Search Results (1,236)

Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95% CI 3.70–4.75) and AD (OR 2.95, 95% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings. Full article

Modern societies are increasingly experiencing limited contact with nature, a phenomenon referred to as the “nature deficit.” The article presents a systematic review of the literature on this issue, with particular emphasis on the role of forests in mitigating its effects. The analysis, based on the Scopus and Web of Science databases, synthesizes the current state of knowledge on the consequences of nature deficit for physical, mental, and social health, while also highlighting the potential of forests as spaces supporting human well-being. The review process followed a systematic methodology, using precisely defined keyword combinations and multi-stage screening. From an initial pool of 88 publications, a critical selection process led to 11 articles that met the inclusion criteria and were analyzed in depth. The findings show that regular contact with nature reduces stress, anxiety, and ADHD symptoms, supports cognitive development, and im-proves concentration, creativity, and social skills. At the same time, there is a lack of consistent tools for clearly diagnosing nature deficit, and existing studies face significant methodological limitations (small samples, subjective measurements, lack of laboratory control). The article also identifies research gaps, particularly in the context of sustainable forest management, cultural differences, and the long-term health effects of exposure to nature. Full article

This work presents a comprehensive study of weakly B-symmetric warped product manifolds ${\left(WBS\right)}_n$, a natural extension of several classical curvature-restricted geometries including B-flat, B-parallel, and B-recurrent manifolds. We begin by formulating the fundamental properties of the B-tensor $B(X,Y)=aS(X,Y)+brg(X,Y)$, where S is the Ricci tensor, r the scalar curvature, and $a,b$ are smooth non-vanishing functions. The warped product structure is then exploited to obtain explicit curvature identities for base and fiber manifolds under various geometric constraints. Detailed characterizations are established for Einstein conditions, Codazzi-type tensors, cyclic parallel tensors, and the behavior of geodesic vector fields. The weakly B-symmetric condition is analyzed through all possible projections of vector fields, leading to sharp criteria describing the interaction between the warping function and curvature. Several applications are discussed in the context of Lorentzian geometry, including perfect fluid and generalized Robertson–Walker spacetimes in general relativity. These results not only unify different curvature-restricted frameworks but also reveal new geometric and physical implications of warped product manifolds endowed with weak B-symmetry. Full article

Background/Objectives: Sarcopenia, defined as the progressive loss of muscle mass and function, is increasingly recognized in pediatric cancer patients as a significant clinical and prognostic factor. Sarcopenia in children arises from malignancy-related inflammation, malnutrition, and treatment toxicity, negatively affecting treatment response, recovery, and quality of life. Methods: We searched MEDLINE and Scopus for English-written articles published over the last five years using synonyms for the terms “sarcopenia” and “pediatric cancer”. Screening and data extraction were performed in a duplicate-blinded method. We qualitatively synthesized eligible articles. Results: Recent studies identify pre-treatment sarcopenia as a marker of poor prognosis, especially in hepatoblastoma and neuroblastoma. Total psoas muscle area (tax) and skeletal muscle index (SMI) are emerging diagnostic tools, though standardized methods remain lacking. Sarcopenia’s etiology is multifactorial, involving impaired mitochondrial metabolism, chemotherapy-induced appetite loss, and systemic inflammation. Sarcopenic obesity is common, particularly among leukemia survivors, often masked by normal BMI. Survivors also face reduced bone density, impaired immunity, and persistent muscle loss, linked to prior therapies such as radiotherapy and hematopoietic stem cell transplantation. Increase in muscle mass post-treatment correlates with better survival outcomes. Conclusions: Early detection of sarcopenia can support timely interventions such as nutritional support and physical activity. Yet, significant diagnostic heterogeneity across existing studies hampers definitive conclusions regarding its true prevalence and the optimal assessment method. Standardized diagnostic criteria are urgently needed to enable more reliable prevalence estimates and evidence-based clinical strategies. Full article

