Search Results (340)

Air pollution is a major environmental determinant of premature mortality and population health burden. Liguria represents a vulnerable Mediterranean region due to intense urbanisation, port-related emissions, complex topography and an ageing population. This study quantified the mortality burden and Years of Life Lost (YLL) attributable to long-term exposure to PM_2.5, NO₂ and O₃ in Liguria (Italy), and estimated the potentially avoidable burden under WHO guideline scenarios. A Health Impact Assessment (HIA) was conducted using ARPAL air quality data and ISTAT mortality data for the population aged ≥30 years during 2022–2024. Relative risks were derived from the European ELAPSE project and WHO meta-analyses. Attributable mortality was estimated using a log-linear Health Impact Function, while YLL were calculated using regional life tables and normalised per 100,000 inhabitants. PM_2.5 was the main contributor to air pollution-related mortality, accounting for 1333 attributable deaths in 2022. Corresponding YLL ranged from 755 to 1012 per 100,000 inhabitants over the study period. NO₂ showed a relevant but secondary contribution, while O₃ effects were smaller and more uncertain. WHO guideline scenarios indicated a substantial potentially avoidable burden of deaths and YLL. These findings support targeted environmental and public health interventions in highly urbanised coastal regions. Full article

Introduction: The Melody transcatheter pulmonary valve (TPV) was the first percutaneous bioprosthetic valve approved for transcatheter pulmonary valve implantation (TPVI). We report our single-centre experience with Melody TPV implantation in patients with congenital heart disease (CHD). Methods: This retrospective observational single-centre study included all patients evaluated in the catheterization laboratory for Melody TPV implantation. Early outcomes included procedural failure, life-threatening adverse events, and mortality. Long-term outcomes assessed during follow-up included infective endocarditis, transcatheter reintervention, and surgical reintervention. Results: Between 2015 and 2025, 50 consecutive patients were evaluated for TPVI with the Melody TPV at our institution. In four patients (8%), the procedure was aborted because of coronary artery compression detected during balloon interrogation of the right ventricular outflow tract (RVOT). One patient (2%) died of septic shock following acute pulmonary oedema in the immediate post-procedural period. The remaining 45 patients (90%) underwent successful Melody TPV implantation and were discharged from hospital. In six patients, the Melody TPV was implanted off-label: in the tricuspid position (n = 2) and in small conduits (<16 mm) (n = 4). Mean follow-up duration was 5.8 ± 3.6 years. One patient was lost to follow-up. Among the remaining 44 patients, seven (15.9%; 2.7% per patient-year) developed infective endocarditis, seven (15.9%; 2.7% per patient-year) underwent transcatheter reintervention (six balloon dilatations of the Melody valve and one valve-in-valve implantation), and four (9.1%; 1.5% per patient-year) required surgical replacement of the Melody TPV. Conclusions: Transcatheter implantation of the Melody TPV is an effective treatment for RVOT dysfunction. At mid-term follow-up, the majority of implanted Melody valves demonstrated satisfactory function, and only a minority of patients required surgical valve replacement. Full article

