Nepali school teachers' perceptions of child abuse in Dhulikhel municipality: A qualitative study.

To our knowledge, no study assessed the published obesity-related nutrition educational interventions (ONEI) delivered to medical students, residents or fellows. The current scoping review undertook this task. We searched PubMed, Web of Science and EMBASEdatabases. Original articles of ONEI delivered to medical students, residents or fellows were included. The ONEIs' goals, content, teaching and learning characteristics, health professionals involved, duration of the intervention, trainees, target populations, evaluation methods, and outcomes were scrutinized. Extracted data were categorized, condensed, and mapped to identify gaps. Thirty six ONEI were included, mostly (88.8%) from North America. Physicians were the instructors in less than half the ONEI (44.4%), followed by dietitians (30.5%). Most ONEI (75%) were for medical students, 25% for residents, and none for fellows. The majority of ONEI (83.3%) were for adult patients with obesity (PWO), whereas 16.7% focused on childhood obesity. ONEIs' overarching goals were to improve nutrition knowledge, skills and confidence in assessment, counseling, intervention, and attitudes towards PWO. The teaching and learning methods included face-to-face traditional lectures, oral presentations, case-based scenarios, interactive group discussions, simulated and standardized patient interactions and role play activities. Technology-based education modalities were also utilized such asonline videos, web-based and computer-based learning. Other interventionsinvolved culinary classes to deepen trainees' understanding of nutrition and health. A range of evaluation tools wasused to appraise effectiveness including pre- and post-surveys, multiple-choice questions, observed structured clinical examinations, learning essays and narrative reflections. The ONEI resulted in significant improvements in knowledge, competencies, confidence, nutrition assessment, counseling, weight management, andpromoting healthy lifestyle. Positive improvements were also noted in communication skills, attitudes toward PWO, and in the trainees' own personal behaviors. Obesity-related nutrition education does not appear to be sufficiently prioritized across the medical education continuum. The review also identified five paradoxes: (1)a slow developing evidence base of obesity-related nutrition education in the face of a fast-paced obesity epidemic; (2)only a minority of physician instructors participate in nutrition education, despite their complementary role to dietitians and the well-recognized benefits of collaborative nutrition training; (3)a low representation of ONEI outside of North America despite the global prevalence of obesity; (4)a dearth of ONEI delivered to residents, and none identified for fellows, despite the roles of these young physicians in delivering care to PWO. In addition, (5)ONEItargeting childhood obesity remain insufficiently emphasized, despite its significant long-term health consequences. These 'mismatches' suggest the necessity for efforts to enhance the obesity-related nutrition education for young physicians-in-training.

The rising global burden of colorectal cancer (CRC) has now positioned it as the third most common cancer worldwide. Chemotherapy regimens are known to disrupt the composition of the gut microbiota and lead to long-term health consequences for cancer patients. However, the alteration of gut microbiota by specific chemotherapeutic agents has been insufficiently explored until now. The purpose of this study was to assess changes in the gut microbiota following treatment with VERU-111 as a chemotherapy agent for the treatment of CRC. We thus performed a metagenomic study using 16S rRNA gene amplicon sequencing of fecal samples from different experimental groups in the azoxymethane (AOM) and dextran sodium sulfate (DSS)-induced murine model of CRC. To predict the functional potential of microbial communities, we used the resulting 16S rRNA gene sequencing data to perform Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. We found that the administration of VERU-111 led to a restructured microbial community that was characterized by increased alpha and beta diversity. Compared to the mice treated with DSS alone, VERU-111 treatment significantly increased the relative abundance of several bacterial species, including Verrucomicrobiota species, Muribaculum intestinale, Alistipes finegoldii, Turicibacter, and the well-known gut-protective bacterial species Akkermansia muciniphila. The relative abundance of Ruminococcus, which is negatively correlated with immune checkpoint blockade therapy, was diminished following VERU-111 administration. Overall, this metagenomic study suggests that the microbial shift after administration of VERU-111 is associated with suppression of several metabolic and cancer-related pathways that might, at least in part, facilitate the suppression of CRC. These favorable shifts in gut microbiota suggest a novel therapeutic dimension of using VERU-111 to treat CRC and emphasize the need for further mechanistic exploration.

