The central nervous system exhibits exceptionally high metabolic demands, yet neurons possess limited intrinsic metabolic reserves. As a result, neuronal function and survival depend on coordinated metabolic interactions with glial cells, a process collectively described as glial–neuron metabolic coupling. This review evaluates mechanistic and experimental evidence on glial–neuron metabolic interactions, identifies gaps and inconsistencies in current knowledge, and examines how these pathways are altered across aging, injury, and regeneration. A qualitative synthesis of mechanistic, experimental, and translational studies was conducted, focusing on astrocyte–neuron, oligodendrocyte–axon, and microglial–neuronal metabolic interactions. Evidence was integrated across aging, central nervous system injury, and regenerative contexts to identify conserved mechanisms and therapeutic opportunities. Evidence from experimental and translational studies indicates that astrocytes, oligodendrocytes, and microglia dynamically regulate neuronal energetics through lactate shuttling, lipid transfer, mitochondrial exchange, and immunometabolic signaling. Aging is associated with impaired glial glycolysis, reduced lactate availability, mitochondrial dysfunction, and chronic inflammatory metabolic states, contributing to neuronal vulnerability. Acute injury induces transient glycolytic reprogramming and metabolic compensation, which, when prolonged, promotes excitotoxicity and failed repair. In contrast, regenerative states engage adaptive glial metabolic responses, including enhanced lactate shuttling, mitochondrial donation, and redox remodeling, supporting neurogenesis, remyelination, and synaptic recovery. Glial–neuron metabolic coupling is a unifying framework linking energy metabolism to neural resilience, repair, and degeneration. While emerging pharmacological, dietary, and gene-based strategies targeting glial metabolism show promise, most evidence remains preclinical. Advancing clinical translation will require integrative multiomics approaches, improved metabolic imaging, and human-relevant models.
Postpartum depression (PPD) is a significant public health concern. Trace minerals are involved in neurophysiological pathways relevant to mood regulation and are proposed to be a potential nutritional factor influencing depressive symptoms during postpartum period. This systematic review aimed to evaluate the effectiveness of mineral supplementation for the prevention and reduction of depressive symptoms among postpartum women. A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, EBSCO, Google Scholar, and ProQuest Dissertations and Theses databases for studies published between January 2000 and April 2025. Eligible studies included randomized controlled trials (RCTs) and observational designs investigating selenium, zinc, iodine, or iron supplementation and PPD. Study quality was assessed using the Cochrane Risk of Bias tool for RCTs and the Newcastle–Ottawa Scale for observational studies. The primary outcome was PPD, evaluated using the Edinburgh Postnatal Depression Scale and Beck Depression Inventory. Potential adverse effects were narratively summarized. The review protocol was registered in PROSPERO (CRD420251135697). Six eligible studies were included: Four RCTs, one case-control study, and one cohort study, comprising 1265 participants. Study quality ranged from moderate to high. Findings across studies were heterogeneous. Selenium was associated with reductions in depressive symptom scores in some studies, while evidence regarding zinc, iodine, and iron was inconsistent or limited. Overall, available evidence suggests certain trace mineral supplementation may present a potential adjunctive approach for managing PPD. However, evidence remains heterogeneous and limited by methodological shortcomings, preventing definitive conclusions. Well-designed, powered RCTs with standardized protocols are needed to determine effective dosages, treatment durations, and clinical applicability.
Background: Antenatal care (ANC) encompasses preventive, diagnostic, and educational services to optimize maternal and neonatal outcomes. Although ANC coverage in India has improved, disparities in access and quality remain. While socioeconomic factors influencing ANC are documented, the role of gender norms is less understood. This study investigates the socioeconomic and gender-norm predictors of adequate ANC using nationally representative Indian data. Methods: The analyzed data included 24,371 women aged 15–49 years with a live birth in the 5 years preceding the 2019–2021 National Family Health Survey-5. ANC adequacy was defined as receipt of at least six of eight World Health Organization-aligned components, including skilled provider contact, early registration, and essential clinical and counseling services. Multivariable logistic regression estimated adjusted odds ratios (AORs) for socioeconomic and gender-related predictors, controlling for confounders. Results: Overall, 91.3% of women received adequate ANC. Higher education (AOR: 5.014; 95% confidence interval [CI]: 4.175–6.020), wealth (richest quintile AOR: 5.368; 95% CI: 4.408–6.538), and internet use (AOR: 2.088; 95% CI: 1.875–2.324) were strongly associated with adequacy. Joint healthcare decision-making with a partner (AOR: 1.224; 95% CI: 1.038–1.442) and employment (AOR: 1.273; 95% CI: 1.131–1.432) also increased odds. Unexpectedly, later age at marriage (≥20 years) and sexual debut (≥20 years) were linked to substantially lower odds (AORs: 0.178 and 0.167, respectively; both P < 0.001). Conclusion: ANC adequacy in India is influenced by socioeconomic and gender-norm factors. Enhancing education, reducing economic gaps, improving digital access, and addressing relational and cultural norms are essential for equitable maternal healthcare.
