Search Results (13,870)

Non-communicable diseases (NCDs) are the leading global cause of death, causing over 43 million deaths in 2021, including 18 million premature deaths, disproportionately affecting low- and middle-income countries. NCDs also incur significant economic losses, estimated at USD 7 trillion from 2011 to 2025, despite low prevention costs. This study evaluated body mapping indicators: body mass index (BMI), waist circumference, and waist-to-hip ratio—for predicting NCD risk, including hypertension, diabetes, and cardiovascular diseases, using data from a nationally representative survey in Ghana. The study sampled 5775 participants via multistage stratified sampling, ensuring proportional representation by region, urban/rural residency, age, and gender. Ethical approval and informed consent were obtained. Anthropometric and biochemical data, including height, weight, waist and hip circumferences, blood pressure, fasting glucose, and lipid profiles, were collected using standardized protocols. Data analysis was conducted with STATA 17.0, accounting for complex survey design. Significant sex-based differences were observed: men were taller and lighter, while women had higher BMI and waist/hip circumferences. NCD prevalence increased with age, peaking at 60–69 years, and was higher in females. Lower education and marital status (widowed, divorced, separated) correlated with higher NCD prevalence. Obesity and high waist circumference strongly predicted NCD risk, but individual anthropometric measures lacked screening accuracy. Integrated screening and tailored interventions are recommended for improved NCD detection and management in resource-limited settings. Full article

Background/Objectives: Cardiometabolic risk remains a major challenge in patients with type 2 diabetes mellitus (DMT2). This study aimed to evaluate cardiovascular (CV) risk stratification using advanced glycation end-products (AGEs) measured via skin autofluorescence (SAF) and to assess the achievement of evidence-based ABC targets (HbA1c, blood pressure, low-density lipoprotein (LDL) cholesterol) in adults with DMT2 in Dalmatia. Methods: In this single-center cross-sectional study, 251 adults with DMT2 were stratified by CV risk based on SAF measured AGE levels. Clinical, biochemical, and anthropometric data were collected, including ABC goal attainment and medication use. Statistical analyses compared groups and explored predictors of ABC target achievement using regression models adjusted for clinical factors. Results: Only 17.5% of participants achieved all three ABC goals, indicating suboptimal cardiometabolic control. Those with elevated CV risk had higher hip circumference and lower diastolic blood pressure. Use of sodium-glucose cotransporter 2 (SGLT2) inhibitors was positively associated with ABC goal achievement in patients with prior CV or cerebrovascular events, while higher body mass index was negatively associated. SAF measured AGE levels correlated with cardiometabolic risk but showed no significant differences across LDL cholesterol or other traditional markers. Conclusions: SAF AGE measurement shows potential for CV risk stratification in DMT2 beyond traditional factors. The low rate of ABC goal attainment highlights the need for intensified individualized management incorporating novel biomarkers and therapeutics like SGLT2 inhibitors. Further prospective studies are needed to validate these findings and improve prevention of cardiovascular complications in DMT2. Full article

Background: Insulin resistance (IR) is common in overweight or obese individuals. Dysregulation of trace elements such as cobalt (Co) and manganese (Mn) has been associated with obesity and IR markers in individuals with diabetes. However, their role in non-diabetic states is less understood. Objective: This study aimed to analyze the association between serum Co and Mn levels and IR in overweight and obese women without diabetes. Methods: A total of 112 overweight or obese women were evaluated for their anthropometric, metabolic, and biochemical characteristics. To estimate IR, the homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), triglyceride–glucose index (TyG), and triglyceride–glucose–body mass index (TyG-BMI) were calculated. Serum Co and Mn concentrations were quantified by inductively coupled plasma mass spectrometry (ICP-MS). Results: Our results show that 77% of participants exhibited central fat accumulation and a high prevalence of IR. Fasting insulin (FINS), HOMA-IR, and TyG-BMI were significantly higher in obese women, while adiponectin (Adpn) was lower. Moreover, Co was inversely associated with FINS (p = 0.003) and HOMA-IR (p = 0.011), and positively associated with QUICKI (p = 0.011) in obese women. In contrast, serum Mn levels showed negative correlations with fasting glucose (FG) (p = 0.021) and the TyG index (p = 0.048) in overweight women. Conclusions: Co serum levels were positively associated with FG and QUICKI and negatively associated with FINS and HOMA-IR in the obese group. Mn showed negative associations with FG and the TyG index, suggesting that these trace elements may play a role in the IR in people with obesity. Full article

