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Long-term effects of yoga-based practices on neural, cognitive, psychological, and physiological outcomes in adults: a scoping review and evidence map

BMC Complement Med Ther. 2025 Mar 6;25(1):92. doi: 10.1186/s12906-025-04825-x.

ABSTRACT

BACKGROUND: Compared with short-term practices, long-term yoga might promote differential qualitative and quantitative outcomes. Following JBI’s and PRISMA-ScR guidelines, this scoping review followed an apriori and systematic protocol to document the long-term effects of yoga on neural, cognitive, psychological, and physiological outcomes, provide evidence maps for each yoga component, and summarize results identifying knowledge gaps and promising directions.

METHODS: Four databases (PubMed, Cochrane, LILACS, and PubPsych) were last searched in March 2023. Studies were included if they evaluated adults with > 1 year of practice, specified yoga-based practice(s) of interest, measured neural, cognitive, psychological, and/or physiological outcomes, were written in English, Spanish, or Portuguese, presented original data, and mentioned search terms in the title/abstract. Evidence maps for each yoga component followed a 4-level structure of outcome category, method, study design and literature size. Qualitative summaries followed the same structure, to facilitate information retrieval.

RESULTS: Out of 2270 screened studies, 65 were included (meditative studies = 36, predominantly postural studies = 25, breathing practice studies = 8). Physiologicaland neural outcomes were the most common, followed by psychological and cognitive outcomes. Although heterogeneous, neural results reveal structural and functional changes related to sensorimotor, interoceptive, emotion regulation, and executive functions. Physiologically, most studies have associated long-term practice with parasympathetic-driven autonomic, hormonal and immune responses, but some studies revealed sympathetic-driven or mixed responses, maybe due to the specific technique or individual differences. Psychological outcomes included lower levels of negative affect, psychopathological symptoms, and emotional reactivity. Cognitive measures have shown improved memory/cognition for older adults, but mixed or null effects for other constructs. Commonly, however, long-term practitioners demonstrated improved neural or physiological efficiency while performing cognitive tasks.

CONCLUSIONS: Future research should provide clear descriptions of the investigated yoga practice, employ more experimental paradigms, and refine statistical reports and models. We encourage researchers to work with specific overarching theoretical frameworks to refine research predictions, such as the neurovisceral integration model or predictive coding models; to consider motivational, cultural, and contextual factors that might influence long-term outcomes; and to develop systematic reviews and meta-analyses as next steps of evidence summary.

PMID:40050913 | DOI:10.1186/s12906-025-04825-x

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COVID-19 infection and longevity: an observational and mendelian randomization study

J Transl Med. 2025 Mar 6;23(1):283. doi: 10.1186/s12967-024-05932-y.

ABSTRACT

BACKGROUND: Studies have indicated that COVID-19 infection may accelerate the aging process in organisms. However, it remains unknown whether contracting COVID-19 affects life expectancy. Furthermore, the underlying biological mechanisms behind these findings are still unclear.

METHODS: We conducted a prospective cohort study on 56,504 participants of European ancestry from the UK Biobank who reported the time and number of COVID-19 infection between January 2020 and September 2023. The parental average longevity was used as a proxy for their own longevity. Linear regression was used to assess the relationship between COVID-19 infection and longevity. Furthermore, we investigated the shared genetic basis between COVID-19 and longevity using large-scale genome-wide association studies (GWAS) for COVID-19 (122,616 cases and 2,475,240 controls) and longevity (3,484 cases and 25,483 controls). Mendelian randomization (MR) and mediation analysis were utilized to assess causal relationships and potential mediators between COVID-19 susceptibility and longevity. Shared genetic loci between the two phenotypes were identified using conjunctional false discovery rate (conjFDR) statistical frameworks.

RESULTS: After controlling for relevant covariates, COVID-19 infection might not be significantly correlated with longevity. In all MR methods, generalized summary-data-based Mendelian randomization (GSMR) analysis revealed a significant decrease in longevity due to severe COVID-19 infection (OR = 0.91, 95%CI: 0.84-0.98, P = 0.015). Mediation analysis identified stroke and myocardial infarction as potential mediators between COVID-19 susceptibility and reduced longevity. At conjFDR < 0.05, we identified rs62062323 (KANSL1) and rs9530111 (PIBF1) as shared loci between COVID-19 and longevity.

