Search Results (472)

Background: Plant-based protein supplementation in supporting muscle recovery following resistance exercise remains an area of growing interest, particularly among vegan athletes, as a potential alternative to animal-based proteins. This systematic review aimed to evaluate the effectiveness of plant-based proteins on recovery from resistance exercise-induced muscle damage in healthy young adults. Methods: A systematic and comprehensive search was administered in eight databases up to 1 May 2025, identifying 1407 articles. Following deduplication and screening, 24 studies met the eligibility criteria, including 22 randomized controlled trials and 2 non-randomized studies, with the majority from high income western countries. Results: Interventions primarily involved soy, pea, rice, hemp, potato, and blended plant protein sources, with doses ranging from 15 to 50 g, typically administered post resistance exercise. Outcomes assessed included muscle protein synthesis (MPS), delayed-onset muscle soreness (DOMS), inflammatory biomarkers, muscle function, and fatigue. The review findings reaffirm that single-source plant proteins generally offer limited benefits compared to animal proteins such as whey, particularly in acute recovery settings, a limitation well-documented consistently in the literature. However, our synthesis highlights that well-formulated plant protein blends (e.g., combinations of pea, rice, and canola) can stimulate MPS at levels comparable to whey when consumed at adequate doses (≥30 g with ~2.5 g leucine). Some studies also reported improvements in subjective recovery outcomes and reductions in muscle damage biomarkers with soy or pea protein. However, overall evidence remains limited by small sample sizes, moderate to high risk of bias, and heterogeneity in intervention protocols, protein formulations, and outcome measures. Risk of bias assessments revealed concerns related to detection and reporting bias in nearly half the studies. Due to clinical and methodological variability, a meta-analysis was not conducted. Conclusion: plant-based proteins particularly in the form of protein blends and when dosed appropriately, may support muscle recovery in resistance-trained individuals and offer a viable alternative to animal-based proteins. However, further high-quality, long-term trials in vegan populations are needed to establish definitive recommendations for plant protein use in sports nutrition. Full article

The present study explores the innovative application of virtual reality (VR) in conducting the Radial Arm Maze (RAM) task, a performance-based test traditionally utilized for assessing spatial memory. This study aimed to develop a gamified version of the RAM implemented in immersive VR and investigate the interaction between the sense of presence, movement features, and performance within the RAM. We developed software supporting a head-mounted display (HMD), addressing prior limitations in the scientific literature concerning user interaction, data collection accuracy, operational flexibility, and immersion level. This study involved a sample of healthy young adults who engaged with the immersive VR version of the RAM, examining the influence of VR experience variables (sense of presence, motion sickness, and usability) on RAM performance. Notably, it also introduced the collection and analysis of movement features within the VR environment to ascertain their impact on performance outcomes and their relationship with VR experience variables. The VR application developed is notable for its user-friendliness, adaptability, and integration capability with physiological monitoring devices, marking a significant advance in utilizing VR for cognitive assessments. Findings from our study underscore the importance of VR experience factors in RAM performance, highlighting how a heightened sense of presence can predict better performance, thereby emphasizing engagement and immersion as crucial for task success in VR settings. Additionally, this study revealed how movement parameters within the VR environment, specifically speed and directness, significantly influence RAM performance, offering new insights into optimizing VR experiences for enhanced task performance. Full article

This comprehensive review examines the role of septoplasty in the pediatric population, emphasizing its therapeutic significance in relieving nasal obstruction and facilitating normal craniofacial growth. Despite the evident advantages of septoplasty, its application in young patients remains a subject of ongoing debate. This issue is primarily characterized by concerns regarding the still-developing immaturity of nasal cartilage, potential intraoperative and postoperative risks, and the current absence of robust data on long-term outcomes following septoplasty. Common complications such as bleeding, septal perforation, saddle nose deformity, and persistent nasal obstruction are reported in the literature; however, many studies lack long-term follow-up data on the incidence of these adverse events and revision rates, which may be higher compared to adult populations, often leading to the need for secondary surgical interventions. Strict inclusion criteria and comprehensive patient selection are paramount to maximize therapeutic success while minimizing complications. Current evidence suggests that appropriately indicated septoplasty can improve airway patency, support optimal facial development, and reduce the risk of secondary sinonasal pathology. There is a significant necessity for additional prospective, large-scale studies to establish standardized therapeutic guidelines and management strategies for this specific population, thereby ensuring effective and evidence-based pediatric otolaryngologic care. Full article

