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Food is Medicine (FIM) programs to improve the accessibility of fruits and vegetables (FVs) or other healthy foods among patients with low income and diet-related chronic diseases are promising to improve food and nutrition security in the United States (US). However, FIM programs are relatively new and implementation guidance for healthcare settings using an implementation science lens is lacking. We used a narrative review to describe the evidence base on barriers and facilitators to FIM program integration in US healthcare settings following the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework. Evidence surrounding the EPIS Inner Context was a focus, including constructs Leadership, Organizational Characteristics, Quality and Fidelity Monitoring and Support, Organizational Staffing Processes, and Individual Characteristics. Peer-reviewed and grey literature about barriers and facilitators to FIM programs were of interest, defined as programs that screen and refer eligible patients with diet-related chronic disease experiencing food insecurity to healthy, unprepared foods. Thirty-one sources were included in the narrative review, including 22 peer-reviewed articles, four reports, four toolkits, and one thesis. Twenty-eight sources (90%) described EPIS Inner Context facilitators and 26 sources (84%) described FIM program barriers. The most common barriers and facilitators to FIM programs were regarding Quality and Fidelity Monitoring and Support (e.g., use of electronic medical records for tracking and evaluation, strategies to support implementation) and Organizational Staffing Processes (e.g., clear delineation of staff roles and capacity); although, barriers and facilitators to FIM programs were identified among all EPIS Inner Context constructs. We synthesized barriers and facilitators to create an EPIS-informed implementation checklist for healthcare settings for use among healthcare organizations/providers, partner organizations, and technical assistance personnel. We discuss future directions to align FIM efforts with implementation science terminology and theories, models, and frameworks to improve the implementation evidence base and support FIM researchers and practitioners.

PURPOSE OF REVIEW: Because nutrition plays a crucial role in the development of chronic diseases, ensuring nutrition security is important for promoting population health. Nutrition security is defined as having consistent and equitable access to healthy, safe, affordable foods essential to optimal health and well-being. Distinguished from food security, nutrition security consists of two constructs: healthy diets and nutritional status. The study aimed to identify population measures that reflect the important constructs of nutrition security (i.e., healthy diets and nutritional status) to inform U.S. nutrition security assessment and monitoring. RECENT FINDINGS: Through a narrative review conducted across multiple databases, associations between subconstructs of healthy diets and nutritional status were identified. Of the six subconstructs that constitute healthy diets, nutrient adequacy and moderation were most often used to assess and monitor healthfulness of U.S. population diets and were associated with health outcomes. There is little evidence of an association between health outcomes and macronutrient balance or diversity in the U.S. Thirteen instruments were identified as potentially suitable for measuring at least one subconstruct of healthy diet in the population. This review highlights the importance of nutrition security in addressing population health challenges. It emphasizes the potential use of multiple instruments and measures to comprehensively monitor population nutrition security and inform intervention strategies. Identifying feasible and practical measures for assessing and monitoring nutrition security is imperative for advancing population health and mitigating the burden of chronic diseases.

BACKGROUND: Understanding nutritions role in multiple sclerosis (MS) can guide recommendations and intervention-based studies. OBJECTIVE: Evaluate the association between nutrition and pediatric-onset MS outcomes. METHODS: Prospective longitudinal multicenter study conducted as part of the US Network of Pediatric MS centers. Predictors were collected using a food screener estimating intake of various dietary food groups (e.g. dairy and fruits) and additional calculated indices (e.g. Healthy Eating Index (HEI)). Outcomes included time-from-enrollment to clinical relapse, new magnetic resonance imaging (MRI) T2 lesions, and Expanded Disability Status Scale (EDSS) increase. RESULTS: 353 children with MS were enrolled (mean ± SD age 15.4 ± 2.9, follow-up 3.9 ± 2.6 years). Multivariable analysis demonstrated that increased dairy by 50% of recommended intake was associated with increased relapse risk by 41% (adjusted hazard ratio (HR) 1.41, 95% CI 1.07-1.86), and risk of T2 progression by 40% (1.40, 1.12-1.74). Increased intake of fruit or vegetable above recommended, and every five-point HEI increase decreased relapse risk by 25% (0.75, 0.60-0.95), 45% (0.55, 0.32-0.96), and 15% (0.84, 0.74-0.96), respectively. No associations were found with EDSS. CONCLUSION: This work supports the influence of dietary intake on MS course, particularly with dairy intake. Future prospective study is required to establish causation.

BACKGROUND: Combining smoking with poor eating habits significantly elevates the risk of chronic illnesses and early death. Understanding of how dietary quality shifts post-smoking cessation remains limited. The objective of this study is to examine dietary quality - using Healthy Eating Index (HEI - 2020) and its 13 components, among current, former, and never smokers, and particularly the impact of quitting and the duration of cessation on dietary habits. METHODS: A cross-sectional analysis of 31,569 adults from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 was conducted. Dietary quality was assessed using HEI-2020 scores, which were determined by NIH developed - simple HEI scoring algorithm per person. Smoking status was categorized into current, former, and never smokers, with further subdivisions for current (heavy/light smokers) and former smokers (duration post-cessation). Descriptive analysis and multiple regression models weighted to represent the US population were performed. RESULTS: The current smoking rate was 19.4%, with a higher prevalence in males (22.5%) than females (17.5%). Current smokers reported statistically significantly lower HEI total score than both former and never smokers. Former smokers exhibited HEI scores similar to those of never smokers. The adjusted HEI total scores for current, former, and never smokers were 49.2, 54.0, and 53.3, respectively, with a statistically significant difference (p  0.05, respectively). Compared to current smokers, former smokers tended to consume more beneficial foods (e.g., fruits, vegetables, greens and beans, whole grains, proteins, and fatty acids), while also consuming more sodium and less added sugar. CONCLUSIONS: Current smokers, particularly heavy smokers, exhibit poorer dietary habits than former and never smokers. The dietary quality of former smokers aligns with never smokers over time, highlighting the positive impact of smoking cessation on diet. This has implications for reducing chronic disease risks associated with poor diet and smoking.

PURPOSE AND OBJECTIVES: Although considered a promising model of practice, integrating healthy nutrition standards and practices into a large county governments contracting process with food vendors has not been widely described in empirical literature. We conducted an implementation evaluation project to address this gap. INTERVENTION APPROACH: County of Los Angeles food vendors provide food or meals annually to more than 100,000 employees and millions of clients and visitors. In 2011, the County of Los Angeles Board of Supervisors adopted a policy to integrate healthy nutrition standards and practices into its requests for proposals (RFPs) and contracting process with food vendors. The policy required all contracts awarded to adhere to these new standards. EVALUATION METHODS: In 2011, the Los Angeles County Department of Public Health (DPH) began reviewing RFPs for food services for county departments that procured, served, or sold food. From 2011 through 2021, DPH applied a 4-pronged formative-evaluative approach to help county departments implement the Board of Supervisors policy and ensure that nutritional requirements were appropriately integrated into all RFPs for new and renewing contracts with food vendors. We focused our evaluation on understanding the process and tracking the progress of this policy intervention. Our evaluation included 13 key informant interviews, a 2-part survey, reviews of contract data, and synthesis of lessons learned. RESULTS: Based on reviews and subsequent actions taken on more than 20 RFPs, DPH successfully assisted 7 county departments to incorporate healthy nutrition standards and practices into their food vendor contracts. Implementation of the food policy encountered several challenges, including staffing and training constraints and a limited infrastructure. An iterative approach to program improvement facilitated the process. IMPLICATIONS FOR PUBLIC HEALTH: Although the model for integrating healthy nutrition standards and practices into a government contracting process is promising, more work is needed to make it less resource-intensive and to increase user buy-in.

