Background: Telemedicine has emerged as a key digital healthcare platform, offering convenient access to medical services for the public. Despite its potential, widespread adoption remains hindered by lingering consumer skepticism. Objectives: The aim of this systematic review was to investigate the factors increasing telemedicine adoption across adult non-healthcare professionals. Materials and methods: This was a systematic review conducted of primary observational studies published between 2021 and 2025. Adhering to PRISMA guidelines, the authors systematically searched three online databases (PubMed, ProQuest, and Science Direct) and screened articles using the PRISMA Flow Chart to identify eligible studies based on predefined inclusion criteria. The Joanna Briggs Institute’s (JBI) critical assessment techniques were used to evaluate the quality of the research findings. Results: From the reviewed secondary data derived from primary studies, 22 original articles were selected for analysis. Four major themes emerged as drivers of telemedicine utilization, including: 1) socioeconomic-demographic, such as age, education, income, employment, marital status, and social influence, 2) user’s perceived benefits factors like perceived usefulness, benefits, ease of use, and trust, 3) health-related problems, such as frequent healthcare demands, caregiving responsibilities, having chronic disease, and mental health conditions, and 4) internal factors or technological factors of telemedicine systems: price, service, and system quality. Conclusion: In conclusion, telemedicine adoption is influenced by a multifaceted interplay of socioeconomic and demographic factors, a user’s perceived benefits, individual health needs, and systemic features.

Given the intimate link between muscle function and the skeleton's ability to adapt to mechanical loads, it is no surprise that individuals with neuromuscular disorders (NMDs) are at risk for low-trauma (i.e., osteoporotic) fragility fractures. In this review, we highlight the interdependent relationship between muscle and bone strength and the need to assess individuals with NMD who demonstrate muscle weakness that interferes with weight bearing and typical activities of daily living. This review also emphasizes the importance of the clinical context when evaluating the risk of bone fragility, as well as the potential to reclaim bone strength in the absence of bone-targeted therapy. Indeed, longitudinal skeletal phenotyping is key to understanding the individual's bone health trajectory and the need for progressive intensification (or de-escalation) of osteoporosis prevention and treatment. Overall, osteoporosis management has moved away from a bone mineral density (BMD)-centric approach to a fracture-focused approach, with vertebral fractures a clear indicator for bone-strengthening therapy (recognizing that they are frequently asymptomatic, necessitating periodic spine imaging for their timely identification). BMD assessments help guide the frequency of spine imaging and response to bone-targeted therapy and are best undertaken at multiple skeletal sites given the potential for "regional osteoporosis." Multidisciplinary osteoporosis prevention and treatment, including an expert in skeletal health, is the cornerstone of effective osteoporosis management. Looking forward, the field is shifting from secondary osteoporosis prevention to a more proactive, anticipatory approach in those with persistent risk factors, one that involves initiation of bone-targeted therapy prior to first-ever fractures.

Food packaging contaminants and offspring reproductive health: Disease risks and underlying mechanisms.

In this review, we discuss the under-recognition of harms associated with corticosteroid overuse in asthma and highlight the concept of corticosteroid stewardship as an approach to address these harms. Adverse health effects of chronic systemic steroids to treat asthma are well known in the medical community. There is less familiarity with recent data showing similar harms from repeated short courses of systemic corticosteroids (SCS) to treat asthma flares and long-term use of high dose inhaled corticosteroids (ICS). In this review, we summarize recent advances in our knowledge of adverse effects of corticosteroid overuse in asthma, highlight recent calls for corticosteroids stewardship in asthma care, and describe effective systems-based strategies used to reduce corticosteroid overuse in asthma. Those involved in primary care, acute care, and specialty care of asthma may use this review for an updated understanding of corticosteroid associated harms, and as a guide to both individual practitioner and health systems-based approaches to corticosteroid stewardship.

Association between air pollution and health outcomes in patients with IPF: A nationwide multicenter cohort study.

Parabens exposure, depression, and cardiovascular metabolic health in the elderly: Findings from a cross-sectional study in China.

Long-term capsaicin intake and gut inflammation: microbial alterations, metabolic mechanisms, and intervention effects.

