Search Results (3,081)

Objective: Metabolic syndrome (MetS) represents a growing and significant public health burden worldwide. The evidence regarding whether skipping breakfast affects the development of MetS and its components remains inconsistent and uncertain. This study aimed to synthesize the best available evidence regarding the association between skipping breakfast and the risk of MetS and its components. Methods: This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 guidelines. We systematically searched the PubMed, Embase, Cochrane Library, and Web of Science databases from inception until May 2025. Two reviewers independently screened titles/abstracts and full texts, extracted data, and assessed the risk of bias. This review included cross-sectional and cohort studies on the association between breakfast skipping and the risk of MetS and its components. Results: Nine studies were included after quality evaluation by NOS. Pooled results from the meta-analysis revealed that skipping breakfast was significantly associated with an increased risk of MetS (OR: 1.10, 95% CI: 1.04–1.17) and its components—namely abdominal obesity (OR = 1.17, 95% CI 1.01–1.34), hypertension (OR: 1.21, 95% CI: 1.10–1.32), hyperlipidemia (OR: 1.13, 95% CI: 1.04–1.23), and hyperglycemia (OR = 1.26, 95% CI: 1.16–1.37). Conclusions: The meta-analysis demonstrated that skipping breakfast was significantly associated with an increased risk of MetS and its key components—abdominal obesity, hypertension, hyperlipidemia, and hyperglycemia. These findings highlight regular breakfast consumption as a potential modifiable factor for preventing and managing MetS and related cardiometabolic diseases. Full article

The recent growing adversarial activity against critical systems, such as the power grid, has raised attention on the necessity of appropriate measures to manage the related risks. In this setting, our research focuses on developing tools for early detection of adversarial activities, taking into account the specificities of the energy sector. We developed a framework to design and deploy AI-based detection models, and since one cannot risk disrupting regular operation with on-site tests, we also included a testbed for evaluation and fine-tuning. In the test environment, adversarial activity that produces realistic artifacts can be injected and monitored, and evidence analyzed by the detection models. In this paper we concentrate on the emulation of attacks inside our framework: A tool called SecuriDN is used to define, through a graphical interface, the network in terms of devices, applications, and protection mechanisms. Using this information, SecuriDN produces sequences of attack steps (based on the MITRE ATT&CK project) that are interpreted and executed by software called Netsploit. A case study related to Distributed Energy Resources is presented in order to show the process stages, highlight the possibilities given by our framework, and discuss possible limitations and future improvements. Full article

This work establishes definitive conditions for the inheritance of categorical completeness and cocompleteness by categories of internal group objects. We prove that while the completeness of $\mathbf{Grp}\left(\mathcal{C}\right)$ follows unconditionally from the completeness of the base category $\mathcal{C}$, cocompleteness requires $\mathcal{C}$ to be regular, cocomplete, and admit a free group functor left adjoint to the forgetful functor. Explicit limit and colimit constructions are provided, with colimits realized via coequalizers of relations induced by group axioms over free group objects. Applications demonstrate cocompleteness in topological groups, ordered groups, and group sheaves, while Lie groups serve as counterexamples revealing necessary analytic constraints—particularly the impossibility of equipping free groups on non-discrete manifolds with smooth structures. Further results include the inheritance of regularity when the free group functor preserves finite products, the existence of internal hom-objects in locally Cartesian closed settings, monadicity for locally presentable $\mathcal{C}$, and homotopical extensions where model structures on $\mathbf{Grp}\left(\mathcal{M}\right)$ reflect those of $\mathcal{M}$. This framework unifies classical category theory with geometric obstruction theory, resolving fundamental questions on exactness transfer and enabling new constructions in homotopical algebra and internal representation theory. Full article

