Currently, many studies have shown that there is a link between metabolic syndrome (MetS) and endometrial cancer (EC). However, there has been no systematic bibliometric analysis of related publications, which limits the comprehensive understanding of research trends and priorities. Our study makes up for this problem.

Through bibliometric analysis, this study aimed to reveal key research focus areas, developmental trends, and major contributors of EC and MetS.

The literature for this study was obtained from the Web of Science Core Collection (WoSCC) through August 31, 2024. We searched for EC and MetS using subject and free terms. Microsoft Office Excel 2016, CiteSpace, and VOSviewer software packages were used for bibliometric analysis, considering specific characteristics such as year of publication, country, institution, authorship, journal, references, and keywords.

A total of 367 publications were included. Annual publications exhibited exponential growth (R2 = 0.8282), indicatingsustained interest in the field. The United States (111 publications), China (80), and Italy (38) were the most productive countries. The University of California System led institutional contributions. Keyword co-occurrence and burst analysis revealed that obesity (occurrence: 113; link strength: 630), insulin resistance (112; 587), and polycystic ovary syndrome (83; 386) were the most frequent and interconnected research foci. Emerging trends, identified through keyword time-zone mapping (average citation year: 2015-2019), highlighted weight control and bariatric surgery as novel interventions. Journals with the highest impact included ∗Fertility and Sterility∗ (IF: 6.6) and ∗International Journal of Epidemiology (IF: 6.4).

This study conducted a preliminary bibliometric and visual analysis of the EC and MetS research literature, revealing trends, global cooperation models, fundamental knowledge, and emerging frontiers of EC and MetS. For over 30 years, research has mainly focused on the correlation between MetS and EC, disease factors, prognosis, prevention, and other aspects that have guiding significance for public health.

The role of isoflavones in breast cancer, particularly their relationship with inflammatory markers, remains underexplored. We hypothesized that higher intakes of soy and isoflavones are inversely associated with inflammatory markers in breast cancer survivors. This cross-sectional study included 432 breast cancer survivors (mean age: 52 years). We assessed dietary soy and isoflavone intake and measured plasma concentrations of isoflavones, high-sensitivity C-reactive protein (hsCRP), adiponectin, interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α. Generalized linear and logistic regression models were used to obtain adjusted least squares means (LSmeans) and odds ratios (ORs) for individual or combined (if associated with soy intake) inflammatory markers. Participants with higher soy and isoflavone intakes had lower hsCRP and IL-6 concentrations and higher adiponectin concentrations. The LSmeans (95% confidence intervals, CIs) of the lowest and highest quintiles of soy food intake were 0.71 (0.49, 0.96) and 0.52 (0.33, 0.73) for hsCRP (mg/L), and 0.42 (-0.08, 0.91) and -0.02 (-0.50, 0.46) for the combined scores of hsCRP and adiponectin. The OR (95% CI) comparing extreme quintiles of isoflavone intake was 0.43 (0.20, 0.94) for elevated hsCRP. When plasma isoflavone concentrations were examined in relation to the combined scores of hsCRP and IL-6, the OR (95% CI) comparing the extreme quintiles was 0.32 (0.12, 0.91). Our results suggest that dietary soy and isoflavone intake, as well as plasma isoflavone concentrations, are inversely associated with inflammatory markers in breast cancer survivors. These findings highlight the need for further research to better understand their clinical implications.

There is little evidence investigating the association between green space (exposure and inequality) and active transportation during the COVID-19 pandemic. This study focused on the spatial heterogeneity in trajectories of different transportation modes during the COVID-19 pandemic worldwide, as well as the association between green space exposure and inequality and active transportation during the COVID-19 pandemic from a global perspective.

This study was based on an ecological study design and used three different Apple Mobility indices (driving, walking and public transit) to evaluate the trajectories of different transportation modes during the COVID-19 pandemic in 299 cities across 46 countries. Green space exposure was calculated based on fine-resolution population and green space mappings. Green space inequality was calculated by incorporating the Gini index into the green space exposure (green space Gini index). The hot/cold spot analysis was used to explore spatial heterogeneity in trajectories of different transportation modes during the COVID-19 pandemic worldwide, while Gaussian spatial mixed models were used to model the association between green space exposure and inequality and active transportation.

The hot/cold spot analysis shows that there were spatial inequalities in the trajectories of different transportation modes worldwide during the COVID-19 pandemic. Results from Gaussian spatial mixed models showed that green space exposure was positively associated with the walking index (Coef.=46.82; SE=18.20), while green space inequality was positively associated with the walking index (Coef.=58.88; SE=26.87) and public transit index (Coef.=162.07; SE=80.16). Also, the effect of green space varied across city development levels, the stringency of policy and COVID-19 severity.

Our findings demonstrate the importance of sufficient city-scale green spaces to support active transportation, with important implications to help cities better prepare for future pandemics and support active transportation during non-pandemic times.

Pancreatic cancer patients' prognosis may be limited by two conditions, cachexia and sarcopenia. Resistance exercise and protein supplementation are safe non-pharmacological strategies that may increase or preserve skeletal muscle mass within this population. Therefore, the primary aim of this study is to examine the feasibility of a home-based virtually supervised resistance exercise intervention, with or without protein supplementation in pancreatic cancer patients initiating neoadjuvant chemotherapy. This intervention may also maintain skeletal muscle mass and improve plasma biomarkers associated with muscle tissue wasting, physical function and psychological measures.

We aim to recruit 45 patients with locally advanced pancreatic cancer initiating neoadjuvant chemotherapy. Patients will be randomized to receive either Resistance Exercise (RE) (n = 15), Resistance Exercise and Protein Supplementation (RE + PS) (n = 15), or Attention Control (AC) (n = 15). Patients randomized to RE or RE + PS will receive 16-weeks of home-based virtually supervised resistance exercise. The AC will receive a 16-week stretching program. Primary and secondary outcomes will be measured at baseline and after 16 weeks during study visits.

The REBUILD trial is the first randomized controlled trial that combines resistance exercise with daily protein supplementation during neoadjuvant chemotherapy in pancreatic cancer patients. Our novel home-based virtually supervised exercise intervention seeks to mitigate barriers to participation in this vulnerable population. Furthermore, results of this trial will address important research gaps associated with pancreatic cancer-related cachexia, a condition closely connected with poor prognosis and mortality.

