Search Results (237)

Background/Objectives: Cardiometabolic risk remains a major challenge in patients with type 2 diabetes mellitus (DMT2). This study aimed to evaluate cardiovascular (CV) risk stratification using advanced glycation end-products (AGEs) measured via skin autofluorescence (SAF) and to assess the achievement of evidence-based ABC targets (HbA1c, blood pressure, low-density lipoprotein (LDL) cholesterol) in adults with DMT2 in Dalmatia. Methods: In this single-center cross-sectional study, 251 adults with DMT2 were stratified by CV risk based on SAF measured AGE levels. Clinical, biochemical, and anthropometric data were collected, including ABC goal attainment and medication use. Statistical analyses compared groups and explored predictors of ABC target achievement using regression models adjusted for clinical factors. Results: Only 17.5% of participants achieved all three ABC goals, indicating suboptimal cardiometabolic control. Those with elevated CV risk had higher hip circumference and lower diastolic blood pressure. Use of sodium-glucose cotransporter 2 (SGLT2) inhibitors was positively associated with ABC goal achievement in patients with prior CV or cerebrovascular events, while higher body mass index was negatively associated. SAF measured AGE levels correlated with cardiometabolic risk but showed no significant differences across LDL cholesterol or other traditional markers. Conclusions: SAF AGE measurement shows potential for CV risk stratification in DMT2 beyond traditional factors. The low rate of ABC goal attainment highlights the need for intensified individualized management incorporating novel biomarkers and therapeutics like SGLT2 inhibitors. Further prospective studies are needed to validate these findings and improve prevention of cardiovascular complications in DMT2. Full article

Background/Objectives: Each year, the number of kidney transplants (KT) performed in older recipients continues to rise. The process of aging may impact early post-transplant outcomes. The aim of this study was to analyze one-year outcomes, clinical and surgical complications, as well as patient and graft survival in senior recipients. Methods: This retrospective, observational study included a total of 270 participants who underwent KT during the period between January 2021 and April 2024. Recipients were divided into two groups: the older group (≥60 years; n = 75) and the younger group (<60 years; n = 195) and then analyzed during a one-year follow-up period. Results: Older recipients were characterized by a higher body mass index (MD = 1.77, CI95 [0.63; 2.91], p = 0.002), suffered more often from diabetes mellitus (RR = 2.94, CI95 [1.79; 4.82], p < 0.001), cardiovascular diseases (RR = 5.20, CI95 [2.90; 9.32], p < 0.001) and were more likely to receive a kidney from older (MD = 12.37, CI95 [8.94; 15.80], p < 0.001) deceased (p < 0.001) donors. Senior patients had more infections (p = 0.019) and surgical complications (RR = 1.81, CI95 [1.14; 2.87], p = 0.020), more cardiac events (RR = 2.28, CI95 [1.17; 4.43], p = 0.025), and a higher incidence of delayed graft function (p < 0.001) compared to younger patients. The estimated glomerular filtration rate (eGFR) was significantly lower in the older group both at initial hospital discharge (MD = −6.50, CI95 [−13.00; −3.00], p = 0.004) and at one-year follow-up (MD = −11.79, CI95 [−17.32; −6.25], p < 0.001). No differences were observed in the incidence of biopsy-proven acute rejection, cytomegalovirus replication, and polyomavirus replication. One-year patient and graft survival was 97.3% and 94.7% in the older group, and 98.5% and 96.9% in the younger group, respectively. Conclusions: Kidney transplantation in older recipients is safe in the short term. Although eGFR was lower in the older group, it remained within an acceptable range. Full article

