To assess the effectiveness of two different neck strengthening protocols at increasing isometric neck strength in male and female rugby players. Cluster randomised controlled trial. The team training facility of 3 amateur clubs. 142 male and female amateur rugby players were recruited to take part in the study. Isometric neck strength in flexion, extension, left and right side flexion, left and right rotation and sum of strength scores. Changes in neck strength were analysed for within-group and between group differences. Relative to the control group the male Band resisted group recorded the largest strength gain with statistically significant increases in sum of strength scores (p = 0.002), extension (p = 0.034), right flexion (p = 0.004), left rotation (p < 0.001) and right rotation scores (p < 0.001). The male Partner resisted group recorded improvements in left rotation (p < 0.001) and right rotation (p = 0.006). In the female band resisted group significant improvements in neck strength were recorded for sum of strength scores (p = 0.042), right rotation (p = 0.003) and left rotation (p = 0.005) however in the Partner resisted group significant improvements were recorded in right rotation only (p = 0.015). We have developed two time efficient and low cost neck strengthening protocols that demonstrate efficacy at enhancing neck strengthen in a team setting.
Syncope is a common clinical condition characterized by a transient loss of consciousness caused by temporary global cerebral hypoperfusion. Exercise-associated syncope is clinically important because it may reflect benign physiological mechanisms or represent the initial manifestation of a potentially life-threatening cardiovascular disorder. This narrative review examines current evidence on its epidemiology, pathophysiology, classification, diagnostic evaluation, differential diagnosis, and management. The reviewed evidence indicates that syncope occurring during exercise should be considered a high-risk presentation requiring prompt cardiovascular evaluation, whereas post-exercise episodes are more frequently associated with reflex mechanisms and impaired venous return. Initial assessment should include a detailed history, physical examination, orthostatic blood pressure measurement, and 12-lead electrocardiography, with echocardiography, exercise testing, ambulatory rhythm monitoring, or head-up tilt testing selected according to the suspected mechanism. Head-up tilt testing is most useful when reflex syncope remains suspected after the initial evaluation. A structured, risk-based diagnostic approach is therefore recommended to identify cardiac causes early while avoiding unnecessary testing in patients with likely benign syncope.
Wearable fabrics embedding crystalline semiconductor materials (e.g. germanium, silicon) are promising biomedical devices for their therapeutic potential in musculoskeletal disorders, including osteoarthritis, tendinopathies, and chronic pain, and for supporting tissue healing and regeneration. These fabrics exert their bioactive functions without applying mechanical pressure or drug delivery systems, offering a non-invasive and comfortable therapeutic alternative that operates through mild thermal stimuli at body temperature. Recent peer-reviewed literature on semiconductor-based wearable textiles, far-infrared-emitting biomaterials, bioelectric signalling in tissue repair, and their clinical application in musculoskeletal disorders. At body temperature, semiconductor-containing fabrics consistently emit far-infrared radiation, experimentally associated with improved microcirculation and modulation of inflammation. Limited clinical studies report improvements in pain and functional outcomes in chronic musculoskeletal conditions, with good tolerability during prolonged wear. Proposed mechanisms include thermally induced electron release, ion generation, and piezoelectric or piezoresistive activity during movement, but direct biological evidence remains limited. The specific contribution of far-infrared emission is difficult to distinguish from thermal or placebo effects. Advances in bioelectric signalling research and textile engineering provide a framework to investigate electroactive interactions between semiconductor fabrics and biological tissues. Well-designed randomized trials, quantitative characterization of emitted physical stimuli, and mechanistic cellular studies are needed to establish clinical efficacy and inform regulatory classification.
Sarcopenia in older adults has become a prominent public health challenge that jeopardizes their health and capacity for independent living. Characterized by the decline or loss of muscle mass, strength, and physical function, this condition leads to impaired activities of daily living and diminished quality of life in affected individuals. Conventional exercise interventions yield suboptimal improvements and suffer from low patient adherence. In contrast, functional training, which is designed to align with the daily living scenarios of older adults, can enhance their muscle strength, flexibility, coordination, and other physical capacities, thereby effectively ameliorating multiple physical functions in older adults with sarcopenia. This mini review synthesizes the mechanisms, benefits, and clinical implications of functional training across various physiological and functional systems in older adults with sarcopenia, and explores future research and development directions. It aims to provide a reference for the design and implementation of personalized and long-term intervention studies in this field.