Menopausal symptoms can substantially impair women’s quality of life, yet large-scale, population-based data from German-speaking regions are lacking. We used data of a cross-sectional online survey among 26,338 women in Germany, Austria, and Switzerland, using validated instruments such as the Menopause Rating Scale (MRS II), Insomnia Severity Index (ISI), and Alcohol Use Disorders Identification Test (AUDIT-C). Additional questions covered weight change, employment, nutrition, and physical activity. We investigated correlations and group differences using descriptive statistics and univariate tests. The average MRS score was 16.94, with 51% classified as severe discomfort and 15% as requiring treatment. Insomnia was common, with 90.3% reporting at least some degree of sleep disturbance and nearly half (48%) meeting criteria for clinical insomnia. Sleep problems were significantly associated with menopausal symptom severity. No correlations were found between MRS scores and reported nutrition and exercise. Unemployment and weight gain were significantly associated with higher symptom burdens. These findings highlight the considerable health burden faced by menopausal women in the DACH region and suggest a substantial unmet need for clinical and public health interventions. Full article

Background: Sarcopenia is a critical complication in hemodialysis patients, associated with poor clinical outcomes, increased morbidity, and reduced quality of life. Despite this, its significance, prevalence, and risk factor data in developing countries remain limited. Objective: This study aimed to determine the prevalence of sarcopenia and identify its independent risk factors in patients undergoing maintenance hemodialysis, while evaluating its impact on physical performance, nutritional intake, and quality of life. Methods: A multicenter cross-sectional study was conducted across three hemodialysis units in Tunisia. Sarcopenia was diagnosed using EWGSOP2 (European Working Group on Sarcopenia in Older People 2) criteria based on muscle strength, muscle mass, and physical performance. Handgrip dynamometry, mid-arm and calf circumferences, gait speed, Short Physical Performance Battery (SPPB), and Timed Up and Go (TUG) test were employed. Nutritional intake was assessed using a 7-day food history. Quality of life and functional status were evaluated using the SF-36 and Barthel Index, respectively. Logistic regression was used to identify independent predictors of sarcopenia. Results: Among 118 patients (mean age 56.74 ± 14.44 years), the prevalence of sarcopenia was 42.4% (n = 50). Sarcopenic individuals exhibited significantly poorer physical performance than their non-sarcopenic counterparts. Marked reductions were observed in handgrip strength (p < 0.001, d = −1.60, very large), SPPB scores (p < 0.001, d = −1.55, very large), and increased TUG time (p < 0.001, d = 1.46, very large), indicating substantial functional impairment. Limb circumferences were also significantly lower in the sarcopenic group, including calf circumference (p = 0.002, d = −1.39, large) and mid-arm circumference (p = 0.013, d = −0.87, large). Gait speed was slower (p = 0.010, d = −0.40, small to moderate). Health-related quality of life was significantly compromised in sarcopenic individuals, with lower SF-36 total scores (p = 0.001, d = −1.96, very large) and reduced functional independence as measured by the Barthel Index (p = 0.010, d = −0.97, large). Hemoglobin levels were also significantly lower in the sarcopenic group (p = 0.048, d = −0.96, large). Dietary assessment revealed lower fiber intake (p = 0.006, d = 1.80, very large) and reduced magnesium consumption (p = 0.020, d = 0.94, large) among individuals with sarcopenia. In the multivariate logistic regression analysis, diabetes mellitus (OR = 2.14, 95% CI: 1.30–3.67, p < 0.001) and longer duration of hemodialysis (OR = 1.56, 95% CI: 1.20–2.71, p = 0.028) were identified as independent predictors of sarcopenia. A lower SPPB score (OR = 0.48, 95% CI: 0.35–0.65, p < 0.001) was associated with sarcopenia. Conclusion: Sarcopenia is highly common among hemodialysis patients and is independently linked to diabetes, treatment duration, and reduced physical performance. It significantly affects the quality of life and ability to perform daily activities. Routine screening with simple functional tests is crucial, especially in high-risk patients. Early intervention should include physical rehabilitation, nutritional support, and strict blood sugar management to decrease sarcopenia-related complications. Full article

