INTRODUCTION: The objective of this study was to assess the relationship between longitudinal changes in the uterine Doppler velocimetry and the maternal profile of angiogenic factors in the third trimester and to assess their ability to predict term preeclampsia (PE). METHODS: A cohort of low-risk pregnant women was scheduled for a uterine Doppler evaluation and measurement of the circulating levels of angiogenic factors at ∼30 and ∼36 weeks. The performance of both parameters and their change over time in predicting term PE was evaluated. RESULTS: A total of 1,191 women were analyzed, of which 28 (2.4%) women developed term PE. At ∼30 weeks, a model including the sFlt-1/PlGF (fms-like tyrosine kinase-1/placental growth factor) ratio and the uterine Doppler explained 16.2% of the uncertainty of developing term PE, while at ∼36 weeks, the same variables explained 25.2% [p < 0.001]. The longitudinal changes of both predictors had an R2 of 26.8%, which was not different from that of the ∼36 weeks evaluation [p = 0.45]. The area under the curve (AUC) of the ∼36 weeks ratio was significantly higher than at ∼30 weeks (0.86 [0.77-0.94] vs. 0.81 [0.73-0.9]; p = 0.043). The AUC of the longitudinal change of the ratio (0.85 [0.77-0.94]) did not differ from that of at ∼36 weeks (p = 0.82). At ∼36 weeks, for a 10% of false positives, the ratio had a detection rate of 71.4%. CONCLUSION: A cross-sectional measurement of the sFlt-1/PlGF ratio outperforms uterine Doppler in predicting term PE. The combination of both markers does not improve such prediction, nor the evaluation of the longitudinal changes between weeks.
- MeSH
- Adult MeSH
- Humans MeSH
- Placental Circulation physiology MeSH
- Placenta Growth Factor * blood MeSH
- Area Under Curve MeSH
- Predictive Value of Tests MeSH
- Pre-Eclampsia * blood diagnostic imaging MeSH
- Vascular Endothelial Growth Factor Receptor-1 * blood MeSH
- Rheology * methods statistics & numerical data MeSH
- Reproducibility of Results MeSH
- Blood Flow Velocity physiology MeSH
- Pregnancy MeSH
- Pregnancy Trimester, Third * blood physiology MeSH
- Ultrasonography, Doppler methods statistics & numerical data MeSH
- Ultrasonography, Prenatal * methods statistics & numerical data MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
- Comparative Study MeSH
BACKGROUND: Adolescents' movement behaviours (MB) vary between schooldays and weekends, potentially impacting health-related quality of life (HRQoL) and well-being. This study aimed to identify transitions between 24-h MB profiles on schooldays and weekends and examine their associations with HRQoL and well-being. METHODS: This is a cross-sectional study of 1070 Czech adolescents (average age: 13.8 years and standard deviation: 2.2 years; 56% girls). Participants wore accelerometers for 7 consecutive days to assess physical activity (PA) of different intensities, sedentary behaviour (SB) and sleep. A subsample of 451 participants provided data on HRQoL, which was measured using the Paediatric Quality of Life Inventory, and 484 provided valid well-being data measured with the 5-item World Health Organisation Well-Being Index. Latent transition analysis was used on the MB variables to identify transitions across MB profiles, and linear regression was used to examine associations between transitions and HRQoL or well-being. RESULTS: Four MB profiles were identified: Excellent (high PA, low SB and high sleep duration), Good (average MB values), Fair (below-average PA and sleep, above-average SB) and Poor (low PA and sleep, high SB). Most adolescents transitioned to less favourable profiles on weekends. Those remaining in the Excellent profile had higher HRQoL than those transitioning to less favourable profiles. Transitions to the Poor profile were associated with the lowest HRQoL and well-being scores. CONCLUSION: This study underscores the dynamic nature of adolescents' MB and the importance of consistent, healthy routines. Interventions optimizing 24-h MB throughout the week and especially on weekends may enhance adolescent HRQoL and well-being, but further evidence from longitudinal and intervention studies is needed. SUMMARY: We observed a contrast in 24-h MB between schooldays and weekends: 29.7% of adolescents were in the Excellent on schooldays, but only 5.8% did so on weekends, while the prevalence of the Poor profile rose from 1.6% on schooldays to 27.7% on weekends. Adolescents who maintained the Excellent profile across the whole week recorded the highest scores for HRQoL and well-being. Moving into the Poor profile on weekend was associated with about 9 points poorer HRQoL and 14 points lower well-being, compared with peers who remained in the Excellent profile. Behaviour change strategies should target the entire week to preserve PA, reduce SB and protect sleep.