Background: Chronic diseases are known to detrimentally impact an individual's quality of life (QOL) and well-being. Therefore, this study aims to evaluate the QOL and overall well-being among both healthy individuals and those with diverse primary diagnoses. Methods: This is a cross-sectional study and data collection took place from May 2022 to May 2023. Information regarding healthy participants was gathered from healthcare workers without any comorbidities. Data for non-healthy participants were collected from individuals diagnosed with various conditions across four specialist clinics: nephrology, oncology, psychiatry, and cardiology. All participants completed the Significant Quality of Life Measures (SigQOLM), a comprehensive assessment tool consisting of 69 items that evaluate 18 domains of QOL and well-being. Results: The study included a total of 452 participants, with 284 (62.8%) classified as healthy. Among the non-healthy participants, 41 (9.1%) had end-stage renal diseases (ESRD), 48 (10.6%) were diagnosed with cancer, 40 (8.8%) had depressive disorder, and the remaining had heart disease (8.6%). Statistical analysis revealed significant differences (p < 0.001) between healthy and non-healthy participants in both overall SigQOLM scores and across all 18 domains of SigQOLM. Conclusion: Generally, healthy participants also experienced excellent QOL and well-being. However, disparities in both QOL and overall well-being were evident among patients with various diagnoses. These findings provide valuable insights for medical practitioners and policy makers by enabling them to tailor interventions to enhance the QOL and well-being of their patients. [ABSTRACT FROM AUTHOR]

In livestock production, ruminant feed resources are often scarce, and numerous challenges arise during production, such as immune disorders and oxidative stress. Mulberry leaves are rich in various nutrients and exhibit significant antioxidant and immune-regulating properties. Therefore, they can be used as an unconventional feed resource in livestock production. This study investigated the effects of mulberry leaves (ML) as a feed supplement on the blood biochemical parameters and hindgut microbial structure of Hu sheep. Sixteen Hu sheep were randomly divided into two groups and fed either 0 or 60 g/d of ML. Compared to the control group, sheep fed ML showed a significant increase in AKP (P = 0.027) and GPT (P = 0.002) levels in the blood, while TP (P = 0.001) levels decreased significantly. Additionally, there was an increasing trend in GSH-Px (P = 0.082) and CAT (P = 0.058) levels. After the addition of ML, the abundance of Campylobacterota, Campylobacter , and Mailhella in the hindgut significantly increased (P < 0.05), while the abundance of Alloprevotella , Roseburia , and Prevotellaceae UCG-003 significantly decreased (P < 0.05). Therefore, ML can serve as a natural feed supplement to regulate the immune status of animals, thereby promoting the healthy production of ruminants. [ABSTRACT FROM AUTHOR]

Background: Brain-computer interface (BCI) offers promising solutions to cognitive enhancement in older people. Despite the clear progress received, there is limited evidence of BCI implementation for rehabilitation. This systematic review addresses BCI applications and challenges in the standard practice of EEG-based neurofeedback (NF) training in healthy older people or older people with mild cognitive impairment (MCI). Methods: Articles were searched via MEDLINE, PubMed, SCOPUS, SpringerLink, and Web of Science. 16 studies between 1st January 2010 to 1st November 2024 are included after screening using PRISMA. The risk of bias, system design, and neurofeedback protocols are reviewed. Results: The successful BCI applications in NF trials in older people were biased by the randomisation process and outcome measurement. Although the studies demonstrate promising results in effectiveness of research-grade BCI for cognitive enhancement in older people, it is premature to make definitive claims about widespread BCI usability and applicability. Significance: This review highlights the common issues in the field of EEG-based BCI for older people. Future BCI research could focus on trial design and BCI performance gaps between the old and the young to develop a robust BCI system that compensates for age-related declines in cognitive and motor functions. [ABSTRACT FROM AUTHOR]

Objectives: Health-Significant Quality of Life Measure (Health-SigQOLM) provides a generic and dynamic assessment of Health-related quality of life (HRQOL). This study aims to assess the HRQOL among healthy and non-healthy participants with varying chronic diseases. Results: Comparisons between healthy and non-healthy participants revealed statistically significant differences (p < 0.001) in the mean overall HRQOL score as well as across all its nine domains. Therefore, the Health-SigQOLM, along with its nine domains, is demonstrated to have adequate sensitivity in distinguishing between healthy and non-healthy study participants. This had supported the evidence that the Health-SigQOLM is a reliable and valid scale for measuring both generic and dynamic HRQOL. [ABSTRACT FROM AUTHOR]

Concepts and definitions of 'healthy' have been evolving within clinical treatment algorithms as well as reference standards such as Body Mass Index and Dietary Reference Intakes. Consumers' perception of the word 'healthy' is also changing to reflect longer life span, need to stay active and in a good state of mental well-being while managing multiple diseases. Guidelines from the US Food and Drug Administration indicate that substantiating evidence for support of Structure/Function (S/F) claims for dietary supplements is best derived from clinical research conducted in a 'healthy' population. S/F claims cannot be represented to diagnose, treat, cure or prevent any disease. However, in this context, the term 'healthy' is non-descriptive and largely interpreted as an absence of disease. Guidelines for treatment of disease have been broadened to include biomarkers of disease risk such that the pool of 'healthy' volunteers eligible to be enrolled in clinical trials for S/F claim substantiation is greatly diminished. This perspective presents the challenges faced by the food and dietary supplement industry and by researcher efforts designed to substantiate S/F claims and suggest the phrase 'physiologically stable' or 'apparently healthy' as descriptions better suited to replace the term 'healthy.' [ABSTRACT FROM AUTHOR]

Background: The urinary microbiota of healthy children has rarely been studied, and potential differences between boys and girls have not been addressed. Thus, this study aimed to compare the urinary microbiota of healthy prepubescent girls and boys. Methods: We included healthy children aged between 4 and 10 years who were free of functional or organic urinary tract diseases and had no history of urinary tract infection. We collected the mean portion of morning urine during natural micturition and determined aerobic and anaerobic microbiota using HiCrome™ chromogenic growth media. We identified microorganisms on the basis of morphotinctural properties and analyzed α- and β-diversity of microorganisms isolated from the urine of boys and girls. Results: Mean age of the children was 6.1 ± 3.2 years. In general, four-component (28.1%) as well as two-component (15.6%), three-component (15.6%), and six-component (12.5%) combinations of microorganisms prevailed in the urine of children. The urine of boys exhibited four-component combinations significantly more often than that of girls (p ˂ 0.05), while the urine of girls contained seven-component microbial combinations significantly more often than that of boys (p ˂ 0.05). Comparison of multicomponent combinations of microorganisms in boys and girls revealed an overrepresentation of Enterococcus spp. in girls (p < 0.05). Furthermore, there was a trend towards higher microbial α-diversity in the urine of girls, but the difference between girls and boys was not significant. Conclusions: The urine of healthy prepubescent children contained various aerobic–anaerobic combinations of microorganisms. Their diversity in the urine of girls and boys did not differ significantly. However, the level of α-diversity of microorganisms was higher in girls than in boys. We noted differences in the prevalence of certain taxa of microorganisms in the urine of boys and girls. Our study showed a close functional relationship between aerobic and anaerobic microorganisms detected in the urine of children in more than half of the cases. [ABSTRACT FROM AUTHOR]

The transition from secondary school to college or university is a well-known and well-studied risk period for weight and/or fat gain and not meeting the dietary recommendations. Higher education acts as a promising setting to implement nutrition interventions. An important condition for intervention success is that interventions are implemented as intended by the protocol and integrated in the institutional policy. Unfortunately, to date, there is only little understanding of the factors influencing adoption and implementation of nutrition interventions in higher education settings. This study aimed to provide insight into stakeholders' perspectives on facilitators and barriers to adoption and implementation of nutrition interventions promoting healthy and sustainable diets among higher education students in Flanders. Eight online group interviews and three online individual interviews were conducted involving a total of 37 stakeholders (e.g., staff of student services and student restaurants) from ten Flemish higher education institutions with varying food policy quality scores, and one external catering company which provides catering in higher education institutions. A semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR-framework) was used to facilitate the interviews. Afterwards, the data were analyzed using a combined inductive and deductive thematic approach led by the CFIR-framework. Most of the institutions' food policies focused on the provision and promotion of healthy and sustainable nutrition. Therefore, the reported factors in the present study consequently relate primarily to these two strategies. Stakeholders preferred to adopt low cost and institution-tailored interventions supported by experts and evidence, considering them easier and less resourceful to implement in the specific context of the institution. They stressed the importance of considering both students' and institution stakeholders' needs and perspectives in the development of nutrition interventions and implementation plans. Furthermore, interventions should be focused on a combination of different ecological levels and various strategies. Future interventions should be developed participatively and should be focused on a combination of both individual and environmental levels. Higher education institutions are encouraged to use opportunities such as creating win–win situations within the institution, working together with research groups and engaging students through student associations. The findings of this research add to the literature on implementation science and inform future development and implementation of nutrition interventions in higher education settings. [ABSTRACT FROM AUTHOR]

