Tissue-specific metabolism of Naringin and its modulation of the UA metabolism and gut microbiota in hyperuricemia mice.

Self-management experience of young patients with refractory epilepsy: A qualitative study.

Diagnosis of erectile dysfunction (ED) is increasing due to the prevalence of cardiovascular disease, diabetes, lifestyle changes, and an aging population. The worldwide prevalence of ED in 2025 was projected to be 322 million men. ED can negatively affect a man's psychosocial health and quality of life. Of all the available treatment options for ED, the penile prosthesis offers the highest patient and partner satisfaction rates (the inflatable type more than the malleable type) and is covered by most insurance plans in the United States. Despite being irreversible and invasive, per the 2018 American Urological Association guidelines, it is valid for men to begin with a penile prosthesis as the first line of treatment. Consequently, approximately 30 000 penile prostheses are implanted annually in the United States. However, surgery carries inherent risks and potential complications, and like any other implant, an inflatable penile prosthesis (IPP) can be complicated by infection, mechanical failure, and malpositioning. Detection of these complications can be challenging at clinical examination, and MRI is the preferred modality to interrogate the IPP. Other imaging modalities such as CT and US may be used according to the suspected complication and provide complementary information. MRI permits anatomic evaluation of the IPP and offers functional assessment by allowing acquisition of images during both the inflated and deflated states. The aim of this article is to familiarize radiologists with the normal imaging appearance and complications of the three-piece IPP for accurate diagnosis and effective communication with referring clinicians. A structured reporting template is proposed to guide clinical practice. ©RSNA, 2026 Supplemental material is available for this article. See the invited commentary by Schuch and Chojniak in this issue.

The use of pharmacotherapies in non-cirrhotic metabolic dysfunction-associated steatohepatitis: a UK expert consensus.

SWAAT: a simple mnemonic to promote lifestyle change for blood pressure control.

Intensive lifestyle change intervention (LCI) programs and metformin are recommended to prevent the progression of prediabetes to type 2 diabetes. While social drivers of health are known to influence access to preventive health care the impact of neighborhood socioeconomic disadvantage on the uptake of diabetes prevention interventions remains underexplored. Examine the relationship between the social deprivation index and the use of diabetes prevention interventions among people with prediabetes. We analyzed commercial and Medicaid claims data from the Maryland Medical Care Data Base (2017-2019) to identify claims for LCIs and metformin prescriptions and Social Deprivation Index (SDI) 2015 data to measure enrollees' neighborhood socioeconomic disadvantage and examine associations between one or more diabetes prevention interventions. An adjusted multinomial logistic regression model estimating relative risk ratios was used to compare the relationship between SDI quintiles and use of LCI only, LCI and metformin, and metformin only (reference). Among enrollees who used any intervention those living in neighborhoods with SDI scores in the fifth quintile had a significantly higher relative risk (RRR: 1.49; 95% CI: 1.12-1.99) of using LCI only versus metformin only compared with those living in neighborhoods with SDI scores in the first quintile. Enrollees with prediabetes living in neighborhoods with higher levels of socioeconomic disadvantage were more likely to use LCI and more likely to use LCI only compared with metformin only as a diabetes prevention intervention. These findings are relevant for states targeting diabetes prevention in communities of high need.

Obesity is a risk factor for hypercholesterolemia; however, evidence of obesity among Orang Asli (OA) adults remains limited. Lifestyle changes, including unhealthy diets and sedentary behavior, may increase vulnerability to noncommunicable diseases. This study examined the sex-specific associations between body mass index (BMI) and hypercholesterolemia using data from the OA Health Survey 2022. A total of 8160 adults aged ≥18 years with complete questionnaires, anthropometric data, and blood data were analyzed. The prevalence of hypercholesterolemia among OA adults was 47.6%; of these, 41.5% were previously undiagnosed. Compared with normal BMI, overweight and obesity were associated with a higher odds of hypercholesterolemia in both sexes. Older age, Senoi tribe affiliation, and diabetes were associated with hypercholesterolemia in both sexes. These findings highlight the need for culturally tailored interventions to strengthen obesity prevention and cholesterol testing in primary care and outreach services to reduce cardiovascular risk in OA communities.

