Search Results (28,236)

Background/Objectives: This systematic review and meta-analysis of observational studies aimed to assess the association between fish consumption and the risk of general and pregnancy-related depression, with implications for public health promotion. Methods: We retrieved 5074 articles from PubMed and Embase through November 2023 and included 35 observational studies in the analysis. We synthesized effect estimates as relative risks (RRs) with corresponding 95% confidence intervals (CIs) using a random-effects model. Additional dose–response analyses and stratified subgroup analyses were performed. Results: A significant inverse association was found between fish consumption and depression risk (RR = 0.79, 95% CI: 0.73 to 0.86). A similar association was observed for pregnancy-related depression (RR = 0.78, 95% CI: 0.69–0.89). Stratified analyses showed that only studies with fish intake ≥68.4 g/day demonstrated a statistically significant reduction in depression risk (RR = 0.75, 95% CI: 0.67–0.84), whereas studies with lower intake (<68.4 g/day) showed no significant association (RR = 0.83, 95% CI: 0.69–1.01), suggesting a potential threshold effect. Dose–response analysis further supported a 6% reduction in depression risk per 15 g/day increase in fish intake. Conclusions: This meta-analysis supports fish consumption as a modifiable factor for depression prevention, with ≥68.4 g/day as a possible threshold, potentially informing dietary guidelines and public health strategies. Full article

Background/Objectives: Artificial intelligence (AI) has rapidly evolved from experimental algorithms to transformative tools in clinical dentistry. Between 2020 and 2025, advances in machine learning (ML) and deep learning (DL) have reshaped diagnostic imaging, caries detection, prosthodontic design, and teledentistry, while raising new ethical and regulatory challenges. This study aimed to provide a comprehensive bibliometric and conceptual review of AI applications in dental care, highlighting research trends, thematic clusters, and future directions for equitable and responsible integration of AI technologies. In addition, the review further considers the implications of AI adoption for patient-centered care, including its potential role in supporting shared decision-making processes in oral healthcare. Methods: A comprehensive search was conducted in PubMed, Scopus and Embase for articles published between January 2020 and October 2025 using AI-related keywords in dentistry. Eligible records were analyzed using VOSviewer (v.1.6.20) to map co-occurrence networks of keywords, authors, and citations. A narrative synthesis complemented the bibliometric mapping, emphasizing conceptual and ethical dimensions of AI adoption in oral health care. Results: A total of 50 documents met the inclusion criteria. Bibliometric network visualization identified that the largest and most interconnected clusters were centered around the keywords “artificial intelligence,” “machine learning,” and “deep learning,” reflecting the technological backbone of AI-based applications in dentistry. Thematic evolution analysis indicated increasing interest in generative and multimodal AI models, explainability, and fairness in clinical deployment. Conclusions: AI has become a core driver of innovation in dentistry, enabling precision diagnostics and personalized care. However, responsible translation requires robust validation, transparency, and ethical oversight. Future research should integrate interdisciplinary approaches linking AI performance, patient outcomes, and equity in oral health. Full article

Background/Objective: Emerging evidence indicates that temporomandibular disorders (TMD) patients may present features of nociplastic pain (NP), characterized by central sensitization (CS)-related symptoms. This study aims to identify factors associated with CS-related symptoms and pain sensitivity in patients with TMD and NP-related features. Methods: In this cross-sectional study, 43 TMD patients were assessed for CS-related symptoms (CSI), proximal, distal, global pressure pain threshold (PPTs, algometer), orofacial pain intensity (VAS), jaw impairment (FAI), maximal isometric strength of four muscle groups (dynamometer), resting heart rate (RHR, chest band), kinesiophobia (TKS-11), physical activity level (IPAQ), anxiety (HADS), and sleep quality (PSQI). Associations were analyzed using linear regression models adjusted for gender, age, and symptoms duration. Results: Multivariate analysis showed that higher CSI was significantly associated with greater jaw impairment (Estimate 0.09, 95% CI 0.01 to 0.18) and higher pain intensity (Estimate 0.26, 95% CI 0.14 to 0.38). Lower PPT was significantly associated with lower grip strength (Proximal: Estimate 0.03, 95% CI 0.01 to 0.05; Distal: Estimate 0.07, 95% CI 0.01 to 0.14; Global: Estimate 2.44, 95% CI 0.57 to 4.31), and proximal PPT with higher RHR (Estimate −0.02, 95% CI −0.03 to 0). Conclusions: Association was found between CS-related symptoms and pain intensity and jaw impairment, while lower PPTs were related to decreased maximal isometric grip strength and elevated RHR, thus highlighting the need for multimodal treatment in TMD patients. Full article

