The Mediterranean Diet (MD) is a dietary pattern associated with reduced chronic disease risk and increased longevity. This systematic review and meta-analysis aimed to evaluate the association between adherence to the MD and frailty and disability among older people.

A comprehensive literature search was conducted in PubMed/MEDLINE, Cochrane Library, Embase, and Scopus (search date: February 28, 2024) without date restrictions. Observational and interventional studies examining the association between MD adherence (measured by any validated score) and frailty or disability, using any definition, and their complications were included. Study selection and data extraction were performed independently by pairs of reviewers using Covidence. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analysis was conducted, estimating pooled relative risks (RRs) per 1-point increment in MD adherence score. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated by funnel plot. Certainty of evidence was graded using the NUTRIGRADE approach.

Out of 1361 screened records, 19 observational studies were included. Higher MD adherence was associated with a lower incidence (9 cohort studies, n = 94 072 participants; OR = 0.95, 95% CI: 0.93-0.97; moderate certainty of evidence) and prevalence (6 cross-sectional studies, n = 12 277participants; OR = 0.94, 95% CI: 0.90-0.98; low certainty of evidence) of frailty. The association with disability was present only for prevalence (OR = 0.98; 95% CI: 0.97-0.98).

Higher adherence to the MD is associated with a reduced presence of frailty and disability in older adults. These findings support public health strategies promoting the MD as a sustainable dietary model for healthy longevity.

This paper reviews the existing literature supporting a role for fatty acid ethanolamides including oleoylethanolamide and palmitoylethanolamide in regulating cholesterol and triglyceride metabolism and the mechanisms underlying these effects.

Deletion of various fatty acid ethanolamide biosynthesis genes in cellular models and small animal models have provided additional evidence that endogenous biosynthesis of fatty acid ethanolamides regulates cholesterol and triglyceride metabolism, while new clinical trials using oleoylethanolamide and palmitoylethanolamide support their therapeutic potential to normalize lipid levels in individuals with cardiometabolic disease. Fatty acid ethanolamides are biosynthesized in the intestine, liver, and adipose tissue in response to metabolic stimuli like fasting and feeding. These fatty acid ethanolamides then act via receptors including PPARα, GPR119, and GPR55 to regulate cholesterol and triglyceride levels and promote the resolution of inflammation, thereby protecting against cardiometabolic diseases including metabolic-dysfunction associated steatotic liver disease and atherosclerotic cardiovascular disease.

Primary percutaneous coronary intervention (PPCI) is the preferred treatment for ST-segment elevation myocardial infarction (STEMI). Treatment delay significantly affects the prognosis of STEMI patients.

The aim of this study was to investigate the treatment delay and its influencing factors for STEMI in Beijing.

STEMI patients undergoing PPCI at 65 hospitals between 2018 and 2022 were enrolled. Treatment delays were collected and analyzed using mixed-effects models to assess the impact of admission time, arrival mode, and hospital level.

Among 13,445 individuals, median total ischemic time (TIT), symptom onset-to-door time (S2D), and door-to-balloon time (D2B) were 188 minutes (Q1-Q3: 133-288 minutes), 116 minutes (Q1-Q3: 60-200 minutes), and 72 minutes (Q1-Q3: 58-89 minutes), respectively. Compared with off-hours admissions, S2D was longer and D2B was shorter for on-hours admissions (P < 0.001 for both). Median TIT, S2D, and D2B were longer for self-transported patients than for ambulance-transported patients (P < 0.001 for all). Median TIT and S2D were shorter and D2B was longer at nontertiary hospitals than at tertiary hospitals (P < 0.001 for all). According to linear mixed-effects models adjusting for confounders, off-hours admission was linked to 6.6% shorter S2D but 11.6% longer D2B. Ambulance transport was independently associated with 9.0% shorter S2D and 10.3% shorter D2B. Treatment at tertiary hospitals was associated with 19.0% longer S2D.

Despite advances in STEMI management, prehospital delay remains the dominant component of TIT in Beijing. Future strategies should focus on improving hospital preparedness, increasing ambulance use, and minimizing interhospital disparities to reduce treatment delay.