Background/Objectives: A growing body of literature has demonstrated that living with food insecurity (FI) increases risk for mental health concerns in addition to nutritional deficits (e.g., suboptimal micronutrient consumption, excessive macronutrient consumption, malnutrition). Yet, research is needed to improve our understanding of subpopulations potentially at increased risk for mental health concerns when living in the context of FI. The current study examined psychosocial health across women of different developmental life stages all living with FI. Methods: Female clients of a large, urban food bank (N = 680) living with FI completed measures of mental health and health-related quality of life (HRQOL) in a cross-sectional design conducted on site at the food bank. Results: Consistent with past research, FI severity was correlated with poorer psychosocial health across all variables. A multivariate analysis of covariance compared women living with FI across 4 developmental life stages (young adult, early midlife, late midlife, and older adult; age range = 18–94 years), controlling for FI severity and race/ethnicity, on outcomes related to mental health and HRQOL. Women in early and late midlife reported higher anxiety, eating disorder symptoms, and eating-related psychosocial impairment than younger and older women. Conclusions: The mental health toll of living with FI is profound; midlife may comprise a developmental period of increased vulnerability to experience this mental health burden of living with FI for women. Thus, efforts are needed to develop innovative pathways for interventions to support the mental health of midlife women living with FI, likely involving multi-level and/or multicomponent approaches to resource access. Full article

Background/Objectives: Biofeedback interventions are increasingly utilized in pediatric and adult care, with evidence in treating specific medical conditions and specific symptoms. However, evidence supporting their efficacy among children and adolescents and young adults (AYAs, aged 15–39) with cancer is limited. The aims of this systematic review are to present, assess, and synthesize the existing research on biofeedback in pediatric and AYA oncology, identify gaps in biofeedback research within this population, and provide recommendations for future research and clinical implications. Methods: A systematic search for articles was conducted using six bibliographic databases—PubMed/MEDLINE (NLM), EMBASE (Elsevier), CINAHL (EBSCO), SPORTDiscus (EBSCO), PsycINFO (OVID), and PEDro (NeuRA)—with an update on 5/7/2025. Included were studies involving pediatric/AYA oncology participants (0–39 years old) and those receiving at least one biofeedback modality. The methodological quality and risk of bias among included articles were assessed using the Cochrane Risk of Bias (ROB) Tool (modified version for non-randomized studies). A narrative synthesis of included studies examined the type of cancer studied, type of biofeedback used, study designs and methodological quality, and key outcomes evaluated. Results: While the literature suggests that biofeedback may offer beneficial outcomes for managing various pediatric/AYA oncology-related symptoms, such as pain, anxiety, and fatigue, only 8 studies out of 1013 screened (<1%) met inclusion criteria. Limitations included low study quality (small sample sizes, lack of control groups, and methodological inconsistencies). Conclusions: While biofeedback shows promise as a feasible and effective intervention, there is a call to action for well-designed, methodologically rigorous studies to substantiate its effectiveness and inform evidence-based practice specifically for pediatric/AYA oncology patients and clinicians. Full article

Background: Energy drinks (EDs) are non-alcoholic, functional beverages sold worldwide in more than 165 countries. These products are very popular and often consumed by children, teenagers, and young adults to improve physical performance, reduce drowsiness, and improve memory and concentration with increased intellectual effort. However, their consumption is associated with an increased risk of various health consequences. Objectives: The purpose of this non-systematic review was to discuss the components of EDs and their effects, summarize the AEs reported in the literature associated with the consumption of EDs, and briefly characterize the possible ED-related drug interactions. Methods: Scientific evidence was extracted by searching the databases PubMed and Google Scholar. In addition, the reference lists of the retrieved papers were reviewed and cross-referenced to reveal additional relevant scientific evidence. Results: The most common ingredients in EDs are caffeine, taurine, glucuronolactone, B vitamins, the vitamin-like compound inositol, and sweeteners (sugar, fructose, glucose–fructose syrup or artificial sweeteners). Although it is difficult to conclusively prove a cause-and-effect relationship between the consumption of EDs and the observed pathophysiological abnormalities, most scientific evidence (mostly clinical case reports) indicates that both occasional and especially chronic use of EDs is associated with the occurrence of numerous adverse effects (AEs). Among these, the best documented AEs are those on the cardiovascular system. It should also be noted that the components of EDs (primarily caffeine) may have drug interactions; therefore, EDs may be an important factor influencing the safety of pharmacotherapy in patients consuming EDs. Conclusions: Consuming energy drinks lead to various health problems and may interfere with pharmacotherapy due to the potential development of drug interactions. Due to the widespread availability of EDs, their suggestive advertising aimed at the youngest customers, and ambiguous regulations, new legislative policies are required to limit the widespread consumption of such products and their negative health effects. Full article

