Search Results (1,476)

Introduction. Sleep is an essential component in the recovery, performance, and injury prevention processes of soccer players. Associated psychological variables, such as the balance between stress and recovery, have been less explored, despite their potential influence on rest and injury vulnerability. This study aims to examine the relationship between sleep quality, quantity, and chronotype and injury risk in soccer players, also incorporating the modulating role of stress and recovery. Method. A PRISMA systematic review was conducted using searches in ScienceDirect, PubMed, Ovid, EBSCO, MDPI, Springer Nature Link, SPORTDiscuss (full text), and Dialnet. Original studies and reviews on sleep and its relationship with sports injuries in soccer players or comparable athletic populations were included. Eighteen studies were selected that addressed sleep indicators (quality, quantity, chronotype), injury incidence, and, to a lesser extent, measures of stress and recovery using instruments such as the RESTQ-Sport or wellness questionnaires. Results. There is evidence of an association between poor sleep quality or quantity and an increased risk of injury or illness. Chronotype is an emerging variable of interest, although still insufficiently researched. Regarding stress and recovery, direct evidence is limited, although studies that address this issue show that an imbalance between these two dimensions negatively impacts sleep quality and increases susceptibility to injury. Conclusions: Sleep and the stress–recovery balance are key and interdependent factors in the risk of injury in soccer players. Future research should consider including these variables to further understand the mechanisms underlying the injury process and optimize prevention and recovery strategies. Full article

Obstructive sleep apnea (OSA) is characterized by recurrent partial or complete upper airway collapse during sleep. Accurate assessment of airway anatomy is crucial for risk stratification, diagnosis, and treatment planning. While polysomnography (PSG) is considered the gold standard for OSA diagnosis, it provides limited anatomical insights. Cone-beam computed tomography (CBCT) has emerged as a valuable tool with lower radiation dose for three-dimensional (3D) assessment of the upper airway space and craniofacial structures. CBCT enables precise measurement of critical airway parameters including total airway volume and length, minimum cross-sectional area, linear dimensions of anteroposterior and lateral diameters, as well as soft tissue structures such as tongue, tonsils, and adenoids. This review aims to explore and comprehensively review the role of CBCT, primarily in upper airway assessment for OSA, with an emphasis on airway measurement parameters, anatomical reference landmarks, and the variabilities, in addition to its clinical applications in treatment planning and simulation and post-treatment efficacy evaluation. This review also highlights the technical considerations such image acquisition protocols, machine specifications and software algorithm, and patient positioning, which may affect measurement reliability and diagnostic accuracy. CBCT serves as a powerful adjunct in OSA diagnosis and management, enabling comprehensive assessment of the airway space and hard and soft tissue structures. It complements PSG by guiding personalized interventions such as maxillomandibular advancement or CPAP optimization. Standardized imaging protocols and consideration of patient positioning can further improve its clinical utility. Full article

Background: Patients with primary central nervous system (CNS) tumors often experience fatigue and sleep disturbances, significantly impacting their quality of life. Exercise has been shown to improve these symptoms in various cancer populations. The aim of this study is to evaluate the effects of different types of exercise on fatigue and sleep in less-investigated CNS tumor patients. Methods: A literature search was conducted in PubMed, Scopus, Cochrane Library, and CINAHL. Eligible randomized and non-randomized studies evaluating exercise interventions in patients diagnosed with primary brain tumors were systematically reviewed, primarily using a narrative synthesis approach. Cancer-related fatigue and sleep-related outcomes were extracted as variables of interest. Where possible [≥2 Randomized Control Trials (RCTs) available for glioma patients], meta-analyses were conducted to assess the overall effects of physical therapy on the above-mentioned outcomes. Results: A total of 15 relevant intervention studies were identified, either RCTs or other types of studies, such as prospective feasibility cohort studies and case studies. A total of 448 participants were enrolled, with the majority diagnosed with glioma. There were single reports on pituitary adenoma after surgery and meningioma patients. In glioma patients, the overall effect of various modality exercise interventions on fatigue was non-significant, reflecting the heterogeneous characteristics of studies with diverse outcomes. However, meta-analysis focusing on combined exercise interventions (aerobic and resistance training) showed a positive effect on reducing fatigue in these patients [Standardized Mean Difference (SMD) = 0.866, p = 0.03]. Fatigue in glioma patients may also improve through yoga and Pilates. Aerobic but not strength exercise seems to improve sleep in glioma patients (SMD = 1.14, p = 0.02). Sleep quality may also improve through yoga and combined exercise. Conclusions: Certain types of exercise appear to effectively reduce fatigue and improve sleep in patients with CNS tumors. Future, well–controlled, multi-arm, larger-scale studies are necessary to resolve discrepancies, as well as to explore long-term outcomes and define factors influencing individualized exercise responses. Full article

