Search Results (5,704)

Background/Objectives: Lithium (Li), silicon (Si), and boron (B) are proposed nutritional trace elements with potential roles in metabolic, neurobiological, endocrine, inflammatory, and bone-related processes. This review provides a critical synthesis of data on Li–Si–B, emphasizing (i) physiological and mechanistic pathways, (ii) human clinical relevance, (iii) shared biological domains, and (iv) safety considerations. Methods: A narrative review was conducted across PubMed, Scopus, and Web of Science from inception to January 2025. Predefined search strings targeted dietary, environmental, and supplemental exposures of lithium, silicon, or boron in relation to metabolism, endocrine function, neurobiology, inflammation, bone health, and the gut microbiome. Inclusion criteria required peer-reviewed studies in English. Data extraction followed a structured template, and evidence was stratified into human, animal, cellular, and ecological tiers. Methodological limitations were critically appraised. Results: Li, Si, and B influence overlapping molecular pathways including oxidative stress modulation, mitochondrial stability, inflammatory signaling, endocrine regulation, and epithelial/gut barrier function. Human evidence remains limited: Li is supported primarily by small trials; Si by bone-related observational studies and biomarker-oriented interventions; and B by metabolic, inflammatory, and cognitive studies of modest sample size. Convergence across elements appears in redox control, barrier function, and neuroimmune interactions, but mechanistic synergism remains hypothetical. Conclusions: Although Li–Si–B display compelling mechanistic potential, current human data are insufficient to justify dietary recommendations or supplementation. Considerable research gaps—including exposure assessment, dose–response characterization, toxicity thresholds, and controlled human trials—must be addressed before translation into public health policy. Full article

Background/Objectives: In England, gay, bisexual, and other men who have sex with men (GBMSM) are eligible for vaccination at NHS sexual health services, including human papillomavirus (HPV), hepatitis A virus (HAV), and hepatitis B virus (HBV) vaccines. However, current research shows limited understanding of the factors influencing vaccination uptake among GBMSM. This study aimed to examine the barriers and facilitators affecting the offer and uptake of these vaccination programmes. Methods: A qualitative interview study following the Person-Based Approach (a systematic method for developing and optimising health interventions) involving GBMSM and sexual health service staff from two regions of England. Purposive sampling aimed to include GBMSM with diverse backgrounds and engagement with sexual health services. Patient and public involvement shaped the study design and interview topic guides. The interviews were recorded, transcribed, and thematically analysed to identify barriers and facilitators which were interpreted using the COM-B model of behaviour change. Results: Twenty GBMSM and eleven staff took part. The findings showed that opportunistic delivery of HPV, HAV, and HBV vaccination within sexual health services is mostly acceptable and feasible for GBMSM and staff, while also highlighting areas for optimization. Despite low knowledge of these viruses and their associated risks, willingness to be vaccinated was high, with healthcare provider recommendations and the convenience of vaccine delivery during routine clinic visits acting as important facilitators. However, the reach of opportunistic models was limited, particularly for individuals underserved by sexual health services or disengaged from GBMSM social networks. System-level barriers such as complex vaccine schedules (particularly when multiple schedules are combined), inconsistent access to vaccination histories, and limited system-level follow-up processes (e.g., automated invites and reminders) were also found to act as obstacles to vaccination uptake and delivery. Conclusions: To improve equitable uptake, sexual health services should explore the feasibility of addressing both individual and structural barriers through additional strategies, including targeted and persuasive communication to increase knowledge, leveraging regular contact with GBMSM to promote uptake, and implementing enhanced approaches to support vaccination completion (e.g., automated prompts or reminders). Full article

With the progress of global aging, osteoporosis, as a systemic bone disease, has become an increasingly serious public health problem. Osteoporosis has an insidious onset, and the fractures it causes have a high rate of disability and mortality. Early diagnosis and intervention of the disease are particularly important. Currently, diagnostic methods for osteoporosis, such as dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), and bone turnover markers (BTM), all have their limitations. miRNA is a type of non-coding RNA that plays a role in the epigenetic regulation of gene expression. A large number of studies have shown that miRNA is involved in the formation and functional execution of osteoblasts. The differential expression of miRNA levels can effectively distinguish osteoporosis patients from normal individuals, and miRNA detection has the advantages of simple sample collection, non-invasive measurement, specificity for bone metabolism, correct correlation with standard techniques for bone remodeling analysis, and the ability to respond to the treatment of diseases affecting bone metabolism. This makes miRNAs potentially effective diagnostic markers for osteoporosis. This article aims to summarize our current understanding of miRNA regulation of osteoblast generation and function, and we will also discuss the potential value of these miRNAs as biomarkers for the diagnosis of osteoporosis. Full article