Background: Elevated BMI in women is linked to metabolic and endocrine imbalances that impair fertility and increase pregnancy risks. While >10% weight loss before an Assisted reproductive technology (ART) treatment may improve outcomes, sustained results through conventional diets are challenging. A very-low calorie ketogenic diet (VLCKD) promotes rapid fat loss while preserving lean mass and may offer long-term benefits. This study evaluated the efficacy (≥10% weight loss without lean mass reduction), adherence, metabolic effects, and pregnancy outcomes of a meal replacement VLCKD in women with overweight or obesity scheduled for ART. Methods: This monocentric, prospective case-series was conducted at the Obesity and Work Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan (September 2019–September 2023). Eligible women underwent a three-phase dietary program: a 3-month VLCKD (<800 kcal/day), a 6-month transition with gradual carbohydrate reintroduction, and a Mediterranean-style maintenance diet. Participants were monitored for safety, body composition, adherence, and biochemical changes. Results: Of 52 women enrolled, 40 initiated the VLCKD; 27 (68%) achieved ≥10% weight loss while preserving lean mass. Eleven conceived naturally during or after the diet; 22 underwent ART, with 12 additional pregnancies. This corresponds to a 58% pregnancy rate among those who began the VLCKD. Significant improvements were observed in body mass index (BMI), fat mass, waist circumference, glucose metabolism, lipid profile, and liver function. No adverse events were reported. Conclusions: A meal replacement VLCKD protocol is feasible, well-tolerated, and associated with significant improvements in weight, especially in body composition, metabolic health, and potentially outcomes in women with overweight or obesity awaiting ART. Full article

Introduction: Marathon runs conducted in tropical environments can result in high injury rates. This study was conducted to provide information about the burden of injuries in such environments, to aid planning for similar mass events, enhance medical support, and improve participant safety. Methods: This was a retrospective review of casualty data from the Singapore Marathon races from 2013 to 2016. Patient Presentation Rate (PPR) and Transport to Hospital Rate (THR) were calculated and correlated with heat index, derived from weather information. Injury types were also reviewed. The negative binomial regression was performed to investigate impact of heat index on casualty rates. The medical response plan is briefly described. Results: During the four-year period covered, heat index increased from 29° to 35°. There were more casualties amongst the participants from the full marathon than other race categories. The THR was 0.3 to 0.68 per 1000 participants. Two participants had cardiac arrest. Negative binomial regression showed significant impact of heat index on casualty rate. Incidence rate ratio was 1.22 for severe casualties, which indicated that every 1 unit increase in heat index resulted in 22% rise in severe casualty numbers. Compared with 10 km racers, half marathon racers experienced 1.58 times greater likelihood of all injuries and full marathon racers, a 3.87 times greater risk. Conclusions: Adverse weather conditions with high-heat index can increase injury rates during strenuous physical activities such as the marathon. Applying careful measures to minimise the impact of heat and high humidity may help minimise such injuries. Full article