Increasing evidence links the gut microbiome to carcinogenesis. Disruptions in estrogen regulation by the estrobolome-gut microbiota with estrogen-related functions-may promote breast cancer. However, precise information on estrobolome targets and their underlying mechanisms is limited. This review identifies relevant targets for measuring the estrobolome, focusing on enzymes and microbial taxa involved in processing estrogens, precursors, metabolites, and phytoestrogens, to facilitate the exploration of potential links to breast cancer. Evidence from breast cancer case-control studies is synthesized to assess alignment with these targets, highlight gaps in the evidence, and suggest new paths forward. Findings from case-control studies were heterogeneous and showed limited alignment with estrobolome targets, with only Escherichia coli and Roseburia inulinivorans identified as differentially abundant and functionally relevant between cases and controls. The lack of compelling evidence for estrobolome-specific mechanisms may reflect measurement challenges or may suggest that broader ecological changes in the microbiome, which influence a network of interacting mechanisms, are more influential for carcinogenesis. To clarify the estrobolome's role in breast cancer, future research should use advanced sequencing techniques and methods such as metabolomics and transcriptomics, while considering clinical and behavioral factors that may modify estrobolome mechanisms.

This study investigated how workplace culture may affect the development of lifestyle medicine (LM) programming in health systems to inform the successful growth of LM programs. No study has examined how the impact of workplace culture (shared knowledge, values and behaviours within an organisation) affects practitioners' abilities to engage in LM.

A cross-sectional, multiple case study investigation of the implementation of LM in five health systems was conducted by administering semi-structured in-depth interviews (n=45) from May 2022 to January 2023. Following the transcription of interviews verbatim, narrative reports depicting each health system's experience with LM were drafted and collectively reviewed by the research team who discussed emerging themes.

Five health systems across the USA that have implemented LM were selected based on diversity in size, location, payer model, and patient population.

Administrative leaders, physicians and other personnel involved in the LM programming from selected health systems were invited to participate.

The implementation of LM is facilitated when practices such as forming social groups, visually advertising LM and offering plant-based cafeteria items are present to support core values, such as trust, gratitude, collaboration and optimism.

LM implementation can be supported by health system clinicians and administrators striving to make their workplaces more supportive and synergetic so that they can take advantage of all available resources. Future research should further explore this relationship between cultural factors and resource availability.

Background/Objectives: Kinesiophobia, or the fear of movement, is a significant problem in the rehabilitation of patients after a stroke, especially in individuals with diabetes, who have an increased risk of health complications. The aim of the study was to validate the Tampa Scale for Kinesiophobia (TSK) for assessing kinesiophobia in the context of patients with diabetes complicated by stroke to ensure its adequacy and reliability in this specific group of patients. Methods: After considering exclusion criteria, 166 patients with type 2 diabetes after ischemic stroke, hospitalized in the neurological rehabilitation ward, were included in the analysis. A survey using the TSK was conducted in the study group. A reliability analysis of the questionnaire was conducted, and then exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to disclose the number of factors that characterize the study group. Results: The Cronbach's alpha value for the entire scale is 0.875. The value for all the questions on the scale was also above 0.86, so they are considered reliable. Removing any question does not increase the value of Cronbach's alpha or Guttman index. Based on the scree plot, two factors were identified. The first factor includes 12 items and forms a physical factor, while the second factor includes 5 items and forms a psychological factor. The fit of the two-factor model was checked using confirmatory factor analysis. The final two-factor model has an acceptable fit. All the factor loadings are statistically significant. The factor loadings range from 0.262 to 0.729 for the physical factor and from 0.543 to 0.822 for the psychological factor. Conclusions: The TSK is a reliable and valid tool for assessing the level of kinesiophobia in a group of patients with type 2 diabetes complicated by stroke. The results of the study using this tool may contribute to the development of more effective therapeutic strategies that take into account the specific physical and psychological needs of this group of patients.

The association between serum folate concentrations and the mortality of cancer remains unclear. We aim to investigate the association of serum folate concentrations with all-cause and cause-specific mortality among American adults with cancer.

This cohort study included 4535 patients with cancer from National Health and Nutrition Examination Survey (NHANES) 1999 to 2016 and NHANES III (1988-1994). Death outcomes were ascertained by linkage to National Death Index records through 31 December 2019. Cox proportional hazards model and two-piecewise Cox proportional hazards model were used to calculate hazard ratios and 95% confidence intervals for the associations between folate concentrations and the risk of mortality.

During a median follow-up of 37,792 person-years, there were 1998 all-cause deaths and 616 cancer deaths. Non-linear and L-shaped associations were observed between serum folate concentrations and the risk of all-cause and cancer mortality among patients with cancer. Notably, the mortality rates reached a plateau at 23.7 ng/mL for all-cause mortality and 23.57 ng/mL for cancer mortality. When folate levels fell below these thresholds, the risk of all-cause and cancer mortality decreased by approximately 2.1% (HR 0.979; 95% CI 0.969-0.989) and 3.6% (HR 0.964; 95% CI 0.948-0.981), respectively, with each unit increase in the folate concentration up to the thresholds.

Our study reveals that low serum folate concentrations are linked to an elevated risk of cancer mortality among individuals with cancer within a certain range and supplementation of folate in cancer patients to achieve specific serum folate level threshold (23.7 ng/mL) might reduce the risk of cancer mortality.

Diet, physical activity, and general lifestyle modifications are implicated in metabolic pathway prevention and may improve some chronic diseases such as metabolic syndrome. The aim of this study is to measure the effectiveness of a short-time nutrition restriction regime combined with a daily practice of physical and creative activities on metabolic syndrome parameters, inflammasome status, and the compliance of the patients to the proposed scheme.

This pilot study analyzed 95 volunteers who took part in a residential one-week lasting experimental lifestyle period. The program proposed was structured in a four-day detox nutrition based only on vegetable products derived from organic, biologic, synergic, and integrated farming, without animal proteins, fats, and simple sugars. These four days were followed by a three-day fasting or fasting-mimicking diet, consisting of one or two hypocaloric meals based on complex sugars, vegetables, oleaginous seeds, and only in some cases vegetable proteins. Finally, a three-day "weaning" period was administered. During the whole period, 95 participants were offered a daily postural physical activity and a creative activity program. The basal data of the participants were collected (T0). A medical evaluation was conducted to collect the personal and anthropometric data. During this basal evaluation (T0), height, waist circumference, waist-to-height ratio (WtHR), glycemic value, and blood pressure were collected and reevaluated at the end of the 10-day experience (T1).