Lifestyle Medicine (LM) and Behavioral Health (BH) are increasingly recognized as complementary, synergistic disciplines that positively impact chronic disease. Limited data exist on public awareness, perceptions, preferences, and barriers to care. This study evaluated United States (U.S.) adults' understanding and attitudes toward LM, BH, and their integration. A cross-sectional, nationally weighted survey of U.S. adults was conducted in November 2025. Measures included health status, familiarity with LM, provider communication, access barriers, BH attitudes, and preferences for integrated care. Overall frequencies and cross-tabulations were reported. Respondents included 1,001 adults (51% women), with 71% reporting one chronic disease. Half had never heard of LM, 91% were at least somewhat interested in changing lifestyle habits, and 41% were very or extremely confident in their ability to make behavior changes. Seventy-five percent said addressing mental health was very or extremely important, with 82% responding they would be at least somewhat likely to use BH services if offered by their primary care doctor. Commonly cited barriers were cost, insurance coverage, and scheduling difficulties. Overall, U.S. adults reported a strong desire to improve health through lifestyle changes and access integrated LM and BH services within primary care.

Intensive Therapeutic Lifestyle Change Programs have shown promise in improving cardiometabolic risk factors over short durations. This pilot study evaluated the effectiveness of a 12-day residential wellness program in rapidly improving selected cardiovascular disease risk factors. Eighteen participants attended a 12-day residential wellness camp emphasizing plant-based nutrition, structured physical activity, and lifestyle education. Baseline and post-intervention measurements included anthropometrics, blood pressure, lipid profiles, fasting glucose, and fitness assessments. HbA1c was measured at baseline. Paired t-tests evaluated changes in biomarkers, and Hedges'g effect sizes were calculated.Sixteen participants completed the program. Significant reductions (P< 0.05) occurred in systolic and diastolic blood pressure, body mass index, and total cholesterol, with medium to large effect sizes. Triglycerides and LDL-C demonstrated nonsignificant reductions. One-mile walk time improved significantly. Three participants reduced/discontinued diabetes medications, and four adjusted hypertension medications.Participation in a 12-day residential wellness program resulted in meaningful improvements in selected cardiovascular risk factors and functional fitness outcomes. Medication reductions highlight the potential of short-term intensive lifestyle interventions to rapidly improve cardiometabolic health. Larger, controlled studies with follow-up to assess sustainability of outcomes are warranted to confirm these findings.

The COVID-19 pandemic has had a profound impact on the daily lives of people worldwide, with social distancing measures influencing both physical activity and psychological health. In the Arab region, few data exist on the changes in lifestyle and psychological health status during COVID-19. The aim of this study was to assess physical daily life activities and psychological health impacts among the general public in Arab countries during the COVID-19 pandemic. A cross-sectional comparative correlational design was used. A convenience sample with online data collection was used to collect data from adults from seven countries. Adults completed a demographic questionnaire, Perceived Stress Scale and Hamilton Anxiety Rating Scale. The study included 1396 participants. A total of 28.7% of them reported decreased physical activity, 17.2% started exercising at home and 40% reported weight gain. Participants showed moderate stress (mean 19.42 [standard deviation 5.94]) and mild anxiety (mean 14.01 [standard deviation 13.05]), with significant differences between countries (p<0.01). There was a positive correlation between stress and anxiety (r=0.590, p<0.01), while age showed a negative correlation with both stress (r=-0.300, p<0.01) and anxiety (r=-0.229, p<0.01). Anxiety was differentiated with eating behaviour, but neither stress nor anxiety were significantly different with changes in exercise activity. Regression analyses indicated that anxiety and age strongly predicted stress, while stress and age predicted anxiety. The changes in lifestyle and the factors associated with increased stress and anxiety during the COVID-19 pandemic must be considered in future pandemics to develop appropriate care plans for the general public.

Acid reflux disease is one of the most common diseases experienced by the public, especially in adolescents. The causes of this disease are generally due to psychological conditions, diet, sleep patterns, lifestyle and bacterial infections. However, the high number of cases of this disease is not accompanied by awareness and knowledge of the dangers and changes in a better lifestyle. In order to attract interest in knowing about acid reflux disease and invite to change a better lifestyle, education given in another and interesting form is an option. That's why the design of Instagram comic strips with the aim of education about stomach acid disease is carried out. In a comic, character is an important element needed so that the story and message delivery can be done effectively. This design uses descriptive qualitative and descriptive quantitative research methods to analyze data from interviews, questionnaires and literature. The stage is then continued by making design concepts and design results. From this design, it is hoped that the community, especially teenagers, can be more aware and more effective in conveying messages.

