Search Results (30,732)

Background: Frailty is a common finding in elderly subjects with severe aortic stenosis (AoS) and a strong predictor of mortality and disability after aortic valve surgery. The atherogenic index of plasma (AIP) is related to different cardiovascular (CV) risk factors, which in turn are correlated to the progression of frailty as well as of AoS. Aim: to analyze the association of AIP with different CV risk factors and frailty scores and its value as a determinant of mortality in older adults with severe AoS. Methods: The association of AIP with a multidimensional assessment of frailty by using Fried criteria and the following indices; timed up-and-go test (TUG) for gait function; Charlson Index (CI), basic activities of daily living (BADL) and instrumental activities of daily living (IADL) for disability; mini–mental state examination for cognitive function evaluation (MMSE); Geriatric Depression Score for mood disorder (GDS); Mini Nutritional Assessment (MNA) for nutritional status was assessed in 102 elderly AoS patients (33 males; mean age 83 ± 6 yrs). Moreover, the relationship between AIP and demographic, lifestyle, traditional CV risk factors and CV mortality was also evaluated. Results: Significant relationships between AIP and glycemia and inflammatory parameters (CRP, ESR and fibrinogen) as well as with troponin I were found. Moreover, AIP significantly correlates with CI, BADL, IADL and MNA. However, the Kaplan–Meier analysis did not show any significant difference for survival rates according to AIP intervals of risk, whereas ejection fraction remained the only significant determinant after multivariate adjustment for mortality at the Cox proportional hazard models analysis in this patient population. Conclusions: Higher AIP is significantly associated with cardiometabolic risk and increased physical dysfunction risk and frailty in AoS pts, evidencing its potential use as a simple biomarker in this clinical setting, although it did not represent a significant determinant for mortality in this population. Full article

Rheumatoid arthritis (RA) is a chronic inflammatory disease of autoimmune background and unknown etiology. The importance of genetic factors in RA development is well-established. Environmental factors have also been extensively researched in relation to risk of RA and managing its symptoms. Smoking, physical activity, diet, and gut microbiota are considered to be the most essential modifiable factors in RA. Among dietary interventions, the most researched is Mediterranean diet, monounsaturated fatty acids, fish consumption, and fish oil (EPA, eicosapentaenoic acid and DHA, that is, docosahexaenoic acid). Others concerned gluten-free and vegan or vegetarian diet, salt intake, supplementation with vitamin D, antioxidants, prebiotics, and probiotics. Diet modifications can alter the gut environment, and the association between RA development or severity and the composition of gut bacteria has already been shown. This review focuses on effectiveness and usefulness of various dietary approaches and supplements in RA prevention and management, including the influence on disease activity and inflammatory status. The composition of gut microbiota and its changes in response to dietary factors are also considered. There is a great need for further research into mutual dependencies of diet, microbiome, and RA activity. The current state of knowledge provides promising evidence for future nutrition and microbial therapies. Full article

Background: Obesity represents a major public health challenge worldwide and contributes substantially to the burden of type 2 diabetes and hypertension. While body mass index (BMI) is widely used in clinical practice, indices reflecting central adiposity may provide additional prognostic value. This study aimed to assess the prevalence of general and central obesity in an adult population across different age groups from Stara Zagora, Bulgaria, and to examine their associations with cardiometabolic outcomes and lifestyle factors. Methods: A quasi-representative cross-sectional study was conducted among 3512 adults (mean age 53.7 ± 14.9 years). Anthropometric indices, including BMI, waist circumference, waist-to-hip ratio, and waist-to-height ratio were measured. Cardiometabolic outcomes included diabetes, hypertension, and their combined presence. Multicollinearity was assessed using the Variance Inflation Factor (VIF), and the discriminatory ability of indices was evaluated using Receiver Operating Characteristic (ROC) analysis and DeLong’s test. Results: The prevalence of overweight/obesity (BMI ≥25) was 68.4%, while central obesity (WHtR ≥0.5) affected 66.9% of participants. BMI demonstrated the highest discriminatory ability in this dataset for hypertension (AUC = 0.852) and diabetes (AUC = 0.796), significantly outperforming WC and WHR (p < 0.05). However, 24.4% of individuals with normal BMI exhibited high-risk central adiposity. Significant sex-specific differences were observed: short sleep duration (<6 h) was a strong predictor of obesity in women (aOR = 2.98), whereas smoking showed stronger associations in men. Age-stratified analyses revealed that while BMI stabilizes in the oldest age group (75–89 years), WHtR continues to increase, reflecting age-related redistribution of visceral fat. A strong protective effect of physical activity was observed, supported by quasi-complete separation in active subgroups. Conclusions: General and central obesity represent a substantial health burden in this urban population. While BMI remains a robust screening tool, the integration of WHtR enhances the identification of “hidden” cardiometabolic risk particularly in older adults and individuals with normal BMI. Given the quasi-representative nature of the sample, these findings are primarily generalizable to similar urban populations and may inform targeted regional public health strategies. Full article

