Search Results (1,497)

Background: Direct evidence linking meal timing to cardiovascular disease (CVD) remains limited. This study examined the associations of meal timing and temporal eating patterns with prevalent CVD among Chinese older adults. Methods: From September 2021 to October 2025, 1386 community-dwelling adults aged ≥60 years from various socioeconomic regions of China were interviewed face-to-face. Meal timing (breakfast, lunch, and dinner timing) and sleep–wake schedules (wake-up and bedtime) were collected using standardized questionnaires. Four temporal eating parameters were calculated: wake-up to breakfast interval, eating window, dinner to bedtime interval, and the interval from eating midpoint to awake midpoint. Latent profile analysis (LPA) was used to identify temporal eating patterns. Prevalent CVD was assessed by questionnaires and verified with medical records. Results: Among 1305 eligible participants (mean [SD] age, 69.6 [6.9] years; 54.6% female), 196 (15.0%) had prevalent CVD. Compared with participants who had breakfast at ≤6:00, those who had breakfast at >7:00 had 75% higher odds of prevalent CVD (95% CI: 1.02, 2.99). Compared with dinner at ≤17:00, dinner at >18:00 had higher odds of prevalent CVD (OR = 2.61, 95% CI: 1.54, 4.43). Three temporal eating patterns were identified: typical eating pattern (58.1%), early-phase eating pattern (10.9%), and late-phase eating pattern (31.0%). Compared with the typical eating pattern, the late-phase eating pattern was associated with 56% higher odds of prevalent CVD (95% CI: 1.08, 2.26), whereas the early-phase eating pattern was associated with 45% lower odds of prevalent CVD (95% CI: 0.28, 1.07), although this association did not reach statistical significance. Conclusions: Late-phase eating pattern, particularly delayed breakfast and dinner timing, was associated with increased likelihood of prevalent CVD. Temporal eating patterns may represent a modifiable behavioral target for cardiovascular health in older adults. Full article

Pediatric disorders of gut–brain interaction (DGBIs) comprise chronic or recurrent symptom-based gastrointestinal conditions that cannot be fully explained by identifiable structural, biochemical, or organic abnormalities after appropriate clinical evaluation. The term DGBI is used throughout this review in accordance with current terminology, whereas the historical term “functional gastrointestinal disorders” (FGIDs) is retained only when referring to studies that used earlier Rome classifications. This review examines the impact of four modifiable factors—sleep, psychological stress, circadian rhythm, and diet—on their development and severity in children and adolescents. Relevant literature was identified through PubMed, with emphasis on recent pediatric studies, systematic reviews, and meta-analyses. Sleep disturbances are associated with greater abdominal pain, functional disability, and impaired daytime functioning. Stress may exacerbate symptoms through hypothalamic–pituitary–adrenal axis activation, autonomic imbalance, altered motility, and visceral hypersensitivity. Circadian disruption may affect gastrointestinal motility, barrier function, enteroendocrine signaling, and microbial rhythmicity, although pediatric evidence remains limited. Diet influences fermentation, microbiota, intestinal permeability, and symptom expression, with regular meals, adequate hydration, and appropriate fiber intake representing important initial measures. These factors interact bidirectionally through shared neuroendocrine, autonomic, immune, and microbial pathways. Clinical management should therefore adopt a biopsychosocial, multidisciplinary approach combining symptom management with modification of sleep, stress, circadian habits, and dietary patterns. Further prospective pediatric studies are needed to clarify causality and support personalized interventions. Full article

