Health education spans outreach clinics: a concept to consider.
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BACKGROUND: Nutrition plays a central role in the biological mechanisms that shape aging, health span, and longevity. Micronutrients—including vitamins, trace elements, and polyphenols—support genomic stability, mitochondrial integrity, and antioxidant defense, while dietary patterns rich in plant-based foods modulate inflammation, metabolic regulation, and epigenetic processes. Centenarian populations consuming Mediterranean, Okinawan, Nordic, and Nicoyan diets offer a natural model for understanding how nutrient-rich, minimally processed foods, moderate caloric intake, and balanced lifestyles interact with molecular pathways to extend functional life. MAIN BODY: This review synthesizes current evidence on how micronutrients influence DNA repair, oxidative stress reduction, and mitochondrial protection, particularly through the actions of vitamins C and E, niacin-dependent PARP activity, folate-mediated methylation, and metal cofactors involved in antioxidant enzymes. Plant-based diets rich in fiber and polyphenols enhance microbial diversity and promote beneficial taxa such as Akkermansia and Bifidobacterium, supporting gut barrier integrity and immune balance. Caloric restriction and intermittent fasting activate nutrient-sensing pathways, including AMPK and sirtuins, reduce mTOR activity, and stimulate autophagy, collectively improving cellular resilience. Findings from centenarian regions highlight the convergence of lifestyle, nutrition, and cultural practices that reduce systemic inflammation, maintain metabolic flexibility, and support healthy aging trajectories. CONCLUSIONS: Diet emerges as a decisive modifiable determinant of lifespan and health span. The convergence of molecular nutrition, microbiome composition, and traditional dietary habits underlies the exceptional longevity observed in centenarian populations. Future research should integrate nutrigenomics, metabolomics, and microbiome profiling to clarify causal mechanisms and guide precision nutrition strategies for aging societies.
Postmenopausal women represent the fastest-growing demographic at risk of sarcopenia and cardiometabolic disease, yet exercise biology research remains disproportionately derived from male or hormone-replete phenotypes. Menopause constitutes a chronic endocrine perturbation characterized by sustained reductions in estrogen and progesterone, and altered androgen balance, superimposed on the acute and chronic perturbations induced by exercise. This hormonal shift modifies substrate metabolism, inflammation, redox balance, and recovery capacity, factors that shape molecular responses to exercise across tissues and time. Here, we synthesize current evidence on exercise responses in postmenopausal females across genomics, epigenomics, transcriptomics, proteomics, and metabolomics/lipidomics. Across omics layers, direct data in postmenopausal cohorts remain limited, with frequent underreporting of menopausal status, hormone therapy exposure, circulating hormone concentrations, medication use, and biosampling timing relative to exercise and hormone dosing. We outline a menopause-aware framework for exercise-omics that prioritizes endocrine stratification, repeated sampling across exercise and recovery, and integrative multi-omics approaches linking molecular responses to functional outcomes. We also outline minimum reporting standards to improve reproducibility, inclusivity, and translational relevance. Advancing menopause-aware exercise-omics will be essential for developing precision exercise strategies that improve health span and functional independence in later life.
BACKGROUND: Leukocyte telomere length (LTL) and epigenetic age acceleration (EAA) are widely studied biomarkers of biological aging, but their potential roles in healthspan remain unclear. We evaluated whether genetically proxied LTL and EAA show evidence of potential effects on healthspan. METHODS: We conducted a two-sample Mendelian randomization study. Genetic instruments for LTL and four EAA biomarkers were obtained from published genome-wide association studies, including up to 472,174 individuals for LTL and approximately 35,000 individuals for each EAA biomarker. Summary statistics for healthspan, defined as age at first diagnosis of any of eight major chronic conditions or death, were derived from 300,447 unrelated European-ancestry participants in the UK Biobank. We used inverse-variance-weighted (IVW) models for the main analysis, with complementary MR estimators and sensitivity analyses to evaluate consistency, pleiotropy, instrument heterogeneity, and robustness. RESULTS: Genetically proxied longer LTL was associated with extended healthspan (IVW β = 0.106; 95% CI: 0.054-0.158; p = 6.9 × 10-5). The association was robust across multiple sensitivity analyses. In contrast, the four genetically proxied EAA biomarkers did not show consistent MR evidence of an association with healthspan. CONCLUSIONS: These findings provide genetic evidence consistent with a potential role of LTL in healthspan, while providing little support for comparable associations involving the genetically proxied components of the evaluated EAA biomarkers. The findings do not exclude potential associations with environmentally or physiologically acquired EAA.
