Search Results (14,859)

Background/Objectives: The recent development of four-dimensional X-ray velocimetry (4DXV) technology (three-dimensional space and time) provides a unique opportunity to obtain preclinical quantitative functional lung images. Only single-scan measurements in non-survival studies have been obtained to date; thus, methodologies enabling animal survival for repeated imaging to be accomplished over weeks or months from the same animal would establish new opportunities for the assessment of pathophysiology drivers and treatment response in advanced preclinical drug-screening efforts. Methods: An anesthesia protocol developed for animal recovery to allow for repetitive, longitudinal scanning of individual animals over time. Test–retest imaging scans from the lungs of healthy mice were performed over 8 weeks to assess the repeatability of scanner-derived quantitative imaging metrics and variability. Results: Using a murine model of fibroproliferative lung disease, this longitudinal scanning approach captured heterogeneous progressive changes in pulmonary function, enabling the visualization and quantitative measurement of averaged whole lung metrics and spatial/regional change. Radiation dosimetry studies evaluated the effects of imaging acquisition protocols on X-ray dosage to further adapt protocols for the minimization of radiation exposure during repeat imaging sessions using these newly developed image acquisition protocols. Conclusions: Overall, we have demonstrated that the 4DXV advanced imaging scanner allows for repeat measurements from the same animal over time to enable the high-resolution, noninvasive mapping of quantitative lung airflow dysfunction in mouse models with heterogeneous pulmonary disease. The animal anesthesia and image acquisition protocols described will serve as the foundation on which further applications of the 4DXV technology can be used to study a diverse array of murine pulmonary disease models. Together, 4DXV provides a novel and significant advancement for the longitudinal, noninvasive interrogation of pulmonary disease to assess spatial/regional disease initiation, progression, and response to therapeutic interventions. Full article

Advances in geroscience suggest that aging is modulated by molecular pathways that are amenable to dietary and pharmacological intervention. We conducted an integrative critical review of caloric restriction (CR), intermittent fasting (IF), and caloric restriction mimetics (CR-mimetics) to compare shared mechanisms, clinical evidence, limitations, and translational potential. Across modalities, CR and IF consistently activate AMP-activated protein kinase and sirtuins, inhibit mTOR (mechanistic target of rapamycin) signaling, and enhance autophagy, aligning with improvements in insulin sensitivity, lipid profile, low-grade inflammation, and selected epigenetic aging measures in humans. CR-mimetics, such as metformin, resveratrol, rapamycin, and spermidine, partially reproduce these effects; however, long-term safety and efficacy in healthy populations remain incompletely defined. Methodological constraints—short trial duration, selective samples, intermediate (nonclinical) endpoints, and limited adherence monitoring—impede definitive conclusions on hard outcomes (frailty, disability, hospitalization, mortality). We propose the Active Management of Aging and Longevity (AMAL) model, a three-level biomarker-guided framework that integrates personalized diet, chrono-nutrition, exercise, and the selective use of CR-mimetics, along with digital monitoring and decision support. AMAL emphasizes epigenetic clocks, multi-omics profiling, inflammatory and microbiome metrics, and adaptive protocols to enhance adherence and clinical relevance. Overall, CR, IF, and CR mimetics constitute promising, complementary strategies to modulate biological aging; rigorous long-term trials with standardized biomarkers and clinically meaningful endpoints are needed to enable their scalable implementation. Full article

Optimal recovery supports health and enhances performance in soccer players, yet the empirical evidence on various recovery strategies in soccer is complex to interpret. This review aimed to summarize the literature on post-exercise recovery modalities in male and female soccer players of all ages and competition levels. Following PRISMA guidelines, PubMed, SPORTDiscuss, and Web of Science were systematically searched until 17 October 2023. Randomized controlled trials or within-subjects crossover design studies that examined the effects of post-exercise recovery interventions on physical, psychological, or performance outcomes in soccer players were included. A single reviewer extracted data and assessed study quality using the Physiotherapy Evidence Database (PEDro) scale. Overall, 41 studies were included in the final review. The recovery strategies represented in these studies were organized into the following categories: active recovery, blood flow restriction, cold water immersion, contrast water therapy, compression garments, active cool-down, cryotherapy, cold garments, sleep and daytime nap, pneumatic cooling, foam rolling, mindfulness interventions, nutritional intervention, and static stretching. The findings demonstrated that cold-water immersion consistently improved jump performance and perceptions of fatigue, soreness, and overall well-being. Other recovery strategies, such as active recovery, compression therapy, sleep interventions, and nutrition supplementation, also positively impacted recovery, albeit with varying levels of effectiveness and evidence. However, the studies exhibited heterogeneity in methods, outcome measures, and recovery intervention protocols, posing challenges for generalizability. This review summarizes recovery strategies for soccer players, emphasizing the need for practitioners, coaches, and athletes to individualize interventions based on athletes’ needs, preferences, and competition level. Full article