Diabetes mellitus is an important public health challenge worldwide, particularly in low-resource settings where health literacy may be limited. This study assessed perceptions regarding the causes, symptoms, complications, and prevention of diabetes among adult market vendors in Butembo, Democratic Republic of Congo. A descriptive cross-sectional survey was conducted between March and April 2025 among adult market vendors recruited from seven major markets in Butembo, Democratic Republic of Congo. Data were collected using a pre-tested structured questionnaire administered face-to-face in French or Swahili using KoboCollect software and analyzed using descriptive statistics in IBM SPSS version 20. A total of 433 adults participated in the study. Among them, 334 (77.1%) reported having previously heard of diabetes and were included in the perception analyses. Commonly perceived signs of diabetes included weight loss (64.4%) and chronic fatigue (49.4%). High blood pressure (50.3%) and death (48.5%) were frequently perceived as complications. Healthy diet (49.1%) and regular exercise (37.4%) were commonly identified as preventive measures; however, some respondents also reported spiritual or cultural beliefs such as prayer (28.4%) and poisoning-related beliefs. Most respondents (73.7%) reported knowing someone with diabetes, while 52.1% stated that consulting a doctor would be the preferred response if diabetes was suspected. Participants demonstrated mixed perceptions regarding diabetes, combining biomedical explanations with cultural and spiritual beliefs. These findings highlight the importance of culturally adapted community health education interventions in Butembo.
BackgroundPhysical exercise is widely recognized for its cognitive benefits; however, the effect of menopausal status in modulating the cognitive effects of exercise is not definitively established.ObjectiveTo examine the cognitive benefits of two 6-month physical exercise programs in cognitively healthy older women across adulthood, and whether menopause status moderates these benefits.MethodsIn a post hoc analysis of a randomized controlled trial, 93 cognitively healthy women (aged 20-67; 43% at post-menopause) were assigned to either aerobic exercise (AE) or stretching/toning (ST) 4 days a week for six months. Neuropsychological assessment, cardiorespiratory exercise test, and blood draw were performed at baseline, 3-months, and 6-months. Linear mixed-effects regression models assessed whether menopausal status moderated the impact of exercise on executive functions and processing speed.ResultsSeventy-six participants (81.7%) completed the intervention. A time-by-group-by-menopause interaction emerged after 3 months (β = -0.89; p = 0.001) and 6 months (β = -0.67, p = 0.016). Post-menopausal women in the AE group showed greater improvement in executive functions compared to the ST group and pre-menopausal women. Models controlled for age, education, and baseline cognitive performance.ConclusionsOur results provide novel evidence that AE improves cognition with pronounced executive functions benefits in post-menopausal women, a population at higher risk for dementia. Since women are at a higher risk of developing Alzheimer's disease compared to men, these findings support AE as a relevant strategy to promote women's brain health. Although this is a secondary analysis, it may inform future exercise trials targeting women.
Women with gestational diabetes mellitus (GDM) are more likely to develop cardiovascular disease (CVD) within 3 to 10 years following pregnancy. Despite a return to normoglycemia shortly after gestation, GDM mothers still possess an increased risk of future CVD. In this study, we use a novel preclinical hormonal model of GDM to examine the mechanisms underlying future vascular and cardiac dysfunction in mothers with a history of GDM. We treated 16-week-old pregnant C57BL/6J mice with the insulin receptor antagonist (S961; 30nmol/kg, s.c.) from gestational day (GD) 7 (second trimester of pregnancy) until delivery to induce GDM. GDM mice developed systolic and diastolic dysfunction, arterial stiffness, hypertension, increased cardiac mass, and exercise intolerance at 10 weeks postpartum compared with saline-treated pregnant or S961-treated virgin mice. We also observed decreased plasma nitric oxide (NO) and increased endothelin-1 (ET-1) in GDM. The aorta of S961-induced GDM mice had increased pulse wave velocity, impaired vascular relaxation, remodeling, elevated reactive oxygen species (ROS) production and adhesion molecules, increased ET-1 type A receptor expression, and reduced sirtuin-1 (SIRT-1) expression. The left ventricle of S961-induced GDM mice exhibited fibrosis, thickness, and increased ROS production. Additionally, alterations in cardiac kinase activity in the nitric oxide/cyclic guanosine monophosphate/protein kinase G (NO/cGMP/PRKG) and AMP-activated protein kinase (AMPK) alpha pathways were observed at 10 weeks postpartum using novel Pamgene kinome technology. Thus, endothelin activation, suppressed NO/cGMP/PRKG signaling, impaired AMPK, and altered SIRT1 may be responsible for the development of vascular stiffness and cardiac dysfunction in mothers with a history of GDM.