- MeSH
- Accelerometry MeSH
- Time Factors MeSH
- Adolescent Behavior * psychology physiology MeSH
- Exercise * psychology physiology MeSH
- Quality of Life * psychology MeSH
- Humans MeSH
- Adolescent MeSH
- Cross-Sectional Studies MeSH
- Sedentary Behavior MeSH
- Sleep physiology MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
Accelerated epigenetic aging has been associated with changes in cognition. However, due to the lack of neuroimaging epigenetics studies, it is still unclear whether accelerated epigenetic. Aging in young adulthood might underlie the relationship between altered brain dynamics and cognitive functioning. We conducted neuroimaging epigenetics follow-up of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) prenatal birth cohort in young adulthood and tested the possible mediatory role of accelerated epigenetic aging in the relationship between dynamic functional connectivity (DFC) and worse cognition. A total of 240 young adults (51% men; 28-30 years, all of European ancestry) participated in the neuroimaging epigenetics follow-up. Buccal swabs were collected to assess DNA methylation and calculate epigenetic aging using Horvath's epigenetic clock. Full-scale IQ was assessed using the Wechsler adult intelligence scale (WAIS). Resting-state functional magnetic resonance imaging (rs-fMRI) was acquired using a 3T Siemens Prisma MRI scanner, and DFC was assessed using mixture factor analysis, revealing information about the coverage of different DFC states. In women (but not men), lower coverage of DFC state 4 and thus lower frequency of epochs with high connectivity within the default mode network and between default mode, fronto-parietal, and visual networks was associated with lower full-scale IQ (AdjR2 = 0.05, std. beta = 0.245, p = 0.008). This relationship was mediated by accelerated epigenetic aging (ab = 7.660, SE = 4.829, 95% CI [0.473, 19.264]). In women, accelerated epigenetic aging in young adulthood mediates the relationship between altered brain dynamics and cognitive functioning. Prevention of cognitive decline should target women already in young adulthood.
- MeSH
- Default Mode Network * diagnostic imaging physiology MeSH
- Adult MeSH
- Epigenesis, Genetic * physiology MeSH
- Intelligence * physiology MeSH
- Cognition * physiology MeSH
- Connectome * MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Magnetic Resonance Imaging MeSH
- DNA Methylation MeSH
- Young Adult MeSH
- Brain * diagnostic imaging physiology MeSH
- Nerve Net * diagnostic imaging physiology MeSH
- Aging * physiology genetics MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Promoting healthy aging through physical activity (PA) is crucial as the global population grows older. Traditional interventions often fail to engage older adults, underlining the need for personalized, timely approaches. Smartphone-delivered PA interventions can offer personalized support during opportune moments for behavioral change. The current study examined whether the receptivity of inactive older adults influences compliance with mHealth walking suggestions after inactivity, and explored their experiences with it. Thirty healthy older adults (mean age 73.9 years) participated in the study and answered event-based EMA questionnaires via HealthReact after each 30-minute inactivity period. Emotions, physical complaints, intention, self-efficacy, perceived walking, and environmental permissiveness were assessed. Walking suggestions followed each EMA, and semi-structured interviews were conducted post-study. Multilevel logistic regressions in R were applied, and qualitative data were thematically analyzed using NVivo. Results show that higher intention, self-efficacy, and environmental permissiveness positively correlated with compliance, while higher perceived walking negatively correlated. Participants generally found the suggestions motivating and well-timed, but some reported increased alertness and pressure. Consequently, tailoring interventions to individual needs and targeting receptive moments can enhance compliance and promote healthier aging through increased PA. Future mobile interventions should consider self-efficacy, intention, prior activity, and environmental conditions to improve effectiveness.