Background: Physical conditioning is essential to meet the operational demands of military environments. However, high-intensity exercise provokes muscle microinjuries resulting in exercise-induced muscle damage. This condition is typically monitored using serum biomarkers such as creatine kinase (CK), myoglobin (MYO), and lactate dehydrogenase (LDH). Nevertheless, individual variability and genetic factors complicate the interpretation. In this context, the rs1815739 variant (ACTN3), the most common variant related to exercise phenotypes, hypothetically could interfere with the muscle physiological response. This study aimed to evaluate the kinetics of serum biomarkers during a high-intensity activity and their potential association with rs1815739 polymorphism. Materials and Methods: 32 male cadets were selected during the Army Paratrooper Course. Serum was obtained at six distinct moments while they performed regular course tests and recovery time. Borg scale was assessed in 2 moments (~11 and ~17). Results: Serum levels of CK, CK-MB, MYO, and LDH significantly increase after exercise, proportionally to Borg’s level, following the applicability of longitudinal studies to understand biomarker levels in response to exercise. R allele carriers (ACTN3) were only slightly associated with greater levels of MYO and CK, mainly in relative kinetic levels, and especially at moments of greater physical demand/recovery. Although the ACTN3 was slightly related to different biomarker levels in our investigation, the success or healthiness in military activities is multifactorial and does not depend only on interindividual variability or physical capacity. Conclusions: Monitoring biomarkers and multiple genomic regions can generate more efficient exercise-related phenotype interventions. Full article

We ask whether there exist non-isomorphic trace monoids over a fixed alphabet that have the same average parallelism. This question is related to the bivariate generating series $F$ which counts traces by their height and length; trace monoids with the same $F$ also possess the same average parallelism. The series $F$ is known to be rational and has been calculated efficiently via the symmetries of the dependence graph, when the latter is connected. We investigate the existence of non-isomorphic dependence graphs (over a common fixed alphabet) with the same series $F$. Using fractional graph isomorphisms and certain equitable partitions of the Cartier-Foata clique automaton, we prove two classification results. First, we show that all$2$-regular independence graphs of the same order share the same generating series $F$ if and only if they have the same number of triangular connected components. Secondly, for any $d\ge 2$, all triangle-free $d$-regular independence graphs of the same order—except for the complete bipartite graph $K_{d,d}$—share this property. The smallest instance of this result for $d=3,$ is the pair consisting of the cube graph $Q_3$ and the Wagner graph $M_8$, both on eight vertices. Full article

Oxidative stress is a key driver of endothelial dysfunction and early cardiovascular risk. Antioxidant enzymes such as superoxide dismutase (SOD) and glutathione peroxidase (GPX) are vital for vascular protection, especially during growth. While exercise-induced redox adaptations are well established in adults, data in pediatric athletes are limited. This cross-sectional study examined associations between training load and systemic antioxidant enzyme activity in 203 youth athletes aged 10–16 years, also considering sex, age, sports discipline, and redox phenotypes. Physical activity was assessed via validated questionnaires and expressed as weekly hours and MET-hours. Fasting blood samples were analyzed for SOD and GPX. Statistical tests included t-test, ANOVA, regression, and k-means clustering. Antioxidant enzyme levels were stable across training volumes, sports disciplines, and age groups. Boys showed significantly higher SOD than girls (259.43 ± 54.02 U/mL vs. 226.93 ± 48.22 U/mL, p < 0.001); GPX levels were similar between sexes. Cluster analysis identified three distinct redox profiles with differing training and sex distributions. No linear association was observed between training load and enzyme activity. Findings suggest that youth athletes exhibit robust antioxidant defenses, with individual and sex-related factors playing a more prominent role than training volume. These results highlight the value of regular physical activity for vascular health during development and the need for longitudinal studies to track redox adaptation. Full article