Background/Objective: Childhood obesity and mental health disorders in preschool-aged children represent critical public health challenges with a rising global prevalence, closely linked to lifestyle behaviors and the family environment. This cross-sectional study aims to investigate the combined influence of maternal sociodemographic, socioeconomic, anthropometric characteristics, and lifestyle factors on the physical and mental health status of preschool-aged children. Methods: Validated questionnaires were administered to assess dietary habits, psychosocial parameters (depression, anxiety, stress), and sociodemographic, socioeconomic, and anthropometric variables among 200 preschool-aged children and their mothers, who served as the primary informants. Results: Maternal obesity was associated with a higher prevalence of childhood overweight/obesity (36.7% vs. 18.5% in children of non-obese mothers, p = 0.009). Maternal psychological factors, specifically depressive symptoms (B = 0.998, OR = 2.712, 95% CI: 1.222–6.020, p = 0.014) and anxiety (B = 1.676, OR = 5.346, 95% CI: 2.471–11.565, p < 0.001), were independently associated with an increased likelihood of child anxiety. Anthropometric measures, including waist circumference (p = 0.032) and hip circumference (p = 0.031), primarily influenced children’s physical health, whereas maternal psychological factors predominantly affected their emotional well-being. Conclusions: The findings underscore the necessity for targeted interventions focusing on enhancing maternal nutrition and mental health literacy, aiming to promote healthy dietary patterns, physical activity, and lifestyle behaviors. Such interventions are pivotal for preventing childhood obesity and fostering overall well-being at the population level. Full article

Background/Objectives: Academic burnout is an emerging problem among nursing students, characterized by emotional exhaustion, cynicism, and reduced academic efficacy. Sports interventions have been shown to have a positive effect on nurses as a preventive strategy against burnout. The aim of this study was to evaluate the effect of a nature sports program on the levels of academic burnout in nursing students. Methods: A randomized clinical trial was performed. The intervention was a 12-week nature exercise program with two sessions each week. The main dependent variables were burnout (measured using the Maslach Burnout Inventory—Student Survey), stress (measured using the Perceived Stress Scale), and anxiety and depression (measured using the Hospital Anxiety and Depression Scale). The post-intervention sample size was n = 58 in the control group and n = 48 in the intervention group. Results: After the intervention, significant differences were found in respect of emotional exhaustion (p < 0.001; Cohen’s D: 0.483), stress (p < 0.05; Cohen’s D: 0.456), and mean steps per day (p < 0.001; Cohen’s D: −1.09), with the mean values being reduced in the intervention group by around three points in emotional exhaustion and stress; the intervention group also achieved a higher mean number of daily steps compared to the control group. Conclusions: A nature sports program could help to reduce emotional exhaustion and stress, and increase the number of steps per day. Full article

Purpose: Renal angiomyolipomas (AMLs) are benign renal neoplasms that may lead to spontaneous hemorrhage. Transcatheter arterial embolization (TAE) is a nephron-sparing treatment option, yet data on predictors of hemorrhage and re-intervention remain limited. This study evaluates clinical and radiologic outcomes of TAE and identifies predictors of hemorrhage and repeat embolization. Materials and Methods: A retrospective review of 66 patients (69 AMLs) undergoing TAE between 2010 and 2024 was conducted. Clinical, radiological, and procedural variables were analyzed. Tumor size, vascularity, and aneurysmal features were assessed pre- and post-embolization. Logistic regression models identified predictors of hemorrhage and repeat TAE. Results: Pre-treatment tumor diameter was the only significant predictor of hemorrhage (p = 0.011), with a threshold of 6.8 cm yielding 84.6% sensitivity and 71.3% specificity. All hemorrhagic tumors measured ≥4 cm. Post-embolization tumor volume predicted repeat TAE (p = 0.001), with a 248 mL cutoff. TAE significantly reduced tumor diameter (−33.5%) and volume (−60%) (p < 0.001). Radiologic success was achieved in 97% of cases, with a durable success rate of 84%. Clinical success was 94%, and complications occurred in 7.2% of patients, including two major events. Conclusions: TAE is a safe and effective treatment for renal AMLs. Tumor diameter >6.8 cm is a strong predictor of hemorrhage, while larger post-embolization volumes predict the need for re-intervention. These findings challenge the conventional 4 cm treatment threshold and support more individualized management strategies incorporating tumor morphology and response to embolization. Full article

