Search Results (729)

This study examines how Ontario’s Health and Physical Education curriculum addresses the needs of young adults with disabilities. A total of 54 individuals aged 18–35 years old with developmental, learning, or physical disabilities who had completed secondary school in Ontario participated in a cross-sectional mixed-methods survey. Participants were recruited through disability-focused community networks and a university psychology participant pool. They completed the Sex Education subscale of the Sexual Knowledge, Experience, Feelings and Needs Scale, a 35-item sexual knowledge questionnaire, and open-ended questions. Quantitative data were analyzed using descriptive statistics and independent samples t-tests; qualitative responses were examined using thematic analysis. Participants reported limited factual knowledge, minimal classroom representation, and heavy reliance on independent learning. Barriers included inaccessible materials, teacher discomfort, and the absence of disability narratives in sexuality units. Findings point to three priorities: revising curriculum content, expanding educator training, and creating disability-affirming resources. These measures will help ensure comprehensive and rights-based sexuality education that supports the autonomy and well-being of students with disabilities. 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

Prolactin is a hormone with demonstrated roles in the brain, including neurogenesis, neuroprotection, learning, stress response or memory consolidation. To determine the prolactin expression in the rat hippocampus during aging and to resolve some controversies related to the presence of prolactin in the hippocampus, the aim of this study was to analyze whether changes occur in the expression of prolactin during different stages of life. To determine this, we designed an experimental study in which we analyzed the expression and location of prolactin in the rat hippocampus, Ammon’s horn and Dentate Gyrus, during different stages of life (prepubertal, postpubertal, young adult, adult and old) and checked if there are differences related to sex. Overall, the results obtained show that prolactin is present in the rat hippocampus and that prolactin is synthesized, as deduced from the findings obtained via ELISA, immunohistochemistry, qPCR and in situ hybridization. After analyzing the correlation between serum and hippocampal prolactin levels and comparing the amounts of Prl mRNA and the hormone, the results obtained suggest that hippocampal prolactin has a dual origin: local synthesis of the hormone and its passage from the blood. On the other hand, the amounts of prolactin and its mRNA in the hippocampus vary with sex and age, suggesting the existence of age-related sexual dimorphism. The results obtained suggest that hippocampal aging is related to a decrease in the hippocampal prolactin system, which helps to better understand brain aging. Full article

Background/Objectives: The incidence and prevalence of ischemic stroke, a leading cause of death and disability worldwide, are significantly higher in older adults than in younger individuals. Senescence induces a variety of biological changes that influence the pathogenesis of diseases such as ischemic stroke, thereby necessitating age-specific medical treatments. However, the molecular mechanisms underlying age-related differences in ischemic stroke progression remain poorly understood. Methods: We compared the histological and molecular features of ischemic stroke in a photothrombotic mouse model, focusing on 9-week-old (young) and 90-week-old (old) mice. Results: We found that microglial accumulation at the infarct region of the cerebral cortex was significantly lower in old mice than in young ones. This reduction in the microglial response was accompanied by a decrease in the morphological robustness of the astrocytes forming the glial scar. Furthermore, the mRNA expression of proinflammatory cytokines CXCL10, CCL2, and TNF-α, which were upregulated in the infarct region, was considerably higher in the old mice than in the young ones. Cytokine expression was well correlated with the mRNA levels of Toll-like receptor 4 (TLR4), a key regulator of neuroinflammation in old mice, but less correlated with them in young mice. Interestingly, Tlr4 mRNA expression in young mice was negatively correlated with the mRNA expression of the epigenetic regulator HDAC7, whereas this correlation was positive in old mice. Conclusions: These findings suggest that age-dependent changes in epigenetic regulation, such as the interaction between HDAC7 and TLR4, may contribute to the distinct pathological progression of ischemic stroke in older individuals. Full article

