food environment, front-of-pack nutrition labelling, mandatory food reformulation, subsidies and incentives for healthy foods, urban-planning policies that promote physical activity, and policies that expand access to bariatric surgery. A comprehensive approach integrating clinical care with public-health policy is likely to yield more effective outcomes than either alone. Full article

As part of the PRISMA project, which promotes research and innovation for productive, resilient, and healthy agro-pastoral systems in West Africa, a cross-sectional survey was conducted to assess the apparent seroprevalence and investigate epidemiological factors associated with bovine brucellosis in dairy herds. The survey was carried out in Mali (Bamako, Koulikoro, Mopti, and Sikasso regions) and Niger (Tahoua, Dosso, and Tillabéry regions). A total of 1230 animals from 82 herds were tested, including 645 animals from 43 herds in Mali and 585 animals from 39 herds in Niger. At the herd level, apparent seroprevalence was significantly higher in Mali than in Niger (37.21% vs. 15.38%). Within each country, animal-level seroprevalence varied across region, with the highest levels observed in Bamako (11.11%) and Mopti (7.62%) in Mali, and Dosso (6.67%) in Niger. High within-herd prevalence (>20%) was identified in only one herd per country. The higher overall herd-level seroprevalence in Mali was primarily driven by a greater number of herds with low (≤10%) within-herd seroprevalence. Univariate risk factor analysis at the animal level identified a borderline trend toward higher odds of seropositivity in crossbred cattle than other breeds (OR = 1.95, 95% CI: 1.00–3.81, p = 0.0503). In addition, a classification tree analysis highlighted seven exploratory signals of the positive herd status. These included four animal/management-level factors—herd region, environmental disposal of aborted placentas, the number of lactating cows (as a proxy for animal density), and reported herd abortions—as well as three human-level signals within the household: a history of miscarriage, experiencing heavy night sweats, and suffering from undulant fever. In conclusion, this survey provides new insights into bovine brucellosis and its epidemiology in dairy herds in Mali and Niger, confirming established high-prevalence areas such as Bamako and identifying new zones of concern, such as Mopti and Dosso. Our findings underscore that bovine brucellosis remains an important public health and economic threat in both countries. Given that the identified positive regions are hubs for milk production and consumption, these data may support health authorities in implementing targeted surveillance, control, and prevention strategies under a One Health approach. Full article

Accurate differentiation of Alzheimer’s disease (AD) and frontotemporal dementia (FTD) is clinically important because their management strategies differ. This study aimed to develop and evaluate a Dynamic Threshold Graph Convolutional Network (DT-GCN) and to systematically compare four EEG-based functional connectivity (FC) measures—Pearson correlation, phase-locking value (PLV), Granger causality, and copula analysis—for classifying AD, FTD, and healthy controls (HCs). In contrast to fixed graph binarization, DT-GCN updates the connectivity threshold at each training epoch according to training-fold loss. The model is trained under a multi-task objective combining classification, reconstruction, and contrastive losses, with the loss weights adjusted across three stages of training. Resting-state 19-channel EEG recordings from a public dataset (DS004504) comprising 36 AD, 23 FTD, and 29 HC participants were segmented into non-overlapping 8 s epochs. FC estimates were aggregated to obtain a subject-level adjacency matrix for each measure, with one-hot node identity and node degree as node features. Classification was performed at the subject level using stratified five-fold cross-validation with normalization and hyperparameter selection confined to training folds. Under the broadband setting, copula-based FC with DT-GCN yielded the highest observed three-class accuracy of $0.82\pm 0.07$ (macro-F1 $0.79\pm 0.07$), compared with $0.45\pm 0.06$ accuracy and $0.36\pm 0.06$ macro-F1 for the standard GCN baseline. However, the small single-center cohort ($N=88$, including 23 participants with FTD) and the resulting small test folds limit the precision of the performance estimates and preclude robust inferential comparisons among FC methods and classification scenarios. These exploratory, dataset-specific findings require independent external validation and should not be interpreted as generalizable clinical performance or validated clinical biomarkers. Full article

