Search Results (1,205)

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized for its impact on social functioning, including deficits in social cognition and empathy. Emerging neurobiological evidence highlights the potential role of oxytocin in these impairments. However, the influence of pharmacotherapy, particularly methylphenidate (MPH) and atomoxetine (ATX), on these domains remains underexplored. This study aimed to examine the effects of MPH and ATX on social cognition, empathy, and serum oxytocin levels in children with ADHD. Methods: This study included 152 children aged 6–12 years diagnosed solely with ADHD. The patient group consisted of 102 children, comprising n = 52 receiving MPH and n = 50 receiving ATX for at least 3 months. The control group comprised 50 newly diagnosed, untreated children. A sociodemographic form, the Social Skills Rating Scale (SRSS), the Reading the Mind in the Eyes Test (RMET), the Bryant Empathy Index (BEI), and the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) were applied. Serum oxytocin levels were measured via venous blood samples. Results: Medicated children exhibited significantly elevated SRSS scores, irrespective of the pharmacotherapy administered. RMET scores were significantly higher in the ATX group. No significant differences were found between the three groups in terms of empathy scores and serum oxytocin levels. A significant negative correlation was identified between ADHD symptom severity and RMET and SRSS-Total scores. Regular medication use was a significant predictor of SRSS scores, while empathy and serum oxytocin levels were nonsignificant predictors. Conclusions: Pharmacotherapy may enhance social cognition among children with ADHD. Longitudinal studies are warranted to assess the long-term effects of medication on social cognition and empathy. Full article

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

Objectives: Neurocognitive disorders (NCDs) refer to a broad spectrum of conditions characterized by declining cognitive functions, such as memory, attention, language, and executive abilities. It is estimated that up to half of patients affected by NCDs remain undiagnosed or are diagnosed at an advanced stage of the disease. This study aimed to analyze the utility of subclinical organ damage markers, which could be used in primary care for the detection and prevention of NCD. Methods: The study participants (n = 137) completed neuropsychological tests (Addenbrooke’s Cognitive Examination/ACE and Mini-Mental State Examination/MMSE), a sociodemographic survey, an interview on past illnesses, and had their ankle-brachial index (ABI) and pulse wave velocity (PWV) values measured. Results: Based on the MMSE test, 26 participants (19.0%) were diagnosed with mild cognitive impairment (MCI) and 8 participants (5.8%) with NCDs. The study found that lower ABI values were associated with worse cognitive performance, suggesting that the ABI may be a useful tool for identifying individuals at increased risk of NCDs, while PWV cannot be used as a predictor for this group of diseases. Conclusions: Lower ABI values were associated with reduced cognitive performance, whereas PWV showed no significant relationship. The secondary findings suggest that physical activity, regular computer use, and better mental well-being were linked to improved cognitive outcomes. A low ABI value could potentially serve as a predictor of cognitive disorders, and as a diagnostic tool that is easily accessible and quick, it may improve diagnostics and the overall health of primary care patients. Health education regarding modifiable risk factors for dementia is also of crucial importance. Full article

Background/Objectives: Headache disorders, including migraine and tension-type headache (TTH), are among the most prevalent and disabling neurological conditions globally. This study aimed to evaluate temporal changes, demographic disparities, and socio-geographic variation in the burden of headache disorders across European countries. Methods: We analyzed data from the Global Burden of Disease Study 2021, covering 45 European countries grouped into Western, Central, and Eastern regions. We examined age-standardized prevalence, incidence, and disability-adjusted life year (DALY) rates for headache disorders between 1990 and 2021. Analyses were stratified by sex, age group, region, and country-level socio-demographic index (SDI). All estimates were reported with 95 percent uncertainty intervals where relevant. Spearman correlation was used to assess associations between disease burden and SDI. Results: Between 1990 and 2021, the number of individuals with headache disorders in Europe rose from 345.0 to 370.6 million, although age-standardized prevalence remained stable. The burden of migraine slightly increased, with age-standardized DALY rates rising from 648.35 to 657.27 per 100,000 population. Conversely, TTH showed a minor decline in both prevalence and DALY rates. Women and individuals aged 30 to 44 years consistently exhibited the highest burden, particularly for migraine. Higher SDI scores were positively correlated with DALY rates for migraine (rho = 0.392, p = 0.008) but negatively correlated for TTH (rho = −0.466, p = 0.001). Conclusions: Headache disorders continue to pose a major and largely unmitigated health burden across Europe. Regionally targeted strategies are essential to reduce disability and improve outcomes across diverse European populations. Full article

