Search Results (380)

Genotypic characteristics may determine the body’s response to stressful conditions as well as its susceptibility to cardiovascular diseases and stroke. Old age worsens the course of these diseases, and often concomitant hypertension can negatively affect brain function, especially in cases of social isolation. In this work, we studied how social isolation and hypertension affect the transcription activity of genes associated with glucocorticoid signaling in the rat brain. The study was performed on 10-month-old rats of the outbred Wistar stock (n = 48) and the inbred spontaneously hypertensive (SHR) strain (n = 28). The animals of each genotype were divided into groups, one of which was kept in home cages in groups of 3–4 individuals, and the other in single cages for 3 months. Physiological parameters and plasma corticosterone were controlled before the start and after 3 months of isolation. Each group was additionally divided into two subgroups: one subjected to 1 h of restraint stress, and changes in blood glucose and corticosterone levels were assessed. At the end, the levels of Nr3c1, Nr3c2, Hsd11b1, and Fkbp5 mRNAs were measured in the hippocampus and frontal cortex using the Q-PCR technique. After isolation, weight gain stopped in SHRs, although blood pressure did not change, and heart rate increased in rats of both genotypes. In response to restraint, there was practically no increase in corticosterone in isolated Wistar rats, whereas in SHRs, there were significant glucose and corticosterone responses. Significant disruptions in the system responsible for corticosterone-activated signaling cascades were found in the brains of SHR rats. The transcriptional activity of genes encoding corticosterone receptors and proteins regulating their action was reduced in the hippocampus and frontal cortex in SHRs compared to Wistar rats. However, neither isolation nor acute stress significantly affected the contents of transcripts studied. Meanwhile, after isolation, the relationships between the expression of these genes changed significantly, in different directions, in rats of the studied genotypes, both within and between brain structures. Thus, the SHR genotype is associated with persistent changes in the brain that affect the expression of glucocorticoid-associated genes. This indicates a more complex regulation of the stress response, not limited only by the feedback system within the hypothalamic–pituitary–adrenocortical or sympatho-adrenomedullary systems, but operated at the level of the limbic system and the cerebral cortex. Full article

Background/Objectives: Hope plays an important role in coping with difficulties and is predictive of resilience, improving the skills necessary to sustain life plans and well-being, and overcoming stressful situations in adulthood and especially in older age adults. We hypothesised that the dimensions of hope, including spirituality, are connected to personal, educational, and contextual conditions, and play a mediating role in fostering resilience and well-being after stressful events; this mediating role might differ in adulthood and among the elderly. Methods: The sample consisted of 100 adults without severe pathologies and living in their own homes, aged between 50 and 86 years (M = 66.08; SD = 8.48). They completed an online survey that included the Stress Event scale, the Comprehensive State Hope Scale, the Resilience Scale for Adults, and the Well-being Profile. The data were analysed using SPSS and JAMOVI software, applying the following statistical tests: t-test, ANOVA and mediational model. Results: Stressful events influence resilience and well-being differently in adulthood and old age, with non-significant differences due to gender and living conditions. Hope mediates between stress resulting from negative life events and resilience and well-being, but this mediation involves different hope components for adults (trust) and older adults (self-realisation and perception of social support in interpersonal relationships). Spirituality is a non-significant mediator in both age stages. Conclusions: Appropriate psychological and psychosocial supports are needed to enhance the mediating potential of hope between stressful events and resilience. The results of our study help clarify which components of hope specifically promote resilience in different conditions of normal old age, differentiating them from those more beneficial for adults. Full article