Cardiovascular disease (CVD) and cancer are the two leading health issues in the world, with CVD being the leading cause of death in all age groups and cancer, particularly prostate cancer (PCa), emerging as a significant concern among elderly men. Common risk factors like metabolic disorders, chronic inflammatory diseases, and hormone abnormalities have been theorized to be responsible for the increasing prevalence of these diseases. In this study, we examined the relationship between CVD and PCa, with emphasis on the pathophysiological events that connect them and how their coexistence affects patient outcomes. Common PCa treatments, such as androgen deprivation therapy (ADT) as well as androgen receptor signaling inhibitors (ARSI), have been linked to higher rates of hypertension, myocardial infarction, arrhythmias, and metabolic abnormalities. These cardiovascular side effects complicate the effective management of PCa, resulting in poorer overall results. It is essential to implement new integrated approaches to tackle these comorbid conditions. Recommendations include changes in lifestyle, personalized treatment plans, multidisciplinary collaborative efforts, and routine cardiovascular examinations for patients on PCa treatment. Evidence found that personalized exercise regimens and pharmaceutical treatments like statins and antihypertensives may lower cardiovascular risks and enhance outcomes in patients undergoing PCa treatment. Also, emerging technological interventions like wearable devices and telemedicine, such as smartwatches and mobile ambulatory blood pressure monitors (ABPMs), offer real-time cardiovascular monitoring and improve health outcomes among these patients. This study identifies the substantial gaps in clinical guidelines, notably in cardio-oncology integration, and emphasizes the importance of further research into biomarkers, shared inflammatory pathways, and individualized therapy methods. Hence, addressing these gaps will enable a more comprehensive approach to patient care, improving their quality of life and survival.

Pan-vascular diseases pose a significant and growing global public health burden. However, the burden of pan-vascular diseases remains unknown, especially regarding its trends through 2050. The global burden of ischemic heart disease (IHD), ischemic stroke (IS), and lower extremity peripheral arterial disease (LEPAD) was analyzed in this study. We investigated the prevalence trends of these pan-vascular diseases from 1990 to 2021 across 204 countries and territories, assesses the impact of population aging, lifestyle changes, and epidemiological shifts on the prevalence of pan-vascular diseases, examines health inequalities between countries, and forecasts trends through 2050.In 2021, the estimated global cases of IHD, IS, and LEPAD reached 254.3 million, 69.9 million, and 113.7 million, respectively. The age-standardized prevalence rates (ASPR) were 3031, 1018, and 1337 per 100,000 population, with estimated annual percentage changes (EAPC) of 0.61%, 0.95%, and 0.1%, respectively. Over recent years, population growth contributed most to the increasing burden of IHD, IS, and LEPAD, with a slightly higher impact in females for IS and LEPAD. Notably, epidemiological factors (-18.9%) partially mitigated the burden of LEPAD despite demographic pressures. Trend projections indicate a slow increase in IHD ASPR, particularly among females, while males exhibit a relatively stable trend through 2050. A similar pattern was observed for IS, whereas ASPR for LEPAD is expected to remain stable. Significant absolute and relative inequalities in disease burden were observed across countries with varying sociodemographic index (SDI) levels. The burden of pan-vascular diseases continues to rise globally, driven primarily by demographic changes (population growth and aging). Despite improvements in healthcare, significant cross-country health inequalities persist, particularly in high-SDI countries, where the disease burden has intensified. As prevalence trends are projected to increase further, targeted public health interventions and policies are urgently needed to mitigate the growing impact of pan-vascular diseases and reduce global health disparities.