Professional certification of engineers plays a crucial role in verifying competencies and ensuring the safety and quality of engineering outputs. However, most existing certification systems assign fixed validity periods (e.g., 3–5 years) without considering individual engineer characteristics or the intensity of technological progress in specific fields. This study examines the key factors influencing the optimal validity period of engineering certifications and proposes it as a measurable indicator to support safety in engineering practice. A new model is introduced that integrates expert judgment, fuzzy set theory, and bibliometric analysis of Q1/Q2 Scopus-indexed publications. The model incorporates three main factors: competence level, professional experience, and the technological intensity of the discipline. A case study from the engineering certification system of Kazakhstan demonstrates the model’s practical applicability. Certification bodies, policymakers, and engineering organizations can use these findings to establish more flexible certification validity periods, thereby ensuring timely reassessment of competencies and reducing safety risks. For example, for mechanical engineers, the optimal validity period is 3 years rather than the statutory 5 years; in other words, the model recommends a 40% reduction in certification validity. This reduction reflects the combined effects of competency level, professional experience, and technology intensity on certification renewal schedules. Overall, the proposed factorial approach supports a more personalized and safety-oriented certification process and offers insights into improving national qualification systems. Full article

Left ventricular (LV) hypertrabeculation is increasingly recognized as a phenotype that may reflect physiological adaptation, particularly in athletes exposed to chronic overload, although its functional relevance remains uncertain. This study evaluated the prevalence of excessive trabeculation and its physiological correlation with LV remodeling. We conducted a single-center, cross-sectional study involving 320 Olympic-level athletes without cardiovascular disease. All underwent cardiac magnetic resonance (CMR). Hypertrabeculation was defined by the Petersen criteria. Athletes meeting these criteria were classified as hypertrabeculated and compared with non-hypertrabeculated matched for age, sex, and sport category. LV morphology, function, strain parameters, and hemodynamic forces (HDFs) were analyzed. Hypertrabeculation was identified in 9% of the cohort. No significant differences were observed between groups for training exposure (p = 0.262), body surface area (p = 0.762), LV volumes (end-diastolic volume indexed p = 0.397 end-systolic volume indexed p = 0.118), ejection fraction (p = 0.101), mass (p = 0.919), sphericity index (p = 0.419), myocardial wall thickness (p = 0.394), tissue characterization (T1 mapping p = 0.366, T2 mapping p = 0.833), global longitudinal strain (GLS p = 0.898), global circumferential strain (GCS p = 0.219), or HDFs. All values were within the normal range. In our cohort, LV hypertrabeculation, evaluated by CMR, was relatively common but not associated with structural or functional abnormalities, supporting its interpretation as a benign variant in asymptomatic athletes with normal cardiac function. Full article

Background/Objectives: Obstructive sleep apnea (OSA) is strongly associated with cardiovascular morbidity, and depressive symptoms are common in affected individuals. Both OSA and depression have been linked to autonomic dysfunction, but the independent contribution of depressive symptoms to autonomic dysfunction in OSA remains unclear. We investigated whether depressive symptom severity is associated with autonomic function, indexed by heart-rate variability (HRV), in patients with OSA. Methods: We retrospectively analyzed 1713 adults with OSA at a university-affiliated sleep center from 2011 to 2024. HRV was derived from electrocardiography during polysomnography, and frequency-domain indices (natural log-transformed LF, HF, VLF, TP, and LF/HF) were computed. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II). Associations between BDI-II and HRV indices were evaluated using univariable and multivariable linear regressions. Results: In univariable regression analyses, higher BDI-II scores were significantly associated with lower HRV indices (ln LF, ln HF, ln VLF, ln TP; all p < 0.01). In multivariable analyses, higher BDI-II scores were independently associated with lower ln LF, ln HF, and ln TP (all p < 0.05), adjusting for age, sex, body mass index, hypertension, diabetes, apnea–hypopnea index, arousal index, and sleep quality. Conclusions: Greater depressive symptom burden is independently associated with reductions in multiple HRV indices, suggesting attenuated parasympathetic activity and autonomic dysregulation in patients with OSA. These findings support integrated management strategies that address both physiological and psychological domains in OSA and motivate longitudinal studies to test whether effective depression treatment improves HRV and mitigates long-term cardiovascular risk. Full article

