Search Results (23,544)

Background: Chronic exercise has been linked to positive effects on cognitive function and brain health. The aim of our study was to investigate how exercise affects cerebral resistance artery morphology, with an underlying focus on potential sex differences. Methods: Wistar rats were divided into male exercising (M.Ex; n = 6), female exercising (F.Ex; n = 5), male sedentary (M.Sed; n = 5), and female sedentary (F.Sed; n = 5) groups. After a 12-week swimming program, histological examinations of the intracerebral and pial arterioles were performed. SMA-DAB (smooth muscle actin) and resorcin-fuchsin (elastica) stained brain coronal sections were used for quantitative colorimetric analysis. Results: Investigating the effect of exercise, we found that in both pial and intracerebral arterioles, the elastic fiber density increased in both female and male exercising animals compared to the sedentary groups (p < 0.05 (M.Sed vs. M.Ex); p < 0.0001 (F.Sed vs. F.Ex)). As sex differences, we found that in female animals’ pial arterioles, the density of elastic fiber was increased compared to the male exercising group (p < 0.001 (M.Ex vs. F.Ex)). In pial arterioles, the smooth muscle density was higher in the male sedentary animals (p < 0.01 (M.Sed vs. F.Sed)); in intracerebral arterioles, the smooth muscle density increased with exercise in the male animals as well (p < 0.0001 (M.Ex vs. F.Ex)). Conclusions: Our results demonstrate that the increase in vascular elasticity is more pronounced overall in female animals. Full article

Background/Objectives: Depression and anxiety in children pose a significant public health concern, with long-term implications for well-being. Over 10% of children and adolescents are affected by emotional disorders such as depression and anxiety. African American youth face disproportionate exposure to mental health risk factors, including poverty, adverse childhood events, community violence, and racial discrimination, which elevate their vulnerability to these disorders. A particularly at-risk subgroup includes African American children in kinship care arrangements (e.g., grandparents raising grandchildren), who may face additional factors such as family disruption and separation from birth parents. Methods: This mixed-methods sequential study examined how caregiver stress and birth mother–child relationship quality relate to depression and anxiety symptoms in African American children in kinship care. Phase I included survey data from 58 caregivers of children aged 5 to 12; Phase II involved interviews with 16 of these caregivers. Results: Results indicated that lower caregiver stress was associated with reduced child depression and anxiety symptoms. Furthermore, findings suggest that a high quality of the birth mother–child relationship serves as a promotive factor, particularly for depressive symptoms. Qualitative findings highlighted two themes: (1) the weight of kinship care, marked by factors such as ongoing grief and financial strain; and (2) birth parent relationships, defined by a mix of connection, conflict, and loss that affects children’s mental health. Conclusions: These findings underscore the need for greater understanding of the strengths and resources within kinship families that support positive mental health outcomes and highlight the importance of targeted interventions to reduce caregiver stress and foster supportive parent–child relationships. Full article

Several diseases caused by tick-borne pathogens, including Lyme borreliosis (LB) and spotted fever group rickettsioses, are endemic in the Balkan Peninsula, positioned between Central Europe and the Middle East. This cross-sectional study aimed to assess serological exposure to Borrelia spp. and spotted fever group Rickettsiae (SFGR) among individuals with recent tick bites and healthy controls in two Balkan countries—Serbia and North Macedonia. Serum samples from 223 participants were tested for anti-Borrelia and anti-SFGR IgG antibodies. SFGR exposure was significantly higher in tick-exposed individuals from Skopje (North Macedonia) compared to those from Novi Sad (Serbia) (30.9% vs. 8.0%; p = 0.003). In contrast, anti-Borrelia IgG was more frequently detected in Novi Sad, though differences did not reach statistical significance. The findings support a north-to-south gradient in Borrelia exposure and a reverse trend for SFGR, consistent with earlier studies and regional tick infection data. Given the high SFGR exposure and limited clinical reporting in North Macedonia, the results highlight the likelihood that tick-borne rickettsioses remain under-recognized. Additionally, Borrelia exposure in North Macedonia warrants further investigation. These findings emphasize the need for enhanced tick-borne disease surveillance, identification of endemic zones, and improved diagnostic and public health infrastructure in both countries. Full article