Background/Objectives: Weight loss supplements (WLS) are popular dietary agents; however, their effectiveness is rarely supported by scientific-based evidence. This cross-sectional study aimed to identify the types of WLS used among adult Poles in relation to sociodemographic factors, anthropometric indices, and physical activity (PA). Methods: The study was conducted among 1071 adults aged 19–80 years in Świętochłowice, a region in Poland with a high rate of overweightness and obesity. Body mass index (BMI), waist-to-hips ratio, and weight-to-height ratio were calculated. Fat mass percentage was assessed. Data on PA level and the use of WLS were collected via a face-to-face questionnaire. Results: Nearly 70% respondents declared consumption of WLS, including 486 females and 259 males. Among WLS consumers, 43.4% had normal BMI, and 6.3% were underweight. The most popular WLS were supplements aiming at enhancing thermogenesis (38.0% of WLS consumers), followed by WLS decreasing appetite (15.0%) and blocking dietary fat absorption (13.0%). Sociodemographic factors (sex, age, marital status, education and financial status) were strong determinants of using particular types of WLS. Mean values of anthropometric indices and PA level were different among consumers of various WLS. Conclusions: WLS use was common, including among individuals without overweightness/obesity, or cardiometabolic risk. Extensive educational programs and legislation are essential to promote justified, rational, effective, and safe methods for reducing excessive body mass. Full article

This study investigates the key factors that influence marriage decision among Chinese youth using machine learning techniques. Using data from the China Family Panel Studies (2018–2020), we extracted 1700 samples and filtered 26 significant variables. Seven machine learning algorithms were evaluated, with CatBoost emerging as the most effective. SHAP (SHapley Additive exPlanations) analysis revealed that work-related variables were the most strongly associated with predictions, accounting for 30% of the predictive power, followed by other factors such as demographic and education. Notably, we found that commute time and working hours exceeding 50 min/hours were negatively associated with marriage likelihood, while job satisfactions showed a non-linear relationship with marriage decision. The findings highlight the determinant of work–life balance in marriage decision and the complexity and nonlinear relationship in social decision-making. The objective of this study is to provide scientific data support for policy makers in an era of declining marriage rates in China. This study not only reveals the key factors affecting marriage decision but also provides critical evidence-based support for policymakers to prioritize resource allocation and formulate targeted policies amid declining marriage rates in China. Full article

One of the key problems humanity faces in this age of profound digitalization is globalization-related threats, which no longer affect just one country but pose a threat to a very large area, encompassing several or even a dozen countries, or, in the case of global warming, a threat to all of humanity worldwide. This topic inspired the investigation and verification of this threat in the Baltic Sea, along with other threats operating in the Baltic Sea region. This topic is highly topical, as estimates from maritime institutions indicate that the rate of sea level rise is an irreversible process, which, when combined with other threats, could lead to the degradation of the sea and the population living in the coastal zone. This led to the delegation clarifying the main objective of the article: to demonstrate the impact of potential global threats on the investment process in the Polish coastal belt. Based on this, an analysis of threats in the Baltic Sea region was conducted, preceded by a review of the literature and data from online resources, including data from industry portals in the maritime sector. This article presents a simulation of erosion-accumulation changes in selected areas of Poland’s Southern Baltic coast, focusing on the coastal real estate market and indicating the propensity to invest in these areas. Simulating erosion changes, using a cartographic base with a generated digital terrain model and interpolation tools to visualize the changes, represents an innovative approach to issues related to the outflow of investment land in the real estate market. This emphasizes the directionality of land changes, thus providing a predictive tool for decision-making and spatial planning in the coastal area. Full article

