Search Results (7,718)

Multiple sclerosis is an inflammatory and neurodegenerative disease that leads to motor, cognitive, and sensory impairments, significantly affecting walking and quality of life. This study aimed to analyze the relationship between quality of life and kinematic walking parameters in individuals with multiple sclerosis, as well as to evaluate the influence of fatigue, balance, and cognitive performance on different aspects of quality of life. A cross-sectional observational study was conducted with 32 patients diagnosed with multiple sclerosis with Expanded Disability Status Scale scores of ≤5.5. Quality of life was assessed using the MusiQoL questionnaire, and clinical variables included fatigue (Fatigue Scale for Motor and Cognitive Functions, Borg scale), balance (Berg Balance Scale), and cognitive performance (Trail Making Test). Walking kinematics were analyzed using the Vicon motion capture system to obtain walking speed, step frequency, and joint asymmetry indices. Spearman correlations and linear regression models were applied. Results showed significant correlations between quality of life and walking speed (rho = 0.506), step frequency (rho = 0.508), and knee asymmetry (rho = −0.525), as well as strong associations with cognitive fatigue (rho = −0.796) and balance (rho = 0.635). Regression models explained up to 58.4% of the variance in the Activities of Daily Living dimension. These findings indicate that quality of life in multiple sclerosis is influenced by both clinical and biomechanical factors, highlighting the importance of comprehensive assessments to guide physiotherapeutic interventions. Full article

Background: Adequate sleep is essential for recovery and performance in athletes. Internal and external training loads closely relate to sleep, but few studies have examined their distinct off-season effects. This study investigated the relationships among training load, hormonal markers, and sleep parameters in collegiate male rowers. Methods: Eleven rowers were monitored over 4 months (October 2022–January 2023). Internal load was assessed via session ratings of perceived exertion, external load by accelerometry-based indicators, sleep variables by actigraphy and the Pittsburgh Sleep Quality Index, and hormonal status via salivary cortisol and testosterone. Repeated-measures analysis of variance and correlation and regression analyses were applied. Results: Training load showed significant temporal variation (p < 0.01), with October having the highest intensity. Increased loads were associated with poorer sleep outcomes, including reduced total sleep time (p < 0.05), higher latency (p < 0.05), and decreased efficiency (p < 0.05). External load was linked to fragmentation indices (wake after sleep onset, awakenings; p < 0.05), whereas internal load correlated with improved efficiency in certain months (p < 0.05). Hormonal fluctuations, particularly cortisol and testosterone, also correlated with sleep parameters (p < 0.05). Conclusions: Internal and external loads exerted distinct influences on sleep, supporting the hypothesis that both must be monitored. Sleep duration and efficiency emerged as modifiable targets for optimizing recovery and performance in athletes. Full article

This article examines intergenerational social mobility as a driver of sustainable development on the case of Lithuania, a country in Eastern Europe. Using data from the European Social Survey (2020), the analysis explores how parental education and occupation shape individual educational and occupational outcomes. Descriptive, correlational, and regression analyses reveal that while structural mobility has been facilitated by Lithuania’s transition from Soviet rule to a market economy and subsequent European integration, family background remains a decisive factor. The study also highlights the key factors that promote or constrain social mobility in contemporary Lithuania. The interaction between mothers’ and fathers’ education fosters the attainment of higher levels of education, whereas mothers’ occupational status and respondents’ gender (male) appear to limit it. Similarly, the achievement of a higher occupational level is positively influenced by the interaction between parental education and the respondent’s own highest educational attainment, while negatively influenced by gender. These findings demonstrate that education not only determines social mobility but also supports the broader objectives of sustainable development by reducing inequality, fostering human capital, and advancing gender equality. The results underscore the importance of inclusive social policies that ensure equitable access to quality education and align educational opportunities with labor market demands, thereby reinforcing social mobility as a foundation for long-term social resilience and sustainability. Full article