Background/Objectives: Chronic rhinosinusitis (CRS) is commonly accompanied by sleep disturbance and cognitive complaints, but the relationships among CRS, cognition, subjective sleep, and circulating inflammatory cytokines remain incompletely understood. Methods: In this case–control study, 80 adults with CRS and 98 controls completed validated sleep and sinonasal questionnaires and a 12-test cognitive battery assessing six domains. Plasma cytokines were measured in 101 participants with available biospecimens. Multivariable linear regression and exploratory correlation analyses were performed with false discovery rate correction. Results: Adjusted cognitive domain scores did not differ between CRS and controls. In age-by-group interaction models, CRS showed a nominally steeper age-associated decrease in episodic memory (β = −0.12, 95% CI −0.21 to −0.03; p = 0.009; q = 0.053), with weaker nominal patterns for working memory (β = −0.10, 95% CI −0.20 to −0.003; p = 0.044; q = 0.096) and visuospatial ability (β = −0.08, 95% CI −0.15 to −0.001; p = 0.048; q = 0.096). Plasma IL-6 was nominally higher in CRS after adjustment (β = 0.36, 95% CI 0.04 to 0.67; p = 0.026; q = 0.18) but did not remain significant after cytokine-level correction. Within CRS, exploratory analyses showed nominal inverse correlations between IL-6 and visuospatial ability (ρ = −0.36; p = 0.008; q = 0.236), as well as a nominal positive correlation between IL-13 and semantic memory (ρ = 0.33; p = 0.020; q = 0.236); however, none survived correction for multiple comparisons. Conclusions: Adults with CRS reported greater sleep-related burden and showed a nominally steeper age-related decrease in episodic memory. IL-6 and IL-13 showed nominal cognitive associations that did not survive correction, supporting the need for larger longitudinal studies to clarify clinical relevance. Full article

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality worldwide, driven by complex interactions among dyslipidemia, chronic inflammation, insulin resistance, endothelial dysfunction, and gut microbiome-derived metabolites. This review synthesizes mechanistic and clinical evidence on non-pharmacological strategies that modulate these pathways and contribute to ASCVD risk reduction. Dietary patterns such as Mediterranean, DASH, and plant-based diets improve lipid metabolism, attenuate inflammation, and enhance endothelial function. Chrononutrition approaches, including time-restricted feeding and structured fasting protocols, influence circadian regulation of glucose and lipid homeostasis. Circadian misalignment—including irregular sleep timing, shift work, and disrupted feeding–fasting cycles—independently contributes to ASCVD through impaired glucose tolerance, dyslipidemia, endothelial dysfunction, and systemic inflammation. Modulation of the gut microbiome, particularly through increased short-chain fatty acid production and reduced TMAO formation, provides additional cardiometabolic benefits. Key nutraceuticals—phytosterols, omega-3 fatty acids, and berberine—demonstrate clinically meaningful effects through micellar competition, inflammation-resolving lipid mediators, and AMPK activation, respectively. When combined with evidence-based pharmacotherapy, these interventions exert synergistic effects on cardiometabolic risk factors. This integrative biomedical framework highlights the importance of combining lifestyle, metabolic, microbiome-targeted, and nutraceutical strategies for comprehensive ASCVD prevention. Full article

Background: Transitional age youth aged 18–25 years are more likely to engage in risky behaviors, displaying significantly higher alcohol and illicit drug use levels than adolescents and older adults. College students are particularly vulnerable at this critical life juncture as transitioning to adulthood may impact emotional health and well-being, contributing to anxiety, depression, and feelings of hopelessness, all of which are linked to increased risk of substance use and disorders. Objective: This study characterizes the design and status of the MAPme Project, a prospective project centered on substance use and emotional wellness during and beyond college. Herein, we describe the 2018–2024 pilot cohort that was followed during the first two years of college, remotely during the COVID-19 pandemic, and upon the return to campus. We also describe our latest 2025+ cohort with ongoing data collection. Participants: The 2018–2024 cohort comprised 301 college freshmen who completed online assessments at baseline (Wave 1). The 2025+ cohort has currently enrolled 618 students and counting. Methods: We provide descriptive information on both cohorts, along with preliminary associations of pre- and early collegiate substance use outcomes, psychopathology, sleep patterns, and personality traits. Results: Approximately 64% of first-year students reported use of a substance in the 90 days leading up to college in 2018. Alcohol and cannabis were the most prevalent substances used in both cohorts with males consuming more alcohol than females. Females reported greater levels of daily stressors and mood symptoms. Other health and personality characteristics and observed associations between psychosocial risk and protective factors are described. Prior studies demonstrate the ability to test research hypotheses in the social, health, and clinical areas of psychology with robust statistical power. Conclusions: Substance use and emotional well-being vary considerably upon entry into college/university and at any particular moment in time. The MAPme Project encourages the engagement of students to address challenges associated with lack of awareness, inclusivity, and acceptance of scientific research. Overcoming barriers of inclusivity and empowering the community is key to the successful adoption and implementation of campus health and community-oriented research programs and systematically enhancing research training. Full article