CONCLUSION: Together, our findings provided preliminary evidence for the shared genetic basics between COVID-19 and aging. This discovery may have implications for personalized medicine and preventive strategies, helping identify individuals who may be more vulnerable to severe outcomes from COVID-19 due to their genetic makeup.

PMID:40050903 | DOI:10.1186/s12967-024-05932-y

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The relationship between smartphone addiction and sleep quality in older adults: the mediating role of loneliness and depression

BMC Nurs. 2025 Mar 6;24(1):253. doi: 10.1186/s12912-025-02883-7.

ABSTRACT

BACKGROUND: This study explores the relationship between smartphone addiction and sleep quality, and to further assess the mediating role of loneliness and depression.

METHODS: A survey of 200 older adults individuals was conducted using the Smartphone Addiction Scale-Short Version (SAS-SV) for smartphone addiction, Pittsburgh Sleep Quality Index (PSQI) for sleep quality, Geriatric Depression Scale-15 (GDS-15) for depression, and DeJong Gierveld Loneliness Scale (DGLS) for loneliness. Linear regression and mediation analysis were performed for statistical analysis.

RESULTS: A negative causal relationship was observed between smartphone addiction and sleep quality in the older adults (p < 0.05). Depression and loneliness in the older adults may potentially exacerbate the effect of smartphone addiction on sleep quality (p < 0.05).

CONCLUSION: Individuals with smartphone addiction appeared to have poorer sleep quality, psychological factors play a mediating role in the association between smartphone addiction and sleep quality in the older adults. This emphasizes the importance of care for the mental health of the older adults and recognizes the negative impact of smartphone addiction on their quality of life.

PMID:40050901 | DOI:10.1186/s12912-025-02883-7

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Revisiting NANDA International-Nursing Interventions Classification-Nursing Outcomes Classifications Linkages of Nursing Home Residents in Korea

Comput Inform Nurs. 2025 Mar 5. doi: 10.1097/CIN.0000000000001261. Online ahead of print.

ABSTRACT

Standardized nursing languages help nurses articulate issues with patients, forming the groundwork for the selection of nursing interventions aimed at achieving outcomes. However, the application of standardized nursing linkages on nursing processes and nursing home residents’ outcomes, as well as the identification of facility and resident factors, remains unexplored. The purpose of this study was to examine nursing home facility and resident factors on the use of NANDA, Nursing Interventions Classification, and Nursing Outcomes Classification (NNN) and frequently occurring NNN linkages surrounding nursing home residents in Korea. Data were collected from 53 nurses of 273 residents in 19 nursing homes in Korea using a newly developed smartphone application. Descriptive statistics, analysis of variance, and analysis of covariance were used for the data analysis. Nine NNN linkages were identified in this study, mostly centered on fall prevention. We also identified that residents’ factors (including acuity, age, and admission period) and organizational factors (including year of facility establishment and facility ownership status), were related to the use of NNN. Nursing home nurses’ clinical and critical judgment and the utilization of standardized nursing languages to select proper nursing interventions and outcomes should be based on both resident and organizational factors.

PMID:40048734 | DOI:10.1097/CIN.0000000000001261

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Introduction to Spine Injuries in the Pickleball Athlete

J Am Acad Orthop Surg. 2025 Feb 26. doi: 10.5435/JAAOS-D-24-01234. Online ahead of print.

ABSTRACT

INTRODUCTION: Pickleball is one of the fastest growing sports in the United States. Despite its popularity, there is limited research on pickleball-related orthopaedic injuries, particularly in the spine. This study aims to provide a deeper understanding of spinal injuries in pickleball players and offers insights into injury patterns and risk factors.

METHODS: A retrospective review from our urban tertiary medical center’s electronic medical record from 2013 to 2023 was done using OpenAI’s Generative Pretrained Transformer-4 model to identify pickleball-related orthopaedic injuries. After artificial intelligence-driven identification, a manual review of medical records identified injuries related to the spine. The resulting medical records were manually reviewed for variables such as injury year, age, sex, spinal region affected, and treatment. Artificial intelligence did not generate any data, participate in writing, or assist with statistical analysis. Statistical analyses were done using Stata software, with significance set at P < 0.05.

