Search Results (44,259)

Background and Objectives: Diabetes affects quality of life (QoL) in physical, psychological, and social aspects. With high prevalence rates in Saudi Arabia, this study aimed to assess QoL in adults with diabetes across different regions and identify associated factors, addressing research gaps on complications and demographic influences. Materials and Methods: This cross-sectional study recruited adults diagnosed with diabetes from all regions of Saudi Arabia through phone interviews and the distribution of self-administered questionnaires via social media platforms. Data on demographics, health behaviors, diabetes-related complications, comorbidities, and diabetes management were collected. QoL was assessed using the Diabetic Quality of Life (DQoL) tool. Statistical analysis included descriptive statistics and multivariate regression, with significance set at p < 0.05. Results: Among the 527 individuals with diabetes, 57.7% were married, 56.1% were female, 93.7% lived in urban areas, and 37.2% had at least a bachelor’s degree. Common comorbidities included hypertension (29.2%) and hypercholesterolemia (22.8%). Physical activity and healthy weight were linked to improved DQoL. Diabetic complications, such as neuropathy (6.6%) and diabetic foot (4.9%), were significantly associated with lower DQoL scores. Depression was reported in 4.7% of participants and was the strongest predictor of poor QoL (β = −2.01, p < 0.001). Furthermore, individuals who exercised less than five times per week had significantly lower QoL scores (beta = −1.83; 95% CI = −2.56 to −1.10; p-value < 0.001). Conclusions: The study highlights the significant impact of education, health behaviors, diabetes complications, and comorbid depression on QoL. Comprehensive diabetes care that addresses both physical and psychological factors is essential for achieving improved outcomes. Full article

Background/Objectives: This study examined the relationship between nutritional status and muscle strength in the upper and lower large muscles, with a specific focus on shoulder, hip, and knee muscle strength in community-dwelling older adults. It also investigated the relationship between nutritional status and functional performance as measured by the Timed Up and Go (TUG) test. Methods: A secondary analysis of a cross-sectional study involving 2045 older adults (aged 60 years or older) from 15 randomly selected primary health care centers in Riyadh was conducted between January 2015 and April 2017. After excluding participants with specific medical conditions, 1741 individuals were included in the analysis. Nutritional status was assessed using the Arabic version of the Mini-Nutritional Assessment (MNA). Handgrip strength (HGS) and large muscle strength (shoulder, hip, knee) were measured using a hydraulic hand dynamometer and the Nicholas Manual Muscle Tester, respectively. The TUG test was also assessed to evaluate physical performance. Results: The study revealed that well-nourished older adults had significantly greater upper and lower muscle strength than those who were malnourished or at risk (p ≤ 0.001), with males generally exhibiting stronger muscle strength than females. Furthermore, in both genders, older adults showed significant positive correlations between MNA scores and upper and lower muscle strength. Additionally, longer times on the TUG test indicated a higher risk of malnutrition (OR: 1.135, CI: 1.087–1.186; p ≤ 0.001). Conclusions: this study breaks new ground by being the first to explore the relationship between nutritional status and the muscular strength in the shoulder and hip regions. Findings indicate that muscle strength and physical performance were associated with malnutrition. Full article

Background: Electronic monitoring adherence devices (EAMDs) are increasingly being utilized in various healthcare settings to track medication adherence. Objective: To determine the accuracy of the Sensal Health MyAide™ Smart Doc in capturing dose removal from the vial, specifically the time of dose removal and the number of pills removed for each actuation of the device. Methods: This validation study compares the device’s recording of dose withdrawals from a prescription vial by simulated patients against reference documentation reported using MS Forms by the participants. Three participants completed a 4-day study consisting of two non-consecutive 1 h sessions per day encompassing six actuations from the prescription vial to be captured by the Sensal Health MyAide™ Smart Dock after their informed consent was obtained. Statistical analysis included percent agreement and Cohen’s kappa assessing agreement between user-reported data and electronic measurement data recorded by the MyAide™ Smart Dock. Outcome measures included confirmation of the specific user, time of dose removal (±1 min), and the number of pills withdrawn. Results: Three subjects were recruited to provide data for a total of 144 actuations. The study found perfect 100% agreement across the number of pills withdrawn and specific users withdrawing the pills and 99% agreement for the time of administration. The Cohen’s kappa values for the outcome measures were 1.00 (95%CI [1.00, 1.00]) for the number of pills dispensed and specific user and 0.993 (95%CI [0.990, 0.996]) for the time of administration. Conclusions: This study found that the Sensal Health MyAide™ Smart Dock can accurately record the time of administration, the number of pills dispensed, and the identity of the user dispensing the pills. Full article