Background/Objectives: Metabolic syndrome (MetS), defined by abdominal obesity, dysglycemia, dyslipidemia, hypertension, and insulin resistance, markedly increases the risk of type 2 diabetes mellitus and cardiovascular disease. Affecting an estimated 25–30% of the global adult population, MetS represents a major and growing public health challenge. A growing body of evidence supports a significant bidirectional relationship between MetS and oral health, particularly periodontitis. The present study aimed to synthesize current evidence on the pathophysiological mechanisms, epidemiological associations, interventional outcomes, and clinical implications of the bidirectional relationship between metabolic syndrome (MetS) and periodontitis. Methods: A narrative review following the SANRA framework was performed. PubMed, Scopus, and Web of Science were searched for articles published in January 2021–March 2026 using MeSH and free-text terms including “metabolic syndrome”, “periodontal disease”, “insulin resistance”, and “oral microbiota”. Eligible studies included original research and systematic reviews in English with full-text availability; animal and in vitro studies were included if directly informative of mechanistic pathways. Results: A total of 64 references were selected for inclusion. Shared mechanisms include chronic systemic inflammation, insulin resistance, oxidative stress, adipokine imbalance, endothelial dysfunction, and oral–gut microbiome dysbiosis. Cross-sectional and longitudinal studies show that MetS components are independently associated with higher prevalence and severity of periodontitis; meta-analyses report pooled odds ratios of 1.7–1.9 compared with metabolically healthy controls. Non-surgical periodontal therapy produces modest but significant reductions in glycated hemoglobin (HbA1c) and systemic inflammatory markers. Sodium–glucose cotransporter-2 (SGLT2) inhibitors may alter oral microbiota composition and cause mucosal changes, while glucagon-like peptide-1 (GLP-1) receptor agonists may increase caries risk through gastrointestinal side effects and xerostomia; both drug classes warrant proactive dental monitoring. Conclusions: The bidirectional relationship between MetS and oral health supports integrated screening and interdisciplinary management. Routine periodontal assessment should be integrated into the metabolic risk management pathway, and dental professionals should screen patients with severe periodontitis for metabolic risk factors. The oral microbiome emerges as a promising target for future mechanistic research and therapeutic intervention. Recognition of oral health as an integral component of metabolic health may improve risk stratification, prevention, and long-term patient outcomes. Large-scale randomized controlled trials with standardized endpoints are needed to establish causal directionality and optimize combined therapeutic strategies. Full article

Background/Objectives: Healthy eating and regular physical activity support chronic disease prevention and healthy aging, while smoking, sugar-sweetened soft drink consumption, and excess weight remain important public health concerns in Europe. Nutritional status and lifestyle behaviors are also relevant to the progression and management of obesity-related metabolic and degenerative diseases, which justify a broader, systems-oriented analysis of lifestyle–health profiles. This study examines the associations between lifestyle behaviors, excess weight, and population health outcomes across European Union Member States and explores whether Member States exhibit distinct lifestyle–health profiles. Methods: The analysis uses cross-sectional data from the European Health Interview Survey for the 27 European Union Member States, along with related Eurostat indicators. Healthy dietary behavior is measured through daily fruit and vegetable consumption. The study also includes health-enhancing physical activity, daily smoking, sugar-sweetened soft drink consumption, overweight and obesity prevalence, life expectancy, and healthy life years. Pearson and Spearman correlations, reduced linear regression models, hierarchical clustering, K-means clustering, and cluster-based comparisons are used. Results: Healthy dietary behavior was positively associated with life expectancy (r = 0.459, p = 0.016), as was health-enhancing physical activity (r = 0.435, p = 0.023), while overweight prevalence was negatively associated with life expectancy (r = −0.505, p = 0.007). The reduced regression model, including healthy dietary behavior, physical activity, and overweight prevalence, explained 47.4% of the variance in life expectancy. Cluster analysis identified three distinct lifestyle–health profiles: a healthy-diet, low-excess-weight and high-longevity profile; a lower-diet-quality, higher-smoking and lower-health-outcome profile; and a mixed profile characterized by low smoking, higher excess weight, and relatively favorable health outcomes. Conclusions: The study supports a systems-oriented view of lifestyle and population health in Europe. Its findings may inform more targeted nutrition, obesity prevention, and public health policies across EU countries. Full article