Background/Objectives: Traumatic brain injury (TBI) is a global public health concern, affecting over 60 million people annually. It is associated with high rates of mortality and disability, particularly among young and economically active individuals, and remains the leading cause of death in people under 40 years of age. Although computed tomography (CT) is the standard method for excluding intracranial bleeding (ICB), it is frequently unavailable in resource-limited settings where the burden of TBI is greatest. The InfraScanner 2000 is a near-infrared spectroscopy (NIRS) device designed to detect ICB and may serve as a triage tool in environments without access to CT imaging. This study aimed to evaluate the diagnostic performance of the InfraScanner 2000 for detecting ICB in the emergency department (ED) of a trauma center in a cohort of Colombian patients with TBI. Methods: This prospective study was conducted in Cali, Colombia, between December 2019 and February 2021. Adult patients presenting to the ED with blunt TBI were enrolled. InfraScanner assessments were performed according to a standardized protocol, and all participants underwent head CT within 6 h of injury. Results: A total of 140 patients were included. Of these, 66% were male and 34% were female. Most patients (63.57%) were between 18 and 39 years old, with a median age of 39 years (IQR: 18–86). The InfraScanner demonstrated a sensitivity of 60.0% (95% CI: 32.5–84.8), specificity of 78.4% (95% CI: 71.2–85.6), positive predictive value (PPV) of 25.0%, and negative predictive value (NPV) of 94.2% for detecting ICB. Conclusions: The InfraScanner 2000 showed good specificity and high NPV in identifying ICB among Colombian patients with TBI. These findings suggest it could serve as a useful triage tool to support decision-making in emergency settings with limited access to CT imaging. Full article

Background: Longitudinal studies on cognitive disengagement syndrome (CDS) are scarce, and only one study has investigated the trajectory of CDS from childhood to early adulthood. Given this, the aims of the present study were to explore, with a quasi-longitudinal design, (1) whether scores for childhood CDS were associated with scores for CDS during early adulthood; (2) whether childhood CDS scores were associated with childhood and adult scores for depression, anxiety, stress, and insomnia; (3) whether childhood CDS, depression, anxiety, stress, and insomnia and adult depression, anxiety, stress, and insomnia were independently associated with adult scores for CDS, and (4) whether childhood CDS scores were directly and indirectly associated with adult CDS scores via adult depression and stress in two conditional effect models. Methods: A total of 246 young adult students (mean age = 22.62; 56.3% females) participated in a cross-sectional and quasi-longitudinal study. The participants completed questionnaires assessing CDS (Adult Concentration Inventory; ACI), depression, anxiety, stress, and insomnia for the following two developmental periods: for the present time point as young adults and for a past time point, when they were about eight years old. To enable retrospective past recall, the participants undertook a standardized imagination exercise. Results: Childhood scores for CDS, depression, anxiety, stress, and insomnia were highly associated with adult scores for CDS, depression, anxiety, stress, and insomnia. In the regression model, higher childhood scores for CDS, depression, and anxiety and higher adult scores for depression, stress, and insomnia, but not adult anxiety, were strongly and independently associated with adult scores for CDS. In the two conditional effects models, childhood CDS was associated with adult CDS directly and indirectly via adult depression and adult stress. Conclusions: In this quasi-longitudinal study, childhood scores for CDS were associated with adult scores for CDS, suggesting a potentially stable trajectory of CDS from childhood to early adulthood. Further, the two conditional effects models suggested that childhood and adult CDS were both directly and indirectly associated via adult depression and stress. As such, symptoms of depression, anxiety, stress, and insomnia should be considered in conceptualizations of adult CDS. Next, given that standardized psychotherapeutic interventions for depression, stress, and insomnia are available, such interventions might also favorably impact CDS symptoms. These findings further underscore the importance of prospective longitudinal and intervention studies on adult CDS. Full article