The long-term health consequences of childhood body size and whether it can be mitigated by a healthy adult lifestyle remains unclear. This study aims to explore the associations between childhood body size and the risk of mortality and major non-communicable diseases (NCDs), and the role of a lifestyle in adulthood in these associations. This study included 358,990 UK Biobank participants (mean age 56.3 years, 53.2% female). Childhood body size at age 10 was self-reported as thinner, average, or plumper. Adult lifestyle factors included physical activity, diet, sleep duration, smoking, and alcohol consumption. Outcomes included risk of mortality and 47 NCDs. Cox regression models were used to estimate associations between childhood body size and outcomes. Mediation and interaction analyses assessed the role of adult lifestyle in these associations. Here we show that, individuals with plumper body size have a higher risk of mortality and 26 NCDs, compared to those with average childhood body size, where 1.07% to 28.54% of these risks are mediated by adult lifestyle. Thinner body size is associated with increased risk of 24 NCDs, with 2.12% to 32.59% of the risks mediated by adult lifestyle. Significant interactions are observed between plumper childhood body size and adult lifestyle for all-cause mortality and 6 NCDs, including hypertension, alcohol problems, constipation, diverticular disease, chronic obstructive pulmonary disease, and chronic kidney disease. Both plumper and thinner body sizes during childhood are associated with an increased risk of developing NCDs later in life. However, adherence to a healthier lifestyle in adulthood may partially mitigate these long-term health risks, especially for individuals with larger childhood body size.

Oropharyngeal and oral cancers (OOC) represent a growing public health concern with significant long-term health and economic consequences. This study evaluated risk-adjusted dental utilization patterns and associated healthcare costs among patients with OOC in Medicare and commercially insured populations. Using the 2013-2024 Merative™ MarketScan® Research Databases, individuals with at least one medical claim for OOC were identified and matched 1:1 to non-OOC controls using propensity score matching. Analyses were stratified by insurance type (Medicare vs. commercial). Outcomes included frequency of dental visits, types of dental procedures, treatment modalities, and total annual healthcare costs. The prevalence of OOC was 67 per 100,000 among commercially insured and 397 per 100,000 among Medicare enrollees. Compared with controls, OOC patients were older and predominantly male (all p<0.01). OOC patients had significantly fewer annual dental visits than controls (2.79 vs. 2.98 [Medicare]; 2.81 vs. 3.20 [Commercial], all p<.0001). Restoration and periodontal treatments were the most common dental procedures. Surgical treatment alone was more frequent among OOC patients (20.1% Medicare; 15.6% Commercial). The risk-adjusted total annual healthcare burden was $22,984 for Medicare and $47,542 for Commercial OOC patients (p<.001). Despite higher medical costs and intensive cancer treatment, OOC patients had fewer dental visits, indicating a gap in survivorship care. These findings highlight the urgent need for integrated medical-dental care models and policies that enhance access to preventive and restorative dental services, potentially reducing complications, improving quality of life, and lowering healthcare costs among OOC survivors.

Syphilis, caused by Treponema pallidum, remains a significant public health concern globally. While early treatment can prevent the acute effects, syphilis has been linked to long-term neurological and cardiovascular complications. However, the magnitude of this association remains unclear. This meta-analysis aims to evaluate the association between syphilis and the incidence of neurological and cardiovascular diseases, providing a comprehensive overview of the long-term health risks associated with syphilis infection. We systematically reviewed and synthesized data from 14 clinical trials published through 2024. A total of 792 syphilis patients and 563 controls were included in the analysis of neurological outcomes, and 21,139 syphilis patients and 22,640 controls were analyzed for cardiovascular outcomes. A fixed-effect model was used due to low heterogeneity, assessed by I2 statistics. The meta-analysis found a significant increase in the incidence of neurological diseases in syphilis patients, with a mean difference of 2.53 (95% confidence interval: 1.78–3.59, P < .00001). Similarly, syphilis was associated with a higher risk of cardiovascular diseases, showing a mean difference of 2.85 (95% confidence interval: 2.64–3.07, P < .00001). Both analyses showed low heterogeneity (I2 = 0.53, P = .05 for neurological and I2 = 0.94, P < .00001 for cardiovascular outcomes). Syphilis is significantly associated with both neurological and cardiovascular diseases, highlighting the importance of early detection and treatment to prevent these long-term complications.

Mondays Really Are More Stressful: The start of the workweek can be a biologically measurable stressor, with consequences for long-term health that can stretch into retirement.

Mitochondrial dysfunction induced by E-cigarettes.

