Telomere length (TL) serves as a marker for biological aging, influenced by chronological aging but distinct from it. This systematic review aims to synthesize the evidence on the associations between components of physical aging and TL in the elderly population.

A comprehensive search was conducted in online databases of PubMed, Web of Science, ProQuest, and ScienceDirect to identify the eligible papers published until 1st August 2024. The authors independently extracted data using the standardized form. The quality of the included studies was evaluated for the risks of biases.

A total of 1080 records were initially identified using the predefined search strategy. A total of 40 eligible records were included in this review. When assessing physical aging, the nature and type of measurements across studies vary, including subjective, objective, and a combination of both approaches. Subjective assessments of general health or physical limitations may be linked with TL, while frailty, whether measured subjectively or objectively, shows associations with TL in less than 35 percent of total studies. In contrast, composite measures of physical performance/ability are consistently associated with TL in the elderly population.

In conclusion, we demonstrated that the associations between physical aging and TL varies depending on the type and nature of physical aging assessments. Composite measures of physical performance/ability demonstrate a strong and consistent parameter of physical aging to link with TL. Future research should prioritize standardized, multidimensional approaches to measure physical aging to understand better its association with TL to support healthy aging strategies.

The Ganga River (known internationally as the Ganges) is one of the world's most prominent rivers, running from the Himalayas to the Bay of Bengal and supporting the livelihoods of > 40 % of India's 1.4 billion population. The Ganga River is regionally and globally important, supporting agriculture and industry, yet faces potentially detrimental water quality challenges arising from runoff and discharge from increasing urbanization, industry and agriculture. A ∼ 2700 km longitudinal survey of the nutrient and microbial water quality, including phytoplankton composition, of the Ganga River was undertaken in November 2019. The aim was to investigate if and how anthropogenic activities (e.g. urbanisation, industry, and agriculture) and tributary convergence (potentially reflecting both human activity and flow influences) affect and shift physicochemical, nutrient, and microbial water quality parameters along the river continuum. Segmented regression identified four zones of distinct nutrient/microbial characteristics along the Ganga River, with breakpoints located near Kanpur, Varanasi and downstream of the Farakka Barage, at distances of ∼ 1020, ∼ 1500 and ∼ 2350 km downstream from the Himalayan Ganga source. Population density, land use and urban cover were associated with selected water quality parameters in parts of the catchment, with elevated nutrient, microbial and chemical concentrations likely associated with agriculture, industry, and sewage inputs. Some urban areas (e.g. Kanpur and Varanasi), converging tributaries (e.g. Yamuna and Varuna) and barrages (e.g. Farakka) were associated with changes in nutrient availability, microbial activity/abundance and modelled discharge, likely driving apparent water quality changes in the relevant locations. Downstream shifts in nutrient and microbial water quality parameters were observed throughout the ∼ 2700 km Ganga River continuum. This information can help prioritize locations for targeted monitoring and/or remediation interventions and has illustrated an approach to quantify impacts of anthropogenic inputs on major river systems, such as the Ganga River.

Background/Objectives: The adherence to a healthy lifestyle is important for supporting healthy cognitive function as aging progresses. This study aimed to assess the association between a healthy lifestyle, specifically diet quality, physical activity, and smoking, and cognitive function in middle-aged and older adults. Methods: A cross-sectional study was conducted among participants aged 45 and older with normal cognition. Participants' cognitive performance was assessed by the Montreal Cognitive Assessment (MoCA). Dietary intake was assessed using a 24 h dietary recall, and diet quality was assessed using the Diet Quality Index-International (DQI-I). Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Participants were categorized as unhealthy (score ≤ 1), average (score 2), and healthy (score 3). Results: In this study, a total of 176 participants were recruited, 46% of them were classified as unhealthy, 40% was average, and 14% as healthy. Participants in the unhealthy group had lower performance in the naming cognitive domain compared to the other groups (p = 0.01). Participants in the average group scored significantly lower than the other groups in the orientation domain (p = 0.02). Performing moderate and high physical activity levels were significantly associated with higher scores of MoCA (p = 0.04) and in the naming domain (p = 0.02). Conclusions: Adopting a healthy lifestyle is associated with maintaining cognitive health among middle-aged and older adults, supporting the relevance of multidomain lifestyle interventions. Further longitudinal research is warranted to evaluate the long-term feasibility and effectiveness of lifestyle interventions in this population.

This study investigates the development and application of cellulose hydrogel-based slow-release fertilizers derived from waste materials, specifically waste paper and sawdust, in cultivating water convolvulus. The slow-release fertilizers were created using carboxymethyl cellulose (CMC) derived from these waste sources with citric acid as a cross-linker, aiming to enhance nutrient efficiency and sustainable agricultural practices. The CMC hydrogels demonstrated high water swelling-approximately 10 times its dry weight, enhancing soil moisture holding levels across different soil types. Notably, the slow-release fertilizer derived from sawdust (HyU_CMC_SD) showed the highest urea absorption (330.8 ± 2.3 mg/g) and a high urea release rate in water and soil owing to its polymeric chain property. Cultivation trials over 25 days revealed that water convolvulus grown with the sawdust-derived slow-release fertilizer had the most extended stem growth, while the slow-release fertilizer from waste paper (HyU_CMC_P) provided gradual, more prolonged release, supporting consistent plant growth post-14 days of growing. Overall, slow-release fertilizers from the CMC hydrogels proved effective in slowing nutrient release, conserving soil moisture, and minimizing nutrient leaching. This research suggests that cellulose hydrogel-based slow-release fertilizers from waste materials offer a promising approach for sustainable and efficient agricultural production.

The rhizosphere hosts a diverse group of beneficial bacteria that can serve as an alternative to chemical fertilizers. Exploring the potential traits of these bacteria can lead to sustainable farming practices, promoting crop yields while minimizing environmental impact. The present study was conducted to characterize and identify native plant growth-promoting bacteria (PGPB) from the rhizosphere of tomato plants cultivated in the organic state of Sikkim, India. Seventy bacterial strains were isolated from different tomato cultivation sites in Sikkim and characterized for their plant growth-promoting (PGP) traits. Out of these, eight potential bacterial strains were selected, and identified as Klebsiella variicola AST1, Bacillus cereus AST3, Enterobacter sichuanensis AST4, Enterobacter mori KH2, Bacillus cereus SG1, Enterobacter sichuanensis SG2, Enterobacter asburiae YG1, and Priestia aryabhattai YG2. Among them, Enterobacter sichuanensis AST4 demonstrated notable ammonia production (55.14 ± 0.03 mM), phosphate solubilization (564.6 ± 0.19 µgmL-1), and nitrogen fixation potential. Similarly, Klebsiella variicola AST1 exhibited the highest indole-3-acetic acid (IAA) production (125.33 ± 0.2 µgmL-1) during in vitro experiments. Likewise, Enterobacter sichuanensis SG2 displayed substantial gibberellic acid (GA3) production (18.3 ± 0.02 µgmL-1), and siderophore production (85%), against the uninoculated control. Greenhouse experiments further revealed that Klebsiella variicola AST1 significantly improved agronomic performance, with increases in plant height (70%), root length (86%), number of leaves (36.6%), and fresh and dry root weight (77% and 58.3% respectively), compared to the uninoculated control. These findings underscore the potential of rhizospheric bacteria from Sikkim's organic tomato fields to enhance plant growth and agricultural productivity, promoting a sustainable crop production system.