Background/Objectives: Schwannoma is a rare tumor, typical in young adults, originating from the myelin sheath that surrounds Schwann cells. It can occur in any part of the Peripheral Nervous System (PNS). It develops in the head and neck region in 25–48% of cases, and the eighth pair of cranial nerves (vestibulocochlear nerves) are the most hit (vestibular schwannoma). Oral cavity involvement is exceedingly rare, accounting for about 1–2% of all cases. The most affected oral site is the tongue, especially its anterior third, while localization on the lip is one of the least common sites for the development of this lesion. Case Presentation: A lower lip schwannoma on a 17-year-old boy, present for about 7 years, was documented. Material and Methods: PubMed and Google Scholar were used as research engines; English scientific works published in the last 20 years (2005–2024) regarding oral cavity involvement, using the keywords “Schwannoma”, “Oral Schwannoma”, “Pediatric Oral Schwannoma”, and “Schwannoma of the lip”, were considered. Results: In total, 805 and 16,890 items were found on PubMed and Google Scholar search engines, respectively. After title, abstract, full text evaluation, and elimination of duplicates, 26 articles were included in the review process. Discussion: Clinically, oral schwannoma presents as an asymptomatic hard–elastic fluctuating mass, often misdiagnosed on the lip as a traumatic or inflammatory lesion (e.g., mucocele). Biopsy is mandatory, and histological examination reveals positivity to the neuronal marker S-100. Conclusions: Complete excision also prevents recurrence. Malignant transformation is extremely rare. Full article

(1) Background: The provision of monofunctional or inadequately distributed services in urban park green spaces often constrains residents’ opportunities and diversity for outdoor activities, particularly limiting access and participation for specific age groups or activity preferences. However, functional nodes with temporal and spatial flexibility demonstrate high-quality characteristics of resilient and shared services through integrated development. Accurately identifying user demand provides a solid basis for optimizing the functional configuration of urban parks. (2) Methods: This study took the old city area of Zhengzhou, Henan Province, China, as a case study. By collecting and integrating various types of data, such as geographic spatial data, field investigation data, and behavioral observations, we developed a population demand quantification method and a modular analysis approach for park service functions. This framework enabled correlation analysis between diverse user needs and park services. The study further classified and combined park functions into modular units, quantifying their elastic and shared service capabilities—namely, the adaptive flexibility and shared utilization capacity of park services. Additionally, we established a demand-responsive evaluation system for identifying and diagnosing problem areas in park services based on multi-source data. (3) Results: The demand response index and diagnostic results indicate that the supply of fitness facilities—particularly equipment-based installations—is insufficient within the old urban district of Zhengzhou. Among the three user groups—children, young and middle-aged adults, and the elderly—the elderly population exhibited the lowest demand response index, revealing a significant gap in meeting their specific needs. (4) Conclusions: Based on the research findings, a three-tier optimization strategy is proposed: A. improve green space connectivity to expand the service coverage of parks; B. implement multifunctional overlay and coordinated integration in spatial design based on site characteristics and demand diagnostics; and C. increase the total supply of facilities to enhance spatial efficiency in parks. By integrating the demand assessment data and diagnostic results, this approach enabled a data-driven reorganization of service types and targeted allocation of resources within existing park infrastructure, offering a practical tool and reference for the planning of urban outdoor activity spaces. 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