Symptoms persisting for more than three weeks after the diagnosis of Covid-19 are known as Post-Covid syndrome. The leading symptoms during Covid-19 are acute and the most of patients recover fully but a significant portion of patients are suffering from long-term health consequences. This study aimed to find out the variation and severity of Post-Covid syndrome. This cross-sectional descriptive study was conducted among adult population (age more than 18 years) from October 2022 to December 2022 residing in some selected villages in Chandina, Upazila of Cumilla, Bangladesh. Sample size was 335. Data were collected using a semi-structured questionnaire by face to face interview. The most common symptoms among the study population in post Covid-19 condition were fatigue 205(61.2%), followed by palpitation 161(48.1%), headache 149(44.5%), mental problem 142(42.4%), sleep disturbances 128(38.2%), anosmia 109(32.5%), abdominal pain 106(31.6%), respiratory distress 92(27.5%) and weight gain or loss 76(22.7%). A wide variety of clinical manifestations including fatigue, palpitation, dyspnea, headache, mental problem, sleep disturbances, anosmia and respiratory distress were the frequent post-covid-19 syndrome.

Integrated assessment of arsenic and pathogen contamination in surface waters impacted by mining activities and sewage discharge: challenges and strategies for water quality management and treatment.

Psychological intervention for postpartum depression: A systematic review and network meta-analysis.

Association of respiratory diseases with humidifier disinfectants exposure and its latency: A study of health damage reporter cohort in South Korea.

Uranium and thorium levels in urine and hair of coal miners and local residents in Shanxi, China.

Infertility is a growing global challenge, with ARTs significantly improving birth rates for infertile couples. However, ART conceptions are associated with a higher risk of negative obstetrical and perinatal outcomes, with potential long-term effects on offspring health. Many pre-implantation embryos exhibit abnormal morphokinetics, implantation failure, or arrested development. ART procedures and parental factors are suspected to perturb the embryonic transcriptome, potentially affecting molecular and epigenetic events during gametogenesis and early development. The timing and mechanisms of these perturbations remain unclear. Genome-wide transcriptomic misregulation in ART-conceived human pre-implantation embryos may provide important insights into observed differences between ART and naturally conceived offspring. This narrative review aims to explore how the transcriptome of the human pre-implantation embryo is influenced by parental characteristics, ART conditions, and embryonic factors, with the characterization of the temporal sequence of acquisition of lineage-specific markers at the blastocyst stage serving as a prerequisite. The primary objective is to compile changes in gene expression resulting from parental and intrinsic characteristics or from ART-specific interventions. A secondary aim is to identify common dysregulated molecular pathways across all factors studied. A comprehensive PubMed search (up to December 2024) was conducted to identify studies assessing transcriptomic profiles in human blastocysts. Studies were included based on parental infertility characteristics (e.g. age, polycystic ovary syndrome (PCOS), endometriosis, diminished ovarian reserve (DOR), sperm alterations, unexplained infertility (UI), and obesity), ART interventions (e.g. hormonal stimulation, IVM, IVF, culture conditions, and vitrification), and intrinsic embryo factors (e.g. morphology, ploidy, sex, and developmental arrest). Differentially expressed genes between different embryo groups were compared across studies, and Gene Ontology analysis identified common or specific pathways. Single-cell RNA sequencing data were used to map lineage-specific transcriptomic patterns in human blastocysts, categorizing expression changes by cell lineages (epiblast, primitive endoderm, and trophectoderm). Where human data on blastocysts were limited, animal studies or other cleaved stages were discussed. Maternal age was the most significant contributor to misregulated gene expression in human blastocysts, affecting metabolic and developmental processes. Variations in culture medium impacted cell cycle regulation, carbohydrate metabolism, and RNA biosynthesis. Blastocyst morphology mostly influenced metabolic process changes. Blastocyst aneuploidy induced significant changes in developmental pathways and pluripotency gene expression in the epiblast. Evidence on the effects of PCOS, endometriosis, DOR, sperm alterations, UI, and ART technologies remains limited. Dysregulated pathways commonly involve metabolic, cellular, reproductive, and developmental processes. Dysregulation of genomic imprinting and chromatin-modifier genes was also observed across at least two conditions. This review highlights the complexity of interpreting gene expression in human pre-implantation embryos due to diverse influences, including parental age, ART conditions, developmental stage, and embryo sex. ART procedures may have cumulative effects on the blastocyst transcriptome. Modifiable factors, such as culture conditions, offer opportunities for improving IVF outcomes. Epigenetic modifications may also be sensitive to these diverse influences and involved in observed transcriptomic changes, opening further research investigation to clarify long-term health effects. n/a.

