Search Results (1,697)

Background: Foods containing nutraceuticals from the mineral element group are being developed to compensate for the problem of deficiency in billions of people around the world. This research focuses on essential elements of patented cereal-based mixtures to complement the deficiencies of these elements and, at the same time, assesses their safety in terms of toxic elements in the human diet. Methods: The mineral and trace element contents in the mixtures were determined using the ICP-MS method with a subsequent evaluation of the contributions of the mixtures to the essential and toxic reference values based on dietary intakes and exposures for adults at 60, 80 and 100 kg of adult body weight and a portion size of 50 g. The potential health risk was evaluated using a metal pollution index. Results: The concentrations of minerals and trace elements in the cereal-based mixtures analyzed were as follows: K (up to 4150 µg/g) ≥ P > Mg > Ca > Na > Fe > Zn > Mn > Cu > Al > Ba (up to 4.40 µg/g) > Sr (up to 480 ng/g) ≥ Ti ≥ Ni > Ce ≥ Co > As ≥ Cs > Ag ≥ Li > Se > Be > Cr > Tl > Pb ≥ Hg > Ho > Cd > Sn (up to 1.12 ng/g). The mixtures contribute significantly to the reference values for Mn, Cu, Zn, Fe, and P for adults. Individual dietary exposure values of toxic elements for adults weighing 60 kg decrease in this order: Al (10.1 µg/kg bw/day) > Ni (362 ng/kg bw/day) > As ≥ Pb > Ag > Hg > Cd > and Sn (0.93 ng/kg bw/day). Conclusions: In terms of Regulation (EU) No 1924/2006 of the European Parliament and of the Council on nutrition and health claims made on foods, the cereal-based mixtures could be labelled “source of” Mn, Cu, Zn, Fe, and P” when their contributions to the reference values exceeded 15%; in addition, “low sodium/salt” or “very low sodium/salt” can be applied. The mixtures contribute insignificantly to the toxic reference values of Al, Sn, Hg, Cd, Ni, and Ag, and the exposure values of Pb for developmental neurotoxicity, nephrotoxicity, and cardiovascular effects were considered safe. Regarding the metal pollution index of mixtures, there is no concern for potential health effects. Cereal-based mixtures are suitable for use in the food industry as a potential source of beneficial micronutrients for the human diet, although bioaccessible studies should not be neglected. Full article

Background: This study evaluated the impact of diabetes mellitus (DM) and its treatments on cardiovascular outcomes in prostate cancer (PC) patients aged 66 years and older, with or without androgen deprivation therapy (ADT) exposure. Methods: Using the SEER-Medicare database (2009–2017), two cohorts were created: Cohort 1 included all PC patients enrolled in Medicare Parts A and B; Cohort 2 was a subset of Cohort 1 receiving ADT and enrolled in Medicare Part D. Exposures were DM and DM medications. Outcomes included cardiovascular events (CVEs), cardiovascular mortality (CVm), PC-specific mortality (PCsm), and all-cause mortality, analyzed using multivariable Fine-Gray and Cox models. Results: Cohort 1 included 150,647 PC patients (32% with DM, median age 72). DM was associated with higher risk of CVE (subdistribution hazard ratio [sHR] 1.20, 95% CI 1.17–1.22), CVm (sHR 1.35, 1.28–1.43), and all-cause mortality (adjusted HR [aHR] 1.22, 1.19–1.26) (all p < 0.001). Non-Hispanic Blacks (NHBs) and patients from lower socioeconomic (SES) and education areas experienced comparable or worse outcomes. In Cohort 2 (n = 14,938), DM patients on non-metformin therapies had higher all-cause mortality (aHR 1.33, 1.11–1.25; p = 0.002) than those on metformin, particularly in NHB and low education groups. Sensitivity analyses with follow-up limited to two years showed consistent results as overall. Conclusions: Diabetic PC patients, especially NHB, lower SES and lower education subgroups, were associated with worse cardiovascular and all-cause mortality outcomes. Metformin may be associated with better outcomes in these populations, warranting further research on the disparities in PC and diabetes, and cardioprotective effects of DM medications across different subpopulations. Full article