Background: Developmental coordination Disorder (DCD) is a prevalent and persistent neurodevelopmental condition characterized by motor learning difficulties that significantly affect daily functioning and participation. Despite growing interest in artificial intelligence (AI) applications within healthcare, the extent and nature of AI use in the evaluation and intervention of DCD remain unclear. Objective: This scoping review aimed to systematically map the existing literature on the use of AI and AI-assisted approaches in the evaluation, screening, monitoring, and intervention of DCD, and to identify current trends, methodological characteristics, and gaps in the evidence base. Methods: A scoping review was conducted in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines and was registered on the Open Science Framework. Systematic searches were performed in Scopus, PubMed, Web of Science, and IEEE Xplore, supplemented by snowballing. Peer-reviewed studies applying AI methods to DCD-relevant populations were included. Data was extracted and charted to summarize study designs, populations, AI methods, data modalities, clinical purposes, outcomes, and reported limitations. Results: Seven studies published between 2021 and 2025 met the inclusion criteria following a literature search covering the period from January 2010 to 2025. One study listed as 2026 was included based on its early access online publication in 2025. Most studies focused on AI applications for assessment, screening, and classification, using supervised machine learning or deep learning models applied to movement-based data, wearable sensors, video recordings, neurophysiological signals, or electronic health records. Only one randomized controlled trial evaluated an AI-assisted intervention. The evidence base was dominated by early-phase development and validation studies, with limited external validation, heterogeneous diagnostic definitions, and scarce intervention-focused research. Conclusions: Current AI research in DCD is primarily centered on evaluation and early identification, with comparatively limited evidence supporting AI-assisted intervention or rehabilitation. While existing findings suggest that AI has the potential to enhance objectivity and sensitivity in DCD assessment, significant gaps remain in clinical translation, intervention development, and implementation. Future research should prioritize theory-informed, clinician-centered AI applications, including adaptive intervention systems and decision-support tools, to better support occupational therapy and physiotherapy practice in DCD care. Full article

Obesity is associated with multiple comorbidities and therefore requires a multidisciplinary approach. Particular attention is given to the role of visceral adiposity and its impact on quality of life. Childhood obesity, in particular, is a major global public health challenge with physical, psychological, and social consequences extending into adulthood. Within the framework of personalized medicine, assessing physical fitness and health-related quality of life (HRQoL) offers valuable insight for defining individualized therapeutic goals. Objective: To evaluate the relationship between physical fitness and HRQoL in children with simple obesity and to highlight the potential value of personalized approaches in pediatric obesity management. Methods: This study included 123 patients aged 8–16 years with simple obesity who were hospitalized at the Children’s Memorial Health Institute in Warsaw. Obesity was diagnosed according to CDC growth charts (OLAF study). Physical fitness was assessed using the EUROFIT test battery (8 trials), and HRQoL was measured with the Kidscreen-52 questionnaire (10 domains). Results: The overall EUROFIT test performance in the study group was significantly lower compared with population norms (p < 0.001). Similarly, HRQoL scores reported by both children and their parents were significantly below reference values (p < 0.001). Conclusions: Reduced physical fitness is strongly associated with impaired quality of life in children with obesity. Personalized interventions aimed at improving motor performance may represent an effective strategy in the prevention and treatment of pediatric obesity. Full article

Influenza has long been a well-documented contributor to cardiovascular morbidity and mortality, particularly among high-risk groups. COVID-19 has notably altered the seasonality and natural history of pandemic influenza, with broad implications for related cardiac complications. This review examines the interaction between influenza and cardiovascular illness, especially myocardial infarction, congestive heart failure, stroke, and other acute cardiac events. We review the impact of the COVID-19 pandemic on influenza transmission dynamics, public health policy, and the evolving burden of cardiovascular complications. New evidence indicates that both diseases exacerbate endothelial dysfunction, systemic inflammation, and prothrombotic states, thereby increasing cardiovascular risk. A comparative analysis of pre- and post-COVID-19 influenza-related cardiac complications clarifies evolving trends and guides future preventive strategies. In light of the recent resurgence of influenza following the relaxation of COVID-19 mitigation measures, maximizing vaccine coverage and collaborating to manage viral infections in patients with cardiovascular disease are critical. This review focuses on key research needs to understand long-term cardiac consequences and the urgent requirement for targeted public health strategies to counter viral-mediated cardiovascular threats. In the post-COVID era, integrating influenza and COVID-19 vaccination strategies into cardiovascular risk management may represent a critical opportunity to reduce virus-triggered cardiovascular morbidity and mortality. Full article

