Search Results (1,212)

Heavy episodic drinking (HED) is prevalent in young adulthood, yet its relationship with psychosocial well-being remains complex. This study examines the association between HED and perceived social isolation among young adults and tests whether this relationship varies by sexual orientation. Using pooled, nationally representative data from the 2022 and 2024 Health Information National Trends Survey (HINTS), this study analyzed adults aged 18–29 (N = 723). Perceived social isolation was measured using the PROMIS Social Isolation Short Form. Weighted multivariable linear regression models assessed interactions between sexual orientation and HED occasions (0 vs. 1+), adjusting for sociodemographic variables and psychological distress. 45.5% reported HED. Lesbian/gay (B = 5.62, SE = 0.58, p < 0.001) and bisexual (B = 1.66, SE = 0.34, p < 0.001) young adults reported higher isolation than straight peers; HED was inversely associated with isolation (B = −1.71, SE = 0.20, p < 0.001). A significant interaction indicated that among lesbian/gay young adults, heavy drinking was associated with lower perceived isolation (B = −5.77, SE = 0.98, p < 0.001). Interventions should account for the social meanings of alcohol use to avoid unintentionally increasing isolation among sexual minoritized populations. Full article

Background/Objectives: Low back pain (LBP) is one of the most common musculoskeletal conditions globally and a leading cause of disability. University populations may be particularly vulnerable due to prolonged sitting, academic stress, and frequently suboptimal ergonomics, especially in rapidly expanding higher education systems such as those in Saudi Arabia. This systematic review and meta-analysis aimed to synthesize evidence on the prevalence of LBP among university attendants in Saudi Arabia and to quantify its associations with key demographic and environmental risk factors. Methods: We systematically reviewed observational studies reporting LBP prevalence and/or risk factors among university students and faculty in Saudi Arabia published in English, following Cochrane methodological guidance and PRISMA 2020 reporting recommendations. The protocol was prospectively registered in PROSPERO (CRD420250654048). We searched PubMed, Embase and CINAHL from inception to February 2025. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Joanna Briggs Institute checklist for analytical cross-sectional studies. Random effects meta-analyses were used to pool prevalence estimates across recall periods, regions, populations, and measurement tools, and to calculate pooled odds ratios (ORs) for age, sex, smoking, family history of LBP, and college seating conditions. Heterogeneity, subgroup, and sensitivity analyses were undertaken. Results: Thirteen cross-sectional studies were included. The overall pooled prevalence of LBP was 57% (95% confidence interval [CI] approximately 43–71), with substantial heterogeneity. Prevalence varied by recall period, region, population group, and measurement instrument; pooled prevalence was 58% among students and 50% among faculty. Increasing age (OR 1.17, 95% CI 1.01–1.34) and poor college seating conditions (OR 1.42, 95% CI 1.07–1.76) were significantly associated with LBP. Male gender, smoking, and family history showed non-significant pooled effects. These estimates are limited by substantial between-study heterogeneity, variable measurement tools, and exclusively cross-sectional designs, which restrict causal inference. Conclusions: LBP is prevalent among university attendants in Saudi Arabia, affecting both students and faculty. The consistent associations with age and seating ergonomics highlight the need for ergonomic classroom redesign and age-sensitive preventive strategies. Future work should adopt standardized LBP measures and longitudinal designs to clarify causal pathways and evaluate targeted interventions. Funding: This work was supported by the Deanship of Graduate Studies and Scientific Research at Jouf University (grant DGSSR-2026-NF-01-002). Full article

The hemodialysis population has progressively aged over the past two decades; in several settings, adults aged ≥75 years represent one of the fastest-growing populations receiving dialysis. Frailty, characterized by reduced physiological reserve and heightened vulnerability to stressors, has emerged as a critical determinant of outcomes and is commonly assessed using validated instruments such as the Fried Frailty Phenotype or the Clinical Frailty Scale (CFS). Reported frailty prevalence in hemodialysis varies widely (approximately 20% to >80%), largely depending on the assessment instrument and the population studied, with consistently higher prevalence in older cohorts. It is consistently associated with older age, female sex, diabetes, lower serum albumin, cardiovascular disease, longer dialysis vintage, and lower physical activity. Compared with non-frail patients, frail hemodialysis patients have a substantially higher risk of death (approximately two-fold in pooled analyses). Seminal trials and large observational programs that shaped hemodialysis targets underrepresented very old, frail, and highly comorbid patients, limiting generalizability. In frail older adults with limited life expectancy and substantial comorbidity burden, standard thrice-weekly schedules, higher ultrafiltration intensity, and a uniform ‘fistula-first’ approach may increase treatment burden without clear proportional gains in patient-centered outcomes. This review examines evidence supporting individualized hemodialysis strategies in frail older adults. As the dialysis population continues to age, proficiency in goal-concordant, personalized prescribing is increasingly important for nephrologists and dialysis teams. Full article