Background/Objectives: Physician burnout and mental health issues are widespread, with over 50% experiencing burnout and nearly 25% suffering from depression, trends that have worsened since 2018. High-demand specialties like urology face additional stressors, including increasing workloads and technological changes. Gender disparities further exacerbate these challenges, with female urologists reporting higher burnout and work–life balance struggles. To evaluate perceptions of work–life balance, career satisfaction, and workplace experiences among urologists worldwide, and to provide potential strategies to improve physician well-being, promote gender equity, and support the sustainability of urology. Methods: A web-based, cross-sectional survey was conducted from March to June 2025, involving urologists, residents, and fellows globally. The 30-item questionnaire covered demographics, working conditions, work–life balance, and gender-related workplace issues. Data were analyzed using descriptive statistics stratified by gender, age, role, and region. Results: We received replies from 390 doctors in urology. Work-related stress was reported by 87.4% (340). A total of 17.7% (69) felt their career progression to be fully compatible with their personal life, while 42.3% (165) perceived a significant imbalance. Female urologists experienced higher perceptions of inequality in career and work–life opportunities. Over 50% expressed willingness to reduce workload for family reasons, highlighting systemic barriers. Burnout was most prevalent among younger urologists (<50 years), with persistent gender disparities across regions. Conclusions: Work–life imbalance and burnout remain major concerns for urologists globally, especially among female and early-career physicians. Addressing these issues requires institutional policies promoting flexibility, gender equity, and targeted support. Further research is needed to develop effective interventions to sustain a resilient urological workforce. Full article

Background and Objectives: Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTSs) can substantially impair health-related quality of life (HRQoL). We examined the relationship between LUTS severity, measured by the International Prostate Symptom Score (IPSS), and HRQoL assessed with the World Health Organization Quality of Life-BREF (WHOQOL-BREF) in men receiving pharmacological treatment for BPH. Materials and Methods: We conducted a cross-sectional study at the University Clinical Center of Vojvodina (May–July 2024). Seventy men aged 50–80 years on ≥1 year of pharmacological therapy for BPH were enrolled. LUTS severity was categorized by IPSS (mild, moderate, severe). HRQoL was measured across WHOQOL-BREF domains (physical, psychological, social, environmental). Group differences were tested with one-way analysis of variance (ANOVA) and post hoc tests; associations were evaluated with Spearman’s rank correlation; multivariable linear regression adjusted for age, socioeconomic status, and therapy type. Results: Severe LUTS were associated with significantly lower HRQoL in the physical (p = 0.002), social (p = 0.007), and environmental (p = 0.008) domains compared with mild or moderate symptoms, while psychological scores did not differ. IPSS correlated negatively with the physical (ρ = −0.438, p < 0.001), social (ρ = −0.470, p < 0.001), and environmental (ρ = −0.449, p < 0.001) domains. In multivariable regression, IPSS remained independently associated with lower physical HRQoL (β = −0.768, p < 0.001), independent of age, socioeconomic status, and therapy type. Conclusions: Greater LUTS severity is associated with poorer health-related quality of life in men receiving pharmacological treatment for BPH. Integrating comprehensive symptom assessment with HRQoL measures may enhance clinical evaluation and support more personalized management. Longitudinal studies are needed to determine whether symptom improvement translates into meaningful gains in quality of life. Full article