Background/Objectives: This study investigates whether psychological well-being moderates the relationship between burnout and depressive symptoms among mental health professionals, who are frequently exposed to high emotional labor. Methods: A sample of 607 professionals—including psychologists, guidance counselors, social workers, and psychiatrists—working in public and private institutions in Turkey participated in the study. Data were collected online using the Maslach Burnout Inventory, the Psychological Well-Being Scale, and the Beck Depression Inventory–II. A latent interaction term between burnout and psychological well-being was tested using Structural Equation Modeling (SEM). Results: Burnout was positively associated with depressive symptoms (β = 0.37, p < 0.001), and psychological well-being showed a significant main effect on depressive symptoms (β = 0.26, p < 0.001). Importantly, the interaction between burnout and psychological well-being was significant (β = 0.20, p < 0.001), indicating that psychological well-being significantly moderates the relationship between burnout and depressive symptoms. Specifically, the positive interaction suggests that the association between burnout and depressive symptoms becomes stronger at higher levels of psychological well-being. The model explained 27% of the variance in depressive symptoms. Conclusions: These findings highlight the protective role of psychological well-being and suggest that interventions aimed at enhancing well-being may help reduce depressive symptoms among mental health professionals in high-stress environments. Full article

Sedentary behavior contributes to obesity and metabolic dysfunction, yet few interventions individualize exercise intensity using fuel-based metrics such as the respiratory exchange ratio (RER; VCO₂/VO₂). This study investigated the effects of metabolically guided walking combined with whole-food, plant-based nutrition on body composition and metabolic outcomes in sedentary overweight and obese women. Forty-four women mean age 43 years; BMI 30.1 kg·m⁻²) were randomized to low-intensity continuous training (LICT; RER ≈ 0.75), moderate-intensity intermittent training (MIIT; RER ≈ 0.85), or high-intensity continuous training (HICT; RER ≈ 0.95). Following a 2-week dietary lead-in with an individualized ~200 kcal·day⁻¹ energy deficit, participants completed an 8-week RER-guided walking program (5 sessions·week⁻¹; 15–50 min·session⁻¹). Assessments included air-displacement plethysmography (BodPod) body composition, resting metabolic rate and substrate utilization, and oxygen uptake at the first ventilatory threshold (VT1). Data were analyzed using ANCOVA, mixed-factorial ANOVA, and Pearson correlations. Percent body fat decreased significantly across participants (p < 0.0001, η² = 0.827), with MIIT demonstrating the most favorable integrated outcomes. MIIT elicited the largest reductions in total body mass (−11.2%), fat mass (−25.9%), and percent body fat (−17.1%), alongside improvements in VT1 VO₂ (Δ = 1.487 ± 0.895 L·min⁻¹; p = 0.038). Resting respiratory quotient (RQ) declined in LICT and MIIT but increased in HICT, corresponding with increased fat oxidation in LICT and MIIT and reduced fat oxidation in HICT. Changes in RQ were significantly associated with changes in percent body fat (r = 0.316, p = 0.039). Metabolically guided moderate-intensity intermittent walking combined with whole-food, plant-based nutrition produced the most consistent improvements in adiposity, substrate utilization, and submaximal fitness, supporting the public-health feasibility of a community-deliverable, substrate-informed walking prescription. Full article

Background: Food allergy [FA] is a growing public health concern among school-age children, with schools and childcare/daycare settings representing high-risk environments for accidental exposure and anaphylaxis. Objective: To systematically review evidence on digital health interventions supporting FA education, prevention, and management in school settings. Methods: A systematic search of PubMed, Scopus, Web of Science, and CINAHL was conducted to identify studies published between January 2015 and December 2025 [PROSPERO CRD420251185553]. Eligible studies evaluated e-learning, mHealth, or web-based programs targeting school staff, parents, or students. Results: Sixteen studies met inclusion criteria. Digital health emerged as a catalyst for professional development, interprofessional communication, and health equity within school communities. Interventions consistently improved knowledge, preparedness, and self-efficacy in anaphylaxis management among school staff, strengthened parental empowerment and communication with schools, and supported coping and inclusion among allergic children. Evidence on clinical outcomes; however, remains limited. Conclusions: Digital health can meaningfully enhance school preparedness and reduce inequalities in allergy management. Integrating digital tools into national school health frameworks—particularly where school nursing is not yet institutionalized—may represent a pivotal step toward safer, more equitable inclusion of children with food allergy. Full article