Background: Dietary fiber plays a crucial role in body weight regulation and metabolic health. Despite benefits, fiber intake remains suboptimal. This study investigated the relationship between dietary fiber intake, BMI, and fiber sources among young Austrian adults in higher education. Methods: A cross-sectional study was conducted using a validated screening tool (18-item FiberScreen) to assess total daily fiber intake. Self-reported anthropometric data were used to calculate BMI, and participants were categorized into normal-weight and overweight groups. Differences in fiber intake and sources were analyzed by sex and BMI category. Correlations between fiber intake, BMI, and food group contributions were assessed. Results: The mean daily fiber intake among participants (n = 813) was 15.72 g/day. Overweight individuals consumed significantly less total fiber (13.18 ± 0.44 g/day) compared with those of normal weight (16.09 ± 0.22 g/day). Normal-weight participants obtained fiber mainly from fruits, vegetables, and legumes, while the overweight group relied more on potatoes and white bread. Fiber intake was also negatively correlated with BMI (p < 0.001). Conclusions: Low fiber intake is widespread among young adults and associated with higher BMI. The findings suggest that not only the quantity but also the quality of fiber sources play a role in weight status. Interventions aimed at improving dietary fiber intake through targeted education and healthier food environments would be a good strategy to support better health outcomes in young adults. Full article

Premenstrual dysphoric disorder (PMDD) is a psychological condition that significantly influences female students’ behavior, cognitive ability, and mental health status. It has a critical role in mental health and well-being and in the academic success and professional performance of nursing students. Objectives: This study aimed to assess the relationship between PMDD, perceived stress levels and sleep quality among female nursing students in Saudi Arabia. Methods: This study utilized a cross-sectional, correlational, descriptive design. The sample size was 144 students, and we used a convenience sampling technique. Data were collected using the following tools: Demographics and Gynecological Data Sheet, Premenstrual Symptoms Screening Tool, Pittsburgh Sleep Quality Index, and Perceived Stress Scale. Results: The levels of premenstrual symptoms and sleep disturbances among the participants can be regarded as moderate, whereas the level of perceived stress was found to be at its highest level, with 63.9% of participants experiencing a moderate level and 14.6% reporting severe stress. There was a significant positive correlation between premenstrual symptoms and perceived stress (r = 0.39, p = 0.005). Thus, as premenstrual symptoms increase, so does perceived stress. Additionally, there is a noteworthy correlation between perceived stress and sleep disturbance (r = 0.28, p = 0.04), indicating that higher levels of stress are associated with more sleep disturbances. Conclusions: PMDD symptoms have a detrimental influence on female students’ emotional state; thus, mental health experts play an important role in identifying variables that mitigate the severity of PMDD among female’s students. Full article

Background and Objectives: Osteoporotic vertebral compression fractures (OVCFs) are a common cause of morbidity in the elderly, often resulting in pain, reduced mobility, and diminished quality of life. Treatment options include conservative management, vertebroplasty (VP), and kyphoplasty (KP). This study aimed to compare the clinical outcomes and complication rates of patients treated with kyphoplasty/vertebroplasty versus conservative methods and identify risk factors associated with the development of new fractures. Materials and Methods: This retrospective cohort study included patients diagnosed with OVCFs who were treated either surgically (KP/VP) or conservatively between January 2020 and January 2025. Inclusion criteria encompassed vertebral height loss on CT, STIR hyperintensity on MRI, and a T-score below −2.5. Patients were followed for at least one year. Clinical evaluations included pain scores (VAS), functional status (ODI), and quality of life assessments. Complications and new fracture rates were recorded. Logistic regression analysis was performed to identify risk factors influencing fracture recurrence. Results: A total of 132 patients were analyzed: 65 in the KP/VP group and 67 in the conservative treatment group. The KP/VP group achieved better postoperative pain results (3.2 ± 1.0 vs. 4.0 ± 1.2) with a significant difference of −0.8 (95% CI: −1.2 to −0.4, p = 0.032) and better mobility results (ODI: 4.5 ± 0.8 vs. 3.9 ± 0.9) with a significant difference of 0.6 (95% CI: 0.3–0.9, p = 0.047) and improved quality of life scores (6.7 ± 1.1 vs. 5.9 ± 1.3) with a significant difference of 0.8 (95% CI: 0.4–1.2, p = 0.041). The incidence of new fractures was similar between groups (15.4% vs. 17.9%, p = 0.678). Overall complication rates were 7.7% in the KP/VP group versus 11.9% in the conservative group (p = 0.435). The results from logistic regression analysis showed that age (adjusted OR: 2.48, 95% CI: 1.20–5.13), low bone mineral density (adjusted OR: 0.31, 95% CI: 0.15–0.63), and cement leakage (adjusted OR: 3.10, 95% CI: 1.21–7.99) were identified as risk factors for new fractures. The study found that outdoor activity (adjusted OR: 0.38, 95% CI: 0.20–0.73) and anti-osteoporosis treatment (adjusted OR: 0.17, 95% CI: 0.04–0.79) acted as protective factors against new fractures. The KP/VP group required half the time to recover from their injuries because they used their braces for 3.0 ± 0.5 months instead of 6.0 ± 1.0 months (p < 0.001). Conclusions: Kyphoplasty and vertebroplasty were more effective than conservative treatment in improving pain, mobility, and quality of life in patients with OVCFs. Although the incidence of new fractures did not differ significantly between groups, surgical treatment demonstrated lower complication rates and significantly faster recovery, as evidenced by reduced brace use duration. These findings support the use of KP/VP as a viable option for managing OVCFs in appropriately selected patients. Full article