Proximity-oriented planning aims to deliver everyday services within a short walk, yet closeness does not guarantee usable access for all residents. This study quantifies the gap between spatial proximity and functional accessibility in Timișoara, România, focusing on people with mobility and visual impairments. A three-stage analysis was conducted to evaluate accessibility to public amenities. First, (1) a survey was conducted with 605 respondents to identify distinct accessibility priorities based on 15-Minute City core dimensions defined by Carlos Moreno and adapted afterwards to the city context and needs. In the second stage (2), GIS mapping (radial buffers and isochrones) revealed major disparities among non-disabled residents and residents with mobility and visual impairments. Coverage decreased substantially across amenities under reduced-speed scenarios and after excluding wheelchair-inaccessible destinations. In the third stage (3), field-observed pedestrian routes in three areas of Timișoara were examined against the top-ranked criteria for each group, using the items sourced from the previous survey and grounded in the 15-Minute City concept. The route scoring is exploratory and specific to this context. The findings confirmed recurrent functional barriers, especially for vulnerable groups. These results expose a proximity-accessibility gap, where apparent nearness masks physical or sensory barriers. A shift toward experience-based accessibility planning is needed to ensure that proximity is not only spatial, but also usable by all and inclusive. Full article

Background: Depression affects around 280 million people globally and is one of the main causes of disability. Among people with cancer, depression and anxiety affect 20–25%, significantly reducing quality of life, adherence to treatments, and survival. Despite the availability of pharmacological and psychological treatments, their application can be limited by side effects, accessibility, and costs—especially in low- and middle-income countries. Physical exercise is emerging as a valuable complementary strategy, improving both physical and mental well-being. Nevertheless, structured exercise programs are still rarely implemented in oncology. This review aims to provide evidence-based recommendations for integrating physical activity into mental health support for people with cancer. Methods: This review includes six randomized controlled trials (RCTs) evaluating physical exercise interventions for depression and anxiety in people with cancer aged over 18 years. Included studies compared exercise interventions to control or standard care and reported outcomes related to psychological well-being and adverse effects. Exclusion criteria included non-original studies, non-English articles, and works not focused on exercise. The search was conducted in PubMed, Scopus, Google Scholar, and the Cochrane Library using MeSH terms and Boolean operators. The review protocol was registered in PROSPERO (CRD42025637522). Results: Exercise interventions—such as aerobic, resistance, and mind–body practices—proved effective and feasible across cancer types. Benefits were seen in both psychological and physical outcomes. However, variations in protocols and outcome measures, as well as a lack of long-term data, limit generalizability. Conclusions: Personalized exercise programs can significantly reduce depression and anxiety in people with cancer. Standardized core methods, long-term research, and systemic support are needed to integrate exercise into routine oncology care. Full article

Public green spaces are vital to urban life, offering recreational opportunities, enhancing mental and physical well-being, and supporting environmental sustainability. This study presents a structured evaluation of ten public parks in Riyadh, categorized as neighborhood, local, and large parks, and compares their performance to two internationally recognized benchmark parks—Hyde Park and Regent’s Park in London. A partly original evaluation framework was developed to assess the design-related and environmental (nature-based) qualities of these parks. The framework integrates 50 criteria grouped into nine categories, combining quantitative scoring on a five-point scale with qualitative on-site observations. This method enables a comprehensive assessment of design quality, accessibility, and sustainability features. A city-wide map with a color-coded legend illustrates the distribution of the evaluated parks, while field observations and photographic documentation supported the data collection. Findings reveal notable variations in design quality, accessibility, and sustainability across the parks. The results highlight both strengths and gaps compared to international benchmarks, providing valuable insights for improving park design and management. This study contributes to ongoing efforts to enhance park usability and align with Riyadh’s Vision 2030 objectives, offering a practical decision-support tool for planners, managers, and policymakers seeking resilient and inclusive public green spaces. Full article

Background/Objectives: Historically, federal investment in nutrition education programming in the U.S. has exceeded USD 500 million annually. The purpose of this study was to develop evidence-based Optimal Nutrition Behavior (ONB) criteria related to data collected by federal nutrition education programs and apply these criteria to established cost–benefit analysis methodology to determine the healthcare savings attributable to participation in these programs. Methods: A quasi-experimental study was conducted using the Eat Smart Idaho (ESI) program as a model for federal nutrition education programs (n = 78) and a matched control group (n = 78). Surveys administered at baseline and post-program collected dietary intake and physical activity behaviors. Optimal Nutrition Behaviors were defined as those behaviors that were associated with reduced chronic disease risk as determined by published meta-analyses, systematic reviews, or large cohort studies. Direct and indirect benefits generated by ESI were calculated using established methods. Results: The frequency of individuals meeting ONB criteria at post-assessment was significantly greater in the ESI group compared to control for all diseases except for colorectal cancer (p ≤ 0.05). ESI’s benefit–cost ratio of $11.62 suggests each dollar spent to administer the program results in USD 11.62 of economic benefits through chronic disease medical costs and lost earnings avoided. Conclusions: Federal funds supporting nutrition education programs contribute to reduced medical costs. Full article