The interrelationships between diet and life span are reviewed, with emphasis on results obtained in studies with experimental animals. Ad libitum feeding throughout life does not promote maximal survival and food restriction increases mean life span. The possible importance of total energy, carbohydrate, and protein intake are considered, as well as the influence of mode of feeding. A number of mechanisms that might explain how nutrition affects life span are discussed, including disease pattern, free radicals, neuroendocrine system, and protein turnover. The significance of these findings in relation to the health and life span of human subjects is not known and deserves further exploration. However, they emphasize the importance of diet as a tool to help explore the biochemical and physiological basis for aging in animal models.
Saccharin is carcinogenic for the urinary bladder in rats and mice, and most likely is carcinogenic in human beings. The neoplasms of the urinary bladder are malignant and invade and metastasize. Male rats are more susceptible to urinary bladder carcinogenesis than female rats. Rats exposed as fetuses develop neoplasms more readily than rats exposed as weanlings. The lesions in the urinary bladder go through the stages of hyperplasia, hyperplastic nodules, and later carcinomas. The male of the human species ingesting saccharin, as for rats, is more susceptible to carcinogenesis of the urinary bladder than the female. Neoplasms of the urinary bladder in rats were not caused by stones, parasites, sodium, or impurities. There is a cocarcinogenic effect between saccharin and methylnitrosurea for the urinary bladder. Even through carcinomas of the urinary bladder are present in rats given the higher doses of saccharin, one was observed in a female rat given 0.5%. Chronic renal disease develops in rats ingesting saccharin. The disease is more advanced at the lower doses than at the higher doses, suggesting that saccharin at the lower doses does not reach the urinary bladder. Early neoplasms are seen in the renal pelvis of rats given the higher doses of saccharin. The risk ratios for urinary bladder carcinomas in human beings increase with both frequency andduration of saccharin usage. Benign and malignant neoplasms at all sites are significantly increased in mice and rats ingesting the higher doses of saccharin. These neoplasms are present in the reproductive and hematopoietic systems, and to a lesser extent in the lungs, vascular system and squamous epithelium. Neoplasms in some organs develop with the lower doses of saccharin. Lymphosarcomas of the lung are significantly increased in rats given 0.01% saccharin. Chronic renal disease in rats given saccharin interferes with the health and life span and consequently with development of neoplasms. Saccharin initiates neoplasms of the skin when its application is followed by croton oil. Epidemiological studies have not been done for neoplasms other than the urinary bladder in human beings.
Aspects of social and psychologic functioning are compared for 51 patients randomly assigned to surgical or medical management of chronic stable angina. No differences were found between the two groups in work status, social activity, adequacy of family functioning, perceived health, life satisfaction, memory span, extent of anxiety, hypochondriasis and hysteria. However, surgically treated patients were significantly less depressed and more likely to report improvement in health and family functioning after the initiation of treatment. It is concluded that the psychologic and social outcomes appear slightly more favorable in patients treated surgically than in those treated medically.
This article reports the results of an investigation of the professional activities of graduates of National Institute of Mental Health-supported residency programs, spanning the five-year period 1968 to 1972. The results explode the mythical notion that the majority of such trainees enter straightway into the private practice careers. In fact, the majority devote at least half-time to some type of public-service psychiatry, with no less than 43% in full-time public service.