Background/Objectives: Diabetes mellitus (DM) is a disorder which affects carbohydrate metabolism and has been associated with other conditions such as disease-related malnutrition (DRM), leading to specific challenges in its management. This study aims to evaluate the implications of DM, its complications, and its duration on energy and protein intake in patients at high risk of malnutrition. Methods: Descriptive cross-sectional study in 179 patients with high risk of malnutrition. Patients were compared based on the presence or absence of DM, diabetes duration and the presence of complications. Age, gender, body mass index, bioimpedanciometry, ultrasonography and dynamometry parameters and the diagnosis of sarcopenia were recorded. Energy and protein requirements were calculated, and the composition of the patients’ three-day diet was analyzed. Results: DM was associated with lower weight-adjusted energy intake (Overall: 29.15 (9.99) vs. DM: 24.87 (8.28) vs. NoDM: 30.65 (10.13) kcal/kg/day; p < 0.01) and lower weight-adjusted protein intake (Overall: 1.29 (0.47) vs. DM: 1.18 (0.39) vs. NoDM: 1.33 (0.49) g of protein/kg/day; p < 0.05). DM was a risk factor for poorer compliance with energy requirements (OR: 2.38, 95% CI: 1.13–5.01, p < 0.05). Similarly, the occurrence of complications was identified as a risk factor associated with reduced adherence to energy intake requirements (OR: 1.78, 95% CI 1.06–2.98; p < 0.05), and a duration of diabetes mellitus exceeding 10 years was linked to lower adherence to protein intake requirements (OR 1.79, 95% CI 1.08–2.99; p < 0.05). Conclusions: Among patients at high risk of malnutrition, diabetes mellitus was associated with suboptimal adherence to both caloric and protein intake requirements. The presence of diabetes and its related complications emerged as risk factors for inadequate fulfillment of energy needs, while a longer disease duration was specifically linked to reduced compliance with protein requirements. Full article

Lattice structures are lightweight architected materials particularly suitable for aerospace and automotive applications due to their ability to combine mechanical strength with reduced mass. Among various topologies, Body-Centered Cubic (BCC) lattices are widely employed for their geometric regularity and favorable strength-to-weight ratio. Advances in Additive Manufacturing (AM) have enabled the precise and customizable fabrication of such complex architectures, reducing material waste and increasing design flexibility. This study investigates the low-velocity impact behavior of two polylactic acid (PLA)-based BCC lattice panels differing in strut diameter: BCC1.5 (1.5 mm) and BCC2 (2 mm). Experimental impact tests and finite element simulations were performed to evaluate their energy absorption () capabilities. In addition to conventional global performance indices, a dimensionless parameter, is introduced to quantify the ratio between local plastic indentation and global displacement, allowing for a refined characterization of deformation modes and structural efficiency. Results show that BCC1.5 absorbs more energy than BCC2, despite the latter’s higher stiffness. This suggests that thinner struts enhance energy dissipation under dynamic loading. Despite minor discrepancies, numerical simulations provide accurate estimations of and support the robustness of the index within the examined configuration, highlighting its potential to deformation heterogeneity. Full article

Background: Air pollution is a well-established risk factor for cardiovascular and metabolic diseases. Although Southern Switzerland is considered a relatively low-pollution area, levels of nitrogen dioxide (NO₂) and particulate matter (PM₁₀) still exceed the latest WHO air quality guidelines. This study aimed to assess the association between long-term exposure to air pollutants, vascular aging, and body composition in a Swiss population sample. Methods: A cross-sectional analysis was conducted on 1202 participants from the Ticino Epidemiological Stiffness Study (2017–2018). Vascular health was assessed via pulse wave velocity (PWV), used to estimate vascular age. Body composition was evaluated through bioimpedance analysis, yielding fat mass index (FMI), body cellular mass (BCM), and body cellular mass index (BCMI). Individual exposure to NO₂ and PM₁₀ was estimated, using geocoded residential data and environmental monitoring records from 2002 to 2017. Statistical models were adjusted for major cardiovascular risk factors. Results: Higher exposure to NO₂ was significantly associated with increased vascular age (mean delta age: +0.53 years in the high exposure group) and adverse body composition markers, including higher FMI and lower BCM/BCMI. These associations remained significant after adjusting for confounders. PM₁₀ showed weaker associations, significant only in unadjusted models. Conclusions: Even in a relatively clean environment, exposure to NO₂ is linked to early vascular aging and unfavorable body composition. These findings reinforce the need for stricter air quality standards and underline the importance of continuous environmental health surveillance, even in regions considered low risk. Full article