The global aging process has increased the number of older individuals providing care for relatives with severe mental disorders (SMD). This population faces unique health challenges. The present cross-sectional study examined the relationship between self-perceived health (SPH) and clinical, functional, and sociodemographic variables among 71 older caregivers (median age: 65 years) in Bogotá, Colombia. SPH was assessed by answering the question: “How would you describe your overall health status?” and dichotomized into good versus poor perception. Comorbidity was measured as the number of self-reported chronic conditions. Caregiver burden was evaluated using the Zarit Caregiver Burden Interview, and health-related quality of life (HRQoL) was assessed using the SF-36, including dimensions such as physical functioning, emotional well-being, bodily pain, and general health. Descriptive analyses, non-parametric comparisons, and logistic regression models were conducted. The results revealed a marked feminization of caregiving (92.96%) and a high prevalence of good SPH (70.42%), despite a substantial burden of physical comorbidities (mean: 3.21). Dimensions such as physical functioning, emotional well-being, and pain were significant in univariate analyses. However, the multivariate model identified general health as the only independent predictor of good SPH (adjusted odds ratio [OR]: 1.112; 95% confidence interval [CI]: 1.053–1.174; p < 0.001). These findings suggest that subjective health assessment may transcend objective disease counts for older caregivers. Public health policies could prioritize wellness-based interventions and emotional support over traditional disease-centered approaches to improve the quality of life of this growing, active, socially valuable, yet vulnerable population. Full article

Background/Objectives: Evidence remains limited on how post-diagnosis changes in moderate-to-vigorous physical activity (MVPA) are associated with triglyceride and fasting glucose levels in newly diagnosed diabetes. We examined this association in a Korean national cohort. Methods: Using the National Health Insurance Service National Sample Cohort, we identified adults with newly diagnosed diabetes in 2009–2010 who completed health screenings in both 2010–2011 (period I) and 2012–2013 (period II). Period II MVPA frequency was examined within strata defined by period I MVPA category. Adjusted least-squares means for five metabolic indicators were estimated using multivariable linear regression. Results: Among 3719 participants, the clearest associations were observed among those performing MVPA five or more times per week during period I, in whom lower period II MVPA frequency was associated with higher triglyceride (P for trend = 0.036) and fasting glucose (P for trend = 0.015) levels. Increases in MVPA among initially inactive participants were not consistently associated with favorable metabolic profiles. Conclusions: A post-diagnosis decline in MVPA was associated with higher triglyceride and fasting glucose levels, particularly among initially active individuals. Preventing declines in MVPA after diabetes diagnosis may be clinically relevant. Full article

Urban residents require space-efficient interventions to mitigate chronic stress. While indoor digital nature shows promise, the precise impact of interactive design parameters remains unclear. This study investigated how interactive feedback intensity (none, slow, fast) and color hue (neutral, warm, cool) influence psychological and physiological restoration. Following negative emotion induction, healthy participants engaged in within-subject conditions evaluated via multimodal assessments, including EEG, HRV, and subjective scales (PANAS, PRS, SAM/PAD). Results identified interactive feedback intensity as the primary driver of restoration. Specifically, fast feedback improved positive affect by up to 20.4% and reduced negative affect by 20.8% compared to passive self-restoration. Neurologically, interactive engagement was associated with elevated EEG alpha-band activity by up to 97.8% relative to standing controls, a pattern consistent with cortical relaxation. Furthermore, while physical interaction was uniformly associated with physiological indices broadly consistent with recovery, color hue significantly moderated subjective outcomes. Neutral and warm hues generated significantly higher overall perceived restorativeness (M = 73.18 and M = 70.14, respectively) than the self-restoration control (M = 61.26). Notably, neutral tones were uniquely associated with modest changes in HRV time-domain indices suggestive of parasympathetic autonomic modulation. These findings provide actionable, empirically validated guidelines for deploying responsive digital interventions to support mental well-being in dense urban interiors. Full article