This study analyzes the role of positive parenting, encompassing affection, responsiveness, encouragement, and teaching, on 79 children’s negativity aged 10 to 24 months during interactions with their adolescent mothers (aged 15 to 21). Parenting behaviors were evaluated using the Spanish version of the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO). Maternal well-being was assessed using the Spanish version of the Hospital Anxiety and Depression Scale (HADS). At the same time, the Ages and Stages Questionnaire-Socioemotional Development (ASQ-SE) measured mothers’ perceptions of their children’s socioemotional development. Children’s negativity was assessed using the Subscale of Negativity from the Early Head Start Research and Evaluation Project (EHSREP Negativity Subscale). Bivariate analysis revealed a significant association between maternal affection, responsiveness, encouragement, higher maternal anxiety, and maternal perceptions of their children’s socioemotional development with children’s negativity regarding anger, hostility, or dislike toward their mothers during interaction. Moreover, multivariate regression analysis showed that maternal affection, responsiveness, anxiety, and perceptions of children’s socioemotional development could predict negativity. The study underscores the significance of positive parenting, maternal well-being, and perceptions of children’s socioemotional development to prevent high levels of children’s negativity. Full article

Metabolic syndrome (MetS)—characterized by dyslipidemia, hypertension, hyperglycemia, and abdominal obesity—is a common, modifiable condition that contributes to functional decline and premature mortality in older adults. The accumulation of MetS components increases the risk of cardiovascular, cerebrovascular, and renal diseases, as well as cognitive impairment and polypharmacy in aging populations. A narrative review was conducted focusing on the management of MetS in adults aged 65 and older. Sources were identified through targeted searches of PubMed and relevant guidelines, with an emphasis on literature discussing geriatric-specific considerations. The review was structured using the Institute for Healthcare Improvement’s (IHI) 4Ms Framework: What Matters, Medication, Mentation, and Mobility. Findings highlight that current MetS guidelines are often extrapolated from younger populations and insufficiently account for geriatric-specific factors such as altered pharmacokinetics, multimorbidity, and social determinants of health. The 4Ms Framework provides a comprehensive lens to adapt these guidelines, supporting individualized treatment plans that consider patient goals, cognitive status, and functional capacity. Incorporating social services and aligning interventions with socioeconomic realities can further bridge disparities in care. The 4Ms framework can help healthcare providers communicate effectively with patients, ensuring treatment plans align with evidence-based practices and the patient’s individual priorities. Treatment of MetS must be tailored to individual patient needs based on presented risk factors, severity of risks, and social determinants of health. Adjusting treatment plans in accordance with the socioeconomic status (SES) of patients will allow for systematic improvement of outcomes. Full article

Background/Objectives: Adolescence is a critical period for identity development and self-perception, increasingly shaped by digital media. This study aimed to examine how gender, body mass index (BMI), and Internet use influence body esteem and global self-esteem among adolescents aged 15–18 years old, with particular focus on the psychological impact of digital exposure. Methods: A three-wave online study was conducted using the Computer-Assisted Web Interview (CAWI) technique. The final sample consisted of 500 Polish adolescents (251 girls, 249 boys). Participants completed the Body Esteem Scale (BES) and Rosenberg Self-Esteem Scale (SES) at three time points. The study explored gender differences, the role of BMI, and the impact of time spent online. Results: Girls reported significantly lower BES and SES scores than boys (p < 0.001), despite no significant gender differences in BMI. Time spent online was negatively associated with both body esteem and self-esteem (p < 0.01), with the most pronounced effects among girls using the Internet for more than 4 h daily. Regression analyses identified gender and Internet use as significant predictors of self-perception, while BMI did not. Conclusions: Digital media use, particularly prolonged exposure, appears to be a stronger predictor of adolescent self-perception than objective body measures such as BMI. Girls are especially vulnerable to its adverse effects on both body esteem and global self-esteem. These findings underscore the need for gender-sensitive interventions focused on media literacy, emotional resilience, and healthy digital habits among adolescents. Full article

The cellular senescence and functional decline of stem cells are primary contributors to the reduced regenerative capacity and weakened disease resistance in aged tissues. Among the various factors involved, oxidative stress resulting from the accumulation of reactive oxygen species (ROS) is a key driver of stem cell senescence. In an oxidative environment, cells continuously generate ROS, which accelerates cellular senescence and leads to functional deterioration. To intervene in the cellular senescence process of stem cells under such conditions, we selected bone marrow mesenchymal stem cells (BMSCs) as the model system and developed ROS-responsive selenium (Se)-containing nano-micelles capable of efficiently scavenging intracellular ROS. The optimal formulation was determined by modulating the selenium content. Analysis of cellular senescence markers and regenerative capacity reveals that nano-micelles containing 8% Se (Wt %), at a concentration of 15 μg/mL, can significantly modulate ROS levels in BMSCs under oxidative stress, thereby effectively delaying cellular senescence and preserving the osteogenic differentiation potential of BMSCs. These findings offer a promising strategy for mitigating stem cell senescence. Full article