Endothelial dysfunction induced by lipotoxicity is a critical initiating factor in atherosclerosis. Sweroside, a bioactive iridoid glycoside, possesses significant anti-inflammatory activities; however, its therapeutic potential in regulating vascular endothelial inflammation and dysfunction remains unexplored. This study aimed to investigate the protective effects of Sweroside against endothelial injury and to elucidate the underlying molecular mechanisms, specifically focusing on the transcriptional regulation of inflammatory cascades.

Human umbilical vein endothelial cells (HUVECs) and mouse aortic endothelial cells (MAECs) stimulated with palmitic acid (PA), along with C57BL/6J mice fed a high-fat diet (HFD), served as the in vitro and in vivo models, respectively. Transcriptome sequencing (RNA-seq) was employed to screen for potential therapeutic targets. Molecular mechanisms were validated using small interfering RNA (siRNA) knockdown, Western blotting, and dual-luciferase reporter assays. Vascular function was evaluated via wire myograph to assess endothelium-dependent relaxation and pulse wave velocity (PWV) to measure arterial stiffness.

Sweroside treatment significantly attenuated PA-induced cytotoxicity, oxidative stress, inflammation, and cytoskeletal disruption in ECs. RNA-seq identified Krüppel-like Factor 2 (KLF2) as a core target up-regulated by Sweroside. Mechanistically, Sweroside restored KLF2 expression, which subsequently functioned as a transcriptional repressor by directly binding to the promoter of Fatty Acid Binding Protein 4 (FABP4). This repression reduced FABP4 levels, thereby alleviating the suppression of PPAR-γ and blocking the NF-κB-dependent induction of the downstream chemokine CCL20. In vivo, Sweroside administration effectively improved endothelium-dependent relaxation, and reduced aortic stiffness and vascular inflammation in HFD-fed mice.

Sweroside ameliorates endothelial dysfunction and vascular remodeling by activating the KLF2-mediated signaling axis to repress FABP4 and the downstream CCL20 inflammatory cascade. These findings highlight Sweroside as a promising therapeutic candidate for the treatment of atherosclerosis and cardiovascular diseases associated with metabolic inflammation.

It is analyzed whether differences in how the daily usage time is determined in a population exposed to hand-transmitted vibration are the cause of discrepancies between exposure-response models constructed for vibration-induced white finger (VWF). The predictions of the models are then used to evaluate the one in ISO 5349-1:2001.

Pooled analyses employing data from epidemiologic studies of vibration-exposed occupations deemed the most reliable, together with published ratios between daily tool or machine usage times determined by questionnaire or interview and measured values, are used to construct exposure-response relations. These models are compared to those in which the daily usage time is not compensated.

Of 17 data points, for 7 the usage time ratio is greater than 1, and for the rest the ratio is equal to 1. Adjusting daily vibration exposures, expressed as A(8)-values, by means of such ratios, results in reductions of varying magnitude. However, the exposure-response models show minor changes, and the scatter in the data points previously observed remains.

Methods for estimating 10% prevalence of VWF from the prevalence recorded in a population study are found to have more effect on the models than different methods for estimating the daily usage time. Yet, the spread and clustering in the data remain and point to issues in the constituents of the A(8)-value. The ISO relation is generally consistent with the lower 95-percentile confidence limit of the models and so provides a conservative exposure limit at least for A(8)-values greater than about 3 [Formula: see text].

Mental health conditions account for 18% of years lived with disability worldwide. 1-in-6 adults are affected in England, with most mental health conditions beginning in childhood and adolescence. Mental distress and ill health are unequally distributed in the UK, with strong associations with wider determinants of health, and higher prevalence among systemically disadvantaged groups. Currently, there is a lack of evidence to inform effective and timely policymaking for primary prevention in the UK.

