Search Results (1,400)

Facial bone fractures represent a significant clinical challenge due to their impact on function, aesthetics, and quality of life. Despite advances in imaging and surgical techniques, early and accurate assessment of the healing process remains limited. Conventional diagnostic methods often detect complications, such as delayed union or non-union, too late for optimal intervention. Oxidative stress—an imbalance between reactive oxygen species (ROS) and antioxidant defenses—plays a critical role in bone regeneration. In this review, biomarkers are presented in two main categories: (1) oxidative damage biomarkers (lipid peroxidation products: malondialdehyde, 4-hydroxynonenal, and F2-isoprostanes) and (2) antioxidant biomarkers (glutathione, enzymatic antioxidants: SOD, GPx, CAT). Their potential as non-invasive diagnostic and prognostic tools in craniofacial fracture healing is evaluated, along with emerging therapeutic strategies. Monitoring their levels in blood samples may provide real-time insights into the dynamics of fracture repair, enabling earlier detection of healing disturbances and informing personalized treatment approaches. Full article

Background and Objectives: Musculoskeletal pain is a global public health issue. Eight Constitution Medicine (ECM), a type of East Asian Traditional Medicine, offers personalized, minimally invasive treatment through Eight Constitution Acupuncture (ECA) and Eight Constitution Lifestyle Intervention (ECLI). Despite its clinical use, scientific evidence supporting ECM’s effectiveness remains limited. This study aimed to evaluate the effectiveness in treating musculoskeletal pain in primary care settings. Materials and Methods: This retrospective study analyzed medical records from three ECM clinics (Gangnam-Shingwang, Yeson, and Yebon) between January 2018 and August 2023. A total of 163 patients were included, with 44 providing follow-up data. Pain intensity, quality of life, and functional outcomes were assessed using validated instruments including the PainDETECT questionnaire, Korean Cancer Pain Assessment Tool (KCPAT) somatic pain scores, EuroQol 5-Dimension 5-Level (EQ-5D-5L), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oswestry Disability Index (ODI), Neck Disability Index (NDI), and Shoulder Pain and Disability Index (SPADI). Pre- and post-treatment scores were statistically analyzed. Results: Significant decreases were observed in KCPAT somatic pain scores (11.77 ± 4.77 to 9.77 ± 5.32) and significant improvements in EQ-5D-5L scores (0.74 ± 0.12 to 0.80 ± 0.07). WOMAC and ODI scores also showed significant improvements. However, the changes in the NDI, SPADI, and PainDETECT scores were not statistically significant. No adverse events were reported. Conclusions: ECM, through ECA and ECLI, may offer effective personalized treatment for musculoskeletal pain, improving both pain intensity and quality of life. Despite its small sample size and retrospective design, this study offers valuable preliminary evidence for ECM. Further large-scale prospective studies are needed to confirm these findings. Full article

Background: Fear of cancer recurrence (FCR) is a common, distressing concern among cancer survivors, with implications for psychological well-being and quality of life. Despite the proliferation of patient-reported outcome measures (PROMs) to assess FCR, consensus on the most valid and reliable instruments remains limited. Objective: To conduct a comprehensive psychometric evaluation of FCR PROMs developed or validated between 2011 and 2023, using the full COSMIN methodology. This review builds on earlier work by systematically appraising both newly developed and adapted instruments to inform evidence-based PROM selection for clinical and research use. Methods: This review followed the COSMIN 10-step procedure and PRISMA 2020 guidelines. Six databases were searched from January 2011 to December 2023. A search cut-off of 31 December 2023 was applied to align with COSMIN feasibility recommendations and ensure sufficient time and resources for full psychometric evaluation across all included PROMs. Eligible studies included adults diagnosed with cancer and reported on the psychometric evaluation of a self-reported, Likert-scale-based FCR PROM. PROMs were appraised across eight psychometric properties using COSMIN’s Risk of Bias checklist, criteria for good measurement properties, and modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) for evidence quality. Instruments were categorized as A, B, or C according to COSMIN’s recommendations. Results: Of the 34 PROMs evaluated across 32 studies, 28 achieved COSMIN Category A status, indicating sufficient psychometric quality for clinical or research use. Among the 19 FCRI and FoP-Q instruments validated in new cultural or population contexts, 15 received a Category A rating, reflecting strong cross-cultural performance. Short forms such as the FCRI-SF and FoP-Q-SF demonstrated consistent psychometric strength across French, English, Portuguese, and Asian-language versions. Of the 14 newly developed PROMs—including the CWS-6, FCR4/7, CARQ-4, and FCR-1—12 achieved Category A. The FCR-1 was the only single-item PROM to demonstrate responsiveness, supporting its use in both screening and longitudinal monitoring. For practical guidance, five PROMs (FCR-1, FCRI-SF, FoP-Q-SF, FCR-7, and CWS) emerged as the most strongly supported for clinical use. Conclusions: This review provides a comprehensive evaluation of contemporary FCR PROMs and highlights substantial progress in the development of valid, reliable, and culturally adaptable tools. The FCRI, FoP-Q-SF, and several newly developed short forms, such as FCR7, CWS, and particularly, the FCR-1, emerge as strong candidates for use in clinical screening and longitudinal assessment. These findings offer clear evidence-based guidance for instrument selection in research and survivorship care. PROSPERO registration: CRD42023453783. Full article