5G-Advanced (3GPP Release 18) architectural changes include multi-access edge computing (MEC) architectural changes, network automation, and non-public networks (NPNs). It is important to note that even though these advancements provide substantial performance advantages, they destroy fixed-perimeter security models, providing a distributed attack surface. The use of current security assessment strategies, which are usually non-fluid and isolated, is inadequate to offer the required runtime security health assurance needed in such fluid environments. This study presents a new security assurance framework (SAF) that would be used to provide ongoing evidence-based protection on core, edge, and private network domains. This framework employs a four-layer architecture, including monitoring, analytics (LM), policy engine, and enforcement, to convert security periodically audited to a dynamic threat-control-metric evidence chain. A 96% attack detection rate and a 99.8% reduction in response time (with a mean of 20.1 s) are proven by validation on an emulated 5G-Advanced testbed (approximating Release 18 features using Open5GS (v2.7.2 Rel-17, community developed, Seoul, Republic of Korea and custom extensions) based on a design science research (DSR) paradigm. Although the overhead (13% CPU, 21.4% memory) is manageable, the findings prove that all-time, multi-domain assurance is crucial to the healthy functioning of 5G-Advanced and is a key roadmap to autonomous 6G security. Full article

Populations of European bison (Bison bonasus), Eurasian beaver (Castor fiber), and Eurasian moose (Alces alces) in Poland are currently experiencing significant growth. These species are subject to strict legal protection or specific regulatory frameworks. The purpose of the study is to analyze Polish legislation concerning the protection of selected species and to identify legislative actions that could ensure healthy, sustainable, and well-managed population levels in Poland. The study also explores carefully regulated forms of sustainable use, including the potential consumption of meat from these species. During this research, the methodology of analysis and scientific interpretation of legal acts was used. Case law and relevant socio-economic and environmental factors were also analyzed and highlighted. The results show that the law currently in force and its interpretation may pose challenges to achieving fully effective conservation outcomes. Wildlife protection requires effective, locally adapted population management. Proposals for legal changes that would support diversified and sustainable management approaches, while maintaining a high level of protection, ensuring environmental stability and sustainability, and ensuring the highest standards of public safety, are presented. De lege ferenda postulates indicate that it is essential to balance the legitimate interests of wildlife conservation, public health, and society. Full article

Excessive fluoride intake from drinking water remains a public health concern in geogenic high-fluoride regions, yet direct evidence linking environmental fluoride levels to internal exposure in remote high-altitude areas is limited. This study integrated environmental monitoring with human biomonitoring to assess fluoride exposure and health risks in the Taruo Lake region of the Tibetan Plateau. Surface water (n = 45 for Taruo Lake; n = 8 for its tributaries) and groundwater samples (n = 4) were collected and analyzed for fluoride concentrations, and blood ionic fluoride (BIF) levels were measured in 122 local residents (47 adults, 75 children). The results showed that fluoride concentrations in most surface water tributaries of Taruo Lake and groundwater sources were below China’s drinking water standard, whereas those in Taruo Lake exceeded this limit (routine monitoring mean 2.54 mg/L; multi-site mean 2.79 mg/L). BIF levels were significantly higher in adults (0.126 ± 0.041 mg/L) than in children (0.075 ± 0.032 mg/L) and showed a positive correlation with age (r = 0.533, p < 0.001). Notably, 23.4% of adults and 1.3% of children exceeded 0.15 mg/L, an empirical threshold typical for healthy populations in non-endemic areas. Based on the hazard quotient (HQ) model recommended by the US EPA, most drinking water sources posed acceptable non-carcinogenic risks (HQ < 1). In contrast, Taruo Lake water presented an elevated risk (HQ > 1) in 2024 primarily due to the regional geological background, and although not used for daily drinking, this finding offers an indicative reference for local water management and risk prevention. This preliminary monitoring and biomonitoring assessment provides baseline data for future studies and underscores the necessity of continuous surveillance and evaluation of total dietary fluoride intake to protect the health of this vulnerable high-altitude population. Full article