Tobacco use remains a leading preventable cause of morbidity and mortality. Digital health tools and wearable technologies offer scalable opportunities for behavioral self-monitoring. However, real-world evidence characterizing long-term tobacco use trajectories and associated physiological changes during wearable adoption are limited. To characterize longitudinal trajectories of self-reported tobacco use during the first 72 weeks of wearable adoption and examine associations between tobacco use and wearable-derived cardiopulmonary and sleep measures. We analyzed data from 12,678 new wearable members (18-79 yrs) who contributed up to 72 weeks of daily self-reported tobacco use and wearable-derived biometric data. Longitudinal trajectories of tobacco use were examined across prespecified 12-week quarters (Q1-Q6) using generalized linear mixed-effects models. Associations between tobacco use and nocturnal resting heart rate (RHR) and heart rate variability (HRV), respiratory rate (RR), and sleep duration were evaluated using linear mixed-effects models that accounted for within- and between-person variation and adjusted for demographic and temporal covariates. Across 3,765,573 person-days, the estimated daily probability of tobacco use declined from 55.1% (95% CI: 53.8, 56.4) during Q1 to 27.2% (95% CI: 26.1, 28.3) during Q6, representing an absolute reduction of 27.9 percentage points (95% CI: -28.4, -27.4). Among tobacco users with end-of-follow-up data, 28.2% (1,404 of 4,975) reported no tobacco use during Q6. Greater logging engagement was associated with larger reductions in tobacco use; each 10 percentage point increase in engagement corresponded to a 0.92 percentage point greater decline from Q1 to Q6 (95% CI: -1.58, -0.26). Following tobacco-use days, RHR was 1.71 bpm higher (95% CI: 1.70, 1.73), HRV was 3.54 ms lower (95% CI: -3.59, -3.49), RR was 0.19 breaths/min higher (95% CI: 0.19, 0.20), and sleep duration was 9.78 minutes shorter (95% CI: -10.08, -9.49), relative to non-use days. Reductions in tobacco use over time were associated with directionally favorable changes in RHR, RR, and sleep duration (Ps≤.03). In this large-scale, observational, real-world study of wearable device users, the probability of tobacco use declined over the first 72 weeks of wearable adoption. Among participants with end-of-follow-up data, more than one-quarter reported no tobacco use during Q6. Tobacco use was consistently associated with less favorable cardiopulmonary and sleep measures, while reductions in tobacco use over time co-occurred with directionally favorable changes in these measures, though such changes may also reflect broader lifestyle or health changes. These findings provide large-scale, longitudinal evidence that sustained reductions in tobacco use co-occur with measurable favorable changes in physiological markers within a digital self-monitoring environment. As these findings derive from a single commercial ecosystem, independent replication in non-commercial, multi-platform settings will be needed to establish generalizability.

This study aimed to explore women’s perceptions of a gender-tailored diabetes education program and examine self-reported behavioral, psychosocial, and self-management changes following participation among women in underserved Saudi communities and identify barriers influencing sustained diabetes management. An exploratory sequential mixed-methods study was conducted from January to June 2024 in community health centers in Al-Leith and Adham, Makkah region. Semi-structured interviews were carried out with 20 women aged 18 to 65 years to explore experiences and perceptions. Findings informed a structured questionnaire administered to 136 program participants. Descriptive statistics were used to summarize behavioral changes and perceptions, and thematic analysis followed Braun and Clarke’s 6-phase framework. Participants reported positive changes in lifestyle and self-care behaviors. Approximately 70% reduced sugar intake, 65% increased physical activity, 72% improved hydration practices, and 68% performed regular glucose monitoring. Most respondents agreed that the advice was easily applicable (73.7%), addressed women-specific challenges (71%), and enhanced motivation (72.4%). Qualitative themes highlighted daily life changes, helpful program aspects, challenges, and recommendations. Barriers included time constraints (22%), family duties (20%), financial limitations (19%), and limited healthcare access (8%). Participants perceived the tailored diabetes education program as helpful in supporting healthier behaviors, self-management practices, and motivation in underserved Saudi settings. Addressing social expectations, time pressures, and access barriers through digital follow-up and community support could strengthen long-term outcomes and advance Vision 2030 preventive health goals. Because findings were based on self-reported cross-sectional data, causal relationships regarding program effectiveness cannot be established.

From the known to the unknown: the diverse family of TetR-like regulators in Bacillus subtilis.