In recognition of these challenges, a national Population Mental Health (PMH) Consortium was established, as part of Population Health Improvement UK (PHIUK). PHIUK is a national research network which works to transform health and reduce inequalities through change at the population level. Our aim is to establish an interdisciplinary PMH Consortium, focussing on upstream determinants and the prevention of risks and onset of mental health conditions through interdisciplinary stakeholder engagement, to create new opportunities for population-based improvement of mental health in the UK.The PMH Consortium brings together leading interdisciplinary representation in population mental health, spanning from sciences to the arts, across the UK. Membership includes six academic institutions, third sector organisations, lived experience expertise, and strong links with national bodies to ensure integrated cross-national and regional policy impact. The PMH Consortium comprises four cross-cutting platforms (Partners in policy, implementation, and lived experience; Data, linkages, and causal inference; Narrowing inequalities; Training and capacity building) and three challenge areas (Children and young people's mental health; Prevention of suicide and self-harm; Multiple long-term conditions) which are highly integrated and interdependent. The work will be underpinned by a Theory of Change across an initial four-year life cycle.

This paper describes the aim, objectives, and approach of the PMH Consortium, as well as anticipated challenges and strengths. The goal of the PMH Consortium is to develop a model for population mental health research and policy translation that is both scalable and sustainable. It is critical to ensure continued impact and viability beyond the initial four years, contributing to the prevention of mental health conditions in the UK, with personal, economic, social, and health benefits.

Hidradenitis suppurativa (HS), an inflammatory skin disorder characterized by painful nodules and abscesses, has varying prevalence among different races/ethnicities. This study explored the social drivers of health, burden, and impact of HS among different racial and ethnic groups.

An online, cross-sectional survey was conducted among adult patients with HS (September 2023-December 2023) in the USA. Patients were recruited through HS Connect (patient advocacy group) and AmeriSpeak (US national sample panel). Descriptive data were collected using patient-reported outcome measures and de novo questions about patients' disease knowledge and perception, healthcare access and utilization, impact on quality of life (QoL), and social impact. All analyses were descriptive and stratified by racial/ethnic groups.

The study included 583 patients (mean age, 34.8 years; 95.5% female) representing a range of racial backgrounds: Black or African American (n = 273; 46.8%), white (n = 236; 40.5%), Two or More Races (n = 47; 8.1%), American Indian or Alaska Native (n = 18; 3.1%), Asian (n = 7; 1.2%), and Native Hawaiian and Other Pacific Islander (n = 2; 0.3%). Ethnic representation also varied (Hispanic/Latino = n = 76; 13.0%). Patients of all races and ethnicities reported considerable QoL impact (Dermatology Life Quality Index, EQ-5D-5L), with results for smaller subgroups (n < 10) included for descriptive completeness only and not intended for comparison with other groups. During flaring, most patients used over-the-counter products/medications (54.2%) or nonmedical intervention/home remedy (56.9%) Up to 36.5% of patients reported challenges in procuring food, utilities, medicine/healthcare, phone, clothing, or childcare when needed in the past year. Among those who paid out-of-pocket for their HS treatment, 55.6% reported that it stopped them from visiting a healthcare provider for treatment.

The findings indicate a high burden and impact of HS across all races and ethnicities. Patients reported social drivers of health and challenges with healthcare utilization, indicating the need for integrating social workers and care management teams in dermatology practice, which could facilitate improved care of patients with HS.

Parents of undiagnosed children (POUC) experience significant psychosocial challenges, including anxiety, uncertainty, and isolation, that stem from parenting medically complex children while facing obstacles throughout the diagnostic journey. Despite these well-described challenges, a mental health intervention designed to meet the unique needs of POUC, which is necessary to promote the psychological and overall wellbeing of this population, does not exist. Acceptance and Commitment Therapy (ACT) has proven effective in a wide range of populations and shows promise for POUC. With the goal of designing and implementing an ACT-based intervention tailored to POUC, this pre-implementation study aimed to understand their psychosocial needs and prior mental health support experiences, explore their reactions towards ACT, and determine their anticipated barriers, facilitators, and preferences for participating in an ACT skills group, guided by the Consolidated Framework for Implementation Research (CFIR).

Semi-structured, individual interviews were conducted with 18 POUC, including an experiential portion that exposed participants to key ACT concepts and exercises. Inductive coding based on participant responses and deductive coding based on the CFIR were employed to code interview transcripts. Reflexive thematic analysis was performed to identify key findings.

Isolation was a psychosocial challenge for which all participants desired support. Many participants reported inadequacies in their prior mental health support, primarily due to lack of understanding from therapy providers regarding their unique circumstances. Although most participants indicated that ACT could help them manage difficult thoughts and emotions and act in alignment with their values, they also described achievability, collaboration, and accountability as key elements that could support their uptake. The main barriers, facilitators, and preferences that participants highlighted were related to group design (accessibility, flexibility) as well as their own characteristics as recipients (capability, need, and motivation).