- MeSH
- Patient Compliance * psychology MeSH
- Walking * psychology MeSH
- Smartphone MeSH
- Exercise psychology MeSH
- Middle Aged MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Health Promotion * methods MeSH
- Self Efficacy MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Telemedicine MeSH
- Intention MeSH
- Healthy Aging * psychology MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: The extent to which changes in lung function are due to natural variability in patients with primary ciliary dyskinesia (PCD) is unknown. We aimed to assess intra-individual variability in forced expiratory volume in 1 s (FEV1) derived from spirometry to define the extent to which the observed changes were due to test variability in clinically stable PCD patients. METHODS: PROVALF-PCD (Prospective Observational Multicentre Study on Variability of Lung Function in Stable PCD Patients) was a large international prospective cohort conducted in 2017-2019. We included patients aged ≥5 years who were clinically stable at two or more consecutive visits and provided spirometry-derived lung function measurements. To calculate the upper limit of normal (ULN), we fitted an unadjusted multilevel mixed-effect model, and to determine the absolute change in FEV1 z-scores, we calculated the coefficient of repeatability (CR). We performed sensitivity analyses by stratifying relative change by age (adults versus children), number of measurements (at least four), and time between measurements (<4 months apart). RESULTS: We included 252 participants from 12 countries with confirmed or highly likely PCD. We included 1028 FEV1 measurements from patients in stable state. The ULN for relative change between two measurements of FEV1 was 25%. Test variability remained high in all sensitivity analyses. The CR was 1.88 FEV1 z-score. CONCLUSIONS: Changes in intra-individual FEV1 >25% between visits in stable PCD patients lie beyond the expected test variability and therefore could be considered physiologically relevant. These findings inform the selection of end-points for pulmonary intervention trials in PCD, as they suggest that FEV1 is not a sensitive test for monitoring lung health in PCD.
- Publication type
- Journal Article MeSH
BACKGROUND: The online environment provides adolescents with vast amounts of health-related information; however, navigating this effectively requires high levels of eHealth literacy to avoid misinformation and harmful content. Parental guidance is often considered a crucial factor in shaping adolescents' online health behaviors; however, there is limited longitudinal research examining how parental eHealth literacy mediation influences adolescents' development of eHealth literacy over time. OBJECTIVE: This study aims to examine the reciprocal relationship between parental eHealth literacy mediation and adolescents' eHealth literacy. It also investigates whether parental education moderates this relationship, specifically exploring whether higher levels of parental education enhance the effectiveness of eHealth literacy mediation in improving adolescents' eHealth literacy. METHODS: A 3-wave longitudinal study was conducted, collecting data from 2500 adolescent-parent pairs. A random intercept cross-lagged panel model was applied to assess the reciprocal effects between parental eHealth literacy mediation and adolescents' eHealth literacy across the 3 waves. Parental education was included in the model as a potential moderating variable to examine whether it influences the strength of the relationship between parental eHealth literacy mediation and adolescents' eHealth literacy. RESULTS: The findings revealed no significant within-person effects, indicating that changes in parental eHealth literacy mediation over time did not lead to corresponding changes in adolescents' eHealth literacy (T1→T2 β=-.03, P=.65; T2→T3 β=.01, P=.84), and vice versa (T1→T2 β=.02, P=.71; T2→T3 β=-.07, P=.19). Furthermore, the data did not support a moderating effect of parental education, suggesting that higher educational attainment does not enhance the impact of parental eHealth literacy mediation. However, a significant between-person association was observed: adolescents with higher levels of eHealth literacy tend to have parents who engage more frequently in eHealth literacy mediation (r=0.30, P<.001). CONCLUSIONS: This study contributes to the understanding of parental involvement in shaping adolescents' eHealth literacy. Contrary to expectations, parental eHealth literacy mediation does not appear to have a significant longitudinal impact on the development of adolescents' eHealth literacy, nor does higher parental education strengthen this relationship. These findings suggest that additional factors beyond parental mediation and education may play a critical role in supporting adolescents' ability to navigate online health information effectively.
- MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Adolescent MeSH
- Parents * MeSH
- Telemedicine * MeSH
- Parent-Child Relations * MeSH
- Health Literacy * MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Aim: Complications associated with obesity may negatively affect the physiological growth and development of the fetus and the health of the child. The aim of the research was to determine the effect of pregnancy and the postpartum period on the body composition of first-time pregnant women using standardized anthropometric methods with the use of the Matiegka method for fractionation of body composition. Design: A longitudinal cohort study. Methods: The study was conducted in gynecological outpatient clinics on a population of 40 nulligravidas aged 18-40 years. The women were assessed in three stages corresponding to the trimesters of pregnancy and Stage IV, the postpartum period of six weeks. The parameters obtained were used to determine body composition according to the Matiegka method. The women were divided into two groups according to BMI, normal weight and overweight and obesity. Results: Significant changes in body composition were found during the measurements in Stages I-IV, with a decrease in skeletal muscle mass and an increase in fat component. There were significant changes in body composition between the categories of women with BMI normal weight and BMI overweight and obese in the ratio of skeletal muscle to body fat. Conclusion: The results indicate that monitoring body composition in pregnant women is important not only for preventing maternal obesity, but also for preventing fetal macrosomia and possible maternal and neonatal morbidity and mortality associated with childbirth and the postpartum period.
- Keywords
- Matiegkova rovnice, Matiegkova metoda,
- MeSH
- Anthropometry * methods MeSH
- Adult MeSH
- Risk Assessment methods MeSH
- Body Mass Index MeSH
- Humans MeSH
- Young Adult MeSH
- Pregnancy in Obesity complications prevention & control MeSH
- Body Composition MeSH
- Pregnancy MeSH
- Body Weights and Measures methods statistics & numerical data MeSH
- Pregnancy Trimesters MeSH
- Gestational Weight Gain MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Clinical Study MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Maternal alcohol consumption can adversely affect children's development, but the impact of paternal drinking is less understood. We aimed to investigate whether maternal or paternal alcohol consumption during pregnancy affected children's mental health and behavior. METHODS: A total of 2,013 parent-child triads from the European Longitudinal Study of Pregnancy and Childhood cohort were used. Data on alcohol consumption was obtained from questionnaires during pregnancy and after the child's birth. Mental health and behavior of children were assessed with Strength and Difficulties Questionnaire (SDQ). The associations were tested using linear regression, adjusting for socio-demographic and psychosocial covariates. RESULTS: Increased maternal alcohol consumption was associated with higher total SDQ scores at ages 7, 11, and 18 years old when the outcomes were reported by mothers, but only at 11 years when reported by children. We did not observe any dose-response relationship, and the effect size did not change during the follow-up. The effects were observed across various domains of SDQ: in the emotional symptoms subscale at age 11, in the conduct problems subscale at ages 7 and 11, and in the hyperactivity/inattention subscale at age 18. Paternal alcohol consumption was not associated with SDQ. CONCLUSIONS: Maternal alcohol consumption during pregnancy is associated with long-term effects on children's mental health and behavior, particularly when reported by mothers. No association was found between paternal alcohol consumption, suggesting that the results may stem from biological effects of alcohol or other factors beyond the direct exposure, potentially encompassing broader maternal psychosocial or behavioral characteristics.
- MeSH
- Child Behavior * MeSH
- Child MeSH
- Adult MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Mothers * statistics & numerical data MeSH
- Adolescent MeSH
- Fathers * statistics & numerical data MeSH
- Alcohol Drinking * adverse effects epidemiology MeSH
- Pregnancy MeSH
- Prenatal Exposure Delayed Effects * epidemiology MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
BACKGROUND: The education of healthcare professionals, including nurses, represents a critical intersection with health systems science (HSS), which is often considered the third pillar of healthcare education alongside basic and clinical sciences. Despite the amount of research on nursing education during the COVID-19 pandemic, there remains a gap in analysis from an HSS perspective. METHODS: A Comparative Education Approach involving undergraduate nursing programs (UNPs) across Europe, with longitudinal data collection from 2002 to 2023. The aim of the study was threefold: (a) to summarize the overall changes in UNPs during the COVID-19 pandemic; (b) to identify the changes retained in the post-pandemic era; and (c) to identify the impact of the pandemic on nursing education as perceived by nurse educators across nine European countries. RESULTS: This study compares the changes in nursing education in European countries during and after the COVID-19 pandemic using a qualitative approach with data from nine universities. The COVID-19 pandemic had a significant impact on education provision. During the first wave, government restrictions forced a complete shift to online learning for theory classes, clinical training and laboratories. In subsequent waves, a hybrid format was chosen that combined online and face-to-face sessions. A major challenge was the placement of nursing students alongside general university students. This approach neglected their need for practical clinical training, which is crucial for their future careers. To compensate for the lack of clinical hours, various alternative teaching methods were introduced. Students were also offered the opportunity to volunteer in large-scale public health initiatives such as vaccination and testing campaigns, although bedside care for COVID-19 patients remained limited. The pandemic has also left its mark in the post-pandemic period. Some UNPs have retained elements of online education, notably lectures, research seminars, meetings, consultations and even online exams. Interestingly, an initial increase in applicant numbers was observed at six of the nine participating UNPs. CONCLUSIONS: The COVID-19 pandemic has widened the gap between university-educated nurses and the clinical setting, i.e. between theory and practise, underlining the importance of HSS in nursing education. Rebuilding strong partnerships is crucial, but simply returning to the pre-pandemic model is not enough. To ensure uninterrupted education during future crises, proactive planning, including the creation of predefined protocols for collaboration, is essential. The pandemic underscores the need for closer alignment between the two sectors, which would better equip future nurses with the skills they need to thrive in the nursing workforce and ensure they are prepared for the challenges of the 21st century.