Worldwide, ischemic heart disease is less prevalent in women than in men, but this gap has narrowed in recent decades. This study aims to evaluate trends and gender differences in the global burden of ischemic heart disease (IHD) across demographics and regions from 1990 to 2021.

We utilized the data of the Global Burden of Disease Study from 1990 to 2021. The standard epidemiological measurements, including incidence, prevalence, mortality rates, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), were obtained to estimate the burden of IHD concerning age, sex, and the sociodemographic index, allowing for comparisons over time.

The sex parity ratio (SPR), defined as the ratio of females to males, has increased globally. The SPR of age-standardized prevalence (ASPR) and age-standardized incidence (ASIR) rose from 0.610 to 0.631 in 1990 to 0.653 and 0.670 in 2021, respectively. From 1990 to 2021, the SPRs for ASPR and ASIR of IHD increased across all age groups. However, the SPRs for the age-standardized mortality rate (ASMR) and the age-standardized DALY rates (ASDR) of IHD declined. This decrease in the SPR for both ASMR and ASDR of IHD was observed in most regions of this study.

While progress has been made in reducing the burden of IHD, the increasing sex disparities in specific regions and age groups emphasize the need for continuous monitoring, adaptive health policies, and sex-specific healthcare practices to ensure equitable health outcomes for all populations.

not applicable.

To examine the association between body fat distribution, dysmobility syndrome, and cognitive impairment in 181 community-dwelling older women and assess physical activity's mediating role.

Body composition was assessed using dual-energy X-ray absorptiometry, and the android-to-gynoid (A/G) fat ratio was calculated as the android fat proportion divided by the gynoid fat proportion. Participants were categorized into high and low 50 % groups based on the A/G fat ratio. Dysmobility syndrome was defined as the presence of at least three of the following: increased body fat percentage, decreased muscle mass, osteoporosis, slow gait speed, reduced grip strength, or a history of falls. Cognitive impairment was defined as a Mini-Mental State Examination for Dementia Screening score ≤ 23. Physical activity was measured using the International Physical Activity Questionnaire, with ≥600 metabolic equivalent of task-minutes per week classified as active and < 600 as inactive. Binary logistic regression was used to compute odds ratios (OR) and 95 % confidence intervals (CI) for the A/G fat ratio and physical activity. The mediating effects of physical activity were analyzed using Process Macro Model 4.

Participants in the low 50 % A/G fat ratio group had higher odds of dysmobility syndrome (crude OR = 3.500, p < 0.001; adjusted OR = 3.678, p = 0.002) and cognitive impairment (crude OR = 2.714, p = 0.005; adjusted OR = 3.293, p = 0.005) than did those in the high 50 % group, even after covariate adjustments. The inactive group had higher odds of dysmobility syndrome (crude OR = 4.185, p < 0.001; adjusted OR = 3.199, p = 0.005) and cognitive impairment (crude OR = 3.190, p = 0.001; adjusted OR = 2.551, p = 0.022) than did the active group. Mediation analysis indicated that physical activity partially mediated the association between the A/G fat ratio and dysmobility syndrome (indirect effect = -0.5099, 95 % CI = -0.9045 to -0.1786) and cognitive impairment (indirect effect = 0.1446, 95 % CI = 0.0554 to 0.2582).

A lower A/G fat ratio increases the risks of dysmobility syndrome and cognitive impairment in older women; physical activity may mitigate these effects.

With an increasingly older population, the number of frail patients requiring surgical management for degenerative spine diseases is rapidly increasing. Older patients are at increased risk of developing postoperative delirium (POD), which increases the odds of postoperative morbidity and mortality in spine surgery patients. Therefore, frail spine surgery patients may be at greater risk of developing POD and subsequent adverse outcomes.

To understand the relationship between frailty and POD in spine surgery patients, and the effect of POD on nonfatal and fatal adverse outcomes in frail patients.

Retrospective cohort study utilizing data from the 2021 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.

Patients aged ≥75 years undergoing spine surgery screened for POD, with a total sample size of 4,195 patients.

Primary outcomes were postoperative delirium (POD), 30-day mortality, and nonfatal adverse outcomes.

Frailty was measured using the Risk Analysis Index (RAI) with tiered cutoffs indicating increasing frailty. Statistical methods included multivariable logistic regression and mediation analysis to evaluate the relationships between RAI, postoperative delirium, and 30-day mortality.

Out of 4,195 spine surgery patients aged ≥75 years screened for POD, 353 (8.4%) exhibited POD. POD patients had significantly higher RAI scores relative to those without POD (p<.001). Multivariable analysis demonstrated that increasing frailty predicted POD (p<.001). In patients with POD, there were increased odds of mortality and all nonfatal adverse outcomes within 30 days (p<.001). A complementary mediation effect of POD on frailty's contribution to 30-day mortality was observed (p<.001).

POD and increasing preoperative frailty RAI scores were independent predictors of mortality and morbidity in older spine surgery patients. POD has a significant synergistic contribution to the adverse effects of frailty following spine surgery. The RAI may be used to identify frail patients at risk of developing POD to enable optimal surgical candidate selection and provide opportunities for risk mitigation, such as prehabilitation and/or specialized perioperative care teams for frail patients.

Chronic pain is highly prevalent among older adults and its burden will become increasingly significant as our population ages. Yet, chronic pain is often undertreated in this vulnerable population due to various barriers in health care delivery. To improve geriatric chronic pain management, we assert that older adults require a dedicated research agenda designed to inform the development, testing, and implementation of chronic pain treatments that account for the unique vulnerabilities and healthcare needs of this population. Specifically, we propose that the following four areas of research require immediate attention to better serve older adults with chronic pain: (1) health equity, (2) substance use, (3) dyadic interventions, and (4) digital health. Our proposed research agenda aims to create a more robust and comprehensive body of evidence that will ultimately transform and advance geriatric chronic pain management.

By the end of 2024, 22% of the Chinese population was aged 60 and above, making old-age social welfare a critical challenge. Despite abundant literature, a gap remains between research and policy. This study applies Nelson's computational grounded theory to systematically analyze China's old-age social welfare research and propose targeted policy priorities.

We searched Chinese literature (2014-2024) from the Wanfang, CNKI, and CQVIP databases. After preprocessing the abstracts, we applied topic modeling using the latent Dirichlet allocation, guided by human analysts. Optimal topics were determined using perplexity and coherence metrics. Researchers then linked each topic to sociologically meaningful concepts to derive abstract policy conclusions.