Background. Physical activity enhances cognitive performance in adolescents, yet the role of circadian timing within the school day remains poorly understood. Purpose. This study examined whether the timing of school-based physical activity (morning, midday, afternoon) influences cognitive performance, subjective alertness, and mood states in early adolescents. Methods. A 12-week crossover intervention was conducted with 102 students (aged 12–13 years) from southern Italy. Each class participated in three 4-week conditions of structured physical activity scheduled in the morning (8:10–9:10), midday (12:10–13:10), and afternoon (15:10–16:10), separated by one-week washouts. Cognitive outcomes (d2-R, Digit Span backward, TMT-A), subjective alertness (KSS), and mood (PANAS-C) were assessed at baseline and after each condition. Analyses employed linear mixed-effects models and repeated-measures ANOVAs, adjusting for sex, BMI, chronotype, and sleep duration. Results. Morning activity produced the strongest improvements in attention (d2-R, η²p = 0.16), working memory (Digit Span backward, η²p = 0.06), processing speed (TMT-A, η²p = 0.08), alertness (KSS, η²p = 0.19), and positive affect (PANAS-C, η²p = 0.05). Midday sessions yielded moderate benefits (d2-R, η²p = 0.09; Digit Span backward, η²p = 0.05; TMT-A, η²p = 0.07; KSS, η²p = 0.09), while afternoon activity showed the weakest or nonsignificant changes (all η²p < 0.05). Chronotype moderated the effects on attention and working memory, with morning types deriving the largest gains. Conclusions. The timing of physical activity is a critical determinant of its cognitive and affective benefits. Incorporating morning exercise into school timetables may represent a low-cost, scalable strategy to optimize both learning readiness and well-being in adolescents. Full article

(1) Background: The Iowa Oral Performance Instrument (IOPI) is the well-established device for assessing tongue strength. The current study aimed to assess the effectiveness of the HEAL device in patients with obstructive sleep apnea (OSA) exhibiting varying degrees of tongue base obstruction, as determined by drug-induced sleep endoscopy (DISE). All participants had undergone modified uvulopalatopharyngoplasty (UPPP), and tongue strength was measured using the IOPI. (2) Methods: This retrospective observational study utilized DISE to assess patterns of upper airway collapse in patients with OSA who were candidates for surgical intervention. Based on DISE findings, patients were divided into two groups: the M group (no or partial tongue base obstruction) and the S group (severe obstruction). The first tongue strength assessment using the IOPI was conducted one month after modified UPPP, prior to initiating HEAL training. Patients then underwent tongue muscle training with the HEAL device, starting one-month post-surgery. A second IOPI assessment was performed after at least one month of training. (3) Results: Forty-nine OSA patients with varying degrees of tongue base obstruction (assessed via DISE) received modified UPPP and were included in the analysis. The mean age was 38.3 ± 7.4 years, and mean BMI was 27.8 ± 3.9 kg/m². After training with the HEAL, average tongue strength increased by 20.6 ± 11.5 kPa. The M group showed significantly greater improvement than the S group (22.45 ± 11.77 vs. 13.33 ± 6.93 kPa, p = 0.024). Linear regression confirmed this difference remained significant (p = 0.024). (4) Conclusions: In this study, participants who received modified UPPP exhibited improvements in tongue base strength following a minimum of one month of training with the HEAL device. Those with no or mild tongue base obstruction, as determined by DISE prior to surgery, experienced greater improvements in tongue strength compared to those with severe tongue base obstruction. Full article

Household food waste remains a persistent challenge despite widespread pro-environmental intentions. Drawing on Brehm’s Motivational Intensity Theory, this study examined how perceived difficulty and perceived ability interact with motivation to predict self-reported food waste. We surveyed 939 participants in Flanders and Spain, measuring motivation to avoid waste, self-rated perceived ability to manage food, meal planning perceived difficulty, and food waste. Moderated moderation analyses revealed that motivation and perceived ability each independently predicted lower waste. Crucially, a significant three-way interaction showed that motivation most effectively reduced waste when perceived difficulty was low and perceived ability was high; when perceived difficulty exceeded perceived ability, motivation had no mitigating effect. These findings underscore that effort mobilization influenced by both individual capacity and situational demands is key to closing the intention–behavior gap in food waste. Practically, interventions should go beyond raising awareness to simplify tasks and bolster consumers’ skills, aligning action demands with realistic effort levels. Full article