Objective: This study investigated the association between paternal preconception paternal body mass index (BMI) categories and physical/neurodevelopmental outcomes in Chinese small-for-gestational-age (SGA) children. Methods: A prospective cohort study enrolled 412 singleton SGA infants born at Peking University People’s Hospital in 2020–2022. Fathers were stratified into underweight, normal-weight, overweight, and obese groups. Follow-up assessments at 24–36 months evaluated growth parameters weight, height, BMI Z-scores and neurodevelopment using the Ages and Stages Questionnaire-3 (ASQ-3) and ASQ: Social–Emotional (ASQ:SE). Multivariable regression was adjusted for paternal covariates. Results: In SGA offspring, paternal underweight correlated with lower birth weights vs. normal/obese paternal BMI and the highest severe SGA rates. Prospective monitoring identified elevated BMI Z-scores (ΔZ = +0.40) and 8.7-fold heightened obesity risk in the paternal obesity group versus normal-weight counterparts. Neurodevelopmental evaluations demonstrated gross motor impairments in both underweight (ΔZ = −0.22) and obese paternal subgroups (ΔZ = −0.25) compared with the normal-weight group, with the obesity cohort additionally exhibiting problem-solving deficiencies (ΔZ = −0.19). The paternal obesity group manifested three-fold greater likelihood of social–emotional delays than the normal-weight group. The underweight and obese paternal groups showed 3.46-fold and 2.73-fold higher probabilities of gross motor deficits, respectively, while obesity was linked to 3.27-fold elevated problem-solving impairment risk-all comparisons versus normal paternal BMI. Overweight status showed no significant links to growth or neurodevelopmental outcomes. Normal-weight fathers had lower risks of obesity and neurodevelopmental issues. Conclusions: This study revealed U-shaped paternal BMI–neurodevelopment links in SGA offspring. Paternal obesity raised offspring obesity/neurodevelopmental risks, while underweight linked to severe SGA and motor deficits, highlighting paternal weight optimization’s modifiable role. Full article

Despite the increased research on violence toward teachers and public policies aimed at protecting teachers from violence, knowledge of the factors contributing to teachers’ sense of safety at school remains limited. Drawing from socioecological theory, we examined the contributions of both teachers’, parents’, students’, and schools’ characteristics to teachers’ sense of feeling unsafe in school. Specifically, we examined teachers’ individual and work characteristics (sex, age, years of experience, and working in the regular classroom or not), their perceptions of school violence, and their relationships with students and their peers. At the school level, we examined the school size, poverty level, and school-level reports of parents’, students’, and teachers’ perception of the school climate and school violence. The sample consisted of 9625 teachers (73% female), 126,301 students, and 56,196 parents from 2116 schools with a low socioeconomic status in Chile. Descriptive statistics showed that most teachers do not feel afraid (72.9%) nor thought that their job was dangerous (74.6%). A hierarchical multivariate regression analysis and multilevel analyses showed that teachers with higher perceptions of feeling unsafe were females or reported being “other sex”, had fewer years of experience, worked mainly in the classroom, perceived a higher level of school violence, and had worse perceptions of peer relationships and teacher–student relationships. These teachers were mostly in schools with higher poverty levels, larger enrollment, and higher student-reported and parent-reported school violence compared to the rest of the sample of low-SES Chilean schools. We discuss the implications of these findings for preventive school interventions and programs regarding school violence and teacher turnover. Full article

Objective: Investigate patient characteristics, treatments used, treatment response, and factors associated with outcomes when managing SE in a pediatric population admitted to the emergency department (ED). Methods: This retrospective observational study included pediatric patients (age ≤ 18 years) with SE admitted to the ED at King Khalid University Hospital between 2015 and 2023. SE and refractory SE (RSE) were diagnosed according to the American Epilepsy Society (AES) definitions. The data included demographics, home medications, treatment sequences, medication dosing, and clinical outcomes. To assess appropriateness, the administered doses were compared with the AES standards for pediatric patients. Results: The study included 487 episodes of SE. The mean patient age was 6.1 ± 4.1 years, and most patients were males (57.3%) with a history of epilepsy (74.1%). Benzodiazepines (BDZs) were administered first in 83.0% of cases, with a 10.9% success rate, whereas anti-seizure medications (ASMs) were administered first in 17.0% of cases, with a 66.3% success rate (p < 0.0001). Surprisingly, medications administered at appropriate doses during the first round were significantly less effective compared to those that were underdosed (18.2% vs. 28.4%; p = 0.0222), mainly because of poor response to BDZs. Younger patients and those who received BDZs on their first medication round had higher hospital admission rates. Conclusions: ASMs were more effective than BDZs in managing pediatric patients with SE, regardless of the dosing precision. These findings point toward the adoption of personalized treatment strategies and may warrant early initiation of ASMs. National multicenter studies are needed to define a standardized pediatric SE protocol. Full article