Background. Type 2 diabetes mellitus (T2D) and moderate-to-severe obstructive sleep apnea (OSA) commonly coexist and exacerbate poor glycemic control, systemic inflammation, and diminished quality of life (QoL). Although continuous positive airway pressure (CPAP) therapy has demonstrated metabolic and anti-inflammatory benefits, its real-world impact in Bulgarian outpatient settings—where CPAP costs are borne entirely by patients—has not been characterized. Objectives. To evaluate the effects of six months of CPAP therapy on glycemic control (hemoglobin A₁c [HbA₁c]), systemic inflammation (high-sensitivity C-reactive protein [hsCRP]), body mass index (BMI), lipid profile (low-density lipoprotein [LDL]), QoL (Short Form 36 Physical Component Summary [SF-36 PCS] and Mental Component Summary [SF-36 MCS]), and survival among Bulgarian outpatients with T2D and moderate-to-severe OSA. Methods. In this prospective, multicenter cohort study conducted from January 2022 to July 2023, 142 adults with established T2D and OSA (apnea–hypopnea index [AHI] ≥ 15) were enrolled at three outpatient centers in Bulgaria. Fifty-five patients elected to purchase and use home-based CPAP (intervention group), while 87 declined CPAP—either because of cost or personal preference—and continued standard medical care without CPAP (control group). All participants underwent thorough outpatient evaluations at baseline (month 0) and at six months, including measurement of HbA₁c, hsCRP, BMI, fasting lipid profile (LDL), and patient-reported QoL, via the SF-36 Health Survey. Survival was tracked throughout follow-up. Results. After six months, the CPAP group experienced a significant reduction in HbA₁c from a median of 8.2% (IQR 7.5–9.5%) to 7.7% (6.7–8.7%), p < 0.001, whereas the control group’s HbA₁c decreased modestly from a median of 8.6% (IQR 7.9–9.4%) to 8.3% (7.6–9.1%); p < 0.001), with a significant between-group difference at follow-up (p = 0.005). High-sensitivity CRP in the CPAP arm fell from a median of 2.34 mg/L (IQR 1.81–3.41) to 1.45 mg/L (IQR 1.25–2.20), p < 0.001, while remaining unchanged in controls (p = 0.847). BMI in the CPAP group declined significantly from 28.6 kg/m², IQR 26.6–30.6 to 28 kg/m², IQR 25.6–29.2 (p < 0.001), compared to no significant change in controls (median 28.9 kg/m²), p = 0.599. LDL decreased in the CPAP group from a median of 3.60 mmol/L (IQR 3.03–3.89) to 3.22 mmol/L (IQR 2.68–3.48), p < 0.001, with no significant reduction in controls (p = 0.843). Within the CPAP arm, both SF-36 PCS and SF-36 MCS scores improved significantly from baseline (p < 0.001 for each), although between-group differences at six months did not reach statistical significance (PCS: 48 ± 10 vs. 46 ± 9, p = 0.098; MCS: 46, IQR 40–54 vs. 46, IQR 39–53, p = 0.291). All-cause mortality during follow-up included 2 events in the CPAP group and 11 events in the control group (log-rank p = 0.071). Conclusions. In Bulgarian outpatients with T2D and moderate-to-severe OSA, six months of CPAP therapy significantly improved glycemic control, reduced systemic inflammation, lowered BMI and LDL, and enhanced QoL, with a non-significant trend toward reduced mortality. These findings underscore the importance of integrating CPAP into multidisciplinary management despite financial barriers. Full article

A novel skin test for an in vivo assessment of SARS-CoV-2-specific T-cell immunity was developed using CoronaDermPS, a multiepitope recombinant polypeptide encompassing MHC II–binding CD4+ T-cell epitopes of the SARS-CoV-2 structural proteins (S, E, M) and full length nucleocapsid (N). In silico epitope prediction and modeling guided antigen design, which was expressed in Escherichia coli, was purified (>95% purity) and formulated for intradermal administration. Preclinical evaluation in guinea pigs, mice, and rhesus macaques demonstrated a robust delayed type hypersensitivity (DTH) response at optimal doses (10–75 µg), with no acute or chronic toxicity, mutagenicity, or adverse effects on reproductive organs. An integrated clinical analysis included 374 volunteers stratified by vaccination status (EpiVacCorona, Gam-COVID-Vac, CoviVac) prior to COVID-19 infection (Wuhan/Alpha, Delta, Omicron variants), and SARS-CoV-2–naïve controls. Safety assessments across phase I–II trials recorded 477 adverse events, of which >88% were mild and self-limiting; no severe or anaphylactic reactions occurred. DTH responses were measured at 24 h, 72 h, and 144 h post-injection by papule and hyperemia measurements. Overall, 282/374 participants (75.4%) exhibited a positive skin test. Receiver operating characteristic analysis yielded an overall AUC of 0.825 (95% CI: 0.726–0.924), sensitivity 79.5% (95% CI: 75.1–83.3%), and specificity 85.5% (95% CI: 81.8–88.7%), with comparable diagnostic accuracy across vaccine, and variant subgroups (AUC range 0.782–0.870). CoronaDerm-PS–based skin testing offers a simple, reproducible, and low-cost method for qualitative evaluation of T-cell–mediated immunity to SARS-CoV-2, independent of specialized laboratory equipment (Eurasian Patent No. 047119). Its high safety profile and consistent performance across diverse cohorts support its utility for mass screening and monitoring of cellular immune protection following infection or vaccination. Full article