Background: Whether the fatal and non-fatal composition of aggregate pancreatitis burden has changed over time remains unclear. We assessed long-term changes in the fatal-to-non-fatal composition of aggregate pancreatitis burden using Global Burden of Disease (GBD) 2023 estimates. Methods: We conducted a systematic descriptive and trend analysis using publicly available estimates from the GBD 2023 Results Tool for incidence, prevalence, deaths, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) across 204 countries and territories from 1990 to 2023. Because GBD reports pancreatitis as an aggregate cause category, the analysis could not distinguish acute pancreatitis, recurrent acute pancreatitis, chronic pancreatitis, or acute exacerbations of chronic pancreatitis. Primary analyses used age-standardised rates per 100,000 population. Four burden–composition metrics were derived within each location–year stratum: the YLL:YLD ratio, YLD:DALY proportion, deaths-to-incidence ratio, and prevalence-to-incidence ratio. Temporal trends were modelled in R version 4.5, using segmented regression, with up to three joinpoints selected by a Bayesian information criterion. Results: Globally, all six age-standardised native GBD measures declined between 1990 and 2023. The age-standardised incidence rate decreased from 37.62 (95% UI 32.20–43.11) to 32.91 (28.84–37.17) per 100,000, prevalence from 93.78 (69.26–126.25) to 68.92 (52.53–90.32), deaths from 1.76 (1.49–2.16) to 1.40 (1.21–1.66), YLDs from 5.70 (2.75–9.45) to 4.34 (2.18–7.04), YLLs from 55.96 (46.50–69.72) to 43.60 (36.89–53.53), and DALYs from 61.66 (50.62–75.61) to 47.94 (40.57–58.16). However, the fatal-to-non-fatal composition changed little: the global YLL:YLD ratio was 9.82 in 1990 and 10.04 in 2023, while the YLD share of DALYs was 0.092 and 0.091, respectively. Joinpoint modelling showed fluctuation rather than a sustained shift toward disability-dominant burden: the global YLL:YLD ratio was stable until 1998, increased from 1998 to 2002 (annual percent change [APC] 1.38%, 95% CI 0.42 to 2.36), and then declined modestly thereafter (APC −0.13%, −0.20 to −0.06). Burden remained higher in males, whereas females had a greater non-fatal share of total burden (YLD:DALY in 2023: 0.134 vs. 0.073). All sociodemographic index strata remained mortality-dominant in both 1990 and 2023; low-SDI settings had the greatest fatal dominance (YLL:YLD 34.94 in 1990; 24.72 in 2023). Using a descriptive YLD:DALY ≥ 0.50 benchmark, 203 of 204 countries and territories remained below the disability-dominant threshold in both years, no country crossed from below to above this benchmark, and only Georgia moved from above to below the benchmark. Conclusions: Despite declines in global incidence, mortality, and DALY rates, the aggregate GBD pancreatitis burden remained overwhelmingly mortality-dominant from 1990 to 2023. Because GBD pancreatitis combines acute and chronic pancreatitis, this finding should be interpreted as describing the modelled aggregate pancreatitis cause category rather than proving subtype-specific mortality dominance. The intensity of fatal dominance varied by sex, SDI, region, age, and country, but a structural shift toward disability-dominant aggregate burden was not observed. Full article

Background/Objectives: Impaired quality of life (QoL) represents one of the most important clinical determinants in heart failure with preserved ejection fraction (HFpEF). This study aimed to evaluate the incremental explanatory value of functional performance and inflammatory biomarkers for QoL in a clinically stable HFpEF cohort. Methods: A single-center observational study enrolled 110 consecutive patients with stable HFpEF. Functional capacity was assessed using the six-minute walk test (6MWT), expressed mainly as percentage of predicted distance. Health-related QoL was measured using the EQ-5D-5L utility index (primary outcome). Circulating IL-6, CRP, and NT-proBNP were obtained from peripheral blood. Hierarchical multivariable linear regression was applied to quantify the incremental contribution of clinical variables, functional capacity, and biomarkers. Results: The median age was 72 years, and 52.7% of the participants were women. The median 6MWT distance was 340 m (75.9% of predicted), and the median EQ-5D index was 0.76. The baseline clinical regression model (age, sex, atrial fibrillation, and glomerular filtration rate) explained 23.5% of EQ-5D variance. The addition of functional capacity increased explained variance to 45.2% (ΔR² = +0.217). The inclusion of IL-6 and NT-proBNP provided a modest additional increase (R² = 0.468; ΔR² = +0.042 in addition to Model 2). In the fully adjusted model, functional capacity (β = 0.376, p < 0.001) and IL-6 (β = −0.185, p < 0.05) remained independent predictors, whereas NT-proBNP lost significance. Conclusions: In stable HFpEF, objective functional capacity represents the dominant determinant of QoL, while inflammatory activation provides an independent but smaller contribution. Functional assessment may therefore be central to patient-centered phenotyping and therapeutic targeting. Full article