Background: Chronic pain is a leading contributor to disability worldwide, yet population-based data from rural and medically underserved settings remain limited. Evidence describing the biopsychosocial correlates of chronic pain in rural Filipino communities is particularly scarce. Methods: We conducted a secondary analysis of cross-sectional data from the I-HELP-FILIPINO community cohort, collected between January and June 2017. Participants included 909 adults aged 18–93 years who voluntarily attended barangay clinic days in rural Philippine communities. Pain severity was assessed with standardized self-report tools. Sociodemographic, psychosocial, sleep, and functional health factors were examined using bivariate analysis and hierarchical linear regression. Results are shown with 95% confidence intervals. Results: Chronic pain was very common, affecting 83.8% of participants, with 5.6% experiencing severe pain. In multivariable models, psychosocial distress, sleep issues, and reduced physical functioning were significantly linked to increased pain severity, while demographic factors contributed minimally to the variance. Most of the explained variance in pain outcomes was accounted for by psychosocial and clinical variables. Conclusions: In this rural Filipino cohort, chronic pain was strongly associated with modifiable psychosocial, sleep, and functional health factors. Focusing on community-based and culturally tailored interventions can inspire hope and empower healthcare professionals and policymakers to tackle these issues more effectively. Full article

Background: Although several studies have reported associations between screentime and shortened sleep duration among adolescents, contextual relationships between different forms of screentime are not well understood. The purpose of this study was to examine how television (TV) watching (passive media use) and video/computer gaming (interactive media use) are associated with short sleep duration among 8th and 11th grade adolescents. Methods: We used data from adolescents (8th and 11th grade students) who participated in the Texas School Physical Activity and Nutrition (Texas SPAN) survey in 2015–2016. Sleep duration was the outcome variable, which was dichotomized into short sleep duration (less than 8 h) and meeting sleep recommendations (more than 8 h). Independent variables included daily TV screentime and video/computer game screentime. We used weighted logistic regression models to understand associations between sleep duration and both TV screentime and video/computer game screentime. Results: Among both 8th grade boys and Hispanic 8th grade girls, spending more than 2 h/day playing video/computer games was associated with greater odds of shorter sleep duration. Among 11th graders, TV screentime was associated with lower odds of shorter sleep duration. Conclusions: Watching TV and playing video/computer games have differential associations with sleep duration among adolescents, and these associations differ by grade, gender, and ethnicity. Researchers and public health agencies interested in associations between meeting sleep recommendations and screentime in adolescents should consider these contextual differences when designing and conducting studies related to electronic media use and sleep. Full article