This study aims to systematically evaluate the impact of exercise interventions on reproductive endocrine profiles in adult patients with polycystic ovary syndrome (PCOS) using a three-level meta-analytical approach. We performed a systematic search of PubMed, Web of Science, The Cochrane Library, and Embase for randomized controlled trials (RCTs) investigating the effects of exercise on reproductive endocrine profiles in PCOS patients, spanning from database inception through April 7, 2026. A three-level meta-analysis was conducted in R using a random-effects model fitted via restricted maximum likelihood (REML). Effect sizes were quantified as Hedges' g with 95% confidence intervals (CIs). Global heterogeneity was assessed using the Cochran's Q test, and the robustness of results was verified through leave-one-out sensitivity analyses. Model fit was compared using likelihood ratio tests (LRT). Publication bias was scrutinized via Egger's test, with the trim-and-fill method employed as a corrective measure where necessary. Methodological quality was appraised using the PEDro scale, and the certainty of evidence was graded via the GRADE profiler. Nineteen studies involving 1,018 participants were synthesized. Exercise interventions significantly lowered testosterone levels (g = -0.34; 95% CI [-0.61 to -0.07]; P = 0.0146). Subgroup analysis revealed that the "aerobic exercise" group was statistically significant (k = 14, g = -0.5120, 95% CI [-0.8230 to -0.2010], P = 0.0027). The mean body mass index (BMI) "25 to 29.9" group was also statistically significant (k = 17, g = -0.4859, 95% CI [-0.7775 to -0.1943], P = 0.0025), as was the mean age group of "26 to 30 years old" (k = 13, g = -0.4878, 95% CI [-0.8465 to -0.1290], P = 0.0105). In conclusion, exercise interventions exert a favorable impact on serum testosterone (T) levels in adult patients with polycystic ovary syndrome (PCOS). PROSPERO (registration no. CRD420251108464; https://www.crd.york.ac.uk/prospero/).
As a critical preclinical stage of type 2 diabetes (T2D), prediabetes necessitates urgent lifestyle interventions to halt disease progression. Despite robust evidence supporting the efficacy of exercise in improving glycemic control, exercise adherence remains suboptimal among individuals with prediabetes. This review aimed to identify barriers and facilitators to exercise adherence in individuals with prediabetes while also extracting evidence-based behavior change techniques (BCTs) that may enhance physical activity maintenance. Mixed-methods systematic review. A comprehensive literature search was performed in 10 databases from inception to November 2024. Guided by the JBI Manual for Evidence Synthesis, a convergent integrated approach was used to map barriers and facilitators to the Behavior Change Wheel (BCW) and Theoretical Domains Framework (TDF). TDF domains were ranked by frequency across studies, while adherence-promoting interventions were mapped to BCW intervention functions and BCTs. Barriers were systematically linked to BCW intervention functions and BCTs to guide implementation design. A total of 36 studies were included, consisting of 9 qualitative studies, 24 quantitative studies (15 randomized controlled trials, 5 cross-sectional studies, and 4 quasi-experimental studies), and 3 mixed-methods studies. The synthesis identified "lack of time," "lack of appropriate exercise equipment or venues," and "health-related physical limitations" as predominant barriers. Conversely, "perceived health benefits," "social support," and "tools or methods to help with exercise adherence" emerged as key facilitators. These factors were mapped to five primary TDF domains: reinforcement, environmental context and resources, behavioral regulation, social influences, and skills. Furthermore, seven intervention functions derived from the BCW were linked to 21 BCTs. This review highlights multifaceted determinants of exercise adherence in individuals with prediabetes and identifies theory-informed strategies to address barriers to adherence. Determinants supported more consistently across studies may provide a stronger basis for intervention development, whereas less frequently reported findings should be interpreted more cautiously. PROSPERO CRD42024605588. What helps or stops people with prediabetes from exercising, and how can we support them? Prediabetes is a condition where blood sugar levels are higher than normal but not yet high enough to be called type 2 diabetes. Exercising is one of the best ways to stop prediabetes from getting worse. However, many people find it hard to stick to an exercise routine. In this study, we looked