The data were evaluated according to the three metabolic syndrome parameters (i.e., WtHR, glycemic value, and blood pressure). A significant improvement in the variables analyzed at the end of the program was observed.

This study revealed that a short integrated lifestyle program can influence some well-defined metabolic parameters and might decrease damage from metabolic syndrome.

Isoflavones are estrogen-like compounds found in plants and their health effects remain equivocal. We investigated dietary isoflavone intake and its associated factors in Korean breast cancer survivors, with a comparison to cancer-free women.

The usual dietary intake of breast cancer survivors (n = 981, mean age 52 yrs) in 9 hospitals between 2012 and 2019 was assessed using 3-day food records or food frequency questionnaires (FFQs). They were age-matched to 2,943 cancer-free women who completed FFQs as part of a nationwide study conducted between 2012 and 2016. We used the flavonoid database of common Korean foods and the Phenol-Explorer database to estimate isoflavone intake. The contribution of each food or food group to the total isoflavone intake was calculated. The adjusted least-squares means of dietary isoflavone intake according to lifestyle and clinical factors were calculated using generalized linear models.

Breast cancer survivors had a higher mean dietary isoflavone intake (23.59 mg/day) than cancer-free women (17.81 mg/day). Major food sources, including tofu, soybeans, and doenjang, contributed to over 70% of the isoflavone intake in both groups. When we estimated dietary isoflavone intake according to lifestyle characteristics, isoflavone intake increased with higher scores of adherence to the American Cancer Society dietary guidelines but decreased with increasing body mass index in both groups. Among cancer-free women, dietary isoflavone intake was higher among those who had never smoked and among dietary supplement users. Among breast cancer survivors, dietary isoflavone intakes did not vary with clinical characteristics, including time since surgery and estrogen receptor status.

Breast cancer survivors were more likely to consume isoflavones than age-matched cancer-free women. Dietary isoflavone intake was associated with healthy lifestyle characteristics in women both with and without breast cancer. Further research is needed to understand the role of the higher isoflavone intake among breast cancer survivors compared to cancer-free women on their prognosis.

Cancer is a fatal disease with a high global prevalence and is associated with an increased incidence of metabolic disorders. This study aimed to develop a novel metabolic prognostic system to evaluate the overall metabolic disorder burden in cancer patients and its relationship with their prognosis. The patients in this study were enrolled from the Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) project. The least absolute shrinkage and selection operator (LASSO) analysis was used to screen for indicators of metabolic disorders. Cox regression analysis was used to evaluate the independent association between indicators of metabolic disorders and mortality in patients. The Kaplan-Meier method was used to evaluate the survival of patients with varying burdens of metabolic disorders. Finally, nomogram prognostic models and corresponding calculators were constructed and evaluated using the areas under the receiver operating characteristic curves (AUC), decision curve analysis (DCA), and calibration curves. Five of the 19 hematological indexes, including hemoglobin, neutrophils, direct bilirubin, albumin, and globulin, were selected as the evaluation indicators of metabolic disorder burden and independent risk factors for prognosis in cancer patients. Patients with a higher metabolic disorder burden had poorer survival rates. The AUC of the 1-year, 3-year, and 5-year overall survival of the prognostic nomogram was 0.678, 0.664, and 0.650, respectively. DCA and calibration curves indicated that the clinical benefit rate of metabolic disorder burden prognostic markers was high. Patients with a higher metabolic disorder burden had poorer survival rates. The nomogram and corresponding calculator can accurately evaluate the metabolic disorder burden and predict the prognosis of patients with cancer.

An increasing number of studies in recent years investigate various dietary and lifestyle patterns and associated breast cancer (BC) risk.

This study aimed to comprehensively synthesize and grade the evidence on dietary and lifestyle patterns and BC risk.

Databases were systematically searched up to 31 March, 2022, for evidence from randomised controlled trials and prospective cohort studies on adherence to a dietary pattern alone or in combination with lifestyle behaviors and incidence of or mortality from primary BC in adult females. Findings in all, premenopausal, and postmenopausal females were descriptively synthesized instead of meta-analyzed due to patterns heterogeneity. An independent Global Cancer Update Programme Expert Panel graded the strength of the evidence.

A total of 84 publications were included. Results for patterns reflecting both a healthy diet and lifestyle were more consistent than for patterns that included diet only. There was strong-probable evidence that a priori World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and American Cancer Society (ACS) dietary and lifestyle scores may reduce BC risk in all and postmenopausal females, whereas in premenopausal females, less evidence was found contributing to limited-suggestive grade. There was also a limited-suggestive evidence that adherence to the Healthy Lifestyle Index and other diet and lifestyle scores may reduce BC risk in postmenopausal females; a posteriori Western/Meat/Alcohol dietary patterns may increase BC risk in postmenopausal females; and Prudent/Vegetarian/Mediterranean dietary patterns may reduce BC risk in all females. For the remaining patterns, evidence was graded as limited-no conclusions.

Advice to adopt combined aspects of a healthy diet and lifestyle according to WCRF/AICR and ACS scores, encouraging a healthy weight, physical activity, alcohol and smoking avoidance, and a healthy diet rich in fruits, vegetables, (whole)grains and cereals and discouraging red and processed meat, can be proposed to females to lower BC risk. This review was registered at PROSPERO as ID CRD42021270129 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021270129) on 28 August, 2021, and further updated on 4 May, 2022, in order to extend the search period.

This study aimed to clarify the physical activity level of patients with upper gastrointestinal cancer during outpatient chemotherapy and the factors associated with decreased physical activity levels after drug administration.

In this cross-sectional study, activity intensity and steps were measured using an accelerometer in 39 patients with upper gastrointestinal cancer for 1 week before and after drug administration. Furthermore, the participants responded to a questionnaire on their lifestyles.

No significant differences in steps and activity intensity were found before and after drug administration, and many participants had low activity levels. Logistic regression analysis showed that the Geriatric 8 scores and domestic roles were positively associated with higher activity levels after drug administration, whereas total bedtime showed a negative association. A predictive score for low activity was calculated from the three associated factors, and receiver operating characteristic analysis was conducted, resulting in an area under the curve of 0.90.