(1) Background: Chronic pulmonary diseases (CPDs), such as COPD, asthma, and interstitial lung disease, are often accompanied by psychological distress and reduced quality of life. Mindfulness-Based Interventions (MBIs), including digital and virtual reality (VR) formats, have emerged as promising non-pharmacological approaches to improve symptom management and well-being. This systematic review aimed to evaluate the effectiveness of MBIs—delivered in-person or digitally—on anxiety, depression, disease-related stress, dyspnea, and health-related quality of life in individuals with CPDs. (2) Methods: A systematic review was conducted following PRISMA guidelines across PubMed, Scopus, and Web of Science (2005–2025). Thirteen studies (8 randomized controlled trials, 5 non-randomized) met inclusion criteria. Outcomes assessed included psychological distress, physical symptoms, and health-related quality of life (HRQoL). Risk of bias was evaluated using RoB 2 and ROBINS-I tools. (3) Results: MBIs were associated with improvements in anxiety, depression, stress, and HRQoL in several studies. Interventions were generally well-tolerated and effective across various delivery methods, including digital and VR-based formats. Improvements were especially notable when interventions were tailored and sustained. (4) Conclusions: MBIs, including digital and VR-delivered formats, show promise in supporting psychological and physical outcomes in CPD populations. They represent a feasible and complementary tool in modern respiratory care. Full article

Background/Objectives: Diabetic foot syndrome (DFS) is a chronic complication of diabetes mellitus that negatively impacts patients’ quality of life (QoL). Patients’ perceptions of health status and healthcare can be assessed using Patient-Reported Experience Measures (PREMs) and Patient-Reported Outcome Measures (PROMs). This article aims to review the available literature on PREMs and PROMs, evaluate their characteristics, and determine whether an existing measure is applicable to or can be developed for the patient population of a third-level unit for diabetic foot. Methods: A search through Cinahl, Scopus, and Pubmed electronic databases was conducted to identify studies published between 2000 and 2024. Eligible studies included those using PREMs and PROMs in patients with DFS. Studies that used self-assessment methods or open questions and those that applied PROMs in people living with diabetes without diabetic foot were excluded. Results: After a careful selection, 53 studies met the inclusion criteria: none of these applied PREMs. Regarding PROMs, 46 studies applied a generic method alone or in combination with a specific tool to large populations comparing patient groups, while 7 studies applied a specific PROM alone to small populations evaluating specific aspects of pathology. Conclusions: In the existing literature, generic tools are mainly reported. No gold standard has yet been identified among all the tools considered for assessment of quality of life or patients’ perceptions of their health. Further studies are needed to develop a reliable and specific PREM or PROM questionnaire for complex patients affected by DFS. Full article

Primary ovarian insufficiency (POI) in adolescents and young women is a rare but serious endocrine disorder with far-reaching reproductive, metabolic, and psychological implications. This study aimed to evaluate diagnostic timelines, treatment patterns, and psychosocial outcomes among affected individuals in a secondary care setting in Saudi Arabia. A retrospective observational analysis was conducted on 96 patients aged 13–39 years diagnosed with POI between 2018 and 2024. Data were extracted from electronic medical records and assessed using validated clinical and psychological tools, including the MENQOL and HADS. The mean age at diagnosis was 22.9 years, with one-third of patients experiencing diagnostic delays exceeding 18 months. Hormone replacement therapy was initiated in 69.8% of cases, while fertility counselling and bone mineral density screening were provided to 61.5% and 74.0% of patients, respectively. Over 60% exhibited clinically significant symptoms of anxiety or depression. Multivariate analysis revealed that delayed diagnosis, absence of hormone therapy, and lack of fertility counselling significantly increased the risk of psychological distress. These findings underscore the importance of timely diagnosis, multidisciplinary intervention, and integrated mental health support in the management of POI. Comprehensive, culturally responsive care models are essential to improving quality of life and long-term outcomes in this vulnerable population. Full article