Chronic obstructive pulmonary disease (COPD) and tuberculosis (TB) increasingly co-occur in low- and middle-income countries and aging populations. Prior pulmonary TB is a robust, smoking-independent determinant of COPD and is linked to persistent systemic inflammation, endothelial dysfunction, dyslipidemia, and hypercoagulability axes that also amplify cardiovascular disease (CVD) risk. We conducted a targeted narrative non-systematic review (2005–2025) of PubMed/MEDLINE, Embase, Scopus, and Web of Science, selecting studies for clinical relevance across epidemiology, clinical phenotypes, pathobiology, biomarkers, risk scores, sleep-disordered breathing, and management. No quantitative synthesis or formal risk-of-bias assessment was performed. Accordingly, findings should be interpreted as a qualitative synthesis rather than pooled estimates. Prior TB is associated with a distinctive COPD phenotype characterized by mixed obstructive–restrictive defects, reduced diffusing capacity (DLCO), radiographic sequelae, and higher exacerbation/hospitalization burden. Mechanistic insights: Convergent mechanisms chronic immune activation, endothelial injury, prothrombotic remodeling, molecular mimicry, and epigenetic reprogramming provide biologic plausibility for excess CVD, venous thromboembolism, and pulmonary hypertension. Multimarker panels spanning inflammation, endothelial injury, myocardial strain/fibrosis, and coagulation offer incremental prognostic value beyond clinical variables. While QRISK4 now includes COPD, it does not explicitly model prior TB or COPD-TB outcomes, but data specific to post-TB cohorts remain limited. Clinical implications: In resource-constrained settings, pragmatic screening, prioritized PAP access, guideline-concordant pharmacotherapy, and task-shifting are feasible adaptations. A history of TB is a clinically meaningful modifier of cardiopulmonary risk in COPD. An integrated, multimodal assessment history, targeted biomarkers, spirometry/lung volumes, DLCO, 6 min walk test, and focused imaging should guide individualized care while TB-aware prediction models and implementation studies are developed and validated in high-burden settings. Full article

Far-infrared (FIR)-emitting textiles are increasingly used in sleepwear; however, their influence on sleep physiology has not been comprehensively evaluated with multi-modal wearable sensing. This randomized, double-blind, placebo-controlled crossover study examined whether FIR-emitting garments modulate nocturnal thermoregulation, autonomic activity, and sleep architecture. Fifteen healthy young men completed two overnight laboratory sleep sessions wearing either FIR-emitting garments or visually matched polyester controls. Tympanic membrane temperature (TMT), sweating rate, skin temperature, and humidity were continuously monitored using wearable sensors, and sleep stages and heart rate variability (HRV) were assessed using validated portable systems. Compared with control garments, FIR garments produced consistently lower TMT across the night (p = 0.004) and reduced mid-sleep sweating (condition × time interaction: p = 0.026). The proportion of rapid eye movement (REM) sleep was higher in the FIR condition (22.2% ± 6.5% vs. 18.6% ± 6.5%, p = 0.027), despite no changes in total sleep time or sleep efficiency. A transient increase in low-frequency power during early sleep (p = 0.027) suggested baroreflex-related thermal adjustments without sympathetic activation. These findings indicate that FIR-emitting garments facilitate mild nocturnal heat dissipation and support REM expression, demonstrating their potential as a passive intervention to improve sleep-related thermal environments. Full article