Physical activity may be low in patients with upper gastrointestinal cancer during outpatient chemotherapy. To maintain and promote physical activity, the results suggest the need to predict those who become less active after treatment and to support them by focusing on their domestic roles and total bedtime while considering their general condition. Our newly proposed predictive score can objectively identify patients with lower physical activity, regardless of the nurse's experience and ability, and improve patients' support during chemotherapy, even in the limited time available as outpatients.

Breast cancer is the most common cancer among women globally, and it negatively impacts diet and quality of life, increasing the risk of recurrence. Adhering to World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) lifestyle guidelines, such as healthy eating habits and nutritional status, can help in primary and secondary cancer prevention. However, no questionnaire was found for self-assessment of these guidelines for the Brazilian population. The aim of this study is to carry out content validity, pilot, and usability testing of the self-administered digital instrument "PrevCancer" assessing adherence to the WCRF/AICR recommendations in Brazilian female breast cancer survivors.

We conducted a psychometric study that involved the development of an instrument based on WCRF/AICR recommendations. Assessment of content validity involved the Content Validity Index (CVI) based on expert assessments (n = 7). The pilot study involved the System Usability Scale (SUS) after applying the developed instrument (n = 65) and anthropometric assessment for convergent validity by female participants (n = 55). The final usability test consisted of evaluating the satisfaction with the instrument of women with breast cancer (n = 14).

The "PrevCancer" instrument demonstrated good content (CVI = 1.0) as well as good usability and acceptability in the pilot study (mean SUS score = 88.1). The convergent validity stage demonstrated positive associations between the PrevCancer parameters and anthropometric parameters (p < 0.001). In the final usability study (mean SUS score = 90.3), participants' receptivity to the instrument was excellent.

The PrevCancer instrument had valid content and great usability by the target population, proving to be a useful tool for future cancer research.

Currently, in Australia, 1 in 8 women are diagnosed with breast cancer. A common adjuvant treatment for breast cancer is radiation therapy (RT). The amalgamation of side effects caused by RT treatment can ultimately affect a patient's quality of life (QoL). With increasing breast cancer survival, a greater focus on the non-lethal consequences of this disease and its treatment is warranted. Exercise and nutrition have proven beneficial in promoting and supporting overall health and managing chronic diseases. Furthermore, exercise has demonstrated improvement and sustainment to QoL. The focus of this scoping literature review was to determine the scale of evidence regarding the effectiveness of exercise and/or nutritional interventions for women with breast cancer receiving radiation therapy. An online search of five databases was conducted to identify studies published between 2000 and 2023. The 58 studies included in the scoping review comprised 46 interventions and 4615 women with breast cancer who received radiation therapy participated. Most studies (90%; n = 52) were 'exercise only' based, 3% (n = 2) were 'nutrition only', and the remaining 7% (n = 4) of studies were combined exercise and nutrition interventions. The findings from this review highlight most studies are dedicated to investigating exercise. Further research is required to fully understand the potential benefits of these interventions and their synergistic impact on the quality of life of women with breast cancer receiving radiation therapy.

Ovarian cancer remains a significant public health concern for women despite advancements in cancer management. Despite comprising only 2.5 % of cancers in women, ovarian cancer ranks as the fifth leading cause of cancer-related deaths among women, with patients frequently receiving late diagnoses. Chemotherapy, a primary treatment, frequently causes chemotherapy-induced peripheral neuropathy (CIPN), affecting over 60 % of patients and leading to severe sensory, motor, and autonomic nerve impairments. This often necessitates dosage reduction or discontinuation of treatment, thereby increasing mortality. While CIPN's impact on patients is well-documented, there is a paucity of knowledge of how structural and intermediary social determinants of health factors (SDOH), such as socioeconomic and political context, material circumstances such as living and walking conditions, area deprivation, and food availability, affect CIPN severity. The aim of this article was to explore the association between various SDOH and CIPN severity in ovarian cancer, identifying potential research gaps and future research directions. This article seeks to inform targeted interventions to mitigate CIPN's impact by elucidating these associations.

Oxidative stress has emerged as a key contributor to numerous NCDs (non-communicable diseases), including cardiovascular diseases, cancer, and diabetes. This study aims to explore the potential of targeted interventions to mitigate oxidative stress as part of a primary prevention strategy.

The study included 32 healthy participants (11 men, 21 women) aged 45-65 who completed both the initial and follow-up assessments of the Healthy Days Initiative, a community-based wellness program organized by the non-profit Associazione O.R.A. ETS. Through blood analysis, vital sign assessment, lifestyle questionnaires, and individualized recommendations, participants received guidance on improving their health and reducing disease risk. The initiative also offered the opportunity for participants to consume a flavonoid supplement containing quercitrin, rutin, and hesperidin, with the goal of reducing oxidative stress. Participants who opted for supplementation were instructed to take 1-2 tablets daily for two weeks. Data collected included demographic information, anthropometric measurements, vital signs, dietary and lifestyle habits, medical history, WHO-5 Well-Being Index scores, and blood parameters.

Significant reductions were observed in glucose levels (from 82 to 74.5 mg/dL), reactive oxygen metabolites (d-ROMs) (from 394.5 to 365.5 U.CARR), and systolic blood pressure (from 133 to 122 mmHg) after the two-week flavonoid intervention. Most participants (26/31) reported no side effects, and the majority (30/31) expressed a willingness to continue using a product combination of quercitrin, rutin, and hesperidin or a similar product long-term.

While limited in scope and duration, the PREVES-FLAVON study contributes valuable insights to the growing body of evidence suggesting that flavonoid supplementation may play a significant role in reducing risk factors associated with NCDs in primary prevention settings. By targeting novel risk factors such as oxidative stress, this intervention holds promise for mitigating the global burden of NCDs and promoting healthy aging.

Plants encounter numerous adversities during growth, necessitating the identification of common stress activators to bolster their resistance. However, the current understanding of these activators' mechanisms remains limited. This study identified three anti-stress activators applicable to apple trees, all of which elevate plant proline content to enhance resistance against various adversities. The results showed that the application of these sugar substitutes increased apple proline content by two to three times compared to the untreated group. Even at a lower concentration, these activators triggered plant stress resistance without compromising apple fruit quality. Therefore, these three sugar substitutes can be exogenously sprayed on apple trees to augment proline content and fortify stress resistance. Given their effectiveness and low production cost, these activators possess significant application value. Since they have been widely used in the food industry, they hold potential for broader application in plants, fostering apple industry development.