BACKGROUND: Female athlete health encompasses multiple interconnected domains; however, the self-report screening tools used to assess these domains have not been comprehensively synthesised. OBJECTIVE: To systematically identify self-report health screening tools used to assess female athlete health, map domain coverage, determine validation reporting, and describe application across participation levels. METHODS: This systematic review was pre-registered with PROSPERO ( CRD420251056910 ) and conducted in accordance with PRISMA guidelines. Four databases (PubMed, MEDLINE, SPORTDiscus and Web of Science) were searched from inception to January 2026 using female health and screening-related terms. Methodological quality was appraised using Joanna Briggs Institute and National Institutes of Health tools, and findings were synthesised descriptively. Eligible, peer-reviewed studies reported the use, development or validation of self-report health screening tools assessing one or more domains relevant to female health applied in female athlete populations, spanning recreational through elite participation levels. All sports and activities were included. The search was restricted to English language with no date limits. RESULTS: In total, 360 studies (1990-2026) representing 134,506 female participants spanning recreational to elite sport and 273 screening tools were included. Mental health (n = 77, 34.1%), disordered eating (n = 33, 14.6%) and body image (n = 30, 13.3%) predominated. Domains related to female health, including menstrual health, pelvic floor health, pregnancy/postpartum and breast health were comparatively underrepresented. Most studies reported tools were used for risk identification (n = 323, 80.3%). Validation reporting was inconsistent, with half (n = 180, 50%) reporting use of at least one validated tool. Tool use was concentrated in professional and elite sport, with limited inclusion of recreational, masters and disability athlete cohorts. Health literacy constructs were explicitly assessed in 12.5% of studies (n = 45). CONCLUSIONS: Health screening in female athlete populations remains fragmented and uneven in domain coverage, with inconsistent validation reporting. Development of integrated, multi-domain and contextually inclusive screening frameworks is warranted.
The essential trace element selenium retards the growth of certain chemically induced tumors in animals. The addition of subtoxic amounts of this element in form of selenite to the supply water lowers the incidence of spontaneous mammary tumors in female C3H mice significantly without affecting the health and life-span of the animals. Arsenic, a selenium antagonist, administered in form of arsenite in the supply water, also lowers the tumor incidence at dosage levels of 10 ppm, but those animals which develop spontaneous mammary tumors under these conditions demonstrate dramatically enhanced tumor growth rates. The results of initial epidemiological studies suggest that the human cancer mortality is lower in areas providing an adequate dietary intake of selenium as estimated from the selenium content in grains and forage crops in various regions of the United States, or the dietary selenium intakes as calculated from food consumption data in various countries.
BACKGROUND: Osteoporosis is influenced by both genetic and environmental factors, yet the relative contribution of the exposome remains unclear. This study aimed to systematically identify non-genetic exposures related to osteoporosis and develop an exposome risk score (ERS) to evaluate individual osteoporosis susceptibility. METHODS: We conducted an exposome-wide analysis of 477,792 UK Biobank participants to identify key exposures associated with osteoporosis. The selected exposures were combined into a weighted Meta-ERS and validated in the Scotland/Wales cohort. The Meta-ERS was further compared with polygenic risk scores (PRS) and linked to plasma proteomics to explore underlying biological pathways. RESULTS: We identified 41 independent non-genetic exposures spanning socioeconomic status, mental health, sleep, diet, smoking, physical activity, environment, and marital status, with socioeconomic status and mental health emerging as the most significant drivers. Based on the identified exposures, we constructed eight domain-specific exposure risk scores and integrated them into a weighted Meta-ERS. The Meta-ERS (R2 = 5.1%; Proportion of Chi-Square = 14.3%) demonstrated an ability to explain osteoporosis variation that was on par with polygenic risk scores (R2 = 4.8%; Proportion of Chi-Square = 12.0%). Importantly, modifying unfavorable exposures mitigated the negative effect of PRS on osteoporosis, particularly among high PRS individuals (1.5- to 1.8-fold greater absolute risk reduction than in those with low PRS). Proteomic analyses further revealed potential mechanisms through which the exposome influences osteoporosis, including hormonal regulation, inflammation, ossification, muscle development, lipid metabolism, and accelerated bone aging. Among these, growth/differentiation factor 15 was identified as a key mediator protein, with a mediation proportion of 13.13%-36.52%. CONCLUSIONS: The Meta-ERS facilitates the quantification of individual osteoporosis risk and identifies modifiable exposures for targeted prevention. Its application can enable personalized risk stratification and guide lifestyle or environmental interventions.