Objective: Depressive symptoms exist on a continuum in the general population, yet the underlying neurobiological mechanisms, particularly the interplay between resting-state networks and task-evoked social cognitive responses, remain elusive. Methods: Leveraging the Human Connectome Project (HCP) dataset, we included 867 participants. With depression scores as the independent variable and age/sex as covariates, we systematically examined associations with sleep quality, negative emotions, sensory scores, gray matter volume (GMV), fractional amplitude of low-frequency fluctuations (fALFF), multi-seed resting-state functional connectivity (rsFC), as well as brain activation and behavioral performance during working memory, emotion recognition, social cognition, relational reasoning, language comprehension, and gambling tasks. The statistical threshold was set at voxel-level p < 0.001 (uncorrected) combined with cluster-level FWE correction at p < 0.05. Results: (1) Depression scores were positively correlated with sleep disturbances, negative emotions (anger/fear), and pain. (2) In resting-state, depression scores negatively correlated with ventral striatum (VS)–cerebellum/parahippocampal gyrus/fusiform rsFC, yet positively correlated with pregenual anterior cingulate cortex (preACC)–supplementary motor area (SMA) rsFC. (3) In task-fMRI, only the social task showed a positive association with task accuracy and regional activation in bilateral pre/postcentral gyri, superior temporal gyri, left middle frontal gyrus, and SMA/paracentral lobule. Conclusions: Elevated depression scores are linked to a pattern that may reflect relative decoupling between reward and perceptual systems, along with enhanced connectivity in cognitive control circuits. Socially, high scorers exhibit a pattern suggestive of compensatory hypervigilance, accompanied by enhanced behavioral performance. This study provides multidimensional evidence for the dimensional neural representation of depressive symptoms. Full article

Quantitative electroencephalography (qEEG) converts the raw EEG signal into reproducible numerical descriptors (spectral power, hemispheric symmetry, coherence and signal complexity) and has emerged as a candidate translational biomarker linking human and canine neurology. This integrative review examined the diagnostic, prognostic, pharmacological and translational value of qEEG, with emphasis on functional connectivity, and assessed the comparability of the dog as a natural model of human disease. Seventy-five studies were included, spanning epilepsy, acute brain injury, neurodegeneration, rehabilitation and paroxysmal disorders. In both species, epilepsy was consistently associated with altered spectral power and with reduced or reorganized coherence, and interictal abnormalities were demonstrable even in the absence of visible epileptiform discharges. Dogs reproduced the human patterns closely: phenobarbital induced the spectral redistribution predicted by human pharmaco-EEG data, canine cognitive dysfunction reproduced the slowing and the sleep-architecture changes described in Alzheimer’s disease, and a single machine-learning pipeline classified human and canine recordings with comparable accuracy. Conversely, acute brain injury remains virtually unexplored in the dog, and no canine normative database comparable to the human ones is yet available. The evidence was limited by heterogeneous acquisition protocols, small samples and scarce longitudinal veterinary data. qEEG, and coherence in particular, appears to be a promising cross-species biomarker of network dysfunction and supports the dog as a translational platform, although standardized validation remains necessary. Full article