Introduction: University period is a critical developmental stage in which health-related behaviors that will be effective throughout life are acquired. This study aims to to evaluate the effect of health promotion education given touniversity students on health perception, health behaviors and risky behaviors, to investigate the impact of the demographic characteristics of the participants on these three variables, and to investigate the potential relationship between the three variables. Methods: It is a quasi-experimental study using a pre-post test design This study was conducted with 179 students. The Health Perception Scale, the Healthy Lifestyle Behaviors Scale, and the Risky Behaviors Scale were used to collect the data. A 7-week training program was implemented, and the post-training evaluation was made after 3 months. Percentage, mean, standard deviation, Mann–Whitney U, Kruskal-Wallis, Wilcoxon analysis, and Spearmen Correlation analysis were used to analyze the data. Results: After health promotion training, it was determined that health perception and healthy lifestyle behaviors increased and risky behaviors decreased. A significant negative relationship was found between health perception after training and antisocial behavior, suicidal tendencies and dropping out of school. A significant negative relationship was found between healthy lifestyle habits and antisocial behavior, suicidal tendencies and school dropout. A positive significant relationship was determined between health perception and healthy lifestyle behaviors. The results of this study provide evidence of the effectiveness of training interventions in improving healthy lifestyle behaviors and health perception and reducing risky behaviors. Discussion: The results support the planning of training programs to promote health on campuses. It also shows the effectiveness of training programs in preventing antisocial behavior, suicidal tendencies and school dropout. [ABSTRACT FROM AUTHOR]

The advent of next‐generation sequencing (NGS) technologies has made it possible to investigate microbial communities in various environments, including different sites within the human body. Therefore, the previously established belief of the sterile nature of several body sites, including human blood, has now been challenged. However, metagenomics investigation of areas with an anticipated low microbial biomass may be susceptible to misinterpretation. Here, we critically evaluate the results of 16S targeted amplicon sequencing performed on total DNA collected from healthy donors' blood samples while incorporating specific negative controls aimed at addressing potential bias to supplement and strengthen the research in this area. We prepared negative controls by increasing the initial DNA quantity through sequences that can be recognized and subsequently discarded. We found that only three organisms were sporadically present among the samples, and this was mostly attributable to bacteria ubiquitously present in laboratory reagents. Despite not fully confirming or denying the existence of healthy blood microbiota, our results suggest that living bacteria, or at least their residual DNA sequences, are not a common feature of human blood in healthy people. Finally, our study poses relevant questions on the design of controls in this research area that must be considered in order to avoid misinterpreted results that appear to contaminate current high‐throughput research. [ABSTRACT FROM AUTHOR]

The Planetary Health Diet (PHD), also known as the EAT-Lancet reference diet, was developed to optimize global dietary quality while keeping the environmental impacts of food production within sustainable planetary boundaries. We calculated current national and global adherence to the PHD using the Planetary Health Dietary Index (PHDI). In addition, we used data on diet and mortality from three large US cohorts (n = 206,404 men and women, 54,536 deaths) to estimate the total and cause-specific mortality among adults 20 y of age and older that could be prevented by shifting from current diets to the reference PHD. The PHDI varied substantially across countries, although adherence was universally far from optimal (mean PHDI = 85 out of 140). By improving the global PHDI to 120, approximately 15 million deaths (27% of total deaths) could be prevented annually. Estimates of preventable deaths due to this shift ranged from 2.5 million for cardiovascular diseases to 0.7 million for neurodegenerative diseases. Our analysis suggests that adopting healthy and sustainable diets would have major direct health benefits by reducing mortality due to multiple diseases and could contribute substantially to achieving the United Nations Sustainable Development Goals. These numbers of preventable deaths are based on evidence that human biology is similar across racial and ethnic groups, but the exact numerical estimates should be interpreted with caution because some assumptions used for the calculations build on limited data. Refinement of these estimates will be possible when additional regional data on diet and mortality become available. [ABSTRACT FROM AUTHOR]

This study evaluates the current scope of smart technology applications that support aging in place and identifies potential avenues for future research. The global demographic shift towards an aging population has intensified interest in technologies that enable older adults to maintain independence and quality of life within their homes. We conducted a systematic review of the scientific literature from Web of Science, PubMed, and ProQuest, identifying 44 smart technologies across 32 publications. These technologies were classified into three categories: nonmobile technologies for individual monitoring, nonmobile technologies for home environment monitoring, and wearable technologies for health and activity tracking. Notably, the research in this area has grown significantly since 2018; yet, notable gaps persist, particularly within the traditional disciplines related to aging and in the use of quantitative methodologies. This emerging field presents substantial opportunities for interdisciplinary research and methodological advancement, highlighting the need for well-developed research strategies to support the effective integration of smart technology in aging in place. [ABSTRACT FROM AUTHOR]

The food sector is constantly responding to consumers' increased demands concerning healthy nutrition and beneficial ingredients. This study presented the development of three pudding alterations using lyophilized fruit (apricots, plum–apricots, and plums) powders. The same concentrations of fruit powder fully substituted the sugar in each formulation. The results showed that each new formulation formed a thick gel consistency and had full water-holding capacity at 24 h of storage. The color differed according to the established CIE-lab data. The lightness varied from 42.57 ± 1.97 (pudding formulation using plum powder) to 81.91 ± 1.18 (control sample). The total soluble solids and titratable acidity showed that the control sample was different from each new formulation. The water activity was similar in all studied samples varying from 0.978 ± 0.003 to 0.989 ± 0.001, and the plum and plum–apricot formulations had a pH near the control samples, at 6.54 and 7.23, respectively. The antioxidant activity, total polyphenol content, and total flavonoid content were also evaluated. The ABTS assay revealed the highest results compared to the other three applied methods. The sensory evaluation showed that it is necessary to further improve the recipes for better consumer perception. [ABSTRACT FROM AUTHOR]

Neurovascular coupling (NVC) is the perturbation of cerebral blood flow (CBF) to meet varying metabolic demands induced by various levels of neural activity. NVC may be assessed by Transcranial Doppler ultrasonography (TCD), using task activation protocols, but with significant methodological heterogeneity between studies, hindering cross-study comparisons. Therefore, this review aimed to summarise and compare available methods for TCD-based healthy NVC assessments. Medline (Ovid), Scopus, Web of Science, EMBASE (Ovid) and CINAHL were searched using a predefined search strategy (PROSPERO: CRD42019153228), generating 6006 articles. Included studies contained TCD-based assessments of NVC in healthy adults. Study quality was assessed using a checklist, and findings were synthesised narratively. 76 studies (2697 participants) met the review criteria. There was significant heterogeneity in the participant position used (e.g., seated vs supine), in TCD equipment, and vessel insonated (e.g. middle, posterior, and anterior cerebral arteries). Larger, more significant, TCD-based NVC responses typically included a seated position, baseline durations >one-minute, extraneous light control, and implementation of previously validated protocols. In addition, complementary, combined position, vessel insonated and stimulation type protocols were associated with more significant NVC results. Recommendations are detailed here, but further investigation is required in patient populations, for further optimisation of TCD-based NVC assessments. [ABSTRACT FROM AUTHOR]