Background: This study aimed to examine whether a physical education program based on the ecological dynamics approach, implemented through small-sided games (SSG), produces greater improvements in motor skills, daily physical activity levels, and perceived physical fitness in middle school students. Methods: Forty-eight students were assigned to an SSG group (ecological dynamics lessons including small-sided games, n = 26) or a Control group (traditional lessons based on teacher-centered instruction and analytical exercises, n = 22). The intervention lasted 12 weeks, with two sessions per week. Motor performance was assessed using the standing broad jump, 5-standing broad jump, 20 m sprint, 10 × 5 m shuttle run, 5-0-5 agility test, and sit-and-reach test. Daily physical activity was evaluated using the International Physical Activity Questionnaire—Short Form (IPAQ-SF), and perceived physical fitness was assessed using the Visual Analogue Fitness Perception Scale for Adolescents (FPVASA). Results: Significant group-by-time interactions were found in all motor tests. IPAQ-SF data revealed significant group-by-time interactions for vigorous and moderate physical activity. Perceived physical fitness showed significant group-by-time interactions for all items except flexibility. Conclusions: Physical education lessons structured according to the ecological dynamics approach and implemented through SSG-based protocols led to greater improvements than traditional methods. The dynamic and variable nature of SSG likely enhances neuromuscular stimulation, motor engagement, and motivation during physical education lessons. Full article

Background/Objectives: Understanding the genetic basis of food consumption is a key step toward precision nutrition, viewed as a long-term future perspective. This study aimed to investigate genetic variants associated with grapefruit (Citrus paradisi) intake and to evaluate their potential relationship with obesity risk. Methods: A genome-wide association study (GWAS) was conducted on 19,653 European-ancestry participants from two prospective cohorts, the Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS). We employed a functional annotation strategy to select a suggestive locus for follow-up analysis, and computationally derived molecular docking simulations explored a plausible functional link between grapefruit’s bioactive compounds and the candidate gene product. Results: Although falling short of the conventional threshold for genome-wide significance, a suggestive locus was prioritized on chromosome 14, with the lead single nucleotide polymorphism (SNP), rs2124 (p < 5 × 10⁻⁶), located within the metabolic gene ADCK1 (aarF domain containing kinase 1). Molecular docking simulations supported a plausible mechanistic hypothesis, indicating that key bioactive compounds in grapefruit could bind with high affinity to the ADCK1 protein. Consistent with the GWAS finding, individuals with the CC genotype reported lower mean grapefruit intake. This genotype was also associated with other lifestyle factors, notably, lower physical activity in women. In age- and multivariate-adjusted models, the CC genotype was associated with a modestly increased risk of incident obesity in females, but not in males. Conclusions: Our exploratory findings suggest a prioritized candidate locus associated with grapefruit intake, and its link to obesity risk may be mediated by the metabolic gene ADCK1. However, given the lack of genome-wide significance and independent replication, these findings should be considered preliminary and exploratory. These hypothesis-generating results support the integration of genetics and dietary habits, warranting further mechanistic validation. Full article

Home has been recognized as a health infrastructure through hospital-at-home, home care, and direct-to-consumer wellness and fitness products. However, the patient home environment has been largely overlooked by healthcare as a means to improve therapy outcomes for difficult-to-treat chronic conditions, such as migraine; high-impact pain; and treatment-resistant depression, anxiety, or insomnia. Growing research evidence enables the formulation of a therapeutic home environment standard consisting of three pillars: biophilic design, indoor environmental quality, and intentional self-care spaces that serve as habit cues and foster sleep hygiene, stress management, relaxation, physical activity, and social interactions. Together, these environmental and behavioral interventions can transform real-world inputs into clinical benefits through autonomic, circadian, and emotional regulation. We also highlight the converging roles of self-management, self-efficacy, self-regulation, and self-compassion in sustaining patient engagement and healing at home. The applicability of the therapeutic home environment as an adjunct is illustrated in the case of chronic migraine, a debilitating neurological condition commonly associated with comorbidities. Current challenges in achieving migraine freedom with FDA-approved pharmacotherapies, neuromodulation devices, and digital health technologies are underscored by the high prevalence of refractory, chronic, episodic, and pediatric migraine. Perspectives on developing a personalized, multimodal cure for migraine are illustrated through a hypothetical drug + digital combination therapy comprising anti-CGRP drugs and an AI-powered digital health platform that promotes daily self-care practices within the therapeutic home environments. In conclusion, achieving sustained freedom from high-morbidity conditions requires end-to-end care ecosystems that integrate pharmacological, cognitive, behavioral, and environmental interventions into real-world settings. Full article