Background: Undernutrition is a major determinant of tuberculosis (TB) disease progression and treatment outcomes. Anthropometric indices such as body mass index (BMI) are simple tools to assess nutritional status among TB patients. To assess the anthropometric profile of adult TB patients and explore associations with selected sociodemographic and clinical factors in an urban setting in Western India. Methods: A community-based cross-sectional study was conducted among adult TB patients registered from January to March 2022 in the East-1 TB Unit, Vadodara, Gujarat, India. Anthropometric measurements were obtained during home visits, and BMI was calculated using WHO criteria. Data on sociodemographic and clinical variables were collected through a structured questionnaire. Data analysis included descriptive statistics, Chi-square tests, and regression analyses. Results: Of 76 participants, 56.6% were undernourished (BMI < 18.5 kg/m²), including 21.1% with severe underweight. Mean BMI was 18.61 ± 2.54 kg/m². Undernutrition was more prevalent among males, younger adults, and participants from lower socioeconomic strata. A family history of TB was significantly associated with lower BMI. Conclusion: Undernutrition remains highly prevalent among adult TB patients. Routine nutritional assessment and targeted nutritional support should be integrated into TB control programs to improve outcomes.
Autism spectrum disorder (ASD) presents unique perioperative challenges that require specialized approaches to anesthetic management. This paper draws upon my clinical experience as an anesthesiologist with over 15 years of experience managing patients with ASD, synthesizing evidence-based practices with personal observations to propose a comprehensive protocol for perioperative care. Key elements include individualized preoperative assessment, structured preparation strategies, sensory-friendly environmental modifications, and tailored pharmacological approaches. The protocol emphasizes the importance of parental involvement, multidisciplinary collaboration, and careful attention to emergence and recovery phases. Evidence suggests that patients with ASD may have altered responses to anesthetic medications, necessitating personalized dosing strategies. By applying this protocol in my practice, I have observed significant improvements in patient cooperation, reduced perioperative anxiety, and increased parental satisfaction. This paper aims to provide clinicians with practical strategies for optimizing anesthetic care for patients with ASD while highlighting areas requiring further research.
Diabetes mellitus continues to pose a major public health challenge in the United Arab Emirates (UAE). This study presented a bibliometric and thematic analysis of diabetes-related research published between 1980 and 2025. The objectives are to evaluate research productivity, identify leading institutional contributors, examine research themes and international collaborations, and highlight existing knowledge gaps. All English-language publications on diabetes were retrieved from the Scopus database, and bibliometric indicators were analyzed using VOSviewer and Biblioshiny. The dataset included 2167 documents revealing four distinct phases of research development, with the most substantial growth occurring between 2019 and 2025. The United Arab Emirates University emerged as the most prolific institution, while the UK, USA, and India were the leading international collaborators of the United Arab Emirates. Thematic mapping and keyword clustering were used to identify four main research domains. Well-developed central motor themes included type 2 diabetes and Ramadan fasting. Basic but less - developed themes include insulin resistance and gestational diabetes. Niche areas such as artificial intelligence and insulin secretion reflect specialized but expanding interests. Emerging or declining topics include bariatric surgery, whereas the limited attention to diabetic retinopathy highlights its underrepresentation. Overall, the analysis demonstrated significant progress in diabetes research within the United Arab Emirates. However, critical gaps persist, particularly in type 1 diabetes, diabetes-related complications, pediatric studies, prevention strategies, and investigations of sociocultural and genetic factors unique to the region.
