Search Results (2,250)

Background: The relationship between body composition and bladder cancer outcomes is complex. While a higher body mass index (BMI) has been associated with an increased risk of bladder cancer development, its impact on survival outcomes is less clear. This study aimed to explore the association between BMI, survival, health-related quality of life, and the performance of ADLs in a cohort of older patients with bladder cancer. Methods: Data were obtained from the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey, including patients diagnosed with bladder cancer who had recorded BMI values. Analysis of variance was used to assess the association between BMI categories and patient demographics as well as cancer/treatment characteristics. Generalized linear models examined the impact of BMI on health-related quality of life, as measured by the physical and mental component summary scores when controlling for confounding variables. Kaplan–Meier survival curves across BMI categories were compared using log-rank tests. Results: The final cohort consisted of 8013 patients (age ≥ 65) with a mean age of 77.7 ± 7.1 years, the majority of whom were White (85.6%) and male (74.8%). We observed no significant association between BMI and cancer/treatment characteristics. The severely obese subgroup had the highest rate of disability in performing ADLs (18.3%) followed by the underweight subgroup (10.3%). Overweight patients exhibited the highest physical and mental component summary scores, indicating better health-related quality of life. BMI was a significant predictor of overall survival, with overweight, obese, and severely obese patients demonstrating improved survival compared to those with healthy or underweight BMI. These findings remained statistically significant in multivariable analysis. Conclusions: Our findings suggest a dual role of BMI in older patients with bladder cancer: higher BMI provides a survival advantage and, to an extent, a QoL advantage. At the same time, severe obesity did lead to the lowest QoL despite improved survival outcomes. These results underscore the complex interplay between BMI, survival, and QoL in this bladder cancer population. Full article

Behavioral activation therapy (BAT) was initially developed to treat depression and was subsequently extended as a transdiagnostic therapy for other psychiatric and neurocognitive disorders. However, research on its impact in people with multiple sclerosis (MS) is lacking. We suggest that MS-adapted BAT reduces neuropsychiatric symptoms, neurocognitive impairment, social isolation, and impairment of activities of daily living—key components of MS-related quality of life. Our proposed adaptation of the traditional therapy includes a focus on increasing engagement in cognitive, physical, or social activities (activity demand characteristics) to improve cognition and daily life function. In addition, these activities should be individually perceived as energizing, relaxing, or meaningful (subjective activity characteristics) to benefit neuropsychiatric symptoms and social connectedness. Finally, we propose that BAT in MS should specifically focus on reducing stressful activities (i.e., unenjoyable, high-arousal activities) and increasing relaxing activities (i.e., enjoyable, low-arousal activities), as this dimension might tackle the neuroinflammatory etiology of MS. Full article

Background and Objectives: Ravulizumab, a long-acting C5 complement inhibitor, was approved in the US and Europe in 2022 as an add-on therapy for the standard treatment of AChR-positive generalized MG (gMG). We share our real-world experience with adult patients receiving this therapy in Romania. Materials and Methods: Six AChR-positive gMG patients received ravulizumab through an Early Access Program (January 2023–October 2024). Patient outcomes were assessed at the therapy start and q8w using Quantitative MG (QMG), MG Activities of Daily Living (MG-ADL), and MG Quality of Life 15-item revised (MG-QoL15r) scales. Results: Age at disease onset ranged from 15 to 35 years. Four of the six patients were women. Two patients had gMG severity level of IIa, and four patients of IIb according to the Myasthenia Gravis Foundation of America (MGFA) classification. Five patients experienced rapid and sustained improvements in MG symptoms with MG-ADL score reductions ranged from −3 to −5 at 26 weeks post-ravulizumab start (except for those with a low baseline score: three and one). QMG score dropped in three patients (−2 to 12) during the treatment period, increased in two (+2 and +8), and remained stable in one (zero). Three patients showed sustained improvement in MG symptoms after ≥60 weeks. MG-QoL15r significantly dropped (−22 to −10) throughout the treatment period. One patient experienced ravulizumab-associated adverse events (vomiting, diarrhea, chills) that resolved within 24 h following symptomatic management, two to three episodes of myasthenic exacerbations during treatment, and discontinued it. Conclusions: All cases presented here had early-onset AChR antibody-positive, non-thymomatous MG. Despite differences in disease duration and underlying conditions, clinically meaningful and sustained improvements in gMG symptoms, and reduced corticosteroid doses were observed in all patients except one after adding ravulizumab to the treatment plan. Full article