Background/Objectives: Astaxanthin, a naturally occurring carotenoid renowned for its potent antioxidant properties, has been proposed as a dietary supplement for weight management due to its potential effects on adipose tissue and skeletal muscle metabolism, as well as its anti-inflammatory properties. This meta-analysis systematically evaluated the impact of astaxanthin supplementation on body mass index (BMI) and body weight in adult populations. Methods: Comprehensive searches of reputable databases were conducted, adhering to the PRISMA guidelines, with statistical analyses performed using Jamovi. Results: The study incorporated data from nine clinical trials. Pooled results indicated no significant reduction in the context of BMI (−0.2162; 95% CI: −0.4697 to 0.0374) and a non-significant decrease in body weight (0.0230; 95% CI: −0.4534 to 0.4994) relative to control groups. The heterogeneity observed across studies was 30.1251% (p = 0.1593) for BMI and 73.3885% (p = 0.0002) for body weight management. The dose–response analysis showed no statistically significant association between astaxanthin dosage and outcomes related to BMI and body weight management. Additionally, statistical assessment of funnel plot asymmetry indicated no evidence of publication bias. Conclusions: The findings indicate that astaxanthin does not provide benefits in BMI regulation nor in weight control management, highlighting the need for additional large-scale and long-term clinical trials. This study contributes to the growing body of evidence on the role of nutraceuticals in metabolic health, providing a foundation for future clinical recommendations. Full article

Background: Coronary collateral circulation (CCC) plays a crucial protective role in patients with chronic total occlusion (CTO), mitigating ischemia and improving long-term outcomes. However, the degree of collateral vessel development varies substantially among individuals. Systemic inflammatory and nutritional status may influence this variability. The Naples Prognostic Score (NPS) is a composite index reflecting these parameters, yet its relationship with CCC remains incompletely defined. Methods: We retrospectively analyzed 324 patients with angiographically confirmed CTO at Selçuk University Faculty of Medicine between 2014 and 2025. Coronary collaterals were graded using the Rentrop classification, and patients were categorized as having poor (grades 0–1) or good (grades 2–3) collaterals. The NPS was calculated using serum albumin, cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. Baseline clinical and laboratory data were compared between groups. Univariate and multiple binary logistic regression analyses were performed to identify independent predictors of collateral development. Results: Of the 324 patients, 208 (64.2%) had poor and 116 (35.8%) had good collateral circulation. Patients with good collaterals had higher body mass index, HDL Cholesterol (HDL-C), and triglyceride levels, and significantly lower NPS values compared with those with poor collaterals (p < 0.05 for all). In multiple binary logistic regression analysis, HDL-C (OR 1.035; 95% CI 1.008–1.063; p = 0.011) and NPS (OR 0.226; 95% CI 0.130–0.393; p < 0.001) emerged as independent predictors of well-developed collaterals. Conclusions: Both NPS and HDL-C are independently associated with the degree of coronary collateral circulation in CTO patients. These findings highlight the interplay between systemic inflammation, nutritional status, lipid metabolism, and vascular adaptation. As simple and routinely available measures, NPS and HDL-C may serve as practical tools for risk stratification and identifying patients at risk of inadequate collateral formation. Prospective studies with functional assessments of collateral flow are warranted to confirm these associations and explore potential therapeutic interventions. Full article

This study aims to investigate the effects of continuous glucose monitoring (CGM) on glycemic control in patients with diabetes mellitus (DM) and to identify the sociodemographic or health behavioral factors that influence the outcomes. The data were collected from 510 diabetic patients prescribed to use CGM for 12 weeks and analyzed using SPSS 27.0. Paired samples t-tests were used to compare the glycemic control (HbA1c and fasting glucose) and metabolic health (body mass index and total cholesterol) measures of subjects before and after the CGM use, and independent t-tests were conducted to examine whether the effectiveness of CGM differs according to subjects’ sociodemographic and health behavioral characteristics. As a result of this study, the use of CGM resulted in a significant reduction in HbA1c from 8.09 to 7.48 percent (p < 0.001) and in fasting glucose from 152.41 to 137.16 mg/dL (p < 0.001). In the subgroup analysis of CGM effectiveness, fasting glucose reduction was greater in females than in males and in patients with type 2 diabetes than in those with type 1 diabetes. In conclusion, it is essential to consider patient characteristics to enhance the effectiveness of CGM and to expand its use to type 2 diabetes to reduce the social burden of the disease. Full article