Background/Objectives: Obstructive sleep apnea (OSA) is characterized by recurrent episodes of complete or partial upper airway collapse during sleep, leading to apnea or hypopnea and recurrent oxygen desaturation. Intermittent hypoxia (IH) and sleep fragmentation have been proposed as key mechanisms contributing to the adverse cardiovascular consequences observed in OSA. The present study aimed to identify clinical variables independently associated with IH in patients with OSA and to examine their relationships with common comorbid conditions. Methods: This retrospective study included 569 adult patients diagnosed with obstructive sleep apnea (OSA) by overnight polysomnography (apnea–hypopnea index [AHI] ≥ 5 events/hour) between February 2020 and January 2025 at the Sleep Laboratory of Trakya University Hospital. Demographic characteristics, body mass index (BMI), AHI values, comorbid medical conditions, average nocturnal oxygen saturation, and the duration of intermittent hypoxia (time below 90% SpO₂ [T90]) were retrieved from the laboratory database. Normality of distribution was assessed using the Kolmogorov–Smirnov test. Group differences were evaluated using the Mann–Whitney U test and the Kruskal–Wallis test with Dunn–Bonferroni post hoc analysis. Correlations were examined using Spearman’s correlation analysis, and variables independently associated with average nocturnal oxygen saturation and intermittent T90 were assessed using multivariable linear regression analysis. Results: The presence of hypertension, diabetes mellitus, and comorbid conditions was associated with significant differences in T90 among patients with OSA. T90 also differed significantly across AHI severity grades. Significant negative correlations were observed between nocturnal oxygen saturation and BMI, hypertension, diabetes, comorbidities, and age. Nocturnal oxygen saturation values likewise differed significantly across BMI-defined obesity groups. In the multivariable regression analysis, BMI, AHI, and age were independently associated with lower nocturnal oxygen saturation and longer T90. Conclusions: This study provides important insight into the complex relationships among OSA severity, patient demographics, comorbidities, and intermittent hypoxia. In multivariable analysis, BMI, AHI, and age showed independent associations with reduced nocturnal oxygen saturation and prolonged T90. These findings highlight the importance of a multidimensional clinical assessment in OSA and support the use of intermittent hypoxia metrics as additional indicators of disease burden and potential clinical impact. Full article

Background: Primary fallopian tube carcinoma (PFTC) is a rare gynecologic malignancy, and data describing its biopsychosocial characteristics remain limited. Understanding the biological, psychological, and social features of affected women may support patient-centered care and inform future research. Methods: This retrospective, single-center, descriptive pilot study included 20 patients with histopathologically confirmed PFTC treated in 2024–2025. Demographic, reproductive, clinical, preventive, and record-documented psychosocial variables were extracted from medical records. Categorical variables were analyzed using chi-square tests (or Fisher’s exact test where appropriate), and effect sizes were summarized using Cramér’s V. Proportions were reported with 95% confidence intervals using the Wilson method. Results: Half of the women were aged ≥70 years (50.0%; 95% confidence interval (CI): 29.9–70.1) and 65.0% had never been pregnant. Normal body mass index (BMI) predominated (65.0%). International Federation of Gynecology and Obstetrics (FIGO) stage was available for 12/20 patients; among those with documented staging, 58.3% were FIGO stage III. Preventive behaviors documented in medical records suggested suboptimal screening patterns: cervical cytology was classified as occasional in 75.0% of patients. Psycho-oncological support was documented in 45.0% of patients, and sleep problems were documented in 25.0%. An age-group difference in documented psycho-oncological support was observed (χ² = 14.007; p = 0.007; Cramér’s V = 0.751); however, given the very small sample size and the distribution of observations across age categories, this finding should be interpreted as hypothesis-generating rather than confirmatory evidence. No association was observed between place of residence and FIGO stage in the subset with available staging data. Conclusions: In this small retrospective, single-center cohort, patients with PFTC were predominantly older and frequently nulligravid, while normal BMI was common. Record-documented psychosocial needs (including psycho-oncological support and sleep problems) were observed in a subset of patients and underscore the importance of systematic psychosocial assessment using validated tools in future studies and clinical pathways. Findings are preliminary and hypothesis-generating and support the need for larger prospective multicenter studies integrating comprehensive clinical and standardized psychosocial data in PFTC populations. Full article

Aging involves progressive changes in sensory perception, appetite regulation, and metabolic flexibility, which together affect dietary intake, nutrient adequacy, and health-related outcomes. Meanwhile, current wearable technologies allow continuous, minimally invasive monitoring of physiological and behavioral markers relevant to metabolic health, such as physical activity, sleep, heart rate variability, glycemic patterns, and so forth. However, digital nutrition approaches have largely focused on physiological signals while underutilizing the sensory dimensions of eating—taste, smell, texture, and hedonic response—that strongly drive dietary intake and adherence. This narrative review synthesizes evidence on the following: (1) age-related sensory changes and their nutritional consequences, (2) metabolic adaptation and markers of resilience in older adults, and (3) current and emerging wearable technologies applicable to nutritional personalization. Following this, we propose an integrative framework linking subjective (implicit) sensory perception and objective (explicit) wearable-derived physiological responses into adaptive feedback loops to support personalized dietary strategies for healthy aging. In this light, we discuss practical applications, technological and methodological challenges, ethical considerations, and research priorities to validate and implement sensory–physiological integrated models. Merging together sensory science and wearable monitoring has the potential to enhance adherence, preserve nutritional status, and bolster metabolic resilience in aging populations, moving nutrition from one-size-fits-all prescriptions toward dynamic, person-centered, sensory-aware interventions. Full article