Introduction: Evidence supports using multicomponent lifestyle medicine programs to alleviate depression, yet few studies detail the program development process. This study aimed to systematically develop a complex lifestyle medicine program for depression based on Traditional Chinese Medicine theory. Methods: A stepwise, multi-method study was conducted. The preparation phase involved understanding the public health issue, identifying resources, and reviewing published evidence. Based on these results, a Delphi survey was performed, followed by an analysis of the context understanding as well as design and refinement of the program. Subsequently, the program was modeled, and a program theory was developed, incorporating explanations and assumptions in a relevant conceptual framework and logic model. Results: A complex lifestyle medicine program and program manual were established. The program involves three major themes, each with six 120 min weekly consecutive sessions: nourishing the heart (two sessions), nourishing according to the time (two sessions), and nourishing the Qi (two sessions). The program covered TCM theory and practice to promote healthy sleep, diet, stress management, and self-administered acupressure and TCM exercise. Teaching materials were created accordingly. Conclusions: This study reports the development of a complex multicomponent TCM lifestyle medicine program to relieve depression thoroughly and transparently, with a specific focus on the Hong Kong context and a particular focus on TCM theory. The developed program will be examined for feasibility, acceptability, and preliminary efficacy in alleviating depression in a mixed-methods clinical study. Full article

Sleep disturbances and poor sleep quality are growing public health concerns, adversely affecting both physical and mental health. While exogenous melatonin supplements are used to manage the condition, there is limited evidence available on the efficacy of sustained-release (SR) melatonin formulations. This multicenter, randomized, double-blind, placebo-controlled clinical trial evaluated the efficacy and safety of melatonin-SR capsules (2 mg) in healthy adults with poor sleep quality. Participants aged 30–60 years with poor sleep quality received melatonin-SR (2 mg) or a placebo capsule at night for 28 days. Changes from baseline to day 28 in polysomnography (PSG)-derived sleep parameters, Pittsburgh Sleep Quality Index (PSQI), WHO-5 Well-Being Index, sleep diary parameters, and safety profile were evaluated. Of 62 enrolled participants, 59 (melatonin-SR, n = 28; placebo, n = 31) completed the study. Compared with placebo, melatonin-SR supplementation resulted in significant improvements at day 28 in PSG-derived sleep efficiency (change from baseline: 3.49 for melatonin-SR vs. −6.30% for placebo; p = 0.001) and total sleep time (change from baseline: 23.83 for melatonin-SR vs. −39.25 min for placebo; p = 0.001), along with significant reductions in sleep onset latency (change from baseline: −10.28 for melatonin-SR vs. 16.70 min for placebo; p = 0.031) and wake after sleep onset (change from baseline: −14.92 for melatonin-SR vs. 24.71 min for placebo; p = 0.001). Melatonin-SR supplementation demonstrated a large treatment effect for the improvement in sleep efficiency compared with placebo (Cohen’s d = 0.9). A significant reduction in PSQI global scores was observed in the melatonin-SR group from day 07 onwards (change from baseline on day 07: −2.21 vs. −0.23; day 14: −4.86 vs. −0.65; and day 28: −5.61 vs. −0.65 for melatonin-SR and placebo, respectively; p = 0.001). Improvement in subjective psychological well-being was significant from day 14 onwards (change from baseline on day 14: 9.86 vs. 0.77; and day 28: 13.29 vs. 0.77 for melatonin-SR and placebo, respectively; p = 0.001). A significant improvement in subjective sleep parameters at day 28 (p < 0.05) was observed. Reported adverse events in both groups were mild and transient in nature. Supplementation with melatonin-SR 2 mg capsule at night for 28 days was found to be effective and safe in improving objective and subjective sleep quality outcomes and overall well-being in the trial population. Full article

