Effects of pickleball on pre-frailty, physical fitness, 24-hour movement behaviors, and quality of life in older adults: A randomized controlled trial.

Digital health interventions for improving mental health outcomes and wellbeing for adults with diabetes: A systematic review.

Generative Artificial Intelligence in the Lives of Young Adults: Exploring Motivations and Mental Health.

Limited Utility of Serum Scores vs. Shear Wave Elastography for Graft Fibrosis in Adult and Pediatric Liver Transplant Recipients.

Cytomegalovirus infection and coronary artery disease in liver transplant recipients: Nationwide study using protocolized cardiac computed tomography.

Exploring the impact of intermittent fasting plus time-restricted eating versus calorie restriction on eating behavior, mood, sleep, quality of life in adults with obesity.

Diabetic polyneuropathy (DPN) contributes to impaired postural control and increases the risk of falls due to sensory and motor deficits. The Feldenkrais Method (FM), a sensorimotor approach that enhances body awareness and coordination, may offer therapeutic benefits in addressing these challenges. To evaluate the effectiveness of the Feldenkrais Method in improving dynamic balance, postural control, fear of falling, and quality of life in adults with DPN. Twenty-six participants aged 45-60years with DPN were randomized into a study group receiving FM-based training or a control group receiving conventional balance training. Both interventions were administered twice weekly for 24weeks. Primary outcomes included Timed Up and Go (TUG), limits of stability (LoS), Falls Efficacy Scale (FES), and Diabetes-39 Questionnaire for quality of life (QoL). Data were analyzed using repeated-measures ANOVA and post hoc Bonferroni tests. Significant post-intervention improvements were observed in the FM group across all outcomes: TUG (p=0.0001), LoS (p=0.0001), FES (p=0.0001), and QoL (p=0.0001). Furthermore, the FM group demonstrated statistically significant superiority over the control group in all primary and secondary measures (p<0.05). The control group showed no statistically significant changes. The Feldenkrais Method appears effective in enhancing balance, postural control, and quality of life in individuals with DPN. These results support its integration into neurorehabilitation programs.

BackgroundPreferences for routines (PR) are crucial for structuring the daily lives of older adults. This study aims to evaluate the psychometric properties of the Arabic translation of the PR Scale-Short Form (PRS-S).MethodThis study involved 539 older Arabic-speaking adults residing in the Egyptian community.ResultsCFA indicated that fit of the one-factor model of the Arabic PRS-S was poor at first; after adding a correlation between residuals of items 1 and 2 because of high modification index, the fit indices became excellent. Reliability was borderline acceptable (α = .69), approaching the conventional threshold of .70. Measurement consistency was established across males and females. PRS-S scores showed significant correlations with resilience and quality of life scores.ConclusionFindings support the overall validity and acceptable reliability of the Arabic PRS-S, although internal consistency fell slightly below the conventional .70 cutoff. The new measure could enhance the understanding of the prevalence and features of PR among Arabic-speaking older adults.

The global aging population is rapidly increasing, prompting the United Nations to declare the "Decade of Healthy Aging" (2021-2030) to improve the quality of life for older adults. Health-related quality of life (HRQoL) is crucial in this context, and the International Classification of Functioning, Disability and Health (ICF) provides a standardized framework for its evaluation. This study aimed to apply a previously proposed method for converting SF-36 domain scores into ICF qualifiers in community-dwelling older adults attending primary care services in a middle-income country, describing the resulting classification of functioning domains using standardized ICF qualifiers. A cross-sectional study was conducted with older adults aged 60 and above who accessed primary healthcare services and had no cognitive impairment. Participants underwent HRQoL assessment using the SF-36, and ICF codes previously linked to SF-36 domains were classified using ICF qualifiers. A simple calculation method was developed to convert SF-36 scores into ICF qualifiers. The study included 52 participants, with a mean age of 71.6±7.0years, 92.3% of whom were women. The ICF framework qualified 27 codes from SF-36 domains. Moderate impairments were observed in "Bodily Pain," "General Health," and "Vitality" domains, while "Physical Functioning," "Social Functioning," and "Mental Health" domains showed mild impairments. No impairments were noted in the "Role Physical" and "Role Emotional" domains. The application of ICF qualifiers to SF-36 domain scores yielded standardized classifications of HRQoL domains across the ICF framework, allowing HRQoL outcomes to be described according to the severity levels defined by the ICF qualifier scale.