Background/Objectives: Osteoporosis is highly prevalent and contributes substantially to morbidity and mortality, yet long-term concerns about pharmacologic therapies leave a major treatment gap. Soy isoflavones have been investigated as safer alternatives, but results across trials are inconsistent. A key unresolved issue is the equol-producer phenotype, the gut microbial ability to convert daidzein to S-equol, the most bioactive isoflavone metabolite, which may explain much of this variability. This narrative review synthesizes mechanistic, translational, and clinical evidence to clarify the potential skeletal relevance of S-equol. Methods: Literature was identified through PubMed and Scopus searches (January 2000–October 2025) for experimental, mechanistic, and clinical studies examining S-equol, estrogen receptor β (ERβ), and bone metabolism, with emphasis on equol-producing status, bone strength and bone microarchitecture. Results: S-equol acts as a high-affinity ERβ agonist with antioxidant and anti-inflammatory properties but lacks the carcinogenic or thrombotic risks linked to ERα activation. In estrogen-deficient rodent models, S-equol improves trabecular bone volume by 10–20%, increases trabecular number, and enhances biomechanical strength. These findings align with preclinical evidence demonstrating that S-equol preserves trabecular microarchitecture, enhances bone strength, and reduces bone turnover. A limited number of human trials show reductions in bone resorption by 20% at a daily dose of 10 mg S-equol. In contrast, trials of soy isoflavones in humans have produced inconsistent findings, partly because of substantial variability in equol-producer phenotype among participants and the reliance on dual-energy X-ray absorptiometry, which cannot distinguish trabecular from cortical compartments. Advanced bone imaging and microbiome-informed approaches enable the precise evaluation of S-equol’s skeletal effects on trabecular bone and cortical bone, separately. Conclusions: S-equol represents a promising model for “precision nutrition,” where microbiome, hormonal, and host factors converge with potential to prevent age-related bone fragility. Rigorous trials that integrate microbiome phenotyping and advanced imaging are needed to validate this approach, translate mechanistic promise into clinical benefit, and better define safety. Full article

The objective of this study is to explore the applicability of irregular area cartograms for the visualization of sustainable development indicator components, utilizing earth observation (EO) data. The analysis focuses on selected Sustainable Development Goals (SDG 11 ‘Make cities and human settlements inclusive, safe, resilient and sustainable’ and SDG 13 ‘Take urgent action to combat climate change and its impacts’) and specific targets and indicators related to green urban areas and air quality (targets: 13.2, 11.6, and 11.7; indicators: 11.6.2., 11.7.1., 13.2.2.). A comprehensive review of the relevant literature indicates that irregular area cartograms are employed only sporadically in the context of SDG monitoring, particularly at lower levels of territorial division (i.e., communes and counties). To address this gap, a series of thematic maps, including choropleth maps and irregular area cartograms, was developed. These visualizations are based on EO-derived datasets and supplemented with statistical information obtained from the Local Data Bank of the Statistics Poland. The analysis demonstrates that irregular area cartograms provide an effective means of visualizing spatial disparities in variables such as urban green space availability and air pollution at the commune and county levels. These visualizations enhance the interpretability of complex indicator structures and support more nuanced assessments of progress toward selected Sustainable Development Goals, especially in spatially detailed analytical frameworks. Preliminary usability testing among potential users revealed that irregular area cartograms are perceived as an interesting visualization technique that enhances data interpretation. Full article

Background: Dialysis is a life-sustaining treatment for patients with end-stage renal disease (ESRD), but it requires high financial costs due to the need for continuous treatment and the associated expenses of medical supplies, equipment, and related care. Objective: This study aims to compare the out-of-pocket (OOP) health expenditure incurred by patients undergoing haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). Methods: The data for this observational cross-sectional study were obtained through a survey at two public hospitals, comprising a sample of 220 ESRD patients. In order to compare the OOP health expenditure between two modalities, the Mann–Whitney U test and the chi-square test were employed. Multiple linear-regression analysis was then used to identify the contributing factors associated with the aforementioned OOP expenses. Results: The estimated median monthly OOP health expenditure for HD patients was MYR 388 (interquartile range [IQR: 224–519]), significantly higher than CAPD (MYR 160 [IQR: 100–231]; p < 0.001). Our findings confirm that the choice of dialysis modality significantly affects the OOP health expenditures for dialysis patients (MYR 145.73; 95% CI: 75.51–218.15; p < 0.05; 0.001). Additional determinants of OOP health expenditure identified in this study include the interaction between the modality choice and the distance from home to the dialysis centre (MYR 3.39; 95% CI: 0.27–6.66; p < 0.05; 0.022), comorbidity status (MYR 49.51; 95% CI: 9.09–90.77; p < 0.05; 0.031), duration of illness (MYR 4.01; 95% CI: 0.71–7.63; p < 0.05; 0.041), and household income MYR 67.43 (95% CI: 1.71–134.81; p < 0.05; 0.021). Conclusions: This study emphasises the need to improve the training and awareness of CAPD to increase its use, as it requires less travel and lowers OOP expenses. In addition, introducing a travel reimbursement scheme is also recommended to reduce the transportation costs for HD patients. Full article