Background and Objectives: Post-menopausal estrogen decline is considered a contributing factor to sarcopenia, and inspiratory muscle training (IMT) may provide benefits in this demographic. This study examined the impact of a four-week IMT program on diaphragm thickness, abdominal wall muscle thickness (AWMT; transversus abdominis, internal oblique, and external oblique), and liver fat percentage in healthy elderly women. Materials and Methods: Twenty-six women aged 60–80 years were randomly assigned to an IMT group (n = 13) or a control group (n = 13). The IMT group used the PowerBreathe^® Classic device at 40% of maximal inspiratory pressure (MIP), with weekly increments of 10%. Training was performed twice daily, five days per week, with 30 breathing cycles per session (60 per day). The control group maintained their usual routines. AWMT, diaphragm thickness (DT), and fatty liver density (FLD) were measured by a radiologist before and after the intervention. Results: After four weeks, the IMT group showed significant improvements in all parameters compared to controls. Mid-diaphragm thickness (MDT) increased by 11.44% (effect size (ES) = 0.358, p < 0.001) versus 0.76% in controls (p = 0.271). Posterior diaphragm thickness (PDT) improved by 7.48% (ES = 0.282, p < 0.001) versus 0.38% (p = 0.564). Right AWMT increased by 12.7% (ES = 0.492, p < 0.001) compared to 0.10% (p = 0.872), and left AWMT increased by 9.93% (ES = 0.395, p < 0.001) versus 2.64% (p = 0.014). FLD improved by 11.79% (ES = 0.959, p < 0.001) in the IMT group, while the control group showed no meaningful change (−0.13%, p = 0.847). Conclusions: A short-term IMT protocol significantly enhanced diaphragm and AWMT and reduced liver fat in elderly women. These findings support the use of IMT as a simple, non-invasive intervention to preserve musculoskeletal and metabolic health in aging populations. Full article

Major depressive disorder (MDD) is a prevalent and disabling condition. Transcranial direct current stimulation (tDCS) may improve symptoms by modulating neuroplastic and inflammatory mechanisms. This randomized, double-blind, placebo-controlled trial will recruit adult outpatients with MDD showing residual symptoms despite at least four weeks of stable SSRI treatment. Participants will be randomized to active or sham add-on tDCS while continuing their antidepressant regimen. The intervention will consist of 15 sessions over 3 weeks, targeting the left dorsolateral prefrontal cortex (anode F3, cathode F4) at 2 mA for 30 min per session. The primary outcome is the reduction of depressive symptoms measured by the Hamilton Depression Rating Scale-17 (HDRS), with remission defined as HDRS-17 ≤ 7. Secondary outcomes include cognitive performance (attention, executive functioning, memory), serum biomarkers (BDNF, VEGF, NGF, NRG1, angiogenin, IGF1, IL-6, TNF-α), cortical excitability assessed by transcranial magnetic stimulation (motor threshold, silent period, intracortical inhibition/facilitation), and cerebral hemodynamics by transcranial Doppler sonography (blood flow velocity, pulsatility, resistivity). Assessments will occur at baseline, post-treatment, and 3- and 6-month follow-ups. This trial aims to evaluate the efficacy of adjunctive tDCS in MDD with residual symptoms and its biological correlates, bridging clinical improvement with electrophysiological and neurovascular mechanisms Full article

Urban school environments often face significant thermal discomfort due to extensive paved surfaces, limited vegetation, and outdated building designs. This study examines how green spaces can mitigate temperature extremes and improve thermal comfort at two secondary schools in Coimbra, Portugal: Escola Secundária José Falcão (ESJF) and Escola Secundária D. Dinis (ESDD). Using a mixed-methods approach that combined school community surveys with on-site microclimatic measurements, we integrated user feedback on comfort with data on temperature and humidity variations across different indoor and outdoor spaces. Results revealed that tree-shaded areas consistently maintained lower air temperatures and higher relative humidity than unshaded zones, which experienced intense heat accumulation—up to a 5 °C difference. At ESJF, the older infrastructure and large asphalt surfaces led to severe heat retention, with east-facing classrooms recording the highest indoor temperatures. ESDD’s pavilion-style layout and existing green spaces provided comparatively better thermal conditions, although insufficient vegetation maintenance and limited shade reduced their effectiveness. The findings demonstrate a clear correspondence between the school community’s perceptions of thermal comfort and the measured microclimatic data. Vegetation—particularly deciduous trees—plays a critical role in cooling the school microclimate through shading and evapotranspiration. Strategic interventions such as expanding tree cover in high-exposure areas, installing green roofs and walls, and carefully selecting species can significantly reduce temperature extremes and improve outdoor usability. In addition, fostering environmental education and participatory co-design programs can encourage sustainable behaviors within the school community, underlining the importance of inclusive, nature-based solutions for climate adaptation. This research highlights that integrating green infrastructure in school design and management is a cost-effective strategy for thermal regulation. Green spaces, when co-designed with community involvement, not only enhance climate resilience and student well-being but also contribute to broader sustainable urban development goals. Full article