Background/Objectives: Myopia is a growing global health concern, especially among school-aged children in East Asia. Topical atropine is a key treatment for pediatric myopia control, but individual responses vary, with some children showing rapid progression despite higher doses. This retrospective observational study aims to develop an interpretable machine learning model to predict individualized treatment responses and support personalized clinical decisions, based on data collected over a 3-year period without a control group. Methods: A total of 1545 pediatric eyes treated with topical atropine for myopia control at a single tertiary medical center are analyzed. Classification and regression tree (CART) is constructed to predict changes in spherical equivalent (SE) and identify influencing risk factors. These factors are mainly received treatments for myopia including atropine dosage records, treatment duration, and ophthalmic examinations. Furthermore, decision rules that closely resemble the clinical diagnosis process are provided to assist clinicians with more interpretable insights into personalized treatment decisions. The performance of CART is evaluated by comparing with the benchmark model of least absolute shrinkage and selection operator regression (Lasso) to confirm the practicality of CART usage. Results: Both the CART and Lasso models demonstrated comparable predictive performance. The CART model identified baseline SE as the primary determinant of myopia progression. Children with a baseline SE more negative than −3.125 D exhibited greater myopic progression, particularly those with prolonged treatment duration and higher cumulative atropine dosage. Conclusions: Baseline SE has been identified as the key factor affecting SE difference. The generated decision rules from CART demonstrate the use of explainable machine learning in precision myopia management. Full article

Background: Intradialytic hypotension is a common complication in haemodialysis, affecting up to 30% of sessions. It results from an imbalance between ultrafiltration and compensatory mechanisms, such as vascular tone and plasma refilling. Volume-controlled biosensors allow for the continuous monitoring of the haemoconcentration, enabling early detection and prevention of hypotension. Methods: A quasi-experimental study was conducted to assess the effectiveness of biosensors in reducing hypotensive episodes. Two biosensors were compared: the Blood Volume Monitor and the Haemomaster system. Data were collected over two four-month periods: before and after biosensor implementation. Nursing staff received specific training, and a protocol for consistent data collection was established. Informed consent was obtained from all eligible participants. The incidence of intradialytic hypotension was compared between sessions with and without biosensor use. Additionally, outcomes were analysed according to biosensor type. Results: A total of 2262 dialysis sessions from 22 patients were analysed. The cohort was 54.5% male, with a mean age of 60 years (SE = 21); 27.3% had diabetes and 81.8% had hypertension. Post-dilution haemodiafiltration was performed in 62.8% of sessions. Intradialysis hypotension occurred in 11.2% of sessions using biosensors compared to 14.0% without (p = 0.021). No significant difference was found between biosensor types (10.8% vs. 11.8%; p = 0.531), although device 1 reached a significantly lower critical blood volume (mean: 10 L; SE = 4 vs. 16 L; SE = 5; p = 0.000). Conclusions: Biosensor use was associated with fewer hypotensive episodes and greater haemodynamic stability. These findings support their integration into routine dialysis practice to improve treatment, safety, and individualised care. Full article

Volatile organic compounds (VOCs) are common indoor air pollutants known to pose significant health risks, yet little is known about how internal exposure varies across populations and environments. This study investigated the associations between indoor air pollutants and urinary VOC biomarkers in a nationally representative sample. We analyzed data from 1880 adults in the eighth Korea National Health and Nutrition Examination Survey (2020–2021) who completed an indoor air quality (IAQ) survey and provided urine samples, assessing the influence of sociodemographic, behavioral, and environmental factors. Indoor concentrations of PM_2.5, CO₂, formaldehyde, total VOCs, benzene, ethylbenzene, toluene, xylene, and styrene were measured, alongside the urinary concentrations of nine VOC biomarkers. Associations between pollutants, sociodemographic variables, and biomarkers were evaluated using univariate and multivariable linear regression with Bonferroni correction. Older age, female, lower socioeconomic status (SES), and smoking were associated with higher urinary VOC biomarker concentrations, with smoking showing the strongest associations. Indoor ethylbenzene, styrene, benzene, and CO₂ were also associated with multiple metabolites. These findings indicated significant associations between household air pollutants and urinary VOC metabolites, with disparities by age, sex, SES, and smoking status, underscoring the importance of targeted IAQ interventions for vulnerable populations. Full article