A total of 413 articles met eligibility criteria. Seven topics emerged: (1) the theoretical significance of social welfare policy; (2) enhancing rural old-age care; (3) providing care for special groups; (4) promoting a home-community care model; (5) optimizing precision care through collaborative mechanisms; (6) developing community culture; and (7) establishing supply-driven care services. Notably, topics two and seven dominated the literature.

Based on these themes, we propose policy priorities to enhance comprehensive social welfare programs. China's big government model-a top-level design involving diverse stakeholders-may serve as an effective framework for addressing a global aging society marked by rising non-communicable diseases and AI-driven economic growth. Moreover, our computer-assisted approach offers a valuable method for information scientists, aiding policymakers in navigating extensive digital data for more cost-effective and timely decision-making.

Subseasonal precipitation whiplashes, marked by sudden shifts between dry and wet extremes, can disrupt ecosystems and human well-being. Predicting these events two to six weeks in advance is crucial for disaster management. Here, we show that the propagation diversity of the Madden-Julian Oscillation (MJO)-a key source of subseasonal predictability-will alter under anthropogenic warming. This is evidenced by a 40% increase in fast-propagating events by the late 21st century. Fast-propagating MJOs may rise in a period as early as 2028-2063, increasing the global risk of precipitation whiplashes through teleconnections. We propose a heuristic framework diagnosing that MJO's acceleration is primarily driven by enhanced atmospheric stabilization and El Niño-like sea surface warming. The expected rise in fast-propagating MJOs could improve the predictability of subseasonal weather whiplashes, offering critical lead time for disaster preparedness. Understanding these impending shifts is essential for enhancing subseasonal prediction capabilities.

RNA interference (RNAi) is a tool for studying gene function and has emerged as a promising eco-friendly alternative to chemical pesticides. RNAi relies on delivering double-stranded RNA (dsRNA), which is processed into small interfering RNA (siRNA) to silence genes. However, so far, knowledge and tools for optimizing the dsRNA sequences for maximum efficacy are based on human data, which might not be optimal for insect pest control.

Here, we systematically tested different siRNA sequences in the red flour beetle Tribolium castaneum to identify sequence features that correlated with high efficacy using pest control as a study case. Thermodynamic asymmetry, the absence of secondary structures, and adenine at the 10th position in antisense siRNA were most predictive of insecticidal efficacy. Interestingly, we also found that, in contrast to results from human data, high, rather than low, GC content from the 9th to 14th nucleotides of antisense was associated with high efficacy. Consideration of these features for the design of insecticidal dsRNAs targeting essential genes in three insect species improved the efficacy of the treatment. The improvement was associated with a higher ratio of the antisense, rather than sense, siRNA strand bound to the RNA-induced silencing complex. Finally, we developed a web platform named dsRIP, which offers tools for optimizing dsRNA sequences, identifying effective target genes in pests, and minimizing risk to non-target species.

The identified sequence features and the dsRIP web platform allow optimizing dsRNA sequences for application of RNAi for pest control and research.

Alcohol is a major risk factor for cancer development. Our study aimed to provide the updated global, regional and national burden of alcohol-attributable cancer.

We analysed the Global Burden of Disease Study 2021 to determine the death and age-standardised death rate (ASDR) from alcohol-attributable cancer and the change of these measures between 2000 and 2021 (reflected as annual percent change [APC]), classified by region, nation and country's developmental status, which is based on the sociodemographic index (SDI).

In 2021, there were 343,370 deaths globally from alcohol-attributable cancer, which was an increase from 2000 by 51%. Alcohol-attributable cancer accounted for 3.5% of all cancer deaths. Among alcohol-attributable cancer, liver cancer (27%) accounted for the highest mortality from alcohol, followed by oesophageal (24%) and colorectal cancer (16%). From 2000 to 2021, ASDR from alcohol-attributable cancer decreased (APC: -0.66%). Regionally, from 2000 to 2021, the fastest-growing ASDR was observed in South Asia. Classified by SDI, low (APC: 0.33%) and low-to-middle SDI countries (APC: 1.58%) exhibited an uptrend in ASDR from alcohol-attributable cancer. While the ASDR from all other cancers decreased, ASDR from early-onset (15-49 years) lip and oral cavity cancer increased (APC: 0.40%).

From 2000 to 2021, although the ASDR from alcohol-attributable cancer declined, the total number of deaths continued to rise. This trend was accompanied by variations across sociodemographic groups and cancer types, particularly gastrointestinal cancers. Urgent efforts are needed both globally and at regional levels to address the burden of alcohol-attributable cancers.

Sexual dysfunction and sexual dysfunctional beliefs are common problems in postmenopausal women. The purpose of this study was to evaluate the effect of sexual counseling based on the BETTER (Bring up, Explain, Tell, Time, Educate, Record) model in these women.

The randomized controlled trial study was conducted with 106 postmenopausal women in 2023. Eligible women were assigned randomly to the intervention and control groups. Accordingly, the intervention group received two individual counseling sessions based on the BETTER model. The Female Sexual Function Index (FSFI) and the Sexual Dysfunctional Beliefs Questionnaire (SDBQ) were used for collecting data at baseline and 4 weeks after the intervention.

The sexual function score in the intervention group increased from 15.97 to 18.51 (p = 0.001), and the score of sexual dysfunctional beliefs decreased from 33.80 to 24.86 (p = 0.001). In the control group, the sexual function score decreased from 19.09 to 18.59 (p = 0.032) and the sexual dysfunctional beliefs score increased from 31.83 to 32.18 (p = 0.111).

Sexual counseling based on the BETTER model has demonstrated efficacy in promoting sexual function and diminishing sexual dysfunctional beliefs. Consequently, the use of this model in the sexual health counseling of postmenopausal women can be considered.

IRCT20150128020854N12; October 12, 2023. Iranian Registry of Clinical Trials: https://irct.behdasht.gov.ir/user/trial/71128/view.

Research has highlighted under-utilisation of mental health services by older adults. This review aims to systematically review existing literature on older adults' experiences of accessing community mental health support from secondary care services. The review aims to develop recommendations to improve the mental health support older adults receive.

A comprehensive systematic search was conducted across four databases. Terms relating to older adult experiences and factors impacting access to secondary mental health community services were included. Nineteen eligible papers were identified. Data were thematically synthesised.

Four analytical themes and 12 descriptive subthemes were identified. Overarching themes included social influences and service factors which impacted engagement and accessibility, and personal factors. Sub-themes included mental health knowledge and beliefs, the impact of past experiences and social factors including discrimination and support. Help-seeking behaviours were influenced by accessibility of services, service support and clinician factors.