Background: Metabolic syndrome is a constellation of medical conditions including central obesity, high blood sugar, and high triglycerides known to increase the risk of heart disease, stroke, and type 2 diabetes, with significant sex differences in the syndrome’s incidence and prevalence. These clinical symptoms may be accompanied by cognitive impairment. Methods: In the present experiment, we fed rabbits a diet high in fat and sugar (HFSD), assessed symptoms, and measured changes in cognition using trace eyeblink conditioning. Results: We show that a range of symptoms of metabolic syndrome resulted from HFSD in male and female rabbits and obesity, high blood sugar, and glucose intolerance were higher in male than female rabbits. Specifically, HFSD male rabbits gained more weight and had a higher body-mass index, more body fat, higher fasting glucose levels, and greater glucose intolerance. Importantly, using trace and delay eyeblink conditioning, we show that there was cognitive impairment because of the high-fat and high-sugar diet in both male and female rabbits, but this was greater in HFSD male rabbits than HFSD female rabbits. Conclusions: Metabolic syndrome modeled in rabbits fed a diet high in fat and sugar reflects trends in the adult population including central obesity, high blood sugar, and high triglycerides and cognitive impairment and provides an important model and test bed for assessing interventions. Full article

Background/Objectives: The COVID-19 pandemic disrupted healthcare systems globally, with dental services significantly limited due to infection control measures. This study investigates the impact of the pandemic on the clinical presentation, management, and outcomes of odontogenic abscesses over three distinct periods. Methods: A retrospective study was conducted at University Clinical Hospital (Poznan, Poland), which included adult patients hospitalised for odontogenic infections between March 2019 and February 2022. The cohort comprised 101 patients (median age: 33 years; 59.41% male), with admissions distributed across pre-pandemic (37.62%), pandemic (19.80%), and post-pandemic (42.57%) periods. Clinical, biochemical, and radiographic data were analysed. Results: No statistically significant differences were found between periods for abscess severity, hospitalisation length, or inflammatory marker levels. Elevated procalcitonin (Rs = 0.289, p = 0.005), C-reactive protein (Rs = 0.385, p < 0.001), and body mass index (Rs = 0.253, p = 0.011) independently predicted longer hospital stays. In regression modelling, procalcitonin (β = 0.464, p = 0.001) and prior outpatient antibiotic use (β = 0.281, p = 0.038) were mainly associated with larger abscess volumes, while comorbidities (β = 0.262, p = 0.025), longer hospitalisation (β = 0.594, p = 0.001) and abscess volume (β = −0.294, p = 0.040) increased the risk of reoperation. Conclusions: The study highlights clinically important findings linked to delayed dental care and increased systemic inflammation related to the pandemic. Elevated procalcitonin and CRP levels provide prognostic information that can guide early triage, risk stratification, and decisions regarding surgical versus outpatient management. These findings emphasise the importance of maintaining essential dental services, implementing preventive strategies, and optimising management protocols to reduce the risk of severe infections and improve patient outcomes during healthcare disruptions. Full article

Background and Objectives: To identify clinical, ultrasound (US) and real-time elastography (RTE) characteristics indicative of malignancy in small thyroid lesions. Materials and Methods: 141 consecutive patients with incidentally discovered solid thyroid nodules (diameter ≤ 10 mm) by neck US were assessed, and RTE was performed. The nodules were classified per American (ACR-TIRADS) and European (EU-TIRADS) criteria; US-guided FNA was conducted on EU-TIRADS 5 nodules. The US and RTE features of nodules classified as benign (Bethesda II) or malignant (Bethesda V and VI) were compared. Results: 41 nodules were classified as EU-TIRADS 5. Their Fine Needle Aspiration (FNA) cytology was Bethesda II (n = 11), III-IV (n = 3), V (n = 10) or VI (n = 17). Bethesda V–VI patients had a higher rate of autoimmune thyroiditis (p = 0.015) and higher ACR-scoring points (p < 0.001) compared with Bethesda II. The elastography ratio was equal between the groups (p = 0.584). In logistic regression analysis, ACR-scoring points predicted FNA results, with an area under the curve (AUC) of 0.993 (sensitivity 92.6% and specificity of 100%). The clinical model (age, body mass index, sex, autoimmunity, L-thyroxine treatment, nodule diameter, elastography ratio) achieved an AUC of 0.744. A “mixed” model, combining clinical characteristics with the ACR scoring points, achieved perfect performance (AUC = 1.000), predicting FNA results with 100% sensitivity and specificity. Conclusions: The proposed “mixed model” can predict Bethesda V–VI in thyroid nodules <10 mm, allowing for the selection of those needing further evaluation. Full article