Background/Objectives: Early identification of terminally ill patients is crucial for enhancing care, patient and care partner satisfaction, and healthcare staff confidence in discussing disease trajectories. Yet, timely recognition remains challenging. To address this, we developed a minimally invasive intervention (MINI) for general hospital wards. We aimed to evaluate the MINI’s feasibility in facilitating an earlier identification of terminally ill patients and improving patient reported outcomes in a hospital setting. Methods: This prospective, two-arm pre-post intervention study at a university hospital evaluated the MINI alongside usual care. Patient-reported outcomes, including quality of life (SF-12), palliative care needs (IPOS), and functional status (ECOG), were collected at baseline and every three months over 12 months. Participants were allocated to a control or intervention group. Results: Of 188 patients identified using the Surprise Question, 58 completed the baseline assessment. While physical functioning (SF-12 PCS) remained comparable, the intervention group experienced clinically meaningful improvements in mental health (SF-12 MCS) at three months, with positive trends at six months. This group also showed a decline in palliative care needs, reduced emotional symptoms, and improved performance status, evidenced by significant differences in non-parametric analyses. These findings underscore the MINI’s potential to significantly improve patient well-being. Conclusions: This pilot study demonstrated the feasibility of the MINI and suggests it may foster meaningful system-wide change in patient-centred care within acute hospital settings, leading to improved patient outcomes and more confident healthcare staff in identifying terminally ill patients. However, given the small sample size, these findings should be interpreted with caution. Future research with larger cohorts and extended intervention periods is warranted to fully elucidate the MINI’s impact and refine strategies for improving care for terminally ill patients. Full article

Background: Outdoor and household PM_2.5 are established risk factors for chronic disease and early mortality. In China, high levels of outdoor PM_2.5 and solid fuel use for cooking and heating, especially in winter, pose large health risks to the country’s aging population. Hand grip strength is a validated biomarker of functional aging and strong predictor of disability and mortality in older adults. We investigated the effects of wintertime household and outdoor PM_2.5 on maximum grip strength in a rural cohort in Beijing. Methods: We analyzed data from 877 adults (mean age: 62 y) residing in 50 rural villages over three winter seasons (2018–2019, 2019–2020, and 2021–2022). Outdoor PM_2.5 was continuously measured in all villages, and household (indoor) PM_2.5 was monitored for at least two months in a randomly selected ~30% subsample of homes. Missing data were handled using multiple imputation. We applied multivariable mixed effects regression models to estimate within- and between-individual effects of PM_2.5 on grip strength, adjusting for demographic, behavioral, and health-related covariates. Results: Wintertime household and outdoor PM_2.5 concentrations ranged from 3 to 431 μg/m³ (mean = 80 μg/m³) and 8 to 100 μg/m³ (mean = 49 μg/m³), respectively. The effect of a 10 μg/m³ within-individual increase in household and outdoor PM_2.5 on maximum grip strength was 0.06 kg (95%CI: −0.01, 0.12 kg) and 1.51 kg (95%CI: 1.35, 1.68 kg), respectively. The household PM_2.5 effect attenuated after adjusting for outdoor PM_2.5, while outdoor PM_2.5 effects remained robust across sensitivity analyses. We found little evidence of between-individual effects. Conclusions: We did not find strong evidence of an adverse effect of household PM_2.5 on grip strength. The unexpected positive effects of outdoor PM_2.5 on grip strength may reflect transient physiological changes following short-term exposure. However, these findings should not be interpreted as evidence of protective effects of air pollution on aging. Rather, they highlight the complexity of air pollution’s health impacts and the value of longitudinal data in capturing time-sensitive effects. Further research is needed to better understand these patterns and their implications in high-exposure settings. Full article

This cross-sectional study evaluated the seroprevalence and clinical impact of West Nile virus (WNV) infection in horses from three ecologically high-risk counties in western Romania (Timiș, Arad, and Bihor) between 2023 and 2025. A total of 306 unvaccinated horses were tested using a commercial ELISA, with 8.17% testing positive for WNV antibodies, indicating prior exposure. Passive surveillance for clinical signs during mosquito seasons identified 16 horses with acute neurological symptoms, four of which were confirmed as clinical cases based on WNV-specific IgM positivity, suggesting probable silent WNV circulation in the region. The overall case fatality rate among confirmed clinical cases was 25.0%. WNV seropositivity was highest in Bihor (8.85%), followed by Arad (8.57%) and Timiș (7.32%). Statistical comparisons using χ² tests and binary logistic regression indicated no significant differences in seroprevalence between counties, sexes, or age groups, consistent with the overlapping 95% confidence intervals. These findings suggest the continued silent circulation of WNV in the region and support the integration of equine surveillance into the One Health framework as a potential tool for early detection and risk mitigation. However, in the absence of molecular confirmation (e.g., RT-PCR or virus isolation), these results should be interpreted as indicative of prior exposure rather than direct evidence of ongoing viral activity. Full article