Background: This review explores the influence of eco-anxiety on sustainable consumption, with a specific focus on the urban context. While the literature on green consumerism continues to expand, the role of emotional and psychological factors, especially eco-anxiety, in shaping sustainable consumption decisions remains underexplored. Most existing studies emphasize cognitive, social, or contextual drivers, often overlooking affective dimensions that may significantly influence consumer behavior. Addressing this gap, the review examines how emotional responses to climate change, such as eco-anxiety, inform and potentially motivate eco-friendly consumption patterns. Understanding these affective pathways offers valuable insights on how individuals and urban communities can effectively adapt to climate change and establish a sustainable consumption culture. Methods: A systematic literature search was conducted in Scopus and Web of Sciences databases, following a predefined keyword strategy, resulting in 56 initial records. We further implemented a supplementary search of gray literature on Google Scholar to search for additional reports. The full-text screening process identified 12 eligible studies based on the following inclusion criteria: quantitative or mixed-methods studies focusing on adult and young adult individuals, including both measures of eco-anxiety and green consumption and assessing their direct or indirect relationship. Results: Findings suggest that eco-anxiety functions as a cognitive–affective motivator for sustainable consumer choices; however, the strength and direction of this influence appear contingent on moderating emotional and psychological variables and cross-cultural and demographic moderators. Discussion: This review highlights the need for urban-focused intervention tailored communication, marketing, and business strategies that address the emotional dimensions of climate change. Policymakers and businesses are encouraged to consider affective drivers as eco-anxiety to promote sustainable consumption stewardship within urban communities. By addressing these psychological responses, urban societies can become more resilient and proactive in confronting climate change challenges. Full article

Objectives: This systematic literature review aimed to identify studies assessing the clinical efficacy and real-world effectiveness of current and emerging treatments for Fabry disease. Methods: Searches of the MEDLINE, EMBASE, and Cochrane library databases, as well as relevant congress proceedings, were conducted to identify publications reporting on studies in patients of any age, sex, race, or ethnicity who received any approved or experimental treatment for Fabry disease, published before 17 June 2024. Results: Of 1881 publications screened, 234 reported data on renal, cardiac, cerebrovascular, and disease severity outcomes from 225 studies. The majority of reported studies were observational in nature (n = 150; 67%) and involved only adults (n = 172; 74%). Study designs and patient populations were highly heterogeneous, and cross-study conclusions about the effectiveness of different therapies could not be made. Enzyme replacement therapy (ERT) with agalsidase alfa or agalsidase beta stabilized renal function and cardiac structure in patients with Fabry disease. Early initiation of ERT in childhood or young adulthood was associated with better renal and cardiac outcomes than treatment initiation at a later age. The small number of comparator studies of agalsidase alfa and agalsidase beta suggested similar efficacy. Patients treated with migalastat and pegunigalsidase alfa also maintained stable renal function and cardiac structure. Conclusions: Overall, current treatments slow the progression of renal and cardiac decline in patients with Fabry disease. Large cohort studies with long-term follow-up and baseline stratification based on clinical phenotype are needed to address evidence gaps and provide clinicians with robust data to inform treatment decisions. Full article

Background: Bertolotti syndrome describes a painful lumbosacral transitional vertebra (LSTV) with a pseudoarticulation between an enlarged lateral process of the caudal lumbar vertebra (L5) and ilium or sacrum. It often presents with chronic lower back pain with or without radiculopathy. The current literature emphasizes Bertolotti as a differential diagnosis in young adults. However, it is presumably underdiagnosed in middle-aged and older patients. Treatment ranges from conservative treatment with physiotherapy, infiltration, and radiofrequency ablation to surgical interventions. Case Description: In this case illustration, we present the diagnostic and therapeutic challenges in a 48-year-old female triathlete with persistent left gluteal pain caused by Bertolotti syndrome. When conservative treatment with physiotherapy, infiltrations, thermocoagulation, and radiofrequency ablation of the pseudoarticulation failed, microsurgical reduction of the hypertrophic transverse process was performed. This minimally invasive intervention achieved satisfactory pain relief of at least 70% one year after surgery, allowing the patient to resume her athletic activities. Conclusions: Bertolotti syndrome should be considered a potential differential diagnosis in patients of all ages. Since many patients endure years of misdiagnosis, adequate treatment is crucial upon diagnosis. If conservative measures fail, surgical treatment such as “processectomy” or spinal fusion should be evaluated. This case follows the CARE reporting guidelines. Full article