Obesity and colorectal cancer are global public health issues, with the prevalence of both conditions increasing over the last 4 decades. In the United States alone, the prevalence of obesity is greater than 40%, and this percentage is projected to increase past 50% by 2030. This review focuses on understanding the association between obesity and the risk of colorectal cancer while also highlighting hypotheses about molecular mechanisms underlying the link between these disease processes. We also consider whether those linkages can be disrupted via weight loss therapies, including lifestyle modifications, pharmacotherapy, bariatric surgery, and endobariatrics.

Cancer and heart failure (HF) are increasingly relevant worldwide, both from an epidemiologic and clinical point of view. This review aims to explore the relationship between cancer and HF by underscoring risk factors and disclosing the cardiotoxic effects of the current chemotherapy agents. We also deal with the current evidence on the diagnosis and management of HF related to cancer therapy. Finally, we will address the main gaps in knowledge and future perspectives in this field.

Although physical activity (PA) has a profound impact on health, many college and university students are still physically inactive. There is some evidence to suggest that social support (SS) could impact the PA levels of students, but the internal relationship and specific effects are not very clear. The purpose of this review was to determine the strength of the relationship between SS and PA and examine whether any potential associations differed in terms of age, gender, and region among college and university students. Studies were identified using the following electronic databases: PubMed, SPORTDiscus, Web of Science, and Sociological Abstracts. Moderator analyses investigating the effects of students' age, gender, and region (nation) were performed. This review included 19 articles. The results showed total SS was significantly associated with PA (r = 0.30, 95% confidence interval [CI]: [0.22, 0.37], p < .001). With respect to different types of support, friend support was more strongly associated with PA than family support. Gender factors had a significant moderating effect on the correlation between SS and PA (QM = 17.433, p < .001). Separate analyses examining the moderating effects of gender (percentage of females) found that the association between SS and PA was stronger with the increase in female percentage. In conclusion, SS is an important factor associated with PA levels and should foster SS within intervention programs according to types of SS and gender differences to increase PA levels among college and university students.

Although there are many reported benefits of physical activity for patients with cancer (e.g., improving quality of life), many patients with cancer do not meet the recommendations of physical activity guidelines. The amount of physical activity declines after diagnosis of cancer. This study aimed to clarify the elements that contribute engagement in regular moderate-or-higher-level intensity of physical activity (MHPA), based on the Health Action Process Approach (HAPA), among patients with cancer.

Two web surveys were conducted among cancer outpatients, asking them to respond to a questionnaire. Participants provided information regarding their demographics, physical activity, purpose, advantages, disadvantages, barriers, triggers, and need for support for regular MHPA.

Categories were obtained for purposes, advantages, disadvantages, barriers, triggers, and support needs for regular MHPA. For example, the support they considered necessary to regularly engage in MHPA were developed 9 categories, such as Improving the environment, Support for the implementation of PA (interpersonal), and Reducing the burden. Women and younger patients provided more statements about reducing their burden; younger patients also mentioned on improving the environment more among those who did not engage in MHPA. Additionally, patients with cancer who provided statements about interpersonal support reported higher barriers to physical activity.

These findings will contribute to the development of a scale to measure the components of the HAPA on physical activity in patients with cancer. In addition, it will help develop a support system that promotes engagement in regular MHPA.

Low socioeconomic status has been linked to increased mortality. However, the impacts of poverty, alone or combined with health behaviors, on mortality and life expectancy have not been adequately investigated.

Data from the Southern Community Cohort Study was used, including nearly 86,000 participants recruited during 2002-2009 across 12 US southeastern states. Analysis was conducted from February 2022 to January 2023.

During a median follow-up of 12.1 years, 19,749 deaths were identified. A strong dose-response relationship was found between household incomes and mortality, with a 3.3-fold (95%CI=3.1-3.6) increased all-cause mortality observed for individuals in the lowest income group (<$15,000/year) compared with those in the highest group (≥$50,000/year). Within each income group, mortality monotonically increased with declining healthy lifestyle score. Risk was significantly lower among those in the lowest income but healthiest lifestyle group, compared to those with the highest income but unhealthiest lifestyle (HR=0.82, 95%CI=0.69-0.97). Poor White participants appeared to experience higher all-cause mortality than poor Black participants. Life expectancy was more than 10.0 years shorter for those in the lowest income group compared with those in the highest income group.

Poverty is strongly associated with increased risk of death, but the risks could be modestly abated by a healthier lifestyle. These findings call for a comprehensive strategy for enhancing a healthy lifestyle and improving income equality to reduce death risks, particularly among those experiencing health disparities due to poverty.

Natural products are being developed as possible treatment options due to the rising prevalence of cancer and the harmful side effects of synthetic medications. Arctiin is a naturally occurring lignan found in numerous plants and exhibits different pharmacological activities, along with cancer. To elucidate the anticancer properties and underlying mechanisms of action, a comprehensive search of various electronic databases was conducted using appropriate keywords to identify relevant publications. The findings suggest that arctiin exhibits anticancer properties against tumor formation and various cancers such as cervical, myeloma, prostate, endothelial, gastric, and colon cancers in several preclinical pharmacological investigations. This naturally occurring compound exerts its anticancer effect through different cellular mechanisms, including mitochondrial dysfunction, cell cycle at different phases (G2/M), inhibition of cell proliferation, apoptotic cell death, and cytotoxic effects, as well as inhibition of migration and invasion of various malignant cells. Moreover, the study also revealed that, among the various cellular pathways, arctiin was shown to be more potent in terms of the PI3K/AKT and JAK/STAT signaling pathways. However, pharmacokinetic investigation indicated the compound's poor oral bioavailability. Because of these findings, arctiin might be considered a promising chemotherapeutic drug candidate.