To evaluate the feasibility and acceptability of a home-based online psychoeducation (HOPE) programme amongst community-dwelling older adults with frailty. This study adopted a single-blinded, two-arm randomised controlled trial design. Participants were randomly assigned to either the intervention or control group. All participants received 60-min weekly group-based online sessions at home via a videoconferencing platform for 12 weeks. The intervention group received psychoeducation sessions guided by self-determination theory to empower the participants to cope with frailty proactively. By contrast, the control group received educational sessions for general health management. Feasibility was assessed based on eligibility, recruitment and attrition rates; acceptability was evaluated through attendance rate, satisfaction survey and qualitative interviews. Physical and psychosocial outcomes were measured at baseline and 12 weeks post-allocation. The Mann-Whitney U test and Wilcoxon signed-rank test were performed for data analysis, as appropriate. Interview transcripts were analysed using qualitative content analysis. Twenty-four participants were recruited with a mean age of 77.7 years (SD = 6.2), and most of them (91.7%) were female. The study demonstrated good feasibility with eligibility, recruitment and attrition rates of 55.8%, 82.8% and 16.7%, respectively. The mean satisfaction score was 4.6 out of 5. Participants experienced physical and psychological benefits, despite some practical challenges. Improvements in subjective well-being and agility were observed in the intervention group across 12 weeks, and the intervention group showed significantly higher subjective well-being compared to the control group at 12 weeks. The HOPE programme is feasible and acceptable for community-dwelling older adults with frailty. Suggested improvements include technical support during sessions, flexible scheduling, practical examples and content consolidation. Home-based online delivery mode is a feasible, acceptable for providing psychological support for older adults with frailty. To optimise participation, practitioners should provide technical training and flexible scheduling that accounts for individual health fluctuations. This study adhered to the CONSORT guidelines for pilot and feasibility trials. No patient or public contribution. WHO Primary Registry-Clinical Trials Registry Identified: NCT06415617.

various forms, methylmercury (MeHg) is the most toxic, highly bioavailable, and prone to bioaccumulation. Exposure to mercury alters antioxidant enzyme function, elevates lipid peroxidation, and disrupts metabolic processes, ultimately impairing growth and immunity. At the behavioural level, affected fish display changes in locomotion, feeding, predator evasion, and reproductive activity. Histopathological investigations reveal significant tissue damage in the gills, liver, kidney, and gonads, compromising organ functionality. Additionally, mercury interferes with endocrine regulation, causing hormonal imbalance, reduced gamete quality, diminished fertility, and abnormalities in offspring development. Collectively, these toxic effects threaten individual health, population stability, and ecosystem resilience. Current studies (2020–2025) emphasize the urgent need for systematic monitoring of mercury contamination and mechanistic understanding of its toxic impacts to safeguard freshwater biodiversity.

Centering What Matters: Aligning Action with Individual and Community Health Goals

Abstract - Heart disease is a cause of death in many parts of the world and therefore early disease diagnosis and risk evaluation is the key factor in efficient prevention and treatment of the disease. Conventional diagnostic tools usually involve some clinical knowledge and might not be readily available to the masses. This paper introduces a Heart Disease Prediction System, which uses machine learning methods to deliver precise as well as real-time risk evaluation on the basis of health parameters inputted by users. The system is deployed as a web application that is interactive and is based on Streamlit, allowing users to enter medical and lifestyle information and make immediate predictions in a user-friendly format. Several classification models such as the Logistic Regression, the Decision Tree and the XGBoost are used and the model that performs best is chosen by considering the evaluation measures like accuracy and precision. To increase transparency and user trust, the system incorporates Explainable Artificial Intelligence (XAI) with SHAP that offers information on the contribution of features to the prediction. The system also creates individual health recommendations and facilitates the automatic creation of PDF-based reports to document and analyze. The experimental findings prove that the suggested system can reach high levels of prediction accuracy, and it is also interpretable and usable. Combining machine learning, explainable AI, and web technologies, the system can be used as an effective tool in early detection and preventive healthcare support. Keywords - Heart Disease, Machine Learning, XGBoost, SHAP, Explainable AI, Web Application

Regular exercise is a first-line nonpharmacological strategy for managing metabolic syndrome (MetS), but varied exercise modalities and outcomes across studies have led to inconsistent findings that limit clinical guidance. To synthesize up-to-date evidence on the efficacy of exercise-based interventions in improving MetS components and cardiometabolic health in individuals with MetS. Following the Preferred Reporting Items for Overviews of Reviews guideline, we searched seven databases from inception to May 2025 for systematic reviews with meta-analyses evaluating various types of exercise-based interventions (aerobic, resistance, high-intensity interval training [HIIT], mind-body, and combined aerobic and resistance training). Outcomes included MetS components-waist circumference (WC), systolic/diastolic blood pressure (SBP/DBP), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and fasting blood glucose (FBG)-along with other clinically relevant cardiometabolic parameters. Twelve systematic reviews with meta-analyses, representing 122 primary studies (9639 participants), were included. Overall, exercise-based interventions significantly improved all MetS components and secondary cardiometabolic outcomes (all p < 0.001). Subgroup analyses showed aerobic and mind-body exercises improved all MetS components, whereas resistance, HIIT, and combined training enhanced specific components. Compared to usual care, combined training elicited larger effects on reducing FBG (-0.73 mmol/L, 95% CI: -1.43 to -0.02), TG (-0.26 mmol/L, 95% CI: -0.48 to -0.05), SBP (-4.25 mmHg, 95% CI: -7.16 to -1.34), and DBP (-3.69 mmHg, 95% CI: -5.18 to -2.20) than aerobic or resistance exercise alone. This umbrella review represents the largest evaluation specific to patients with MetS to date, indicating that exercise-based interventions, across various modalities, significantly improve MetS components. The findings underscore the versatility of exercise, supporting tailored, patient-centered prescriptions for managing MetS.