While most of the Alzheimer’s disease (AD) cases are sporadic and manifest after age 65 (late-onset AD, LOAD), a subset of patients develop symptoms earlier in life (early-onset, EOAD) due to mutations in the PSEN1, PSEN2, or APP genes with an autosomal-dominant inheritance pattern (AD-EOAD). In this study, we examined the association between age of onset (AoO) and first clinical manifestation (FCM) with the APOE and DAOA genotypes, previously described as modifiers of clinical phenotypes in LOAD and EOAD in 88 individuals clinically diagnosed with AD-EOAD due to the PSEN1 A431E variant (39 females, 49 males). We classified the population according to their genotype (APOEε2, APOEε3, and APOEε4 and DAOA G/G, G/A, and A/A) and FCM (cognitive, behavioral, motor, and memory impaired). Memory impairment was the most frequent symptom (51%), followed by motor disturbances (31.8%), cognitive symptoms other than memory (10.4%), and behavioral changes (6.8%). We found a significant association between APOE genotype and AoO (p < 0.001), with the APOEε4 allele being linked to a delayed onset (β = 4.04, SE = 1.11, p = 0.0003). Similarly, individuals with the DAOA rs2391191 A/A genotype showed a significantly later AoO compared to G/G carriers (β = 2.13, SE = 0.96, p = 0.0301). No significant association was found between APOE or DAOA genotypes and FCM. The findings suggest that both the APOEε4 allele and DAOA rs2391191 A/A genotype may act as genetic modifiers of AoO, delaying symptom onset in individuals with AD-EOAD. Further research is needed to elucidate the molecular pathways through which APOE and DAOA influence AD-EOAD progression. Full article

The understanding of hidden emotions—situations in which individuals deliberately express an emotion different from what they genuinely feel—is a key skill in theory of mind (ToM) development. This ability allows children to reason about discrepancies between internal emotional states and external expressions and is closely tied to linguistic development, particularly vocabulary related to mental states, which supports complex emotional reasoning. Children who are deaf or hard of hearing (DHH), especially those born to hearing non-signing families and raised in oral language environments, may face challenges in early language exposure. This can impact the development of social and emotional skills, including the ability to understand hidden emotions. This study compares the understanding of hidden emotions in hearing children (n = 59) and DHH children (n = 44) aged 7–12 years. All children were educated in spoken language environments; none of the DHH participants had native exposure to sign language. Participants completed a hidden emotions task involving illustrated stories where a character showed a certain emotion in front of two observers, only one of whom was aware of the character’s true emotional state. The task assessed children’s understanding of the character’s emotional state as well as their ability to reason about the impact of hiding emotions on the beliefs of the observers. The results showed that the hearing children outperformed their DHH peers in understanding hidden emotions. This difference was not attributed to hearing status per se but to language use. Specifically, children’s spontaneous use of cognitive verbs (e.g., think or know) in their explanations predicted task performance across the groups, emphasizing the role of mental state language in emotional reasoning. These findings underscore the importance of early and accessible language exposure in supporting the emotional and social cognitive development of DHH children. Full article

Adolescents have lower rates of breastfeeding (BF) compared to older mothers. BF self-efficacy (SE) has been identified as an important factor influencing BF outcomes. An innovative BF program for young women was co-designed and implemented, which included staff training, a prenatal BF class, and BF peer support. The objective of this prospective pilot cohort study was to evaluate the effectiveness of prenatal education and peer support in improving a young mother’s BF SE. Participants were pregnant adolescents recruited from a large urban non-profit social service outreach centre. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was administered to participants before and after participating in the BF program. BSES-SF scores were summed to determine a composite score and compared descriptively using median score. Un-aggregated, item-by-item, comparison of pre- versus post-BF program scores were also compared to examine improvements in SE. A total of 20 adolescent mothers (mean age = 16.6) attended the program. An increase in the total BSES-SF score was observed based on descriptively comparing the mean pre- versus post-intervention. Participation in tailored prenatal education classes and a peer-support program was associated with increased BSES-SF. Identifying mothers with low BF SE can enable healthcare professionals to implement targeted interventions in this at-risk population. Full article