Background/Objectives: Emotional eating has been linked to neurobiological mechanisms similar to those observed in addictive behaviors, and this occurrence appears not fully understood, even in academic communities/environments. To supplement existing information, a preliminary assessment of university students' emotional eating patterns, nutritional status, and the risk of developing type 2 diabetes has been performed in this current work. Methods: A cross-sectional study was conducted with 129 students from the University of Extremadura, Spain. Emotional eating was assessed using the Emotional Eating Questionnaire (EEQ) and the Three-Factor Eating Questionnaire—Spanish version (TFEQ-R18(SP)) questionnaires, while type 2 diabetes risk was evaluated through the Finnish Diabetes Risk (FINDRISC) score test. Anthropometric data, including height, weight, BMI, and body composition, were collected using standardized measurement protocols. Statistical analyses included ANOVA and Kruskal–Wallis tests. Results: Significant differences were observed in BMI (mean ± SD: 23.93 ± 5.36 kg/m²) and total EEQ score (mean ± SD: 9.82 ± 5.82) across FINDRISC risk categories (p < 0.001 and p = 0.001, respectively). The Very Emotional Eaters group presented higher BMIs and FINDRISC scores, along with greater score dispersion. No significant differences were identified in EEQ subscales. Conclusions: Emotional eating behaviors may serve as indirect indicators of metabolic vulnerability, particularly when combined with excess body weight. These findings underscore the importance of incorporating emotional regulation and mindful eating strategies into health promotion programs for young adults. Full article

Isometric strength is widely used to monitor training adaptations, assess neuromuscular fatigue, and play a critical role in the maintenance of muscle health. This study assessed repeatability (intra-session) and reliability (inter-session) of a force production machine in different exercises: Isometric Mid-Thigh Pull (IMTP), Knee Flexion (KF) at 30°, and Seated Calf Raise (SCR). Parameters measured included Peak Force (PF), RFD at 0–50, 0–100, 0–150, 0–200, 50–100, 100–150 and 150–200 ms. Thirty male individuals (IMTP = 30; KF = 11 and SCR = 30) participated (age: 20.6 ± 3.6 years, mass: 75.3 ± 7.5 kg, height: 1.80 ± 0.64 m). Repeatability and reliability were calculated for bilateral PF and RFD for IMTP and SCR, and unilateral for KF. PF demonstrated good to excellent repeatability in all exercises: IMTP (ICC = 0.93), KF (left: ICC = 0.98; right: ICC = 0.97), SCR (ICC = 0.84). RFD displayed poor to good repeatability in IMTP (ICC = 0.45–0.87) and SCR (ICC = 0.40–0.85), moderate to excellent repeatability in KF (left: ICC = 0.53–0.96; right: ICC = 0.61–0.92). PF reliability was excellent in IMTP (ICC = 0.93) and KF (left: ICC = 0.99; right: ICC = 0.97), and moderate in SCR (ICC = 0.64). RFD reliability was moderate to excellent in IMTP (ICC = 0.58–0.94), poor to good in SCR (ICC = 0.13–0.64), and poor to excellent in KF (left: ICC = 0.33–0.96; right: ICC = −0.19–0.95). This study shows that portable dynamometry can measure maximal and explosive strength in different exercises, demonstrating good reliability for most parameters in IMTP and KF. Full article

The search for natural alternatives to sodium nitrite in meat products is driven by concerns about consumer health and the need to maintain product quality and safety. In this study, the effect of sodium nitrite reduction on the quality parameters of canned pork meat with 1% lyophilized cell-free supernatant (CFS) from L. paracasei B1, during 30 days of storage, was assessed. Reduction of sodium nitrite content led to measurable changes in the color, texture, and oxidative stability of canned pork; however, the presence of 1% CFS helped preserve color, alleviated the negative impact on textural parameters, and limited lipid oxidation, thereby counteracting the typical consequences of nitrite reduction. Among the tested variants, S_75, containing 75% of the standard nitrite dose, showed the best overall balance between color retention, textural integrity, and oxidative stability. Samples without nitrite (S_0) exhibited a noticeable increase in lightness (L*) and decrease in redness (a*) over time, accompanied by a shift towards yellow-brown hues (b*, C*, H°). Importantly, the total color difference (ΔE) was least pronounced in the S_75 variant, with values of approximately 2.5 after 1 day and 2.7 after 30 days, which was markedly lower than in S_50 (ΔE ≈ 6.0 and 3.9) and S_0 (ΔE ≈ 7.9 and 8.5), thereby confirming superior color retention and overall stability during storage. Texture analysis showed that initial hardness and chewiness were higher in nitrite-free samples (S_0), suggesting that the complete omission of nitrite may negatively affect product structure. Nevertheless, all variants softened during storage, and samples with higher nitrite content, particularly S_75, retained better elasticity and cohesiveness. Lipid oxidation, expressed as TBARS values, progressed fastest in samples completely depleted of nitrite (S_0), increasing from 0.31 mg MDA/kg (day 1) to 1.35 mg MDA/kg (day 30), which confirms the antioxidant role of sodium nitrite. Interestingly, the presence of 1% CFS in the variants with reduced nitrite content partially mitigated this effect, as TBARS values in S_75 increased only from 0.29 to 0.46 mg MDA/kg, and, in S_50, from 0.45 to 0.66 mg MDA/kg, compared to the nitrite-free variant. This suggests that CFS may also have contributed to antioxidant protection. Fatty acid profiles remained relatively consistent across methods. Microbiological analysis revealed no significant differences between groups. These results demonstrate that partial nitrite reduction combined with CFS is effective, highlighting the potential of CFS as a promising functional additive in clean label meat preservation. Furthermore, reducing the sodium nitrite content in canned pork products may contribute to improved consumer health by reducing exposure to potentially harmful nitrosamine precursors. Full article