Background: The COVID-19 pandemic significantly disrupted patterns of physical activity and participation in mass sporting events, with recreational runners in Latin America among the most affected. In Colombia, pre-existing inequalities in access to sport further exacerbated these impacts. Nevertheless, evidence on post-COVID-19 impact and recovery experiences among regional runners remains limited. Objective: We examined the sociodemographic profiles, athletic experience, and perceptions of COVID-19-related impact and recovery among participants in the 2023 Medellín Marathon, and to assess differences by educational attainment, employment status, age group, and geographic origin. Methods: A cross-sectional descriptive study was undertaken involving 2486 registered marathon runners. An ad hoc questionnaire assessed COVID-19 symptoms and sequelae, perceived respiratory and physical limitations, fears associated with group exercise, and self-reported recovery. Analyses included descriptive statistics, bivariate comparisons and one-way ANOVA tests. Results: Older participants, retirees and those with lower educational levels reported significantly greater COVID-19 impact, longer recovery periods and higher perceived physical and respiratory limitations. In contrast, younger runners and those with a college education showed more complete physical recovery and attributed protective benefits, such as improved cardiorespiratory function and a lower incidence of respiratory symptoms, to their training. Additionally, runners originating from smaller municipalities and other Latin American countries reported higher levels of impact and lower perceptions of recovery. Conclusions: Post-COVID-19 effects among marathon runners are not uniform but vary according to sociodemographic and contextual factors. These findings underscore the importance of tailored support and readaptation strategies—particularly for vulnerable subgroups—to ensure their safe and equitable return to mass endurance events. Full article

Background: In Mexico, research on somatotypes in athletes has primarily focused on team sports, taekwondo, climbing, and triathlon. However, the available evidence remains limited. Therefore, the purpose of this study was to determine the somatotype of Mexican athletes by sex, and to compare somatotype and body composition across sport macro-categories in 43 disciplines. Methods: Anthropometric measurements were conducted according to the International Society for the Advancement of Kinanthropometry (ISAK) protocol. Athletes who participated in regional, national, or international competitions between 2008 and 2024 were included. Results: A total of 889 Mexican athletes (477 males and 412 females) across 43 disciplines were evaluated. Among male athletes, the predominant somatotype was endomorphic mesomorph (52.4%), followed by balanced mesomorph (17.6%) and ectomorphic mesomorph (13.6%). Among female athletes, the most reported somatotypes were endomorphic mesomorph (24.5%), mesomorphic endomorph (24.0%), and mesomorph-endomorph (21.4%). Athletes in endurance sports showed significant differences for both sexes compared to those in power and skill-based sports for both sexes (p < 0.05). Among males, team sports showed the highest values for body mass, height, and body fat percentage (%BF), while mesomorphy was greatest in track and field and ectomorphy in sprint events. Among females, track and field athletes presented the highest values for body mass, height, %BF, mesomorphy, and endomorphy, whereas endurance athletes exhibited the highest ectomorphy values. Conclusions: The findings suggest that, compared to international athletes, Mexican athletes exhibited a higher endomorphic component. It is recommended that somatotype assessments should be incorporated into regular monitoring protocols at national sports centers and considered in physical training programs to optimize performance and reduce the risk of injury. Full article

Background: Diabetes mellitus (DM) is a significant factor affecting prognosis and functional capacity in patients after cardiovascular events. This study aimed to assess the impact of coexisting diabetes on exercise tolerance and hemodynamic parameters in patients qualified for cardiac rehabilitation. Methods: A total of 452 patients (86 women, 366 men; mean age 63.21 ± 7.16 years) who had experienced cardiovascular incidents, including 226 individuals with coexisting DM (DM group) and 226 age- (±1 year) and sex-matched individuals without DM (non-DM group), were included in the analysis. All participants underwent an exercise test using a bicycle ergometer. Clinical data, comorbidities, medication use, left ventricular ejection fraction, and exercise test parameters were evaluated. Results: Patients with DM displayed a higher number of comorbidities (4.29 ± 1.26 vs. 3.19 ± 1.30; p < 0.001), greater medication use (8.71 ± 2.16 vs. 7.83 ± 2.05; p < 0.001), higher body mass (86.93 ± 13.35 kg vs. 80.92 ± 15.25 kg; p < 0.001), and a lower left ventricular ejection fraction (48.78 ± 8.99% vs. 50.01 ± 8.40%; p = 0.002) compared to those in the non-DM group. Diabetic patients also exhibited lower exercise capacity, expressed as peak power per kilogram of body mass (1.05 ± 0.27 W/kg vs. 1.16 ± 0.31 W/kg; p < 0.001). No significant differences were observed regarding absolute peak power or maximum heart rate. Conclusions: In patients after cardiovascular incidents, the presence of diabetes is associated with reduced relative exercise capacity and lower ejection fraction. Full article