Educational initiatives can help to increase mental health knowledge of older adults and their families allowing for improved access to services. Increased training for clinicians can improve referral processes and enable services to adapt to the unique needs of older adults. Studies reviewed were worldwide and reflected a range of views supporting relevance of outcomes globally.

Slower gait is prevalent in older adults. Multiple factors contribute to the slowness in older adults. However, whether these factors affect gait speed similarly or differently remains unknown. The primary purpose of this study was to explore the relative importance of eight modifiable factors (body mass index, leg muscle strength, power, dorsiflexion range of motion, tactile sensation, balance, fear of falling, and cognition) affecting gait speed in community-living older adults.

Eighty-five community-living older adults (mean ± standard deviation age: 72.3 ± 5.5 years; 51 females and 34 males) were enrolled in this cross-sectional study. A motion capture system assessed their gait speed. Those eight factors that could slow gait speed in older adults were also evaluated. A multiple linear regression model and relative weight analysis were utilized to determine the relative importance of each factor in contributing to the gait speed variation.

All eight factors were significantly correlated with the gait speed. Together, they accounted for about 50% of the observed variation in gait speed. Six factors (body mass index, strength, power, range of motion, balance, and fear of falling) each explained a statistically significant portion of the gait speed variation. The most important factor was the leg muscle power (relative weight = 0.124), contributing 25.2% of the explained speed variation.

Leg muscle power could be a principal factor determining gait speed in older adults. Other factors also significantly influence gait speed in this population. The findings could guide prioritizing actions to improve gait speed in older individuals.

This study investigates the effects of pilot scale Alnus japonica hot water extract (AJHW) on muscle loss and muscle atrophy. Building on previous in vitro studies, in vivo experiments were conducted to evaluate muscle strength, mass, fiber size, protein synthesis, and antioxidant activity. The results showed that AJHW significantly restored muscle strength, increased muscle mass, enhanced the expression of muscle synthesis markers, such as Akt and mTOR, and apoptosis inhibition markers, such as Bcl-2, compared to the muscle atrophy control. Muscle degradation markers, such as Atrogin1, MuRF1, FoxO3α, and the apoptosis activation marker Bax, were decreased compared to the muscle atrophy control. Additionally, AJHW significantly boosted the activity of antioxidant factors like SOD, catalase, and Gpx, suggesting its protective role against oxidative stress-induced muscle damage. The enhanced effects were attributed to the high content of hirsutanonol and hirsutenone, which synergized with oregonin, compounds, identified through phytochemical analysis. While these findings support the potential of AJHW as a candidate for preventing muscle loss, further studies are needed to confirm its efficacy across diverse atrophy models and to elucidate its exact mechanisms.

The aging of the global population is intensifying, and the issue of depression among middle-aged and older individuals in China has garnered significant attention. Social integration is considered closely related to the risk of depression in patients with multiple chronic conditions (MCCs). This study aims to explore the relationship between different dimensions of social integration and depression in middle-aged and older individuals.

This study utilized data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), including 2,901 middle-aged and older individuals with MCCs. Depression risk was assessed using a depression scale. Social integration was measured across three dimensions: economic integration, relational integration, and community integration. Statistical analyses were conducted using Logit and Tobit models to explore the relationship between social integration and depression among middle-aged and older individuals.

There was no significant association between overall social integration and the risk of depression, but economic integration and community integration were negatively correlated with the risk of depression, and relational integration was positively correlated with the risk of depression, and this relationship was heterogeneous among different demographic characteristics. Sensitivity analysis and subgroup analysis further confirmed the robustness of the results.

Mental health interventions for middle-aged and older adults MCCs patients should consider the multi-dimensional characteristics of social integration. It is recommended to improve the economic status of the middle-aged and older adults, improve the quality of family and social interactions, and pay attention to the construction of the community environment. And further explore the interaction of each dimension and its applicability in different contexts.

Antimicrobial resistance (AMR) is one of the biggest problems facing the scientific and medical communities. According to WHO, this growing issue might make once-effective antibiotics obsolete and pose a substantial risk to public health. Estimates indicate that multimillion deaths were either directly or indirectly caused by AMR, making it one of the most substantial risks to public health and development in the world. The issue of AMR is primarily caused by healthcare workers' excessive and inappropriate use of antimicrobial agents. Dentists are believed to prescribe a considerable portion of all antibiotics globally. The emergence of AMR, its causes, and its effects on human health are examined in this article, with special attention to dental offices and medical facilities. It draws attention to the rising issue of antibiotic overprescription and abuse, particularly in low- and middle-income countries, where improper antibiotic use is an everyday practice around the globe. The article discusses the role of antimicrobial stewardship programs and the importance of implementing precise, evidence-based practices in preventing AMR. Since antibiotic abuse in livestock greatly accelerates the spread of resistance, the role of antibiotics in animal agriculture is also investigated. To address AMR, the paper highlights the necessity of a global, coordinated response that bolsters surveillance systems, cuts back on needless antibiotic use, and expands access to alternative treatments. Recent research has called into question the efficacy of preventive antibiotic medication in these situations. According to other researchers, it might not help avoid surgical site infections. However, other experts say disrupting deeper tissues and local mucosal defenses during an intraoral surgical operation may raise the risk of infection even when antibiotics are used.

Human reproductive, mortality and migration behaviours can often be standardized across countries. However, the universality of population growth laws remains a subject of debate. This study models age-specific population data as a three-dimensional tensor and applies high-dimensional tensor decomposition to uncover macro-level patterns in demographic systems across 200 countries over the past 70 years. The findings reveal that, while disparities in age demographics are widening, most nations follow remarkably similar evolutionary trajectories, differing mainly in the pace of change. A universal transition from the demographic dividend to population ageing is evident, with even labour-abundant regions such as Africa, Asia and South America inevitably facing this demographic shift. By incorporating economic indicators, the study quantitatively demonstrates the coordination between population structure and economic growth, while identifying notable exceptions, such as Gulf states that remain both affluent and youthful, and countries like North Korea, Tunisia, Sri Lanka and Ukraine that are ageing without first achieving significant economic wealth.

This study introduces a novel neuromechanical model that employs a hybrid triple inverted pendulum (HTIP) framework combined with state-dependent intermittent control to simulate human quiet stance in the sagittal plane.

The proposed neuromechanical model integrates the biomechanics of the ankle, knee, and hip joints, focusing on the stabilization of the body's center of mass (CoM) rather than controlling each joint individually. Unlike computational models that require precise joint control, the central nervous system maintains posture by simplifying neural control mechanisms. Specifically, the state-dependent control strategy activates neural feedback only as the CoM approaches the stability boundaries.

Experimental validation against real-world data demonstrated that the model can accurately replicate natural postural sway patterns in the sagittal plane.

The model provides a computationally efficient mechanism and a realistic simulation of human posture control, addressing a long-standing challenge in neuromechanical modeling of human quiet stance.

This study enhances understanding and simulation capability offers significant new insights for developing targeted interventions for individuals with impairments in postural control.