This research examines road users’ willingness to pay for enhanced active mobility infrastructure at King Mongkut’s Institute of Technology Ladkrabang (KMITL), a suburban university campus in Bangkok, Thailand. The study addresses the need for sustainable transportation solutions in middle-income urban environments by analyzing factors that influence walking and cycling adoption among university community members. The research employed a comprehensive mixed-methods framework combining qualitative SWOT analysis, a stated preference survey of 400 participants, and regularized logistic regression modeling with cross-validation. The analysis revealed that specific infrastructure improvements significantly increase the likelihood of active mobility adoption. Rest areas demonstrated the strongest positive association (OR = 2.15, 95% CI: 1.08–4.27, p = 0.029), followed by CCTV security systems (OR = 1.89, 95% CI: 0.98–3.65, p = 0.047), and improved public transport connectivity (OR = 2.84, 95% CI: 1.42–5.68, p = 0.003). Demographic analysis uncovered notable resistance patterns, with male participants (OR = 0.48, 95% CI: 0.26–0.89, p = 0.020) and higher-income individuals showing reduced willingness to transition from motorized transportation. Using the Contingent Valuation Method with proper bias mitigation strategies, the study quantified potential behavioral changes, projecting a 12–18 min daily increase in active mobility engagement. This enhancement would generate measurable health benefits valued at 2840–4260 THB per person annually using WHO-HEAT methodology. The research contributes valuable insights to the limited body of active mobility literature from Southeast Asian suburban contexts, providing a replicable framework for similar investigations. Full article

Background/Objectives: There is still debate about students’ health in medical schools. The aim of this study was to assess the proportion of chronic diseases among medical students and analyze their predictors. Methods: We performed a secondary cross-sectional analysis using a database from a single Portuguese university. The sociodemographic/clinical variables of 309 medical students were included. Logistic regression was performed to ascertain the effects of sex, age, medical course year, financial situation, and family history of chronic diseases on the likelihood of medical students having chronic disease. Results: Median age (Q1, Q3) was 21 (17, 43) years, with females comprising 79.9% of the sample. The distribution of students by school year was similar. The majority (65.7%) reported having sufficient money. Twenty-three percent suffered from chronic disease, and around forty percent had parents or siblings with chronic disease. In the regression model, only a family history of chronic disease was associated with a personal history of chronic disease. Medical students with parents or siblings who have a chronic disease are 3.3 times more likely to have a chronic disease themselves. Conclusions: Future interventions targeting the medical student population will be needed in Portugal to reduce the prevalence and burden of chronic diseases, particularly among those with a positive family history. Full article

Background: Air traffic control is a stressful job and vital to aviation safety. Although technological developments have been introduced to enhance and facilitate the tasks of air traffic control officers (ATCOs), ATCOs still experience high levels of job stress. This study explores the influence of mindfulness and social work support (SWS) on the job performance and job stress of ATCOs in Saudi Arabia. Methods: Grounded in Job Demands–Resources (JDR) theory, this study used a cross-sectional design to survey 324 ATCOs, with a 72% response rate. Mindfulness and SWS were treated as individual and situation-specific resources that influence stress and performance outcomes. Results: The results indicated that mindfulness could reduce workplace stress and improve performance. Moreover, SWS was also critical in reducing the adverse impacts of stress on job performance, reflecting the buffering effect posited by JDR theory. Conclusions: This study demonstrates that JDR theory is applicable to the context of ATC since it validates the importance of mindfulness and SWS as critical resources in minimizing stress levels and improving performance. The findings have implications for the viability of mindfulness-based training interventions and peer-support programs in supporting the health of ATCOs and their ability to deal with highly stressful situations. Full article