Real-world Impact of GLP-1 Receptor Agonists on Health-related Quality of Life in Type 2 Diabetes and Obesity (SEVERAL Study).

Osteoarthritis is the most common degenerative joint disease worldwide and one of the leading causes of morbidity and reduced quality of life in older adults. In Germany, approximately 17.9% of adults are affected, including 21.8% of women and 13.9% of men. In individuals over 65years of age, up to 48% of women and 31% of men are affected, with direct annual costs exceeding 12billion euros in 2020. The pathophysiology is multifactorial and is driven by the interplay of cellular senescence, inflammatory cascade reactions, biomechanical factors, and metabolic dysregulation. Modifiable risk factors such as overweight, previous joint injuries, and physical inactivity account for roughly half of all incident cases of knee osteoarthritis. Evidence-based management prioritizes intensive (active) exercise therapy, weight management, and targeted analgesic strategies, with topical NSAIDs as the first-line option. Emerging biological approaches, including mesenchymal stem cell therapy, platelet-rich plasma (PRP), and disease-modifying osteoarthritis drugs (DMOADs), show promising potential but still require further clinical validation.

Developmental and systemic toxicity of the triazole fungicide tetraconazole in zebrafish: Integrated evidence from ER stress, apoptosis, and metabolomic disruption.

Mindfulness knowledge and practice in patients with cardiopulmonary conditions: A qualitative thematic analysis of adults living with pulmonary hypertension and chronic obstructive pulmonary disease✰.

Early-life environmental exposures, including nutritional supply, can influence health in adulthood. Leucine, isoleucine, and valine are collectively known as branched-chain amino acids (BCAAs). While BCAAs are essential nutrients, their elevated abundances in adults have been tightly associated with metabolic disorders. However, whether excessive intake of BCAAs in early life affects the metabolic dysfunctions in adult life remains unknown. Continuous BCAAs supplementation in drinking water throughout gestation, lactation, and early-juvenile period reduced body weight, decreased fat mass and improved glucose homeostasis in adult male mice challenged with a high-fat diet (HFD) starting at 6 weeks of age. Lactational BCAAs supplementation alone partially recapitulated these beneficial metabolic effects, resulting in decreased body weight and improved insulin tolerance, whereas gestational or early-juvenile exposure showed no significant metabolic impacts in adult males. Analysis of individual BCAA supplementation during lactation period showed that leucine, isoleucine, and valine demonstrated either beneficial or detrimental impacts on obesity, insulin resistance, and fatty liver in adult male mice, respectively. In females, lactational supplementation of individual BCAA produced distinct effects compared with males. Excessive BCAAs exposure during developmental stages, particularly the lactation period, shows pronounced effects on male adult metabolic dysfunction. Moreover, supplementation with individual BCAA during lactation exerts distinct and sexually dimorphic effects on adult metabolic health. These results highlight the potential of early-life precision nutrition strategies to mitigate metabolic dysfunction later in life.