Preventive health is an appealing method to better our quality of life. However, in the practice of preventive health, its probabilistic nature and the time lag for results lessen its appeal. The specter of genetic diseases also has a probabilistic nature but has a time lag that spans generations. Thus any preventive health effort for genetic diseases should be studied so the results can be predicted in advance. A number of mathematical genetic problems have been solved that include mutation and phenotype selection factors. This paper takes a large human population that has birth and death frequencies that vary with age and that operates under Mendelian genetics. Hypothetical mutation and backmutation rates are put into this population; this results in an adverse effect on the death rate for those individuals born with homogenously mutated genes. This is called a genetic defect. The mutated genes are carried in the gametes of individuals who are born with the genetic defect and those who are exposed to the mutation rates; their manifestation is an increased probability of producing method gametes for reproduction. The preventive health control effort is birth control after genetic counseling. Various combinations of birth control selection effectiveness are tried on the different genotypes. It is found that a high selection factor for homogenously mutated genotypes gives the best result for reducing excess deaths caused by the genetic defect, and that a selection factor for heterozygous genotypes is a counterproductive effort. This model, employing a set of difference equations, may be used to evaluate preventive health policies on the control of genetically linked diseases such as sickle cell anemia, which affect the death rate of afflicted individuals. Also, effects other than death rate may be incorporated to evaluate policies on genetic diseases such as retinal blastoma.
The authors studied potential violations by mental health centers of individuals' rights to privacy and confidentiality by sending questionnaires to state directors of mental health programs and to mental health centers in all the 50 United States and its teritories. The questionnaires assessed the extent to which information that could identify a patient is reported to state offices; it also addressed issues of mental health center discretion in reporting information, the life span of patient files, and the access of outside agencies to mental health center files. The authors conclude that legislative action prohibiting the reporting of identifying information appears desirable.
Microbiomes play crucial roles in diverse ecosystems, spanning environmental, agricultural, and human health domains. However, in-depth metagenomic data analysis presents significant technical and resource challenges, particularly at scale. Existing computational pipelines are typically limited to either reference-based or reference-free approaches and exhibit inefficiencies in process large datasets. Here, we introduce MetaflowX (https://github.com/01life/MetaflowX), an open-resource workflow integrating both analytical paradigms for enhanced metagenomic investigations. This modular framework encompasses short-read quality control, rapid microbial profiling, hybrid contig assembly and binning, high-quality metagenome-assembled genome (MAG) identification, as well as bin refinement and reassembly. Benchmarking tests showed that MetaflowX completed full metagenomic analyses up to 14-fold faster and with 38% less disk usage than existing workflows. It also recovered the highest number of high-quality and taxonomically diverse MAGs. A dedicated reassembly module further improved MAG quality, increasing completeness by 5.6% and reducing contamination by 53% on average. Functional annotation modules enable detection of key features, including virulence and antibiotic resistance genes. Designed for extensibility, MetaflowX provides an efficient solution addressing current and emerging demands in large-scale metagenomic research.
Utilization patterns in two adjacent rural Utah counties were compared over a span of five years (1971-1976). In one, a three-physician National Health Service Corps site was established during the interval; the other went from one family physician to two during the same period. The Corps site showed an increase in physician utilization while the "control" county utilization remained unchanged. However, despite the increased utilization of physicians in the Corps site, fewer respondents identified a family physician, especially one located within the county. This is consistent with an interpretation that county residents were content to use Corps physicians, but saw them as transitory figures with whom they could form no permanent attachment. A second brief follow-up study a year later suggests that the community had already begun to acknowledge the Corps doctors as their family physicians.