Sargassum inundation of Caribbean and American shorelines is a growing environmental hazard. Hydrogen sulfide (H2S) and ammonia (NH3) produced by decomposing Sargassum could be involved in airway obstruction and bronchial inflammation. The study was undertaken to evaluate the effects of exposure to H2S and NH3 gases emitted during Sargassum decomposition based on measures of airflow obstruction and bronchial inflammation in a study population from the French Caribbean Island of Martinique. Ambient air exposure was estimated by the closest ground H2S/NH3 sensor. Lung function and bronchial inflammation were evaluated by spirometry and fractional measurement of nitric oxide in the exhaled air (FeNO), respectively. Multivariate logistic and linear regression were applied to analyze associations between cumulative Sargassum H2S/NH3 exposure and risk of airway obstruction and FeNO changes. The analyses also took into account the effects of confounding factors, notably air pollution. Among the 335 study patients, 72% were living in Sargassum-impacted zones. Compared with nonexposed patients, exposed patients had lung measures showing airway obstruction and increased FeNO levels. Exposed patients with asthma presented a two-fold rise in FeNO levels. Multivariate modeling retained mean cumulative concentrations of Sargassum H2S and NH3 as independent predictors of increased risk of airway obstruction and bronchial inflammation. The present study highlights a potential association between impaired lung function and exposure to Sargassum H2S and NH3 during coastal stranding episodes. Present study results strongly support the deleterious effect on the respiratory health of individuals chronically exposed to Sargassum gas emissions.

In the UK, over 25% of adults are living with obesity, with disproportionately higher rates among Black adults (35%) and those in the most deprived areas (36%). Obesity is linked to increased comorbidity, mortality, stigma, and substantial annual health costs exceeding £11.4 billion. Behavioral weight-management programmes are the primary intervention recommended for obesity treatment, yet they demonstrate limited effectiveness, inadequate long-term support, a lack of personalized care and poor cultural relevance. Participatory approaches, that is, bottom-up strategies engaging communities, are increasingly applied in public health to address social determinants and reduce disparities. Individuals supported to manage their health and access care are considered "empowered"; however, this concept remains ambiguous, lacking clear definition and consistent application. Although global policy promotes empowerment to promote individual health, including weight-management, no review has explored its role within obesity and weight-management programmes. This scoping review examined how empowerment has been defined and implemented across behavioral weight-management programmes. Eleven studies were identified published between 2004 and 2023, revealing poor consensus in their theoretical foundations, definitions, and practical applications of empowerment, with no UK-based studies. To support conceptual clarity, studies definitions and empowerment-based processes were consolidated. Further research is needed in UK settings to help define empowerment in this context and to enable effective translation between research, practice, and policy.

Purpose Maximal oxygen uptake (VO2max) is a strong, independent predictor of both all-cause and disease-specific mortality, making it a key health and performance marker for individuals with heart disease. While cardiopulmonary exercise testing is the gold standard for determining VO2max, its use in primary healthcare settings remains underexplored. This study aims to evaluate standard criteria for assessing VO2max in individuals enrolled in cardiac rehabilitation. Methods A cross-sectional study was conducted in a primary healthcare setting. Participants who referred to exercise-based cardiac rehabilitation underwent a cycle ergometer exercise test to determine VO2max. The primary validation criterion was the presence of a VO2 plateau, defined by cut-offs of ≤50 and ≤100 mL O2/min. Secondary criteria included respiratory exchange ratio, rate of perceived exertion, and maximal heart rate. Results Among 93 participants, 88% reached a VO2 plateau using the ≤100 mL cut-off. Additionally, 61% met at least two secondary criteria, indicating maximal effort. Conclusion In primary healthcare cardiac rehabilitation, a cut-off of ≤100 mL may be suitable for identifying a VO2 plateau. For those not reaching a plateau, maximal effort can be assessed using RER ≥1.15 and RPE ≥17 as criteria.