E-waste -the aftermath of large amount of electrical and electronic equipment ferried into Africa from which Nigeria receives a significant chunk, is composed of components known to be hazardous to health. Composition of series of heavy metals (HMs) in e-waste is traceable to many health conditions including cancer which is hitherto incompletely understood. This study harmonizes primary data on HMs from e-waste in different Nigerian environmental media including the air, soil, surface dust, water and plant. We estimated the possible health implications, single and aggregative soil and water pollution indices both in adult and children categories, carcinogenic and non-carcinogenic risks secondary to HM exposure and mapped out the possible mechanism of carcinogenesis. Analysis showed that soil, water, surface dust and plant matrices in Nigerian environment are variedly but considerably contaminated with combination of HMs. The significantly high values of the hazard quotient and hazard index of both water and surface dust matrices are indicative of adverse health effect of the non-carcinogenic risk. The highest HQ is generated by Pb and Cr through dermal exposure to soil and surface dust with mean values of 1718.48, 1146.14, 1362.10 and 1794.61 respectively among Nigerian children followed by the oral exposure. This pattern of observation is similar to that obtained for adult category. HI due to Pb and Cr in soil constitutes the highest HI (2.05E+03 and 1.18E+03 respectively) followed by surface dust. However, this study precipitates the observation that children are more at health risk than adults in contaminated environment. Carcinogenic risk also follows the same pattern of expression in the Nigerian environment. We conclude that exposure to e-waste poses significant carcinogenic and non-carcinogenic health risks and the induction of toxicity may be mediated via DNA damage, oxidative stress and inflammatory/immune cells dysfunction in Nigerian environment.

Although exercise has been shown to improve cancer survivorship in other communities, cancer exercise studies among Native American communities are rare. We sought to adapt a Navajo-tailored cancer exercise pilot program to serve a broader Native American cancer community.

Tribal experts representing 10 different Tribal Nations were engaged in small focus groups (n = 2-4) to assess program materials for cultural appropriateness and adaptation to expand tribal inclusiveness. Facilitated by a trained Native American interviewer, focus groups were provided a primer survey and then reviewed intervention materials (protocols, incentives, logo, flyers, etc.). Consensus was reached by the research team on all program adaptations.

The program name, Restoring Balance, layout, graphics, and symbols were considered culturally appropriate overall. Program exercises and biomarker measurements were viewed as valuable to health improvements in the community. Important color, linguistic, and logistic program modifications were recommended to improve cultural alignment. The order of incentive items was revised to highlight restoration and the logo rotated to align with the four corners of the earth, an important cultural element. Linguistic modifications primarily related to prior traumatic research experiences in Native American communities where data had been taken without adequate community benefit or permission. Program emphasis should be on nurturing, added value and giving.

The methodology used for cultural expert review was successful in eliciting adaptations to expand the tribal inclusiveness of Restoring Balance. Culture, as well as historically traumatic research experiences, among Native American populations must be considered when adapting health promotion programming.

Individuals diagnosed with a chronic oral disease that increase the risk of mouth cancer, such as oral epithelial dysplasia (OED), require appropriate knowledge to make informed decisions. The present study aimed to assess whether patient information needs of a group of patients concerning dysplasia were met and to what degree clinicians agree with patients on 'important' topics.

This represented secondary analyses of a cross-sectional study to assess the information needs of 86 patients diagnosed with dysplasia compared with those of 77 clinicians using the validated OED Information Needs Questionnaire. Descriptive, concordance and regression analyses were performed for the collected data.

The mean and median total scores for all items in the amount of information received subscale were 2.33 and 2.44, indicating overall unmet needs concerning dysplasia. Clinicians were generally able to predict topics of greatest importance to patients, although their scores were mainly lower than those of patients (k = 0.06). There was a higher agreement between patients (k = 0.25) than clinicians (k = 0.09).

Clinicians are encouraged to assess a patient's information needs to ensure tailored and patient-centred communication concerning OED during all clinical consultations.

Colorectal cancer (CRC) is one of the most common cancers and is currently the third leading cause of cancer-related deaths worldwide. This study aimed to evaluate whether the dietary approach to stop hypertension (DASH) and Mediterranean (MED) diets are associated with CRC in Iranian adults.

This hospital-based case-control study was conducted on 71 cases and 142 controls (40-75 years old) in three general hospitals in Tehran, Iran. The dietary intakes of individuals were collected through face-to-face interviews using a semi-quantitative food frequency questionnaire (FFQ) that included 125 food items. The DASH and MED diet scores were calculated according to food items based on guidelines. Two logistic regression models were applied to evaluate the association between DASH and MED score adherence.

After adjusting for confounding factors, a negative association between DASH diet adherence and CRC risk was observed in the second and last tertile compared to the first tertile (T) (T2: odds ratio (OR) = 0.33; 95% confidence interval (CI): 0.14-0.77 - T3: OR = 0.09; 95% CI: 0.03-0.27). There was no significant association between the MED diet and the risk of CRC.

In conclusion, the current study's findings presented that adherence to a DASH diet could reduce the odds of CRC.

This study aimed to examine the association between dietary patterns, lifestyle factors, and colorectal cancer (CRC) risk among the Malaysian population.

We recruited 100 patients and 100 controls from two selected government hospitals. Principal component analysis was used to identify dietary patterns using a 123-item semiquantitative food frequency questionnaire. Tobacco smoking and alcohol consumption questionnaires were modified from the WHO STEPS Survey questionnaire. Physical activity levels were assessed using the revised Global Physical Activity questionnaire. Associations between dietary patterns, lifestyle factors and CRC risk were assessed using logistic regression with SPSS version 24.0.

Three dietary patterns were derived from factor analysis: i) vegetables; ii) meat, seafood and processed food; and iii) grains and legumes. High vegetable diet intake was independently and significantly associated with an 81% decreased risk of CRC (odds ratio [OR]: 0.19; 95% confidence interval [CI]: 0.08, 0.46). Both recreational-related physical activity (OR: 2.04; 95% CI: 1.14, 3.64) and vigorous physical activity (OR: 2.06; 95% CI: 1.13, 3.74) are significantly associated with decreased risk of CRC. Increasing the number of cigarettes smoked (≥ 16 cigarettes) per day significantly increased the odds of developing CRC (OR: 2.58; 95% CI: 1.95, 6.75). The duration of alcohol consumption cessation was inversely associated with CRC risk (OR: 2.52; 95% CI: 2.30, 10.57).

The protective effects of a fruit and vegetable diet, and a healthy lifestyle can be used to develop interventions that help reduce the risk of CRC in the Malaysian population.