Liver transplantation (LT) in critically ill patients with chronic liver disease is a high-risk procedure. Recent studies show that the frequency of intensive care unit (ICU) LTs has risen, and outcomes of such transplants have improved significantly. Variation in practices and the impact of center experience with ICU LTs on outcomes is unknown outside of acute liver failure (ALF). This study evaluated the impact of center experience with ICU LT on outcome metrics. Using the United Network for Organ Sharing database, we conducted a retrospective analysis of adult liver transplants performed 2014-2023 in which the patient was in an ICU before transplant, excluding those listed for multiorgan, retransplant, or ALF. Critical care requirements, in-hospital, 1-year, and 3-year mortality, and retransplant were compared by center ICU LT volume quartiles. In total, 9542 ICU LTs were performed across 130 centers (12.8% of total LTs). Over half of U.S. centers performed fewer than 5 ICU LTs per year on average, while the centers in the highest quartile performed nearly two-thirds of all ICU LTs in this period. Utilization of dialysis and of concurrent critical care therapies in ICU LT recipients was higher at high-volume centers ( p <0.05). In-hospital, 1-year, and 3-year mortality for ICU LTs overall were 6.2%, 10.4%, and 23.1%, respectively, with no differences across center volume quartiles (all p >0.05). Adjusting for severity of illness, center volume of ICU LTs in the prior year was associated with a small but significant reduction in 1-year post-ICU LT mortality: aOR 0.96 per 5 ICU LTs ( p <0.001). Expansion of LT for ICU candidates does not appear to threaten center-based metrics and may even offer important benefits to future candidates.

Background: Type 2 diabetes mellitus (T2DM) is a major global and national public-health challenge. Most adults do not meet the aerobic and strength guidelines necessary for the prevention and management of the disease. Purpose: To synthesize evidence on how combined exercise training (CET: aerobic + resistance) affects cardiometabolic risk factors, adherence, and quality of life (QoL) in adults with T2DM; identify the impact of supervision features, and produce equity-focused, practice-ready recommendations. Methods: Narrative synthesis reporting CET effects on cardiometabolic risk factors, adherence, and QoL, emphasizing intervention parameters and supervision models. Results: CET consistently yields modest to clinically meaningful reductions in HbA1c and fasting glucose and improves body composition, lipids, blood pressure, vascular function, inflammatory markers (CRP, IL-6), myokine responses, and VO2max. Supervised CET produces larger effect sizes, greater adherence, better technique and safety, and stronger psychosocial benefits (self-efficacy, social support, QoL) than unsupervised/usual-care programs. Heterogeneity in modalities (MICT, HIIT), resistance intensity/equipment, scheduling, supervision models, outcome metrics, and underrepresentation of diverse populations limit definitive guidance. Conclusions: Supervised CET effectively improves cardiometabolic health and QoL in adults with T2DM. Standardized reporting, head-to-head trials of scheduling and supervision, and pragmatic studies in diverse settings are needed to support scalable implementation.

Dolutegravir improves physical health-related quality of life in adults with HTLV-1 infection: a randomized controlled trial.

Although there are numerous studies on the parents of children undergoing peritoneal dialysis (PD) treatment, there are only a limited number of studies examining what children undergoing PD treatment experience until adulthood and their experiences with PD treatment during childhood. The aim of this study is to examine the changes that occur in the lives of adults who received PD treatment during childhood after diagnosis and their experiences related to the treatment process. This retrospective and qualitative study was conducted with 18 adult participants living in the province of Izmir in Turkey who had received at least 6 months of PD treatment during childhood. Participants were selected using snowball sampling. A semi-structured interview form was used as the data collection tool. Study data were collected through face-to-face interviews using the individual in-depth interview technique. Data obtained from interviews were analyzed using Braun and Clarke's thematic analysis approach. The study identified four main themes: psychological effects, daily life effects, social effects, and academic effects. Psychological effects include the sub-themes of fear, shock, sadness, hopelessness, and shame. Daily life effects include the sub-themes of changes in eating habits, changes in body image, difficulty taking medication, repeated hospitalizations, stress coping, and adaptation. Social effects include social isolation, peritoneal dialysis room, social support, and personal life. Academic effects include the sub-themes of absenteeism, taking a break from education, academic failure, and being forced to change career choice. The findings from this research will provide guidance for a deeper understanding of the needs of children undergoing PD today and for initiatives planned in this context.