Background: Older adults with cancer are surviving longer due to earlier detection and more effective treatments for advanced stages. This population is at an elevated risk of osteoporosis due to age-related changes in bone density as well as the impact of cancer and cancer treatments on the skeletal system. Main Body: Cancer treatments are associated with increased bone loss and fracture risk via a variety of mechanisms. International guidelines recommend screening for cancer treatment-induced bone loss and provide treatment algorithms for pharmacological agents for those on hormonal therapy. There is a paucity of guidelines on bone health protection for those receiving intermittent glucocorticoid and newer immunotherapy regimes. Results: All patients receiving cancer treatment should undergo an individualised fracture risk assessment to optimise their bone health with regular review and reassessment of their risk profile. Dedicated bone health guidelines in cancer populations should be expanded to consider the impact of newer treatment modalities. All patients should receive education around non-pharmacological management and undergo a shared decision-making approach where there are indications for bone-targeted agents. Conclusions: Bone health assessment is an integral part of comprehensive geriatric assessment for older people with cancer. Strategies to minimise bone density loss and reduce fracture risk are an important consideration for cancer survivorship programmes for the majority of people and require a standardised approach. Full article

Vector-borne diseases (VBDs) continue to pose a persistent global health challenge, disproportionately impacting low- and middle-income countries where surveillance and healthcare infrastructure are constrained. Within these countries, residents of remote island communities are particularly vulnerable to emerging VBD threats; however, they remain critically understudied. We conducted a community-based cross-sectional survey of 300 residents from Shahpori Island, Bangladesh, and Gaya Island, Malaysia, to assess knowledge, attitudes, and practices (KAP) related to VBDs. Using a structured questionnaire and mixed-effects Poisson regression modeling, we identified socio-demographic predictors of VBD-related knowledge and compared KAP outcomes across the two islands. Significant disparities were observed between the two settings: the Gaya Island residents demonstrated a higher level of awareness regarding VBDs and preventive practices compared to the Shahpori residents. Education was a strong predictor of VBD knowledge, with individuals possessing secondary education or above exhibiting significantly better knowledge (β = 0.2024, p = 0.0003). Marital status was also a significant factor, with unmarried respondents showing lower levels of knowledge (β = –0.1657, p = 0.0372). Age was positively correlated with VBD knowledge (β = 0.0051, p = 0.0119), indicating a gradual increase with age, while income, gender, occupation, and household size were not significantly associated. Despite basic awareness of VBD symptoms and transmission, detailed understanding of mosquito ecology, disease symptoms, and breeding prevention strategies was remarkably poor, especially among the Shahpori residents. Our findings highlight critical gaps in VBD-related knowledge and prevention behaviors shaped by socio-economic and educational disparities. Community-focused public health strategies including educational campaigns, establishment of health infrastructure, access to trained healthcare providers, and integrated vector control interventions are urgently needed to enhance resilience against emerging VBD threats such as drug-resistant malaria in remote island populations. Full article

