Search Results (1,762)

Dry eye disease (DED) is a highly prevalent multifactorial disorder of the ocular surface that extends beyond local tear film pathology to involve systemic immune, neuroendocrine, and neurosensory mechanisms. Increasing evidence reveals a strong and bidirectional association between DED and psychiatric disorders, particularly depression, anxiety, post-traumatic stress disorder (PTSD), and sleep disturbances. This review synthesises the current knowledge on shared molecular, neuroimmune, and neuropathic pathways that underlie this comorbidity. Key mechanisms include hypothalamic–pituitary–adrenal (HPA) axis dysregulation, systemic and ocular inflammation, oxidative stress, mitochondrial dysfunction, and impaired neurotrophic signaling, especially reduced brain-derived neurotrophic factor (BDNF). Dysregulation of monoaminergic neurotransmitters such as serotonin and norepinephrine not only contributes to mood disturbances but also alters tear secretion and corneal pain perception. Corneal nerve changes and trigeminal–limbic sensitisation further reinforce the overlap between neuropathic ocular pain and affective dysregulation. Psychotropic medications, while essential for psychiatric care, may exacerbate ocular surface dysfunction through anticholinergic effects, altered neurotransmission, and tear film instability, highlighting the iatrogenic dimension of this interface. Conversely, tear-based biomarkers, including cytokines, serotonin, and BDNF, offer promising translational tools for patient stratification, diagnosis, and treatment monitoring across ocular and psychiatric domains. Recognising DED as part of a systemic, biopsychosocial continuum is critical for effective management. Multidisciplinary strategies that integrate ophthalmologic and psychiatric care, alongside novel therapies targeting shared molecular pathways, provide a framework for improving outcomes. Future research should prioritise longitudinal studies, biomarker validation, and personalised interventions to address this complex comorbidity. Full article

Burnout is increasingly recognized as both a psychosocial and a chronobiological disorder characterized by endocrine dysregulation and circadian disruption. It arises from chronic occupational stress and manifests through psychological, physical, and physiological symptoms. Although psychosocial determinants are well established, the biological and chronobiological mechanisms, particularly those involving cortisol and melatonin, remain less explored. This systematic review synthesizes current evidence on hormonal and circadian dysregulation in burnout and complements it with exploratory observational data from healthcare professionals. Peer-reviewed studies evaluating endocrine or circadian biomarkers in individuals with burnout were systematically reviewed. In addition, an exploratory observational analysis was carried out among 195 Romanian clinicians using an adapted Maslach Burnout Inventory. Morning salivary cortisol was measured once at 9 a.m. in a small subsample (n = 26) to provide preliminary physiological data. Because only a single time point was obtained, these values were interpreted as indicative of stress-related activation rather than circadian rhythm. Thirty-seven studies met the inclusion criteria. Across the literature, burnout was associated with altered HPA-axis activity, blunted diurnal cortisol variation, and irregular melatonin secretion related to shift work and disrupted sleep–wake cycles. Complementary exploratory data from our Romanian cohort indicated strong correlations between burnout severity, physical symptoms, and higher morning cortisol values among shift-working clinicians. These findings are preliminary and not representative of full circadian profiles. Burnout should be considered both a psychosocial and a systemic disorder influenced by endocrine and circadian dysregulation. Recognizing alterations in cortisol and melatonin as objective indicators may facilitate earlier detection and inform chronobiological interventions such as optimized scheduling, light exposure management, or melatonin therapy. The observational data presented here is preliminary and intended to generate hypotheses; future research should employ repeated cortisol sampling under controlled Zeitgeber conditions to confirm circadian associations. Full article