Introduction: Lumbar radiculopathies involving the entrapment of nerve roots in the lumbar spine are common neuropathic conditions. These conditions affect 40% to 70% of individuals in their lifetime and lead to significant medical costs. Objective: This study aims to identify clinical, psychological, and biomarker-based prognostic factors that predict functional outcomes following surgery for lumbar radiculopathy. Materials and Methods: This prospective cohort study, conducted at Hospital Central de la Defensa Gómez Ulla, Madrid (Spain), adheres to the STROBE guidelines. The study includes patients aged 18–75 with lumbar radiculopathy, confirmed by clinical diagnosis, imaging, and electromyography (EMG) findings. Exclusion criteria include previous lumbar spine surgeries and systemic diseases. The primary outcome is the Oswestry Low Back Pain Disability Questionnaire. Sample size calculations, based on a conservative effect size (f² = 0.20), determined the need for 172 participants, accounting for a 15% dropout rate and 80% power. Procedure: Patients will undergo an initial assessment, including EMG tests, sociodemographic and psychological questionnaires, blood sample tests, and physical questionnaires. This process will be repeated six months post-intervention, except for the blood sample test, expectations questionnaire, and EMG, which will be performed only once. Statistical Analyses: Data will be analyzed using Python 3.12.3, employing a multivariate linear regression analysis. Assumptions of linearity, independence, homoscedasticity, normality, and no multicollinearity will be validated. Corrective measures will be applied if assumptions are violated. Ethics and Dissemination: The study follows the Declaration of Helsinki guidelines and has been approved by the Ethics Committee of Universidad Rey Juan Carlos (070220241052024). Potential risks will be minimized, and adverse events will be recorded and addressed. Findings will be published in high-impact journals and presented at conferences. Full article

The acceleration of industrialization and urbanization have led to the increasingly serious problem of waste gas pollution. Pollutants such as sulfur dioxide (SO₂), nitrogen oxides (NOx), volatile organic compounds (VOCs), ammonia (NH₃), formaldehyde (HCHO), and hydrogen sulfide (H₂S) emitted from industrial production, transportation, and agricultural activities have posed a major threat to the ecological environment and public health. Although traditional physical and chemical treatment methods can partially reduce the concentration of pollutants, they face three core bottlenecks of high cost, high energy consumption, and secondary pollution, and it is urgent to develop sustainable alternative technologies. In this context, probiotic waste gas treatment technology has become an emerging research hotspot due to its environmental friendliness, low energy consumption characteristics, and resource conversion potential. Based on the databases of PubMed, Web of Science Core Collection, Scopus, Embase, and Cochrane Library, this paper systematically searched the literature published from 2014 to 2024 according to the predetermined inclusion and exclusion criteria (such as research topic relevance, experimental data integrity, language in English, etc.). A total of 71 high-quality studies were selected from more than 600 studies for review. By integrating three perspectives (basic theory perspective, environmental application perspective, and waste gas treatment facility perspective), the metabolic mechanism, functional strain characteristics, engineering application status, and cost-effectiveness of probiotics in waste gas bioconversion were systematically analyzed. The main conclusions include the following: probiotics achieve efficient degradation and recycling of waste gas pollutants through specific enzyme catalysis, and compound flora and intelligent regulation can significantly improve the stability and adaptability of the system. This technology has shown good environmental and economic benefits in multi-industry waste gas treatment, but it still faces challenges such as complex waste gas adaptability and long-term operational stability. This review aims to provide useful theoretical support for the optimization and large-scale application of probiotic waste gas treatment technology, promote the transformation of waste gas treatment from ‘end treatment’ to ‘green transformation’, and ultimately serve the realization of sustainable development goals. Full article