The transition from work to retirement is a critical shift in an individual's later life. Utilizing retrospective data from the 2014 China Health and Retirement Longitudinal Study (CHARLS), this study employed sequence analysis to identify typical retirement transition patterns, followed by multiple regression analysis to examine their association with physical health. Five groups of retirement trajectories are identified: "Not Retired," "Early Retirement," "Late Retirement from Agricultural Employment," "Statutory Retirement," "Late Retirement from Self-employment". The "Statutory Retirement" and "Early Retirement" groups typically complete their retirement transition earlier, often retiring at the statutory age with substantial pension support. In contrast, the "Not Retired," "Late Retirement from Agricultural Employment," and "Late Retirement from Self-employment" groups exit the labor force later in life. These individuals are primarily engaged in agricultural production or self-employment and generally lack robust pension insurance. Regression analysis found a significant association between retirement transition patterns and physical health. The "Statutory Retirement" group demonstrates lower Instrumental Activity of Daily Living (IADL) (B = -0.393, P < 0.001), and NAGI (B = -0.791, P < 0.001) scores. The "Late Retirement from Self-employment" group also showed lower IADL (B = -0.356, P < 0.01) and NAGI (B = -0.555, P < 0.001) scores. The "Early Retirement" group exhibits a lower NAGI score (B = -0.345, P < 0.001). In contrast, the "Late Retirement from Agricultural Employment" group was associated with higher scores in Activities of Daily Living (ADL) (B = 0.212, P < 0.05) and IADL (B = 0.407, P < 0.01). Contact with children moderated the relationship between retirement transition and physical health. Increased intergenerational contact had a stronger positive correlation with health for individuals in the "Late Retirement from Agricultural Employment" group but showed no significant health benefit for those in the "Statutory Retirement" group.

Food Is Medicine (FIM) programs integrate interventions such as medically tailored meals or produce prescriptions into clinical care. However, there is limited evidence on how to design these programs to be responsive to the lived experiences of participants to optimize initiation, engagement, and long-term retention. The objective of the study was to develop interventions to promote initiation, engagement, and retention in FIM programs that are responsive to the lived experiences of participants. We used a human-centered design approach to engage current and former cardiac rehabilitation participants in the development of interventions to promote participation and engagement in a FIM program. We recruited participants through invitations sent via electronic health record messages. We interviewed participants about their experiences, preferences, and unmet needs related to healthy eating and program design. Additionally, we elicited participant feedback on draft versions of patient navigator scripts and text messages promoting healthy eating habits. A total of six participants identified themes across Theory of Planned Behavior constructs and emergent themes, including the cost of healthy food, cultural appropriateness, clear and timely communication, transportation, local food access, scheduling flexibility, the ability to provide feedback to the program, and personalized support for navigating food resources. Participants described financial strain as a key barrier to healthy eating and noted that social influence often shaped eating behaviors. Feedback on navigator scripts led to revisions clarifying program logistics, addressing barriers such as language and cultural dietary restrictions, and tailoring positive endorsements to individual health goals. Based on participant feedback, text messages were made more concise, reframed positively (eg, humor and gratitude), and encouraged to be warmer, with respectful language that is easy to understand, while avoiding stigmatizing or overly clinical phrasing. Participants also suggested that messages should reflect empathy and offer actionable information to increase trust and engagement with the program. Trust in the health care system and a sense of dignity in receiving food support emerged as critical themes influencing overall satisfaction and retention. Participants emphasized that endorsement from their health care team and cardiologist was important for building trust in the program. Communication between health care navigators and FIM navigators could help reduce the burden placed on patients to navigate food resources. Using a human-centered design approach, we gained insights about participant-identified needs for navigation scripts and text messages that are culturally sensitive and personalized to promote optimal participation in a FIM program.

The present study aims to reflect on the impacts of the infodemic on global health. A theoretical-reflective study was conducted based on the concepts of health education and health promotion, that is, it proposes to think about the different dimensions that constitute it. To this end, Therrien’s proposition about the pillars that constitute an investigation phenomenon was adopted: ontology, epistemology and methodology. The search was conducted in the second half of 2024 through the guiding question: What are the impacts of the infodemic on global health? The following descriptors were used: infodemic; global health and misinformation with the help of Boolean operatives to help and refine the search for studies for analysis. The infodemic represents the phenomenon of dissemination of information, not always true, in an exacerbated way, this phenomenon can impact people’s adherence to sanitary measures, stimulate negative behavior in relation to individual and collective health, increase in the level of insecurity with the present and future, negative outcomes in relation to mental health and indiscriminate use of medications. Therefore, the performance of professionals and public managers in coping with the infodemic is essential, given the great burden of morbidity and mortality that it can cause.