Background: The Hybrid-Flexible (HyFlex) learning model combines face-to-face instruction with online options, offering flexibility and personalized learning. Assessing faculty and student satisfaction is crucial for successful implementation, especially in multidisciplinary education, where adaptability is essential. Limited research has evaluated HyFlex’s real-world application at the University of Sharjah (UoS). Methods: A cross-sectional study at UoS evaluated satisfaction with HyFlex learning in the colleges of Medicine, Health Sciences, Humanities, and Sciences. Online questionnaires were distributed to faculty (n = 101) and students (n = 781) participating in HyFlex classes between December 2023 and January 2024. Quantitative data were analyzed using descriptive statistics and nonparametric tests, whereas qualitative data from open-ended questions underwent content analysis. Results: Among students, 40.7% were from the Arts and Humanities, Law, and Sharia, and 62.9% were female. Whilst 72.5% rated their HyFlex experience as excellent, the faculty were less positive, with 37.6% rating it good and 29.7% rating it poor. Student satisfaction varied significantly across programmes and genders. Faculty reported challenges with student engagement, unclear policies, and insufficient technological support. Students appreciated the model’s flexibility but identified technical issues and a need for more interactive online sessions. Conclusion: HyFlex learning offers flexibility and accessibility, particularly for students managing multiple commitments. However, engagement challenges, technology limitations, and unclear policies hinder faculty satisfaction. To enhance HyFlex’s effectiveness and sustainability at the UoS, it is recommended that interactive teaching methods be adopted, policies strengthened, technological support improved, and supportive learning environments fostered. This recommendation could have vital implications, potentially increasing students’ satisfaction and enhancing learning.
Background: The risk of diabetes mellitus (DM) development is a significant concern for patients with β-thalassemia major (β-TM), primarily because of iron overload from frequent blood transfusions and chelation therapy. Research indicates that DM prevalence among β-TM patients is higher than in the general population and is estimated to be 10.5% in the United Arab Emirates. This study aimed to update the data on DM prevalence and clinical correlations in this population. In addition, it evaluates the effectiveness of fructosamine as a predictive marker for DM in patients with β-TM. Methods: A total of 252 patients with β-TM were recruited in a cross-sectional study. All clinical and laboratory variables of the patients were extracted. Statistical analyses were performed using the SPSS software package. Results: Based on the medical records, 38 patients (15.1%) were found to have DM; most were over the age of 25 years. Patients with DM showed elevated random glucose and fructosamine levels compared to non-DM patients. The serum ferritin levels remained consistent. Fructosamine positively correlated with random point-of-care testing (POCT) glucose levels. Similarly, ferritin was correlated with random glucose and POCT glucose but inversely correlated with Vitamin D. Magnetic resonance imaging T2 imaging revealed moderate-to-severe pancreatic iron overload in 20 patients. Fructosamine emerged as a significant predictor of diabetes in patients with β-TM, exhibiting high accuracy. Conclusion: This study reveals a significant increase in the prevalence of DM among patients with β-TM in the United Arab Emirates, surpassing previous estimates. These findings emphasize the critical need for regular screening and proactive healthcare interventions to improve patient outcomes and enhance overall quality of life.
Background: Midwives and maternity nurses use evidence-based active management of the third stage of labor (AMTSL), a practice recommended by the World Health Organization, which is crucial for preventing postpartum hemorrhage (PPH). This study investigates the knowledge, attitudes, and practices of Omani midwives and maternity nurses regarding third-stage labor management and the factors affecting the implementation of evidence-based AMTSL guidelines. Methods: A cross-sectional study was conducted with 300 midwives and maternity nurses from six Omani hospitals with varying care levels. Convenience sampling was used to collect the data using a validated questionnaire and the Prevention of PPH Initiative Checklist. The analyses included frequencies, binary logistic regression, and Fisher’s exact test (P < 0.05). Results: With an 80% response rate (n = 240; 9 maternity nurses, 231 midwives), 39.2% correctly identified all AMTSL components and 62% reported full adherence, although oxytocin was often delayed. Knowledge and adherence were associated with age (<34 years: adjusted odds ratio [AOR] =2.6; >45 years: AOR = 3.1) and experience (≥5 years: AOR = 3.1). Full adherence (62%, n = 149) was higher in tertiary hospitals (AOR = 1.8) and maternity nurses (AOR = 1.9). Staffing shortages and high workloads have hindered implementation, emphasizing the need for better staffing and training. Conclusion: Omani midwives and maternity nurses need improved education, training, staffing, and updated policies to bridge the gap in knowledge and practice regarding evidence-based third stage of labor management. This study offers valuable insights for future research and evaluation.
Background: The objective of this study was to assess Omani women’s knowledge of cervical cancer (CC) and its screening, as well as their attitudes, screening practices, and perceived barriers. Methods: A nonexperimental cross-sectional study was conducted among women attending primary healthcare institutions in North Batinah Governorate, Oman. Results: A total of 431 women participated in this study. Most participants (n = 324; 75.2%) demonstrated poor knowledge of CC, its cause, and human papillomavirus vaccine (HPV) vaccination, whereas 259 (60.1%) exhibited an acceptable level of knowledge regarding Pap smears. Nearly all participants (99.8%) underwent regular screening for early detection of precancerous lesions. Attitudes toward HPV vaccination were overwhelmingly negative, with 99.8% opposing and only 0.2% supporting vaccination in young women. Screening uptake was low, with 32% having previously undergone a Pap smear, and 26.2% reporting receipt of the HPV vaccine. The most commonly reported barriers included lack of knowledge about CC and screening (48%), family or peer influence (37.4%), and the perception that screening was unnecessary for older women (36.2%). Conclusion: This study revealed substantial gaps in women’s knowledge, screening practices, and acceptance of HPV vaccination in Oman, underscoring the urgent need for policymakers to implement targeted health education initiatives and policy interventions to improve awareness, enhance screening uptake, and address the persistent misconceptions regarding CC prevention.