Background: Muscle health is an emerging concept linked to physical performance and functional independence. However, the term lacks a standardized definition and is often used as a broad muscle-related outcome descriptor. Clinical communication and research would benefit from a conceptual model of muscle health grounded in an established framework. Methods: We conducted systematic search and narrative synthesis to identify multifactorial measurement approaches explicitly described under ‘muscle health’. PubMed and CINAHL were searched for clinical and randomized controlled trials published in the past 5 years (final search: March 2025) that used the term “muscle health.” Studies were reviewed for explicit definitions of “muscle health,” and all identified outcomes (e.g., strength, mass) and measurement tools (e.g., grip strength, ultrasound) were synthesized. This review was retrospectively registered (INPLASY202580069). Results: Of the 65 clinical or randomized controlled trials that met inclusion criteria, 29 provided an operational definition of ‘muscle health’, while 36 inferred measurements without a clear definition. The identified measurements spanned four primary categories, with body composition/muscle mass being the most common (92.3%), followed by muscle performance (78.5%), physical function (63.1%), and tissue composition (30.8%). Most studies included more than one muscle health metric (93.9%). Common assessment methods included DXA (44.6%), grip strength (64.6%), and gait speed (27.7%). Conclusions: While there are common measurement approaches, the definition of muscle health varies widely in the cited works. The framework of the International Classification of Functioning, Disability and Health, was used to identify domains aligned with muscle health components of muscle morphology/morphometry (e.g., mass and composition), functional status (performance-based tasks), and physical capacity (muscle performance). This framework provides a structured basis for evaluating muscle health in research and clinical practice. Consistent use of these domains could enhance assessment and support efforts to standardize testing and interpretation across settings. Full article

Background: Children today are growing up in a digital environment where screen-based technology is a central part of everyday life. While screens can offer educational and recreational benefits, there is growing concern about their influence on different areas of child development. Objective: This review explored how screen time affects developmental outcomes in children and adolescents aged 0 to 18 years, focusing on physical, cognitive, emotional, and social domains. Methods: A structured search was carried out across databases such as PubMed, Scopus, Web of Science and PsycINFO to identify relevant studies published between 2014 and 2024. Studies were included if they examined the relationship between screen time and at least one area of child development, involved participants within the target age group, and were peer-reviewed and published in English. The review followed PRISMA guidelines, and articles were independently screened and evaluated for quality by two reviewers. Results: A total of 46 studies met the inclusion criteria. Overall, the evidence points to a link between higher levels of screen use and negative outcomes such as reduced physical activity, poorer sleep, attention difficulties, and challenges in emotional and social functioning. However, some studies indicated that limited or educational screen use, especially with parental involvement, may have neutral or even positive effects in certain contexts. Conclusions: Screen time can have both positive and negative effects on child development, depending on factors like duration, type of content, and the context in which screens are used. Managing screen use through age-appropriate guidelines and adult supervision may help reduce risks and promote healthier development. More longitudinal research is needed to establish clearer recommendations for screen use in childhood. Full article

This study investigates the role of residential architecture in fostering social interaction and strengthening residents’ identification with their living environment. It focuses on two key dimensions through which housing environments support social cohesion: the spatial dimension, referring to the physical design of buildings and spaces, and the organizational dimension, which involves the engagement of prospective residents in planning, and in the co-creation and development of housing projects. Two dwelling-oriented projects located in Vienna’s Leopoldstadt district were selected as case studies: Wohnprojekt Wien and PaN-Wohnpark. Wohnprojekt Wien represents a fully participatory model, characterized by maximum resident involvement throughout all stages of the design process. In contrast, PaN-Wohnpark followed a more conventional approach, involving only limited resident participation in the form of post-occupancy consultations. This participation was limited to aspects of social life, community management, and integration, without influence on the architectural or spatial layout of the buildings. Both projects were evaluated using ten architectural and spatial criteria previously developed by the author to assess features that promote neighborly interaction. The evaluation was based on qualitative field research, including site visits and expert interviews The findings indicate that the participatory design approach implemented in Wohnprojekt Wien significantly contributed to stronger social ties and a heightened sense of community among residents. In contrast, in PaN-Wohnpark—where participation was limited and occurred only after completion—the impact on social cohesion was considerably less pronounced. These results suggest that integrating participatory design methods into residential development can substantially enhance social sustainability by fostering informal social interactions and strengthening residents’ sense of belonging. Importantly, the extent to which residents are empowered to influence decisions about their living environments appears to be a critical factor in achieving these outcomes. Full article