The prevalence of obesity continues to rise, and public health dietary recommendations are not being adhered to. The transition to higher education is a period of risk for weight gain in young adults and has been demonstrated as a good time to initiate behaviour change. A genotype‐based personalised approach to dietary recommendations may motivate young adults to maintain or adopt positive dietary behaviours. The aim of the present study was to determine the efficacy of genotype‐based personalised dietary and physical activity advice on healthy eating motivation in young adults. Participants were young adults (n = 153), aged 18–25 years. Baseline measures (participant characteristics, height, weight, body mass index [BMI], body fat percentage [BF%], healthy eating motivation and physical activity) were collected. Participants were genotyped for a SNP in the FTO gene (rs99396090) and randomly allocated (stratified for genotype) to three different groups (1. Genotype‐based personalised advice: dietary and physical activity advice based on genotype, BMI and reported physical activity; 2. Non‐genotype‐based personalised advice: dietary and physical activity advice based on BMI and reported physical activity; 3. Control: no advice). A week after receipt of advice delivered via email, participants completed the healthy eating motivation questionnaire for a second time. Genotype‐based personalised dietary advice did not affect healthy eating motivation: when participants were analysed across the whole group (p = 0.417), when analysed according to those informed of a risk or non‐risk‐associated genotype (p = 0.287), or when analysed according to those with a BMI (>25 kg/m2; p = 0.336) or BF% (male >18%, female >31%; p = 0.387) outside the healthy range. There was also no significant difference in healthy eating motivation at 1‐week in the control or non‐genotype‐based advice groups. Genotype‐based personalised advice for the prevention of obesity did not affect healthy eating motivation in this group of healthy, young adults. [ABSTRACT FROM AUTHOR]

Phospholipase A2 receptor 1 (PLA2R1) exists important role in membranous nephropathy. In this study, we evaluate a PLA2R1 in a middle‐aged rat model of renal function repair to further investigate the molecular mechanisms of membranous nephropathy. We analyzed the PLA2R1 knockout (KO) model and PLA2R1 knock in (KI) model in rats, extending the time to 85 weeks of age. Urinary biochemical indicators were detected using a fully automated biochemical analyzer. The complement C3, IgG, and Nephrin were detected using the immunofluorescence method. Western blot was used to detect the expression levels of complement C3, IgA and PLA2R1 in middle‐aged models. The KO model continues to display glomerular proteinuria, complement C3 aggregation, and IgA and IgG deposition. Comparing with the KO model, the deposition of complement C3 and IgA in the glomerulus of the KI chimeric model still exists and IgG expression weakened. Inserting humanized PLA2R1 into rats can continuously repair partial renal function and reduce proteinuria, which will help investigate the pathogenesis of membranous nephropathy and complement activation signaling pathways. Summary: In our search for a model of chronic kidney disease, we continuously constructed the PLA2R1 model. During the identification process, we unexpectedly discovered an interesting model that not only does not cause kidney damage but also keeps healthy when the middle age. Although we are only publishing this new phenomenon and reporting on this discovery, it is enough to attract readers. [ABSTRACT FROM AUTHOR]

Purpose. Previous research indicates that physical education (PE) classes frequently fail to meet the recommended levels of moderate to vigorous physical activity (MVPA). This study aimed to compare the intensity levels achieved through different PE strategies, and, as a secondary objective, to evaluate students' perceptions of fun, motivation, and engagement. Materials and Methods. A total of 52 students (23 girls and 29 boys) participated in the study. The children were healthy and none of them were taking medication continuously or presented any orthopedic physical inability that would prevent them from performing the tests. All the children attended three PE classes on separate days; a recreational strategy, a circuit-based high-intensity interval training (circuit/HIIT) class, and a traditional class. All classes included games and activity content that followed the country's guidelines. Intensity levels were measured using portable heart rate (HR) monitors, and perceived exertion was assessed using the rate of perceived exertion (RPE) scale. For comparisons between each class strategy, the Kruskal-Wallis test and Dunn's test were used to identify significant differences (P<0.05). Qualitative data are presented as percentages of interview responses. Results. All strategies led to a level of engagement in MVPA for more than 50% of the total class duration. The circuit/HIIT and recreational strategies demonstrated significantly higher proportions of time spent in MVPA compared to the traditional class (P<0.01). The qualitative results showed that the recreational class received the highest number of positive responses, followed by the traditional class, while the circuit/HIIT received fewer positive responses. In addition, the RPE values aligned with the quantitative HR results, reflecting the class intensities. Conclusion: The circuit/HIIT strategy achieved the highest percentage (93.2%) of time in MVPA, followed by the recreational (91.8%) and traditional classes (77.6%). The results highlight the excellent percentage of time spent in MVPA in the recreational strategy, and qualitatively, the higher levels of fun, motivation, and engagement among students in this model. Thus, the recreational strategy led to excellent intensity of activity during the class, as well as positive responses in relation to the students' motivation and engagement. [ABSTRACT FROM AUTHOR]

Abstract Background Brain-computer interface (BCI) offers promising solutions to cognitive enhancement in older people. Despite the clear progress received, there is limited evidence of BCI implementation for rehabilitation. This systematic review addresses BCI applications and challenges in the standard practice of EEG-based neurofeedback (NF) training in healthy older people or older people with mild cognitive impairment (MCI). Methods Articles were searched via MEDLINE, PubMed, SCOPUS, SpringerLink, and Web of Science. 16 studies between 1st January 2010 to 1st November 2024 are included after screening using PRISMA. The risk of bias, system design, and neurofeedback protocols are reviewed. Results The successful BCI applications in NF trials in older people were biased by the randomisation process and outcome measurement. Although the studies demonstrate promising results in effectiveness of research-grade BCI for cognitive enhancement in older people, it is premature to make definitive claims about widespread BCI usability and applicability. Significance This review highlights the common issues in the field of EEG-based BCI for older people. Future BCI research could focus on trial design and BCI performance gaps between the old and the young to develop a robust BCI system that compensates for age-related declines in cognitive and motor functions.

Background and aims: Familial hypercholesterolemia (FH) is an inherited disease associated with hypercholesterolemia, and dietary treatment is part of the treatment. We aimed to assess the dietary pattern in relation to the Healthy Nordic Food Index (HNFI) in adults with and without heterozygous FH (HeFH), and to examine the associations between dietary quality and biomarkers related to cardiovascular disease in adults with HeFH. Methods: We included 205 adults (≥18 years) with HeFH who received follow-up at the Lipid Clinic in Oslo and compared them to controls (n = 228). Dietary intake was assessed using a food frequency questionnaire and dietary quality was assessed using the HNFI. Blood samples were analysed for levels of blood lipids, plasma fatty acids (FAs), and markers of inflammation and platelet activation. Results: The HeFH patients (median 60 years; 50.2 % female; 25.9 % in secondary prevention) had lower intake of total and saturated fat compared to controls (32.6 energy percent (E%) vs. 34.9 E%, and 9.6 E% vs 12.0 E%, respectively; p

We examined relationships between prenatal dietary patterns and child autism-related outcomes, including parent-reported clinician diagnoses of autism spectrum disorder (ASD) and Social Responsiveness Scale (SRS-2) scores, in up to 6084 participants (with analytic samples ranging from 1671 to 4128 participants) from 14 cohorts in the Environmental Influences on Child Health Outcomes (ECHO) consortium. Associations between quartiles of the Healthy Eating Index (HEI-2015), the Alternative Healthy Eating Index modified for Pregnancy (AHEI-P), and the Empirical Dietary Inflammatory Pattern (EDIP), calculated based on reported prenatal diet, and outcomes were examined using crude and multivariable regression (quantile for SRS scores and logistic for diagnosis). In adjusted models, the higher quartile of prenatal HEI score was associated with lower SRS scores (Q4 vs. Q1 β for median quantile = -3.41 95% CI = -5.15, -1.26). A similar association was observed for the AHEI-P score when adjusting for total calories (Q4 vs. Q1 β = -2.52 95% -4.59, -0.45). There were no significant associations of prenatal diet with ASD diagnosis. Findings from this large U.S.-based study do not suggest strong associations between prenatal dietary patterns and ASD-related outcomes, although subtle associations with broader traits suggest the need to further consider how prenatal diet may relate to ASD-related phenotypes.