Background and clinical significance: Ectopic ureters are a rare urinary tract malformation, typically diagnosed in childhood and infrequently in adulthood. The prenatal detection by ultrasound and magnetic resonance imaging (MRI) of this clinical entity has scarcely been reported. Careful foetal scanning during the late second and third trimester might provide clues and lead to prenatal detection. However, even the postnatal diagnosis is challenging, and often delayed towards adulthood, since the condition may present with nonspecific symptoms, leading to underdiagnosis or misdiagnosis. In female patients, approximately 25% of ectopic ureters open into the vagina. Due to the high risk of recurrent urinary tract infections and the potential development of uretero-hydronephrosis, timely diagnosis is essential, and prompt surgical correction is mandated. Case presentation: We report the case of a 33-year-old GII PI patient diagnosed with cystic dysplasia of the left foetal kidney at the 16 WG (weeks of gestation) scan. The malformation was consistent at 21 WG when karyotyping by amniocentesis identified a normal female molecular karyotype. MRI performed at 28 weeks confirmed the left renal dysplasia and raised the suspicion of an abnormal insertion of the left ureter into the vagina. After delivery, the vaginal ureteral ectopy was confirmed at 3 weeks postpartum via cystoscopy. Postpartum whole exome sequencing identified a variant of uncertain significance (VUS) mutation in the SOX 13 gene (SRY-box transcription factor 13). Renal scintigraphy performed 7 months postnatally identified a hypo/afunctional left kidney which led to the indication of nephrectomy by the paediatric urologist. The surgical intervention was performed at 8 months postpartum with a favourable outcome. Conclusions: Ectopic ureters are a pathology generating life-long morbidity and discomfort of the offspring and young adult. Awareness to this pathology must be raised among clinicians, especially regarding the potential detection by minute prenatal ultrasound examinations, followed by MRI to refine diagnosis. Postnatally, the persistence of suspicious yet unspecific symptoms, in both males and females, must trigger thorough imaging/cystoscopic examination to reach diagnosis and provide correct management. Full article

Many studies have focused on ageing and gut microbiota, but the correlation between gut microbiota and physical function in older adults, especially those with longevity, remains obscure and deserves further exploration. In this study we investigated changes in the gut microbiota and the association between gut microbiota and physical function in adults with longevity. This is a prospective observational study. Fifty-one older adults aged ≥ 60 years (including 27 participants aged 90 years and above) were enrolled. Information on clinical data, physical function including intrinsic capacity by Integrated Care for Older People (ICOPE) tool, and dietary habits of participants was collected and analysed. Gut microbiota structure and functional pathways were analysed by Metagenomics. Intrinsic capacity (measured as ICOPE scores) of adults’ longevity (aged 90–98, longe group) was significantly lower than older adults aged 60–89 years (CON group) (5.44 ± 2.15 vs. 6.71 ± 1.46, p = 0.017). Gut microbiota of the longe group is enriched in Akkermansia and Bifidobacterium, which may be beneficial to health. Gut microbiota was closely related to daily milk (including plain milk, flavoured milk with a content of cow’s milk or reconstituted milk of ≥80%, or reconstituted milk or fermented milk with a content of cow’s milk or milk powder of ≥80%) consumption, anxiety, and physical function including grip strength by the Short Physical Performance Battery (SPPB). Bacteroides plebeius and Bacteroides eggerthii were increased in long-living adults with better physical function. Escherichia coli was more abundant in frail young-old adults. Grip strength is positively correlated with the abundance of Roseburia hominis, Eubacterium rectale, Eubacterium eligens, and Roseburia intestinalis (p < 0.05). Pathways related to amino acid synthesis that include L-isoleucine, L-valine, and L-threonine were over-presented in long-living adults of better physical function. Adults with longevity showed comparable gut microbiota abundance to younger elderly individuals. The gut microbiota of long-living adults showed higher abundance of potentially beneficial bacteria, and the altered bacteria are closely associated with physical function. Changes in the gut microbiota may precede clinical indicators during the process of ageing. Gut microbiota may be a potential biomarker for longevity and healthy ageing. Nutrition and emotional state can be important influencing factors. Full article

Historical cross-sectional approaches examining cognitive aging consistently reveal a pattern of steady decline on nonverbal problem-solving, speeded tasks, and maintenance on verbal tasks. However, as measures developed and broadened the factor structure to align with Cattell–Horn–Carroll (CHC) theory, and age ranges were extended from 75 to 90 years, a more nuanced approach to cognitive aging emerged. The present study, using the Wechsler Adult Intelligence Scale, Fifth Edition (WAIS-5), examined the cognitive aging process through a cross-sectional approach. WAIS-5 normative sample data (aligned with the 2022 U.S. census) were obtained from the test publisher. The sample included adult participants aged 20–24 through 85–90 (n = 1660), which were mapped into 11 age groups. Using post-stratification weighting to control for educational attainment, cognitive decline was observed throughout aging; verbal skills were maintained longer than other abilities, while processing speed declined steadily and rapidly from young adulthood to old age. Working memory was vulnerable to the aging process but demonstrated slower patterns of decline than the other vulnerable abilities. Fluid reasoning and visual spatial skills (although aligning with separate CHC broad abilities theoretically) were strikingly similar in their pattern of decline across a person’s lifespan. Results are highly consistent with the large body of cross-sectional research conducted during the previous generation by Salthouse and his colleagues, as well as other teams of researchers. Full article