Soil health is critical for the sustainability of tropical plantation ecosystems, However, the ecological factors driving productivity gradients remain inadequately understood. This study investigated rubber plantations on Hainan Island with varying yield levels to assess soil health and its underlying ecological mechanisms using a minimum data set (MDS) approach. Twenty-seven soil physical, chemical, and biological indicators were analyzed at two depths (0–20 cm and 20–40 cm). Principal component analysis identified seven key indicators for the MDS: soil organic matter (OM), alkaline-hydrolyzable nitrogen (AN), cation exchange capacity (CEC), dissolved organic carbon (DOC), microbial biomass phosphorus (MBP), acid phosphatase activity (ACP), and microbial diversity (Shannon-Wiener index, SHDI). The soil health indices derived from the MDS showed strong correlations with those generated from the total data set (TDS) (p < 0.001), confirming the reliability of the MDS framework. Overall, soil health levels were rated low to moderate with no significant differences across low-yield plantations (≤900 kg·ha⁻¹), medium-yield plantations (900–1200 kg·ha⁻¹), and high-yield plantations (≥1200 kg·ha⁻¹)., suggesting a decoupling of soil health and rubber productivity under uniform management practices. Random forest analysis identified microbial-driven phosphorus cycling, particularly MBP and ACP, as the primary determinant of soil health across soil layers, with DOC and SHDI also contributing significantly. These findings highlight the critical role of microbial-mediated nutrient cycling in maintaining soil health in rubber plantations and suggest that current management practices prioritize short-term yields over long-term soil ecological stability. Enhancing microbial activity and increasing organic matter inputs may be essential for improving soil health and ensuring the sustainability of rubber production in tropical agroecosystems. Full article

Background: Food bank users experience food insecurity, a social determinant of health linked to poorer physical and mental health. However, evidence on the health-related quality of life (HRQoL) of food bank users in Spain is scarce. Objectives: This study sought to assess HRQoL among users of the Navarra Food Bank and identify associated sociodemographic factors. Methods: We performed a cross-sectional study of heads of household using the Navarra Food Bank. A simple random sample of 350 participants was selected from a population of 2749 families. HRQoL was assessed by telephone using the EQ-5D-5L. We described the prevalence of problems in the five EQ-5D-5L dimensions, calculated the EQ-5D-5L utility index using the Spanish value set, and analyzed EuroQol Visual Analogue Scale (EQ-VAS) scores. Associations with sociodemographic characteristics were examined using multivariable general linear models. Results: Mean EQ-VAS was 73.56 (95% CI: 71.62–75.50), and mean EQ-5D-5L utility index was 0.815 (95% CI: 0.800–0.831). The most frequently reported problems were anxiety/depression (62.9%) and pain/discomfort (55.7%), while mobility (25.5%), usual activities (19.7%), and self-care (8.7%) were less commonly affected. Older age was significantly associated with both EQ-VAS and EQ-5D-5L utility index. Employment status and nationality were significantly associated with EQ-VAS, whereas sex was significantly associated with the EQ-5D-5L utility index. Conclusions: HRQoL was impaired among users of the Navarra Food Bank, with the greatest burden observed in the anxiety/depression and pain/discomfort dimensions. Older age and selected sociodemographic characteristics were associated with poorer HRQoL. Given the cross-sectional design, the findings should be interpreted as associative rather than causal. Full article

Background/Objectives: University life is often accompanied by unhealthy lifestyle behaviors, reduced physical activity, lower fitness levels, and a high prevalence of mental health symptoms. Daily step count has emerged as a practical indicator of habitual physical activity; however, evidence on its association with cardiorespiratory fitness and symptoms of depression, anxiety, and stress in university students remains limited. Therefore, this study examined the association of daily step count with cardiorespiratory fitness and symptoms of depression, anxiety, and stress in university students. Methods: This cross-sectional association study included a convenience sample of 120 students aged 18 to 25 years from a single university. Daily step count was assessed over seven consecutive days using a Xiaomi Mi Band 9. Cardiorespiratory fitness was evaluated with the 20 m shuttle run test, and symptoms of depression, anxiety, and stress were measured using the Depression, Anxiety and Stress Scale-21 Items (DASS-21). Partial correlations, ANCOVA, MANCOVA, binary logistic regression, and restricted cubic spline models were performed after adjustment for sex, age, and socioeconomic status. Results: Higher daily step count was associated with greater cardiorespiratory fitness and with lower symptoms of depression, anxiety, and stress, although the associations with mental health symptoms were weak and not uniform across outcomes. Restricted cubic spline models showed inverse non-linear associations for mental health symptoms, with steeper inverse gradients at lower step-count levels and a tendency to level off at higher volumes, approximately around 9000 steps/day. For cardiorespiratory fitness, the association was positive across the step-count range. Step counts around 7500 steps/day were associated with lower odds of elevated symptoms of depression, anxiety, and stress. Conclusions: A higher daily step count was associated with more favorable mental health symptom profiles and greater cardiorespiratory fitness in this sample of university students. Full article