Background: Work-related musculoskeletal disorders (WMSDs) are prevalent among orthopaedic surgeons as a result of prolonged exposure to non-neutral postures and forceful manual tasks during surgery. Although working height is a key determinant of trunk and upper-limb posture, the systematic evaluation of ergonomic working-height recommendations in orthopaedic surgery remains limited. Methods: A simulated left total knee arthroplasty (TKA) was divided into twelve critical surgical steps and analysed across four commonly used surgeon positions (A–D). Two conditions were compared: uncorrected working height (N) and working height corrected according to Canadian Centre for Occupational Health and Safety (CCOHS) recommendations (C). Joint angles were measured from standardized photographs using Kinovea software, and postural load was quantified with the Rapid Entire Body Assessment (REBA) method. Two trained evaluators conducted three independent assessments, yielding 288 REBA scores. Results: Mean REBA scores decreased across all surgeon positions following ergonomic correction, with statistically significant reductions observed in positions A, B, and D. When pooled across all position–step combinations (n = 48), the mean reduction was 0.92 REBA points (95% CI 0.50–1.33; p < 0.001). Notably, 27 of the 48 position–step comparisons exceeded the minimal detectable change threshold. The largest reductions occurred during force-intensive surgical steps, including bone cutting, drilling, and implant impaction. Conclusions: Adjusting working height in accordance with CCOHS ergonomic recommendations reduces surgeons’ postural load during TKA. These findings support the integration of evidence-based ergonomic adjustments into routine orthopaedic surgical practice. Full article

Background: As life expectancy increases, more elderly patients require a pancreaticoduodenectomy (PD). While minimally invasive approaches are preferred, data indicating the safety of robotic PD in elderly patients remains limited. This study compares operative outcomes of robotic PD in elderly versus younger patients to define its oncological role. Material and Methods: A systematic search of PubMed, Embase, Web of Science, and Scopus identified studies comparing robotic pancreaticoduodenectomy in elderly versus younger patients. Robotic-exclusive cohorts were analyzed for perioperative outcomes, complications, and mortality. A meta-analysis was performed using R to calculate pooled prevalences, Odds Ratios (ORs) and Weighted Mean Differences (WMDs). Results: Elderly patients experienced significantly longer operative times (MD = 11.4 min) and hospital stays (MD = 7.76 days). They demonstrated higher odds of severe complications (Clavien–Dindo ≥ III: OR = 2.20), delayed gastric emptying (DGE) (OR = 2.34), and mortality (OR = 3.42). There were no significant differences in blood loss, transfusions, overall complications, pancreatic fistulae, bile leakage, hemorrhage, infection, readmission, or reoperation. Notably, age-stratified subgroup analyses revealed a distinct risk divergence: studies using an 80-year cutoff reported significantly higher odds of mortality and DGE, whereas 70-year-threshold studies demonstrated more pronounced odds for severe and overall complications. Conclusions: While robotic pancreaticoduodenectomy is feasible in elderly patients with comparable intraoperative blood loss and overall complication rates to younger patients, it does not eliminate all age-related risks. Elderly patients remain at significantly higher risk for severe complications and mortality. Therefore, robotic application in this demographic requires rigorous preoperative assessment, utilizing age as an initial risk-stratifier while allowing physiological reserve to determine final surgical candidacy. Full article

Background: Artificial intelligence (AI) holds transformative potential for mental health services. However, existing reviews have predominantly focused on algorithmic accuracy, with limited attention to how these technologies are implemented and integrated into real-world service delivery. This scoping review addresses this gap by examining the contexts in which AI technologies—including large language models (LLMs) and machine learning—are implemented, as well as the factors influencing their sustainable adoption within real-world mental health service systems. Methods: Following the established methodological framework, a systematic search (2015–2026) was conducted in PubMed and Scopus. Two independent reviewers screened an initial pool of 829 records using Zotero and Rayyan to minimize selection bias. Following title, abstract, and full-text screening based on predefined eligibility criteria, 26 studies focusing on real-world AI applications (e.g., clinical settings, community services, and case management) were included in the final synthesis. Results: The findings indicate a rapid acceleration in research, with 50% of included studies (n = 13) published since 2024. AI-driven decision support systems were the most prevalent (50%, n = 13), followed by predictive machine learning models (27%) and generative AI applications (15%). Most tools were designed for clinician use (77%) and implemented in hospital-based settings (46%). Although 46% of studies reported real-world implementation, more than half remained at the pilot stage. Notably, research emphasis has shifted from technical efficacy toward feasibility, and implementation contexts (n = 17). Conclusion: AI in mental health is transitioning from laboratory validation to real-world integration. However, the current landscape remains heavily centered on clinician workflows and screening functions, with limited expansion into community-based recovery and long-term prevention. To move beyond the pilot stage, future initiatives should prioritize seamless workflow integration and the application of structured ethical and implementation frameworks that support clinician–patient relationships. This review provides an evidentiary basis for advancing sustainable, AI-enhanced mental health service delivery. Full article