Objectives: In view of a lack of evidence on the subject, we aimed to perform a scoping review to understand the impact of health education among people attending mass gatherings. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines. PubMed, EMBASE, Scopus, and Cochrane Library were searched from inception to March 2025 to identify eligible studies. Observational and interventional studies that reported the impact of health education on any health-related outcome among those attending a mass gathering were considered. A narrative synthesis of review results was performed to gather evidence. Recommendations were framed in the context of this evidence. Results: Of the 1731 records, only 17 studies met the inclusion criteria. These included cross-sectional (n = 10), pre-post design (n = 3), quasi-experimental (n = 2), randomized controlled trial (n = 1), and ethnographic (n = 1) studies. These studies involved participants attending hajj, umrah, and basketball events. The current evidence on health education in mass gatherings is highly varied in its objectives, intervention strategy, educational plan, mode of delivery, design, and reported outcomes. Most studies agreed that health education should be initiated by the country of origin and continued throughout the event. It is recommended that this education should be tailored to patient needs based on age, medical condition, and other personal factors, and given in the local language for better acceptability. Such sources can be provided in various forms, either online or offline, as per the participant’s convenience. Conclusions: The current evidence on the effectiveness of health education during mass gatherings, particularly in pilgrimage settings, is varied and inconsistent. Participant-tailored health education should be provided, preferably in the local language, through convenient formats. Full article

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

Background: Mass casualty events in conflict-affected regions can lead to the displacement of civilians and are often accompanied by substantial psychological and emotional impact on those affected. While physical activity is known to support mental health, the ways in which it relates to anxiety, resilience, and well-being in conflict-affected populations are still being explored. Objective: This study examined the associations among physical activity, anxiety, resilience, and well-being in evacuees from a conflict-affected zone. We hypothesized that higher levels of intense physical activity would be associated with higher levels of resilience and well-being and lower levels of anxiety. Methods: In this cross-sectional study, 107 evacuees completed an online survey in December 2023. The questionnaire assessed the frequency and intensity of physical activity, generalized anxiety, resilience, and well-being. Participants were categorized by weekly total physical activity levels. Data was analyzed using ANOVA, Pearson correlations, and multiple linear regression. Results: Evacuees engaging in more than three hours of vigorous-intensity physical activity exhibited significantly higher resilience and better well-being compared to those with lower activity levels. Although not statistically significant, the data suggested a possible pattern of lower anxiety among evacuees engaging in higher levels of physical activity. Regression analysis identified higher resilience and lower anxiety as significant predictors of greater mental well-being. Additionally, residing in a community exposed to a higher number of traumatic events was associated with reduced well-being. The overall model explained a substantial portion of the variance in mental well-being. Conclusions: Physical activity, especially intense exercise, is associated with improved mental health and resilience among evacuees, supporting its inclusion in interventions for trauma-affected populations. Full article