Background/Objectives: Urinary tract infections (UTIs) in older adults are common and potentially life-threatening conditions that often present with atypical symptoms. Early identification of prognostic factors is essential to improve clinical outcomes and reduce mortality in this vulnerable population. Methods: This retrospective, multicenter study included patients aged ≥65 years who were hospitalized with a diagnosis of UTI between January 2019 and December 2023. Diagnoses were established by infectious disease specialists based on clinical findings and microbiological confirmation in accordance with international guidelines. Only patients with urine cultures showing ≥100,000 CFU/mL bacterial growth were included. Demographic, clinical, laboratory, and microbiological data were analyzed. Multivariable logistic regression was used to identify independent predictors of in-hospital mortality. Results: A total of 1175 patients (median age: 75 years; 51.1% male) were included. The in-hospital mortality rate was 14.6%, and 25.6% required intensive care unit (ICU) admission. Multidrug-resistant (MDR) bacteria were detected in 63.6% of isolates, and bacteremia was present in 24.3% of cases. In multivariable analysis, MDR/ESBL positivity (OR: 2.09, 95% CI: 1.24–3.50, p = 0.005), bacteremia (OR: 2.10, 95% CI: 1.32–3.35, p = 0.002), and SOFA score (OR: 1.53, 95% CI: 1.42–1.65, p < 0.001) were independently associated with in-hospital mortality. Age and altered mental status were also significant predictors, while CRP and procalcitonin lost significance after adjustment. Conclusions: UTIs in elderly patients are associated with substantial morbidity and mortality. Multidrug-resistant pathogens, bacteremia, and disease severity play a central role in determining outcomes. Early identification of high-risk patients using clinical severity scores and microbiological data may improve risk stratification and guide timely, targeted therapeutic interventions. Full article

Background: Pulmonary arterial hypertension is a rare but life-threatening condition in children, with hereditary forms often being linked to mutations in genes such as bone morphogenetic protein receptor type 2 (BMPR2), caveolin 1 (CAV1), and potassium channel subfamily K member 3 (KCNK3). Among these, CAV1 mutations are associated with severe disease phenotypes, though cases resulting from de novo heterozygous CAV1 mutations with multi-system involvement remain rarely reported. The CAV1 mutation (c.424C > T, p.Q142X) disrupts caveolin-1 function, leading to dysregulated pulmonary vascular remodeling and multi-system abnormalities. Methods: This was a retrospective case study of a pediatric patient with hereditary PAH. The patient was followed at our hospital from initial presentation until death. Clinical data were collected from medical records, including physical examinations, laboratory tests, echocardiography, chest X-ray, computed tomography pulmonary angiography (CTPA), and genetic analysis. The patient was treated sequentially with various PAH-targeted medications. This report also includes a review of the relevant literature on CAV1-associated PAH. Results: A female aged 3 years and 11 months was diagnosed with hereditary PAH associated with a de novo heterozygous CAV1 mutation (c.424C > T, p.Q142X). Both parents underwent genetic testing and were negative for the mutation, confirming its de novo origin. Clinical manifestations included special facial features, congenital telangiectasia, cutis marmorata (marbled skin), congenital cataract, hereditary lipodystrophy, and severe PAH. The patient presented with progressive exercise intolerance, syncope, and worsening dyspnea over nine years. Echocardiography revealed pulmonary hypertension with an estimated pulmonary artery systolic pressure of 69–105 mmHg, right heart enlargement, right ventricular hypertrophy, and moderate tricuspid regurgitation. Blood and urine metabolic screenings were normal. A chest X-ray showed progressive enlargement of the cardiac silhouette and bulging of the pulmonary artery segment. CTPA demonstrated pulmonary hypertension, secondary right heart dysfunction, decompensated right ventricular function, and mosaic perfusion in both lungs, suggestive of small arterial branch occlusion. Right heart catheterization was declined by the parents. Thus, the diagnosis of PAH was established based on clinical, echocardiographic, CTPA, and genetic findings. The patient was hospitalized four times and lost to follow-up from 2017 to 2023. She received sequential treatment with digoxin, hydrochlorothiazide, tadalafil, ambrisentan, selexipag, and treprostinil. Despite these therapies, pulmonary artery pressure continued to rise with progressive clinical deterioration. The patient ultimately died at 13 years of age due to a pulmonary hypertensive crisis and multiple organ failure following a severe episode of gastroenteritis. Conclusions: Despite aggressive treatment with multiple targeted reduced pulmonary artery pressure drug therapies, managing hereditary PAH caused by CAV1 mutations in children remains a significant challenge, with a high mortality rate. Early genetic diagnosis, regular follow-up, and individualized treatment are crucial. It requires the joint efforts of patients, parents, and healthcare providers. Full article