Young children are particularly vulnerable to measles infections. Investigating the gap between the waning of maternal antibodies and onset of vaccination-induced immunity via seroprevalence studies can be hampered by recruiting enough young-aged participants. We present measles IgG-antibody results from 2148 patients aged 0 to 2 years, who were hospitalized with acute aseptic meningitis or encephalitis in Lower Saxony or Bremen. Measles serology was performed for differential diagnostics clarification of neurotropic pathogens, during syndromic surveillance between 2006 and 2024. At birth, 79% of children presented with measles IgG-antibodies, but only 30% of three-month-old patients and 11% of five-month-olds. From 0 to 10 months, seropositivity declined monthly by 8%. Over 95% of children aged six to 11 months were unprotected. From 11 months onwards, measles seroprevalence increased, reaching 80–90% towards the end of the second year of life. Our results indicate an absence of maternal measles IgG antibodies after nine months of age and that vaccination starts around 11 months of age; however, not all children had received vaccination by their second birthday. These findings confirm the current recommendation to advance first measles vaccination to nine months in high-exposure settings and support efforts to increase vaccination rates in small children and young adults. Full article

Introduction: Methadone, a synthetic opioid used for opioid substitution therapy (OST), is typically associated with arrhythmias rather than direct myocardial depression. Neurological complications, especially with concurrent antipsychotic use, have also been reported. Acute left ventricular failure in young adults is uncommon and often linked to genetic or infectious causes. We present a rare case of reversible cardiogenic shock and cerebellar insult due to methadone toxicity. Case Presentation: A 37-year-old man with a history of drug abuse on OST with methadone (130 mg/day) was admitted to the ICU with hemodynamic instability, seizures, and focal neurological deficits. Diagnostic workup revealed low cardiac output syndrome and a right cerebellar insult, attributed to methadone toxicity. The patient received individualized catecholamine support. After 10 days in the ICU, he was transferred to a general ward for ongoing cardiac and neurological rehabilitation and discharged in stable condition seven days later. Conclusions: Methadone-induced reversible left ventricular failure, particularly when accompanied by cerebellar insult, is rare but potentially life-threatening. Early recognition and multidisciplinary management are essential for full recovery in such complex toxicological presentations. Full article

Hypertrophic cardiomyopathy (HCM) is the most prevalent acquired heart disease in cats and shares many clinical, phenotypical and pathological features with human HCM. Despite its relevance, knowledge on the pathomechanisms underlying the disease is limited. The present study aimed to characterize the molecular phenotypic changes in cardiomyocytes in feline HCM (fHCM) to better understand their contribution to the pathogenesis. To achieve this, the myocardium of the left ventricular free wall of 15 cats with confirmed fHCM and 30 control cats (two age groups: 16 cats 18-month-old, and 14 older adult cats without cardiac disease) were subjected to RT-qPCRs for markers representative of cardiomyocyte function. Overall, all markers were expressed at the highest level in young control cats, and increasing age correlated with decreased expression, regardless of sex. The comparison between the older adult control cats and those with HCM showed increased transcription levels for most markers associated with the disease, and higher expression of all markers in affected male cats compared to females. The constitutive transcription of all markers provides evidence of continuous myocardial adaptation throughout cats’ life. The high transcription values in the myocardium of young healthy cats and male cats affected by HCM suggest a particularly high myocardial responsiveness early in life and with HCM and reveal sex as relevant factor in the disease process. These results support the relevance of age and sex in the cardiac response to HCM in feline hearts. Full article