Prescription drug misuse among youth is a significant public health problem that can lead to negative consequences, including addiction and overdose deaths. This study examined the effectiveness of an evidence-based hybrid approach in preventing prescription drug misuse outcomes in high school students. The prevention program used a combination of e-learning modules and classroom activities to enhance social and personal competence skills and refusal skills to deter prescription drug misuse and other types of substance misuse. Findings indicated that prescription sedative misuse was lower among students who received the hybrid prevention program compared to students in the control group. Perceived risk of using prescription sedatives, painkillers, and stimulants prescribed for someone else was higher in the intervention group relative to the control group students. These findings indicate that a comprehensive, universal school-based hybrid prevention program can produce positive impacts on sedative use and perceived risks of prescription drug misuse. Full article

To redress systemically biased approaches to health interventions and service design, it is critical that public health researchers employ frameworks that are intentional in their approach to recognizing and working against existing power structures to advance equity in public health. Design Justice represents an approach to design which centers marginalized people and uses collaborative design processes to address community needs and challenges. The purpose of this paper is to describe our process for applying a Design Justice framework to Project XX. Project XX is a study funded by XX designed to develop and test an eHealth-enhanced peer navigation intervention to improve engagement in substance use and HIV-related services for young adults with recent carceral system involvement. We situate the project within the theoretical foundation of Design Justice and community-engaged research, describe its development and implementation, and analyze the application of Design Justice principles from an implementation science perspective by overlaying them with Stanford University’s Center for Dissemination and Implementation’s five key dimensions of dissemination and implementation methods. We highlight successes, challenges, and lessons learned, offering recommendations to guide more equitable and inclusive approaches for future research and practice. Full article

Background: In recent years, the sociopolitical landscape in the United States has shifted due to an increase in state-level legislation regarding LGBTQ+ rights, a trend that has been particularly pronounced in the Commonwealth of Kentucky. While the mental health impacts of enacted laws are increasingly documented, a critical gap remains in understanding the psychological toll of the legislative debates themselves—the prolonged periods of public discourse surrounding the restriction of rights. Methods: Utilizing data from the 2025 Queer Kentucky Survey (N = 817), this exploratory study examined the association between LGBTQ+ community belongingness and acute suicidality attributed specifically to anti-LGBTQ+ legislative debates. Data were derived from a non-probability snowball sample. Binary logistic regression models that adjusted for age, race, gender identity, education, and income were utilized. Results: Prevalence of debate-attributed suicidality was alarmingly high: 59.7% of the sample attributed increased suicidal thoughts, and 44.1% attributed a suicide attempt, specifically to the legislative debates. LGBTQ+ belongingness was a robust protective correlate, associated with significantly lower odds of both suicidal thoughts (OR = 0.61, p < 0.001) and attempts (OR = 0.41, p < 0.001). Analyses further revealed divergent risk for suicidality across demographic characteristics. Conclusions: Findings are consistent with the interpretation that legislative debates may function as distinct structural stressors associated with suicidal thoughts and suicide attempts. While community belongingness may offer a critical buffer, the elevated risks among Transgender and Black, Indigenous, and People of Color (BIPOC) populations highlight the need for intersectional, structural interventions beyond individual resilience. Full article