The use of conventional water-soluble mineral fertilizers in modern agriculture brings about serious economic and environmental issues related to the loss of nutrients, the contamination of underground water and the contribution to greenhouse gas emissions. To mitigate these issues, both researchers and industrials are turning to alternative solutions such as slow-release fertilizers. In line with this trend, here we report on the formulation of a novel sodium alginate based slow-release NPK fertilizer beads using sodium alginate as a biopolymer, polyacrylamide as a graft polymer, complex NPK fertilizer as a source of nutrient and calcium (Ca2+) as a crosslinking cation. Five NPK-rich sodium alginate-based slow-release beads were formulated and then extensively characterized by FTIR, XRD and SEM. The swelling capacity in water was also evaluated and was found to be a function of the grafting percentage. The nutrients release profiles were evaluated in water as well as in sandy loamy soil. The release experiments showed that the formulated hydrogel beads displayed a delayed nutrient release profile compared to water-soluble NPK fertilizer. The magnitude of the release was significantly slow down as the grafting rate increased with the graft copolymer at 20 wt% exhibiting the prolonged longevity as compared to the other formulations The cumulative release of nitrogen, phosphorus and potassium from the NPK-rich SA-g-PAM 20 % were 65 52, and 43 % during the first 56 days of release in water and were 23, 16, and 15 % during the first 35 days of release in a sandy loamy soil, respectively. The study of nutrients release kinetics indicated the release behavior of N, P and K in water and soil was controlled by a non-Fickian diffusion mechanism. These performances highlight that the fabricated fertilizer beads could be a promising alternative to water soluble fertilizer in the moder agriculture.

Late-life depression (LLD) represents a growing global public health concern. This study aimed to assess the worldwide burden of LLD using comprehensive data.

Leveraging the latest evidence from the Global Burden of Disease Study, we analyzed trends in LLD burden from 1990 to 2021, encompassing incidence, prevalence, and disability-adjusted life years (DALYs). We quantified disparities in LLD burden across socioeconomic, gender, regional, and national dimensions. Decomposition analysis was employed to identify key drivers of LLD burden variation. Frontier analysis illustrated the potential for burden reduction in various countries.

Globally, there were 49,137,544 new cases, 46,672,175 prevalent cases, and 7,351,377 DALYs attributed to LLD in 2021. Between 1990 and 2021, the agestandardised incidence rate (ASIR), age-standardised prevalence rate (ASPR), and age-standardised DALYs rate (ASDR) of LLD all rose. In 2021, low SDI regions exhibited the highest all ASRs, while middle SDI regions had the fastest growth rates in these indicators. Regionally, Central and Eastern Sub-Saharan Africa had the highest ASIR, ASPR, and ASDR, respectively. Nationally, Uganda ranked highest in all ASRs in 2021. Women had higher burdens than men. Population growth was a primary driver of DALYs increase in middle SDI regions that had the greatest potential for improvement.

The global burden of LLD has risen, with marked inequities across SDI, gender, region, and country. The burden is most pronounced in low and middle SDI regions. These findings offer guidance for developing LLD screening guidelines and enhancing prevention and intervention strategies in relevant countries, particularly Uganda.

This study introduces a novel system for evaluating hand motor function through synergy-based analysis during object manipulation in virtual and mixed-reality environments. Conventional assessments of hand function are often subjective, relying on visual observation by therapists or patient-reported outcomes. To address these limitations, we developed a system that utilizes the leap motion controller (LMC) to capture finger motion data without the constraints of glove-type devices. Spatial synergies were extracted using principal component analysis (PCA) and Varimax rotation, providing insights into finger motor coordination with the sparse decomposition. Additionally, we incorporated the HoloLens 2 to create a mixed-reality object manipulation task that enhances spatial awareness for the user, improving natural interaction with virtual objects. Our results demonstrate that synergy-based analysis allows for the systematic detection of hand movement abnormalities that are not captured through traditional task performance metrics. This system demonstrates promise in advancing rehabilitation by enabling more objective and detailed evaluations of finger motor function, facilitating personalized therapy, and potentially contributing to the early detection of motor impairments in the future.

Femtosecond laser-assisted cataract surgery (FLACS) has increasingly been adopted worldwide. Lagging behind is evidence-based consensus regarding optimal timing for intraocular pressure (IOP) measurement following FLACS. The purpose of this study was to determine if enough evidence currently exists to guide best practice.

A comprehensive literature search was performed on MEDLINE and EMBASE until February 6th, 2023. Articles reporting IOP measurements following uncomplicated FLACS were screened. For change in IOP at various post-operative timepoints, standardized mean difference (SMD) was calculated as the mean difference in IOP from baseline. Risk of Bias Assessment was conducted following data extraction.

The meta-analysis incorporated six randomized clinical studies involving a total of 1356 eyes from 1032 participants. Post-operative day one was the only timepoint with a non-significant increase in IOP (SMD = -0.08 [95% CI: -0.41 to +0.24]) compared to the 7-days, 30-days, 60 to 90-days, and 180-days follow-up periods. All studies except one utilized an ophthalmic viscosurgical device (OVD) in their procedure; this was the only publication that reported a decrease in IOP from baseline within the 1-day follow-up period.

The results suggest that the optimal time to measure IOP is within the first 24 hours after FLACS. However, these findings are limited by a small study sample. Future prospective clinical trials may be beneficial to determine if specific timepoints within the first 24 hours exist to optimize outcomes and patient reported experiences.

Since Europe's 2018 neonicotinoid ban on outdoor use of clothianidin, imidacloprid, and thiamethoxam, there has been growing political, scientific, and public interest in further understanding the impact of neonicotinoids on bees and the environment. Here, we assessed the trends in pesticide use in New Zealand, with a particular focus on neonicotinoids, to aid discussion on their use and associated risks. Obtaining data on annual trends in pesticide quantities is challenging, as there is no central collection of pesticide data across the agrichemical or regulatory sectors in New Zealand. Consequently, the true scale and frequency of pesticide usage, including neonicotinoids, remain largely unknown. The difference in neonicotinoid use patterns between New Zealand, where 45 % of forage brassicas (annual planting) and pastures (infrequent planting) are grown from neonicotinoid-treated seeds, and northern hemisphere countries, where 56 % to over 90 % of annual food crops rely on neonicotinoid-treated seeds, indicates a lower overall neonicotinoid use in New Zealand. This difference underscores the need for region-specific approaches to pesticide management and regulation. Although residues can persist and migrate in the soil, current regulations only consider the risk of foliar spray to protect honey bees, overlooking the potential risks to native bees, which primarily live underground, as well as wider lethal and sublethal impacts of residues on non-target organisms. The lack of publicly accessible pesticide data limits scientific research on non-target and environmental effects, and the absence of readily available substitutes for neonicotinoids is the key challenge to be overcome in order to better manage the impact of these pesticides on New Zealand ecosystems.