Background: Ventriculoperitoneal shunting (VPS) is the mainstay of treatment for most forms of hydrocephalus; VPS infection (VPSI) is a leading cause of shunt-related morbidity and mortality. A meta-analysis of the existing literature on risk factors for VPSI is currently lacking. Herein, the authors performed a systematic review and meta-analysis to evaluate the role of different clinical factors in the development of VPSI. Methods: A systematic search in the PubMed, Scopus, and Cochrane databases was performed to identify studies comparing patients developing VPSI to controls. The following data were extracted where available: number of patients who developed VPSI vs. number of patients with a regular course, demographics (gender, age at VPS insertion, age > 18 years), average length of hospital stay before shunt implant (days), aetiology of hydrocephalus (tumour-associated hydrocephalus; post-haemorrhagic hydrocephalus; congenital hydrocephalus; spinal dysraphism-associated hydrocephalus; post-infectious hydrocephalus; post-traumatic hydrocephalus; post-craniotomy hydrocephalus), and hydrocephalus type (obstructive hydrocephalus, communicating hydrocephalus, normal-pressure hydrocephalus—NPH). Results: Five studies including 2333 patients (225 with VPS infection) were analysed. Tumour-related hydrocephalus was linked to a lower infection risk (OR 0.418; p < 0.001), while congenital hydrocephalus (OR 2.502; p < 0.001) and spinal dysraphism (OR 2.359; p < 0.001) increased the risk. Conclusions: VPSI represents a serious complication after shunt surgery. Our meta-analysis identifies three key factors influencing the risk of VPSI. VPS-centred, large multicentre prospective studies are needed to possibly confirm the role of the factors we identified and to identify additional ones, enabling earlier detection of VPSI and allowing for better patient care. Full article

Non-alcoholic beer is increasingly popular worldwide but still faces flavor challenges compared to regular beer. These flavor-related challenges include pronounced ‘wort-like’ notes, excessive sweetness, and a lack of desirable aroma complexity. The industry is trying to improve the taste of non-alcoholic beer by trying new techniques and yeasts. A newly isolated maltose-negative brewer’s yeast (M-I) from an industrial-scale brewery collection has attracted attention due to its reduced wort-like flavor. This study aims to characterize the volatile profile of a newly isolated maltose-negative brewer’s yeast (M-I) in comparison with the well-known Saccharomycodes ludwigii. The novelty of this work lies in evaluating the aroma potential of a maltose-negative isolate newly applied in industrial brewing and its contribution to improving the flavor quality of non-alcoholic beer. An SPME-GC/MS system was used to analyze aroma compounds. According to volatile compound analysis, the M-I sample has higher amounts of esters and higher alcohol composition than the S. ludwigii beer sample. Also, it has lower amounts of Strecker aldehydes, which can give a worty off-flavor. Sensory analysis revealed that, interestingly, the control S. ludwigii sample was rated as having stronger ester notes, along with more pronounced sour and bitter characteristics, whereas the M-I sample was perceived as having a more balanced flavor, leading to a more favorable rating by the panelists. Full article

Background/Objectives: The post-COVID-19 condition frequently includes dysphonia. We aimed to assess objective and subjective voice disorders and short-term responses to multimodal therapy in patients with isolated post-COVID-19 dysphonia. Methods: This retrospective, single-center pre–post study screened 244 post-COVID-19 patients; a subset of 14 with isolated dysphonia underwent standardized assessment at baseline and at 1-month follow-up. Patient-reported outcomes (Voice Handicap Index, VHI; Voice-Related Quality of Life, V-RQOL) and endoscopic evaluation were performed using videolaryngostroboscopy (LVS) and high-speed videoendoscopy (HSV) with kymographic analysis to quantify parameters describing vocal fold oscillations. The treatment included short-term systemic corticosteroids, inhaled corticosteroids, hyaluronic-acid inhalations, and structured voice therapy. Results: At baseline, HSV revealed signs of glottal insufficiency—irregular and asymmetric vocal fold motion, reduced amplitude and pliability, a disrupted mucosal wave, and an increased open quotient. At follow-up, HSV showed increased oscillation, amplitude, and cycle regularity with reduced left–right asymmetry and phase differences; phonovibrograms displayed clearer and more structured patterns. Perturbation indices decreased across jitter and shimmer measures, and the mean fundamental frequency was lower. Improvements in instrumental measures aligned with better VHI and V-RQOL scores. Conclusions: In patients with persistent dysphonia after acute SARS-CoV-2 infection, comprehensive ENT evaluation with instrumental laryngeal assessment is warranted. Short-term multimodal management was associated with improvements in both HSV-derived measures and patient-reported outcomes; confirmation in controlled studies is needed. Full article