This article presents a structured review of literature published between 2015 and 2025 on the experiences of rural LGBTQIA+ youth. Using targeted search terms—including “LGBT*,” “rural,” “country,” “young people,” “sexual and gender minority (SGM),” “small town,” “youth,” and “students”—a research team identified 26 peer-reviewed articles that met inclusion criteria. Through team-based thematic analysis, six core themes emerged: (1) gaps in intersectional analysis, (2) mental health outcomes, (3) culturally responsive services and resources, (4) community climate and context, (5) experiences of victimization, and (6) policy. Across these themes, the review highlights the resilience, agency, and strength of LGBTQIA+ youth navigating rural environments. The literature consistently demonstrates how experiences of victimization are closely linked to mental health outcomes, while access to social support—particularly from affirming adults in systems (such as schools)—can mitigate harm and foster well-being. Implications for social work research, practice, and policy are discussed, with an emphasis on supporting LGBTQIA+ youth in U.S. Southern rural settings. Full article

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory disorder primarily affecting adults. The disease in pediatric age is unusual and preferentially affects adolescents. In contrast to adults, who commonly exhibit the involvement of multiple organs simultaneously or sequentially over time, young patients tend to present with a localized disease, typically affecting the orbits. Proptosis, ptosis, diplopia, and restricted eye movement may be observed in these patients. Symptoms are proteiform, and the disease is chronic and indolent with a relapsing–remitting course. Diagnostic criteria have been developed for adults, which may not fully capture the pediatric disease phenotype. If untreated or poorly managed, IgG4-RD can lead to progressive fibrosis and scarring of affected organs, potentially causing irreversible damage. We conducted a narrative review using the IMRAD approach, presenting a nonsystematic analysis of the literature on pediatric IgG4-RD. Original papers, case reports/series, and relevant reviews in English were selected from PubMed, EMBASE, and Web of Science up to January 2024. Keywords included “IgG4-Related Disease” and “pediatric” and, additionally, we presented two original pediatric cases. Our purpose is to offer an overview of IgG4-RD manifestations, and challenges in diagnosing and managing this rare condition in children. Full article

Background: The rising focus on dietary choices has contributed to maladaptive eating patterns, including orthorexia nervosa (ON)—a pathological preoccupation with healthy eating. This study investigated ON prevalence and correlates in two Polish young adult cohorts to address inconsistencies in the existing literature and ON’s ambiguous nosological status. We explored its complex interplay with specific lifestyle and sociodemographic factors. Methods: The study sample consisted of 412 young adults, comprising Group 1 (G1; n = 136; 95 women, 38 men, and 3 non-binary individuals) and Group 2 (G2; n = 264; 194 women, 65 men, and 5 non-binary individuals). Data collection utilized a proprietary questionnaire for sociodemographic and health, the ORTO-15 questionnaire (cut-off < 35 points) for ON risk, and the EAT-26 for eating disorder (ED) risk. Depression was self-assessed. An analysis of sociodemographic, clinical, and lifestyle data was conducted to explore the association with orthorexia risk. Results: ON risk was identified in 26.5% of participants in G1 and 76.8% in G2. Logistic regression analysis identified different, independent predictors of ON risk for each group. In G1, these were depressive symptoms (OR = 2.52) and a co-occurring risk of eating disorders (ED) (OR = 11.37). In contrast, for G2, the predictors were smoking (OR = 2.14) and, inversely, a lower ED risk (OR = 0.16). No consistent associations were found with ON risk and age, gender, education, residence, or occupational status. Conclusions: This study confirms a strong link between ON and other eating disorders. The high ON prevalence in G2, combined with low internal consistency of ORTO-15, suggests tool limitations in specific populations. These findings highlight the need for more precise ON diagnostic tools and further research into its correlates, including body image, specific lifestyle factors, and its role within eating pathology. Full article