Background: The use of electronic cigarettes (ECs) has become a significant public health problem, especially among young people. EC use has been associated with increased nicotine exposure and other toxic substances, increasing the risk of early addiction and health problems. Recently, attention has focused on understanding the interplay between psychosocial stressors, exposure to violence, psychological distress, and an increased propensity to experiment with nicotine. Hence, the aim of this study was to estimate the prevalence of EC use in the previous month and its associated factors. Methods: This is a cross-sectional study based on secondary data analysis of a nationwide survey conducted to monitor risk and protective factors for the health of school-aged adolescents (52.89% males; 55.97% aged up to 15 years old). Specifically, we analyzed data from adolescents aged 13–17 years who answered questions on EC use (n = 36,659). Results: The results show that the prevalence of EC use in this sample was 11.23% (IC95%: 11.23, 11.87). Logistic regression revealed several factors that increased the likelihood of EC use, such as alcohol use by friends, alcohol use in the past month, gender (male), intentional binge drinking, higher mental health symptoms, living in urban areas, experience of abuse at home, report of other drug use, and smoking friends, with the latter exerting a higher influence. Conclusion: Findings show the interplay of peers, family and environmental influences on youth risk behavior. Prevention strategies should therefore include school- and family-based interventions, trauma-informed approaches and anti-marketing campaigns to dispel misconceptions regarding EC. Full article

Background/Objectives: Polysomnography (PSG) is the gold standard for diagnosing sleep-disordered breathing (SDB). However, in a hospital testing setting, it may produce the first-night effect, viz., prolonged sleep latency, lower sleep efficiency, and uncertain apnea–hypopnea index (AHI). Here, we aim to determine the influences of hypnotic agents and gender. Methods: In this retrospective study, we reviewed the post-PSG questionnaires and electronic medical records of patients aged ≥20 years receiving overnight PSG for the diagnosis of SDB at Taichung Veterans General Hospital in a period between April 2024 and March 2025. Results: We studied a total of 1053 patients, aged 47.0 ± 14.7 years old. Compared to sleeping at home, 42.2% of patients reported worse perceived sleep quality (PSQ) with hypnotic agents, and 53.0%, without, before PSG testing in the hospital. For those without taking hypnotic agents, men had an odds ratio (OR) of 1.570 (95% CI: 1.127–2.189) for worsening PSQ compared to women (p = 0.008). Also, per increasing 1 Epworth Sleepiness Scale (ESS) score, the risk of worsening PSQ was reduced by OR of 0.963 (95% CI: 0.933–0.994) (p = 0.021). Once male patients had ESS < 10, as many as 57.3% of them reported the worse PSQ. Conclusions: Our study suggests a potentially more patient-centric approach to diagnosing sleep-disordered breathing. In some male patients with ESS scores < 10, short-acting hypnotics might be considered during in-lab PSG to improve subjective comfort, thereby potentially enhancing study reliability. Meanwhile, home sleep apnea testing can serve as a practical initial tool for selected patients—offering convenience, mitigating the first-night effect, and potentially reducing long wait times. However, its use in individuals with comorbid insomnia requires careful clinical judgment to avoid false-negative results, often making in-lab assessment the preferred option in such cases. Full article

One of the most important factors in how infants and young children learn to move is postural control. This systematic review aims to evaluate the machine learning methods in posture-related applications for children aged 0–12. Following PRISMA guidelines, we systematically searched the PubMed, Web of Sciences, SCOPUS, and ProQuest Central databases. Twenty-two studies were included in the qualitative synthesis following screening of 199 articles, with methodological quality assessed as moderate to good using the MINORS scale (scores ranging from 8/16 to 19/24). The reviewed research involved diverse samples of infants and children up to 12 years old, employing sensor-based technologies such as inertial measurement units, force plates, pressure mats, and video cameras to extract kinematic and postural features for machine learning applications. Reported accuracies, typically exceeding 85%, reflected considerable methodological heterogeneity related to sensor modality, data quality, and model architecture. Algorithms such as Random Forest, SVM, and CNN were most frequently and effectively applied for posture classification, early detection of developmental delays, and diagnosis of conditions such as cerebral palsy and autism spectrum disorder, demonstrating promising potential for at-home monitoring and clinical interventions. Full article