Background/Objectives: Impaired kidney function significantly increases mortality in recipients of implantable cardioverter defibrillators (ICDs). However, in the landmark studies evaluating ICDs and cardiac resynchronization therapy with a defibrillator (CRT-D) for the treatment of heart failure (HF) with a reduced ejection fraction (HFrEF), patients with Chagas cardiomyopathy (CC) have been underrepresented. This study aimed to determine whether kidney dysfunction has the same negative impacts on patients with ICDs or CRT-Ds and CC. Methods: We prospectively followed patients with CC and left ventricular ejection fractions (LVEFs) of ≤40% who underwent ICD or CRT-D implantation and had at least one prior creatinine measurement. The primary outcome was the survival rate during follow-up. Variables with a p of <0.10 from the univariate analysis were selected for inclusion in the Cox regression model. Results: A total of 343 patients were enrolled, with a median follow-up duration of 777 days. The mean age was 60.2 (±11.2) years. Fifty percent of patients were observed to have a New York Heart Association (NYHA) functional class of III, and the median left ventricular ejection fraction (LVEF) was 27% (22–32). Overall mortality events occurred in 113 (32.9%) participants during follow-up. Although the estimated glomerular filtration rate (eGFR) was significantly associated with survival in the univariate analysis [HR 0.98 (CI 95% 0.98–0.99), p = 0.007], it did not retain significance in the multivariate model [HR 0.99 (0.98–1.00), p = 0.138], which was adjusted for age, gender, atrial fibrillation (AF), body mass index (BMI), and the use of digoxin, furosemide, anticoagulants, and LVEF. Conclusions: Unlike other cardiomyopathies, impaired eGFR was not an independent predictor of mortality in this cohort of CC patients undergoing ICD or CRT-D implantation, possibly due to the distinctive pathophysiological mechanisms of the disease. These findings suggest that clinicians should not be discouraged from recommending CIEDs in patients with CC and moderately impaired kidney function, although further studies are warranted to assess outcomes in those with advanced CKD. Full article

Background: This study investigated the impact of competitive fatigue on physiological (blood lactate and heart rate [HR]), neuromuscular (countermovement jump [CMJ]), and psychological (rate of perceived exertion [RPE]) variables in youth swimmers. Methods: Forty-two swimmers (mean ± SD, 14 ± 0.5 years; height for boys: 1.73 ± 0.03 m, girls: 1.69 ± 0.02 m; body mass: 67 ± 2.8 kg for boys and 62 ± 2.8 kg for girls) participated during a four-day championship, with data collected before and after their competition heats. Results: Significant post-race increases in lactate levels (p < 0.05) and RPE (p < 0.05) were observed across all distances, particularly after the 100 m and 200+ m events. Heart rate showed a decrease after the 50 m event and an increase after longer distances, reflecting different recovery demands. Although CMJ performance decreased after the races, these changes were not statistically significant (p = 0.810). The findings underscore the importance of race distance in modulating fatigue responses and suggest that RPE and lactate are the most sensitive indicators of competition-induced stress in these youth swimmers. Conclusions: Lactate accumulation and perceived exertion were the most sensitive indicators of fatigue (both p < 0.01), while HR and CMJ responses exhibited variability depending on race distance. These findings highlight the practical use of lactate and RPE monitoring related to fatigue and recovery strategies during competitions in youth swimmers. Full article

Background: Disasters pose significant challenges to public health by disrupting essential services, especially during mass gatherings such as the Hajj pilgrimage. These complex events demand swifts coordinated action from healthcare professionals. However, many remain insufficiently equipped for large-scale emergencies due to gaps in triage training, disaster knowledge, and established response protocols—issues that are particularly critical in high-risk settings. Aim: This systematic literature review aims to explore the clinical insights of registered nurses and other healthcare professionals in disaster preparedness and response during the Hajj pilgrimage in Saudi Arabia. Methods: A systematic literature review was conducted following PRISMA guidelines. A comprehensive database search was performed across CINAHL, Scopus, Medline, Embase, and APA PsycINFO, focusing on studies published between 2012 and 2025. Eligible studies addressed disaster nursing education, preparedness, and response. The Mixed Methods Appraisal Tool (MMAT) was used for quality assessment. Results: Twenty-three studies met the inclusion criteria. Three main themes emerged: disaster preparedness, experiences and challenges in disaster response, and education and training. The review revealed lack in nurses’ readiness, policy awareness, and real-world disaster experience. Training and curriculum improvements are essential to enhance disaster response capabilities. Conclusions: This review highlights the urgent need for standardized disaster nursing curricula to enhance preparedness and response competencies. Incorporating structured disaster training into nursing education will strengthen healthcare system resilience. Future research should adopt qualitative methods to capture healthcare professionals lived experiences during the Hajj. Including diverse participants and focusing on the unique cultural context can enhance disaster preparedness and response strategies. Full article