This study aims to investigate the effects of continuous glucose monitoring (CGM) on glycemic control in patients with diabetes mellitus (DM) and to identify the sociodemographic or health behavioral factors that influence the outcomes. The data were collected from 510 diabetic patients prescribed to use CGM for 12 weeks and analyzed using SPSS 27.0. Paired samples t-tests were used to compare the glycemic control (HbA1c and fasting glucose) and metabolic health (body mass index and total cholesterol) measures of subjects before and after the CGM use, and independent t-tests were conducted to examine whether the effectiveness of CGM differs according to subjects’ sociodemographic and health behavioral characteristics. As a result of this study, the use of CGM resulted in a significant reduction in HbA1c from 8.09 to 7.48 percent (p < 0.001) and in fasting glucose from 152.41 to 137.16 mg/dL (p < 0.001). In the subgroup analysis of CGM effectiveness, fasting glucose reduction was greater in females than in males and in patients with type 2 diabetes than in those with type 1 diabetes. In conclusion, it is essential to consider patient characteristics to enhance the effectiveness of CGM and to expand its use to type 2 diabetes to reduce the social burden of the disease. Full article

Background: There are limited data on the association between B12 levels, objective sleep quality, and cardiovascular disease in patients with obstructive sleep apnoea (OSA). Therefore, the aim of our study was to assess vitamin B12 levels in a sleep clinic population in Crete, Greece, and investigate possible correlations with polysomnographic parameters and prevalent cardiovascular disease (CVD). Methods: In this cross-sectional study, data from 1468 recruited patients with OSA from the clinical database of the Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, were analyzed. OSA was defined as an apnoea–hypopnoea index ≥ 5 events per hour of sleep after type-1 Polysomnography (PSG). Data regarding anthropometrics, socio-demographics, and medical history was obtained. Logistic regression analysis was applied to examine the effect of vitamin B12 levels on PSG parameters and prevalent CVD after controlling for potential explanatory variables, including age, gender, obesity, smoking status, and co-morbidities. Results: The median vitamin B12 was 380.5 (301, 490) pg/mL. After adjustments, Vitamin B12 levels < 380.5 were associated with 24% higher odds of prolonged sleep latency (≥40 min) prevalence (OR = 1.240, 95% CI = 1.005–1.531, p = 0.045) and alterations in the proportion of NREM and REM sleep stages with 2.3 times higher likelihood of elevated NREM sleep > 80% of total sleep time (OR = 2.312, 95% CI = 1.049–5.096, p = 0.038) and 2.9 times higher likelihood of low REM sleep < 20% of total sleep time (OR = 2.858, 95% CI = 1.197–6.827, p = 0.018). Moreover, Vitamin levels < 380.5 were significantly associated with a 59.9% increase in the odds of prevalent CVD (OR = 1.599, 95% CI = 1.035–2.471, p = 0.034). Conclusions: In conclusion, our results suggest that vitamin B12 status may be associated with impaired objective sleep quality in OSA patients, potentially influencing prevalent CVD. However, further prospective research is needed to establish causality and elucidate the potential underlying mechanisms that could link vitamin B12 levels to various sleep parameters and cardiovascular disease in patients with OSA. Full article