Background: Dilated cardiomyopathy (DCM) is a major contributor to heart failure-related morbidity and mortality. While type 2 diabetes mellitus (T2DM), obesity, and thyroid dysfunction are individually linked to cardiovascular disease, their combined effects on DCM remain poorly understood. Objective: To evaluate the independent and synergistic associations of diabetes (stratified by treatment), thyroid dysfunction, and obesity with the prevalence of DCM and 30-day hospital readmission. We further examined the utility of a composite Metabolic Burden Score for risk stratification. Methods: In this retrospective cohort study, electronic health record data from 1079 adult patients at a tertiary care center were analyzed. Multivariable logistic regression, including ridge regularization, was used to identify predictors of DCM. Endocrine phenotypes were stratified by diabetes and thyroid status. A Metabolic Burden Score (range: 0–3) based on diabetes, obesity, and thyroid dysfunction was developed and correlated with clinical outcomes. Results: DCM was diagnosed in 46% of the cohort. Non-insulin-treated diabetes (OR: 6.93; 95% CI: 3.78–12.73), hypothyroidism (OR: 1.78; 95% CI: 1.02–3.11), and male sex (OR: 2.33; 95% CI: 1.36–4.00) were independently associated with increased DCM risk. Obesity was not independently predictive but contributed to DCM prevalence when assessed within the Metabolic Burden Score. DCM prevalence increased across burden strata, reaching 50% in the high-risk group. Notably, the moderate-risk group had the highest 30-day readmission rate (42.8%). Conclusions: Non-insulin-treated diabetes and hypothyroidism are key metabolic drivers of DCM. A simple composite burden score offers a clinically useful tool for stratifying risk of DCM and early readmission. These findings support integrated endocrine–cardiac screening strategies to improve early identification and prevention of structural heart disease. Full article

Background and Objectives: This study aimed to compare gait patterns between young adults and physically active older adults. Additionally, the relation between these parameters and age was explored. Materials and Methods: Transversal case and control study, recruiting 81 participants divided into two groups: young adults (18–45 years) and physically active older adults (60+ years). Participants were assessed using the PodoSmart Insole^® system, which recorded spatiotemporal and kinematic gait data. Gait parameters were measured during a self-selected walking test. Data analysis included descriptive statistics, t-tests for group comparisons, and Pearson’s correlation to explore relationships between age and gait parameters. Results: Significant differences in gait parameters were found between young and older adults, particularly in stride length (right foot: p = 0.009, left foot: p = 0.001), cadence (p < 0.001), contact time (p < 0.001), swing time (p < 0.001), and support phase duration (p < 0.001), with moderate to large effect sizes. Sex differences were also observed within each group for several gait variables. Correlation analysis evidenced worsened parameters with increasing age, with moderate to strong associations in terms of cadence (r = −0.590), contact time (r = −0.504, r = −0.462), swing time (r = −0.662), and support phase duration (r = −0.524, r = −0.439). Conclusions: Evident differences in gait parameters are observed between young adults and active older adults. Although these results follow the trend of previous studies that employed more sophisticated lab-based protocols for gait analysis, slight differences between our study and these others could be attributed to the regular physical activity performed by these participants, which should be explored in more detail in future studies. Full article

This research aims to evaluate and highlight the potential mesostructured architecture of established behaviours and operational practices based on the working model change imposed by the pandemic emergency in the public sector. After the intervention of an exogenous shock, the readiness, perceived usefulness and ease-of-use of technologies made the Technology Acceptance Model [TAM] verifiable. Concurrently, it is also possible to verify the Theory of Planned Behaviour [TPB] in the motivation and intention to change employees’ working habits under the lens of complexity and urgency, involving a From Knowledge To Knowledge Strategy [FKTKS]. The research protocol encompasses semi-structured interviews with public managers in Italy, alongside a perceptual and sentiment trend analysis of 70 public employees [35 females and 35 males] regarding their sentiments on digital transition and smart/hybrid working habits before, during, and after the pandemic. In the public sector, change is perceived as a shock-generative tension. In this way, the research aims to answer the genderised issue related to the perception and the persistence of using digital tools in the workplace during the post-urgency period as a regular habit based on perceived usefulness and ease-of-use. The study highlights a gender-specific trend in the use of the smart/hybrid working model after the health emergency. This propensity may also be attributable to the gender traits defined by Hofstede, within whose paradigm the interpretative dynamic provided is embedded. The during-COVID-19 acceptance and usage behaviours define an element related to masculinity because of its urgency and pressing deadlines. In contrast, endurance connects to femininity, emphasising resilience and long-term goals. This approach prioritises resilience and comprehensive well-being, focusing on achieving a good work–life balance [WLB] rather than just addressing immediate issues. Full article