Soil compaction is a widespread problem, leading to soil degradation, yield losses, and adverse environmental impacts. Nowadays, various measurement methods exist to assess and map soil compaction, with vertical cone penetration resistance measurements being one of the most commonly used. This method is easy, rapid, inexpensive, and generally accepted. However, manual penetration resistance measurements are time-consuming, labor-intensive, and often less accurate due to inconsistent penetration speed. To address these limitations, an automated penetrometer was developed and integrated on an autonomous robot platform, paving the way for high-resolution compaction mapping as a starting point for precision subsoiling to remediate soil compaction. The performance of this setup was validated in controlled and field conditions against a hand-held penetrometer. Therefore, experiments were conducted in soil-filled cylinders and on plots of a long-term field experiment, including measurements across spraying tracks. The automated penetrometer demonstrated high correlations with the hand-held device under controlled conditions, though the correlation was somewhat lower in the field due to the soil's heterogeneity. Deviations between the two measurement devices were likely caused by the inconsistent insertion speed of the hand-held penetrometer, particularly in soils with high penetration resistance. Both penetrometers successfully identified the plow pan at a depth of 30-40 cm but were unable to clearly show the effect of the long-term presence of spraying tracks.

Surgical resection is the primary treatment modality for colorectal cancer. Prehabilitation is about enhancing the patient's physiological capacity preoperatively to reduce the risk of treatment-related complications. Clear definitions of the modality, content, and duration of prehabilitation, including its components such as nutrition, exercise, and psychological support, are lacking. Some review articles have proposed that a multimodal approach may yield the best overall outcomes, but the clinical efficacy of such an approach requires further exploration.

This study consisted of a systematic review and meta-analysis to investigate the effectiveness of multimodal prehabilitation programs for patients undergoing colorectal surgery.

We searched PubMed, Embase, CINAHL, and the Cochrane Library from inception to August 5, 2023, without language or publication period restrictions. The included studies were randomized controlled trials, prospective studies, or retrospective studies that examined the effectiveness of multimodal prehabilitation programs for patients undergoing colorectal surgery. A random-effects model was used for data analysis.

This study included 14 articles that analyzed data from 2314 patients who underwent colorectal cancer surgery. In comparisons against a control group, multimodal prehabilitation significantly reduced the length of hospital stay ([mean difference; MD] = -2.47 days, 95% confidence interval [CI] [-3.56, -1.39]), postoperative complication rate (odds ratio; [OR] = 0.74, 95% CI [0.59, 0.94]), and time to the first passage of flatus (MD = -0.43 days, 95% CI [-0.66, -0.20]).

Multimodal prehabilitation interventions before colorectal cancer surgery reduce hospital stay lengths, lower complication rates, and promote bowel recovery, particularly in older populations.

The demand for intelligent monitoring systems tailored to elderly living environments is rapidly increasing worldwide with population aging. Traditional acoustic scene monitoring systems that rely on cloud computing are limited by data transmission delays and privacy concerns. Hence, this study proposes an acoustic scene recognition system that integrates edge computing with deep learning to enable real-time monitoring of elderly individuals' daily activities. The system consists of low-power edge devices equipped with multiple microphones, portable wearable components, and compact power modules, ensuring its seamless integration into the daily lives of the elderly. We developed four deep learning models-convolutional neural network, long short-term memory, bidirectional long short-term memory, and deep neural network-and used model quantization techniques to reduce the computational complexity and memory usage, thereby optimizing them to meet edge device constraints. The CNN model demonstrated superior performance compared to the other models, achieving 98.5% accuracy, an inference time of 2.4 ms, and low memory requirements (25.63 KB allocated for Flash and 5.15 KB for RAM). This architecture provides an efficient, reliable, and user-friendly solution for real-time acoustic scene monitoring in elderly care.

Annually, tropical diseases are a major cause of mortality; for instance, in 2019, neglected tropical diseases (NTDs) caused 150,000 deaths and 19 million DALYs, with sub-Saharan Africa bearing over half the burden and the other concentrations in Asia and South America. Their impact, though significant, is lower than ischemic heart disease and respiratory infections. The World Health Organization is critical in combating these tropical diseases through surveillance, information campaigns and health promotion. Through international collaborations and initiatives, tropical diseases have been relatively mitigated; for example, global initiatives eradicated smallpox (1980), cut polio cases by 99% (1988-2022), and reduced Guinea worm cases from 3.5 million (1986) to 14 (2023), while NTD prevalence dropped significantly from 1990 to 2020. Main body The potential departure of a major player like the United States, the largest WHO donor, which contributed $1.284 billion (20% of its budget) in 2022-2023, surpassing the Gates Foundation ($689M), Gavi ($500M), and the EU ($412M), and its potential withdrawal threatens WHO's financial stability, jeopardizing emergency responses, disease prevention, and global health initiatives, urging stakeholders to reinforce global health systems. Governments, international organizations, and private partners must work together to create strong, flexible frameworks that prioritize prevention, research, and equitable healthcare delivery. By fostering collaboration, transparency, and mutual accountability, the global health community can continue to make progress toward eliminating the burden of major tropical diseases such as malaria and Dengue fever, among others. Failure to do so could reverse hard-won gains such as the 99% reduction in polio cases since 1988, the near-eradication of Guinea worm disease (from 3.5 million cases in 1986 to 14 in 2023), and declining NTD burdens, leading to resurgence and increased mortality among vulnerable populations worldwide, with devastating consequences for millions of people throughout the world.

This review examines the role of countries and organizations in fighting tropical diseases, with a perspective on the potential consequences of the U.S. exit from the WHO. We also discuss the importance of cross-border collaborations in fighting tropical diseases, healthcare systems strengthening efforts, and a call to strengthen efforts through other sources of funding and collaborations.

Aging population and growing obesity prevalence are two major public health issues. Bariatric surgery has been shown to be both safe and effective, but its role in the treatment of the elderly remains controversial.

To evaluate the efficacy and safety of laparoscopic bariatric surgery in patients over 70 years of age.

A systematic review and assessment of the literature was performed in November-December 2023. Inclusion criteria gathered studies of elderly (age ≥70 years old) who underwent laparoscopic bariatric surgery. The data extraction focused on weight loss, obesity-related diseases, and complications.

Fourteen retrospective studies were included, involving 3923 septuagenarians (female, 69.70%). One year after the surgery, the mean excess weight loss was 54.66%. At last follow-up, the improvement in obesity-related diseases was regarded as 50% diagnosed with diabetes, 36% with hypertension, 50% with reflux, 36% with sleep apnea, and 25% with hyperlipidemia. The overall postoperative major morbidity and mortality were about 2% and 1%, respectively.

This systematic review suggests that laparoscopic bariatric surgery is an effective and safe treatment for patients over 70 years of age.