Background and Objectives: Previous research shows that stress can alter eating habits. This study analyzed the impact of COVID-19 confinement on eating behaviors and weight in Spanish adults, as well as related factors. Methods: A total of 2834 adults (69.3% women, Mean age: 41.36) completed an online questionnaire assessing eating habits, weight, and sociodemographic variables. Results: Strict lockdown in Spain was linked to a general worsening of eating habits, particularly increased food intake and weight gain. Risk factors for less healthy eating and weight gain included being female (p < 0.001), under 35 years old (p < 0.001), overweight or obese (p < 0.001), caring for minors (p = 0.002), and experiencing nervousness or anxiety (p < 0.001). Conversely, maintaining pre-confinement eating habits and weight was more common among men (p < 0.001), individuals aged 50 years or older (p < 0.001), those with normal or underweight BMI (p < 0.001), those working outside the home (p < 0.013), and those without minors in their care (p = 0.001). Conclusions: Prolonged lockdowns associated with high stress may negatively influence diet and weight. Prevention strategies should therefore promote healthy eating during such periods, particularly targeting groups at higher risk of worsening habits and weight gain. Full article

Background/Objective: Worldwide, ~45% of hypertensives remain undiagnosed, and ~26% are adequately controlled. The active involvement of all healthcare professionals in diagnosing hypertension at primary health care units (PHCUs) is linked to better blood pressure (BP) control. There is currently no research examining the potential role of senior medical students in the diagnosis of hypertension. This study aimed to evaluate the contribution of final-year medical students’ active participation in the diagnosis of hypertension. The study also examined the prevalence and control of hypertension among health service users in Greek PHCUs. Methods: This is a cross-sectional convenience sample study. During clinical placement in PHC, sixth-year medical students received systematic training and performed BP measurements, according to the guidelines, in private, well-organized spaces. Adult patients and visitors were enlisted for BP measurements. The BP readings were provided to the participants so they could discuss any concerns about their BP with their physician. Statistical analysis was performed with SPSS. Categorical variables are presented as frequencies. Continuous variables were assessed for normality and, based on their distribution, are expressed as mean ± standard deviation or median (interquartile range). Appropriate tests were performed for the comparisons across groups (chi-square for the categorical variables, and two-sample t-test or Mann–Whitney test for continuous variables). A p-value < 0.05 was considered statistically significant. Results: In the present study, 124 medical students performed BP measurements in 68 PHCUs. BP was measured in 704 individuals, aged 61 (IQR: 48.0–73.0) years old; 58.8% were female, 68.3% of whom were patients. The prevalence of hypertension was 56.7%. The control rate was 44.9% (BP < 140 and 90 mmHg among all hypertensives), and the control rate under treatment was 61.0% (BP < 140 and 90 mmHg among treated hypertensives). The involvement of medical students contributed positively, increasing the diagnosis of hypertension in individuals who might not have their BP measured in routine clinical practice. Ninety-nine newly diagnosed hypertensives were detected. Students identified 220 uncontrolled hypertensives and 112 uncontrolled under-treated patients, who were then referred to the consultant physicians. Conclusions: Students played a critical role in diagnosing hypertension and identifying newly diagnosed hypertensive patients. Embracing interprofessional care in the diagnosis and management of hypertension is essential for achieving better outcomes for our patients. Engaging medical students in BP measurements is a practical and feasible approach to improve hypertension diagnosis and control, taking into consideration the increased workload of PHC physicians. While this action has important medical education implications, the impact on the knowledge level of medical students was not evaluated. Limitations of this study include the assessment of BP in one visit without home BP measurements or a second visit, lack of follow-up of newly diagnosed hypertensives, and the low average number of BP measurements per student. Full article