Use of contemporary diabetes technologies, including continuous glucose monitoring (CGM) and hybrid closed-loop insulin pumps (HCLs), has expanded rapidly among people with Type 1 diabetes. However, limited research has characterised the impact of hypoglycaemia on quality of life in this population. We analysed cross-sectional survey data from US adults aged ≥ 18 years who were using CGM or HCL and who were recruited through the T1D Exchange. Survey responses included participant characteristics, diabetes technology use, and hypoglycaemia-specific quality of life measured by the 12-item Hypoglycaemia Impact Profile (HIP-12), which assesses hypoglycaemia-related impact across 12 major life domains. HIP-12 composite and domain-specific scores were summarised and compared between CGM-only (without HCL) and HCL users. The analytic sample included 796 participants (mean age 47 years; 53% female), of whom 23% used CGM only and 77% used HCL. Overall, 96% reported at least one life domain negatively affected by hypoglycaemia, and 31% reported negative impacts across 10 or more of the 12 assessed domains. The most frequently negatively affected domains were sleep, leisure activities, emotional well-being, spontaneity and physical activity/fitness. Compared with CGM-only users, HCL users reported greater hypoglycaemia-related negative impacts on leisure activities (p < 0.001), physical activity/fitness (p < 0.001), spontaneity (p = 0.011), sex life (p = 0.014) and work or studies (p = 0.021). Hypoglycaemia continues to adversely affect multiple related quality-of-life domains despite using contemporary diabetes technologies. Routine clinical assessment of and clinical support for hypoglycaemia's impact remain important. Further research is needed to clarify the mechanisms underlying these impacts and to guide targeted interventions.

Sarcopenia is an aging-related syndrome characterized by the progressive decline of skeletal muscle mass, strength, and function. With the accelerating global aging population, sarcopenia has emerged as a serious public health issue. It significantly impairs the quality of life in older adults and elevates the risks of falls, fractures, adverse comorbidity outcomes, and mortality. This review aims to systematically summarize recent advances in the clinical management of sarcopenia, focusing on evaluating evidence-based support for various intervention strategies. Exercise intervention remains the cornerstone of treatment, and multiple modalities-such as high-intensity resistance training, low-load blood flow restriction training, multicomponent training, neuromuscular electrical stimulation, and telerehabilitation-have been proven effective in improving muscle mass and function. Nutritional support serves as a core strategy, wherein adequate protein intake (1.2-1.5g/kg daily) and essential amino acids are critical. Specific nutrients, including β-hydroxy-β-methylbutyrate, leucine-rich whey protein, vitamin D, and composite formulations targeting the "gut-muscle axis," demonstrate synergistic or independent muscle-protective effects in both preclinical and clinical studies. Although no pharmacotherapy is yet globally approved, several targeted drugs show potential for increasing muscle mass in clinical trials. These include agents acting on the myostatin/activin signaling pathway (e.g., Bimagrumab), androgen receptors (e.g., LPCN 1148), metabolic and endocrine pathways (e.g., active vitamin D, metformin), as well as anti-inflammatory and immunomodulatory approaches (e.g., probiotics, anti-TNF-α agents). However, their functional benefits and long-term safety require further validation. Furthermore, comprehensive intervention and management strategies-particularly combined exercise and nutrition, multi-domain lifestyle interventions, individualized treatment based on screening and stratification, and prehabilitation programs for specific clinical populations such as those with chronic kidney disease, heart failure, or cancer-have been established as effective pathways to achieve optimal clinical outcomes. Despite notable progress, the field continues to face challenges including disease heterogeneity, inconsistent diagnostic criteria, poor long-term adherence to interventions, and inadequate functional translation of drug therapies. Future research should prioritize advancing precision medicine, optimizing personalized regimens, exploring novel biomarkers, and integrating and disseminating effective interventions into community and clinical practice to comprehensively improve the clinical management of sarcopenia.