BACKGROUND: Racial and ethnic disparities in infant-feeding practices may negatively influence diet quality and health. OBJECTIVES: This study investigated the racial, ethnic, and language (English or Spanish) differences in infant diet quality, later diet quality, and weight status at 2-5 y, and whether these differences were explained through infant diet quality among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). METHODS: Using the WIC Infant and Toddler Feeding Practices Study-2 (unweighted n = 2663; weighted n = 362,712), relationships between the Infant Dietary Quality Index (IDQI; range 0-1) and Healthy Eating Index-2020 (HEI-2020; range 0-100) and BMI z-score (BMIz) at 2-5 y were analyzed by race, ethnicity, and language preference [Hispanic Spanish-speaking, Hispanic English-speaking, non-Hispanic (NH) White, and NH Black participants]. Statistical interaction between IDQI and each group was evaluated in multivariable models. The mediation of each group through the IDQI was assessed using causal mediation methods. RESULTS: Differences in IDQI [mean (standard deviation)] were observed between Hispanic Spanish-speaking participants [0.41 (0.10)], Hispanic English-speaking participants [0.37 (0.10)], NH White participants [0.36 (0.10)], and NH Black participants [0.35 (0.09)], P < 0.001. Differences in HEI-2020 occurred at 2-5 y, with the Hispanic Spanish-speaking participants having consistently higher HEI-2020 scores. Differences in BMIz were observed at 5 y, with higher scores among Hispanic Spanish-speaking participants. Interaction between race, ethnicity, and IDQI was observed for all outcomes except for BMIz at 3 y. Through mediation, IDQI explained 13%-20% of the difference in HEI-2020 scores between Hispanic Spanish-speaking and NH White participants at 2-5 y. IDQI explained 22%-25% of the difference in HEI-2020 scores between the Hispanic Spanish-speaking and NH Black participants at 4 y and 5 y. CONCLUSIONS: Higher infant diet quality scores observed in Hispanic Spanish-speaking participants explain some of the racial and ethnic differences observed in later diet quality, suggesting that improving infant diet quality may help reduce diet disparities during early childhood.

BACKGROUND: The number of breast cancer survivors is increasing, yet evidence to inform dietary and lifestyle guidelines is limited. METHODS: This analysis included 3,658 participants from the Pathways Study, a prospective cohort of women diagnosed with invasive breast cancer. A healthy plant-based dietary index score (hPDI), an American Cancer Society (ACS) nutrition guidelines score, a 2015 Healthy Eating Index score (HEI), hours per week of moderate to vigorous physical activity (PA), and lifetime cumulative pack-years of cigarette smoking (SM) were each measured at diagnosis, 6, 24, and 72 months. Using g-computation, 5- and 10-year risk ratios (RR), risk differences, and 95% confidence intervals (CI) for all-cause mortality under hypothetical interventions on diet quality, PA, and SM, compared with the natural course (no intervention) were calculated. RESULTS: Hypothetical moderate to extreme interventions on hPDI, ACS, and HEI, each in combination with PA and SM, showed 11% to 56%, 9% to 38%, and 9% to 49% decreases in 5-year risks of all-cause mortality compared with no intervention, respectively [(hPDI: RRmoderate = 0.89, 95% CI: 0.82-0.94; RRextreme = 0.44, 95% CI: 0.26-0.67), (ACS: RRmoderate = 0.91, 95% CI: 0.85-0.96; RRextreme = 0.62, 95% CI: 0.43-0.82), (HEI: RRmoderate = 0.91, 95% CI: 0.84-0.95; RRextreme = 0.51, 95% CI: 0.33-0.72)]. While 10-year relative risks were slightly attenuated, absolute risk reductions were more pronounced. CONCLUSIONS: Interventions to improve diet quality, increase PA, or reduce SM at the time of diagnosis may improve survival among breast cancer survivors. IMPACT: We estimate that over 10% of deaths could be delayed by even moderate adoption of these behaviors.

Purpose: To understand the etiology, work-up, and secondary systemic and ocular events of retinal artery occlusion (RAO) in young patients (≤ 45 years old) without typical cardiovascular risk factors. Methods: Retrospective longitudinal case series of 18 young patients with RAO and without typical cardiovascular risk factors evaluated at the University of Michigan Medicine Health System between the year 2000 and 2022. Laboratory and imaging studies performed at the time of RAO diagnosis, along with systemic and ocular events during follow-up, were recorded. These data were combined with data from a literature review of 74 similar patients experiencing a RAO. Results: Fifteen (83%) of patients were female and 10 (56%) suffered a branch retinal artery occlusion (BRAO). 56% of patients had one risk factor associated with cryptogenic stroke, most commonly a migraine history (33%). The most frequent etiology of RAO was vasculitis (28%), followed by idiopathic (22%) and patent foramen ovale (PFO, 17%). Three out of four patients with idiopathic RAOs developed new migraines around the time of RAO diagnosis, whereas none of the patients with a clear etiology had new onset migraines (n = 14). No patients suffered a stroke or myocardial infarction (MI) in the follow-up period (average 3.6 years ± 3.2 years). Two patients (11%) suffered a repeat RAO, both of whom were diagnosed with a vasculitis. Patients with isolated retinal vasculitis required repeat fluorescein angiograms for up to 2 years after the initial event to definitively identify the vasculitic etiology of the RAO. When our data are pooled with similarly healthy patients from previously published RAO series, structural/functional cardiac abnormalities and vasculitides are the most common identifiable etiologies for RAOs in this group. Conclusion: The most common identifiable etiologies of RAO in young patients with low cardiovascular risk are structural/functional cardiac abnormalities and vasculitides, with a small range of additional causes/associations accounting for remaining cases. We suggest a focused work-up algorithm to rapidly identify etiologies in this group while minimizing unnecessary testing. The long-term risk of systemic or ocular secondary events in these patients is low regardless of the etiology of their RAO. Key message: What was Known: • Retinal artery occlusions (RAOs) in young, healthy individuals are rare, making a data-driven work-up for these patients difficult. What is new: • The most common identifiable etiologies for RAO in young, low cardiovascular risk individuals are functional/structural cardiac abnormalities and vasculitides. • Several repeat fluorescein angiographic studies may be required to diagnose an occult retinal vasculitis. • The long-term risk of secondary systemic or ocular events in young, otherwise healthy individuals is low regardless of the etiology of their RAO. [ABSTRACT FROM AUTHOR]

Introduction: The right ventricle (RV) lies on the left ventricle (LV), and their shapes and movements are characteristic and significantly different. The aim of the present study was to investigate the relationship between three-dimensional speckle-tracking echocardiography (3DSTE)-derived LV strains, which represent LV contractility as quantitative features, and tricuspid annular plane systolic excursion (TAPSE) as determined by M-mode echocardiography, which represents the longitudinal movement of the RV, in healthy adults. Methods: A total of 79 healthy adults (mean age: 28.1 ± 6.3 years; 33 men) were enrolled in the present study. After two-dimensional Doppler echocardiography, 3DSTE-derived data acquisition was carried out in all cases, and detailed 3DSTE-based analysis was performed offline at a later date. Results: Reduced TAPSE was associated with increased global and basal LV radial strain (RS). Increased TAPSE was also associated not only with increased global and basal LV-RS but also with global LV longitudinal strain (LS). An increase in global LV-RS and global LV circumferential strain (CS) showed associations with other strains except for global LV-LS. An increase in global LV-LS did not show associations with other strains. Increased global LV-RS was associated with reduced TAPSE, while the degree of global LV-LS and global LV-CS did not show associations with TAPSE. Conclusions: Three-dimensional speckle-tracking echocardiography-derived LV-RS and LV-LS are associated with the longitudinal shortening of the RV represented by TAPSE in healthy adults. [ABSTRACT FROM AUTHOR]