Pain is one of the most prevalent and long-term adverse effects described by people who have undergone breast cancer surgery. Non-helpful perceptions and thoughts about pain may contribute to the transition of acute to persistent pain. Adding educational interventions to the current physical therapy program in this population may help to improve or prevent persistent pain. Pain neuroscience education (PNE) is a type of educational intervention that addresses the experience of pain in a broader sense by explaining pain not only from a biomedical perspective, but also from a psychological and social perspective. A double-blinded randomized controlled trial (EduCan trial) investigated whether PNE, in addition to a standard physiotherapy program immediately after surgery for breast cancer, was more effective on somatosensory functioning in the short (4 months postoperatively) and long term (18 months postoperatively), than providing a biomedical explanation for pain. Somatosensory functioning was evaluated using a self-reported questionnaire as well as a comprehensive quantitative sensory testing evaluation. The findings of this study revealed that adding six sessions of PNE to a standard physical therapy program (n = 184) did not result in a significantly different course of somatosensory functioning up to 18 months postoperatively as compared to biomedical pain education. These findings provide an interesting basis for future research into who should receive PNE after surgery for breast cancer (e.g., patient profiling or phenotyping) and how we can tailor it to the individual to increase its effectiveness.

The most common cancer in Thailand is colorectal cancer (CRC). A lack of knowledge and misleading information from social media have contributed to cancer deaths from malnutrition. A web application is a tool that provides easy access to scientific nutritional information via an online platform. In this study, our goal was to compare the nutritional status of CRC patients using different nutrition-based educational tools with nutrition counseling, namely the Nutrition Educational Prototype based on Smartphone Web Applications (NEPSA) and standard hospital leaflets. Anthropometric and biochemical analyses and a dietary assessment, especially calories and protein, were measured during three visits. This study finally included 28 CRC patients who were undergoing chemotherapy and malnutrition with a body mass index (BMI) of <20 kg/m2. Thirteen participants received NEPSA while the remaining fifteen participants received a standard hospital leaflet. The results showed that NEPSAs improved nutritional outcomes by encouraging weight gain, increasing BMI, hemoglobin, hematocrit, and albumin levels, and consuming more calories and protein. NEPSA should be implemented to enhance the nutrition outcomes from anthropometric, biochemical, and dietary perspectives from nutrition advice among CRC patients. There could be positive impacts at the national level regarding equal accessibility to Thailand's nutrition information.

To assess the efficacy of various machine learning (ML) algorithms in predicting late-stage colorectal cancer (CRC) diagnoses against the backdrop of socio-economic and regional healthcare disparities.

An innovative theoretical framework was developed to integrate individual- and census tract-level social determinants of health (SDOH) with sociodemographic factors. A comparative analysis of the ML models was conducted using key performance metrics such as AUC-ROC to evaluate their predictive accuracy. Spatio-temporal analysis was used to identify disparities in late-stage CRC diagnosis probabilities.

Gradient boosting emerged as the superior model, with the top predictors for late-stage CRC diagnosis being anatomic site, year of diagnosis, age, proximity to superfund sites, and primary payer. Spatio-temporal clusters highlighted geographic areas with a statistically significant high probability of late-stage diagnoses, emphasizing the need for targeted healthcare interventions.

This research underlines the potential of ML in enhancing the prognostic predictions in oncology, particularly in CRC. The gradient boosting model, with its robust performance, holds promise for deployment in healthcare systems to aid early detection and formulate localized cancer prevention strategies. The study's methodology demonstrates a significant step toward utilizing AI in public health to mitigate disparities and improve cancer care outcomes.

Colorectal cancer (CRC) plays a significant role in morbidity, mortality, and economic cost in the Belt and Road Initiative ("B and R") countries. In addition, these countries have a substantial consumption of processed meat. However, the burden and trend of CRC in relation to the consumption of a diet high in processed meat (DHPM-CRC) in these "B and R" countries remain unknown.

To analyze the burden and trend of DHPM-CRC in the "B and R" countries from 1990 to 2019.

We used the 2019 Global Burden of Disease Study to collate information regarding the burden of DHPM-CRC. Numbers and age-standardized rates (ASRs) of deaths along with the disability-adjusted life years (DALYs) were determined among the "B and R" countries in 1990 and 2019. Using joinpoint regression analysis, the average annual percent change (AAPC) was used to analyze the temporal trends of age-standardized DALYs rate (ASDALR) from 1990 to 2019 and in the final decade (2010-2019).

We found geographical differences in the burden of DHPM-CRC among "B and R" countries, with the three highest-ranking countries being the Russian Federation, China, and Ukraine in 1990, and China, the Russian Federation, and Poland in 2019. The burden of DHPM-CRC generally increased in most member countries from 1990 to 2019 (all P < 0.05). The absolute number of deaths and DALYs in DHPM-CRC were 3151.15 [95% uncertainty interval (UI) 665.74-5696.64] and 83249.31 (95%UI 15628.64-151956.31) in China in 2019. However, the number of deaths (2627.57-2528.51) and DALYs (65867.39-55378.65) for DHPM-CRC in the Russian Federation has declined. The fastest increase in ASDALR for DHPM-CRC was observed in Vietnam, Southeast Asia, with an AAPC value of 3.90% [95% confidence interval (CI): 3.63%-4.16%], whereas the fastest decline was observed in Kyrgyzstan, Central Asia, with an AAPC value of -2.05% (95% CI: -2.37% to -1.73%). A substantial upward trend in ASR of mortality, years lived with disability, years of life lost, and DALYs from DHPM-CRC changes in 1990-2019 and the final decade (2010-2019) for most Maritime Silk Route members in East Asia, South Asia, Southeast Asia, North Africa, and the Middle East, as well as Central Europe, while those of the most Land Silk Route members in Central Asia and Eastern Europe have decreased markedly (all P < 0.05). The ASDALR for DHPM-CRC increased more in males than in females (all P < 0.05). For those aged 50-74 years, the ASDALR for DHPM-CRC in 40 members exhibited an increasing trend, except for 20 members, including 7 members in Central Asia, Maldives, and 12 high or high-middle social development index (SDI) members in other regions (all P < 0.05).