Background: The scalp represents a distinct ecological niche within the skin, and the structure of its microbiota, together with the factors shaping it, is considered important for the maintenance of scalp health. Methods: This study systematically analyzed the bacterial and fungal community structures on the scalps of 63 healthy Chinese women aged 18–25, and examined their associations with scalp type, sensitivity, and lifestyle factors. Scalp samples were collected, questionnaire surveys were administered, scalp physiological parameters were measured, and high-throughput sequencing of 16S rRNA and ITS genes was performed. Results: The results showed that, in this unique scalp skin niche, the dominant bacterial phylum was Actinobacteria, while the dominant fungal phylum was Ascomycota. The predominant bacterial genera were Cutibacterium and Staphylococcus, and the fungal community was dominated by Malassezia. When scalp types were categorized according to sebum content, dry scalps showed enrichment of Micrococcus, Streptococcus, Delftia, Staphylococcus aureus, and Staphylococcus hominis, whereas oily scalps, on the other hand, are primarily colonized by Cutibacterium and Staphylococcus species. In addition, we observed microbial interactions under different physiological conditions. The relative abundance of Cutibacterium decreased with increasing scalp sensitivity. Higher psychological stress, insufficient sleep, and high-sugar/high-fat dietary patterns tended to coincide with shifts in the relative abundance of Malassezia, implying that these influences may act through fungal rather than bacterial components of the scalp microbiota. Scalp sensitivity showed the strongest association with β-diversity among the variables examined, although the effect size was modest and did not reach conventional significance in the multivariable PERMANOVA. Conclusions: In young women, the scalp constitutes a distinct cutaneous niche whose microbiota is jointly shaped by sebum level, barrier sensitivity, and lifestyle factors, with sensitivity emerging as one of the more influential dimensions of community variation. These findings provide guidance for future in-depth research on the scalp microbiome network and offer a foundational reference for preventing suboptimal and pathological scalp conditions. Full article

Ecological momentary assessment (EMA) captures real-time data on thoughts, emotions, and behaviours within individuals’ natural environments. Although EMA has been increasingly used to examine self-harm, existing reviews have not focused specifically on adolescents. This systematic review examines EMA research on adolescent self-harm, focusing on methodological considerations and key risk and protective factors for self-harm. Five databases, plus pre-print, unpublished and grey literature sources, were searched up to 30 January 2024. Studies were included if published in English, used EMA methodology, included adolescents aged 10–24 years and measured suicidal ideation, suicidal behaviours, or self-harm. The review included 79 studies, published from 2009 to the present. Self-harm was associated with numerous risk factors, including negative affect, stress, interpersonal influences and sleep. EMA was generally well-accepted by adolescent participants, with high compliance rates. The findings highlight the value of EMA in capturing real-time fluctuations in self-harm and associated risk factors among adolescents. EMA demonstrates strong potential for improving understanding and prediction of self-harm; yet challenges remain, including variability in study designs and a lack of clear reporting of the methodologies. Future research should focus on standardising methodologies, increasing participant diversity, and exploring the clinical utility of EMA in early intervention and prevention strategies. Full article