We evaluated the performance of commonly used methods for estimating the reliability of binomial health care quality measures using simulated datasets spanning a range of performance score means and variances, numbers of entities, and patient sample sizes. For each simulation, reliability was estimated for all selected methods and compared with the known true reliability derived from the simulation parameters, with methods assessed on their accuracy and precision. Logistic regression with reliability estimated on the outcome scale demonstrated the highest accuracy and precision among all methods evaluated. The widely used Adams beta-binomial method performed poorly, although a modification recommended by Nieser and Harris substantially improved its performance. These approaches are applicable only to binomial measures. Among methods that can be applied to both binomial and continuous measures, permutation resampling of the Spearman rank correlation coefficient was the most accurate and precise, outperforming other commonly used approaches. Overall, for binomial quality measures, logistic regression on the outcome scale is the preferred method for reliability estimation, followed closely by the modified beta-binomial approach, while for non-binomial measures, permutation-based Spearman rank correlation appears to be the most suitable method.
AIM: This study aimed to summarize the current state of the science for "health service delivery-oriented outcomes" from nursing in genomics (2012-2025). BACKGROUND: Nurses can play a vital role in increasing access to genomic healthcare and improving outcomes for patients, families, and communities. METHODS: We conducted a scoping review of the literature in four databases (2012-2025). Articles were categorized using the Cochrane Collaboration outcome domains and sub-domains to identify salient topics and synthesize findings. RESULTS: Of 11,646 retrieved articles, 66 publications reporting "health service delivery-oriented outcomes" were included for analysis. Identified articles spanned three sub-domains: "service delivery level," "related to research," and "societal or governmental." Within sub-domains, articles were further categorized into dimensions, the most prominent being "service utilization" under the "service delivery level" sub-domain. Studies were primarily from anglophone countries and near-evenly split into interventional and noninterventional studies. Studies reported that nurses working in multidisciplinary and/or interprofessional teams are a cost-effective means to increase access to genomic healthcare and reduce burden on genetic specialists. Nurses are incorporating genomics in various settings, including oncology, pharmacogenomics, genetic counseling, rare genetic diseases, and symptom science. CONCLUSION: Despite evidence of nurses contributing to health system delivery-oriented outcomes, evidence suggests that nurses are underutilized and underprepared in genomic healthcare. IMPLICATIONS FOR NURSING: A significant barrier to integrating genomics into nursing practice is a lack of foundational knowledge and genomic competency across nursing education, clinical practice, and nursing policymakers. IMPLICATIONS FOR NURSING POLICY: Nursing leadership spanning education, research, practice, and policy domains will be critical for integrating genomics in nursing practice and improving health system delivery-oriented outcomes.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic illness with a multifactorial etiology and heterogeneous symptomatology, posing major challenges for diagnosis and treatment. Here we present BioMapAI, a supervised deep neural network trained on a 4-year, longitudinal, multi-omics dataset from 249 participants, which integrates gut metagenomics, plasma metabolomics, immune cell profiling, blood laboratory data and detailed clinical symptoms. By simultaneously modeling these diverse data types to predict clinical severity, BioMapAI identifies disease- and symptom-specific biomarkers and classifies ME/CFS in both held-out and independent external cohorts. Using an explainable AI approach, we construct a unique connectivity map spanning the microbiome, immune system and plasma metabolome in health and ME/CFS adjusted for age, gender and additional clinical factors. This map uncovers altered associations between microbial metabolism (for example, short-chain fatty acids, branched-chain amino acids, tryptophan, benzoate), plasma lipids and bile acids, and heightened inflammatory responses in mucosal and inflammatory T cell subsets (MAIT, γδT) secreting IFN-γ and GzA. Overall, BioMapAI provides unprecedented systems-level insights into ME/CFS, refining existing hypotheses and hypothesizing unique mechanisms-specifically, how multi-omics dynamics are associated to the disease's heterogeneous symptoms.