Background/Objectives: Bone fractures represent a growing public health concern worldwide, yet national epidemiological assessments remain limited in Brazil. Understanding temporal trends, demographic disparities, and geographic heterogeneity is essential to guide prevention, resource allocation, and trauma-care planning. To characterize the epidemiological profile of bone-fracture-related hospitalizations and mortality in Brazil between 2015 and 2024, analyzing trends by sex, age, fracture type, and geographic and ethnic distribution. Methods: An epidemiological, observational, descriptive, and population-based ecological study was conducted using Hospital Information System of the Unified Health System SIH/SUS and IBGE data. Hospitalization rates, case fatality rates (CFR), relative risks, odds ratios, and Years of Life Lost (YLL) were calculated. Temporal trends were evaluated using Annual Percent Change (APC). Results: Other limb fractures were the most frequent injuries, while femur fractures showed the highest lethality. Men had nearly twice the hospitalization rate of women, driven by high-energy trauma in adults aged 20–59 years, whereas women experienced a sharp increase in femur-fracture admissions at older ages. Skull, facial, and thorax/pelvis fractures contributed disproportionately to premature mortality. Marked geographic and ethnic disparities were observed, with higher burdens in the North/Northeast and predominance among Brown and Indigenous populations. Conclusions: Fracture-related hospitalizations in Brazil have increased consistently, with distinct epidemiological patterns across demographic and regional groups. These findings highlight the need for targeted prevention and improved trauma-care strategies. Full article

Background: The benefit of pharmaceutical innovation manifests when patients access treatment. Following regulatory approval in Europe and Canada, reimbursement decisions depend on health technology assessments (HTAs), which can be prolonged. To quantify the impact of delays on patients, we evaluated market access timelines for olaparib, osimertinib, durvalumab, acalabrutinib, and trastuzumab deruxtecan across six high-income countries with established HTA systems (Canada, England, France, Germany, Italy, Spain). Methods: Time to access was from regulatory approval to reimbursement. Survival benefit was median overall survival (OS) and progression-free survival (PFS) assessed versus the comparator at approval and the latest data cut-off. The number of eligible patients per year multiplied by the years to patient access and survival benefit reflects the lost survival benefit. Results: Efficacy benefits observed at approval continued to the latest data cut-offs. The mean time to patient access was 18 months. Although this varied by country and treatment, with England and Germany typically being the fastest and France and Spain the slowest, timelines often exceeded the 180-day EU target despite identical evidence used in HTA submissions. This resulted in an estimated mean of 2836 patients being unable to access treatment and 3391 OS-derived and 2739 PFS-derived life-years lost. Conclusions: Access processes must evolve to ensure the timely realization of new medicines’ benefits. Full article

Background: Liver cancer remains a persistent global health challenge due to its high occurrence and fatality rates, critically impacting health outcomes and quality of life. The disease burden in East Asia, considering China, Japan, South Korea, and Mongolia, is among the highest globally. This study aims to examine the patterns and trends of liver cancer in selected East Asian countries from 1990 to 2021. Methods: This study employed data from the Global Burden of Disease Study 2021 pertaining to key burden metrics—prevalence, incidence, mortality, years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs)—for selected East Asian countries from 1990 to 2021. Furthermore, the epidemiological trends and patterns were analyzed using decomposition analysis, Joinpoint regression, and age–period–cohort methods. Projections of the cancer burden through 2036 were generated using the Bayesian age–period–cohort model. Results: For all key indicators (incidence, prevalence, mortality, YLDs, YLLs, and DALYs), China had the highest values in both 1990 and 2021. The highest age-standardized rates for incidence (ASIR), mortality (ASMR), prevalence (ASPR), YLDs, YLLs, and DALYs (ASDR) were recorded in Mongolia. For all measured indicators of disease burden, the peak rates in each of the selected East Asian nations were consistently concentrated in the population aged 50 and above. Mongolia is forecasted to maintain the top-ranking ASIR values among the selected East Asian nations considered up to 2036. Conclusions: Over the past three decades, liver cancer has imposed a heavy disease burden on all selected East Asian nations, with rates being notably higher in the elderly population. These insights will provide policy-makers with evidence to guide public health strategies for disease prevention. Full article