As a high-value product used as food, medicine, or cosmetics, honey is particularly susceptible to adulteration. Therefore, it must be regularly tested at various stages of its life cycle to ensure its quality and authenticity, especially its botanical origin. Sensory quality features play a huge role in creating the quality of products, but also in determining their authenticity. Sensory analysis helps determine the honey’s overall quality based on attributes like color, aroma, taste, and texture. Sensory evaluation of honey can reveal issues like crystallization, off-flavors, or off-odors that might indicate adulteration or spoilage. The aim of our work was therefore sensory quality assessment of 84 honey samples in order to create sensory profiles for the varietal classification of honeys. In order to obtain information on the differences in sensory features and their classification based on the assessment of honey quality descriptors, a discriminant analysis was carried out. Then, an assessment was carried out to check whether the compared varieties differ in terms of the value of the sensory feature parameter assessment. As a result, a statistical tool was constructed (canonical discriminant functions, distinguishing/classifying the varieties of honeys tested). These models will ensure the repeatability of results in the classification of sensory profiles of varietal honeys on the example of Polish honey varieties. The results indicate that the sensory analysis is a good analytical tool to differentiate honey types. The findings of this study can be applied by honey producers, suppliers, and customers to differentiate and determine honey varieties according to their sensorial attributes. Full article

Voice pathology diagnosis is essential for the timely detection and management of voice disorders, which can significantly impact an individual’s quality of life. This study employed logistic regression to evaluate the predictive power of variables that include age, severity, loudness, breathiness, pitch, roughness, strain, and gender on a binary diagnosis outcome (Yes/No). The analysis was performed on the Perceptual Voice Qualities Database (PVQD), a comprehensive dataset containing voice samples with perceptual ratings. Two widely used voice quality assessment tools, CAPE-V (Consensus Auditory-Perceptual Evaluation of Voice) and GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain), were employed to annotate voice qualities, ensuring systematic and clinically relevant perceptual evaluations. The model revealed that age (odds ratio: 1.033, p < 0.001), loudness (odds ratio: 1.071, p = 0.005), and gender (male) (odds ratio: 1.904, p = 0.043) were statistically significant predictors of voice pathology. In contrast, severity and voice quality-related features like breathiness, pitch, roughness, and strain did not show statistical significance, suggesting their limited predictive contributions within this model. While the results provide valuable insights, the study underscores notable limitations of logistic regression. The model assumes a linear relationship between the independent variables and the log odds of the outcome, which restricts its ability to capture complex, non-linear patterns within the data. Additionally, logistic regression does not inherently account for interactions between predictors or feature dependencies, potentially limiting its performance in more intricate datasets. Furthermore, a fixed classification threshold (0.5) may lead to misclassification, particularly in datasets with imbalanced classes or skewed predictor distributions. These findings highlight that although logistic regression serves as a useful tool for identifying significant predictors, its results are dataset-dependent and cannot be generalized across diverse populations. Future research should validate these findings using heterogeneous datasets and employ advanced machine learning techniques to address the limitations of logistic regression. Integrating non-linear models or feature interaction analyses may enhance diagnostic accuracy, ensuring more reliable and robust voice pathology predictions. Full article

Background/Objectives: Aging is linked to a loss of muscle mass and strength, which increases the risk of falls, disability, and lower quality of life. Identifying individuals at risk of sarcopenia, cachexia, or malnutrition is important. In settings with limited access to advanced diagnostics, simple anthropometric measurements can serve as practical alternatives. This study aimed to evaluate simple, quick, and non-invasive anthropometric measurements as indicators of muscle mass in older adults, based on body composition analysis (BIA). Methods: The study included 361 patients admitted to a geriatric ward. Standardized protocols were used to measure anthropometric and body composition parameters, including bioelectrical impedance analysis (BIA). Various body composition indices were calculated, such as body mass index (BMI), body adiposity index (BAI), waist-to-hip ratio (WHR), visceral adiposity index (VAI), fat-free mass index (FFMI), and fat mass index (FMI). Results: Strong positive correlations were found between body mass and muscle mass in both women and men. Among anthropometric measures, calf circumference showed the strongest correlation with muscle mass (R = 0.798 in women; R = 0.744 in men, p < 0.001). Other indices, including BMI (R = 0.733 in women; R = 0.606 in men, p < 0.001), FFMI (R = 0.697 in women; R = 0.721 in men, p < 0.001), and FMI (R = 0.600 in women; R = 0.354 in men, p < 0.001), were also positively correlated with muscle mass. Conclusions: Calf circumference is a simple, quick, and non-invasive measure that can effectively estimate muscle mass in older adults. Although other anthropometric parameters, such as body mass, BMI, FMI, and FFMI, also showed positive correlations with muscle mass, calf circumference appears to be the most practical, as it requires minimal equipment, little time, and limited preparation. This makes it particularly useful for routine assessments in primary care and long-term care settings, where access to advanced diagnostic tools like BIA or DXA is limited. These findings support the use of simple anthropometric measurements as cost-effective and easily accessible alternatives for estimating muscle mass in older adults. Further research is needed to determine appropriate cut-off points for specific populations and sexes. Full article