Background/Objectives: The delayed effects of organophosphate poisoning may manifest years after exposure, often masked by age-related diseases. The aim of this retrospective cohort study was to identify the biochemical “trace” that could remain in patients decades after poisoning. We determined a wide range of biochemical parameters, along with the spectrum of esterified and non-esterified fatty acids (EFAs and NEFAs, respectively), in the blood plasma of a cohort of elderly patients diagnosed with occupational pathology (OP) due to (sub)chronic exposure to organophosphates in the 1980s. Methods: Elderly patients with and without a history of exposure to organophosphates were retrospectively divided into two groups: controls (n = 59, aged 73 ± 4, men 29% and women 71%) and those with OP (n = 84, aged 74 ± 4, men 29% and women 71%). The period of neurological examination and blood sampling for subsequent analysis was from mid-2022 to the end of 2023. Determination of the content of biomarkers of metabolic syndrome, NEFAs, and EFAs in blood plasma was performed by HPLC-MS/MS and GC-MS. Results: The medical histories of the examined elderly individuals with OP and the aged control group included common age-related diseases. However, patients with OP more often had hepatitis, gastrointestinal diseases, polyneuropathy, and an increased BMI. Analysis of metabolic biomarkers revealed, in the OP group, a decrease in the concentrations of 3-hydroxybutyrate (p < 0.05), 2-hydroxybutyrate (p < 0.0001), and acetyl-L-carnitine (p < 0.001) and the activity of butyrylcholinesterase (BChE) (p < 0.05), but an increase in the esterase activity of albumin (p < 0.05). Correlation analysis revealed significant relationships between albumin esterase activity and arachidonic acid concentrations in the OP group (0.64, p < 0.0001). A study of a wide range of fatty acids in patients with OP revealed reciprocal relationships between EFAs and NEFAs. A statistically significant decrease in concentration was shown for esters of margaric, stearic, eicosadienoic, eicosatrienoic, arachidonic, eicosapentaenoic, and docosahexaenoic fatty acids. A statistically significant increase in concentration was shown for non-esterified heptadecenoic, eicosapentaenoic, eicosatrienoic, docosahexaenoic, γ-linolenic, myristic, eicosenoic, arachidonic, eicosadienoic, oleic, linoleic, palmitic, linoelaidic, stearic, palmitoleic, pentadecanoic, and margaric acids. Decreases in the ratios of omega-3 to other unsaturated fatty acids were observed only for the esterified forms. Conclusions: The data obtained allow us to consider an increased level of NEFAs as one of the main cytotoxic factors for the vascular endothelium. Modification of albumin properties and decreased bioavailability of docosahexaenoic acid could be molecular links that cause specific manifestations of OP-induced pathology at late stages after exposure. Full article

Background and Objectives: Peripheral arterial disease (PAD), frequently observed in individuals with type 2 diabetes mellitus (T2DM), is associated with diminished life quality, increased cardiovascular risk, and higher mortality rates. Similarly, trimethylamine N-oxide (TMAO), a uremic toxin produced by gut microbiota, has been linked to hypertension, cardiovascular disease, and increased overall mortality. In this study, we aimed to investigate whether serum TMAO levels are related to PAD in T2DM cases. Materials and Methods: In this cross-sectional investigation performed at one medical center, 120 patients with type 2 diabetes mellitus (T2DM) were included. High-performance liquid chromatography–mass spectrometry and an automated oscillometric device were used to measure serum TMAO levels and ankle–brachial index (ABI) values, respectively. Individuals exhibiting an ABI of less than 0.9 were classified as belonging to the low-ABI group. Results: Of the 120 participants, 23 (19.2%) had low ABI. Compared with the normal-ABI group, the low-ABI group was older (p = 0.017) and exhibited higher levels of urine albumin-to-creatinine ratio (UACR, p < 0.001), C-reactive protein (CRP, p < 0.001), and TMAO (p < 0.001). After adjusting for age, UACR, and CRP, multivariable logistic regression analysis identified serum TMAO concentration as an independent predictor of PAD in T2DM patients (odds ratio [OR]: 1.051; 95% confidence interval [CI]: 1.017–1.086; p = 0.003). In Spearman’s rank correlation analyses, log-transformed left ABI (log-left ABI, p = 0.017) and log-right ABI (p = 0.001) negatively correlated with log-TMAO. In patients with T2DM, the predictive performance of serum TMAO levels for PAD yielded an area under the receiver operating characteristic (ROC) curve of 0.812 (95% CI: 0.701–0.923; p < 0.001). Conclusions: Among individuals with T2DM, higher serum TMAO levels were associated with lower left and right ABI values and an increased likelihood of PAD. Full article