• Changes across time in diet indices did not differ by groups in 12-week study. • Compared to the healthy US group, vegetarians had greater increases in fiber. • Compared to the healthy US group, vegetarians had greater increases in riboflavin. • Compared to the healthy US group, vegetarians had greater increases in folate. • Diet indices had varying associations with health outcomes. The goal of this study was to examine the relationship between diet quality, nutrients, and health outcomes among participants in the Dietary Guidelines: 3 Diets study (3-group randomized 12-week intervention; African American; Southeastern virtual teaching kitchen). Participants (n = 63; ages 18-65 y, BMI 25-49.9 kg/m2) were randomized to the Healthy U.S. (H-US), Mediterranean (Med), or Vegetarian (Veg) groups. Hypotheses tested included (1) that the more plant-based diet patterns (Veg and Med) would have greater improvements in all diet quality indices (Dietary Approaches to Stop Hypertension (DASH), Dietary Inflammatory Index (DII), alternate Mediterranean Diet Index (aMED), healthy Plant-based Dietary Index (hPDI) assessed via three dietary recalls) as compared to the H-US pattern and (2) that each index would separately predict changes in weight loss, hemoglobin A1c (HbA1c), and blood pressure (BP). None of the group-by-time interactions for any of the diet indices were significant. Compared to the H-US group, Veg participants had greater increases in fiber (difference between groups 5.72 ± 2.10 5 g/day; P =.01), riboflavin (0.38 ± 0.19 mg/day; P =.05), and folate (87.39 ± 40.36 mcg/day; P =.03). For every one-point increase in hPDI, there was a 1.62 ± 0.58 mmHg decrease in systolic BP, for every one-point increase in aMED there was a 1.45 ± 0.70 mmHg decrease in diastolic BP, and for every one-point increase in hPDI, there was a 1.15 ± 0.38 mmHg decrease in diastolic BP. Findings indicate that there is significant overlap in the dietary recommendations of the three dietary patterns presented in the USDG and similarities in how African American adults adopt those diet patterns. Clinical Trials registry at clinicaltrials.gov: NCT04981847. African American adults (n = 63) were randomized to the US Dietary Guidelines patterns: Healthy US, Mediterranean, and Vegetarian. Vegetarians had greater increases in fiber, riboflavin, and folate (compared to Healthy US). Increases in the healthy Plant-based Dietary Index were associated with decreases in systolic and diastolic blood pressure. Increases in alternate Mediterranean Diet Index were associated with decreases in diastolic blood pressure. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives To determine oxygen saturation (SpO2) values and their variability in healthy-term neonates at high altitude. Methods In a prospective multisite, non-randomized blinded study, we performed SpO2 measurements in healthy neonates admitted to postnatal wards and followed up in Public Health Nurse Clinics (PHNC) in Calgary, Alberta, Canada. We recruited healthy-term neonates (≥37 weeks) between 6 and 24 h of age. Neonates underwent simultaneous pre- and post-ductal SpO2 recordings every 12 to 24 h until hospital discharge and again in the PHNC within a few days after discharge. Neonates were followed for 8 weeks to ascertain their health status. Results We included data for 252 neonates in hospital and 105 neonates presenting to the PHNC for follow-up. In hospital, the mean pre- and post-ductal SpO2 were 94.3% and 96.0%, respectively. In the PHNC, mean pre- and post-ductal SpO2 were 94.4% and 95.6%, respectively. Desaturation episodes occurred frequently at a median rate of once every 5 minutes. The median duration of pre-ductal desaturation episodes was longer in hospital than in the PHNC for all SpO2 thresholds (P < 0.05). Conclusion SpO2 levels in healthy-term neonates at high altitude are approximately 94% and remained stable over the first few days after birth. Desaturation episodes are common in the immediate neonatal period, but their duration decreases over time, and they are not associated with clinical deterioration. Clinic trials.org (NCT 02095041). [ABSTRACT FROM AUTHOR]

Introduction: With age, sensory, cognitive, and motor abilities decline, and the risk for neurodegenerative disorders increases. These impairments influence the quality of life and increase the need for care, thus putting a high burden on society, the economy, and the healthcare system. Therefore, it is important to identify factors that influence healthy aging, particularly ones that are potentially modifiable through lifestyle choices. However, large-scale studies investigating the influence of multi-modal factors on a global description of healthy aging measured by multiple clinical assessments are sparse. Methods: We propose a machine learning model that simultaneously predicts multiple cognitive and motor outcome measurements on a personalized level recorded from one learned composite score. This personalized composite score is derived from a large set of multi-modal components from the TREND cohort, including genetic, biofluid, clinical, demographic, and lifestyle factors. Results: We found that a model based on a single composite score was able to predict cognitive and motor abilities almost as well as a classical flexible regression model specifically trained for each single clinical score. In contrast to the flexible regression model, our composite score model is able to identify factors that globally influence cognitive and motoric abilities as measured by multiple clinical scores. The model identified several risk and protective factors for healthy aging and recovered physical exercise as a major, modifiable, protective factor. Discussion: We conclude that our low parametric modeling approach successfully recovered known risk and protective factors of healthy aging on a personalized level while providing an interpretable composite score. We suggest validating this modeling approach in other cohorts. [ABSTRACT FROM AUTHOR]

To establish age- and sex-specific reference intervals (RIs) for serum tumor markers (AFP, CEA, CA125, CA199, CA153, HE4, CA724, CYFRA21-1, PSA, and NSE) among a cohort of healthy individuals in South China, a retrospective analysis was conducted on 51,353 samples collected from 2015 to 2020, during health assessments at Guangdong Provincial People's Hospital. The influence of age and gender on serum tumor markers was investigated. New RIs were determined using non-parametric rank-based methods per CLSI EP28-A3C guidelines. Significant differences were detected across age groups for AFP, CEA, CA125, CA199, HE4, CYFRA21-1, PSA, and NSE (p < 0.05). The upper reference limits (URLs) for CA153 and HE4 are significantly lower compared to our current laboratory standards. The URL for CA125 exceeds these limits in individuals under 50 but decreases in those aged 50 and above. For CA199, CEA, and PSA, the URLs are below current standards in individuals younger than 60 but exceed them in those aged 60 and older. Noteworthy elevations were observed in CA724, CYFRA21-1, and NSE levels. Our study establishes age- and sex-specific RIs for ten serum tumor markers among healthy individuals from South China, providing a fundamental resource for the prevention, early detection, and management of tumor-related disorders. [ABSTRACT FROM AUTHOR]

Background: Several polymorphisms of the β2-adrenergic receptor gene have been identified. These polymorphisms affect receptor function and significantly reduce expressed receptors in the cells. The main objective of this study is to determine the frequency of β2 adrenergic receptor polymorphism among a healthy Jordanian population and compare it with those of different ethnic groups. Blood samples were collected from 96 healthy Jordanians. β2-adrenergic receptor gene polymorphism at codon 16 and codon 27 was assessed by Polymerase Chain Reaction (PCR) followed by Restriction Fragment Length Polymorphism RFLP. The minor allele frequency of β2-adrenergic receptor polymorphism at position 46 (46 G/A) was 31%, while the polymorphism at position 79 (79 C/G) was 14% in the Jordanian population. The genotype frequencies for 46 (46 G/A) were 51% for (GG), 13% for (AA) and 36% for (GA). In case 79 C/G, the genotype frequencies were 87.5% 7.3 % 5.2% CC, GG and CG genotypes, respectively. This study's results indicate marked interethnic differences in the genotype and allele frequencies of the two β2-adrenergic receptor polymorphisms among healthy Jordanians, Caucasians, African Americans, and Asians. [ABSTRACT FROM AUTHOR]

Aims and objectives: The Review aimed to evaluate the effectiveness of nursing theories in fallprevention and promoting healthy aging among older adults. Background: Promoting patient safety and healthy aging are two areas where nursing theories have a significant impact on practice, teaching, and research. Due to the hazards associated with an aging population, there has been a surge in interest in applying these ideas to fall prevention techniques. Design: PubMed and CINAHL databases were searched, and research meeting criteria were included. Data were identified from all included articles, and themes weredeveloped based on these data. Results: Several important discoveries on the function of nursing theories in improving patient outcomes were disclosed by the review's major conclusions. First, interventions to promote healthy aging and reduce the risk of falls among the elderly may be better evaluated, planned, and executed with the help of nursing theories. Conclusions: By using evidence-based interventions and nursing theories, such as Orem's Self-Care Deficit Theory, Watson's Theory of Transpersonal Caring, Roy's Adaptation Model, and the Neuman Systems Model, this study emphasizes the critical role of nurses in preventing falls among older persons. [ABSTRACT FROM AUTHOR]

Background/Objectives: To date, population pharmacokinetic (PK) studies of vancomycin on healthy Korean adults have not been conducted. This study aimed to investigate the PK properties of vancomycin in healthy volunteers and to identify optimal dosing regimens based on the area under the concentration–time curve (AUC) in adult patients with normal renal function. Methods: We conducted a prospective clinical study, analysing PK samples from 12 healthy participants using noncompartmental analysis and non-linear mixed-effects modelling. The population PK parameters derived were employed in Monte Carlo simulations to evaluate the adequacy of the current dosing regimen and to formulate dosing recommendations. Results: The PK profiles were optimally described by a two-compartment model, with body weight and age as significant covariates affecting total clearance. The simulations indicated that to achieve a therapeutic target—defined as an AUC at steady-state over 24 h of 400–600 mg·h/L—daily doses ranging from 60 to 70 mg/kg are necessary in adults with normal renal function. Conclusions: This study underscores the need to actively adjust dosage and administration based on a vancomycin PK model that adequately reflects the demographic characteristics of patients to meet both safety and efficacy standards. [ABSTRACT FROM AUTHOR]

The six‐minute walking test (6MWT) is commonly used to measure functional capacity in field settings, primarily through the distance covered. This study aims to establish reference curves for the six‐minute walking distance (6MWD) and peak heart rate (PHR) and develop a predictive equation for cardiovascular capacity in Tunisian children and adolescents. A total of 1501 participants (706 boys and 795 girls), aged 10–18 years, were recruited from schools in Tunisia. The Lambda (L), Mu (M), and Sigma (S) methods (LMS method) were employed to develop smoothed percentile curves for 6MWD and PHR. Multivariate linear regression was utilized to formulate a prediction equation for 6MWD. Smoothed percentiles (3rd, 10th, 25th, 50th, 75th, 90th, and 97th) for 6MWD and PHR were presented with age. All variables showed a strong positive correlation (p < 0.001) with a six‐minute walking distance (r ranged from 0.227 to 0.558 for girls and from 0.309 to 0.610 for boys), except resting heart rate, which showed a strong negative correlation (girls: r = −0.136; boys: r = −0.201; p < 0.001). Additionally, PHR showed a weak correlation (p > 0.05). The prediction equations, based on age as the primary variable, were established for both genders. For boys: 6MWD = 66.181 + 38.142 × Age (years) (R2 = 0.372; Standard Error of Estimate (SEE) = 122.13), and for girls: 6MWD = 105.535 + 28.390 × Age (years) (R2 = 0.312; SEE = 103.66). The study provides normative values and predictive equations for 6MWD and PHR in Tunisian children and adolescents. These findings offer essential tools for identifying, monitoring, and interpreting cardiovascular functional deficits in clinical and research settings. Highlights: Established reference curves for six‐minute walking distance (6MWD) and peak heart rate (PHR) from the data of 1501 children and adolescents aged 10–18 years were recruited from multicenter schools in Tunisia.Developed predictive equations for 6MWD based on age using multivariate linear regression.Provides normative values and predictive equations for 6MWD and PHR, offering valuable tools for identifying and monitoring cardiovascular functional deficits in clinical and research settings. [ABSTRACT FROM AUTHOR]

Context: Interindividual variability in pain is modified by interactions of multiple biopsychosocial factors. Though there are reported findings on pain variability from studies around the world, the relationship between pain outcomes and anthropometric profiles remains unclear due to conflicting findings. Aim: This study was designed to investigate relationships between experimental pain outcomes and anthropometric profiles in a healthy Nigerian population. Materials and Methods: One hundred and sixty-one healthy volunteers aged 20 to 65 years were recruited for the study. Experimental pain was induced using cold pressor pain, pressure pain, and ischemic pain procedures. Results: We found that subjects with a normal body mass index (BMI) had a statistically significant higher ischemic pain tolerance than their obese counterparts. Right-handed participants had higher cold pressor pain thresholds than their left-handed counterparts, and the difference was statistically significant. Hb genotype and blood groups affected experimental pain outcomes. There was a statistically significant negative correlation between BMI and ischemic pain tolerance. Conclusion: We concluded that the association between BMI and experimental pain outcomes depends on the type of pain induction method used. Right-handedness appeared to be associated with increased cold pressor pain threshold. [ABSTRACT FROM AUTHOR]

Various ambient air contaminants can spread into the indoor building through air transport. With the additional generation of contaminants from indoor activities, indoor air quality (IAQ) has the potential to be polluted. Indoor air pollution incidents can occur anytime, which is difficult to predict. Therefore, it is necessary to take action to improve IAQ as early as possible and sustainably. The solution to sustainable remediation is using plants to apply phylloremediation, which functions as leaves and leafassociated microbial communities to reduce air contaminants. This study aims to provide new practical yet essential criteria for the sustainable operation of phylloremediation. This review is based on the latest results of a literature-based study. An analysis of the fundamental processes of plant life forms the basis for obtaining these criteria. The study emphasizes key criteria for phylloremediation encompassing the selecting plants with high transpiration and leaf-microbe synergy, and conducting maintenance by spraying water on leaves. These measures optimize efficiency and sustain the process for indoor air pollutant reduction. The final result summarises the new criteria for sustainable phylloremediation to maintain plant life. These essential criteria can be used for conducting experiments in empirical research, indoor design, and education for the community. [ABSTRACT FROM AUTHOR]

Background: Unhealthy eating habits are frequent among university students, and they are linked to an elevated risk of lifestyle and chronic illnesses. There have been few, if any, research on nursing students' lifestyle in Ghana. Aim: The purpose of this study was to characterise lifestyle choices of undergraduate nursing students in All Nations University, Koforidua. A cross-sectional study design was used with 90 nursing students from All Nations University, Koforidua. Methodology: The study was a descriptive cross-sectional study. A semi-structured questionnaire was used to collect lifestyle and sociodemographic data and a food frequency questionnaire was used to collect data on eating patterns. Statistical analysis was performed with Statistical Package for Social Sciences (SPSS) version 20. Results: The mean age of participants was 21.4±9.3 years, the mean weight was 59.5±12.2 kg, and mean body mass index (BMI) was 22.7±6.3 kg/m². No statistical significance was found between the mean age (p = 0.528), the weight (p = 0.197), and BMI (p = 0.189) of the male students and the female students. The BMI of the female students was higher than that of their male counterparts. Over half (52%) of the students took three meals a day and another 41.1% took two meals a day. Only 1.1% was taking one meal per day. However, when asked whether they did regular exercise apart from normal walking, 60% answered 'Sometimes' and only 6.7% answered 'Always' and another 6.7% answered 'Never' to the question. The students were not interested in exercises outside their normal walking. Nonetheless, 66.7% of the students walked more than 30 minutes daily. Principal component analysis (PCA) produced five dietary patterns which were identified. Conclusion: Nursing students have a fair knowledge of nutritional requirements for diet and health; however, this does not necessarily translate to healthy food choices and lifestyle behaviours. [ABSTRACT FROM AUTHOR]

Background: The left ventricular (LV) rotational mechanics are of particular importance in the function of the LV. The rotational movement is the consequence of the arrangement of the subepicardial and subendocardial muscle fibers. These muscle fibers are perpendicular to each other, their contraction creates a characteristic motion. The aim of the present study was to examine the prognostic impact of LV twist assessed by three-dimensional speckle-tracking echocardiography (3D-STE) in healthy circumstances. Methods: 302 healthy adults participated in the study, 181 subjects were excluded due to certain reasons (LV could not be analysed during 3D-STE, subjects were unidentifiable, or lost to follow-up). 121 subjects were involved in the final analysis (mean age of 33.1 ± 12.3 years, 75 males), who were willing to be examined on a voluntary basis. Results: During a mean follow-up of 7.93 ± 4.21 years, 11 healthy adults suffered a cardiovascular event including 2 cardiac deaths. Using receiver operating characteristic analysis, LV twist ≥14.65 degrees as assessed by 3D-STE proved to be significantly predictive regarding the cardiovascular event-free survival (area under the curve 0.70, specificity 70%, sensitivity 65%, p = 0.028). Subjects with LV twist ≥14.65 degrees had higher basal and apical rotations and a significantly higher ratio of these individuals developed cardiovascular events compared to cases with LV twist <14.65 degrees. Subjects with cardiovascular events had lower LV global longitudinal strain, higher basal LV rotation and twist and the ratio of subjects with LV twist ≥14.65 degrees was elevated as compared to cases without events. Conclusions: 3D-STE-derived LV twist independently predicts future cardiovascular events in healthy adults. [ABSTRACT FROM AUTHOR]