Aedes aegypti is a primary vector for globally significant arboviruses such as dengue virus (DENV). The mosquito’s metavirome, particularly its insect-specific virus (ISV) component, is recognized as a key modulator of arboviral transmission. However, the natural ecology of these interactions in populations remains poorly understood. This study presents the first comparative analysis of the metavirome in wild-caught A. aegypti from Vietnam based on natural DENV infection status. Metaviromic analysis was performed on 69 DENV-positive pools from six central provinces. The results obtained were compared with previously obtained metaviromic data from 7 DENV-negative pools (from the same region). Analysis suggests the presence of a stable ‘core metavirome’ of 11 ISVs present in both groups. Interestingly, six ISVs were detected only in DENV-negative mosquitoes, which may suggest potential antagonistic interactions requiring further investigation. Conversely, five ISVs were found only in DENV-positive pools, including Aedes partiti-like virus 1 and Aedes anphevirus. The latter may suggest possible synergistic relationships that facilitate arboviral replication. Phylogenetic analysis of prevalent ISVs, such as Phasi Charoen-like phasivirus (PCLV) and Chaq-like virus, revealed patterns of both local circulation and genetic diversity. The findings describe distinct ISV profiles associated with DENV infection in a natural setting, providing a data-driven foundation for hypothesizing specific virus–virus interactions. The data underscores the complexity of the mosquito metavirome. Here, we identified several candidate ISVs for future experimental studies aimed at understanding potential functional impact on arboviral vector competence. Full article

Background/Objectives: Cardiovascular diseases (CVDs) frequently limit the feasibility and effectiveness of cancer treatment. However, CVD burden has not been comprehensively described in pancreatic cancer. In our systematic review and meta-analysis, we evaluated the prevalence and incidence of CVDs in pancreatic ductal adenocarcinoma (PDAC). Methods: We conducted the systematic search in PubMed, EMBASE, and CENTRAL on 5 February 2024. Studies reporting the prevalence or incidence of CVDs in PDAC were included. Subgroup analyses were performed based on cancer stage and treatment type. Pooled proportions with the 95% confidence interval (CI) were calculated using a random-effects model. (PROSPERO: CRD42023482295). Results: We included 197 articles. At PDAC diagnosis, non-thrombotic cardiovascular diseases (NT-CVDs) were as prevalent as in the general population: hypertension in 33% (CI: 27–40%), ischemic heart disease in 6% (CI: 3–12%), and heart failure, arrhythmia, and stroke each in 2–3%. Their incidence during treatment remained low (1–10%). Thrombotic events, excluding pulmonary embolism, were present in 11% (CI: 7–15%) at diagnosis, with an incidence of 8–10% regardless of stage or treatment. Pulmonary embolism affected 3% at diagnosis and occurred at a similar rate during treatment. Conclusions: Thromboembolic events are common in PDAC and occur both at diagnosis and during follow-up. Their incidence remains stable across treatment modalities and disease stages, suggesting that the tumor itself is the primary driver of thrombotic risk. The prevalence of NT-CVDs in PDAC is comparable to that in the general population and shows minimal variation across cancer stages or treatment modalities. Full article

Background: Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder associated with multiple systemic comorbidities. Gastroesophageal reflux disease (GERD) has been frequently reported among patients with OSA; however, the magnitude of this association remains uncertain. Objective: To systematically evaluate and quantify the association between obstructive sleep apnea and gastroesophageal reflux disease in adult populations. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and a protocol registered in PROSPERO (CRD420261278563). Electronic searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and Embase. Observational studies assessing the association between OSA and GERD were included. Risk of bias was assessed using the Newcastle–Ottawa Scale. A random-effects meta-analysis was performed to pool odds ratios (ORs) with 95% confidence intervals (CIs). Results: Six observational studies were included in the quantitative synthesis. The pooled analysis demonstrated a statistically significant association between obstructive sleep apnea and gastroesophageal reflux disease, with a combined OR of 1.96. Moderate heterogeneity was observed among studies (I² = 65%). No substantial evidence of publication bias was identified based on funnel plot assessment. Conclusions: These findings suggest that obstructive sleep apnea is associated with nearly two-fold increased odds of gastroesophageal reflux disease and support increased clinical awareness rather than formal screening recommendations. Full article