Climate change represents a significant challenge to global food security by altering environmental conditions critical to crop growth. Plant breeders can play a key role in mitigating these challenges by developing more resilient crop varieties; however, these efforts require significant investments in resources and time. In response, it is imperative to use current technologies that assimilate large biological and environmental datasets into predictive models to accelerate the research, development, and release of new improved varieties that can be more resilient to the increasingly variable climatic conditions. Leveraging large and diverse datasets can improve the characterization of phenotypic responses due to environmental stimuli and genomic pulses. A better characterization of these signals holds the potential to enhance our ability to predict trait performance under changes in weather and/or soil conditions with high precision. This paper introduces characterization and integration of driven omics (CHiDO), an easy-to-use, no-code platform designed to integrate diverse omics datasets and effectively model their interactions. With its flexibility to integrate and process datasets, CHiDO's intuitive interface allows users to explore historical data, formulate hypotheses, and optimize data collection strategies for future scenarios. The platform's mission emphasizes global accessibility, democratizing statistical solutions for situations where professional ability in data processing and data analysis is not available.

Using the Irish Longitudinal Study on Ageing (TILDA), we evaluated the prevalence and distribution of chronic kidney disease (CKD), and its determinants in order to identify risk groups for population health planning in Ireland.

Data were analysed from Wave 1 (2009-2011) of the TILDA, a national cohort of participants aged 50+ years who had both plasma creatinine and cystatin C measured at baseline. Kidney function was estimated using the 2012 and 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2. Multivariable logistic regression explored associations using adjusted odds ratios (OR).

Prevalence of CKD was significantly higher using the CKD-EPI 2012(Scr-CysC) compared with the CKD-EPI 2021(Scr-CysC) (14.7% vs 11.3%, respectively). The prevalence was highest in patients with cardiovascular disease (CVD) (33.9%), diabetes (28.0%), cancer (25.5%), urinary incontinence (23.7%), bone diseases (21.5%), hypertension (19.8%) and obesity (19.5%). In multivariable analysis, individuals with hypertension (OR 1.78), diabetes (OR 1.45), CVD (OR 1.43), cancer (OR 1.53), overweight (OR 1.37) and obesity (OR 2.33) experienced greater likelihood of CKD. In addition, individuals with a history of previous hospitalization (OR 1.50), free or subsidized healthcare (OR 1.31), and unemployed individuals (OR 1.86) were also significantly more likely to have CKD.

Compared with the national average, the burden of CKD is far greater in older individuals with major chronic conditions and socioeconomic deprivation. The identification and targeting of these groups through national surveillance programmes is likely to yield substantial benefits from more effective disease management and proactive population health planning.

Plant-based meat can help combat climate change and health risks associated with high meat consumption. To create adequate mimics of animal meats, plant-based meats must match in mouthfeel, taste, and texture. The gold standard to characterize the texture of meat is the double compression test, but this test suffers from a lack of standardization and reporting inconsistencies. Here we characterize the texture of five plant-based and three animal meats using texture profile analysis and rheology, and report ten mechanical features associated with each product's elasticity, viscosity, and loss of integrity. Our findings suggest that, of all ten features, the stiffness, storage, and loss moduli are the most meaningful and consistent parameter to report, while other parameters suffer from a lack of interpretability and inconsistent definitions. We find that the sample stiffness varies by an order of magnitude, from 418.9 ± 41.7 kPa for plant-based turkey to 56.7 ± 14.1 kPa for tofu. Similarly, the storage and loss moduli vary from 50.4 ± 4.1 kPa and 25.3 ± 3.0 kPa for plant-based turkey to 5.7 ± 0.5 kPa and 1.3 ± 0.1 kPa for tofu. All three animal products, animal turkey, sausage, and hotdog, consistently rank in between these two extremes. Our results suggest that-with the right ingredients, additives, and formulation-modern food fabrication techniques can create plant-based meats that successfully replicate the full viscoelastic texture spectrum of processed animal meat.

Older individuals experience increased susceptibility and mortality to bacterial infections, but the underlying etiology remains unclear. Herein, it is shown that aging-associated reduction of commensal Parabacteroides goldsteinii (P. goldsteinii) in both aged mice and humans critically contributes to worse outcomes of bacterial infection. The colonization of live P. goldsteinii conferred protection against aging-associated bacterial infections. Metabolomic profiling reveals a protective compound, apigenin, generated by P. goldsteinii, antagonizes bacterial clearance defects in aged mice. AMP-binding protein (ampB) is identified as a key gene involved in apigenin synthesis in P. goldsteinii using homologous recombination in bacteria. Mechanistically, apigenin binds directly to the potential sites on Fgr (M341 and D404), preventing its inhibitory role on Vav1 phosphorylation, and therefore promoting the activation of Cdc42/Rac1, Arp2/3 expression and subsequent actin reorganization, which contributes to the enhanced phagocytosis of macrophages to bacteria. Collectively, the findings suggest that dysbiosis of the gut microbiota may impair host defense mechanisms and increase susceptibility to bacterial infections in older adults and highlight the microbiota-apigenin-Fgr axis as a possible route to ameliorate aging-associated antibacterial defects.

English language systematic reviews with samples from high-income countries have found an inverse relationship between loneliness and cognitive function. Considering that cultural and contextual resources influence the experience of loneliness and cognitive health, we conducted a systematic review analyzing quantitative studies exploring the relationship between loneliness and cognitive function in older adults in Latin America. Following PRISMA guidelines, we used five databases (PubMed, PsycInfo, Scopus, LILACS, and SciELO). Inclusion criteria were: a) quantitative research examining the relationship between loneliness and cognitive health, b) descriptions of loneliness and measures of cognitive function, c) English or Spanish language peer-reviewed articles, and d) a sample of older adults in Latin America (≥60 years). We assessed bias using the Risk of Bias Instrument for Cross-Sectional Surveys of Attitudes and Practices. Seven of the 1,887 studies (all cross-sectional) met the inclusion criteria, comprising 26,440 participants from Brazil or Mexico. Most, but not all, found a significant inverse association between loneliness and cognitive function after controlling for salient health and psychosocial factors. Measures and conceptualizations of loneliness and cognitive function, as well as theoretical explanations linking these concepts, varied. Two studies had a high risk of bias. Current evidence suggests a possible cross-sectional association between loneliness and cognitive function in older adults in these countries. Further research is needed to examine the possible bidirectional relationship using representative samples and longitudinal designs; test pathways linking dimensions of loneliness (e.g., chronicity) to cognitive function (e.g., Alzheimer's disease continuum), and explore Latin American diversity (e.g., countries, indigenous peoples, sexual minorities).

As global economies rapidly develop, the interplay between environmental efficiency, economic development, and public health outcomes has gained significant attention. Air pollution and resource-intensive economic activities threaten both environmental sustainability and human health, including reproductive health and overall well-being.