Understanding the effects of vapor on the respiratory system is crucial. This study aimed to qualitatively analyze infectious and noninfectious diseases related to electronic cigarette (e-cigarette) use, focusing on clinical presentation, management, and health outcomes. A detailed PubMed search was conducted for articles published up to April 2024 on health issues related to the respiratory tract and e-cigarettes. Forty-seven publications were identified. Of these, 20 were case reports or case series that summarized respiratory tract conditions in adolescent and adult e-cigarette users. The respiratory system is the primary site exposed to the chemical constituents of e-cigarettes. Propylene glycol and vegetable glycerin may cause chemical and thermal injuries owing to inflammatory reactions, cytotoxicity, oxidative stress, and cell death. Heavy metal contamination may lead to the production of reactive oxygen species and aldehydes, which impair immune function and increase susceptibility to infection. Data on the diagnosis and management of vapor-associated respiratory system health issues are lacking. Owing to the chemical constituents of aerosols and heavy metal exposures, e-cigarettes may pose health risks and should be considered in patients with respiratory tract infections. Further research is needed to study the effectiveness of the current treatments for vaping-associated respiratory conditions.
The ongoing economic crisis, the numerous wars, and the coronavirus disease (COVID-19) pandemic have burdened various healthcare systems worldwide, hindering care equity and doctor–patient relationships. The reforms to be implemented through Mission 6 Health of the Recovery and Resilience Plan launched by the European Union after the COVID-19 pandemic in Italy are encountering several delays due to multiple critical issues. Some of these issues are present in Italian healthcare systems and services, while others are associated with the need to restructure both the hospital system and the territorial system according to a very complex network model. This paper brings the reader’s attention to the current situation of the primary care reform and the reorganization of local services in Italy from the perspective of the Recovery and Resilience Plan.
Background: According to the World Health Organization, ~1.39 billion adults aged 30–79 years have hypertension globally. Mud therapy is an efficient treatment for naturopathy and is used to treat hypertension. Currently, the impact of mudpack application to the abdomen and eyes (MAE) on blood pressure (BP) with hypertension remains unknown. This study aimed to assess the effects of MAE on BP and heart rate variability (HRV) in patients with hypertension. Methods: One hundred patients with primary hypertension, aged 30–65 years, were randomly divided into a mud-pack group (MG) and a control group (CG). The MG underwent one MAE session, whereas the CG rested in the supine position for 20 min. BP and HRV were assessed before and immediately after intervention. Results: There was a significant reduction in systolic BP (SBP), diastolic BP (DBP), low-frequency to high-frequency (LF/HF) ratio, and LF, and an increased HF spectrum of HRV in the MG compared to the CG. Within-group analysis showed a significant reduction in SBP, DBP, HR, LF, and LF/HF ratio, and a significant increase in all time-domain variables and HF in the MG, while the CG showed a significant increase in LF and LF/HF ratio, with a significant reduction in HF in the posttest assessments compared to their respective baseline assessments. Conclusion: Twenty minutes of MAE reduced BP and improved HRV immediately after application in patients with hypertension. However, further studies are needed to validate these long-term effects in routine clinical practice.
Background: Learning disabilities are among the most socially and academically debilitating issues faced by school-aged children. Teachers play a crucial role in teaching children the fundamentals of reading and writing; therefore, they have a considerable advantage in detecting learning disabilities in children. The aim of the study was to explore schoolteachers’ levels of awareness and attitudes toward dyslexia in children. Methods: An online questionnaire was distributed to teachers through social media and the school administration. It has 39 questions in three sections: 14 demographic, 14 knowledge, and 11 attitudes toward students with dyslexia. Good knowledge was defined as a score above 7 out of 14 in the knowledge section. Data analysis was performed using the SPSS software. Results: In total, 250 responses were obtained. Of these, 151 met the inclusion criteria and were included in the study. Those teachers achieved a mean score of 5.6 out of 14 knowledge questions. One hundred and twenty-eight teachers (84.7%) showed poor knowledge, whereas 23 teachers (15.25%) displayed good knowledge about dyslexia. Most of the teachers achieved poor scores despite 59 (39.1%) receiving prior training in dyslexia, either as educational courses or seminars. Teachers’ knowledge of dyslexia was not significantly associated with years of experience, age, degree of qualification, or level of teaching. Conclusion: Most schoolteachers were unaware of dyslexia, its consequences, and its management. More awareness needs to be raised among schoolteachers to enable early detection and intervention and to create an equitable and inclusive learning environment.