Porcine reproductive and respiratory virus (PRRSV) has a significant clinical and economic impact on pig farming. The purpose of this study was to assess the global seroprevalence of PRRSV in pigs and wild boars using a systematic review and meta-analysis approach. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a systematic review and meta-analysis on global serological data of PRRSV in pigs and wild boars was conducted. Studies published between 1993 and 2025 were searched in three electronic databases, including PubMed, Web of Science, and Scopus. A total of 86 publications, belonging to 41 countries and including 690,771 animals, were deemed eligible. Following the identification and removal of outlier studies, the pooled serological prevalence was 14% (95% CI: 9–19%), and a high between-study heterogeneity was detected (I² = 99.9%, p < 0.000001). Subgroup analyses showed statistically significant differences according to continents, with the highest prevalence found in Asia (P: 29%, 95% CI: 16–43%), and species, with a higher prevalence in domestic pigs (P: 26%, 95% CI: 18–35%) than in wild boars (P: 2%, 95% CI: 1–3%). Overall, the information hereby presented provides an overview of the global PRRSV situation and identifies key factors associated with increased prevalence, primarily related to animal density. These insights could inform future surveillance strategies and help target interventions to mitigate the disease burden and safeguard swine health. Full article

Background: Dietary calcium and dairy products are hypothesized protective factors against metabolic syndrome (MetS), yet epidemiological evidence remains inconsistent. This systematic review and meta-analysis evaluated the association between total dietary calcium intake or dairy consumption and MetS prevalence in adults. Methods: Following PRISMA 2020 guidelines, PubMed, Cochrane Library, ClinicalTrials.gov, and SCOPUS were searched through to October 2025 for eligible cross-sectional studies assessing dietary calcium or dairy intake and MetS (NCEP ATP III, IDF, or JIS criteria). Longitudinal studies, non-English articles, and pediatric populations were excluded. Quality was assessed via an adapted Newcastle–Ottawa Scale. Random-effects meta-analyses pooled fully adjusted odds ratios (ORs) and 95% confidence intervals (CIs) comparing the highest versus lowest intake categories. Results: Twenty-four studies were included (12 for dietary calcium intake, 12 for dairy products). Higher dietary calcium intake was significantly associated with lower MetS odds (pooled OR: 0.85; 95% CI: 0.80–0.91), despite substantial heterogeneity (I² = 70.1%). Higher dairy consumption was also inversely associated with MetS (pooled OR: 0.78; 95% CI: 0.72–0.85; I² = 64.6%). While small-study effects were observed for dairy, trim-and-fill analysis confirmed the robustness of the findings. Higher calcium intake further correlated with favorable profiles in individual MetS components, including blood pressure, HDL cholesterol, waist circumference, triglycerides, and fasting glucose. Conclusions: Higher total dietary calcium intake and dairy product consumption are associated with a lower prevalence of MetS in adults. However, the cross-sectional nature of the included studies precludes any inference of causality between calcium intake and MetS. Therefore, although these findings suggest a protective role of calcium-rich diets, well-designed prospective and interventional studies are warranted to clarify whether this relationship is causal. Full article

Background: Hypertension is an important target for primordial prevention of complex, noncommunicable diseases, and its prevalence remains high across populations. The urban population in India is at a high risk of hypertension, but the genetic basis of hypertension in this population remains poorly understood. Methods: We conducted a pooled whole-blood genome-wide association study of 28 pools representing 1402 participants of the Diabetes In Sindhi Families In Nagpur (DISFIN) study, which enrolled families of probands with type 2 diabetes (T2D). Genotyping was done using Illumina’s Global Screening Array. Results: From a total of 608,550 single-nucleotide variants, 191 were found to be significantly associated with hypertension even after adjusting for metabolic comorbidities, batch effects, pooling error, kinship status, and pooling variation. These variants mapped to 180 well-characterized genes comprising 55 (31%) genes, and encode long noncoding RNAs (lncRNAs). Many of the genes significantly associated with hypertension (including 35% of the lncRNAs) have also been reported by other studies. However, we identified novel genes (SBF2, ARHGAP12, EPAS1, CLEC16A, and LRPPRC) to be associated with hypertension. The most significantly associated lncRNA gene was FLYWCH-AS1. Bioinformatic analyses indicated that these novel genes are likely to have functional importance in hypertension. Conclusions: Our study thus points to the potential candidate genes associated with hypertension in endogamous Sindhi families with T2D patients. The replicable and functional role of these candidate genes should be investigated in future studies. Full article