at existing research to find out what stops people with prediabetes from exercising (barriers) and what helps them keep going (facilitators). We found that the biggest hurdles are a lack of time, not having the right equipment or places to exercise, and physical health problems. On the other hand, understanding the health benefits, getting support from friends and family, and using helpful tools make people more likely to exercise. To help people overcome these hurdles, we suggest creating personalized exercise plans. These plans should include specific techniques like setting clear goals, making action plans, and building social support. By using these simple strategies, doctors and nurses can better help people with prediabetes stay active, which may help reduce their risk of developing type 2 diabetes.
In 2026, applying for access to data is still more complex and challenging for researchers than it should be. To some extent, this is because access & usage policies are still largely mediated by humans, compounded by a lack of alignment between organisations as to how access processes and workflows are implemented, with little supporting machine-actionable information to improve the situation through automation. This not only degrades the researcher experience, it inhibits progress on federating infrastructures for data that is not completely open. Open Digital Rights Language (ODRL) has been around for over a decade but is now gaining significant traction in a number of arenas as a mechanism to address the problem of machine-actionable access, usage, and rights management more generally. The recent and rapid advent of agentic AI is now making rights management for digital objects a priority issue that can no longer be deferred. "Access" is one of the key planks in the Cross-Domain Interoperability Framework (CDIF) and builds out implementable specifications for the "A" in FAIR. This presentation outlines the work that the UK Data Service has so far undertaken to move ODRL from a standard to an implementable set of metadata, workflows, and tools. We also articulate in detail how this is not merely a simple exercise in translating prose licences to RDF but requires a deeper understanding of the context in which "Access" operates. We also describe how standards such as Data Use Ontology (DUO) and Data Privacy Vocabulary (DPV) complement ODRL within that context.
Pneumothorax is the presence of air in the pleural cavity, often resulting in respiratory distress and impaired lung function. Although clinical observations have shown that high intensity physical activity and frail state affect respiratory health, their causal role in pneumothorax development is unclear. This study is the first to use a two-sample Mendelian randomization method (TSMR) to investigate the causal relationship between physical activity and frailty and the risk of pneumothorax, with a view to providing new insights into the pathogenesis of pneumothorax and preventive strategies. Using Mendelian randomization (MR) analyses, we examined the potential causal relationship between physical activity, frailty, and the risk of pneumothorax. Genetic instrumental variables (IVs) for relevant exposure factors were selected from genome wide association studies (GWAS). The study was analyzed using five different methods, mainly using inverse variance weighted (IVW) to draw causal inferences. Sensitivity analyses were performed to ensure the validity of the MR results. Sensitivity analyses included the detection of horizontal pleiotropy, i.e., genetic variants affecting the outcome through pathways other than the target exposure, which may lead to biased causal inference. Heterogeneity between genetic instrumental variables was also assessed and used to detect variability in effect estimates, which may reflect violations of MR assumptions or differences between populations. Our analyses found that light DIY reduced the risk of pneumothorax, but did not identify a causal association between other levels of physical activity and pneumothorax. In addition, frailty index (FI) showed a positive association with the risk of developing spontaneous pneumothorax, and this causal relationship persisted after adjustment for body mass index (BMI) and light DIY. Sensitivity analyses further validate the robustness of our findings. Our findings support the ability of light DIY to reduce the risk of pneumothorax development. It also emphasizes the need for frail individuals to be more aware of the need to protect against pneumothorax in their daily lives. We encourage appropriate exercise to improve fitness and reduce the risk of pneumothorax.