Flexibility is increasingly recognized as a key competence in addressing current challenges and transitions. It is a multidimensional construct, discussed across various disciplines, encompassing cognitive, behavioral, and emotional dimensions. The European LifeComp framework offers one of the most recent and comprehensive definitions of this competence, emphasizing its role in enabling individuals to adapt to uncertainty, manage complexity, and foster transformative learning. This study investigates the assessment tools available to evaluate flexibility competence, focusing on their alignment with the LifeComp framework. A systematic literature review was conducted using the Scopus and WoS databases, based on inclusion criteria for language, publication type, disciplinary area, research topic, and target population, identifying 22 eligible articles. Following a quality assessment of the articles, a critical analysis revealed the presence of 22 tools and scales, including the actively open-minded thinking (AOT) scale, the resistance to change (RTC) scale, and the flexible thinking in learning (FTL) questionnaire. The findings show overlaps among flexibility and related constructs, such as learning agility and intellectual humility. However, most tools are context-specific and fail to address the multidimensional nature of flexibility competence. Future research should prioritize the development of comprehensive instruments to support educational initiatives, policy development, and professional training. Full article

Introduction: Secure infant/child–caregiver attachment is crucial for the development of social and emotional functioning and can affect long-term outcomes, such as adult relationships, but it may also be influenced by prenatal and early childhood risk factors. Children with a history of prenatal alcohol exposure (PAE) have a complex spectrum of strengths and difficulties and often have the additional risk of early life adversity. There is some evidence that children with PAE are at increased risk of insecure attachment, but it is unclear whether this is consistent or why it is the case. No published review has focused on the relationship between PAE and attachment. Methods: A systematic search of seven academic databases using the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines was undertaken by two reviewers to identify primary studies that have focused on the relationship between PAE and attachment. Quality assessments were undertaken using the Quality of Observational Cohort and Cross-Sectional Studies tool, and the report was written following the PRISMA-ScR checklist. Results: A total of 4199 records were returned from the database searches. A total of 11 studies (eight peer-reviewed papers and three dissertations), published between 1987 and 2021, met the criteria. Five studies showed that PAE was related to insecure or disorganised attachment, two of which showed that infant irritability and caregiver–infant interaction mediated this relationship. The other six studies found no significant relationship between PAE and attachment. Conclusions: This scoping review demonstrates that there is a dearth of published research on this topic, and none that takes advantage of more recent understanding of the relationship between adverse childhood experiences and neurodevelopmental disorders. There is some evidence that PAE may impact the attachment relationship via caregiver–infant interaction and infant irritability, but further studies, including those that assess the additional impact of early life adversity, are needed. Full article

Background and objectives: Knee osteoarthritis (KOA) is a degenerative joint disorder often associated with altered gait mechanics. This systematic review aims to evaluate the effect of rehabilitation treatment on walking, with a focus on gait speed. Material and methods: A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane, and PEDro databases, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Randomised controlled trials published in English between 2015 and 2025, involving patients with KOA undergoing rehabilitation and using computerised gait measurements, including 3D motion capture, force plates, and instrumented treadmills, were included. A meta-analysis was conducted on the selected studies assessing gait speed, with the risk of bias being evaluated using the Cochrane Risk of Bias 2 tool for RCTs. Results: Out of 2143 articles, 7 studies met the inclusion criteria. These studies showed increased gait speed in patients with KOA following exercise therapy, various walking training programmes, massage, or dietary interventions. The meta-analysis revealed a standardised mean difference (SMD) of 1.807, with a 95% confidence interval (CI) of [1.637, 1.977] (p < 0.001). The interventions were associated with improvements in walking parameters and quality of life, as well as reductions in pain and fall risk. Substantial heterogeneity was noted, likely due to variations in intervention types and study populations. Conclusions: The results suggest an overall improvement in gait speed in the intervention groups compared to the control groups. However, only a limited number of studies have investigated the effects of physiotherapy, bath therapy, or mud therapy on gait mechanics in patients with KOA. Full article