Background: Work-related musculoskeletal disorders (WMSDs) are common among surgeons. The objective was to study how economic, demographic, and quality-of-life indicators influence the WMSD prevalence among European surgeons. Methods: A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three open databases were scanned without a date limit to extract the overall WMSD prevalence and by body area. Results: Among the 11,814 articles, 25 were included, with a total of 5174 surgeons. The overall prevalence was pooled at 75.8% (95% CI: 68.6–83.1%). The most affected areas were lower back (52.1%, 95% CI: 43.1–61.0%), neck (51.2%, 95% CI: 43.7–58.9%), shoulder (43.1%, 95% CI: 36.4–49.8%) and upper back (34.2%, 95% CI: 24.2–44.1%). Surgeons aged over 45 with more than 10 years’ experience had a higher prevalence of WMSDs in the neck, hip, upper and lower back. The overall and lower back prevalence was higher among surgeons in countries where the surgery-by-surgeon ratio was greater than 125. A negative correlation was observed between the Human Development Index and the lower back prevalence. Conclusions: Further research is needed to strengthen ergonomics programs, knowledge, and organizational work strategies to effectively reduce WMSD prevalence among European surgeons. Full article

Background: Fixed night work and rotating schedules including nights may contribute to migraine via sleep disruption and circadian misalignment, but evidence is inconsistent and definitions vary. This systematic review and meta-analysis compared past-year migraine prevalence in nurses working night-inclusive schedules versus day-only or non-night schedules. Methods: Following PRISMA 2020 and registered in PROSPERO (CRD420261304288), we searched PubMed, Scopus, Web of Science, CINAHL, and the Cochrane Library from inception to 3 February 2026 (English/Spanish). Observational studies in nurses (≥18 years) reporting past-year migraine prevalence by shift pattern were eligible. All included studies assessed past-year prevalence; pooled PRs reflect 1-year prevalence. Crude prevalence ratios (PRs) were calculated from contingency tables and pooled quantitatively. Risk of bias was assessed with the JBI prevalence checklist. Results: We identified 54 records; 4 studies were included (N = 3843) of which 3323 participants contributed to the comparative meta-analysis because complete disaggregated data were available to construct contingency tables. The pooled association between night-inclusive schedules and migraine prevalence was not statistically significant (PR = 0.95, 95% CI 0.82–1.10; I² = 0%). Secondary intensity contrasts were inconclusive (high vs. low: PR = 1.24, 95% CI 0.46–3.36; high vs. zero nights: PR = 0.85, 95% CI 0.38–1.93). Conclusions: Current nurse-specific evidence does not show a statistically significant difference in migraine prevalence between night-inclusive and non-night schedules; however, the small evidence base and limited generalizability preclude firm conclusions. Future longitudinal studies are needed to clarify this association. Full article

Introduction: Vestibular migraine (VM) is a frequent but underdiagnosed cause of episodic vertigo, characterized by vestibular symptoms often accompanied by migrainous features. Despite its relatively high prevalence, diagnosis remains clinically challenging and may differ depending on the diagnostic criteria used. This systematic review evaluates VM prevalence and clinical features across age groups to improve recognition and guide age-appropriate management. Methods: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO. This research was conducted using PubMed, Google Scholar, Cochrane, Web of Science, Wiley Online Library, and Embase. Two independent reviewers screened studies by title and abstract, and a separate pair screened full texts. Eligible studies were observational and reported prevalence or clinical features of VM. Results: A total of 874 publications were identified, leading to the review of 21 studies. Prevalence of VM varied widely, ranging from 6% to 35% in children and 2.7% to 40.9% in adults. Pooled prevalence across studies was 19% overall, 25% in children, and 14% in adults. Among patients with vertigo, the pooled prevalence was higher at 26%, with 33% in children and 18% in adults. Vertigo was the most consistent symptom in both age groups, and female predominance was observed in all age groups. Prevalence variability likely reflects diversity in applied diagnostic criteria and study design across included studies. Conclusion: VM is a common cause of vertigo, particularly in pediatric populations. Age-specific clinical features highlight the need for tailored diagnostic and management strategies. Future research should focus on large-scale prospective studies. Full article