Motor skills in students can be developed or improved through regular physical activity such as walking in nature, Nordic walking, hiking, cycling and swimming. This study aimed to examine the relationship between motor skills and various anthropometric and health-related factors, and to appraise any differences in motor performance and body mass index (BMI) on a sample of university students from Croatia. A total of 122 students (73 of them in health programs and 49 in non-health programs) aged 18 to 44 years participated in the study. Motor abilities were evaluated using standardized motor tests, while body composition was assessed via bioelectrical impedance analysis, which measured fat tissue, muscle and bone mass, metabolic age, degree of obesity, total body water, and BMI. While the groups were similar in terms of BMI and weight, students in non-health-related study programs had significantly higher values across a wide array of detailed body composition measures, particularly related to fat and muscle mass. Significant negative correlations were observed between body fat percentage and trunk lift performance (r = −0.55, p < 0.01), as well as between metabolic age and trunk lift performance (r = −0.44, p < 0.01) in health students. In non-health students, the strongest negative correlation was found between body fat percentage and flexibility (r = −0.47, p < 0.01). Higher muscle mass was a positive predictor of motor performance while higher fat mass and metabolic age were significant negative predictors. These findings underscore the impact of body composition on motor performance, particularly strength and flexibility, and highlight the need for targeted preventive strategies among university students. The study supports the implementation of early interventions promoting physical activity and healthy body composition to preserve motor abilities and long-term functional health in this critical age group—especially since lifestyle habits formed during university years tend to persist into adulthood. Full article

Dysphagia is a common but often overlooked concern among individuals with intellectual disabilities and may negatively impact their quality of life. This study aimed to examine the association between swallowing function and health-related quality of life (HRQOL) among adults with intellectual disabilities in residential care. Methods: We conducted a cross-sectional study involving 48 individuals in residential care facilities in Japan. Swallowing function was assessed with the Eating Assessment Tool-10 (EAT-10), and HRQOL with the EuroQol-5 Dimension, five-level version (EQ-5D-5L), in which higher index values denote better HRQOL. A generalized linear model (GLM) with gamma distribution was used to identify factors associated with EQ-5D-5L scores. Participants with lower EAT-10 scores (≤2) showed significantly higher EQ-5D-5L scores. In the GLM, better swallowing function was positively associated with EQ-5D-5L score (B = 0.21, p = 0.012). Sensitivity analysis confirmed the robustness of this association. Conclusions: Swallowing dysfunction is linked to reduced HRQOL in individuals with intellectual disabilities, underscoring the need for regular screening and intervention. Full article

The legal minimum dimensions for laboratory rat housing prevent rats from fully performing their behavioural repertoire. In the regular cages, rats cannot run, climb, or even stand upright. The need to house rats in larger cages has been recognized internationally from a welfare perspective, which has led to the development of several commercial cage systems. It is, however, important to evaluate the effect of changes in housing conditions on behaviour in existing animal models. The aim of the study was to determine whether housing animals in larger cages with mandatory enrichment or with additional enrichment would affect play behaviour or sucrose reward sensitivity. This paper describes the effect of housing rats in enlarged cages, the EC4Rats, on social play and for reward seeking. A total of 48 male Lister Hooded rats, PND21-23 at the start of the experiment, were assigned to one of three experimental groups, i.e., (1) standard housing with standard enrichment, (2) EC4Rats housing with standard enrichment and (3) EC4Rats housing with EC4Rats enrichment. The results of the study show that despite subtle differences in social play behaviour, housing rats in these larger cages did not affect reward sensitivity nor the motivation for sucrose self-administration in rats. Taken together, these findings suggest that housing systems that provide rats with more opportunities to engage in natural behaviours do not affect social play or reward-related behaviour. Full article