Hotel capacity in emerging destinations is often described through room counts or conventional classifications, even when these say little about how accommodation systems operate. This study investigates the accommodation sector in Villavicencio, Colombia, through the Hotel Capacity Index (ICH), a classification tool based on three variables: rooms, beds, and services. Using field data from 84 hotels, the analysis considers capacity structure, room and bed configuration, occupancy patterns, service provision, and selected operational practices. The results show a hotel system concentrated mainly in medium-capacity establishments, with 71% of the sample in the ICH-2 category. Although the sector shows some internal flexibility in the way sleeping capacity is organized, it remains only weakly differentiated in service provision and operational sophistication. Occupancy patterns also show marked seasonality, with stronger performance in the second half of the year and clear peaks in the final quarter. Limited digital integration, low levels of certification, weakly formalized feedback systems, and incomplete accessibility conditions show broader constraints in upgrading the accommodation base. The study shows that the main issue in Villavicencio is not simply the amount of hotel supply, but the composition and functionality of that supply. In emerging destinations, expanding accommodation supply is not enough when the structure of that supply remains concentrated and only weakly differentiated. Full article

Objective: Obstructive sleep apnea (OSA) during pregnancy is associated with adverse maternal and fetal outcomes, yet commonly used screening questionnaires may perform differently because of pregnancy-specific physiological changes. This study compared questionnaire-based OSA risk classifications obtained using the Berlin Questionnaire and STOP-BANG and examined their associations with metabolic parameters and diabetes-related history. Methods: This cross-sectional study included 210 pregnant women attending a tertiary obstetrics clinic. Berlin Questionnaire high risk was defined as positivity in at least two categories. STOP-BANG scores of 0–2, 3–4, and 5–8 indicated low, moderate, and high risk, respectively. Sociodemographic, obstetric, anthropometric, and biochemical variables were analyzed using multivariable logistic regression. Results: The Berlin Questionnaire classified 34 participants (16.2%) as high risk. STOP-BANG classified 183 (87.1%) as low risk, 5 (2.4%) as moderate risk, and 22 (10.5%) as high risk. Higher current weight was associated with increased questionnaire-based OSA risk according to both tools. In the Berlin model, HbA1c, BMI, and family history of diabetes were independently associated with high questionnaire-based OSA risk. No independent associations were identified in the STOP-BANG model. Although the Berlin model had 83.3% overall accuracy, it correctly classified only 2.9% of high-risk participants. Conclusions: The questionnaires identified different patterns of OSA risk. Findings were instrument-specific and do not indicate confirmed OSA. Given the absence of polysomnography, modest model performance, and limited high-risk classification, the results should be interpreted cautiously. Full article

Although conventionally quantified as an urban–rural thermal anomaly, urban heat islands are systematic expressions of development choices that shape unequal exposures and health risks across cities. This article develops an integrated urban development-health framework explaining how imperviousness, vegetation deficit, landscape configuration, urban morphology, thermally absorptive materials and nocturnal heat retention connect heat exposure with physical disease, mental well-being and climate-responsive planning. A critical integrative review reported using PRISMA 2020 and PRISMA-ScR principles, organised evidence from urban climate, public health, environmental epidemiology and planning. The synthesis covers the Normalized Difference Vegetation Index (NDVI), Normalized Difference Built-up Index (NDBI), Local Climate Zones (LCZs), sky-view factor (SVF), height-to-width ratio (H/W), land-surface temperature (LST), Universal Thermal Climate Index (UTCI), Physiological Equivalent Temperature (PET), wet-bulb globe temperature (WBGT) and nocturnal minimum temperature, together with cardiovascular, respiratory, psychiatric, sleep, mortality and well-being outcomes. Six recurrent amplification pathways were identified: imperviousness and low canopy cover; nocturnal heat retention; social vulnerability; blue-green and cool infrastructure; heat–pollution–humidity interaction; and sleep/mental-health disruption. The Urban Heat-Health Development Index (UHHDI) and Urban Heat-Health Amplification Pattern (UHHAP) are proposed as transparent, review-derived tools for urban diagnosis and policy prioritisation. A Spanish/Mediterranean climatic-zone transition analysis illustrates how future climatic severity can be translated into planning-relevant exposure potential. The findings support a shift from simply describing urban heat to diagnosing development-driven heat-health risk, with implications for urban regeneration, thermal justice, public-health adaptation and healthy-city governance. Full article