This pre-implementation study affirmed the potential value of ACT for POUC and identified key opportunities for tailoring an ACT skills group to meet their needs. Future research, including pilot implementation studies, are needed to evaluate the effectiveness of a tailored ACT skills group and further refine both the intervention and its implementation strategy.

To understand circumstances surrounding transitions between initial drug use, non-prescribed opioid use, and injection drug use (IDU) among people who use non-prescribed opioids in the rural U.S.

We interviewed adults who use non-prescribed opioids in 10 states. We coded transcript data regarding age, drug, modality, circumstances for each "first use" event and transitions to illicit opioid use/IDU. Transition-related themes were categorized using the Social Ecological Model (SEM) through iterative qualitative memoing. We calculated frequencies and measures of central tendency.

Participants (n = 304, mean age [MA] = 36 years, 56% male) reported marijuana or opioid pills as first drug used (60%, reported MA = 13, and 16%, MA = 19, respectively). First opioid use (MA = 20) was typically pills (74%); 43% were initially prescribed opioids for pain. Of participants reporting IDU (92%, MA = 24), first drugs injected were methamphetamine (26%), opioid pills (22%), and heroin (22%). Reasons for first injection of these three substances were recreational (65%, 84%, 66%, respectively) followed by mental health coping (35%, 16%, 33%). Interviews revealed factors influencing transition to illicit opioid use/IDU at environmental, interpersonal, and intrapersonal levels of the SEM, including early household exposure to drugs, and family/peer encouragement to use opioids for coping. Participants described initial use of prescribed opioids following surgery or workplace injury, followed by illicit use of opioids and later IDU for recreational as well as practical goals. IDU was facilitated by intimate partners and friends in the context of diminished local access to illicit opioid pills.

Among people who use opioids and inject drugs in the rural U.S., drug use typically started in pre-adolescence, first opioid use in early adulthood, and IDU a few years later, highlighting the need for early intervention. Methamphetamine comprised a substantial proportion of initial IDU raising concerns for polysubstance use. Drug use for coping highlights the need for increased mental health resources in rural areas.

Early adolescence is key for adopting healthier lifestyles, yet disadvantaged communities often lack resources to support these changes, perpetuating health inequities. Schools play a crucial role in promoting physical activity and healthy eating. eHealth solutions, like online platforms, offer scalable, cost-effective ways to deliver interventions. These platforms can also enhance adolescent engagement and help bridge health resource gaps. The ePro-Schools project aims to co-design and test an eHealth platform to promote healthy habits among adolescents in socially disadvantaged settings.

A randomized controlled trial (RCT) will be carried out with the participation of 6 secondary schools (three controls and three intervention), with a sample size estimated at 1000 students of Central Catalonia (Spain). In the intervention schools, focus groups sessions and meetings with stakeholders have been conducted to co-create the ePro-Schools eHealth platform. Students and school staff are pilot testing the platform to assess the platform's usability, functionality, and layout. Finally, the RCT will be conducted, in which the intervention group will have full access to the ePro-Schools platform (an interactive and informative platform), while the control group will only have access to the informative platform with health literacy content on physical activity, nutrition, and healthy habits. In both groups, adolescents will complete validated questionnaires at baseline, post-intervention, and at the six-month follow-up to assess their physical activity and eating habits, including depressive symptoms, quality of life, social isolation, and mental health. Sociodemographic characteristics will also be collected. Implementation, effectiveness, and cost-effectiveness analysis will be performed.

The ePro-Schools project introduces a co-designed eHealth platform that integrates physical activity and healthy eating promotion within schools. The intervention aims to enhance adoption, relevance, and sustainability across diverse settings. ePro-Schools project could reduce health inequalities, improve adolescents' physical and mental well-being, and strengthen daily health habits. The model's scalability and embedded implementation planning may support long-term integration into school systems, informing future policies and contributing to educational engagement, reduced disease risk, and broader population health impact.

This trial is registered in ClinicalTrials.gov, with the registration number NCT06792461.