Background: Among Indian adolescent girl’s anemia remains a major public health concern due to rapid growth, menstrual blood loss, and nutritional deficiencies. This systematic review and meta-analysis aim to assess the prevalence and severity of anemia among Indian adolescent girls. Methods: This review (2004–2024) integrated data from 32 studies (14,053 persons) from PubMed, Embase, and Scopus, adhering to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)/ Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Observational studies with the prevalence of anemia in Indian adolescent girls based on WHO criteria were included. The data was pooled using a random-effects model, and subgroup analyses were conducted by Indian region. Heterogeneity was assessed using the I2 statistic. Results: The pooled anemia prevalence was 65% (95% CI: 54%–74%), showed notable regional variations. The burden was highest in East India (81%; 39%–97%), then North India (65%), West India (61%), and South India (52%). The mean hemoglobin levels varied by region, ranging from 10.24 g/dL in the East to 11.20 g/dL in the South. Mild anemia (29%) and moderate anemia (25%) were more common than severe anemia (1%). The substantial heterogeneity (I2=98.7%) indicated differences in socioeconomic status, diet, and healthcare access. Conclusion: Anemia affects disproportionate number of Indian adolescents’ girls, particularly in the country's east, which highlights the need for context-specific interventions. The initiatives must be linked to national programs like Anemia Mukt Bharat to ensure equitable progress towards India's public health objectives and to avoid long-term health and developmental consequences.

This review article comprehensively evaluates recent studies investigating the potential effects of electromagnetic fields (EMFs) emitted from various sources on human health. The literature addresses the biological effects of electromagnetic radiation (EMR) originating both from mobile communication systems (mobile phones, base stations, wireless modems) and from low-frequency power transmission lines (50 Hz). Findings indicate that specific absorption rate (SAR) and power density values can exceed international limits under certain conditions; this situation may lead to outcomes such as DNA damage, oxidative stress, neurological disorders, adverse effects on reproductive health, and hearing loss. In addition, many studies have reported symptoms including headaches, sleep disturbances, fatigue, difficulty in concentration, and skin problems. These findings reveal the necessity for further experimental and epidemiological research to understand better the short- and long-term health effects of electromagnetic exposure. In conclusion, scientific investigation of different frequencies and exposure scenarios, comprehensive evaluation of biological effects, and raising public awareness on this issue will contribute to a clearer understanding of the impacts of electromagnetic radiation on health.

Background: Some patients suffer from persistent symptoms following a COVID-19 infection, referred to as long COVID. The aims of the study were to estimate the prevalence of long COVID and study its determinants in Tunisia. Methods: We conducted a nationwide cross-sectional study among a representative sample of COVID-19 survivors residing in Tunisia between June and August 2022. We selected a random sample, stratified by age and region, among residents registered in the national surveillance database with a SARS-CoV-2 positive test taken from September 2020 to September 2021 (n = 479,743). The expected sample size was 384. We defined a patient with long COVID as having at least one self-reported symptom persisting for more than four weeks after the first confirmation of SARS-CoV-2 infection (RT-PCR or Ag-RDT) and not explained by an alternative diagnosis. Trained healthcare workers interviewed consenting respondents by phone using a structured questionnaire. We described continuous variables using median and interquartile range (IQR). We measured the prevalence of long COVID and its 95% confidence interval (95% CI). We estimated the association between explanatory variables (socio-demographic, lifestyle and comorbidities, SARS-CoV-2 history infection, COVID-19 vaccination status) and long COVID using a log-binomial model, reporting adjusted prevalence ratios (a-PR) and its 95% CI. Results: Of 1094 persons contacted, 416 were enrolled (response rate: 38%). Long-COVID prevalence was 64% (267/416); 95% CI [59–69%]. The sex ratio (M:F) was 0.72. Age ranged from 1 to 101 years, with a median of 41 years (IQR:31–55 years). The most common symptoms were fatigue (63%), myalgia/arthralgia (33%), and cognitive symptoms (52%). Median duration of long-COVID symptoms was 11 months (IQR: 3–14 months). In multivariate analysis, experiencing acute COVID-19 (a-PR = 1.5; 95% CI [1.0–2.1]), being a woman of childbearing age (a-PR = 1.2; 95% CI [1.0–1.4]) and residing in the central region (a-PR = 1.5; 95% CI [1.1–2.0]) were significantly associated with a higher prevalence of long COVID. Conclusions: Long COVID is prevalent in Tunisia affecting patients with multiple symptoms initially, those residing in the central region and young women. We recommend to enhance healthcare access and medical follow-up both during and after the infection, focusing on identified risk groups. We also recommend to conduct further research to optimize management of long-COVID patients.