Post-disaster housing deficiencies compromise long-term habitability due to rigid reconstruction models that restrict spatial flexibility. Following the 2004 tsunami, the Moken preserved traditional dwelling characteristics, but standardized models provided after the 2019 fire introduced unadaptable layout constraints. While these structures did not directly destroy traditional living patterns, their framework limited necessary spatial extensions based on changing family needs. To inform responsive shelter design, this study investigated Moken construction culture through measured surveys across 20 surviving households, analyzing structural relationships and functional zoning between the main house and its extensions. Empirical results reveal six distinct typologies of spatial transformation built around a traditional nine-post core axis, with expanded footprints averaging 32.44 m². These configurations utilize front zones for social use, lateral zones for storage, and rear zones for sleeping quarters. The study concludes that integrating fluid indigenous habits with localized physical constraints remains a critical necessity, advocating for a flexible core house framework that permanently utilizes traditional construction knowledge and localized spatial parameters to secure the continuous transmission of traditional building skills across generations. Full article

Wearable sleep monitoring systems provide a scalable and low-burden alternative to laboratory-based polysomnography, but overnight physiological recordings collected from wearable sensors are frequently corrupted by poor skin contact, sensor displacement, flatline behavior, saturation, abrupt autoscaling, outliers, and non-physiological noise. These low-quality segments can prevent reliable extraction of clinically relevant biomarkers, including heart rate, heart rate variability, pulse rate, oxygen saturation, and electrodermal activity, thereby limiting the robustness of downstream sleep stage classification and sleep apnea prediction. In this work, we present a multistage hybrid anomaly detection framework for signal quality assessment in a custom-designed multimodal wearable sleep monitoring platform. The proposed framework is shared across modalities: each sensor stream is segmented into windows, screened using signal processing algorithms for obvious sensor failures, and then analyzed using an autoencoder trained on normal windows to detect subtler morphology-level deviations from normal physiological patterns. On chest ECG recordings collected over 10 overnight sessions, the hybrid fusion detector achieves an accuracy of 0.9067, AUROC of 0.9068, F1 score of 0.8739, precision of 0.9470, and recall of 0.8202, outperforming rule-based detection and autoencoder-based detection alone. Additional experiments on PPG, EDA and ExG recordings show consistently high F1 scores of 0.9431, 0.9567 and 0.8728, respectively. These results demonstrate that hybrid anomaly detection can serve as an effective quality-control layer for multimodal wearable sleep monitoring and provide a foundation for future work on robust sleep stage and apnea prediction under real-world sensing conditions. Full article

Background/Objectives: The association between sleep deprivation and mental well-being in school-aged children and adolescents has been well documented, but the specific relationship between sleep debt and mental well-being remains unclear. This study aimed to evaluate the association between sleep debt and mental well-being in school-aged children and adolescents. Methods: This cross-sectional study included 4967 children and adolescents aged 9–18 years from eight provincial-level regions in China, using data from a multicenter school-based survey conducted within the framework of the Chinese National Survey on Students’ Constitution and Health (CNSSCH). Participants self-reported relevant sleep parameters, and the sleep debt was calculated based on the difference in sleep duration between weekdays and weekends. The main outcome was mental well-being. Adjusted covariates were age, sex, urban–rural residence, body mass index (BMI), vital capacity, and waist-to-hip ratio. Results: A total of 4967 children and adolescents were included (mean [SD] age 12.77 [2.59] years; 2475 [49.83%] girls) with 3176 participants classified as having higher mental well-being and 1791 participants classified as having lower mental well-being. After adjustment for covariates, sleep debt was associated with greater odds of lower mental well-being (adjusted odds ratio [aOR] = 1.095; 95% CI, 1.050–1.143; p < 0.001). Although statistically significant, the magnitude of this association was modest. In stratified analyses, each quartile increase in sleep debt was associated with 17.8% higher odds of lower mental well-being in boys (95% CI, 8.6–27.8%), 33.8% higher odds in girls (95% CI, 23.8–44.6%), 25.3% higher odds in urban students (95% CI, 16.3–35.0%), and 28.2% higher odds in rural students (95% CI, 17.6–39.7%) (all p < 0.001). In addition, weekend sleep patterns significantly interacted with the sleep debt–mental well-being association (p for interaction < 0.05), while age-specific nonlinear patterns involving nap duration were observed among adolescents aged 15–17 years (p for nonlinearity = 0.004). Conclusions: Sleep debt showed a statistically significant but modest cross-sectional association with lower mental well-being. Numerically larger subgroup-specific estimates were observed among girls and rural students. Given the cross-sectional design, these findings should not be interpreted as evidence of causality. Despite its modest magnitude, the association may have public health relevance at the population level. The observed patterns involving weekend sleep and age-specific nap duration warrant further evaluation in longitudinal and, where appropriate, intervention studies. Full article