RESULTS: Among 1,527 pickleball-related orthopaedic injuries, 135 (8.8%) involved the spine (77% women, median age: 62 ± 12.4 years). Pickleball-related spinal injuries increased 56-fold from 2013 to 2023. Most injuries involved the lumbar spine (84%), followed by the cervical spine (15%) and thoracic spine (1%). The most common complaint was lumbar radicular symptoms (63%). Forty-six percent of patients had a body mass index over 25, and this was associated with lumbar radiculopathy and acute disk herniation (P < 0.05). Most patients sought outpatient care (98%) and 10% required surgical intervention, primarily spinal decompression.

CONCLUSION: Pickleball-related spine injuries are relatively uncommon but increasing as the sport grows in popularity, with the lumbar spine being the most frequently affected region. Elevated body mass index emerged as an important modifiable potential risk factor, and the study found a relatively high rate of surgical intervention at 10%. These findings can help guide counseling and treatment for pickleball athletes, although further research is needed to better understand risk factors, treatment options, prognosis, and return-to-play guidelines.

PMID:40048727 | DOI:10.5435/JAAOS-D-24-01234

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Butter and Plant-Based Oils Intake and Mortality

JAMA Intern Med. 2025 Mar 6. doi: 10.1001/jamainternmed.2025.0205. Online ahead of print.

ABSTRACT

IMPORTANCE: The relationship between butter and plant-based oil intakes and mortality remains unclear, with conflicting results from previous studies. Long-term dietary assessments are needed to clarify these associations.

OBJECTIVE: To investigate associations of butter and plant-based oil intakes with risk of total and cause-specific mortality among US adults.

DESIGN, SETTING, AND PARTICIPANTS: This prospective population-based cohort study used data from 3 large cohorts: the Nurses’ Health Study (1990-2023), the Nurses’ Health Study II (1991-2023), and the Health Professionals Follow-up Study (1990-2023). Women and men who were free of cancer, cardiovascular disease (CVD), diabetes, or neurodegenerative disease at baseline were included.

EXPOSURES: Primary exposures included intakes of butter (butter added at the table and from cooking) and plant-based oil (safflower, soybean, corn, canola, and olive oil). Diet was assessed by validated semiquantitative food frequency questionnaires every 4 years.

MAIN OUTCOMES AND MEASURES: Total mortality was the primary outcome, and mortality due to cancer and CVD were secondary outcomes. Deaths were identified through the National Death Index and other sources. A physician classified the cause of death based on death certificates and medical records.

RESULTS: During up to 33 years of follow-up among 221 054 adults (mean [SD] age at baseline: 56.1 [7.1] years for Nurses’ Health Study, 36.1 [4.7] years for Nurses’ Health Study II, and 56.3 [9.3] years for Health Professionals Follow-up Study), 50 932 deaths were documented, with 12 241 due to cancer and 11 240 due to CVD. Participants were categorized into quartiles based on their butter or plant-based oil intake. After adjusting for potential confounders, the highest butter intake was associated with a 15% higher risk of total mortality compared to the lowest intake (hazard ratio [HR], 1.15; 95% CI, 1.08-1.22; P for trend < .001). In contrast, the highest intake of total plant-based oils compared to the lowest intake was associated with a 16% lower total mortality (HR, 0.84; 95% CI, 0.79-0.90; P for trend < .001). There was a statistically significant association between higher intakes of canola, soybean, and olive oils and lower total mortality, with HRs per 5-g/d increment of 0.85 (95% CI, 0.78-0.92), 0.94 (95% CI, 0.91-0.96), and 0.92 (95% CI, 0.91-0.94), respectively (all P for trend < .001). Every 10-g/d increment in plant-based oils intake was associated with an 11% lower risk of cancer mortality (HR, 0.89; 95% CI, 0.85-0.94; P for trend < .001) and a 6% lower risk of CVD mortality (HR, 0.94; 95% CI, 0.89-0.99; P for trend = .03), whereas a higher intake of butter was associated with higher cancer mortality (HR, 1.12; 95% CI, 1.04-1.20; P for trend < .001). Substituting 10-g/d intake of total butter with an equivalent amount of total plant-based oils was associated with an estimated 17% reduction in total mortality (HR, 0.83; 95% CI, 0.79-0.86; P < .001) and a 17% reduction in cancer mortality (HR, 0.83; 95% CI, 0.76-0.90; P < .001).