Background: Cardiovascular diseases (CVDs) are linked with poor oral health outcomes, yet data on oral health status, behaviors, and awareness among CVD patients in Odisha remain scarce. This study aimed to assess the self-reported oral health status, behaviors, and knowledge among patients with CVD and associated risk factors. Methods: A cross-sectional survey was conducted among 391 patients aged 40–80 years attending dental and cardiology OPDs at a tertiary care center in Bhubaneswar. Participants were grouped into control, at-risk, and established CVD categories. A 24-item questionnaire and panoramic radiographic examination were used to assess oral health. Data were analyzed using the chi-squared test and Kappa statistics. Results: Patients with established CVD reported significantly higher prevalence of oral health problems, poor oral hygiene behaviors, and lower awareness compared to controls. Clinical findings revealed higher rates of periodontal bone loss, caries, and periapical radiolucency in the CVD group. Agreement between radiographic examiners was high. Conclusions: There is a substantial burden of oral disease and poor oral health awareness among patients with CVD in Odisha. These findings emphasize the need for integrated oral health education and care protocols in cardiovascular patient management. Full article

Structural parameters, such as strain or deflection, were collected by sensors and analyzed to assess the bridge’s structural condition and obtain a reliable reference for bridge maintenance. In the data acquisition and transmission process, sensor data inevitably contains noise and interference, resulting in anomalies, especially data distortion during wireless transmission. These anomalies significantly impact data analysis and structural evaluation. To mitigate the effects of these abnormalities, we conducted the cause analysis. The Sanxia Viaduct was used to design a strain monitoring method as a bridge model. We analyzed vibrating string sensor data collected in the cold environment using the Nair method to eliminate outlier data. The analysis results of strain and temperature trends showed that the data fusion method developed in this study showed high precision and stability and effectively reduced the impact of noise and data anomalies. By monitoring actual bridges, the effectiveness and practicality of the method were validated. The model provides significant information on the development and application of bridge health monitoring technology. Full article

The livestock sector, a crucial source of revenue and global food security, is facing serious challenges due to climate change driven by global warming. This leads to serious effects on animal health and productivity, making it difficult for the livestock industry to meet the global demand and sustain the livelihoods of farmers. The main factor affecting livestock’s productivity is heat stress. However, animals develop various adaptive mechanisms to cope with the effects of heat stress. Cellular and molecular responses act as key defense mechanisms, enabling animals adapt to environmental changes. The recent advancements in molecular biology have opened up opportunities for extensive research on epigenetics, which has a key role in regulating gene expression in animals in response to environmental stimuli. Such studies have gained considerable attention regarding heat acclimation in animals due to the fact that epigenetic mechanisms have been recognized as key players in long-term adaptation to high temperatures in farm animals. This review summarizes the different mechanisms and methodologies used to assess heat stress-associated epigenetic changes, including DNA methylation, which is an extensively studied epigenetic regulatory mechanism in relation to gene expression. The review also highlights the mechanisms and regulation of adaptation to heat stress in animals and collates information related to various epigenetic markers to assess the heat stress response, thereby aiding in improving thermal resilience in animals. Full article

Background: Addressing Intensive Care Unit (ICU) patients’ psychological well-being is crucial, yet psychosocial support interventions that can facilitate effective coping, ultimately decreasing stress-related physiological, mental health, and cognitive sequelae, are not currently included in clinical practice guidelines and standards. Objective: To identify and synthesize research evidence on psychosocial support interventions in the ICU, including types of outcomes and measures of effectiveness, and to explore research gaps and barriers to implementation. Method: The review was directed by a protocol based on current guidance for scoping reviews. The quality of studies was assessed using the National Institute for Health and Clinical Excellence. The review focused on articles containing evaluations of psychosocial interventions through an experimental or quasi-experimental design or pretest-posttest comparisons. Databases searched included Medline, CINAHL, PubMed, PsychInfo, and the Cochrane Library. Results: Ten highly heterogeneous studies were identified, encompassing diverse interventions (e.g., relaxation, psychotherapy, spirituality, and positive suggestions) and patient populations. Across the 10 studies, no intervention type was replicated, and most samples were small and quasi-experimental, limiting internal validity and preventing quantitative synthesis. Despite these limitations, the evidence reviewed supports that various psychosocial interventions, including positive suggestions (constructive, reassuring thoughts), relaxation techniques, psychotherapy (emotional, behavioral guidance), and spiritual and/or religious support can alleviate psychological sequelae, such as depression, anxiety, and Post Traumatic Stress in ICU patients. Conclusions: This review highlights the positive impact of psychosocial interventions on alleviating psychological distress in ICU patients. However, a critical gap exists in understanding their effects on other clinical and physiological outcomes, necessitating comprehensive research. Full article