暂无摘要（点击查看详情）
Evidence regarding driving-related outcomes in older professional drivers remains limited. This exploratory feasibility study aimed to evaluate the feasibility of implementing a force-vector-oriented Mat Pilates program in older professional drivers and to explore potential changes in functional performance and braking reaction time. A single-group prospective longitudinal study was conducted among older professional drivers (n = 49 eligible; n = 47 initiated intervention). Participants attended one supervised 50-min Mat Pilates session per week for 30 sessions. Assessments were performed at baseline (M1), after 15 sessions (M2), and after 30 sessions (M3). Outcomes included TUG, handgrip strength, cervical rotation, anterior reach, SPPB, five-repetition calf-raise time (s) endurance, and braking reaction time in a driving simulator. Repeated measure comparisons across M1, M2, and M3 were performed using the Friedman test, with Kendall's W reported as effect size. Analyses were conducted per protocol. Sixteen of 47 participants who initiated the intervention completed it (34.0%), with attrition primarily related to financial and logistical constraints. Statistically significant differences across time points were observed in mobility (TUG), lower-limb performance (SPPB) 4-m walking speed (m/s) and five-repetition calf-raise time (s), with lower times indicating better performance), cervical rotation (left), and anterior reach (p < 0.05). Handgrip strength showed no significant change. Braking reaction time showed a non-significant numerical reduction from 0.90 ± 0.11s at M1 to 0.83 ± 0.15s at M3 (p = 0.098). Exploratory findings were derived from a small per-protocol sample (n = 16) and should not be interpreted as evidence of intervention benefit. The force-vector-oriented Mat Pilates program was feasible to implement within this occupational context. Exploratory analyses identified changes in selected functional performance measures, including mobility and lower-limb performance; however, these findings should not be interpreted as evidence of effectiveness due to the single-group design, small per-protocol sample, and absence of a control group. No statistically significant change was observed in the braking reaction time.
The single leg squat test (SLST) is commonly used for visual movement assessment in subjects with lower extremity injuries. While current methods utilize ordinal rating categorization, adopting a visual analog scale (VAS) may offer potential advantages. The study aims to determine the intra-rater, inter-rater reliability, and validity of a visual analog scale (VAS) for rating the single leg squat test (SLST) in subjects with lower extremity injuries. 58 subjects with lower extremity injuries participated. Intra-rater reliability was assessed by a physical therapist at 1-week and 2-week intervals. Single session inter-rater reliability was assessed by two physical therapists. A 10 cm VAS was used to measure trunk lateral flexion, hip adduction, and dynamic knee valgus during the SLST. Intra-class correlation coefficients (ICC) assessed intra-rater and inter-rater reliability. Validity was assessed by comparing VAS scores to 2-D kinematic analysis. Intra-rater reliability was good at both 1 week (ICC = 0.81-0.92, MDC = 1.2-2.2 cm) and 2 weeks (ICC = 0.77-0.79, MDC = 2.7-3 cm). Inter-rater reliability was good to excellent (ICC = 0.78-0.93, MDD = 1-2.6 cm). The correlation between visual assessment and 2-D kinematic analysis was moderate to good (r = 0.66-0.78). Preliminary data indicate that VAS reliably and validly rates SLST in individuals with lower-extremity injuries, allowing calculation of minimal detectable change and minimal detectable difference to support clinical interpretation. The MDC and MDD values established for trunk lateral flexion, hip adduction, and dynamic knee valgus allows clinicians to objectively determine if scores between repeated measurement and two raters are different.