CONCLUSIONS AND RELEVANCE: In this cohort study, higher intake of butter was associated with increased mortality, while higher plant-based oils intake was associated with lower mortality. Substituting butter with plant-based oils may confer substantial benefits for preventing premature deaths.

PMID:40048719 | DOI:10.1001/jamainternmed.2025.0205

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Aggressive Ablation versus Regular Ablation for Persistent Atrial Fibrillation: A Multicenter Real-World Cohort Study

Europace. 2025 Mar 6:euaf045. doi: 10.1093/europace/euaf045. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Current guidelines for the optimal ablation strategy for persistent atrial fibrillation(PerAF) remain unclear. While our previous RCT confirmed the favorable prognosis of aggressive ablation, real-world evidence is still lacking.

METHODS: Among 4,833 PerAF patients undergoing catheter ablation at 10 centers, two groups were defined: Regular Ablation(PVI-only or PVI plus anatomical ablation) and Aggressive Ablation(anatomical plus electrogram-guided ablation), with 1,560 patients each after propensity score(PS) matching. The primary endpoint was 12-month AF/atrial tachycardia(AT) recurrence-free survival off anti-arrhythmic drugs after a single procedure. Additional PS matching was performed within the regular group between PVI-only and anatomical ablation(n=455 each). Furthermore, anatomical ablation from the regular group was independently matched with aggressive ablation (n=1,362 each).

RESULTS: At 12 months, the Aggressive Group showed superior AF/AT-free survival(66.2% vs. 59.3%, p<0.001; HR 0.745), similar AT recurrence(12.0% vs. 11.3%, p=0.539), and significantly higher procedural AF termination(67.0% vs. 21.0%, p<0.001) than Regular Group. Moreover, patients with AF termination had improved AF/AT-free survival(72.3% vs. 55.2%, p<0.001). Safety endpoints did not differ significantly between the two groups. Both the ablation outcomes and AF termination rate showed increasing trends with the extent of ablation aggressiveness but declined with extremely aggressive ablation. After additional PS matching, within the regular group, no statistical differences were observed though AF/AT-free survival in the anatomical group was slightly higher than the PVI-only group (60.7% vs. 55.6%, p=0.122); while aggressive ablation showed improved AF/AT-free survival compared to anatomical ablation alone from regular group (67.5% vs. 59.9%, p<0.001).

CONCLUSION: Aggressive ablation achieved more favorable outcomes than regular ablation, and moderately aggressive ablation may be associated with better clinical outcomes. AF termination is a reliable ablation endpoint.

PMID:40048703 | DOI:10.1093/europace/euaf045

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Recent Trends in Breast Cancer Mortality Rates for U.S. Women by Age and Race/Ethnicity

J Breast Imaging. 2025 Mar 6:wbaf007. doi: 10.1093/jbi/wbaf007. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze recent trends in U.S. breast cancer mortality rates by age group and race and ethnicity.

METHODS: This retrospective analysis of female breast cancer mortality rates used National Center for Health Statistics data from 1990 to 2022 for all women, by age group, and by race or ethnicity. Joinpoint analysis assessed trends in breast cancer mortality rates.

RESULTS: Breast cancer mortality rates for women 20 to 39 years old decreased 2.8% per year from 1999 to 2010 but showed no decline from 2010 to 2022 (annual percentage change [APC], -0.01; P = .98). For women of ages 40 to 74 years, breast cancer mortality rates decreased 1.7% to 3.9% per year from 1990 to 2022 (P <.001); a decline was found for all cohorts in this age group except Asian women. For women ≥75 years of age, breast cancer mortality rates declined significantly from 1993 to 2013 (APC, -1.26; P = .01) but showed no evidence of decline from 2013 to 2022 (APC, -0.2; P = .24). Across all ages, breast cancer mortality rates declined for White and Black women but not for Asian, Hispanic, and Native American women. Asian women ≥75 years of age had significantly increasing mortality rates (APC, 0.73; P <.001). For 2004 to 2022, breast cancer mortality rates were 39% higher in Black women than White women and varied strongly by age group: 104% for ages 20 to 39 years, 51% for ages 40 to 74 years, and 13% for ages ≥75 years.

CONCLUSION: Female breast cancer mortality rates have stopped declining in women <40 years of age and >74 years of age. The higher mortality rates in Black women compared with White women are age dependent and substantially higher in younger women.