Introduction: Ultra-processed foods (UPFs) are widely consumed despite their established associations with obesity, cardiovascular diseases, and other metabolic disorders. One potential factor contributing to high UPF consumption is the decline in cooking skills, particularly among younger generations. This study aimed to describe the cooking skill perceptions of a sample of Spanish adolescents to examine the relationship between perceived cooking skills and UPF consumption, and to identify the specific UPF subcategories most associated with perceived cooking skills. Methods: This study is a secondary cross-sectional analysis using data from the Eating Healthy and Daily Life Activities (EHDLA) study, which was conducted among 847 Spanish adolescents (12–17 years) from three secondary schools in Valle de Ricote (Region of Murcia, Spain). The participants’ perceptions of their cooking skills were assessed through the following question: “How would you rate your cooking skills?”. The response options included (a) very adequate, (b) adequate, (c) inadequate, and (d) very inadequate. UPF consumption was evaluated via a self-administered food frequency questionnaire (FFQ) previously validated for the Spanish population. UPFs were classified according to the NOVA system, which distinguishes four groups: (1) unprocessed or minimally processed foods; (2) processed culinary ingredients, such as salt, sugar, and oils, used to enhance the preparation of fresh foods; (3) processed foods; and (4) UPF and drink products. To examine the associations between perceived cooking skills and UPF consumption, marginal means and 95% confidence intervals for servings of individual UPF groups were calculated via generalized linear models. These models were adjusted for age, sex, socioeconomic status, physical activity, sedentary behavior, sleep duration, and body mass index to control for potential confounders. Post hoc comparisons between cooking skill categories were conducted via false discovery rate correction following the Benjamini–Hochberg procedure, with significance set at p < 0.05. Results: Most participants (47%) rated their cooking skills as adequate (47%) or very adequate (18%). Overall UPF intake showed a decreasing trend across skill levels, with the “very adequate” group consuming significantly fewer servings than the “very inadequate” group did (p = 0.015). Among the specific UPF categories, adolescents in the “very adequate” category consumed significantly fewer sweets than those in the “very inadequate” and “inadequate” categories did (p < 0.05 for all). Conclusions: This study revealed evidence of a relationship between cooking skills and overall UPF intake. These results support the importance of interventions that promote cooking competencies among adolescents. School-based culinary programs and community initiatives that teach adolescents simple, time-efficient, and cost-effective cooking techniques could help reduce the overall intake of UPFs. Full article

Recent advancements in wearable devices have significantly enhanced remote patient monitoring, enabling healthcare professionals to evaluate conditions within home settings. While electronic health records (EHRs) offer extensive clinical data, they often lack crucial contextual information about patients’ daily lives and symptoms. By integrating continuous self-reported outcomes related to vulnerability, anxiety, and depression from older adult cancer survivors with objective data from wearables, we can develop personalised risk models that address time-varying risk factors in cancer care. Our study combines real-world data from wearable devices with self-reported information, employing process mining techniques to analyse dynamic risk models for vulnerability and anxiety. Unlike traditional static assessments, this approach recognises that risk factors evolve. Collaborating with healthcare professionals, we analysed data from the LifeChamps study to create two dynamic risk models. This collaborative effort revealed how activity and sleep patterns influence self-reported vulnerability and anxiety among participants. It underscored the potential of wearable sensors and artificial intelligence techniques for deeper analysis and understanding, making us all part of a larger effort in cancer care. Overall, patients with prolonged sedentary activity had a higher risk of vulnerability, while those with highly dynamic sleep patterns were more likely to report anxiety and depression. Prostate-metastatic patients showed an increased risk of vulnerability compared to other cancer types. Full article