As essential components of the natural environment, urban green and blue spaces (UGBSs) hold significant potential to enhance public health and wellbeing. However, existing research is limited in understanding the spatiotemporal heterogeneity and nonlinear relationships characterizing how built environment (BE) features of UGBSs influence public happiness. This study takes Nanjing, China as a case study. It integrates multisource data (e.g., social media text, remote-sensing imagery, POI data, land use, etc.) and employs machine learning techniques (including sentiment analysis and random forest), to investigate the nonlinear effects and spatiotemporal dynamics of UGBSs’ BE on public happiness. The results show that nonlinear relationships (e.g., S-shaped and inverted U-shaped) commonly exist between UGBSs’ BE indicators and happiness. The influence of UGBSs’ BE on happiness demonstrates significant spatiotemporal dynamics. Diversity and destination accessibility were dominant factors from 2021 to 2023, whereas the importance of the design and density dimensions increased substantially after 2023. The influence varied across UGBS types; except for the diversity dimension, the BE’s density, design, and destination accessibility were significantly associated with happiness across all UGBS types. The study offers empirical evidence to inform planning and management of UGBS infrastructure, with the aim to maximize public health benefits and foster healthy cities. Full article

Measles remains a major global public health challenge as declining vaccination coverage fuels outbreaks worldwide. Although pneumonia is the most recognized respiratory complication, spontaneous air leak syndrome—including pneumomediastinum, subcutaneous emphysema, and pneumoperitoneum—is rarely documented. We report the case of a 9-year-old previously healthy girl with no documented measles–rubella vaccination who presented with fever, maculopapular exanthem, Koplik spots, and persistent cough. Measles was confirmed by both immunoglobulin M enzyme-linked immunosorbent assay and real-time reverse transcription polymerase chain reaction. She developed sudden cervicothoracic swelling and chest pain. Chest radiography revealed pneumomediastinum and subcutaneous emphysema; computed tomography confirmed extensive air leak including pneumoperitoneum. Flexible bronchoscopy and upper gastrointestinal endoscopy excluded structural airway and esophageal injury. Laboratory evaluation revealed elevated hepatic transaminases, gamma-glutamyl transferase, lactate dehydrogenase, and D-dimer. Conservative management with high-flow supplemental oxygen and clinical surveillance led to progressive resolution. The patient was discharged on hospital day three, asymptomatic and breathing room air. This case highlights the spectrum of air leak complications in measles and supports conservative management in hemodynamically stable pediatric patients when structural injury has been excluded. Full article

Objectives: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease that significantly impairs patients’ quality of life, especially in its moderate to severe forms. Traditional treatments, including antibiotics, hormonal therapies, and surgery, often fail to provide long-term relief in such cases. This study aims to explore the role of radiotherapy, particularly with the use of 3D printing technology to create personalized boluses and applicators, as an adjunctive treatment for refractory HS. A systematic review of published studies was conducted to assess the efficacy of radiotherapy in managing HS, with a specific focus on studies using 3D printing technology to create customized boluses and applicators. Methods: Publications from databases such as PubMed, Scopus, and Google Scholar were analyzed for studies detailing radiotherapy techniques, dosing regimens, and the use of 3D-printed devices in HS treatment. The studies selected included those employing both external beam radiotherapy and brachytherapy, with particular emphasis on patient outcomes and adverse effects. Results: The reviewed studies highlighted a growing body of evidence supporting the use of radiotherapy for HS, especially in severe or treatment-resistant cases. The use of 3D-printed boluses and applicators in radiotherapy demonstrated significant improvements in treatment precision and patient comfort. Personalized treatment plans allowed for more accurate dose distribution, minimized air gaps, and reduced exposure of healthy tissue. No major long-term toxicity was reported across the majority of studies. Conclusions: Radiotherapy, particularly when combined with 3D printing technology, presents a promising treatment option for patients with severe or refractory HS. Customizable boluses and applicators enhance the precision of radiotherapy by conforming to irregular skin surfaces, thereby improving dose conformity and reducing side effects. Despite the positive results, further research is needed to assess the long-term safety and clinical feasibility of this approach. The integration of 3D printing in radiotherapy could significantly improve treatment outcomes, offering a more personalized and effective therapeutic option for HS patients. Full article