PMID:40048690 | DOI:10.1093/jbi/wbaf007

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MRI-Based Predictors of Spinal Ankylosis Progression: ESSR Framework for Axial Spondyloarthritis

Mod Rheumatol. 2025 Mar 6:roaf015. doi: 10.1093/mr/roaf015. Online ahead of print.

ABSTRACT

BACKGROUND: Magnetic resonance imaging (MRI), utilizing fat-saturated T2-weighted and STIR sequences, is essential for the early diagnosis and monitoring of axial spondyloarthritis (axSpA). Recently, the European Society of Musculoskeletal Radiology proposed recommendations for the standardization of MRI findings for axSpA. However, the predictive value of specific MRI findings for spinal ankylosis progression remains unclear. This study investigates whether baseline MRI findings correlate with the progression of spinal ankylosis observed on radiographs over a two-year period.

METHODS: Twenty-six axSpA patients who met ASAS criteria and underwent baseline and two-year follow-up imaging were included. MRI assessments of the lumbar spine and SIJ evaluated inflammatory and structural lesions, including Romanus and Anderson lesions. Radiographic progression was defined as a ≥2-point increase in the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Statistical analyses compared clinical and imaging parameters between progression (n=9) and non-progression (n=17) groups.

RESULTS: Patients in the progression group had significantly higher baseline mSASSS (P=0.04) and mHAQ scores (P=0.04). Positive MRI findings of anterior and posterior corner inflammatory lesions and Anderson-central lesions were significantly associated with progression (P<0.05). Romanus lesions, indicative of early structural changes, were more frequent in the progression group (P=0.02). However, fat lesions and SIJ inflammation showed no significant predictive value.

CONCLUSION: Baseline MRI findings, particularly inflammatory and Romanus lesions, are strong predictors of spinal ankylosis progression in axSpA. These results highlight the importance of incorporating MRI into personalized treatment strategies to mitigate disease progression. Further studies are needed to validate these findings in larger cohorts.

PMID:40048664 | DOI:10.1093/mr/roaf015

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Medical therapy and outcomes in REVIVED-BCIS2 and STICHES: an individual patient data analysis

Eur Heart J. 2025 Mar 6:ehaf080. doi: 10.1093/eurheartj/ehaf080. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: In the Surgical Treatment for Ischaemic Heart Failure Trial Extension Study (STICHES), coronary artery bypass grafting (CABG) improved outcomes of patients with ischaemic left ventricular dysfunction receiving medical therapy, whereas in the Revascularization for Ischaemia Ventricular Dysfunction trial (REVIVED-BCIS2), percutaneous coronary intervention (PCI) did not. The aim of this study was to explore differences in outcomes of participants treated with medical therapy alone in STICHES vs. REVIVED-BCIS2 and to assess the incremental benefit of CABG or PCI.

METHODS: Pooled analysis of adjusted individual participant data from two multicentre randomized trials. All patients had left ventricular ejection fraction ≤35% and coronary artery disease and received medical therapy. Participants were randomized 1:1 to CABG (STICHES) or PCI (REVIVED-BCIS2). The primary outcome was the composite of all-cause death and hospitalization for heart failure over all available follow-up.

RESULTS: A total of 1912 participants (88% male, 76% white ethnicity) were included with 98.3% completeness of follow-up for the primary outcome. The median follow-up was 118 months in STICHES and 41 months in REVIVED-BCIS2. Those receiving medical therapy alone in REVIVED-BCIS2 had fewer primary outcome events than those receiving medical therapy alone in STICHES (adjusted hazard ratio 0.60, 95% confidence interval 0.48-0.74, P < .001). Patients receiving PCI in REVIVED-BCIS2 were less likely to experience a primary outcome event than those receiving CABG in STICHES. Adjusted outcomes of patients treated with CABG in STICHES were worse than those receiving medical therapy alone in REVIVED-BCIS2.

CONCLUSIONS: Patients with ischaemic cardiomyopathy receiving medical therapy in REVIVED-BCIS2 had better outcomes than those in STICHES, with or without CABG surgery. Further trials comparing CABG, PCI, and medical therapy in this population are warranted.

PMID:40048661 | DOI:10.1093/eurheartj/ehaf080