- MeSH
- COVID-19 * epidemiology MeSH
- Education, Distance trends MeSH
- Curriculum MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Pandemics MeSH
- SARS-CoV-2 MeSH
- Education, Nursing, Baccalaureate * trends organization & administration MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
- Geographicals
- Europe MeSH
BACKGROUND: Exposure to benzophenone-1 (BP-1) and benzophenone-3 (BP-3), widely used as UV filters in personal care products, has been associated with adverse health effects. However, epidemiological evidence is limited and inconclusive, particularly in vulnerable populations such as teenagers. OBJECTIVE: To examine the relation between BP-1 and BP-3 concentrations and obesity, cardiometabolic biomarkers, and asthma/allergy outcomes in European teenagers, including possible sex-specific associations. METHODS: A multi-country cross-sectional study was conducted using pooled data from six aligned studies from the Human Biomonitoring for Europe Initiative (HBM4EU). Sociodemographic data, cardiometabolic biomarkers, and asthma/allergy outcomes were collected through questionnaires. Anthropometric data and BMI z-scores were calculated (n = 1339). Plasma/serum cardiometabolic biomarkers and asthma/allergy outcomes were available for a subsample (n = 173-594). Urinary BP-1 and BP-3 concentrations were adjusted for creatinine dilution using the traditional standardization (trad.) and the covariate-adjusted creatinine standardization (CAS) method. Generalized additive models, linear, logistic, and multinomial mixed models were applied, and sex-interaction terms were tested. RESULTS: Each natural log-unit increase in urinary BP-3 (CAS) concentrations was associated with higher odds of obesity in the whole population (OR: 1.20; 95%CI: 1.04-1.38). Sex-specific associations were also found with BP-1 (CAS) and BP-3 (CAS) concentrations, which were associated with higher odds of obesity in male teenagers (OR: 1.25; 95% CI: 1.01-1.55; OR: 1.34; 95%CI: 1.09-1.65, respectively). Linear mixed models showed consistent findings toward higher BMI z-scores. A negative association was found between BP-1 (CAS) concentration and serum adiponectin levels in females (% change per loge-unit increase: -3.73, 95%CI: -7.32, -0.10). BP-3 (CAS) concentrations were also associated with higher odds of non-food allergies in males (OR: 1.27; 95%CI: 1.00-1.63). Traditional creatinine adjustment showed similar or slightly attenuated estimates compared to the CAS method. CONCLUSIONS: BP-1 and BP-3 exposure was cross-sectionally associated with higher odds of obesity in European male teenagers, highlighting the need to update regulations and keep exposure levels as low as practically achievable. Longitudinal studies are needed to confirm these findings.
- MeSH
- Hypersensitivity * epidemiology MeSH
- Benzophenones * toxicity urine adverse effects MeSH
- Biomarkers blood MeSH
- Biological Monitoring MeSH
- Asthma * epidemiology chemically induced MeSH
- Humans MeSH
- Adolescent MeSH
- Obesity * epidemiology chemically induced MeSH
- Sunscreening Agents * adverse effects MeSH
- Cross-Sectional Studies MeSH
- Environmental Exposure * MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH