Search Results (1,039)

Background: Sarcomas are a rare, complex group of malignancies characterized by numerous clinical and pathological features. Sarcomas originate from various tissues such as fat, muscle, bone, nerves, blood vessels and connective tissues. Typically, the treatment of sarcomas consists of surgery, chemotherapy, and radiation therapy. The location, type, stage, and treatment of sarcomas contribute to the development of physical impairments affecting joint and limb function, peripheral nerves, strength, and mobility, diminishing physical function and quality of life. Traditionally, rehabilitative therapy has been implemented after cancer treatment to help improve physical impairments imparted from cancer therapy. Recent work in rehabilitative medicine has explored the implementation of rehabilitative therapy prior to beginning cancer treatment (pre-habilitation) to help mitigate the detrimental physical consequences seen in sarcoma patients. Objective: The objective of this narrative review is to examine the physical impairments affecting sarcoma patients after cancer therapy and the impact of rehabilitative medicine on physical function and quality of life when implemented before and after cancer treatment. Full article

The objective of this study was to synthesise evidence assessing the effectiveness of workplace-based interventions that promote self-management of multiple long-term conditions or disabilities, e.g., type I and II diabetes, asthma, musculoskeletal injury/disorder, cancer, and mental ill-health. A prospectively registered rapid systematic review was conducted. Both academic and grey literature databases were searched for papers published within the last 10 years, reflecting the most contemporary legislation and policy. The outcomes included work productivity, work engagement, self-management, work ability, quality of life, psychological wellbeing, workplace fatigue, job satisfaction, work-based attendance, work self-efficacy, and condition-specific health status. Five randomised controlled trials were included, and all assessed a chronic disease self-management programme consisting of six weekly facilitator-led group sessions. Due to the small number of studies and the variability in outcome measures employed, meta-analyses were not feasible. However, a narrative synthesis indicated that work engagement, self-management and wellbeing improved in the intervention compared to the control groups. All of the other outcomes showed mixed results. The findings highlight the need to develop less resource-intensive workplace-based self-management interventions that cater to both workers and employer stakeholders, to examine intervention implementation processes as well as effectiveness, and to draw on a common set of outcome measures to enable comparative analysis to better inform public health policy and practice. Full article

Background/Objectives: This narrative review paper highlights the multifaceted influence of dysbiotic biofilm, genetic background, host response, and environmental factors on periodontitis. It explores the roles of type I and II diabetes mellitus, gestational diabetes, and metabolic syndrome in the progression of periodontitis, drawing insights from various empirical studies and theoretical perspectives. Methods: Relevant articles were sourced using keywords in databases like PubMed/Medline, Science Direct, Scopus, and Google Scholar. Additionally, this review examines the relationship between aMMP-8 levels and increased glycemic states, as well as varying degrees of periodontitis severity. Results: The biomarker active-matrix metalloproteinase-8 (aMMP-8), produced by polymorphonuclear leukocytes (PMN), is highlighted as a reliable indicator of ongoing connective tissue degradation. Dysfunctions in PMN activity, accumulation of advanced glycation end products (AGE), and oxidative stress aggravate the periodontal inflammatory response and complications of diabetes. Traditional diagnostics of periodontitis do not provide sufficient information about the current or future disease initiation or activity of periodontitis. Conclusions: The implications of this review point to the need for monitoring periodontal health by utilizing innovative strategies like aMMP-8 point-of-care testing, using oral rinse for screening and treatment monitoring, and harnessing the potential of supportive treatments like low-dose doxycycline and light-activated mouth rinses for restoring periodontal health. Its expression in oral fluids is a promising diagnostic tool to differentiate periodontitis from gingivitis and healthy periodontium, especially when associated with systemic diseases, fostering greater collaboration among healthcare professionals. Full article

Background/Objectives: The PPARGC1A gene, encoding the PGC-1α protein, is a critical regulator of energy metabolism, influencing mitochondrial biogenesis, fatty acid oxidation, and carbohydrate metabolism. This narrative review aims to evaluate the role of the PPARGC1A gene, with a specific focus on the c.1444G<A polymorphism (rs8192678), in sports performance, including its impact on aerobic capacity, muscle adaptation, and its potential implications for metabolic health. Methods: A comprehensive literature search was conducted using databases such as PubMed, Scopus, Science Direct, and Web of Science, following PRISMA guidelines. Studies investigating the rs8192678 polymorphism in athletes, its relationship with physical performance, and its broader metabolic effects were included. Data were synthesized qualitatively, and heterogeneity among findings was assessed. The rs8192678 polymorphism influences sports performance differently. Results: the G allele is associated with enhanced mitochondrial efficiency, higher aerobic capacity, and a greater proportion of fatigue-resistant type I muscle fibers, benefiting endurance sports like cycling and triathlon. Conversely, the A allele correlates with reduced mitochondrial biogenesis and oxidative capacity, potentially impairing endurance but showing possible utility in strength-based sports. Furthermore, the A allele is linked to increased risks of metabolic conditions, including type 2 diabetes and obesity. Discrepancies in results highlight the influence of genetic, environmental, and training interactions. Conclusions: the PPARGC1A rs8192678 polymorphism plays a significant role in athletic performance and metabolic regulation. While the G allele confers advantages in endurance sports, the A allele presents mixed implications for strength and metabolic health. These findings support the potential for genetic profiling in personalized training and health interventions but emphasize the need for further research to clarify genotype-environment interactions. Full article

One of the basic features of shamanic rituals cross-culturally in East and Southeast Asia is that the ritual itself is structured as a journey up to the sky, climbing the world mountain or the world tree, or else a journey down to the bottom of the sea and back again. The shamanic retinue is understood to make this journey in person, rather than, as in Daoist ritual, sending divine emissaries up to the highest heavens. The journey is conducted through narrative song and dance, accompanied by strings of bells and lutes. The point of departure is the physical village or village household where the ritual is being conducted, and the journey progresses through a series of well-marked way stations via the temple of the earth god to the higher hills and finally to the villages and markets in the sky, before crossing the heavenly seas and ascending the highest mountain. On the way, demons and other impediments are encountered. The route and way stations vary depending on the purpose of the ritual and the intended divine recipient of offerings and submissions. The present article will explore the route up to the sky and the way stations in more detail, taking a single ritual type as performed by the Pụt and Then ritual practitioners as an example. The Pụt and Then are literate ritual specialists found among the Tày and Nùng peoples in northern Vietnam and southern China, near an area which is known to have been a centre of Brahmanical and Buddhist learning from very early times. Full article

Camera traps offer enormous new opportunities in ecological studies, but current automated image analysis methods often lack the contextual richness needed to support impactful conservation outcomes. Integrating vision–language models into these workflows could address this gap by providing enhanced contextual understanding and enabling advanced queries across temporal and spatial dimensions. Here, we present an integrated approach that combines deep learning-based vision and language models to improve ecological reporting using data from camera traps. We introduce a two-stage system: YOLOv10-X to localise and classify species (mammals and birds) within images and a Phi-3.5-vision-instruct model to read YOLOv10-X bounding box labels to identify species, overcoming its limitation with hard-to-classify objects in images. Additionally, Phi-3.5 detects broader variables, such as vegetation type and time of day, providing rich ecological and environmental context to YOLO’s species detection output. When combined, this output is processed by the model’s natural language system to answer complex queries, and retrieval-augmented generation (RAG) is employed to enrich responses with external information, like species weight and IUCN status (information that cannot be obtained through direct visual analysis). Combined, this information is used to automatically generate structured reports, providing biodiversity stakeholders with deeper insights into, for example, species abundance, distribution, animal behaviour, and habitat selection. Our approach delivers contextually rich narratives that aid in wildlife management decisions. By providing contextually rich insights, our approach not only reduces manual effort but also supports timely decision making in conservation, potentially shifting efforts from reactive to proactive. Full article

Women diagnosed with gestational diabetes mellitus (GDM) face a significantly heightened risk of developing type 2 diabetes mellitus (T2DM) later in life. Breastfeeding (BF) has been identified as a potential strategy to delay or prevent T2DM; however, women with GDM often encounter barriers in initiating and maintaining adequate BF practices compared to those with uncomplicated pregnancies. This paradox prompts an exploration into the causes of these BF challenges and considers the possibility of reverse causation: Does prolonged and intensive BF mitigate the risk of subsequent glucose dysregulation and T2DM? Alternatively, do women with compromised insulin secretion and sensitivity, who are predisposed to T2DM, struggle to sustain intensive BF practices? This narrative review aims to explore the interplay between GDM, BF, and T2DM development by examining the different factors that present BF challenges among women with GDM. Understanding these dynamics is crucial for establishing realistic BF expectations and developing effective clinical and public health strategies to support BF in this high-risk population. Full article

Background and Objectives: Insulin resistance (IR) is the most important factor involved in the pathogenesis of type 2 diabetes but may also develop in type 1 diabetes (T1DM). Developing IR in patients with T1DM may generate a burden in achieving glycemic targets and may deteriorate the overall prognosis. This review aims to describe the pathogenesis of IR in T1DM, summarize the common associations of IR with other conditions in patients with T1DM, describe the consequences of developing IR in these patients, and present the interventions that target IR in people with T1DM. Results: The occurrence of IR in T1DM is multifactorial; however, it is frequently linked to overweight or obesity and sedentary lifestyle. Besides impairments in glycemic control and increased insulin requirements, the presence of IR is associated with an increased cardiovascular risk in patients with T1DM. Considering that patients with T1DM are insulin-treated, IR may be evaluated only using surrogate biomarkers, the most frequently used being the estimated glucose disposal rate. The most important interventions that are shown to be feasible in improving insulin sensitivity in patients with T1DM are lifestyle optimizations, including nutrition therapy or physical activity and pharmacotherapy with metformin, sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, and thiazolidinediones. Conclusions: Targeting the improvement of IR in patients with T1DM is a key element in achieving optimal glycemic control, as well as improving the overall patient’s prognosis besides glycemic control. Full article

An increasing number of studies highlight the critical role of both maternal and paternal nutrition and body weight before conception in shaping offspring health. Traditionally, research has focused on maternal factors, particularly in utero exposures, as key determinants of chronic disease development. However, emerging evidence underscores the significant influence of paternal preconception health on offspring metabolic outcomes. While maternal health remains vital, with preconception nutrition playing a pivotal role in fetal development, paternal obesity and poor nutrition are linked to increased risks of metabolic disorders, including type 2 diabetes and cardiovascular disease in children. This narrative review aims to synthesize recent findings on the effects of both maternal and paternal preconception health, emphasizing the need for integrated early interventions. The literature search utilized PubMed, UNF One Search, and Google Scholar, focusing on RCTs; cohort, retrospective, and animal studies; and systematic reviews, excluding non-English and non-peer-reviewed articles. The findings of this review indicate that paternal effects are mediated by epigenetic changes in sperm, such as DNA methylation and non-coding RNA, which influence gene expression in offspring. Nutrient imbalances during preconception in both parents can lead to low birth weight and increased metabolic disease risk, while deficiencies in folic acid, iron, iodine, and vitamin D are linked to developmental disorders. Additionally, maternal obesity elevates the risk of chronic diseases in children. Future research should prioritize human studies to explore the influence of parental nutrition, body weight, and lifestyle on offspring health, ensuring findings are applicable across diverse populations. By addressing both maternal and paternal factors, healthcare providers can better reduce the prevalence of metabolic syndrome and its associated risks in future generations. Full article

This study explores the Potaxie, Fifes, and Tilinx subcultures on TikTok, examining their origins, characteristics, and cultural significance. Originating from a viral video in 2020, the Potaxie subculture emerged within the Spanish-speaking LGBTQ+ community and evolved to symbolise inclusivity and gender equality. Potaxies use vibrant aesthetics influenced by Japanese and Korean pop culture to express their identities and resistance. In contrast, Fifes, associated with cisgender heterosexual men, embody traditional patriarchal values, often sexist and homophobic, creating a narrative of resistance between the groups. The Tilinx, symbolic descendants of the Potaxies, are inspired by ballroom culture and drag houses, with “Potaxie mothers” continuing the fight for inclusion and diversity. Using a mixed-methods approach, including quantitative analysis through the TikTok API and qualitative content analysis via MAXQDA and Python, this study provides a comprehensive understanding of the subculture that accumulates over 2.3 billion interactions. The findings highlight how TikTok serves as a platform for identity construction, cultural resistance, and the redefinition of social norms. Additionally, the study examines how digital platforms mediate intersectional experiences, favouring certain types of content through algorithms, and how participants navigate these opportunities and constraints to express their intersecting identities. The implications for communication strategies, youth policies, educational plans, and research on the commercialization of these subcultures are profound, offering insights into the transformative potential of social media in shaping contemporary cultural and social narratives. Full article

Sleep disturbances and chronic pain are prevalent and interrelated conditions that have significant impact on individuals’ quality of life. Understanding the intricate dynamics between sleep and pain is crucial for developing effective treatments that enhance the well-being of affected individuals and reduce the economic burden of these debilitating conditions. This narrative review examines the complex relationship between sleep disturbances and chronic pain. We describe the prevalence and types of sleep disturbances and sleep disorders in chronic pain patients. Posteriorly, we critically review the clinical and experimental evidence, investigating the relationship between sleep disturbances and chronic pain, aiming to clarify the impact of chronic pain on sleep and, conversely, the impact of sleep disturbances on pain perception. In conclusion, the literature largely agrees on the existence of a bidirectional relationship between chronic pain and sleep disturbances, though the strength of each direction in this association remains uncertain. Current evidence suggests that sleep impairment more strongly predicts pain than pain does sleep impairment. Additionally, addressing sleep disturbances in chronic pain patients is crucial, as poor sleep has been linked to higher levels of disability, depression, and pain-related catastrophizing. Full article

Background/Objectives: Pain is a complex and subjective experience influenced by psychological, cultural, and social factors. This study aims to investigate how social perceptions of pain affect the lived experiences and coping mechanisms of individuals suffering from pain. By comparing public discourse with the experiences of sufferers, we explore whether the social legitimacy of pain influences how it is managed. Methods: A multi-phase qualitative study was conducted, comprising eight focus groups with members of the Spanish general population and 19 in-depth interviews with individuals suffering from various types of pain. The focus groups explored social perceptions of pain’s legitimacy, while the interviews delved into the sufferers’ personal experiences. The data were analyzed using thematic analysis to identify patterns and disparities between public discourse and individual narratives. Results: The focus groups revealed widespread social empathy towards all types of pain. However, interviewees reported significant social pressure to normalize their behavior and downplay their pain. Many felt misunderstood, unsupported, and stigmatized, especially in environments where they held subordinate roles, such as the workplace or healthcare settings. Sufferers often resorted to silence or isolation to avoid judgment. Conclusions: While Spanish society outwardly legitimizes all forms of pain, sufferers experience significant discrepancies between public empathy and actual social support. The findings suggest that raising awareness alone is insufficient, and that structural changes are needed to address the daily burdens that individuals face when coping with pain, particularly in workplace and healthcare environments. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a refined categorization of non-alcoholic fatty liver disease (NAFLD), highlighting the intricate relationship between hepatic steatosis and metabolic dysfunction. Abdominal obesity (AO), a key diagnostic criterion for metabolic dysfunction, predominantly results from inappropriate diet and unhealthy dietary habits. To comprehensively investigate which dietary factors contribute to MASLD through AO and to understand the underlying biological mechanisms, we initially conducted a systematic review of meta-analysis articles in the PubMed database from the past decade, summarizing dietary factors that affect AO. Subsequently, we conducted targeted searches in the PubMed database for these dietary factors and provided a narrative review of the mechanisms of how these dietary factors lead to AO and how AO exacerbates MASLD. A diet characterized by excessive intake of energy, carbohydrates, fructose, or ultra-processed foods (UPFs) is considered inappropriate. Inappropriate diet leads to the formation of MASLD and AO by enhancing pathways such as de novo lipid synthesis (DNL) in the liver, insulin resistance (IR), gut–liver dysfunction, and inflammation. Dietary interventions for inappropriate diets can effectively intervene in and improve MASLD and AO. The mechanism of inappropriate diet on abdominal fat deposition is through excessive energy or the activation of the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD-1) to increase endocortisol secretion. Then, the excessive accumulation of visceral fat facilitates a rapid and augmented flux of free fatty acids (FFAs) to the liver and initiates a series of deleterious effects, including oxidative stress (OS), endoplasmic reticulum stress (ERS), activation of protein kinase C (PKC) pathways, and inflammation. Additionally, FFAs may mediate excessive lipid deposition and hepatocellular damage through the action of hormones. These pathways to liver damage exacerbate MASLD and progression to metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis. Furthermore, investigating other potential mechanisms by which AO may influence MASLD could offer new recommendations for the treatment guidelines of MASLD. Full article

Background: The ketogenic diet (KD), characterized by high-fat content, virtually no carbohydrates, and adequate protein intake, induces a metabolic state resembling fasting, as the absence of carbohydrates forces the body to rely on the energetic supply from hepatically produced ketone bodies using free fatty acids as substrate. While the KD is clinically used in pharmacologically refractory epilepsy and specific genetic conditions such as GLUT1 deficiency, recent research suggests that, due to its “fasting mimicking” properties, the KD may also beneficially affect obesity and obesity-associated metabolic diseases. Results: Here, we present a narrative review discussing completed and ongoing nutritional studies in human volunteers specifically addressing the potential of the ketogenic diet as an anti-obesity approach and, from a larger perspective, as an intervention to ameliorate the metabolic state in conditions such as type 1 and 2 diabetes and polycystic ovary syndrome (PCOS). Published studies as well as ongoing clinical trials will be discussed. Efficacy and safety considerations will be discussed, as well as the potential physiological mechanisms mediating the effects of the KD in humans in the context of the (i) energy balance model (EBM) and (ii) carbohydrate–insulin model (CIM) of body weight control. Conclusion: Ketogenic diets may be beneficial to attenuate obesity and improve obesity-related metabolic disease, and here, we try, based on current evidence, to define the boundaries of the KD’s nutritional and clinical usefulness. Full article

The COVID-19 pandemic has catalyzed the rapid expansion of telemedicine for managing chronic conditions such as type 1 diabetes (T1D) in children and adolescents. This narrative review aims to explore the role of telemedicine in pediatric T1D management by comparing its use before and after the pandemic. We conducted a comprehensive literature review covering studies published between 2000 and 2024, focusing on telemedicine applications in pediatric T1D care. The review includes clinical trials, systematic reviews, and observational studies examining telemedicine’s impact on glycemic control, patient satisfaction, and healthcare delivery. Results reveal that telemedicine has enhanced access to care, improved glycated hemoglobin (HbA1c) levels, and reduced diabetic ketoacidosis and hypoglycemic events. Patients and caregivers expressed high satisfaction, especially when using continuous glucose monitoring and insulin pump technologies integrated with telemedicine platforms. However, challenges such as digital literacy gaps, variability in healthcare provider training, and logistical issues like reimbursement policies persist. The pandemic highlighted the potential of telemedicine to supplement traditional in-person care, showing promise in enhancing patient outcomes and reducing healthcare burdens. Further research is needed to optimize telemedicine models for T1D, addressing barriers to implementation and exploring its long-term cost-effectiveness. This review underscores telemedicine’s evolving role as a complementary approach in managing pediatric T1D, advocating for the development of standardized care protocols to fully integrate digital health solutions into routine clinical practice. Full article