Background/Objectives: Spanish-speaking patients face persistent barriers in accessing equitable audiological care, particularly when standardized language-appropriate tools are lacking. Two Spanish-language sentence recognition tests, the Spanish AzBio Sentence (SAzB) and the Latin American Hearing in Noise Test (LAH), are commonly used to evaluate speech perception in adults with hearing loss. However, performance differences between these measures may influence referral decisions for hearing intervention, such as cochlear implantation. This study compared test performance under varying noise and spatial conditions to guide appropriate test selection and reduce the risk of misclassification that may contribute to healthcare disparities. Methods: Twenty-one bilingual Spanish/English speaking adults with normal bilateral hearing completed speech perception testing using both the SAzB and LAH. Testing was conducted under two spatial configurations: (1) speech and noise presented from the front (0° azimuth) and (2) speech to the simulated poorer ear and noise to the better ear (90°/270° azimuth). Conditions included quiet and three signal-to-noise ratios (+10, +5, and 0 dB). Analyses included paired t-tests and one-way ANOVAs. Results: Participants scored significantly higher on the LAH than on the SAzB across all SNR conditions and configurations, with ceiling effects observed for the LAH. SAzB scores varied by language dominance, while LAH scores did not. No other differences were observed based on any further demographic information. Conclusions: The SAzB provides a more challenging and informative assessment of speech perception in noise. Relying on easier tests like the LAH may obscure real-world difficulties and delay appropriate referrals for hearing loss intervention, including cochlear implant evaluation. Selecting the most appropriate test is critical to avoiding under-referral and ensuring Spanish-speaking patients receive equitable and accurate care. Full article

Background: Despite advances in surgical techniques and perioperative care, pancreatic resections such as pancreaticoduodenectomy (PD) and distal pancreatectomy (DP) remain high-risk procedures. Postoperative complications significantly impact morbidity, mortality, and patient quality of life. Methods: This narrative review summarizes recent literature on major complications following pancreatic surgery, including postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), and post-pancreatectomy hemorrhage (PPH), with an emphasis on incidence, risk factors, outcomes, and current preventive strategies. Results: POPF is a leading complication, occurring in 5–22% of cases and often linked with sepsis and hemorrhage. Key risk factors include high BMI, soft pancreatic texture, and small duct size. Preventive measures like Pasireotide, modified anastomosis techniques, and neoadjuvant therapy show variable success. DGE affects up to 57% of PD patients and is associated with prolonged recovery; antecolic reconstruction and erythromycin may reduce incidence. PPH, though less frequent (3–13%), can be life-threatening, particularly when secondary to POPF. Endovascular approaches are now favored for late arterial bleeding. Other complications include wound infections, abscesses, bile leaks, and pulmonary issues, all contributing to extended hospital stays and diminished quality of life. Conclusions: Pancreatic surgery continues to carry significant risks, with POPF, DGE, and PPH being the most impactful complications. While multiple interventions have shown promise, standardized protocols and predictive tools are still needed. Surgery should be performed in high-volume centers with experienced multidisciplinary teams to optimize outcomes. Full article

Despite being a preventable disease, cervical cancer remains a significant public health concern in low- and middle-income countries, including those in Latin America (LATAM), where mortality rates are nearly three times higher than in North America. HPV vaccination represents one of the most important strategies for cervical cancer elimination; however, uptake in these regions has been consistently suboptimal. The aim of this review is to analyze the current status of HPV vaccination programs across LATAM, examines the underlying challenges, and proposes strategies to enhance vaccine coverage. Multiple obstacles to widespread vaccine adoption persist, including limited awareness, cultural stigma, and regional disparities in healthcare access, often driven by socioeconomic and infrastructural limitations. Addressing these challenges through multifaceted interventions—such as school-based vaccination programs, healthcare provider engagement, digital dissemination, simplified dosing schedules, and supportive policy measures—is essential to effectively improve vaccination rates and reduce disease burden. Full article