Background: Elderly individuals living in Romanian long-term care facilities encounter substantial challenges in accessing oral healthcare, despite the high prevalence of dental disease and prosthetic needs. This study aimed to evaluate the oral health status, treatment needs, and access barriers among elderly residents in a long-term care facility in Timișoara, Romania, while also analyzing the current legislative framework and public funding mechanisms for geriatric dental care. Methods: A cross-sectional clinical and interview-based study was conducted among 70 residents aged 65–89 years from a residential center. Data collection included intraoral examinations, caregiver-assisted surveys, and individual interviews. Outcomes included oral health status (edentulism, caries, prosthetic use), service utilization, perceived barriers, and quality of life impact. The results were compared to existing literature and analyzed within the framework of Romanian and European healthcare legislation. Results: Total edentulism was found in 66.6% of participants, with only 28% having functional dentures. Caries and periodontal disease were prevalent, and 84% of residents lacked financial resources for dental care. Only 17% had accessed any dental services in the past year. Structural limitations, including the absence of mobile dental services and the lack of institutional protocols, further restricted access. Romanian Law no. 17/2000 guarantees healthcare in residential settings, but oral health is not explicitly included. Conclusions: The study highlights a critical gap in the provision of oral healthcare to institutionalized elderly in Romania. Neglect compromises nutrition, autonomy, and psychosocial well-being, underscoring the urgent need for legislative clarity, dedicated funding, mobile dental services, and integration into geriatric care. Full article

Background/Objectives: Cystic fibrosis transmembrane conductance regulator modulator (mCFTR) therapy has been proven efficacious in controlled clinical trials for individuals with cystic fibrosis. This post-approval retrospective study aimed to determine the comprehensive effects of elexacaftor/tezacaftor/ivacaftor (ETI) on nutritional status, the respiratory system and quality of life over 12 months of clinical use in paediatric patients treatment-naïve to mCFTR. Methods: A retrospective analysis of records of CF adolescents on ETI therapy was conducted. The selected parameters of anthropometric measurements, body composition assessed by BIA, spirometry, and multiple breath nitrogen washout (MBNW) to measure lung clearance index (LCI), were evaluated before therapy and at 3 and 12 months after treatment initiation. Additionally, children completed the Cystic Fibrosis Questionnaire-Revised (CFQ-R). Results: Over 18 months, data from 58 patients (mean age 14.34 ± 1.70, 50% female; 43% homozygous F508del) on ETI were collected. Body weight increased significantly over 12 months, with a mean gain of 3.33 kg at 3 months (p < 0.001) and 7.10 kg at 12 months (p < 0.001), alongside improvements in BMI z-score, fat-free mass, and fat mass. Significant changes (p < 0.001) were also observed after 3 and 12 months in ppFEV₁ (8.91 ± 8.23; 9.67 ± 8.77) and ppFVC (4.46 ± 5.24; 4.61 ± 5.70), with a decrease in LCI (−1.62 ± 2.15; −1.68 ± 1.89). The CFQ-R Respiratory score increased by 11.75 points and correlated with most of the pulmonary and nutritional parameters. Conclusions: In real-world settings, clinical improvement during ETI therapy reflects a comprehensive impact on nutritional status, body composition, pulmonary function, and quality of life for adolescents with CF. Full article

Background: Malnutrition among older adults in China demands greater attention due to its significant implications for both health and functional ability. However, the relationship between nutritional status and health-related quality of life (HRQoL), especially in the context of chronic diseases, remains underexplored in the Chinese elderly population. Methods: This large-scale cross-sectional study aimed to evaluate the association between nutritional status and HRQoL, stratified by chronic disease status, among 41,859 community-dwelling adults aged ≥ 65 years from 31 provinces in mainland China. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), while HRQoL was measured using the SF-36 questionnaire; chronic disease status was based on physician diagnosis. Multiple linear regression was employed to examine the association between MNA and HRQoL, with subgroups defined by Latent Class Analysis (LCA) based on comorbidity patterns. Results: Results revealed significant positive associations between MNA scores and SF-36 total and domain scores among participants with chronic diseases (e.g., Total: β = 0.32, 95% CI: 0.04–0.60), but not among those without chronic diseases. LCA identified four comorbidity patterns: cardiovascular-rich, metabolic-rich, musculoskeletal-rich, and relatively healthy. Significant MNA-HRQoL associations were found in the cardiovascular (β = 0.58, p = 0.025), metabolic (β = 0.76, p = 0.022), and musculoskeletal (β = 1.01, p = 0.021) groups, but not in the relatively healthy group. Conclusions: These findings underscore the critical role of nutritional status in HRQoL among Chinese older adults with chronic diseases and highlight the need for tailored nutritional interventions in geriatric chronic disease management. Full article

Background/Objectives: With increasing survival rates in pediatric oncology, late effects, such as therapy-induced infertility, are becoming more relevant. This study evaluated the management of fertility preservation in children and adolescents with cancer at the Medical University Innsbruck between 2000 and 2018. Methods: In this retrospective monocentric study, 552 patients (0–17 years) receiving chemotherapy were analyzed. Data was extracted from the Clinical Information System and the cryopreservation database. The assessed main variables included pubertal status, sex hormone levels, and use of fertility preservation methods. Results: Fertility preservation was documented in 6.5% of patients, more frequently in males (8.9%) than females (3.2%). Sperm cryopreservation was performed in twenty-eight males, ovarian tissue cryopreservation in six females, and oocyte cryopreservation in three. Pubertal status at diagnosis was recorded in 4.9% of patients and hormone levels in 29.7%. Conclusions: The findings highlight significant gaps in systematic fertility preservation, particularly in female patients. Consistent assessment of pubertal and hormonal parameters at diagnosis is essential to inform decision-making. Standardized procedures and closer interdisciplinary collaboration are needed to ensure equitable access to fertility preservation and safeguard long-term quality of life. Full article