This study aimed to develop a population pharmacokinetic (PK) model for meropenem in healthy adults and explore optimal dosing regimens for patients with normal renal function. PK samples were obtained from 12 healthy participants, which were analyzed using noncompartmental analysis and nonlinear mixed-effect modeling. The PK profiles of meropenem were characterized using a two-compartment model, and serum creatinine level was identified as a significant covariate affecting total clearance. Monte Carlo simulations were conducted using this model to inform dosing recommendations. The target index for meropenem efficacy was defined as the cumulative percentage over 24 h during which free (f) drug concentration exceeded the minimum inhibitory concentration (MIC) under steady state conditions (fT>MIC). These simulations indicated that the current dosage regimen of 1 g for 30 min infusions every 8 h achieved a 90% probability of target attainment (PTA) for 40%fT>MIC when the MIC was <2 mg/L. However, to achieve more stringent therapeutic targets, such as a 90%PTA for 100%fT>MIC or a 90%PTA for 100%fT>4MIC, higher doses administered as 3 h extended infusions or as continuous infusions may be necessary. These results highlight the need for model-informed precision dosing to enhance the efficacy of meropenem therapy across various MIC levels and therapeutic targets. [ABSTRACT FROM AUTHOR]

ImportanceIncreasing evidence suggests that, compared with an omnivorous diet, a vegan diet confers potential cardiovascular benefits from improved diet quality (ie, higher consumption of vegetables, legumes, fruits, whole grains, nuts, and seeds).ObjectiveTo compare the effects of a healthy vegan vs healthy omnivorous diet on cardiometabolic measures during an 8-week intervention.Design, setting, and participantsThis single-center, population-based randomized clinical trial of 22 pairs of twins (N = 44) randomized participants to a vegan or omnivorous diet (1 twin per diet). Participant enrollment began March 28, 2022, and continued through May 5, 2022. The date of final follow-up data collection was July 20, 2022. This 8-week, open-label, parallel, dietary randomized clinical trial compared the health impact of a vegan diet vs an omnivorous diet in identical twins. Primary analysis included all available data.InterventionTwin pairs were randomized to follow a healthy vegan diet or a healthy omnivorous diet for 8 weeks. Diet-specific meals were provided via a meal delivery service from baseline through week 4, and from weeks 5 to 8 participants prepared their own diet-appropriate meals and snacks.Main outcomes and measuresThe primary outcome was difference in low-density lipoprotein cholesterol concentration from baseline to end point (week 8). Secondary outcome measures were changes in cardiometabolic factors (plasma lipids, glucose, and insulin levels and serum trimethylamine N-oxide level), plasma vitamin B12 level, and body weight. Exploratory measures were adherence to study diets, ease or difficulty in following the diets, participant energy levels, and sense of well-being.ResultsA total of 22 pairs (N = 44) of twins (34 [77.3%] female; mean [SD] age, 39.6 [12.7] years; mean [SD] body mass index, 25.9 [4.7]) were enrolled in the study. After 8 weeks, compared with twins randomized to an omnivorous diet, the twins randomized to the vegan diet experienced significant mean (SD) decreases in low-density lipoprotein cholesterol concentration (-13.9 [5.8] mg/dL; 95% CI, -25.3 to -2.4 mg/dL), fasting insulin level (-2.9 [1.3] μIU/mL; 95% CI, -5.3 to -0.4 μIU/mL), and body weight (-1.9 [0.7] kg; 95% CI, -3.3 to -0.6 kg).Conclusions and relevanceIn this randomized clinical trial of the cardiometabolic effects of omnivorous vs vegan diets in identical twins, the healthy vegan diet led to improved cardiometabolic outcomes compared with a healthy omnivorous diet. Clinicians can consider this dietary approach as a healthy alternative for their patients.Trial registrationClinicalTrials.gov Identifier: NCT05297825.

In livestock production, ruminant feed resources are often scarce, and numerous challenges arise during production, such as immune disorders and oxidative stress. Mulberry leaves are rich in various nutrients and exhibit significant antioxidant and immune-regulating properties. Therefore, they can be used as an unconventional feed resource in livestock production. This study investigated the effects of mulberry leaves (ML) as a feed supplement on the blood biochemical parameters and hindgut microbial structure of Hu sheep. Sixteen Hu sheep were randomly divided into two groups and fed either 0 or 60 g/d of ML. Compared to the control group, sheep fed ML showed a significant increase in AKP (P = 0.027) and GPT (P = 0.002) levels in the blood, while TP (P = 0.001) levels decreased significantly. Additionally, there was an increasing trend in GSH-Px (P = 0.082) and CAT (P = 0.058) levels. After the addition of ML, the abundance of Campylobacterota, Campylobacter, and Mailhella in the hindgut significantly increased (P < 0.05), while the abundance of Alloprevotella, Roseburia, and Prevotellaceae UCG-003 significantly decreased (P < 0.05). Therefore, ML can serve as a natural feed supplement to regulate the immune status of animals, thereby promoting the healthy production of ruminants.

Abstract Aim Assessing symptoms and daily functioning in patients with major depressive disorder (MDD) can be challenging, as their limited self‐monitoring abilities may result in behavior observed during structured interviews not accurately reflecting their daily lives. This study aimed to determine if specific occupational behaviors could distinguish individuals with MDD from healthy individuals. Methods Baseline data were collected from medical records and activity programs. Three occupational therapists conducted content analysis to assess occupational performance characteristics. Chi‐squared tests compared the prevalence of these characteristics between patients with MDD and healthy controls. Multivariable logistic regression controlled for potential confounders, with independent variables selected based on clinical relevance and sample size (p

IntroductionUniversity period is a critical developmental stage in which health-related behaviors that will be effective throughout life are acquired. This study aims to to evaluate the effect of health promotion education given touniversity students on health perception, health behaviors and risky behaviors, to investigate the impact of the demographic characteristics of the participants on these three variables, and to investigate the potential relationship between the three variables.MethodsIt is a quasi-experimental study using a pre-post test design This study was conducted with 179 students. The Health Perception Scale, the Healthy Lifestyle Behaviors Scale, and the Risky Behaviors Scale were used to collect the data. A 7-week training program was implemented, and the post-training evaluation was made after 3 months. Percentage, mean, standard deviation, Mann–Whitney U, Kruskal-Wallis, Wilcoxon analysis, and Spearmen Correlation analysis were used to analyze the data.ResultsAfter health promotion training, it was determined that health perception and healthy lifestyle behaviors increased and risky behaviors decreased. A significant negative relationship was found between health perception after training and antisocial behavior, suicidal tendencies and dropping out of school. A significant negative relationship was found between healthy lifestyle habits and antisocial behavior, suicidal tendencies and school dropout. A positive significant relationship was determined between health perception and healthy lifestyle behaviors. The results of this study provide evidence of the effectiveness of training interventions in improving healthy lifestyle behaviors and health perception and reducing risky behaviors.DiscussionThe results support the planning of training programs to promote health on campuses. It also shows the effectiveness of training programs in preventing antisocial behavior, suicidal tendencies and school dropout.

Background and Objectives: Diabetes mellitus is the collective term for disorders affecting glucose homeostasis. The pancreas is situated in the retroperitoneum within the anterior pararenal fascial space and positioned anteriorly to the aorta and inferior vena cava. Specifically, the pancreas is commonly located just below the origin of the superior mesenteric artery. Ultrasound imaging serves as a valuable tool for acquiring detailed information about the pancreas, encompassing factors such as pancreatic size, echotexture, ductal anatomy, and the surrounding structures. This imaging modality not only facilitates diagnostic evaluations but also allows for interventional procedures, all accomplished efficiently within a brief time frame and at a minimal cost. Subjects and Methods: One hundred and fifty healthy adults as controls and 150 diabetic patients of the same age group >65 years of age group were evaluated by ultrasound sonography. Results: The mean pancreatic head and body is 2.01 ± 0.38 cm and 1.26 ± 0.18 cm, respectively, in diabetic participants, whereas in controls, it is 2.40 ± 0.13 cm and 1.59 ± 0.17 cm. This showed a significant decrease in pancreatic head and body size in diabetic individuals. Interpretation and Conclusions: Diabetic individuals exhibit smaller pancreatic head and body compared to normal controls.