Background/Objectives: Maxillary defects, whether congenital or acquired, can compromise chewing, speech, and aesthetics. This systematic review aimed to evaluate the application and characteristics of definitive palatal obturators in the rehabilitation of such defects, analyzing techniques of fabrication, materials, outcomes of the fabrication, and limitations reported in the literature. Methods: The review was conducted in accordance with PRISMA 2020 guidelines and was registered in PROSPERO (ID: 1011648). A comprehensive search was performed in PubMed, Scopus, Lilacs, and Google Scholar for studies published from 1 January 2014 to 1 January 2025. Inclusion criteria comprised adult patients treated with definitive palatal obturators and with reported follow-up. Exclusion criteria included studies on children, animals, or lacking patient data. Two reviewers independently screened studies and assessed eligibility. Bias was evaluated qualitatively across five domains. No meta-analysis was conducted; data were synthesized descriptively using charts and tables. The study was funded by the Italian Ministry of Health—Current Research IRCCS. Results: A total of 59 studies involving 83 patients (46 males, 37 females; mean age 54.6 ± 13.8 years) were included. Mucormycosis and squamous cell carcinoma were the primary causes of defects. Conventional impressions using alginate and silicone were most common, while digital techniques were reported in only 6.6% of cases. All definitive obturators were fabricated using acrylic resin, with some featuring hollow bulbs, velopharyngeal extensions, or magnetic retention. Multiple sources of bias were observed. Conclusions: Definitive palatal obturators provide effective functional and aesthetic rehabilitation for maxillary defects. However, evidence is limited by methodological weaknesses, lack of standardization, and underutilization of digital technologies. Future studies should focus on improving reporting quality, adopting innovative fabrication protocols, and generating higher-level clinical evidence to support best practices. Full article

Background: Current guidelines endorse the integration of exercise into cancer care. The diagnosis of cancer and its treatment, however, may introduce factors that make exercise engagement difficult, especially for individuals with advanced stages of disease. In this paper, we describe the baseline screening and triage process implemented for the Alberta Cancer Exercise (ACE) hybrid effectiveness-implementation study and share findings that highlight the multifaceted complexity of the process and the direct role of the clinical exercise physiologist (CEP). Methods: ACE was a hybrid effectiveness-implementation study examining the benefit of 12-week cancer-specific community-based exercise program. The ACE screening process was developed by integrating evidence-based guidelines with oncology rehabilitation expertise to ensure safe and standardized participation across cancer populations. The screening process involved four steps: (1) a pre-screen for high-risk cancers, (2) completion of a cancer-specific intake form and the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+), (3) a CEP-led interview to further evaluate cancer status, cancer-related symptoms and other health issues (performed in-person or by phone), and (4) a baseline fitness assessment that included measurement of vital signs. Results: A total of 2596 individuals registered and underwent prescreening for ACE with 2570 (86.6%) consenting to participate. After full screening including the baseline fitness testing, 209 participants (8.1%) were identified as requiring further medical clearance. Of these, 191 (91.4%) had either a high-risk cancer, metastatic disease or were in the palliative end-stage of cancer, and 161 (84.3%) reported cancer-related symptoms potentially affecting their ability to exercise. In total, 806 (31.4%) participants were triaged to CEP-supervised in-person programming, 1754 (68.2%) participants to ACE community programming, and 8 (0.3%) specifically to virtual programming (post-COVID-19 option). Conclusions: The findings highlight the complexity and challenges of the screening and triage process, and the value of a highly trained CEP-led iterative approach that included the application of clinical reasoning. Full article

Stream temperatures are expected to increase with warming air temperatures, yet the extent and aquatic health impacts vary significantly across heterogeneous landscapes. This study was conducted in a 3360-ha multi-land-use watershed in the Pacific Northwest region of the USA to assess and compare the driving factors for stream temperature heating, cooling, and cool-water refugia along a 12-km mainstem stream longitudinal profile. Study objectives were to (1) determine yearlong stream temperature variability along the entire stream longitudinal profile, and (2) assess stream-environment relationships influencing stream temperature dynamics across forest, agriculture, and urban landscapes within the watershed. Stream and riparian air temperatures, solar radiation, shade, and related stream-riparian characteristics were measured over six years at 21 stations to determine changes, along the longitudinal profile, of thermal sensitivity, maximum and minimum stream temperatures, and correlation between solar radiation and temperature increases, and potential causal factors associated with these changes. Solar radiation was a primary heating factor for an exposed agricultural land use reach with 57% effective shade, while southern stream aspects and incoming tributary conditions were primary factors for forested reaches with greater than 84% effective shade. Potential primary cooling factors were streambank height, groundwater inflows, and hyporheic exchange in an urban reach with moderate effective shade (79%) and forest riparian width (16 m). Combining watershed-scale analysis with on-site stream-environmental data collection helps assess primary temperature heating factors, such as solar radiation and shade, and potential cooling factors, such as groundwater and cool tributary inflows, as conditions change along the longitudinal profile. Full article