3-Monochloropropanediol esters (3-MCPDEs) and glycidyl esters (GEs) are food processing contaminants that raise significant food safety concerns due to their established potential for carcinogenicity. This study aimed to determine the occurrence of 3-MCPDEs and GEs in common Malaysian food items and to evaluate the associated health risks through dietary exposure assessment. A total of 251 samples, consisting of retail products and cooked/prepared meals, were analysed using GC-MS. The food consumption data were obtained from published national food surveys. Risk was characterised using health-based guidance values (HBGVs) and margin of exposure (MOE), lifetime cancer risk (LCR), and disability-adjusted life year (DALY) estimates. 3-MCPDE was detected in 94.8% of samples (range: ND to 7.77 mg/kg), while GE was found in 83.3% of samples (range: ND to 9.41 mg/kg). The highest levels were consistently observed in refined vegetable fats and oil products, specifically shortening (3-MCPDE: 3.53 [IQR 2.76–5.16] mg/kg; GE: 4.78 [IQR 3.52–6.14] mg/kg) and margarine (3-MCPDE: 2.50 [IQR 1.11–3.59] mg/kg; GE: 3.60 [IQR 1.18–5.26] mg/kg). Exposure assessment identified fried rice as the largest contributor to total daily intake (3-MCPDE: 3.16 μg/kg BW/day; GE: 1.36 μg/kg BW/day). Total exposure to 3-MCPDE exceeded the provisional maximum tolerable daily intake (PMTDI) established by JECFA by 39.5%, indicating a potential health concern. Low MOE estimates (<10,000) for 3-MCPDE and GE were determined for several food categories, including snacks, kuih-muih, and fried cooked dishes. Chronic GE exposure was estimated to cause up to 6.9 (for mean consumers) and 24.9 (for high consumers) cancer cases per year, with total the DALYs quantified at 124.2 years lost per 100,000 of the population. These data represent a worst-case scenario; however, risks could be minimised through continued surveillance, mitigation strategies by relevant authorities regarding food processing, and informed dietary choices. Full article

The concept of “Healthocide,” first defined by Abi-Rached and colleagues, describes the deliberate and systematic destruction of health systems as a weapon of war. Nowhere is this phenomenon more extensively documented than in Gaza, where the collapse of healthcare infrastructure since October 2023 has been rapid, wide-ranging, and intentionally sustained. The consequence is not only immediate excess mortality, but also profound, long-term loss of population health measured in life-years, a metric that captures both premature death and reductions in expected lifespan. To address the aftermath of such destruction, we propose the framework of “Healthogenesis,” defined as a Palestinian-led, equity-driven, and rights-anchored approach to health system reconstruction in which international actors serve as enablers rather than agenda-setters. The aim of Healthogenesis is not merely to restore pre-war capacity, but to build a resilient, sovereign, and future-proof health ecosystem. Using available demographic and mortality data, we estimate that more than three million life-years have already been lost in Gaza since October 2023. Projection models suggest that an additional 1.1 to 2.2 million life-years could be lost over the coming decade unless an organized programme of reconstruction begins immediately. Quantifying harm in life-years reframes the discourse from moral outrage to measurable obligation. If Healthocide names the crime, then Healthogenesis outlines the cure: a coherent, data-anchored, ethically grounded roadmap for rebuilding a devastated health system and protecting the health futures of an entire population. Full article

Introduction: Smoking cigarettes is widely recognized as a significant risk factor for tooth loss. Objectives: The aim of this study was to assess the association between cigarette smoking, smoking cessation, and the number of remaining teeth in an adult population. Methods: Data from the Bialystok Plus population study, collected between November 2018 and January 2024, were analyzed. Participants were stratified into young (20–44 years), middle-aged (45–64 years), and older (65 years and above) groups. The outcome was the number of lost teeth. Smoking status (non-smoker vs. ever smoker and former smoker vs. current smoker) and smoking duration were the main independent variables. Additional variables included age, sex, dental habits and medical history. Risk factor analysis was done with generalized linear models using the negative binomial family. Results: Ever smoking was significantly associated with tooth count. Differences in the number of remaining teeth between former and current smokers were observed across age groups but not in the overall population. Current smokers exhibited a significantly greater decline in the number of teeth with an increasing fraction of life spent smoking compared to former smokers. Negative binomial regression models showed that ever smoking, when adjusted for age and diabetes, was a risk factor of tooth loss, but a protective effect of smoking cessation was not confirmed. Conclusions: This study confirmed that tobacco addiction is associated with tooth loss. Being a current smoker remained non-significant as a risk factor for tooth loss when compared to former smoker status. Full article