Objectives: This study aimed to evaluate how non-invasive ventilation (NIV) and high-flow nasal cannula therapy (HFT) versus conventional oxygen therapy (COT) affect neural ventilatory drive during exercise in patients with severe chronic obstructive pulmonary disease (COPD). Methods: We conducted an experimental, controlled study with one arm and three different conditions for the same cohort. After initial testing on conventional oxygen therapy (COT), patients exercised under NIV and HFT in sequential days and a random order. Participants: Twenty patients (mean age 60 years old (SD 3.9), 6 female) with severe COPD (30% women) on home NIV as a bridge to lung transplantation were enrolled in this study, with a mean FEV₁ of 19.78% predicted and marked hyperinflation. Protocol: Participants performed constant-load cycling exercises at 75% maximum tolerated workload under three conditions: COT, NIV, and HFT. Neuro-respiratory drive (NRD) was measured using surface parasternal and sternocleidomastoid electromyography, and mixed ANOVA was performed to analyze repeated measures across conditions. Results: In total, 20 patients were included in this study. NIV demonstrated superior performance, with 60% lower NRD compared to COT (488.81 µV vs. 1180.63 µV, p < 0.05). HFT showed intermediate effects (807.8 µV). NIV also achieved greater reduction in respiratory rate (4.2 breaths/min), lower perceived exertion (Borg score decrease: 1.8 points), and more pronounced CO₂ reduction (5.3 mmHg) compared to both COT and HFT. Conclusions: NIV significantly reduces NRD during exercise in severe COPD patients compared to HFT and COT. This supports its use as a valuable adjunct to pulmonary rehabilitation in severe COPD. Full article

Background/Objectives: More than half of out-of-hospital cardiac arrests occur at home and are witnessed by family members, who must promptly call the Emergency Medical Services (EMS). The aim of this study was to assess the learning outcomes of an interactive school-based training activity focused specifically on the EMS call. Methods: A single-group, post-test-only simulation study was conducted in five Spanish schools. Participating schoolchildren received basic life support (BLS) training from their Physical Education teachers, integrated into the regular school schedule and following the Kids Save Lives recommendations. An innovative didactic resource (the “BLS Endless Book”) was used to support active learning. Children’s performance was evaluated in a simulated scenario using a standardized checklist. Results: A total of 1341 children aged 6 to 14 years participated. In the simulated scenario, more than 90% of participants were able to recognize the emergency and correctly identified and dialed the national emergency number. However, less than 50% were able to activate the hands-free function (with younger children experiencing more difficulty). During the call, 99.0% stated their full name, and 82.0% provided their complete address. Conclusions: A short, focused BLS training led at school by physical education teachers and based on an interactive, easy-to-use, didactic tool is effective in educating 6–14-year-old schoolchildren to correctly perform an immediate EMS call in case of cardiac arrest. Nevertheless, schoolchildren may require reinforcement training focused on hands-free operation and on providing the correct address. Full article

Background: Older adults are a vulnerable population wherein their advancing age leads to limitations in physical and mental functionality that can compromise quality of life. Objective: The objective of this study was to analyze the relationship between mental health factors and quality of life in older adult users of long-term care services in Mexico. Methods: The present cross-sectional study was conducted with a convenience sample of 131 older adult users of long-term care services (three residential care homes and a day center) in Morelia, Michoacán, Mexico. A questionnaire including the World Health Organization Quality of Life Older Adults Scale (WHO-QoL-Old), Geriatric Depression Scale (GDS), Hamilton Anxiety Rating Scale (HARS), Cognitive Reserve Questionnaire (CRQ), and sociodemographic variables was administered. The analysis of the relationship between variables was performed using bivariate analysis (comparisons between groups and Pearson correlations). Due to the type of sampling, the representativeness of the sample obtained was not evaluated. Results: Depression and anxiety were found to inversely influence overall quality of life and its dimensions, while cognitive reserve is a factor that favors quality of life. Also, as related to cognitive reserve, level of education was found to be a factor that favors quality of life. Conclusions: Older adult users of long-term care services are a vulnerable group, given the negative impact on their quality of life that some mental health conditions could have, such as depression, anxiety, and low cognitive reserve. Full article