Certain environmental exposures are associated with COVID-19 incidence and mortality. To determine whether environmental context is associated with other COVID-19 experiences, we used data from the nationally representative Tufts Equity in Health, Wealth, and Civic Engagement Study data (n = 1785; three survey waves 2020–2022 for adults in the United States). Environmental context was assessed using self-reported climate stress and county-level air pollution, greenness, toxic release inventory site, and heatwave data. Self-reported COVID-19 experiences included willingness to vaccinate, health impacts, receiving assistance for COVID-19, and provisioning assistance for COVID-19. Self-reported climate stress in 2020 or 2021 was associated with increased COVID-19 vaccination willingness by 2022 (odds ratio [OR] = 2.35; 95% confidence interval [CI] = 1.47, 3.76), even after adjusting for political affiliation (OR = 1.79; 95% CI = 1.09, 2.93). Self-reported climate stress in 2020 was also associated with increased likelihood of receiving COVID-19 assistance by 2021 (OR = 1.89; 95% CI = 1.29, 2.78). County-level exposures (i.e., less greenness, more toxic release inventory sites, and more heatwaves) were associated with increased vaccination willingness. Air pollution exposure in 2020 was positively associated with the likelihood of provisioning COVID-19 assistance in 2020 (OR = 1.16 per µg/m³; 95% CI = 1.02, 1.32). Associations between certain environmental exposures and certain COVID-19 outcomes were stronger among those who identify as a race/ethnicity other than non-Hispanic White and among those who reported experiencing discrimination; however, these trends were not consistent. A latent variable representing a summary construct for environmental context was associated with COVID-19 vaccination willingness. Our results suggest that intersectional equity issues affecting the likelihood of exposure to adverse environmental conditions are also associated with health-related outcomes. Full article

Supporting dementia carers is a global priority. As a Randomised Controlled Trial (RCT) (n = 352) of the Word Health Organization recommended, an internationally disseminated ‘iSupport’ e-health intervention was conducted, revealing no measurable benefits to the wellbeing of adult dementia carers. This process evaluation contributes original insights of the trial outcomes. Its aims were to ascertain the usability and acceptability of iSupport, participant engagement and adherence to iSupport, and contextual factors influencing its implementation and potential impact. The process evaluation followed a mixed-method design. The following data were collected from all participants randomised to iSupport (n = 175): (1) post-intervention evaluation questionnaire (n = 93) containing the 10-item System Usability Scale and bespoke items exploring acceptability, engagement, and perceived impact; (2) qualitative interviews (n = 52) with a sub-sample of participants who were purposively sampled according to age, scores on the outcome measures, and gender, as these interviews aimed to generate contextual detail and explanatory accounts; and (3) ‘Access’ data from the iSupport platform (n = 175). Descriptive statistics was used to report on the frequency of survey responses whilst a thematic analysis approach was followed to identify themes from the qualitative interview data. Data sets were analysed independently and then used with respect to one another in order to generate explanatory pathways related to the usability, acceptability, and the impact of iSupport. Despite good trial retention, 8.3% of participants (n = 32) did not spend any time on iSupport, and 54% (n = 94) spent between 30 min and 1.5 h. Factors driving this were the following: time constrains, method of delivery, and content characteristics. Positive impacts of iSupport were also described. Participants, including those with extensive caring experience, reported how iSupport had made them feel reassured, valued, and more able to ask for help. They also reported having an improved outlook on their caring role and on the needs and feelings of the person living with dementia. Research and practice should focus on exploring blended delivery, including self-directed and interactive components, such as regular contact with a health professional. These insights are critical for supporting the global implementation and adaptation of iSupport and offer valuable directions for future research. Full article

Hederagenin, a pentacyclic triterpenoid saponin from various medicinal plants, shows immense therapeutic potential; however, its inherent low bioavailability severely hinders its clinical translation. This comprehensive review synthesizes recent studies on the health benefits of hederagenin and its glycosides, critically the chemical modification strategies and pharmacological mechanisms aimed at optimizing its bioactivity. Key findings reveal that its broad anticancer and anti-inflammatory activities largely stem from its capacity to modulate crucial cellular signaling pathways, including the NF-κB, PI3K/Akt, and MAPK. Structural modification, particularly intelligent derivatization at the C-28 position, is a central strategy to overcome its pharmacokinetic deficiencies and significantly boost cytotoxicity. Furthermore, its unique pro-oxidant function within cancer cells, achieved by inhibiting the Nrf2-ARE antioxidant pathway, offers a novel approach for selective chemotherapeutics. For the clinical translation of hederagenin, we propose a strategic focus on derivatization through multi-target hybrids and sophisticated delivery systems. This approach is essential for addressing its pharmacokinetic barriers while strategically leveraging its context-dependent pro-oxidant effects. Full article