Weight stigma and misconceptions about obesity among healthcare professionals (HCPs) may negatively affect healthcare quality and access for people living with obesity (PLWO). However, no previous research has examined these attitudes and beliefs in Spanish HCPs. This cross-sectional online study examined weight stigma and obesity-related beliefs among 922 HCPs recruited via Spanish professional and academic obesity-related organizations ((74.1% female, mean BMI = 23.73 kg/m2 (SD 3.89), mean age = 43.73 years (SD 12.45), range 23–75, 88.7% provide care for PLWO)). Anti-fat attitudes were measured using the Dislike subscale of the Anti-Fat Attitudes questionnaire (AFA) and the Fat Phobia Scale (F-Scale). ANOVAs adjusted for sociodemographic variables, weight status, and weight bias internalization were conducted. Overall, Spanish HCPs surveyed reported negative attitudes toward PLWO. Lower weight status was consistently associated with higher stigma scores. Younger age (F-Scale) and working in the private sector (Dislike) were associated with higher scores. Differences across specialties were observed, with obesity physicians reporting the lower stigma levels. A substantial proportion of HCPs endorsed beliefs emphasizing personal responsibility: 38% attributed overeating to individual causes, 66% believed obesity could be entirely prevented by a healthy lifestyle, and 59% believed it could be cured through lifestyle changes. Many also attributed weight loss difficulties, poor compliance, and weight regain to lack of motivation and lifestyle choices, and over half considered lifestyle or psychological interventions the most effective treatment for severe obesity. Endorsement of these beliefs was consistently associated with higher stigma scores. These findings provide national evidence that weight stigma among Spanish HCPs is present and linked to beliefs framing obesity as primarily under individual control. These attitudes and knowledge gaps may contribute to inappropriate care and unfair treatment of PLWO. Addressing responsibility-focused beliefs may be a key step towards reducing stigma and improving the quality of obesity care in Spain.

Prostate cancer (PCa) ranks as the fifth most prevalent cancer type globally, with its incidence rising due to lifestyle changes. The prognosis significantly worsens at the metastatic stage, with a 5-year survival rate dropping to 30%. This study focuses on the androgen signaling pathway's role in PCa etiology and aims to identify molecular mechanisms that could serve as potential biomarkers for early diagnosis of the disease in a population of Iranian men. We analyzed the expression levels of long non-coding RNAs (lncRNAs) PCAT18, CTBP1 antisense RNA (CTBP1-AS), and HOTAIR in blood samples from 30 PCa patients and 30 individuals with benign prostatic hyperplasia (BPH). RT-PCR and specific primers were used for quantification. We observed a significant downregulation of PCAT18, HOTAIR and CTBP1-AS in the PCa cohort compared to BPH. ROC curve analysis revealed HOTAIR as the most promising biomarker, with an area under the curve of 0.6897. Further analysis indicated that PCAT18 and HOTAIR demonstrate considerable sensitivity and specificity for distinguishing PCa from BPH, suggesting their potential utility in clinical diagnosis and prognosis evaluation. Significant correlation was found between LNCRNAs expression and demographic information for CTBP1-AS expression vs. size of tumor, PCAT18 expression vs. PSA and PCAT18 expression vs. grade. These results implying that lncRNAs dysregulation may be more indicative of cancer biology. These findings highlight the importance of CTBP1, PCAT18 and HOTAIR as potential biomarkers in prostate cancer and underscore the necessity for further investigation into their roles in cancer progression and therapeutic strategies.