Background/Objectives: Early childhood is a critical period for executive function and broader cognitive development. Physical activity and sleep are modifiable health behaviors that support neurobiological processes underlying learning. While each has been widely examined, research investigating their combined or interactive relationships with learning remains fragmented. This scoping review synthesizes the literature on associations among physical activity, sleep, and cognition in preschool-aged children (3–5 years) and identifies gaps in the integration of these domains. Methods: Electronic databases were searched for peer-reviewed studies published within the past 10 years. Eligible studies included typically developing children aged 3–5 years and examined overlaps between at least two domains: physical activity, sleep, and cognition. Cross-sectional and longitudinal observational studies were included; intervention and review studies, and those conducted during the COVID-19 pandemic, were excluded. Results: Thirty-eight studies met the inclusion criteria. Evidence examining physical activity and sleep was limited and inconsistent. Sleep quality indicators (e.g., sleep efficiency and bedtime regularity) were more often reported to be associated with executive function and broader cognitive outcomes than total sleep duration, which showed variable relationships. Findings linking physical activity and cognition were heterogeneous; however, moderate-intensity and cognitively engaging activities were more often reported in association with executive function than total activity or intensity alone. Conclusions: Findings suggest that sleep quality and characteristics of physical activity may be relevant for preschool cognitive outcomes. Greater integration of these domains is needed, and future research should examine physical activity, sleep, and cognition within a single integrated framework to clarify potential interactive pathways linking these behaviors within this evidence base and to inform physical activity recommendations for early childhood development. Full article

Background: Body mass index (BMI) is widely used as a simple anthropometric indicator, but its functional relevance to physical fitness in physically active populations, such as Physical Education students, remains debated. Aim: This study examined the association between BMI and selected components of physical fitness in Physical Education students, considering sex and country differences. Methods: A cross-sectional study was conducted among undergraduate Physical Education students from Poland and Romania (n = 515; mean age: 21.64 ± 1.34 years). BMI was calculated from measured height and body mass and analyzed as both a continuous and categorical variable. Physical fitness was assessed using three Eurofit tests evaluating upper-limb movement speed, trunk muscular endurance, and lower-limb explosive power. Analyses included correlation methods and multiple linear regression models with subgroup analyses, interaction terms, and quadratic BMI terms to assess nonlinearity. Results: Associations between BMI and fitness components were small in magnitude and inconsistent (r = −0.28 to 0.143; β = −1.614 to 0.005) and varied across tests and subgroups. No significant interaction effects by sex or country were observed, as interaction terms were not statistically significant, and no clear nonlinear relationships were identified. Sex and country were significantly associated with performance levels, whereas BMI contributed only marginally to explaining variability (ΔR² = 0.005–0.011). Conclusions: BMI showed limited and inconsistent associations with the assessed fitness components in this relatively homogeneous group of Physical Education students. It should be interpreted cautiously as a functional indicator and complemented with more precise measures of body composition and physical fitness. Full article

This narrative review synthesizes existing literature on outdoor physical activity and youth well-being, with mountain biking considered as an illustrative example of a high-engagement, nature-based activity. A comprehensive literature search was conducted across multiple academic databases, including Academic Search Complete, MEDLINE, APA PsycINFO, CINAHL Plus, SocINDEX, ERIC, and additional hand searches in Google Scholar and Web of Science. Seventeen studies met the inclusion criteria and were analyzed using an iterative thematic approach. Three primary themes emerged: resilience, mood and emotional well-being, and social connectedness. Across studies, outdoor physical activity was associated with improvements in self-efficacy, stress reduction, and peer relationships. However, most studies examined outdoor activity broadly, with limited evidence specific to mountain biking. While prior literature suggests that biological and psychosocial processes (e.g., engagement with nature, social interaction, and perceived competence) may underlie these associations, these mechanisms were not directly tested in most included studies. Findings should therefore be interpreted as indicative of associations rather than causal effects. Overall, outdoor physical activity represents a promising, accessible approach for supporting youth well-being. Future research should further examine activity-specific impacts, including mountain biking, and prioritize longitudinal and experimental designs to better understand mechanisms and long-term outcomes. Full article