Background/Objectives: Limited data exist on the outcomes of men with bladder stones undergoing cystolitholapaxy alone versus cystolitholapaxy with concurrent transurethral resection of the prostate (TURP). Additionally, factors associated with the need for subsequent TURP in these patients are not well defined. This study aimed to compare the clinical outcomes in men undergoing cystolitholapaxy alone with those undergoing concurrent cystolitholapaxy with TURP, and determine what factors were associated with the need for subsequent TURP. Methods: A retrospective review was conducted of men undergoing cystolitholapaxy at a single Australian hospital between 2014 and 2021. Patients were grouped into cystolitholapaxy alone (Group A) and cystolitholapaxy with concurrent TURP (Group B). Clinical outcomes compared included rates of acute urinary retention (AUR), urinary tract infection (UTI), and subsequent TURP. Prostate volume (PV), stone size, and the presence of intravesical prostatic protrusion (IPP) were evaluated as potential predictors of subsequent TURP in Group A. Results: Fifty men were included in the final analysis, with a median follow-up of 50 months (IQR 24–81). Baseline characteristics did not differ significantly between groups. There was no statistically significant difference in the rates of AUR (11% vs. 13%) or UTI (22% vs. 30%) between Group A and Group B, respectively. However, 41% of Group A underwent subsequent TURP, compared to 9% in Group B (p = 0.0112). Within Group A, those requiring subsequent TURP had a significantly greater PV (65 vs. 34 cc, p = 0.0059), larger stone size (3.5 vs. 2.0 cm, p = 0.0175), and a higher prevalence of IPP (82% vs. 6%, p < 0.001). Conclusions: Cystolitholapaxy alone is a viable initial treatment for bladder stones, with comparable clinical outcomes to concurrent TURP. PV, stone size, and IPP may help identify patients likely to require future TURP, enabling more tailored treatment and potential reduction in TURP-related morbidity. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease worldwide. It greatly increases hepatic cirrhosis and cancer, cardiovascular disease, and chronic kidney disease. Despite the rising frequency of MASLD in Saudi Arabia, public understanding of its management is lacking. Objective: This study seeks to evaluate public knowledge, attitudes, and management barriers related to MASLD, thereby informing future educational and preventive strategies. Methods: A cross-sectional study was conducted from November 2023 to October 2024, involving 502 participants across Saudi Arabia, employing a modified self-administered online questionnaire. Data was analyzed using SPSS 25. Descriptive statistics and Chi-square tests were used to investigate correlations between knowledge or attitude levels and demographics, with a significance threshold of p < 0.05. Results: Less than half of the respondents who took part (47.2%) had heard of MASLD. Of them, 24.9% had good knowledge, 38.2% had fair knowledge, and 36.9% had low understanding. There were strong links between knowledge and age, education, and job status, but not between knowledge and gender (p = 0.514). People were somewhat aware that being overweight (48.4%) and having high cholesterol (51.8%) were risk factors, but they often had wrong ideas regarding diabetes and high blood pressure. Only 7.8% of those surveyed said they had been formally diagnosed, and 74.4% of those who had been were given advice on how to change their lifestyle. Barriers to management included the idea that lifestyle change alone suffices (46.7%), the absence of medical advice (46.7%), and insufficient disease awareness (33.3%). Conclusions: The research shows that many Saudis are unaware of MASLD and have misconceptions about it. Targeted health education programs, greater provider–patient communication, and primary care MASLD knowledge are needed to close these gaps and promote disease prevention and management. Full article