To describe the myopia prevalence and spherical equivalent among primary school students in a district of Anhui Province in 2019, to analyze their changes in 2020 and 2024, to obtain baseline data, and to explore the potential impact of changes in screen time on vision, providing scientific evidence for myopia prevention and control strategies. This cross-sectional study included all the primary school students who underwent vision screening in 2019 (baseline period), 2020 (period of increased screen time), and 2024 (period of slightly resumed screen time). Data on grade, gender, uncorrected distance visual acuity, and refraction were extracted from the screening database. Noncycloplegic refraction was assessed using an FKR-710 autorefractor to measure sphere and cylinder, and uncorrected distance visual acuity was assessed using an K238-AZ LCD visual acuity chart. The spherical equivalent was calculated as sphere + 0.5 × cylinder. Myopia was defined as uncorrected distance visual acuity < 5.0 in either eye with a corresponding spherical equivalent ≤ -0.50 D. Myopia prevalence and spherical equivalent were described using percentage and mean with 95%confidence interval (CI). The Chi-square test and One-way analysis of variance were used to compare myopia prevalence and spherical equivalent across different years, followed by stratified analysis by grade. A total of 183 204 students were screened: 45 294 in 2019, 52 922 in 2020, and 84 988 in 2024. In 2019, the myopia prevalence was 30.8%(95%CI: 30.4%, 31.2%), higher in girls (33.7%) than in boys (28.4%) and increased with grade (P < 0.001), rising from 11.0%in Grade 1 to 35.7%in Grades 2-6. Compared with 2019, the myopia prevalence in 2020 increased by 4.3 (3.7, 4.9) percentage points to 35.1%(P < 0.001). By 2024, it further increased by 6.7 (6.2, 7.2) percentage points from the 2020 level to 41.8%(P < 0.001). In grade-stratified analyses, compared with 2019, Grade 1 students showed the largest increase in 2020; compared with 2020, Grade 1 students showed the smallest subsequent increase in 2024. Quantitative analysis of spherical equivalent showed that the mean spherical equivalent in 2020 was -0.72 D, representing a myopia shift of -0.21 D (-0.23 D, -0.19 D) compared with the 2019 level (P < 0.001); by 2024, the mean spherical equivalent was -0.68 D, indicating a hyperopic shift of 0.04 D (0.02 D, 0.06 D) compared with the 2020 level (P < 0.001). Further grade-stratified analyses indicated that the mean spherical equivalent for Grade 1 students in 2024 (0.08 D) had nearly returned to the 2019 level (0.09 D). The myopia prevalence among primary school students in the study area was 30.8%in 2019, higher than the global level and approximately twice that of the United States and four times that of Germany, indicating that myopia prevention and control among primary school students remains challenging. The myopia prevalence in 2020 and 2024 was higher than in 2019, suggesting that lifestyle changes, such as increased screen time, affect the short-term visual status. Younger students experienced the greatest increase in myopia prevalence in 2020 and the mildest subsequent increased in 2024, and their spherical equivalent in 2024 had almost recovered to the 2019 level, but not for older students. These findings indicate greater ocular plasticity in younger students, i.e. more sensitive to negative exposures and easier to recover after removing such exposures, warranting further investigation on the underlying mechanisms. Additionally, patterns of higher myopia prevalence in girls than in boys and a gradual increase with grade support previous studies, also enhancing the reliability of the relevant results in our study.

Background and AimsRestrictions during the COVID‐19 pandemic significantly affected the global population, particularly those with chronic conditions such as hypertension and diabetes, where lifestyle changes could have disrupted disease management. This study analyzes the association between reduced physical activity (PA) and variations in physical parameters, treatment adherence, and health‐related quality of life (HRQoL).MethodsA pre‐post study design was conducted from March 2019 to June 2021 in a Basic Health Area of central Spain. Clinical parameters (blood pressure, BMI, and HbA1c), PA levels, treatment adherence, and HRQoL (SF‐12) were measured in 152 patients before and after the lockdown. Analysis of covariance (ANCOVA) was used to compare mean differences across PA categories (quartiles), controlling for age and sex.ResultsOne year after the start of the lockdown, participants showed an increase in systolic blood pressure (p = 0.030) and significant decreases in PA (p = 0.004), treatment adherence (p < 0.001), and the mental component of HRQoL (p < 0.001). ANCOVA results indicated that the effect size (partial eta squared, ηp2) for differences in treatment adherence was 0.260, while for mental HRQoL, it was 0.040, suggesting a more moderate clinical relevance for the latter.Subjects in the lowest physical activity category exhibited the poorest outcomes after adjusting for age and sex:Mental HRQoL difference: mean = −8.13 (95% CI: −11.11 to −5.15).Adherence difference: mean = −4.80 (95% CI: −5.94 to −3.65).In contrast, participants with high PA demonstrated an improvement in treatment adherence (mean = 1.69; 95% CI: 0.31–3.06).ConclusionsNegative consequences of the pandemic remain observable 1 year after the lockdown in this population. Higher levels of physical activity are associated with mitigating some of these effects. However, due to the study design, caution is required when making direct causal interpretations.