Obstructive sleep apnea (OSA) is a prevalent disorder characterized by repeated upper airway collapse during sleep, significantly impacting quality of life. Orthodontists are increasingly recognized for their role in screening and managing anatomical factors contributing to airway obstruction. One such intervention is rapid maxillary expansion (RME), originally developed to address transverse maxillary deficiencies but now also studied for its influence on nasal and oropharyngeal airway dimensions. This literature review evaluates the effects of maxillary palatal expansion on airway volume and respiratory function. Evidence consistently shows increases in nasal cavity volume and reductions in nasal airway resistance, particularly in patients treated before the peak of skeletal growth. Some studies reported improvements in sleep outcomes and enhanced oxygen saturation following MARPE in adults with OSA. Results regarding changes in oropharyngeal volume were more variable, with several studies showing significant expansion. Factors influencing outcomes include patient age, skeletal maturity, appliance type, and aging modality. Hybrid and bone-borne expanders generally demonstrated greater skeletal effects compared to tooth-borne devices, though statistical significance was not always reached. While MARPE has shown promising results in non-obese adults with OSA, long-term stability of airway improvements and translation into consistent functional respiratory benefits remain uncertain. Overall, maxillary expansion demonstrates measurable skeletal and airway changes, with the greatest respiratory improvements in growing patients and selected adult populations. Incorporating patient-reported outcomes and standardized polysomnographic measures in future trials will be critical to determine whether these structural gains consistently translate into durable improvements in sleep-disordered breathing and quality of life. Full article

REM sleep behavioral disorder (RBD) is of increasing interest in Parkinson’s disease (PD). Previous studies exploring the association between REM sleep without atonia (RWA) and clinical PD features or other objective sleep metrics are scarce and have used PSG findings. A mobile electroencephalography (EEG)/electrooculography (EOG) recording system with two channels can objectively measure sleep parameters, including RWA, during natural sleep at home. We investigated whether RWA measured on a portable recording device at home could be associated with clinical PD features or other sleep metrics using baseline data from the ZEAL study. Differences between patients with and without RWA was analyzed using ANCOVA test. REM sleep length was significantly longer in patients with RWA than in those without RWA. A multivariate comparison using ANCOVA showed a significant difference in log-transformed REM sleep duration of patients with RWA after adjustment for potential confounders (adjusted mean difference of 1.203; 95% confidence interval 0.468 to 1.937; p = 0.003). The strength of this study was that it evaluated the association between RWA during natural sleep at home and clinical variables as well as other sleep metrics. The major result was that patients with and without RWA did not differ in their clinical variables, and there was no relation between RWA and objective sleep metrics other than REM sleep. The duration of REM sleep may be associated with RWA during natural sleep at home. Full article

Fatigue is a multifactorial phenomenon affecting both physical and psychological performance, particularly in high-stress occupations. Although wearable sensors enable continuous monitoring, conventional machine-learning (ML) models can produce unstable, weakly calibrated, and opaque predictions in real-world settings. To improve reliability and interpretability, we developed a selective Retrieval-Augmented Generation (RAG)–enhanced hybrid ML–LLM framework that integrates the efficiency of ML with the reasoning capability of large language models (LLMs). Using wearable and ecological momentary assessment data from 297 emergency responders (9543 seven-day windows), logistic regression, XGBoost, and LSTM models were trained to classify fatigue levels dichotomized by the median of daily tiredness scores. The LLM was selectively activated only for borderline ML outputs (0.45 ≤ p ≤ 0.55), using symbolic rules and retrieved analog examples. In the uncertainty region, performance improved from 0.556/0.684/0.635/0.659 to 0.617/0.703/0.748/0.725 (accuracy/precision/recall/F1). On the full test set, performance similarly improved from 0.707/0.739/0.918/0.819 to 0.718/0.741/0.937/0.827, with gains confirmed by McNemar’s paired comparison test (p < 0.05). SHAP-based ML interpretation and LLM reasoning analyses independently identified short-term sleep duration and heart-rate variability as dominant predictors, providing transparent explanations for model behavior. This framework enhances classification robustness, interpretability, and efficiency, offering a scalable solution for real-world fatigue monitoring. Full article