This study investigated the relationship between family support (for daily activities and living) and life satisfaction among Nepali older adults, with an additional focus on gender differences. Data were drawn from a cross-sectional survey conducted in rural eastern Nepal through interviewing older adults aged 60 years and above. The total analytical sample for this study was 819. Life satisfaction was measured using Diener’s Satisfaction with Life Scale. Binary logistic regression was employed to explore the associations between reliance on family support and life satisfaction. About 57% of older adults were satisfied with their life. Older adults who relied on family support for daily activities had 51% lower odds of being satisfied with their lives compared to those who did not require such support (OR: 0.49, 95% CI: 0.35–0.69, p < 0.001). Gender did not moderate the relationship between family support for daily activities and life satisfaction, but interestingly, it moderated the relationship between family support for living and life satisfaction. Older men who relied on family support for living had 34% lower odds of experiencing life satisfaction compared to older women in similar situations (OR: 0.66, 95% CI: 0.48–0.90, p < 0.05). This study emphasizes the need for further research to comprehensively understand the impact of family support on life satisfaction among older adults in societies driven by filial piety, focusing on underlying mechanisms to confirm this paradoxical relationship. Full article

Background/Objectives: Metastatic prostate cancer remains a major clinical challenge, with limited therapeutic options. Doxycycline, a tetracycline antibiotic with anti-inflammatory properties, has shown potential as an adjunctive therapy. This study aimed to evaluate its efficacy in reducing prostate-specific antigen (PSA) levels and improving quality of life in patients receiving standard treatment for metastatic prostate cancer. Methods: This phase II, double-blind, randomized controlled trial included 45 participants (aged 57–81 years) assigned to doxycycline (100 mg daily) or a placebo for six months. The primary outcome was the percentage change in PSA levels at 3 and 6 months. Secondary outcomes included quality of life (EQ-5D-5L), cognitive function (Mini-Mental State Examination), and glucose levels. Additionally, a structure–activity relationship (SAR) analysis was performed through an extensive bibliographic review to identify pharmacophores responsible for doxycycline’s biological activity, particularly its tetracyclic core. The SAR analysis included tetracyclines and derivatives, androgen-targeting agents, and other pharmacologically relevant molecules used in prostate cancer therapy. Statistical analysis was conducted using multivariate logistic regression. Results: At six months, the doxycycline group showed a median PSA reduction of 60% compared to 10% in the placebo group (p = 0.043). A ≥50% reduction in PSA levels was observed in 71.4% of patients receiving doxycycline versus 20.8% in the placebo group (p = 0.001), with an adjusted relative risk of 10.309 (95% CI: 2.359–45.055, p = 0.002). Quality of life improved, with 7.1% of doxycycline-treated patients reporting poor quality of life compared to 42.9% in the placebo group (p = 0.028). A slight improvement in cognitive function was also noted (p = 0.037). SAR analysis suggested that the tetracyclic ring of doxycycline may play a crucial role in its observed biological effects. Conclusions: Doxycycline demonstrates potential as an adjunctive therapy in metastatic prostate cancer by reducing PSA levels and improving quality of life. The SAR analysis supports the hypothesis that its tetracyclic structure may be responsible for its therapeutic effects. Further large-scale trials are warranted to confirm these findings. Full article

Background/Objectives: With the advancement of intelligent sensing technology, rehabilitation systems based on wearable devices have a positive impact on the functional recovery and quality of life of stroke patients. This study aims to evaluate the application value of a contextualized intelligent rehabilitation training system for stroke survivors, which is based on wearable devices, in the rehabilitation of motor function impairments following stroke. Methods: A randomized controlled trial design was employed, in which 100 stroke patients were randomly divided into a control group (n = 50, receiving standard physical therapy rehabilitation interventions) and an experimental group (n = 50). The experimental group additionally underwent motor function rehabilitation interventions and intelligent assessments through a wearable device-based contextual intelligent rehabilitation training system, with sessions conducted twice daily for 30 min each, five days a week, over a duration of eight weeks. Both groups of patients underwent clinical scale evaluations and data collection before and after the treatment, with primary outcome measures including motor ability (Fugl–Meyer Assessment, FMA), activities of daily living (Modified Barthel Index, MBI), and participation in rehabilitation therapy. The intervention effects of both groups were compared after eight weeks of rehabilitation. Results: Prior to the intervention, there were no significant differences in Fugl–Meyer Assessment (FMA) and Modified Barthel Index (MBI) scores between the experimental group and the control group (p > 0.05). After eight weeks of rehabilitation, the experimental group demonstrated significantly superior performance in motor function (FMA scores) and activities of daily living (MBI scores) compared to the control group (p < 0.01). Conclusions: The intelligent rehabilitation system significantly enhances motor function and activities of daily living in stroke survivors. Compared to traditional rehabilitation methods, it improves patient adherence to rehabilitation training and overall outcomes. Full article