Background: Psoriasis is a chronic immune-mediated disease affecting approximately 43 million individuals worldwide. While previous studies provide certain insights, there remains different conclusions and a lack of a comprehensive analysis regarding the burden of psoriasis. In response to ongoing therapeutic advances and a growing patient population, this study utilizes the Global Burden of Disease (GBD) 2021 estimates to characterize the spatiotemporal evolution of the psoriasis burden from 1990 through 2021. By integrating these biological, geographic, and socioeconomic determinants, this study aims to inform more targeted and effective health policy planning. Methods: To track changes over time, the Estimated Annual Percentage Change (EAPC) was determined using a linear regression model. In addition, a frontier analysis was utilized to investigate the link between psoriasis burden and socio-demographic progress. Furthermore, geographically weighted regression was used for the spatial econometric assessment of EAPC, age-standardized rates (ASRs), and Human Development Index (HDI) covariance structures across nation-states. Results: Between 1990 and 2021, the global burden of psoriasis increased consistently, with ASRs exhibiting a positive correlation with the Socio-demographic Index (SDI). High-SDI regions reported the highest burden, while high–middle-SDI regions experienced the steepest rise. Conclusions: This study reveals an increasing global psoriasis burden (1990–2021) through systematic analyses, indicating distinct regional progression patterns. These findings advocate for geographically tailored strategies to alleviate healthcare system pressures. Full article

Background/Objectives: Breast cancer remains the most common malignancy among women worldwide, with many patients experiencing persistent psychological symptoms that extend beyond active treatment. Among these, sleep disturbances, anxiety, and depression frequently co-occur and can significantly impair quality of life and treatment adherence. This study aimed to assess the prevalence of poor sleep quality and examine its associations with anxiety and depression in a large cohort of Turkish women with breast cancer. Additionally, the study sought to identify sociodemographic and clinical predictors of sleep disturbance. Methods: In this cross-sectional study, 601 women with histologically confirmed breast cancer who were undergoing or had completed active treatment were recruited from a tertiary oncology center in Turkey between January 2023 and December 2023. The mean age of participants was 54 years (range 25–83). More than half of the patients were postmenopausal (56.3%), and 6% had stage IV disease. Sleep quality and psychological distress were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics, correlation analyses, and multivariate regression models were employed to identify significant predictors. Results: Poor sleep quality (PSQI > 5) was identified in 33.2% of participants. Patients with poor sleep reported significantly higher anxiety and depression scores (p < 0.001). Multivariate analysis revealed that being single, having children, undergoing breast-conserving surgery, and elevated anxiety scores were independent predictors of poor sleep. Additionally, marital status, menopausal status, and treatment modality were significantly associated with anxiety and depression scores. Conclusions: One-third of Turkish breast cancer patients experience clinically relevant sleep disturbances, which are strongly linked to psychological distress, particularly anxiety. These findings underscore the importance of incorporating routine psychological screening into oncologic care and highlight the need for individualized psychosocial support strategies that aim to improve both emotional well-being and overall clinical outcomes. Full article

Air pollution is known to affect skin health, but tools to objectively measure individual exposure based on skin responses are limited. This study introduces the Exposure Intensity Index (EII), a novel tool that correlates lifestyle-related pollution exposure with skin parameters. A panel of 250 women residing in Lombardy completed a detailed questionnaire on socio-demographic features and daily habits, from which an exposure score was derived. Non-invasive bioengineering techniques were used to assess skin parameters, focusing on inflammation-related signs. A positive correlation emerged between exposure scores and variations in specific skin parameters, suggesting a link between daily pollution exposure and skin alterations. The EII emerges as a preliminary exploratory approach to estimate environmental impact on the skin through its correlation with biophysical parameters. It may offer future value for subject selection in in vivo testing of antipollution cosmetic claims. Full article

Background/Objectives: The ongoing prevalence of dental issues within the school-age population continues to present significant public health challenges. This study aims to thoroughly evaluate the oral health conditions of schoolchildren aged 7–10 years, with a particular focus on identifying the prevalence and severity of dental caries, as well as their relationship with dental hygiene and dietary habits. Methods: A cross-sectional approach was employed involving 700 children aged from 7 to 10 years, recruited from nine urban and rural educational institutions across two Romanian counties, namely Mureș and Bistrița-Năsăud. Data were collected regarding the sociodemographic characteristics of participants, including parental educational background and occupational status. Furthermore, information on dental hygiene routines was gathered, encompassing tooth brushing habits, flossing usage, frequency of brushing, along with dietary details such as daily meal count, snacking frequency, and sugar intake levels. An oral examination was performed by a trained specialist to assess the condition of the children’s teeth, documenting the number of decayed, missing, and filled teeth. The presence of plaque was evaluated using a plaque index, and the dental caries status was quantified using the Decayed, Missing, and Filled Teeth (DMFT) index. Results: The findings revealed that the average plaque score was marginally higher in boys (mean = 0.69 ± 0.36) compared to girls (mean = 0.65 ± 0.40). Additionally, children from urban environments demonstrated a mean plaque score of 0.61 ± 0.32, whereas their rural counterparts exhibited a higher score of 0.73 ± 0.38. In multivariable models, irregular brushing, higher daily sugar consumption, and ≥3 snacks/day were independently associated with both caries prevalence (DMFT > 0) and greater DMFT counts (p < 0.05). Conclusions: The evidence denotes a concerning association between poor oral hygiene practices and higher rates of tooth decay among children, particularly among those with elevated sugar intake and frequent snacking behaviors. Dental public health professionals are encouraged to incorporate considerations of oral hygiene habits when developing future health promotion strategies aimed at improving the oral health status of children. Full article