Branched-chain amino acids (BCAAs)—leucine, isoleucine, and valine—are essential nutrients that exhibit context-dependent, paradoxical effects on human health, with mTORC1 (mechanistic target of rapamycin complex 1) signaling serving as a central mechanistic node through which physiological BCAA concentrations support anabolism and repair while chronic pathological elevation drives metabolic and inflammatory injury. While their anabolic properties in promoting muscle protein synthesis, modulating immune responses, and conferring hepatoprotection are well-documented, accumulating evidence demonstrates that chronically elevated circulating BCAA concentrations are strongly associated with the pathogenesis and progression of metabolic, inflammatory, and injury-related diseases, including insulin resistance, type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD), and certain malignancies. This biological duality is mechanistically rooted in a network of interconnected pathological processes, in which BCAA-mediated modulation of mTORC1 signaling—already introduced above—represents one central hub operating alongside impaired catabolic flux, accumulation of branched-chain α-keto acids (BCKAs) and branched-chain acylcarnitines, mitochondrial redox imbalance, and cellular stress pathway activation. Physiological BCAA concentrations support anabolic processes and cellular repair, whereas chronic pathological elevation is associated with mTORC1 hyperactivation alongside impaired BCKDH-mediated catabolic flux, accumulation of branched-chain α-keto acids (BCKAs) and branched-chain acylcarnitines, mitochondrial redox imbalance, and activation of cellular stress pathways—collectively contributing to disrupted metabolic homeostasis, amplified inflammatory cascades, and mitochondrial dysfunction. The ultimate biological impact of BCAAs is not intrinsic to these amino acids but rather is determined by a complex interplay of factors including: dosage and duration of exposure, individual metabolic status (particularly insulin sensitivity and mitochondrial oxidative capacity), specific disease context, and genetic polymorphisms affecting BCAA metabolism alongside gut microbiome composition. This review comprehensively synthesizes current understanding of BCAA biology and advocates for a paradigm shift toward precision nutrition approaches. Evidence supports therapeutic BCAA supplementation in hypercatabolic conditions such as sarcopenia and hepatic cirrhosis, while suggesting potential adverse metabolic consequences in insulin-resistant or obese individuals. Future nutritional and therapeutic strategies should transition from universal dietary recommendations to personalized interventions based on comprehensive metabolic phenotyping and genetic profiling, thereby optimizing BCAA intake for individual health trajectories and providing novel preventive and therapeutic opportunities for chronic disease management.

Objectives Health Japan 21 (Third Term) emphasizes measures targeting individuals who are indifferent to their health. We examined associations between health interest levels and the practice of the three key elements of frailty prevention (regular exercise, food intake diversity, and participation in social activities). We further investigated whether this association differed by participant characteristics.Methods We obtained data from a mailed survey conducted in 2023 targeting 14,013 residents aged ≥65 years living in Wako City, Saitama Prefecture, who had not been certified as requiring level 3 or higher long-term care. We analyzed data from 6,429 valid respondents. We assessed the implementation status of each of the three key elements of frailty prevention: regular exercise (at least once per week), food intake diversity (Dietary Variety Score ≥ 4), and participation in social activities (participation in at least one of the following: employment, volunteer groups, sports groups or clubs, hobby groups, learning or cultural groups, groups for preventing long-term care, senior citizens' clubs, or neighborhood associations). Health interest levels were assessed using the Health Interest Scale (score range: 12-48 points). Participants were categorized into five groups according to the quintiles of their health interest scores. Modified Poisson regression analysis adjusted for major confounding factors was performed to estimate prevalence ratios with 95% confidence intervals (CIs). We also assessed the interactions between health interests and basic respondent characteristics (sex and age group).Results Among all respondents, 22.9% practiced all three elements of frailty prevention, and the mean Health Interest Scale score was 36.6 ± 5.2. Compared with the group with the highest health interest level (5th quintile), the group with the lowest level (1st quintile) had fewer people who regularly exercised (prevalence ratio = 0.64, [95%CI = 0.59-0.68]), consumed various foods (0.65 [0.59-0.71]), or participated in social activities (0.83 [0.78-0.90]), and fewer people who practiced all three elements (0.45 [0.38-0.53]). Additionally, a significant interaction was observed between health interest and age group with respect to participation in social activities (P = 0.031). The association between low health interest and non-participation in social activities was stronger among those aged ≥75 years than among those aged 65-74 years.Conclusion Individuals with low health interests were less likely to engage in frailty prevention behaviors. Frailty prevention interventions should consider an individual's health awareness level.