Background: Hyperphosphorylated tau accumulation and neurofibrillary tangles (NFTs) are hallmarks of tauopathies, including Alzheimer’s disease (AD), and are strongly associated with cognitive decline. The rTg4510 mouse model, which expresses mutant human tau (P301L), develops progressive tauopathy in the absence of amyloid-β pathology, providing a valuable tool for investigating tau-driven neurodegeneration. Previous studies have demonstrated spatial and object-recognition memory deficits at six months of age, which can be prevented by doxycycline (DOX)-mediated suppression of tau expression. However, it remained unclear whether non-spatial hippocampal learning, particularly temporal associative learning, would be similarly affected. Methods: We evaluated six-month-old rTg4510 mice with or without DOX treatment. To control for potential motor confounds, we first assessed spontaneous home cage activity. We then tested hippocampus-dependent non-spatial learning using two paradigms: trace eyeblink conditioning (500-ms trace interval) and contextual fear conditioning. Results: General motor function remained intact; however, rTg4510 mice without DOX treatment exhibited increased rearing behavior. These mice demonstrated significant deficits in trace eyeblink conditioning acquisition, with particularly clear impairment on the final day of training. Contextual fear conditioning showed milder deficits. Analysis of response peak latency revealed subtle temporal processing abnormalities during early learning. Two months of DOX treatment initiated at four months of age prevented these learning deficits, confirming their association with tau overexpression. Conclusions: Our findings demonstrate that rTg4510 mice exhibit deficits in non-spatial temporal associative learning alongside previously reported spatial and object-recognition impairments. Trace eyeblink conditioning serves as a sensitive behavioral assay for detecting tau-related hippocampal dysfunction, and the prevention of learning deficits by DOX treatment highlights its potential utility as a translational biomarker for evaluating tau-targeted interventions. Full article

Toxocariasis, a geohelminthiasis caused by Toxocara canis and Toxocara cati nematodes, has an estimated 19% seroprevalence worldwide. Although children have been considered more prone to infection, adults and the elderly may also be considered at risk. Accordingly, the present study aimed to assess the associated risk factors for Toxocara spp. seropositivity in a population of 290 individuals over 50 years old, attended by the Public Health System in western São Paulo state. Socioepidemiological information was obtained by a semi-structured questionnaire, a blood (serum) sample, and a neurocognitive function assessment by the 10-point cognitive screener (10-CS). Overall, 89/290 (30.7%; 95% CI: 25.7–36.2%) individuals presented anti-Toxocara spp. IgG antibodies by ELISA. Multivariate analysis revealed that individuals raising both dogs and cats were 3-fold more likely to be seropositive than the ones without any pet (p = 0.002), while educational level resulted in an associated protective factor (p = 0.001). No seropositivity influence was observed for the other evaluated variables, including age, gender, monthly income, consumption of drinkable water or raw/undercooked meat, having a dirty floor at home, contact with soil, washing vegetables and hands before meals, and onychophagy. Although seropositivity was not statistically associated with dementia (p = 0.198) and neuropsychiatric disorder (p = 0.440), results herein indicated toxocariasis as a likely under-reported and neglected infection in the older human population. As an immunosenescence risk group that should be continuously monitored, elderly pet owners may be at risk and should be extra careful with self-hygiene and pet deworming, particularly when owning multiple pet species, to reduce the risk of toxocariasis infection. Full article

Background/Objectives: History of gestational diabetes mellitus (GDM) is a strong risk factor in the development of type 2 diabetes (T2D). We sought to examine the association between perceived risk of developing T2D and relevant health behaviors in this population. Methods: We analyzed self-reported survey items and objective electronic health record data of participants in the Gestational diabetes Risk Attenuation for New Diabetes (GRAND) Study, a multisite randomized control trial testing the effectiveness of shared decision-making for women with elevated body mass index (BMI), prediabetes and history of GDM. Data on demographics, health behaviors, and perceived T2D risk were self-reported. We ran four regression models to study the association between women’s perceived risk of developing T2D and four key health behaviors: (1) physical activity, (2) consumption of sugar-sweetened beverages, (3) consumption of ultra-processed foods, and (4) consumption of meals prepared outside the home. All models were adjusted for age, race, ethnicity, income, HbA1c, BMI, family history of T2D, and study arm. Results: Our sample included 242 women who on average were 41 years old (±6 years) with BMI of 32.7 (±6.9 kg/m²). Perceived risk of developing T2D was not significantly associated with physical activity, consumption of sugar-sweetened beverages, ultra-processed food consumption, or meals prepared outside of the home. Higher BMI was significantly associated with increased consumption of sugar-sweetened beverages (OR 1.05, 95% CI 1.01–1.10), but not other health behaviors. Conclusions: We found perceived risk of developing T2D was not independently associated with four key health behaviors. Women with GDM are at high risk of developing T2D and may benefit from tailored or more intensive strategies promoting health behavior changes shown to lower T2D risk. Full article