Background/Objectives: Psychosocial and cultural determinants have a special influence on the development, manifestation and prognosis of common mental disorders such as anxiety and depression. The objectives of this study were to define the psychosocial profile of the people most vulnerable to the development of these health problems, analyse the symptomatology and health determinants that may influence these from a gender perspective, and evaluate the quality of life and coping strategies among the adult population with this diagnosis in a rural area of Catalonia (Spain). Methods: An observational, cross-sectional, and analytical study was conducted on 180 people diagnosed with anxiety or depression. Patients completed an ad hoc sociodemographic questionnaire, the Brief Symptom Checklist (LSB-50), the Quality of Life Scale (EQ-5D-5L) and the Brief Cope Inventory (COPE-28). Results: Women aged 45–64 with a low socioeconomic profile may be more vulnerable to common mental disorders, although psychiatric symptomatology was more pronounced in men. Women were more likely to have problems with mobility (aOR= 2.93, p = 0.039) and daily activities (aOR = 2.75, p = 0.033), as well as lower self-perceived health scores (p = 0.002). Women used active coping, venting and seeking social support as coping strategies, while men used behavioural disengagement. Conclusions: It has been observed that the people most susceptible to developing depression and anxiety disorders may have a specific profile. Although a greater number of women have these common mental disorders, men tend to have more noticeable symptomatology. The coping strategies most used also differ according to gender. Full article

Background/Objectives: The steady increase in the global older adult population highlights critical challenges, including the development of preventive strategies to extend healthy life expectancy and support independence in activities of daily living. Although there is an aging-related reduction in manual dexterity, the difference in bimanual coordination performance between young and older adults remains unclear. We aimed to elucidate the characteristics of bimanual coordination among young, young-old, and old-old adult participants. Methods: The participants performed in-phase (tapping the thumb and index finger together as fast as possible) and anti-phase (alternating movement between the left and right fingers) bimanual coordination tasks, and intergroup comparison of the task parameters was performed. The receiver operating characteristic curve was also conducted to calculate age cut-off points for bimanual coordination. Results: The number and frequency of taps significantly decreased sequentially in young, young-old, and old-old adults, whereas the average of tap interval significantly increased in this order (p < 0.05). There was no significant difference between the young-old and old-old groups in the average local maximum distance (p > 0.05). These findings indicate that bimanual coordination task performance varies depending on specific parameters. Furthermore, the age cut-off points for bimanual coordination were determined as 68.5 years for the right-hand number of taps (AUC = 0.73) in the anti-phase task, 73.5 years for the right-hand average of tapping interval (AUC = 0.72) in the anti-phase task, and 65.5 years for the left-hand frequency of taps (AUC = 0.72) of the anti-phase task. Conclusions: the number of taps, average of tapping interval, and frequency of taps are potential indicators of aging-related changes in bimanual coordination. Full article

Background: The prevalence of diabetes mellitus (DM) is increasing worldwide, and mental health problems such as depression, anxiety, and diabetes distress are common co-morbidities that negatively impact the quality of life, complications, and treatment outcomes of patients with DM. Objectives: In this study, we assessed the impact of dietary patterns and physical activity on the well-being of patients with DM. Methods: A cross-sectional design and data from the European Health Interview Survey (EHIS) data collected in Hungary in 2019, and determination of the relationship between dietary habits and physical activity-related variables contained in the data and the World Health Organization-Five Well-Being Index (WHO-5 index) by suitable statistical methods. Results: Logistic regression showed higher odds of poor mental well-being in females (OR = 1.61, 95% CI: 1.08–2.42) and lower odds with daily fruit intake (OR = 0.52, 95% CI: 0.31–0.89). Infrequent white meat (OR = 3.34, 95% CI: 1.35–8.22) and dairy intake (OR = 1.60, 95% CI: 1.18–2.64) were associated with poorer well-being. Walking 4–7 days/week reduced the odds by 57% (OR = 0.43, 95% CI: 0.23–0.83). Conclusions: The results demonstrate that regular exercise and the consumption of fruits, dairy products, and white meat have beneficial effects on the mental well-being of patients with DM. Full article