Background: Historically, lip and oral cavity cancer (LOC) has been more prevalent among men, largely due to higher tobacco use in this group. However, over the past decades, smoking rates among women have risen and, in some regions, are approaching those of men. This shift highlights the urgent need to analyze the burden of LOC specifically in women, as they may respond differently to tobacco control policies. This study assessed whether the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), launched in 2003, and the implementation of MPOWER measures have influenced LOC trends among women. Methods: A controlled interrupted time series was conducted from 1990 to 2021, with the launch of the WHO-FCTC considered the intervention point. A total of 204 countries and territories were initially categorized into two groups: those without (G1) and with (G2) MPOWER coverage. G2 was further subdivided based on the median MPOWER score from 2007 to 2020 into G2A (equal to or below the median) and G2B (above the median). Analyses were also stratified by Socio-Demographic Index (SDI) levels. Female LOC rates were obtained from the Global Burden of Disease Study 2021. Prais-Winsten segmented regression was applied to estimate annual percent changes (APCs) in LOC rates before and after the WHO-FCTC. Results: Prior to the WHO-FCTC, most trends for G1 and G2A were stable, while all trends for G2B were increasing. After 2003, LOC rates increased across all groups, especially in G2B. In high-SDI settings, rising trends in G2B remained unchanged post-intervention, whereas G1 and G2A shifted from stable to increasing. Among low-SDI groups, slopes were mostly not statistically significant. Conclusions: These findings suggest that the WHO-FCTC has had no measurable impact on reducing LOC burden among women so far. Instead, rates have continued to rise in many regions, signaling a concerning trend for women’s global health. Full article

Urban green space (UGS) accessibility is a cornerstone of equitable and sustainable city planning. However, existing studies focus on large metropolitan areas and rely on limited spatial models that overlook the complexity of urban morphology and socio-demographic diversity. This study shifts the focus to East Lansing, a medium-sized U.S. city that exhibits neither the spatial concentration of major metropolises nor the uniformity of small towns, thereby offering a distinctive context to examine urban green space equity. To this end, we develop a composite accessibility index by integrating four complementary spatial models: Euclidean distance, gravity-based access, two-step floating catchment area (2SFCA), and zone-based analysis. Utilizing high-resolution spatial, demographic, and environmental datasets, the study applies both Ordinary Least Squares (OLS) and Geographically Weighted Regression (GWR) to uncover global patterns and local variations in accessibility determinants. The results reveal pronounced neighborhood-level disparities, with variables such as green coverage, park provision, and commercial density emerging as significant but spatially uneven predictors. The composite index yields a more robust and equitable representation of UGS accessibility than any individual model. This multi-model, spatially explicit framework contributes to methodological advances in accessibility assessment and offers actionable insights for place-based urban greening strategies. Full article