Young athletes face unique nutritional challenges due to their simultaneous engagement in intensive physical training and ongoing growth and development. Standard adult-based dietary recommendations often fail to meet the specific needs of this population. While the role of macronutrients and micronutrients is well recognized, increasing attention is being paid to bioactive compounds—non-essential food-derived elements with potential health benefits. This review aims to summarize current evidence regarding the efficacy, safety, and potential benefits of bioactive compounds in the nutritional management of young athletes. Methods: A narrative review of the literature published over the last 30 years was conducted across PubMed/Medline, Embase, and Scopus databases to identify relevant studies published in English. The inclusion criteria covered original research articles, clinical trials, cohort and case-control studies, and meta-analyses focusing on individuals aged 8–20 years. Studies addressing supplementation strategies, physiological effects, and safety concerns of bioactive compounds in young athletes were selected. Preclinical data and adult-based studies were also included to contextualize molecular mechanisms and support clinical findings. Results: The review highlights that bioactive compounds such as omega-3 fatty acids, curcumin, caffeine, and creatine as well as antioxidant vitamins may play a beneficial role in improving recovery, immune function, and performance in young athletes. Of these 21 studies, 8 focused on recovery and muscle soreness, 6 addressed immune function or antioxidant/anti-inflammatory effects, and 7 investigated direct performance enhancement. However, most of the available evidence derives from adult populations, and pediatric-specific data remain limited. Concerns remain about the misuse of supplements, lack of professional guidance, and potential contamination with banned substances. Conclusions: While some bioactive compounds show promising potential to support the health and performance of young athletes, current evidence is insufficient to support routine use in this population. More pediatric-specific research is necessary to establish safety, efficacy, and appropriate supplementation protocols tailored to young athletes’ unique physiological needs. Full article

Fanconi anemia (FA) is characterized by faulty DNA repair and is associated with bone marrow failure, acute myeloid leukemia (AML), and myelodysplastic syndrome (MDS). Because of the more widespread use of next-generation sequencing (NGS) and increased testing for germline mutations in young patients with MDS and AML, FA is increasingly being first diagnosed in adults, many of whom lack classical physical stigmata. Hematopoietic stem cell transplant is the only cure for the hematologic manifestations of FA but there are several unique considerations in FA patients, including first maintaining a high index of suspicion for the diagnosis in patients with minimal phenotypic abnormalities, second an exaggerated sensitivity to alkylating agents and radiation, precluding the use of standard myeloablative conditioning regimens despite the young age of most of the patients, and lastly a marked propensity for squamous cell cancers of the upper aerodigestive tract and anogenital region, likely further increased by the drugs used in conditioning and by chronic inflammation in patients who develop graft-versus-host disease. Despite a growing number of FA patients surviving into adulthood or first being diagnosed with FA as an adult, there is minimal literature describing transplant methodology and outcomes. In the following case-based review of a patient, we incorporate recent findings from the literature on the care of this challenging patient population. Full article

Headache represents one of the most prevalent and disabling conditions in the pediatric population, with significant repercussions on mental and psychological well-being, as well as on academic achievement and social functioning, ultimately leading to a marked reduction in quality of life. Currently, the diagnosis of headache is based on the clinical criteria of the third edition of the International Classification of Headache Disorders (ICHD-3). However, the characteristics of headache may differ between adults and children, as well as the ability of children to provide a complete description of the pain and associated symptoms. The immature narrative skills of children can represent a limitation in defining the clinical phenotype of headache, making the diagnosis more complex. This is even more challenging when extracting information about the characteristics of the headache in children whose verbal expression is poorly developed or completely absent. Given these limitations, clinical psychology has long used drawing as an effective diagnostic instrument to bypass verbal communication barriers. This tool provides unique access to children’s psychological and emotional states, as a direct window into their inner world and as an expressive medium that often generates more detailed, accurate, and clinically actionable information, compared to verbal reports alone. For these reasons, drawing has been recognized as a valuable diagnostic tool for decades, with multiple studies demonstrating specificity and accuracy rates comparable to standard clinical assessments. Particularly for young children, drawings may give access to fundamental information that might otherwise remain inaccessible, thereby allowing both accurate diagnosis and individualized treatment planning. Multiple studies have highlighted and confirmed the graphic differences between representations of various types of headaches and the undeniable utility of an “artistic diagnosis” alongside the clinical one. Furthermore, the literature suggests and encourages the use of drawing in clinical practice, both in the diagnostic process and during subsequent follow-up, as an effective, enjoyable, easy-to-use, and low-cost resource. Accordingly, we propose a narrative review accompanied by a curated collection of drawings that may help identify and categorize specific correlations between graphic representations and clinical phenotypes, such as pain location, quality, intensity, association with nausea and vomiting, photophobia and phonophobia, and types of migraine aura. Our goal is to create a visual reference that can aid clinicians in the accurate interpretation of children’s drawings. Additionally, we aim to promote the integration of this method into routine clinical practice to improve diagnostic precision and support a more child-centered model of care. We also hope to propose new iconographic models to further enrich the diagnostic framework. Full article