Advanced Glycation End (AGE) Product is produced by atypical metabolism when food is cooked at high temperatures in a short time, such as roasted foods, or when chemicals are added as in processed foods. Research on the association between AGE and breast cancer (BC) has been inconclusive. This multicenter case-control study investigated the relationship between serum AGE (sAGE), tissue AGE (tAGE), and dietary AGE (dAGE) and BC, considering physical activity (PA). The study included 44 hormone receptor-positive premenopausal BC patients and 42 controls. Data on diet and PA were collected using validated Persian questionnaires. sAGE and tAGE were measured using blood and tissue samples. The dAGE was 16,104.98 ± 6542.04 and 15,084.53 ± 5827.69 kilo-units/day, while PA was significantly lower in cases than controls (773.64 ± 829.92 vs. 1920.95 ± 2999.91 MET-minutes/week, p = 0.02). The mean sAGE was 626.11 ± 695.00 ng/mL in cases and 713.93 ± 829.67 in controls. tAGE was positive in 34.1% and 28.6% of cases and controls. We found no association between dAGE and BC or dAGE and sAGE or tAGE. PA was less in the BC group but unrelated to sAGE and dAGE. As we accounted for all relevant variables, our negative findings provide strong evidence against an association between AGEs in diet, PA, and BC.
Knee osteoarthritis (OA) is a leading cause of pain and disability worldwide, with cultural and lifestyle factors shaping its burden in different populations. In Saudi Arabia, the perspectives of both patients and healthcare professionals (HCPs) remain underexplored in understanding management approaches. This study aimed to explore patients' and HCPs' perspectives on management strategies for knee osteoarthritis in Saudi Arabia. A qualitative exploratory study was conducted using focus group discussions (FGDs). Participants included patients with knee OA and HCPs involved in knee OA management recruited from three hospitals within Riyadh's First Health Cluster. FGDs were conducted separately for patients and HCPs using a semi-structured interview guide. Discussions were audio-recorded, transcribed verbatim in Arabic, and translated into English using forward-backward translation. Data were analysed inductively using reflexive thematic analysis. A total of 58 participants (30 patients and 28 HCPs) were included. Five overarching themes were identified: (i) understanding and risk factors of knee OA, (ii) clinical versus lived experience, (iii) treatment and management priorities, (iv) education and self-management, and (v) barriers and facilitators to adherence. Healthcare professionals demonstrated a biomedical understanding of knee OA, whereas patients showed variable knowledge and uncertainty. Although both groups recognised obesity and physical inactivity as key risk factors, a gap existed between knowledge and behaviour. Patients reported broader impacts on daily life and psychological well-being, which HCPs emphasised less. Divergence in treatment priorities was observed, with HCPs emphasising exercise while patients relied more on pharmacological management. Barriers to adherence included limited understanding, low motivation, and constraints in the healthcare system, while facilitators included social support and perceived improvement. Knee OA management in Saudi Arabia is influenced by misalignment between clinical approaches and patient experiences, as well as cultural and system-level factors. Addressing these gaps through patient-centred, culturally tailored interventions and improved support for self-management may enhance adherence and outcomes.
To investigate whether adding visuo-vestibular exercises to standard manual therapy and exercise produces superior improvements in sensorimotor function, pain, balance, and functional disability in adults with chronic neck pain. This prospective, randomized controlled trial enrolled 58 adults with chronic neck pain (≥3 months) allocated to a manual therapy and exercise group (MtE; n = 29) or MtE plus visuo-vestibular exercises (MtE-VVE; n = 29). Both groups completed 12 supervised sessions over six weeks with a daily home exercise programme. Outcomes were assessed at baseline, 6 weeks, and 12 weeks, and included pain intensity (Visual Analog Scale [VAS]), upper extremity reaction time, computerized posturography, the Neck Disability Index (NDI), and cervical muscle endurance. Fifty-four participants (27 per group) completed the study. Both groups improved significantly across all outcomes (p < 0.001). At 12-week follow-up, the MtE-VVE group demonstrated superior outcomes: activity-related pain was reduced by an additional 2.00 cm (95% CI: 0.75-3.25; p = 0.005), bilateral reaction time improved by 1.70 s (p = 0.001), eyes-open mediolateral sway decreased by 0.50 mm (p < 0.001), NDI score was 6.30 points lower (95% CI: 3.42-9.18; p < 0.001), and cervical flexion and extension endurance improved by 12.00 s and 27.70 s, respectively (p ≤ 0.020). Adding visuo-vestibular exercises to standard manual therapy and exercise produces clinically meaningful and sustained improvements in activity-related pain, sensorimotor function, postural control, and functional disability in adults with chronic neck pain, and may be recommended as an effective adjunctive intervention.