Background/Objectives: Migrants are recognized as a vulnerable population for non-communicable diseases (NCDs) due to unique socio-cultural and environmental challenges associated with acculturation. Despite a growing migrant population, evidence on NCD risk among migrants in Japan is scarce. This study examined the prevalence, co-occurrence, and clustering of modifiable NCD risk factors among middle-aged foreign residents in Japan. Methods: A cross-sectional web-based survey was conducted among foreign residents aged 30–60 years (n = 384). Eight risk factors were assessed: tobacco use (including cigarettes, e-cigarettes, and chewable tobacco), harmful alcohol consumption, inadequate fruit and vegetable intake, frequent consumption of ultra-processed foods, insufficient physical activity (PA), poor sleep, high stress levels, and high BMI. Latent class analysis (LCA) was used to identify risk clusters, and associations with demographic and socioeconomic characteristics were examined. Results: The prevalence of risk behaviours was high, with 96% reporting inadequate fruit and vegetable intake, 55% poor sleep, and 50% insufficient PA. Risk factor co-occurrence was common: 32% reported three concurrent risks, 27.1% reported four, and 17.2% reported five or more. LCA identified two clusters. Cluster 1 (46.9% of participants) was characterized by tobacco and alcohol use, with inadequate diet and poor sleep. Cluster 2 (53.1% of participants) was defined by insufficient PA, inadequate diet, and poor sleep, but low tobacco and alcohol use. Cluster membership varied significantly by sex and employment. Conclusions: This study provides preliminary evidence of the high prevalence and clustering of modifiable NCD risk factors among middle-aged migrants in Japan. Findings highlight the need for comprehensive, multi-behavioral interventions tailored to migrant populations, while considering gender roles and occupational contexts. Full article

Background: Sleep disorders, particularly insomnia, represent a significant health concern in medical education. Neuroticism, characterized by emotional instability and stress reactivity, shows cross-sectional associations with sleep disturbances in healthcare trainees. Limited research examines these relationships among South Asian medical students. This cross-sectional study investigated insomnia symptom prevalence, personality correlates, and environmental factors among Pakistani medical students. Methods: We conducted a cross-sectional study among 364 undergraduate medical and dental students in Peshawar, Pakistan (June–November 2024). Data collection occurred during examination months. Data collection employed validated instruments: the Insomnia Severity Index (ISI) and the NEO Five-Factor Inventory neuroticism subscale (NEO-FFI-12). Statistical analyses included Pearson correlations, chi-square tests, and multivariate regression with interaction terms. Results: Among 364 participants (mean age 21.3 ± 2.3 years, 52.2% female), 47.0% reported severe insomnia symptoms (ISI 22–28), with 89.0% experiencing at least subthreshold symptoms (ISI ≥ 8) during the 2-week assessment period. These prevalence rates reflect symptom severity over a 2-week period during examination months and do not represent clinical diagnoses of chronic insomnia disorder, which requires ≥3 months of symptoms with clinical confirmation. High neuroticism (NEO-FFI ≥ 37) characterized 59.8% of students. Multivariate regression revealed a robust cross-sectional association between neuroticism and insomnia symptom severity (β = 0.239, 95% CI [0.173, 0.305], standardized β = 0.342, p < 0.001) and may reflect measurement during peak examination stress rather than stable trait-outcome relationships. Hostel residents showed non-significantly higher clinical insomnia prevalence than day scholars (75.9% vs. 67.5%, p = 0.081). Clinical-year students demonstrated significantly lower insomnia severity than pre-clinical students (β = −1.271, p < 0.001), a finding that contradicts assumptions about increasing stress through training progression. The neuroticism × living arrangement interaction was non-significant (p = 0.118); however, post hoc power analysis indicated the study was underpowered to detect small moderation effects, making this finding inconclusive. Conclusions: This study documents high insomnia symptom severity during a 2-week assessment period in Pakistani medical students, with a robust cross-sectional association with neuroticism. However, these findings must be interpreted within the constraints of the cross-sectional design, which cannot establish temporal precedence or causality between neuroticism and insomnia symptoms. These symptom prevalence rates likely reflect a combination of chronic sleep disorders and transient examination-related stress. Living arrangements showed small, non-significant associations with insomnia. The observed association between neuroticism and insomnia may be partially mediated or confounded by unmeasured variables, including academic stress, psychiatric comorbidities, substance use, and other sleep disorders. Findings suggest potential benefits from interventions addressing cognitive-emotional factors, though comprehensive diagnostic assessment is needed to distinguish chronic insomnia disorder from transient, stress-related sleep difficulties. Longitudinal research with objective sleep measures, structured psychiatric assessment, and systematic confounder evaluation is essential to establish causal relationships and intervention efficacy in this population. Full article

This systematic review included 31 clinical trial articles examining the effects of natural compounds on Alzheimer’s disease (AD) and mild cognitive impairment (MCI), involving 3582 participants aged 50–90. Treatment durations ranged from 8 weeks to 2 years, with an average of 12.5 months. Notably, 11 studies focused on herbal extracts highlighting their prominence in current research. These extracts showed potential cognitive and neuroprotective benefits, although results varied across compounds and study designs. Other natural compounds—including flavonoids, polyphenols, omega-3 fatty acids, Aloe vera, Spirulina, and citrus phytochemicals—may provide cognitive and neuroprotective benefits, with ginseng and Ginkgo biloba combinations also showing promise. Curcumin and Melissa officinalis had limited effects, resveratrol showed mixed outcomes with some side effects, and matcha green tea may improve cognition and sleep quality. Despite generally favorable results, the studies varied considerably in design and quality; nonetheless, herbal extracts represent a prominent category of natural interventions in AD and MCI, underscoring the need for further large-scale, high-quality clinical trials to confirm their therapeutic potential. Full article

Objective: To assess the prevalence and associated factors of malnutrition—including stunting, thinness, overweight, and obesity—among Vietnamese children aged 6–17 years, and to identify demographic, geographic, and behavioral correlates to inform targeted nutrition interventions. Methods: A cross-sectional, nationally representative study was conducted from January 2024 to June 2025 using data from the MIDU Assessment Program. A multistage stratified random sampling approach recruited 43,505 children aged 6–17 years across all regions of Vietnam. Anthropometric measurements were obtained following WHO 2007 growth reference standards. Stunting was defined as height-for-age Z-score (HAZ) < −2 SD, and overweight/obesity as body mass index-for-age Z-score (BAZ) > +1 SD. Data on demographic characteristics, sleep patterns, sports participation, vitamin K₂ use, and pubertal status were collected via structured questionnaires. Multivariable logistic regression was used to identify factors associated with stunting and overweight/obesity. Results: Overall, 3.9% were stunted, 5.1% were thin, 20.7% were overweight, and 11.4% were obese; 8.6% had any undernutrition and 39.5% had any form of malnutrition. Stunting was significantly associated with being male (OR = 1.37, 95% CI: 1.24–1.52), older age—particularly 14–17 years (OR = 6.56, 95% CI: 5.48–7.84)—and residing in the Northern midlands, North Central, South Central, and Central Highlands regions. In contrast, frequent sports participation (OR = 0.76, 95% CI: 0.68–0.84), daily vitamin K₂–MK₇ use (OR = 0.82, 95% CI: 0.72–0.93), and having reached puberty (OR = 0.26, 95% CI: 0.22–0.30) were associated with lower odds of stunting. For overweight and obesity, lower odds were found among females (OR = 0.48, 95% CI: 0.46–0.51) and older children, while higher odds occurred among those living in the Southeast (OR = 1.45, 95% CI: 1.36–1.53) and Mekong River Delta (OR = 1.35, 95% CI: 1.24–1.48) regions. Early sleep (OR = 0.91, 95% CI: 0.87–0.95) and sports participation (OR = 1.07, 95% CI: 1.02–1.11) showed modest associations, whereas vitamin K₂ use and puberty were not significant predictors. Conclusions: Vietnamese school-aged children face a significant rate of malnutrition, with regional, gender, and age disparities. Full article

Background/Objectives: The cerebellum is essential for motor coordination and has recently been implicated in sleep-related disorders. However, the neural mechanisms linking sleep disruption to motor dysfunction remain poorly understood. This study aimed to elucidate the roles of the deep cerebellar nuclei (DCN), particularly the lateral nucleus, in motor dysfunction induced by chronic sleep disruption (CSD). Methods: Using a validated mouse model of CSD with periodic sleep fragmentation induced by an orbital shaker during the light phase, we assessed neuronal activation via c-Fos immunostaining and performed chemogenetic manipulation of glutamatergic neurons within the lateral nucleus. Behavioral performance was evaluated using open-field and rotarod tests. Results: CSD selectively increased c-Fos expression in the lateral nucleus, with no significant changes observed in other DCN subregions. Chemogenetic activation or ablation of glutamatergic neurons in the lateral nucleus decreased locomotor activity in the open-field test and shortened latency to fall in the rotarod task. Conversely, chemogenetic inhibition of these neurons attenuated CSD-induced impairments, restoring locomotor performance toward control levels. Conclusions: Our findings provide direct experimental evidence that glutamatergic neurons in the lateral nucleus play a crucial role in mediating CSD-induced motor dysfunction. These results highlight the cerebellar contribution to the interplay between sleep and motor control and identify a potential target for therapeutic intervention in sleep-related motor disorders. Full article

Background/Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterised by musculoskeletal manifestations such as myopathies, arthritis, and arthralgia. Physical activity may improve patients’ quality of life and overall wellbeing. This study aimed to evaluate physical activity levels in patients with SLE and identify how clinical, psychosocial, and sociodemographic factors influence these levels. Methods: A multicentre cross-sectional study was conducted including 64 patients with SLE. Clinical variables were obtained from medical records, and patient-reported outcomes were collected at the time of the survey. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ-SF). Independent variables included fatigue (FAS), quality of life (SF-36), sleep (PSQI), depression (BDI-II), anxiety (HARS), age, disease factors (activity, duration, damage), sex, smoking, and comorbidities. Results: Significant associations were found between physical activity levels and smoking status (χ² = 11.88; p = 0.003), sleep quality (χ² = 6.81; p = 0.03), and anxiety (χ² = 18.39; p = 0.001). In multivariable analyses, poor sleep (PSQI > 5) (OR = 14.40; 95% CI: 2.50–82.99), higher anxiety (HARS; per point OR = 1.12; 95% CI: 1.05–1.20), and higher SF-36 Physical Component Summary (PCS) scores (per point OR = 1.29; 95% CI: 1.15–1.45) were associated with being in a higher physical activity category. Given the counterintuitive direction for sleep and the limited model fit, these results should be interpreted cautiously. Conclusions: In patients with SLE, physical activity was associated with sleep disturbances, anxiety, and perceived physical health. These findings underscore the need to integrate psychosocial and behavioural factors into multidisciplinary strategies promoting physical activity in lupus care and provide a rationale for future longitudinal and interventional studies to validate and extend these associations. Full article

Background/Objectives: Anxiety and depression are prevalent global health concerns, especially prominent in vulnerable groups such as older adults, individuals with chronic health conditions (e.g., neurodegeneration and cancer), and those from low socioeconomic backgrounds. Digital interventions, including computerized cognitive training (CCT), show promise in addressing emotional dysfunctions in a more accessible and cost-effective manner. The CREATE platform aims to enhance Emotion Regulation (ER) through targeted Working Memory (WM) training, aesthetic engagement, and creativity, while accounting for dopamine activity via spontaneous Eye Blink Rate (sEBR). The purpose of the present study is to evaluate the platform’s feasibility and validity through a single pilot trial. Methods: The study enrolled twenty-seven healthy adults (aged 21–44) who completed standardized self-report questionnaires on sleep quality and ER. They were also enrolled in sEBR recordings and performed a CCT-adapted Corsi block-tapping task and an aesthetic art evaluation. Affective textual narratives and valence/arousal ratings were also collected. Participants were divided into “Good Sleepers” and “Poor Sleepers”. The platform evaluation enrolled a multi-modal pipeline including correlations and regression analysis of intervention metrics, sentiment analysis, and group comparisons. Results: WM task performance correlated positively with global ER and Cognitive Reappraisal scores. Post-training sEBR was significantly associated with ER, and lower sleep efficiency negatively impacted changes in dopamine activity (sEBR Diff). Dopamine activity of “Good Sleepers”, as indicated by sEBR, reached the high levels of the “Poor Sleepers” group after the training, suggesting a dopamine boost caused by the CREATE platform for those with quality sleep. Creativity and emotional expression, as indicated by sentiment analysis, were related to sleep quality. Conclusions: The CREATE platform shows promise in enhancing ER through multi-modal digital engagement, integrating cognitive training, art, and creativity. The findings support the inclusion of sleep and dopamine markers in intervention evaluation. Further studies with larger samples and clinical cohorts are warranted to establish efficacy and generalizability, as the present one was not powered to test the effectiveness of our training platform but was designed to assess its feasibility and validity instead. Full article

Background/Objectives: Excessive screen time and inadequate sleep are well-established developmental risk factors, yet limited research has examined the relationship between adherence to national sleep and screen time guidelines and language outcomes in children with mild language delays. This study examined sleep, screen time, and language outcomes in 765 children aged 1–5 with mild language delays enrolled in the Early Discovery Program. Methods: Sleep and screen time were categorized according to American Academy of Pediatrics and Caring for Our Children guidelines. Language outcomes were measured using standardized scores from the Preschool Language Scales–Fifth Edition. Results: Sociodemographic factors, including race, insurance status, and caregiver education, were significantly associated with sleep and screen behaviors. Excessive screen time was negatively associated with expressive language scores, while sleep duration showed no significant relationship. Conclusions: Findings highlight the need for early interventions that promote adherence to national health guidelines and address sociodemographic factors influencing language development in young children. Full article

Background/Objectives: Sleep disturbances are among the most prevalent and persistent comorbidities in children and adolescents with autism spectrum disorder (ASD), affecting up to 83% of this population. These disturbances not only impact the quality of life but are increasingly recognized as significant contributors to behavioral dysregulation. Methods: This systematic review synthesizes evidence from 26 studies published between 2010 and 2024, examining the association between sleep problems and behavioral outcomes in individuals with ASD aged 2 to 18 years. Results: The findings reveal consistent associations between sleep-onset insomnia, night walking, bedtime resistance, and various behavioral difficulties, including aggression, hyperactivity, and emotional dysregulation. Internalizing symptoms and exacerbation of core ASD features were also linked to chronic sleep problems. Studies employing objective sleep measures, such as actigraphy and polysomnography, further supported these associations by identifying disruptions in sleep architecture correlated with behavioral severity. While most included studies were of moderate to high methodological quality, the limited number of randomized controlled trials and heterogeneity of sleep and behavior assessment tools highlight the need for standardization. Conclusions: Overall, the review emphasizes the importance of routine sleep evaluation in ASD clinical care and supports targeted sleep interventions as a potential strategy to reduce behavioral problems and improve developmental outcomes. Full article

The identification of brain clearance failure as a precursor to a large variety of neurodegenerative diseases has shifted fluid dynamics from a secondary to a tertiary target of brain health. The identification of the glymphatic system, detailing cerebrospinal fluid entry along perivascular spaces and exit via perivenous and meningeal lymphatic pathways, provided a challenge to previous diffusion models and established aquaporin-4–dependent astroglial polarity as a governing principle of solute transport. Multiple lines of evidence now support a coupled glymphatic–venous axis, wherein vasomotion, venous outflow, and lymphatic drainage are functionally interrelated. Failure of any axis will cascade and affect the entire axis, linking venous congestion, aquaporin-4 disassembly, and meningeal lymphatic failure to protein aggregation, neuroinflammation, edema, and intracranial hypertension. Specific lines of evidence from diffusion tensor imaging along vascular spaces, clearance MRI, and multi-omic biomarkers can provide a measure of transport. Therapeutic strategies are rapidly advancing from experimental strategies to translational approval, including behavioral optimization, closed-loop sleep stimulation, vascular and lymphatic therapies, focused ultrasound, pharmacological polarity recoupling, and regenerative bioengineering. Novel computational approaches, such as digital twin dynamic modeling and adaptive trial designs, suggest that clearance measures may serve as endpoints to be approved by the FDA. This review is intended to bridge relevant mechanistic and translational reviews, focusing on impaired clearance as an exploitable systems defect rather than an incapacitating secondary effect. Improving our understanding of the glymphatic-venous axis Injury may lead to future target strategies that advance cognitive resilience, alleviate disease burden, and improve quality of life. By clarifying the glymphatic–venous axis, we provide a mechanistic link between impaired interstitial clearance and the pathological accumulation of amyloid-β, tau, and α-synuclein in neurodegenerative diseases. The repair of aquaporin-4 polarity, venous compliance, and lymphatic drainage might therefore open new avenues for the diagnosis and treatment of Alzheimer’s and Parkinson’s disease, supplying both biomarkers of disease progression and new targets for early intervention. These translational implications not only locate clearance failure as an epiphenomenon of neurodegeneration but, more importantly, as a modifiable driver of the course of neurodegeneration. Full article

Background: Over the past several decades, the prevalence of gestational diabetes mellitus (GDM) has risen markedly worldwide, posing serious threats to both maternal and child health by increasing adverse pregnancy outcomes and long-term metabolic risks. Developing effective risk prediction tools for early detection and intervention has become the most important clinical priority in this field. The current GDM prediction models primarily rely on non-modifiable factors, for example age and body mass index, while modifiable factors such as lifestyle and health literacy, although strongly associated with GDM, have not been fully utilized in risk assessment. This study sought to establish and validate a nomogram prediction model combining modifiable and non-modifiable risk factors, with the goal of identifying high-risk Chinese pregnant women with GDM at an early stage and promoting targeted prevention and personalized prenatal management. Methods: A multicenter study was conducted across 7 maternal health institutions in Southern China (2021–2023), enrolling 806 singleton pregnant women (14–23⁺⁶ weeks). The collected data included sociodemographic, clinical history, and modifiable factors collected through validated questionnaires: dietary quality, physical activity level, sleep quality, and nutrition and health literacy. GDM was diagnosed via 75 g oral glucose tolerance test at 24–28 weeks. Predictive factors were identified through multi-variable logistic regression. A nomogram model was developed (70% modeling group) and validated (30% validation group). Receiver operator characteristic curves, calibration curves, and decision curve analysis were used to evaluate the prediction ability, the degree of calibration, and the clinical benefit of the model, respectively. Results: The finalized risk prediction model included non-modifiable factors such as maternal age, pre-pregnancy weight, and maternal polycystic ovary syndrome, as well as modifiable factors including dietary quality, physical activity level, sleep quality, nutrition and health literacy. The application of the nomogram in the modeling group and the validation groups showed that the model had high stability, favorable predictive ability, good calibration effect and clinical practicality. Conclusions: Overall, the integrated model demonstrates significant clinical utility as it facilitates the prompt identification of individuals at heightened risk and offers actionable targets for personalized interventions. In terms of future implementation, this model can be integrated into prenatal care as a rapid scoring table during early pregnancy consultations or incorporated into mobile health applications. This approach fosters precise prevention strategies for GDM in maternal health by emphasizing nutrition and health literacy, supplemented by coordinated adjustments in diet, physical activity, and sleep. Full article

Early adulthood is a critical period for non-communicable disease (NCD) prevention, with beverage consumption being a modifiable risk factor. Evidence in young Chinese adults remains limited. We conducted a multicenter cross-sectional study (May–June 2023) of 3198 university students aged 18–25 years from seven regions of China. Beverage intake was recorded for seven days using the validated Liq.In7 diary with calibrated cups, and multivariable linear regression, including sex- and age-stratified models and interaction analyses, identified determinants. Sex, age, and sleep quality were the strongest predictors: females consumed less plain water (β = –112.75; 95% CI: –147.98 to –77.53; p < 0.001) and SSBs (β = –23.59; 95% CI: –34.60 to –12.57; p < 0.001), while plain water intake increased with age (β = 33.42; 95% CI: 19.92–46.91; p < 0.001). Poorer sleep quality (higher PSQI) was associated with higher SSBs consumption. SSBs intake among adults aged 22–25 years increased with higher temperature and socioeconomic tier. Interaction models confirmed that plain water intake increased with age in both sexes but remained lower in females. These findings support integrated interventions, including SSBs taxation and nutrition education, aligned with Healthy China 2030 and WHO sugar-reduction targets. Full article

Background: Burnout among healthcare professionals is increasingly recognized as a syndrome with biological correlations. Beyond psychosocial factors, circadian misalignment, sleep disturbances, and hormonal dysregulation—particularly involving melatonin and cortisol—are emerging as relevant mechanisms. Methods: We systematically reviewed studies published between 2015 and 2025 examining associations between burnout, melatonin, circadian disruption, sleep quality, and related biomarkers in healthcare workers. Results: Across 14 included studies, burnout was associated with suppressed melatonin secretion, cortisol dysregulation, and circadian misalignment, including social jet lag and poor sleep quality. Night-shift nurses consistently displayed greater circadian disruption and higher burnout scores than day-shift colleagues. Evidence also suggests that environmental and interventional approaches—such as optimizing daylight exposure and melatonin supplementation to improve sleep quality and cognitive performance—may mitigate circadian disruption and occupational fatigue. Conclusions: Burnout should be recognized as a biopsychosocial syndrome with measurable chronobiological correlates. Future research should integrate circadian biomarkers into occupational health assessments and evaluate preventive strategies aimed at preserving circadian health in healthcare professionals. Full article