Augmented reality (AR) technologies can improve the quality of life of individuals with visual impairments. The current study evaluated the efficacy of Retiplus, a new AR-based low-vision device, which was designed to enhance spatial awareness and visual function in patients with peripheral visual field loss. Thirteen patients diagnosed with retinitis pigmentosa (RP) participated in this study. The patients’ visual acuity, visual field, and subjective perception of peripheral vision and mobility were assessed both without and with the AR aid, following a training period consisting of five 1 h sessions. The results showed a significant expansion of the visual field (VF) in all four quadrants (right, left, upper, and lower) with a greater horizontal diameter enlargement (21.38° ± 12.94°) than vertical (15° ± 10.08°), with a statistically significant difference. However, the increase in VF was accompanied by a modest reduction in visual acuity due to the minification of the image on the display. Patient feedback also highlighted significant benefits on the ability to perform activities of daily living (ADL) in low-light environments and improved spatial orientation, suggesting that the AR system is helpful for some limitations imposed by patients’ conditions. These findings underscore the importance of optimizing AR technology to support visually impaired populations. Full article

Background/Objectives: The 2018 lifestyle recommendations of the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) have been associated with lower incidence of breast cancer, but their impact on mortality, survival, and recurrence of the disease is not known. This study aimed to investigate the association between adherence to WCRF/AICR recommendations on mortality, overall 10-year survival, and recurrence in women diagnosed with breast cancer. Methods: This prospective study included 101 women diagnosed with breast cancer between 2006 and 2011. Food consumption, body weight, and physical activity data were collected at diagnosis to calculate the WCRF/AICR score. Mortality, survival, and recurrence data were collected in 2020–2021. Kaplan–Meier curves and Cox proportional hazards regression models were applied to verify the association between WCRF/AICR score and its components with outcomes. Results: Women with lower adherence to the WCRF/AICR score (1st tertile, which was the reference group for regression models) had lower chance of 10-year overall survival when compared to patients with higher scores (2nd and 3rd tertiles, n = 67) (p = 0.025). Consumption of sugary drinks increased the chance of all-cause mortality (p = 0.005) and daily fiber intake increased the chance of overall 10-year survival (p = 0.027). Conclusions: It is suggested that adherence to WCRF/AICR recommendations before breast cancer treatment may contribute to better life expectancy. Full article

Community-acquired pneumonia (CAP) causes symptoms that disturb the clinical profile, functionality and quality of life of infected patients. Many CAP patients are hospitalized as a result of these conditions. A sedentary lifestyle is a risk factor for symptoms and functional decline in hospitalized patients; for this reason, it could be a key factor before a CAP infection. This study aimed to describe the symptoms, functionality and quality of life of CAP patients during and after hospitalization by comparing their sedentary behavior. A prospective observational study of CAP hospitalized patients was carried out. Participants were divided into two groups according to the daily sedentary time before hospitalization (420 minutes > sedentary). Dyspnea, fatigue, functionality and quality of life were collected upon admission, discharge, and 3 months after hospitalization. Ninety CAP patients were included in this study. At hospital admission, the sedentary patients presented lower functionality and quality of life (p = 0.002). At discharge, there were significant differences in quality of life in favor of the active group (p < 0.05). In addition, sedentary patients showed higher dyspnea (p = 0.04) and poorer functionality and quality of life (p < 0.001) 3 months after discharge. Full article

The transition to renewable energy sources from fossil fuels requires that the harvested energy be stored because of the intermittent nature of renewable sources. Thus, lithium-ion batteries have become a widely utilized power source in both daily life and industrial applications due to their high power output and long lifetime. In order to ensure the safe operation of these batteries at their desired power and capacities, it is crucial to implement a thermal management system (TMS) that effectively controls battery temperature. In this study, the thermal performance of a 1S14P lithium-ion battery module composed of cylindrical 18650 cells was compared for distinct cases of natural convection (no cooling), forced air convection, and phase change material (PCM) cooling. During the tests, the greatest temperatures were reached at a 2C discharge rate; the maximum module temperature reached was 55.4 °C under the natural convection condition, whereas forced air convection and PCM cooling reduced the maximum module temperature to 46.1 °C and 52.3 °C, respectively. In addition, contacting the battery module with an aluminum mass without using an active cooling element reduced the temperature to 53.4 °C. The polyamide battery housing (holder) used in the module limited the cooling performance. Thus, simulations on alternative materials document how the cooling efficiency can be increased. Full article