The burden of DHPM-CRC varies substantially across "B and R" countries and threatens public health. Relevant evidence-based policies and interventions tailored to the different trends of countries in SDIs or Silk Routes should be adopted to reduce the future burden of CRC in "B and R" countries via extensive collaboration.

Emerging research has revealed a complex bidirectional interaction between the gut microbiome and cannabis. Preclinical studies have demonstrated that the gut microbiota can significantly influence the pharmacological effects of cannabinoids. One notable finding is the ability of the gut microbiota to metabolise cannabinoids, including Δ9-tetrahydrocannabinol (THC). This metabolic transformation can alter the potency and duration of cannabinoid effects, potentially impacting their efficacy in cancer treatment. Additionally, the capacity of gut microbiota to activate cannabinoid receptors through the production of secondary bile acids underscores its role in directly influencing the pharmacological activity of cannabinoids. While the literature reveals promising avenues for leveraging the gut microbiome-cannabis axis in cancer therapy, several critical considerations must be accounted for. Firstly, the variability in gut microbiota composition among individuals presents a challenge in developing universal treatment strategies. The diversity in gut microbiota may lead to variations in cannabinoid metabolism and treatment responses, emphasising the need for personalised medicine approaches. The growing interest in understanding how the gut microbiome and cannabis may impact cancer has created a demand for up-to-date, comprehensive reviews to inform researchers and healthcare practitioners. This review provides a timely and invaluable resource by synthesizing the most recent research findings and spotlighting emerging trends. A thorough examination of the literature on the interplay between the gut microbiome and cannabis, specifically focusing on their potential implications for cancer, is presented in this review to devise innovative and effective therapeutic strategies for managing cancer.

Evidence in the literature indicates that aerobic physical activity may have a protective role in aging pathologies. However, it has not been clarified whether different types of aerobic exercise produce different effects. In particular, these potential differences have not been explored in patients with Alzheimer's disease (AD). The present narrative review has the specific aim of evaluating whether land (walking/running) and water (swimming) aerobic activities exert different effects on cognitive functions and neural correlates in AD patients. In particular, the investigation is carried out by comparing the evidence provided from studies on AD animal models and on patients. On the whole, we ascertained that both human and animal studies documented beneficial effects of land and water aerobic exercise on cognition in AD. Also, the modulation of numerous biological processes is documented in association with structural modifications. Remarkably, we found that aerobic activity appears to improve cognition per se, independently from the specific kind of exercise performed. Aerobic exercise promotes brain functioning through the secretion of molecular factors from skeletal muscles and liver. These molecular factors stimulate neuroplasticity, reduce neuroinflammation, and inhibit neurodegenerative processes leading to amyloid-β accumulation. Additionally, aerobic exercise improves mitochondrial activity, reducing oxidative stress and enhancing ATP production. Aerobic activities protect against AD, but implementing exercise protocols for patients is challenging. We suggest that health policies and specialized institutions should direct increasing attention on aerobic activity as lifestyle modifiable factor for successful aging and age-related conditions.

We aimed to examine the association between dietary isoflavone intake and the risk of breast cancer recurrence and summarize evidence on the role of dietary isoflavone intake in breast cancer prognosis. This prospective study included 592 breast cancer survivors who completed a dietary assessment. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. Of the studies published until May 31, 2023, that were searched in PUBMED and EMBASE databases, 14 studies were selected. Adjusted HRs were combined using fixed- or random-effects models. During the median follow-up of 4.3 years, 47 recurrences were identified. The HR (95% CI) for recurrence comparing the highest versus the lowest tertile of isoflavones intake was 1.29 (0.60-2.78). In a meta-analysis of previously published data and ours, dietary isoflavone intake was associated with a better breast cancer prognosis. The combined HRs (95% CIs) comparing the extreme categories were 0.81 (0.67-0.98) for recurrence and 0.85 (0.76-0.96) for all-cause mortality. A nonlinear inverse association was observed between isoflavone intake and the risk of recurrence and all-cause mortality. Our study suggests that dietary isoflavone intake is associated with a favorable prognosis in breast cancer survivors and warrants further investigation.

In recent years, dietary interventions have attracted much attention in cancer therapy. Mechanistic studies suggest that dietary interventions can inhibit the progression of cancer through deprivation of essential metabolites, lowering the levels of protumor hormones, activation of anticancer immunity and synergistic effects with conventional anticancer therapies. The feasibility, safety and promising tumor outcomes have also been established in humans. However, the results from both preclinical and clinical studies are inconsistent or even conflicting, the reasons for which have not been extensively considered. In this review, we discuss the various heterogeneity, including dietary protocols, tissue of origin and cancer locations, spatial and temporal metabolic heterogeneity, and divergent combination treatment, that may affect the responses of different cancers to dietary interventions. Understanding this heterogeneity and taking them into consideration when applying dietary interventions to cancer therapy will allow us to deliver the right diet to the right patient at the right time to maximize compliance, safety and efficacy of conventional anticancer therapy and to improve the outcomes of patients with cancer.

The benefits of consuming fruits and vegetables are widely accepted. While previous studies suggest a protective role of fruits and vegetables against a variety of diseases such as dementia and depression, the biological mechanisms/effects remain unclear. Here we investigated the effect of fruit and vegetable consumption on brain structure. Particularly on grey matter (GM) and white matter (WM) volumes, regional GM volumes and subcortical volumes. Cross-sectional imaging data from UK Biobank cohort was used. A total of 9925 participants (Mean age 62.4 ± 7.5 years, 51.1 % men) were included in the present analysis. Measures included fruit and vegetable intake, other dietary patterns and a number of selected lifestyle factors and clinical data. Brain volumes were derived from structural brain magnetic resonance imaging. General linear model was used to study the associations between brain volumes and fruit/vegetable intakes. After adjusting for selected confounding factors, salad/raw vegetable intake showed a positive association with total white matter volume, fresh fruit intake showed a negative association with total grey matter (GM) volume. Regional GM analyses showed that higher fresh fruit intake was associated with larger GM volume in the left hippocampus, right temporal occipital fusiform cortex, left postcentral gyrus, right precentral gyrus, and right juxtapositional lobule cortex. We conclude that fruit and vegetable consumption seems to specifically modulate brain volumes. In particular, fresh fruit intake may have a protective role in specific cortical areas such as the hippocampus, areas robustly involved in the pathophysiology of dementia and depression.