This study focuses on OECD member countries, using data from 1999 to 2021. An undesirable outputs-oriented DEA approach is employed to assess environmental efficiency across these countries. Baseline regression analysis is conducted to examine the relationship between environmental efficiency and fertility, while heterogeneity analysis explores the impact of industrial and energy consumption structures. Additionally, the moderating effect of economic development levels is investigated.

The baseline regression results indicate an inverted U-shaped relationship between environmental efficiency and fertility, where fertility initially declines as environmental efficiency increases, then rises after reaching a certain threshold. Heterogeneity analysis reveals that industrial and energy consumption structures significantly influence this relationship across different regions. Furthermore, economic development is found to be a reverse moderator: in countries with higher economic development levels, the relationship between environmental efficiency and fertility follows a significant U-shaped curve.

These findings highlight the necessity of integrating environmental policies with public health strategies. Improvements in environmental efficiency may reduce pollution-related health risks, indirectly supporting fertility recovery in advanced economies. By addressing the interaction between environmental efficiency, economic development, and fertility, this study provides evidence-based insights for designing policies that promote sustainable environmental health and equitable social outcomes.

In response to the significant increase in the global aging population, countries have increasingly prioritized Age-Friendly Primary Health Care (AFPHC) to address the unique needs of older adults. This study aims to develop a comprehensive model for assessing the progress of PHC systems in achieving the goals of an elderly-centered services.

A qualitative study design was utilized to develop the progress assessment model for AFPHC initiatives. This process involved a literature review (academic databases and manual search), semi-structured interviews, an expert panel discussion, and the Delphi technique for achieving consensus on the final model. Participants in the semi-structured interviews were selected based on specific inclusion criteria, which required professionals and stakeholders to have a minimum of two years of experience in care for older adults and active involvement in PHC. Additionally, older adults with a university education who had accessed PHC services in Iran at least three times were included. The expert panel was composed of multidisciplinary professionals who met similar criteria, ensuring a diverse and informed perspective.

According to literature review results, 16 main domains and 28 sub-domains were identified. In the next step, through interviews, 7 main domains and 71 indicators were extracted. After summarizing the results of literature reviews, and interviews, and analyzing the results of the Delphi technique, the initial model with 7 main domains, including policymaking and planning processes related to older adults, principles of respect and interaction with older adults, education for older adults, principles of care and provision of services to older adults, access to PHC facilities, physical environment, specialized facilities and equipment, and human resources, was finalized along with the 60 indicators.

The developed model for assessing progress of AFPHC Initiatives offers a comprehensive framework by focusing on key domains and indicators tailored to the needs of older adults. This model serves as a practical tool for assessing the progress of AFPHC, facilitating improvements in the quality and accessibility of PHC services for older adults.

Quality of life (QoL) is a key indicator of well-being in older adults (OAs) and several factors, including nutrition, physical fitness, and dwelling place, can influence QoL. OA residing in institutional settings, such as nursing homes (NH), often can exhibit different QoL outcomes, nutrition status and physical fitness compared to those living independently in age-in-place (AIP) environments. This study seeks to compare the QoL, and physical activity levels of OA residing in NH with those AIP and to evaluate their dietary quality.

This cross-sectional study included a total of 400 voluntary OAs, residing either in Narlıdere Nursing Home and Aged Care Rehabilitation Centre (n = 200) or aging in place (n = 200) in İzmir, Turkey. Participants were recruited between May 2023 and December 2023. Data collection involved face-to-face interviews using a questionnaire that covered demographic and anthropometric measurements, Mini Nutritional Assessment (MNA), Older People's Quality of Life (OPQOL-brief), Physical Fitness and Exercise Activity Levels of Older Adults Scale (PFES), and a 24-hour dietary recall. Nutritional status was further assessed using the Healthy Eating Index for Older Adults (HEI-OA).

Mean age of OAs was 77.8 ± 6.5 years and BMI was 25.8 ± 3.9 kg/m². HEI scores were not differed between groups (NH: 42.8 ± 8.1, AIP: 42.2 ± 11.0, p < 0.542), but AIP residents had lower poor diet quality (NH: 40.4 ± 5.9, AIP: 37.5 ± 7.9, p < 0.001). NH residence had higher OPQOL scores (NH: 54.8 ± 7.8, AIP: 47.6 ± 10.4, p < 0.001), and higher MNA scores (NH: 25.6 ± 2.7, AIP: 22.4 ± 5.5, p < 0.001). NH group had lower PFES scores, indicating reduced physical fitness compared to AIP participants (NH: 67.3 ± 6.3, AIP: 74.7 ± 7.7, p < 0.001). Nutrient intake analysis revealed that NH residents consumed more daily water, protein, and micronutrients than AIP participants, with statistically significant differences in protein, MUFA, and SFA intake (p < 0.001). A significant relationship between MNA and QoL total score in NH (r = 0.157, p = 0.027) and AIP (r = 0.619, p < 0.001) was found.

The findings of this study revealed the potential influence of nutritional status on QoL, in enhancing QoL outcomes.

Metabolic risks are significant factors associated with colorectal cancer. This study aimed to assess global, regional and national burden for CRC attributable to metabolic risks from 1990 to 2021 and to predict mortality by 2046.

Data from the Global Burden of Disease Study 2021 were used to quantify deaths, disability-adjusted life years (DALYs), and age-standardized rates of CRC due to metabolic risk factors, disaggregated by sex, age, region, country/territory, and sociodemographic index (SDI). The average annual percentage change (AAPC) was used to analyze temporal trends from 1990 to 2021. Metabolic risks include high fasting plasma glucose (FPG) and high body mass index (BMI). Future mortality trends up to 2046 were forecast using age-period-cohort models.

Globally, CRC deaths attributable to metabolic risks increased 2.47-fold, rising from 73,443 in 1990 to 181,689 in 2021. The global age-standardized mortality rates (ASMRs) and age-standardized rates of DALYs (ASDRs) of CRC attributable to high FPG and ASDRs attributable to high BMI increased from 1990 to 2021. The ASMRs and ASDRs of males was higher than that of females, with increasing trends. Central Europe had the highest ASMRs and ASDRs of CRC attributable to metabolic risks in 2021. Most regions and countries showed increasing trends in ASMR and ASDR for CRC due to metabolic risks, with Andean Latin America, Southeast Asia, and Cabo Verde increasing the most. High-SDI regions had the largest burden of CRC attributable to metabolic risks, while burden of other SDI regions have been significantly increased. A positive association was observed between SDI and age-standardized rates (ASMR: RFPG = 0.803, RBMI = 0.752; ASDR: RFPG = 0.812, RBMI = 0.756). By 2046, the ASMR of CRC attributable to high FPG was projected to remain stable and the ASMR due to high BMI was expected to see a slightly increase.

Colorectal cancer deaths and DALYs attributable to metabolic risk factors remain high, particularly in males and high-SDI regions. Further researches into the metabolic mechanisms of CRC and effective treatment strategies are needed.