Background: Childhood obesity represents the most common nutritional and metabolic disorder in industrialized countries and constitutes a major public health concern. In Italy, 20–25% of school-aged children are overweight and 10–14% are obese, with marked regional variability. Excess adiposity in childhood is frequently associated with hypertension, dyslipidemia, insulin resistance, and non-alcoholic fatty liver disease (NAFLD), predisposing to future cardiovascular disease (CVD). Objective: To investigate anthropometric indicators of cardiometabolic risk in 810 children and adolescents aged 7–17 years who underwent assessment for competitive sports eligibility at the Sports Medicine Unit of Modena, evaluate baseline knowledge of cardiovascular health aligned with ESC, AAP (2023), and EASO guidelines. Methods: 810 children and adolescents aged 7–17 years undergoing competitive sports eligibility assessment at the Sports Medicine Unit of Modena underwent evaluation of BMI percentile, waist circumference (WC), waist-to-height ratio (WHtR), and blood pressure. Cardiovascular knowledge and lifestyle habits were assessed via a previously used questionnaire. Anthropometric parameters, blood pressure (BP), and lifestyle-related knowledge and behaviors were assessed using standardized procedures. Overweight and obesity were defined according to WHO BMI-for-age percentiles. Elevated BP was classified based on the 2017 American Academy of Pediatrics age-, sex-, and height-specific percentiles. Statistical analyses included descriptive statistics, group comparisons, chi-square tests with effect size estimation, correlation analyses, and multivariable logistic regression models. Results: Overall, 22% of participants were overweight and 14% obese. WHtR > 0.5 was observed in 28% of the sample and was more frequent among overweight/obese children (p < 0.001). Elevated BP was detected in 12% of participants with available measurements (n = 769) and was significantly associated with excess adiposity (χ² = 7.21, p < 0.01; Cramér’s V = 0.27). In multivariable logistic regression analyses adjusted for age and sex, WHtR > 0.5 (OR 2.14, 95% CI 1.32–3.47, p = 0.002) and higher sedentary time (OR 1.41 per additional daily hour, 95% CI 1.10–1.82, p = 0.006) were independently associated with elevated BP, whereas BMI percentile lost significance when WHtR was included in the model. Lifestyle knowledge scores were significantly lower among overweight and obese participants compared with normal-weight peers (p < 0.01). Conclusions: WHtR is a sensitive early marker of cardiometabolic risk, often identifying at-risk children missed by BMI alone. Baseline cardiovascular knowledge was suboptimal. The observed gaps in cardiovascular knowledge underscore the importance of integrating anthropometric screening with structured educational interventions to promote healthy lifestyles and long-term cardiovascular prevention. Full article

External causes account for over four million deaths globally each year, with psychoactive substance use being a major risk factor. However, the true impact and regional patterns of psychoactive substance use in these deaths remains undefined in Brazil. To address this critical knowledge gap, this pioneering four-city study sought to elucidate the prevalence of alcohol and drug use by external cause victims. We collected postmortem blood from 3577 victims of violent death across four distinct Brazilian cities (Belém, Recife, Vitória, and Curitiba), representing the North, Northeast, Southeast, and South regions, respectively, using a standardized protocol to identify alcohol, illicit drugs, and psychoactive medicines. Analysis revealed a predominantly male cohort (89.7%; 56.0% aged 30 years or more), with homicide as the primary manner of death (67.3%). Over half of the victims (53.0%) tested positive for at least one psychoactive substance prior to death; cocaine (29.6%) and alcohol (27.7%) were most common. Substance use was highest among homicide victims (55.7%), especially cocaine (36.0%), and among self-harm cases (54.6%), which showed elevated benzodiazepine prevalence (20.0%). Substance use patterns varied regionally: alcohol-related deaths were more common in Recife (Northeast), drug-only deaths concentrated in Vitória (Southeast) and Belém (North), and Curitiba (South) showed a higher prevalence of alcohol use versus drug use. This widespread, regionally heterogeneous prevalence underscores the urgent need for targeted, region-specific interventions. By critically linking psychoactive substance use to various modes of violent death, these data provide crucial forensic and public health insights to inform tailored preventive strategies. Full article

Visceral leishmaniasis (VL) is a serious vector-borne disease affecting humans and dogs, posing major public health challenges in endemic regions. Control efforts often target sandfly vectors, whose larvae and pupae develop in soil. Environmental management, such as removing organic matter, reducing moisture, and pruning vegetation, aims to limit breeding sites and reduce sandfly populations. This study evaluated the impact of integrated interventions on sandfly behavior in priority areas for VL control in Araçatuba, São Paulo, Brazil. The control strategy combined environmental management, canine surveys, and educational actions across seven local work areas (LWAs). Between 2019 and 2021, CDC-type light traps were installed in intra- and peridomiciliary settings at twelve properties in LWA 5. Spatial risk analysis for canine transmission was conducted in LWAs 3 and 5 using a Generalized Additive Model, with results presented as spatial odds ratios. Vector prevalence was analyzed using negative binomial regression compared to historical municipal data. Intervention coverage averaged 52.91% of visited properties (n = 15,905), ranging from 48% to 76.8% across LWAs. Adherence to environmental management exceeded 85%. Of the 150 sandflies collected, 98.67% were Lutzomyia longipalpis and 1.33% Nyssomyia neivai. A 6% reduction in vector density was observed compared with historical data, although this difference was not statistically significant. Spatial risk varied among LWAs, indicating heterogeneous transmission levels. These findings suggest that integrated environmental and educational interventions may contribute to reducing vector density and that identifying priority areas tends to support surveillance and the effectiveness of disease control actions. Full article