Objectives: The aim of this study was to assess the distribution of abdominal volume index (AVI) conicity index (C-Index) and weight adjusted waist index (WWI) attributes by sociodemographic and health characteristics in apparently healthy individuals (residents of the Janów Lubelski district in the eastern Poland). Additionally, the study examined whether sociodemographic and health characteristics differentiate the distribution of adipose tissue indicators in individuals with a normal body weight, defined as a BMI of less than 25 kg/m². Methods: A total of 3752 apparently healthy respondents participated in the cross-sectional study. In order to determine the participants’ adipose tissue distribution, professionally trained nurses measured their anthropometric indices and interviewed them to assess the sociodemographic and health variables. Results: The study group’s mean values for anthropometric indices related to central adipose tissue distribution were as follows: C-Index 1.26 ± 0.088, AVI 18.28 ± 4.96 and WWI 10.63 ± 0.73. The three indices examined in multivariable analyses showed a significant relationship with age, gender, place of residence, education, living alone, smoking status, alcohol consumption and comorbidities (diabetes, hypertension and hypercholesterolemia). Conclusions: The study findings demonstrate a significant relationship between the level of specific anthropometric indices related to central adipose tissue distribution and sociodemographic and health-related variables. The employment of certain anthropometric indices related to central adipose tissue distribution, which are derived from waist circumference, can be beneficial in primary healthcare by potentially facilitating early prevention of cardiometabolic diseases. Full article

Background and Objectives: Padel is becoming an increasingly popular sport, yet epidemiological data on sport-related musculoskeletal injury in Portuguese practitioners are limited. This study aimed to provide a comprehensive epidemiological analysis of Padel practitioners in Portugal to fill this gap. Materials and Methods: A nationwide self-reported questionnaire was administered to Portuguese Padel practitioners. The questionnaire covered sociodemographic, occupational, and health-related items. Results: Overall, 69.2% of respondents reported at least one lifetime Padel injury (mean 2.1 ± 1.2 injuries per injured athlete). Estimated injury incidence was 3.4 ± 4.7 injuries per 1000 h of exposure for the total sample (6.1 ± 4.9 per 1000 h among injured athletes). Tendinous (35.6%) and muscular (26.1%) injuries predominated. Most affected anatomical sites were the elbow (18.0%), ankle (16.6%), knee (12.5%), and shoulder (10.5%). Injuries most frequently occurred during training (32.9%) and were commonly attributed to fatigue/overload (24.1%). Reported severity was commonly moderate to severe (most frequent absences: 3–4 weeks and 1–3 months); physiotherapy was the principal management approach. Multivariable analyses identified several associations of practical relevance: higher body mass index was linked to greater overall injury risk (and specifically neck injuries); female sex was associated with higher odds of muscular injuries; years of Padel experience and equipment characteristics (e.g., number of overgrips) showed site-specific associations; and instructor supervision correlated with greater warm-up adherence and lower odds of elbow injury. Playing surface also influenced risk patterns. Conclusions: Portuguese Padel practitioners in this study experience a substantial burden of predominantly tendinous and muscular injuries concentrated at the elbow and lower limb. Athlete factors, exposure, surface, equipment, and supervision represent modifiable targets for multidisciplinary prevention and rehabilitation strategies. Full article

Background/Objectives: Sustainable dietary patterns in geriatrics have gained considerable attention. In this cross-sectional study, we investigated whether higher consumption of locally produced foods is associated with higher adherence to the Mediterranean diet and with better healthy aging status among Greek older adults. Methods: Sociodemographic, anthropometrical, lifestyle, dietary, cognitive, and mental characteristics assessed through validated questionnaires and procedures, were assessed. Participants (N = 449) were divided into three local food consumption groups/tertiles: “high” (≥45% of total dietary intake), “moderate” (27–44%) and “low” (≤26%). MedDietScore (0–55) was used to assess the level of adherence to the Mediterranean diet and SAI (0–10) to assess healthy aging. Results: Older adults of the “high” group showed an increase of 0.817 units in the SAI index compared to older adults of the “low” group. Additionally, high local food consumption was also associated with higher SAI levels (b = 0.493, p = 0.007) compared to the “moderate” group. Among older individuals whose diet comprises over 45% local foods, an increase of approximately 2.8 and 1.95 units in the MedDietScore was detected when compared to the “low” and “moderate” groups. Conclusions: Higher consumption of local foods, and more specifically consuming local foods in more than 45% of the total dietary intake, is associated with greater adherence to the Mediterranean diet and better healthy aging. The results suggest that food locality may play an important role in shaping better dietary habits, health trajectories, and quality of life of older adults. Full article