Background: Hearing and cognition decline with age. Hearing is now considered an independent risk factor for later cognitive impairment. Computerized cognitive auditory training is being discussed as a possible adjunctive therapy approach. Objectives: The aim of this exploratory study is to investigate how the success of a computer-based cognitive auditory training (CCAT) can be measured. For this purpose, the influence of a CCAT on different dimensions of hearing and cognition was determined. Materials and Methods: 23 subjects between 52 and 77 years old were recruited with normacusis to moderate hearing loss. They underwent 40 digital training lessons at home. Before, during, and after completion, concentration ability with the d2-R, memory (VLMT), subjective hearing impairment (HHI), hearing quality (SSQ12), listening effort in noise (ACALES), and speech understanding in noise (GÖSA) were measured. Results and Discussion: In this uncontrolled, non-randomized study, one of the main findings was that cognitive dimensions, namely processing speed, improved by 12.11 ± 16.40 points (p = 0.006), and concentration performance improved by 12.56 ± 13.50 points (p = 0.001), which were not directly trained in CCAT. Learning performance also improved slightly by 4.00 ± 7.00 (p = 0.019). Subjective hearing handicap significantly reduced by 10.70 ± 12.38 (p = 0.001). There were no significant changes in the SSQ-12 (p = 0.979). Hearing effort improved by 1.79 ± 2.13 dB SPL (p = 0.001), 1.75 ± 2.09 (p = 0.001), and 3.32 ± 3.27 dB (p < 0.001), respectively. Speech understanding in noise did not improve significantly. CCAT is likely to improve several dimensions of hearing and cognition. Controlled future studies are needed to investigate its efficacy. Full article

Background/Objectives: The COVID-19 pandemic caused a widespread shift to remote work, significantly altering child supervision. In Australia, prolonged lockdowns created unique conditions where many parents were working from home while simultaneously caring for children. This study aimed to investigate potential changes in the epidemiology of paediatric injury-related presentations to emergency health services among children in Southwest Victoria, Australia, during the COVID-19 pandemic. Methods: A retrospective cross-sectional study was conducted using deidentified emergency presentation data from ten health services in regional Victoria for children aged 0–14 years between 2018 and 2023. Injury data were analysed across three timeframes (Pre-COVID, COVID, Post-COVID). Chi-squared tests assessed differences in injury presentations by age, gender, and service type. Significance was determined at p < 0.05. Results: A total of 21,072 child injury-related presentations occurred. Males accounted for 57.6% of presentations, with the 10–14 age group comprising 39.8% of cases. During lockdown, injury presentations increased among 0–4-year-old females (from 30.2% to 32.0%), likely reflecting reduced supervision as parents juggled work-from-home responsibilities. Conversely, rates declined among older children, particularly 10–14-year-olds, potentially due to reduced participation in sports and outdoor activities. More than half of all cases (59.1%) were presented to Victorian Emergency Minimum Dataset (VEMD)-reporting emergency departments. Conclusions: The shift to working from home during the pandemic had a measurable impact on childhood injury patterns, particularly among younger children. These findings highlight the importance of considering parental work and childcare arrangements in injury prevention strategies and highlight the benefits of additional regional data to provide a more accurate picture of regional health service use. Full article