Cancer remains a persistent global health challenge, continuously driving the search for novel and effective therapeutic strategies. In the case of breast cancer, treatment decisions are primarily guided by factors such as the disease stage, histological grade, molecular receptor status, and the presence of genetic mutations. Understanding these parameters is crucial for tailoring interventions and improving clinical outcomes. To enhance prognostic and diagnostic accuracy, attention has increasingly turned to identifying molecular targets that play key roles in breast cancer development. Currently, standard treatments include surgery, chemotherapy, and radiotherapy. However, these approaches are often associated with significant side effects and a diminished quality of life. As a result, many breast cancer patients are turning to complementary therapies—including phytotherapy, nutritional interventions, and dietary supplements—to support conventional treatment, alleviate adverse effects, and improve overall well-being. Within the vast realm of medicinal flora, anticancer plants represent a compelling area of study, serving as a rich reservoir of bioactive compounds. These compounds have demonstrated significant promise in the ongoing battle against cancer. Often highlighted in traditional medicinal practices, these plants harbor a wide array of phytochemicals, such as alkaloids, flavonoids, polyphenols, and terpenoids. These phytochemicals manifest diverse biological activities, notably exhibiting pronounced anticancer properties. The exploration of these natural compounds has opened new avenues for developing innovative and targeted therapeutic strategies in cancer treatment. They achieve definitive chemotherapeutic and chemopreventive roles by integrating with specific molecular signals. Their multiple biological functions include antimutagenic, antiproliferative, antimetastatic, anti-angiogenesis, anti-inflammatory, antioxidant, and immunomodulatory properties, which collectively enable them to control cancer progression and intervene at various stages of cancer cell development. Moreover, these compounds are involved in regulating the cell cycle and microRNA, ultimately leading to cancer cell death by promoting apoptosis and autophagy, often mediated through ROS signaling. Thus, based on a large theoretical revision, we conclude that high-quality evidence is necessary in order to advise these products concerning their efficacy and safety. Also, clinical evidence should be supported by a comprehensive individual diagnosis and adequate research protocols in order to evaluate whether the benefits of these plant-produced interventions can outweigh their harms. Full article

Background/Objectives: Anxiety can influence dietary choices and habits, but dietary choices and habits can also contribute to the intensification of anxiety symptoms. The study aimed to test the hypothesis that a higher level of anxiety predicts poorer diet quality among adults in Poland. Methods: A cross-sectional survey was conducted among 1841 individuals aged 18 years and older across Poland. A self-developed survey drew upon the KomPAN questionnaire, the Healthy Eating Plate with its accompanying infographic and the Penn State Worry Questionnaire (PSWQ). Multivariable logistic regression analysis was used to assess the relationship between anxiety level and gender, age, nutritional status, and other sociodemographic factors. The same approach was applied to evaluate the relationship between diet quality and the aforementioned variables. In addition, hierarchical clustering of variables was performed using Ward’s method. Results: Nearly half of the respondents presented a high level of anxiety (48.29%), while most reported a low-quality diet (64.58%). Participants aged 18–22 years were significantly more likely to exhibit both high anxiety levels (aOR = 1.614; 95% CI: 1.327–1.964; p < 0.001) and low diet quality (aOR = 1.810; 95% CI: 1.482–2.211; p < 0.001) compared to older groups. The findings support the hypothesis that higher anxiety levels are linked to poorer diet quality, particularly among young adults. Conclusions: Higher levels of anxiety were shown to be significantly associated with poorer diet quality, with the strongest effects observed in the youngest age group. These results highlight the need for integrated psychological and nutritional interventions targeting this group. Further longitudinal studies are warranted to clarify the directionality of the observed associations. Full article

Background/Objectives: Nutrition during the reproductive years shapes women’s immediate health, fertility, pregnancy outcomes, and long-term offspring well-being. This position paper narratively synthesizes and critically appraises evidence on how dietary patterns, macro-/micronutrients, and supplementation influence women’s health, female fertility, and reproductive outcomes, to inform practical recommendations. Methods: We narratively reviewed recent reviews, cohort studies, clinical trials, and public-health guidance on macronutrients, key micronutrients, dietary patterns (with emphasis on the Mediterranean diet), ultra-processed food (UPF) intake, and targeted supplementation relevant to menstrual, metabolic, cardiovascular, skeletal, and reproductive outcomes. Results: Balanced, diverse diets rich in whole and minimally processed foods support hormonal regulation, ovulatory function, healthy gestation, and chronic-disease risk reduction. Priority nutrients include iron, folate, calcium, vitamin D, zinc, vitamin B12, and long-chain omega-3s (DHA), with supplementation considered when dietary intake or bioavailability is inadequate. Evidence consistently links Mediterranean-style eating to improved metabolic health, insulin sensitivity, IVF success, lower gestational diabetes risk, and favorable neonatal outcomes. High UPF consumption is associated with poorer diet quality, inflammation, adverse pregnancy outcomes, and potential reproductive impairment, warranting a reduction in favor of nutrient-dense foods. Diet also influences cardiovascular and bone health through effects on lipids, glycemia, blood pressure, and mineral/vitamin status, with fiber-rich carbohydrates, unsaturated fats (notably olive oil), and adequate calcium–vitamin D emerging as central levers. Conclusions: For women of childbearing age, a Mediterranean-aligned, minimally processed dietary pattern—tailored to individual needs and complemented by prudent use of folate, iron, vitamin D, calcium, B12, and DHA when indicated—offers robust benefits across reproductive, metabolic, cardiovascular, and skeletal domains. Public-health actions should improve access to healthy foods, curb UPF marketing, and embed personalized nutrition counseling in routine care; further longitudinal research from preconception through postpartum is needed. Full article