Pre-diabetes is a well-known risk factor for diabetes, a major contributor to morbidity and mortality globally. Identifying patients at highest risk of developing diabetes facilitates early intervention. There is no consensus on diagnostic criteria, with no single modality or range shown to be most predictive of progression to diabetes. This systematic review and meta-analysis aimed to determine which single or combination biochemical test(s) and definition of pre-diabetes best predict progression to diabetes. Following primary screening of 11 980 papers from MEDLINE, Embase and Global Health, 40 original studies published between 2006 and 2024 looking at adults with pre-diabetes were included. Children, pregnant patient populations and groups with significant morbidity were excluded. Risk of bias was assessed with the JBI Critical Appraisal Checklist. Our meta-analysis demonstrated the highest risk of progression to diabetes in the impaired fasting glucose (IFG) 6.1-6.9 mmol/L group, with an HR of 9.0 (4.6 to 13.5). Descriptive statistics identified the combination of IFG 6.1-6.9 mmol/L + impaired glucose tolerance + HbA1c 6.0%-6.4% had the highest percent incidence of diabetes per year, at 15.2%. Generally, combination tests were associated with higher progression rates. Certain single and combination biochemical test combinations may allow better identification of patients with pre-diabetes likely to progress to diabetes. To our knowledge, this is the first systematic review evaluating all testing combinations of these categories in progression and comparing pre-diabetes states as defined by multiple guidelines. This study (PROSPERO CRD42022312640) did not receive funding.
The menopausal transition, accompanied by numerous life challenges, is characterised by significant hormonal fluctuations and various symptoms. This study investigates the intricate relationships among perceived stress, resilience, self-efficacy, and social support vs. negative life events and their combined impact on the psychosocial quality of life (QoL) in women across the menopausal transition. Cross-sectional data were gathered via an anonymous online survey of women aged 40-60 at various stages of the menopausal transition (premenopausal, n = 36; perimenopausal, n = 120; postmenopausal, n = 113), classified using STRAW+10 criteria, resulting in 269 valid responses. The survey included measures for negative life events, perceived stress, social support, resilience, self-efficacy, and menopausal-specific QoL. The study's path model regarded negative life events as an exogenous variable and perceived stress, social support, resilience, self-efficacy, and psychosocial quality of life as endogenous variables, whilst controlling for age and menopausal stage. Negative life events were significantly associated with lower social support (β = -.186) and resilience (β = -.182), higher perceived stress (β = .338), and poorer psychosocial QoL (β = .164). Perceived stress emerged as the strongest predictor of psychosocial QoL (β = .578). Resilience, social support, and self-efficacy were indirectly linked to better psychosocial QoL through their effects on stress reduction. The model explained 47% of the variance in psychosocial QoL and 41% in perceived stress. Perceived stress emerged as the central mediator linking negative life events to psychosocial QoL, with resilience, self-efficacy, and social support as indirect protective factors. Enhancing these modifiable factors through targeted interventions may improve well-being in women across the menopausal transition. Future longitudinal studies are needed to validate these findings.
Across the delivery of oral health care, whether in the halls of learning environments or the operatories of individualized clinicians, corporations, or even unverifiable private equity led acquisitions, ethics is largely seen as a theoretical exercise separate from the day-to-day realities of clinical practice. A call for relational ethics, not merely traditions' ethical principlism, is more than theoretical exercise or an intellectual inquiry. This call is quite literally coming from both inside and outside of the proverbial oral health house. In examining the absence of holistic community-centered commitments of principles such as veracity and justice, this article provides a framework for conceptualizing a reimagined professionalism across various domains of oral health care delivery. Anchored by truth-telling and anti-oppressive justice, the author explores educational practice and pathways, models of care delivery, barriers to optimal learning and clinical environments, while providing individualized and systemic recommendations for change, While the goals are robust, [re]building trust and shifting dentistry and oral health toward outcomes advancing real health equity is imperative for this hour. True ethical dental education and practice must move beyond individual behavior of patients and providers alike, toward systems of accountability, truth-telling, and community engaged partnership.