The global transition toward plant-based diets has intensified the search for sustainable protein alternatives, positioning hemp-based meat analogs (HBMAs) as a promising solution due to their exceptional nutritional profile and environmental benefits. This comprehensive review critically examines hemp protein research, focusing on extraction technologies, nutritional excellence, functional innovation, and sustainable processing approaches for meat analog development. Hemp seeds contain 25–30% protein, primarily consisting of highly digestible edestin and albumin proteins that provide a complete amino acid profile comparable to soy and animal proteins. The protein exhibits superior digestibility (>88%) and generates bioactive peptides with demonstrated antioxidant, antihypertensive, and anti-inflammatory properties, offering significant health benefits beyond basic nutrition. Comparative analysis reveals that while alkaline extraction-isoelectric precipitation remains the industrial standard due to cost-effectiveness ($2.50–3.20 kg⁻¹), enzymatic extraction and ultrasound-assisted methods deliver superior functional properties despite higher costs. Hemp protein demonstrates moderate solubility and good emulsifying properties, though its gelation capacity requires optimization through enzymatic hydrolysis, high-pressure processing, or strategic blending with complementary proteins. Processing innovations, particularly high-moisture extrusion combined with protein blending strategies, enable fibrous structures closely mimicking conventional meat texture. Hemp protein can replace up to 60% of soy protein in high-moisture meat analogs, with formulations incorporating wheat gluten or chickpea protein showing superior textural attributes. Despite advantages in nutritional density, sustainability, and functional versatility, HBMAs face challenges including sensory limitations, regulatory barriers, and production scaling requirements. Hemp cultivation demonstrates 40–50% lower carbon footprint and water usage compared with conventional protein sources. Future research directions emphasize techniques and action processes, developing novel protein modification techniques, and addressing consumer acceptance through improved sensory properties for successful market adoption. Full article

Neurodevelopmental disorders are one of the most prevalent conditions today, and among the limitations in activity and restrictions in the participation of children and their families, we find intervention in activities of daily living; therefore, research focused on outcome measurement is one of the most active lines, and after COVID-19, telerehabilitation has garnered special interest. Background/Objectives: The study objective was to evaluate the effectiveness of a mobile health (mHealth) application in improving the performance of activities of daily living in children with neurodevelopmental disorders. Methods: The study employed a quasi-experimental design with a control group, using a fully remote mHealth-based intervention. The instruments used were a sociodemographic ad hoc, Pediatric Evaluation of Disability Inventory Computer, Family Outcomes Survey, Family Confidence Scale, and System Usability Scale. The final sample consisted of 13 participants. Results: The mHealth intervention showed significant improvements in occupational performance in the experimental group, especially in the global score and in the Responsibility dimension of the PEDI-CAT. No relevant differences were observed in the CON-FAN and FOS scales between groups, although the latter showed improvements over time. The usability of the app was rated positively (SUS = 69.75). Conclusions: The developed application presents good usability for families of children with neurodevelopmental disorders, but to obtain better outcome measures, the intervention should combine face-to-face sessions and the use of mHealth, as well as employing the family-centered model. Full article

The genus Orthoflavivirus includes several mosquito-borne pathogenic viruses, notably West Nile virus (WNV), which is endemic to the Mediterranean region. In Portugal, WNV circulation has been documented in equines, birds and mosquitoes, however human cases remain rare and no recent human seroprevalence studies have been conducted. This study aimed to estimate the national and regional seroprevalence of WNV among blood donors in mainland Portugal and explore associations with sociodemographic factors. A cross-sectional study conducted in 2022 included 3593 blood donors from across mainland Portugal. Serum samples were tested for WNV immunoglobulin G (IgG) by enzyme-linked immunosorbent assay (ELISA) and positive and borderline samples were confirmed using a virus neutralization test. Sociodemographic data were collected through a structured paper questionnaire. Statistical analyses, including multivariate logistic regression, identified factors associated with seropositivity. A total of 55 samples (1.5%) tested positive, and 21 samples (0.6%) were classified as borderline for WNV antibodies by ELISA. Of these, 47 were confirmed by viral neutralization, giving an estimated national seroprevalence of 1.4%. Significant regional variation was noted, with higher seroprevalence observed in the Beira Baixa, Grande Lisboa and Médio Tejo regions. Some seropositive individuals were identified in northern coastal regions such as Ave, Cávado and Área Metropolitana do Porto. In multivariate analysis, geographical area of residence was the only factor associated with seropositivity. This study highlights regions at potential higher risk for human WNV exposure, primarily in the southern half of Portugal. Continued and integrated surveillance is crucial to inform public health strategies to mitigate WNV transmission risks in these regions, as well as in other regions where WNV may be emerging as a relevant One Health concern. Implementing preventive measures for both animals and humans is critical to minimizing exposure and infection, and further confirmatory studies using virus neutralization tests will be important for refining these estimates. Full article