Background: Happiness is an integral part of the human experience that contributes to mental and physical well-being. Owing to its direct impact on the central nervous system, nutritious food is crucial for maintaining optimal physical health, promoting a positive mindset, and boosting overall well-being. This study examined the relationship between healthy eating patterns and subjective perception of happiness among university students. Methods: This study included 400 university students (83.5% female) aged 18–23 years. A self-administered online questionnaire was distributed among university students, which included sociodemographic information and three validated scales for healthy eating and happiness: the Short Healthy Eating Index (sHEI), General Happiness Scale (GHS), and Flourishing Scale (FS). Results: More than two-thirds (69%) of the respondents reported feeling happy, and 92% had a positive experience of flourishing. The mean sHEI score was 47.48 ± 9.12 out of 100, indicating moderately healthy eating patterns with inadequate consumption of whole grains, dairy products, and fruits. Simultaneously, added sugar was the most significant contributor to lower sHEI scores. As for the determinants of the FS and GHS scales, young female participants aged 20–21 years, in their 1st year of study, with higher grade point average, normal body mass index, and healthy diet, were significantly happier than their counterparts. Moreover, a positive relationship was observed between healthier dietary patterns, as indicated by higher sHEI scores, and increased FS and GHS scores (adjusted β = 0.79, 95% confidence level [CI]: 0.38–1.15, and adjusted β = 0.14, 95% CI: 0.01–0.27, respectively). This study identified several important socio-demographic and dietary factors associated with happiness among university students. Conclusion: Prioritizing nutritious foods and adopting healthy eating patterns are crucial for maintaining optimal physical health and well-being, cultivating a positive mindset, and promoting overall happiness among university students.
Background: X-ray imaging is a pivotal diagnostic tool that poses health risks from absorbed radiation doses. This study aimed to determine the variation in the effective dose between posterior–anterior (PA) and anterior–posterior (AP) projections and assess the impact of sex on these doses using the PCXMC simulation software. Methods: A Philips radiography machine and Piranha and Browser dosimeter kits were used to measure the entrance dose of a whole-body phantom. These doses were input into the PCXMC to calculate the effective doses for the organ/tissue. The measured data were used to calculate the risk associated with exposure using a linear no-threshold model. Results: The PA projections were associated with lower effective doses (0.003628 mSv) than the AP projections (0.008424 mSv). Sex comparisons showed no significant difference in effective doses due to uniform organ doses across sexes, except for the reproductive organs and weighted remainder, where shielding minimized radiation exposure. Risk calculation analysis revealed overarching trends, confirming the documented higher sensitivity in female patients and the predominant risk contributions from critical organs, such as the lungs. Conclusion: AP projections yield higher effective doses than PA projections; however, sex does not significantly affect organ dose estimation, suggesting that both projections can be used interchangeably with patient sex. Recommendations and methodological limitations are detailed in the Supplementary Information.
Background: Postmenopausal women, especially those with type 2 diabetes mellitus (T2DM), are at an increased risk of osteopenia and osteoporosis. Hyperglycemia, insulin resistance, and estrogen deficiency exacerbate bone loss. In India, the prevalence of osteoporosis in postmenopausal women ranges from 8% to 62%. Diabetes-induced osteoporosis has been attributed to poor glycemic control in patients with T2DM because glycosuria leads to hypercalciuria. Methods: The present study was carried out on 130 postmenopausal women with T2DM who were compared with 130 normoglycemic postmenopausal women. The effect of raised blood glucose on biomarkers like serum vitamin D levels, inflammatory marker hs-CRP level and bone markers ALP, Calcium and Phosphorus in post-menopausal diabetic women was assessed using SPSS 29.0 software. Results: In postmenopausal diabetic women, the serum ALP and hs-CRP levels were increased, whereas serum Vitamin D, calcium, and phosphorus levels were decreased. Conclusion: Hence, our study concludes that various biomarkers such as ALP, Vitamin D, hs-CRP, calcium, and phosphorus are affected by high glycemic levels in postmenopausal women. Proper screening for impending fractures in at-risk populations (postmenopausal women) is necessary to combat this healthcare burden.