Background/Objectives: Malnutrition is a common but underrecognized complication in colorectal cancer (CRC), contributing to poor treatment outcomes and reduced quality of life. Regional data from the Gulf remains limited. This study assessed the prevalence of malnutrition and nutrition impact symptoms (NISs) among CRC patients in Kuwait. It evaluated the diagnostic performance of the PG-SGA Short Form (PG-SGA SF) in comparison to the full PG-SGA and the Malnutrition Screening Tool (MST). Methods: A cross-sectional study was conducted among 65 CRC outpatients at the Kuwait Cancer Control Center. Nutritional status was assessed using the full PG-SGA, PG-SGA SF, and MST. Dietary intake, anthropometry, biochemical parameters, and NISs were collected. Logistic regression identified independent predictors of malnutrition, and the performance of the tool was evaluated using kappa statistics and diagnostic accuracy metrics. Results: Malnutrition (PG-SGA B/C) was identified in 61.4% of patients. Loss of appetite, dry mouth, and nausea were significantly associated with malnutrition (p < 0.00385); dry mouth independently predicted malnutrition (OR: 17.65, 95% CI: 2.02–154.19, p = 0.009). BMI was not predictive, but reduced mid-arm circumference was significantly associated. PG-SGA SF showed strong agreement with the full PG-SGA (κ = 0.75), with high sensitivity (87.2%) and specificity (88.5%), outperforming MST (κ = 0.38). Only 23.5% of moderately malnourished patients were referred to a dietitian. Conclusions: Malnutrition and NIS are highly prevalent among Kuwaiti CRC patients. PG-SGA SF is a valid and efficient screening tool that should replace MST in oncology settings. Symptom-informed screening and structured referral protocols are crucial for enhancing nutrition care. Full article

Background/Objectives: Despite its growing application, life-cycle assessment (LCA) in the nutraceutical sector has not been systematically studied, leaving a gap in our understanding of the unique challenges of assessing its environmental footprint. The main objective of this study was to provide an overview of scientific publications related to nutraceuticals from the LCA perspective. Methods: This review combined bibliometric analysis, using VOSViewer as an analytic tool, with the search of the Web of Science database, aiming to identify the most relevant papers associated with nutraceuticals and life-cycle assessment. Results: The final selection of the most relevant publications was set at 65, analyzing 78 different nutraceuticals. Results reveal that the main sources of raw materials for extraction of nutraceuticals are marine-based, plant-based, and from agri-food waste. Polyphenols were analyzed 34 times and were predominantly sourced from plants, while carotenoids, analyzed 17 times, were mainly linked with marine-based and food waste-derived sources. The main environmental footprints were focused on climate change, covering most of the nutraceuticals analyzed (97.4%), followed by acidification (78.2%) and eutrophication (74.4%). SimaPro was the prevailing software used for 43.6% nutraceuticals, while the prevailing database was Ecoinvent, used in two thirds of the cases (66.7%). ReCiPe, as a life-cycle inventory assessment method, was used for calculating 34.6% of analyzed cases, followed by CML (33.3%). Conclusions: This systematic review highlights the main challenge in LCA studies, outlining great variability in study boundaries, functional units, and reported environmental footprints, and making it difficult to compare the environmental impacts of similar nutraceutical groups from a life-cycle perspective. This underscores the urgent need to improve input-data quality and develop standardized methodologies to validate sustainability claims using LCA. Full article

Background: CF transmembrane conductance regulator (CFTR) modulators are available for 90% of people with cystic fibrosis (PWCF), which has contributed to substantial nutritional changes. PWCF identify differences in their relationship with food, as well as alterations in body size and image when taking CFTR modulators. This has led to increasing risks relating to issues with body image, disordered eating behaviors (DEBs), and eating disorders (EDs). DEBs can be an early indication of an ED. CF care has traditionally emphasized body mass index and weight gain, which may have heightened the critical focus of body habitus. Prior to CFTR modulators, the “legacy diet” was often promoted and after years of encouragement to eat high volumes of calorically dense foods, PWCF on modulators have shared that the subsequent body changes have been challenging. Given the body changes that PWCF may have experienced, CF care team nutritional guidelines are evolving. The prevalence and etiology of EDs is largely unknown. Therefore, interventions designed to reduce risk factors for EDs and enhance protective factors against the development of DEBs need to be prioritized. To date, there are no reliable and validated screening tools in the United States to identify DEBs for PWCF. The purpose of this paper is to (1) review eating behaviors and disordered eating in PWCF, and (2) discuss important future directions for the assessment and treatment of DEBs to improve quality of life for PWCF. Full article