Post-harvest losses of fruits and vegetables are an important bottleneck in food systems of countries around the world, with 30–50% of perishable food items lost between farm and consumer, smallholder farmers in low-and-middle income countries (LMICs) with poor cold chain infrastructures facing a disproportionate burden. Evaporative cooling (EC) is a low-cost and energy-efficient alternative to mechanical refrigeration; however, traditional systems are operated in one position and are dependent on climate, which restricts its performance. The combination of Internet of Things (IoT) sensing, machine learning (ML), and the advanced control theory has made intelligent evaporative cooling systems (IECS) adaptive, data-driven platforms that can regulate the environment in real-time and optimise autonomously. This is a systematic literature review that was carried out according to PRISMA 2020, summarising 94 peer-reviewed articles published in 2018–2025 to map the technological landscape, performance indicators, and research directions of the field of post-harvest fruit and vegetable preservation using IECS. Findings indicate that IECS can considerably lower the storage temperatures, increase the shelf life by 50–200%, and reduce energy consumption by 75–90% compared to traditional refrigeration, and the payback period is as short as 1.2 years. In arid conditions, ML models are accurate in prediction with an R² of 0.98. The gaps in the research identified are a lack of validation in wet climatic conditions, non-existent standardised Ag-IoT protocols, inadequate Food–Energy–Water (FEW) nexus calculation, and no explainable AI (XAI) interfaces. An example of a conceptual framework of four layers synthesised is proposed to direct next-generation research and implementation of the IECS. Full article

Dengue continues to be a significant public health concern in Indonesia. However, a comprehensive assessment of long-term national trends in disease burden and fatality composition remains to be developed. Ecological time-series analysis for 20 years (2005–2024) was carried out using national surveillance data. Incidence, mortality, and disability-adjusted life year (DALY) rates were calculated using mid-year population estimates. Log-linear regression was applied to estimate the annual percentage change (APC). Joinpoint regression was used to assess potential trend inflection points. Case fatality rate (CFR) trends were examined using negative binomial regression. DALYs were decomposed into years of life lost (YLL) and years lived with disability (YLD). The results indicated that incidence rates did not demonstrate a significant long-term trend, while both mortality and DALY rates declined significantly over time. CFR decreased by approximately 2.2% annually (RR 0.978, 95% CI 0.969–0.987; p < 0.001). Although DALYs remained predominantly driven by premature mortality (>98%), the proportional contribution of YLL declined modestly but significantly over time. Despite persistent dengue transmission, fatal severity has substantially decreased in Indonesia over the past two decades (2005–2024). The findings suggest improved clinical outcomes and a modest structural shift in disease burden composition. Full article

Background and Objectives: Headaches have become one of the global public health burdens in the 21st century. Although findings on the presence of headaches in general and older adult populations have been well-documented, little evidence has been observed for university students. Moreover, their level of quality of life seems to be impaired due to stressful events and the inability to cope with them. However, the mutual relations between headaches and quality of life in this population remain unknown. Therefore, the main purpose of the study was to examine the associations between lifetime headaches and the presence of headaches in the last 12 months with quality of life. Materials and Methods: In total, 1350 university students (age = 22.9 ± 2.3 years; 81.3% female) were recruited. Each participant was instructed to fulfill the Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation (HARDSHIP) questionnaire, a reliable and valid tool to assess headache and quality-of-life characteristics. Headache characteristics, headache-related disability (HALT-90), and quality-of-life domains were analyzed using Spearman’s correlation analyses and structural equation modeling. Results: Participants with migraine reported more frequent and more intense headaches and substantially greater headache-related disability compared with those with tension-type or undifferentiated headache. The mean number of lost days in the previous 90 days (HALT-90) was 14.3 (SD 23.1) in the migraine group compared with 4.53 (SD 12.0) in the tension-type headache group and 5.77 (SD 10.9) in the undifferentiated headache group. Across most WHOQOL domains, students with migraine reported lower quality-of-life scores compared with other headache groups. The WHOQOL-8 total score averaged 30.9 (SD 4.79) in the migraine group and 33.6 (SD 3.93) among participants without headache. Greater headache burden was consistently associated with poorer quality of life, with headache-related disability showing the strongest correlation with energy for everyday life (r = −0.345, p < 0.001). Conclusions: These findings suggest that greater headache burden, particularly migraine and headache-related disability, is associated with poorer quality of life among university students. The results highlight the need for targeted prevention programs aimed at helping students manage stress more effectively and improve their quality of life. Full article