Background: Malnutrition is a significant national health problem in countries with low and intermediate incomes and was announced in the United Nations’ 2030 Agenda for Sustainable Development Goals. Chemotherapy may have adverse effects on nutritional health issues and quality of life experience, particularly in patients with gastrointestinal (GIT) cancer. Our research’s objective was to determine the beneficial effects of oral nutrition supplements on nutritional status assessed by maintenance of whole-body composition and patient-generated subjective global assessment (PG-SGA) in all GIT cancer patients treated with chemotherapy medications. Methods: Among the patients, the nutrition support (NS) group (n = 75) received 500 kcal daily of a balanced oral nutrition supplement formula for 12 weeks, while the control (C) group (n = 75) did not. Anthropometric measures, whole-body composition, nutritional status biomarkers, and the PG-SGA questionnaire were assessed. Additionally, this study analyzed whole-body composition, skeletal mass, fat mass, laboratory data, the complete lipid profile, albumin, total protein, adverse effects, and therapy delays. Results: After 12 weeks, the NS group showed a significant increase in body weight, with a mean difference of 1.27 ± 3.39, while the C group showed a mean difference of only 0.15 ± 0.42. Moreover, fat mass increased in the NS group, showing a mean difference of 0.55 ± 3.69, while the C group showed a fat mass loss with a mean difference of −0.21 ± 2.93. The fat mass index (FMI) indicated statistical significance between the two groups. There was a statistically significant difference in the lean mass index between the two groups, favoring a steady increase in the NS group. The NS group showed improvements in the PG-SGA and nutritional biochemical markers, such as albumin. The initial findings from our study include data from a total of 150 patients, including 75 patients in the NS group and 75 patients in the C group. These results are consistent with earlier research. Conclusions: Early oral nutrition supplements for GIT cancer may enhance nutritional outcomes and reduce the delay of disease-related therapy. Additionally, they may help maintain body composition. Full article

Background and Objectives: This systematic review aimed to analyze published peer-reviewed studies on the effects of exergaming (EXG) compared to conventional physical exercise (CPE) interventions on health status in older people with Parkinson’s disease (PD) according to training dose. Materials and Methods: Using six generic databases: PubMed, EBSCO, Medline, CINAHL Complete, Scopus, and Web of Science, the PRISMA, TESTEX, RoB 2, and GRADE tools assessed methodological quality and certainty. The protocol was registered in PROSPERO (code: CRD42024575969). Results: Out of 805 records, 14 randomized controlled trials with 406 older people with PD were included. Seven overall meta-analyses showed significant improvements (p < 0.01) in favor of EXG in the Berg Balance Scale (BBS, ES = 0.90), Dynamic Gait Index (DGI, ES = 0.77) and quality of life questionnaire (PDQ-39, ES = 0.52), without significant improvements (p > 0.05) in the Unified PD Rating Scale, Montreal Cognitive Assessment, Timed Up-and-Go and Falls Efficacy Scale-International. Four subgroup meta-analyses, according to training schedules, showed that there were significant improvements (p < 0.05) in BBS in favor of EXG at >8 weeks of training (ES = 1.38), >3 weeks per week (ES = 1.18), <45 min duration (ES = 0.99), and with >20 total sessions (ES = 1.31). Both weeks and total sessions were predictors of BBS performance in EXG interventions in older people with PD. Conclusions: EXG is an innovative alternative to improve the health status in balance, gait, and quality of life variables in older people with PD, with a high potential for clinical practice in this population. The training dose is a determinant (weeks and total sessions) that varies the response to intervention in the BBS. Full article