Despite growing evidence of the long-term mental health effects of adverse childhood experiences (ACEs), little is known about protective factors that buffer this relationship among older adults. This study examined personal (e.g., sense of mastery), interpersonal (e.g., social networks and family solidarity), and community (e.g., social cohesion) resources as potential moderators of the association between ACEs and depressive symptoms among older Korean Americans residing in affordable senior housing. Survey data from 315 residents (mean age = 79.4) revealed significant interactions between ACEs and both social networks and family solidarity: stronger social and familial ties buffered the adverse effects of ACEs on depressive symptoms. These findings suggest that close social and family connections serve as key coping resources rooted in Korean cultural values. The study underscores the importance of fostering relationships in senior housing programs that promote engagement, peer support, and family involvement for individuals affected by ACEs.

BackgroundHuman milk palmitic acid (PA) is mainly esterified at the sn-2 position of triacylglycerols, while infant formula contains palmitate predominantly in the sn-1/3 positions. Current evidence on long-term health effects of increasing sn-2 palmitate in formula remains insufficient. This study investigated the effects of high sn-2 PA formula (> 40%) on fecal saponified fatty acid, calcium, magnesium and stool characteristics in healthy full-term infants.MethodsIn this cluster-randomized controlled trial, healthy infants < 14 d were assigned to breastfeeding (BF group, n = 66), high sn-2 palmitate formula (sn-2 group, n = 66, 46.3% sn-2 PA) or low sn-2 palmitate formula (control group, n = 67, 10.3% sn-2 PA). Infant demographics, feeding status, stool characteristics, physical exams, and stool samples were collected at 6, 16, and 24 weeks. Per-protocol analysis was used.ResultsThe sn-2 group exhibited a significant time-dependent decline in fecal saponified PA and calcium over time (Ph for Trend < 0.001). The BF group declined faster than the sn-2 group (Padjusted for Group*Time < 0.001). Fecal saponified PA proportion in sn-2 group was significantly lower than controls at all timepoints. At week 24, fecal calcium was lower in the sn-2 group vs. control (0.9 vs. 1.3 mg/g, P = 0.010). No significant difference was found in stool frequency, consistency or size between sn-2 and control groups at any point.ConclusionInfant formula enriched with > 40% sn-2 palmitate reduces fecal fatty acid and calcium excretion, supports efficient lipid and calcium absorption, shows a fecal magnesium pattern similar to breastfed infants, but does not alter stool characteristics relative to the control formula.Trial registrationThe trial is registered at Chinese Clinical Trial Registry: ChiCTR1800014479; 30/Jan./2018.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12937-025-01248-9.

Background/Objectives: Beyond respiratory problems, COVID-19 can cause a variety of symptoms, such as neurological disorders caused by biological and psychological factors. Brain fog (BF), a post-illness cognitive impairment that many patients report, can be evaluated with reaction time (RT) testing. Response latency is measured by RT, which can be either simple (sRT) or complex (cRT). This study focuses on how COVID-19 affects cognitive function, with particular attention on RT changes, BF prevalence, and implications for daily life. Methods: The study included 599 participants from Bosnia and Herzegovina, Croatia and Serbia. RT was measured using PsyToolkit and participants completed a COVID-19-associated BF questionnaire. Participants who experienced BF after their latest COVID-19 infection rated its severity using a visual analogue scale (VAS). Additional clinical data were obtained from medical records. Results: BF was reported by 40% of participants post-COVID-19. Men reported it less frequently but found it more disruptive. RT progressively declined post-infection, reaching peak impairment at 15 weeks, following recovery, with RT normalizing by six months. Conclusions: COVID-19 is linked to temporary RT impairment, peaking at 15 weeks post-infection and resolving by six months, independent of BF presence. This study emphasizes the need for a biopsychosocial approach to BF management. Easily available RT assessments should be incorporated into routine clinical practice.