Although treated wastewater (TWW) is increasingly being used to irrigate urban landscapes in arid regions like Qatar to preserve scarce freshwater resources, little is known about its long-term ecological impacts. The effects of extended irrigation with TWW on the composition of weed communities and soil characteristics in urban turfgrass systems were assessed in this study for a full year period. Three turfgrass fields in public parks in Doha that are not distant and similar in turf species and type of management were chosen. One of them has received regular tap water, and the other two had received a period of two years or a period of seven years irrigation with TWW. Due to nutrient availability in TWW, long-term irrigation improved turfgrass performance but drastically changed the structure and composition of the weed communities. More weed diversity and abundance were observed under irrigation with TWW, coinciding with cumulative increases in soil salinity [from 265 µS/cm for soil irrigated with regular tap water to about 1799 µS/cm for soil long-term irrigated with treated wastewater] and nutrient levels. Dactyloctenium aristatum and Euphorbia prostrata were dominating the field under TWW irrigation, while Cyperus rotundus prevailed better under regular tap-water irrigation. Crucially, build-up of toxic elements was found in the turfgrass, but not harmful. Overall, the findings showed that although TWW is a useful source for maintaining urban green spaces in arid regions, its long-term use necessitates cautious management to reduce weed growth and adaptation. Maintaining sustainable and healthy urban landscapes may be aided by using salt-leaching irrigation techniques and seasonal blending with freshwater. Full article

Background: Although air pollution is increasingly considered an environmental hazard for inflammatory bowel disease (IBD), existing evidence predominantly relies on single-pollutant models that fail to capture mixed exposures, with modifying effects of individual lifestyle and residential environments remaining largely unexplored. Methods: We conducted a prospective cohort study using UK Biobank data, including 323,608 participants followed for incident IBD. Annual mean concentrations of five air pollutants [nitrogen dioxide (NO₂), nitrogen oxides (NO_x), and PM with aerodynamic diameters of ≤2.5, 2.5–10, and ≤10 μm (PM_2.5, PM_2.5–10, PM₁₀)] and greenspace percentage within 300 m and 1000 m buffers were assigned to each participant’s residential address. A healthy lifestyle score was defined by five factors: smoking status, alcohol consumption, physical activity, sleep patterns, and dietary quality. Cox proportional hazards models with quantile g-computation (QGC) were employed to examine associations between single- and mixed-air-pollutant exposures and IBD risk. Stratified analyses were performed by healthy lifestyle, lifestyle score, and greenspace percentage. Results: During the follow-up period, 1649 and 805 participants developed ulcerative colitis (UC) and Crohn’s disease (CD), respectively. Single-pollutant models suggested that exposures to most air pollutants were substantially associated with increased risk of IBD, and the association strengths were more pronounced for UC than for CD. QGC analyses indicated that the hazard ratios (HR) of IBD risk were 1.068 (95%CI: 1.018–1.121) for each one-quantile increase in the air pollutant mixture, with NO₂ weighted as the largest contributor. High physical activity was significantly linked to an attenuated UC-pollutant mixture association. Conclusions: This study found that exposure to an air pollutant mixture was associated with increased risk of IBD, especially for UC, with NO₂ contributing the largest effect size. The certain attenuated air pollution effects of healthy lifestyles and residential greenspaces underscore the need for integrated public health strategies with environmental management. Full article