Background/Objectives: Autism spectrum disorder (ASD) is currently singularly described as a behaviourally defined neurodevelopmental diagnosis with symptoms affecting social communication and social understanding alongside the presence of restricted patterns of behaviour. Wide, and often very personal, variations in symptom intensities and differing developmental trajectories, reflective of large heterogeneity, are an important feature of the label. ASD carries enhanced risks for multiple over-represented, sometimes overlapping, comorbidities spanning behavioural, psychiatric and somatic domains. Said comorbidities often have numerous and far-reaching effects on quality of life by way of their impacts and, in extreme cases, their potential effects on life expectancy. It is of paramount importance that data on the risks of such comorbidities are available and, where possible, screening, preventive and/or treatment options implemented. Methods: In this narrative review, the authors searched databases (PubMed/Medline, ScienceDirect, Google Scholar) for papers published between 1 January 2015 and 16 February 2026 that were pertinent to comorbidity and autism. Results: We present data on the frequency of various somatic (gastrointestinal, immunological, metabolic, neurological, motor-sensory disorders), psychiatric (anxiety, mood, schizophrenia spectrum, personality, substance abuse, trauma, feeding and eating, sleeping, self-harm, neurocognitive disorders) and neurodevelopmental comorbidities (intellectual, attentional, speech and language, motor disorders) that can present alongside a diagnosis of ASD. We provide accompanying data on the magnitude of potential risk and, where available, information on comorbidity risks according to sex and age. Conclusions: This review paper deals with an extremely broad field. Limitations of the narrative review strategy are discussed alongside how the variable risk of comorbidity mimics the heterogeneity present in autism, thus inviting further investigations. Full article

Background/Objectives: Hypoglossal nerve stimulation (HNS) is an established treatment for moderate-to-severe obstructive sleep apnoea (OSA) in patients intolerant of continuous positive airway pressure. Pre-operative drug-induced sleep endoscopy (DISE) is mandatory for HNS candidacy assessment, with complete concentric velopharyngeal collapse representing the only formally accepted contraindication. The prognostic significance of oropharyngeal lateral wall (OLW) collapse remains contested, with conflicting evidence and no consensus on its role in patient selection. We sought to systematically evaluate whether OLW collapse on pre-operative DISE predicts surgical response to HNS in adults with OSA. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines (PROSPERO: CRD420261347436). MEDLINE, EMBASE, and Cochrane CENTRAL were searched in March 2026 with no date restrictions. Risk of bias was assessed using the QUIPS tool. Data were synthesised narratively due to heterogeneity in DISE protocols and outcome definitions. Results: Eight studies comprising 1051 patients were included. Complete OLW collapse was associated with significantly lower HNS response rates in four of six studies directly testing this association (57.8–66.7% versus 74.2–84.8%; p = 0.024–0.042). On multivariate analysis in the largest study (n = 343), the association was attenuated to non-significance (OR 0.57, 95% CI 0.26–1.22), with BMI effect modification observed. One study reported a null finding and one paradoxically identified partial rather than complete OLW collapse as the failure-associated pattern (p = 0.04). All studies were rated as having a moderate or high risk of bias. Conclusions: Complete OLW collapse was associated with poorer HNS outcomes in several studies, but attenuation on multivariate analysis precludes its designation as a formal contraindication. Prospective validation and standardised DISE reporting are required before OLW collapse can inform HNS candidacy criteria. Full article