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Intermittent fasting is a popular diet for weight loss, but concerns have been raised regarding the effects of fasting on the reproductive health of women and men. Accordingly, we conducted this literature review to clarify the effects of fasting on reproductive hormone levels in humans. Our results suggest that intermittent fasting decreases androgen markers (i.e., testosterone and the free androgen index (FAI)) while increasing sex hormone-binding globulin (SHBG) levels in premenopausal females with obesity. This effect was more likely to occur when food consumption was confined to earlier in the day (eating all food before 4 pm). In contrast, fasting did not have any effect on estrogen, gonadotropins, or prolactin levels in women. As for men, intermittent fasting reduced testosterone levels in lean, physically active, young males, but it did not affect SHBG concentrations. Interestingly, muscle mass and muscular strength were not negatively affected by these reductions in testosterone. In interpreting these findings, it is important to note that very few studies have been conducted on this topic. Thus, it is difficult to draw solid conclusions at present. From the limited data presented here, it is possible that intermittent fasting may decrease androgen markers in both genders. If this is the case, these results would have varied health implications. On the one hand, fasting may prove to be a valuable tool for treating hyperandrogenism in females with polycystic ovarian syndrome (PCOS) by improving menstruation and fertility. On the other hand, fasting may be shown to decrease androgens among males, which could negatively affect metabolic health and libido. More research is warranted to confirm these preliminary findings.

Background/Objectives: This secondary analysis aimed to compare the effects of time-restricted eating (TRE) versus calorie restriction (CR) and controls on mood and quality of life in adults with type 2 diabetes (T2D). Methods: Adults with T2D (n = 69) were randomly assigned to one of three interventions for 6 months: 8 h TRE (eating only between 12 and 8 pm daily); CR (25% energy restriction daily); or a no-intervention control group. At baseline and 6 months, mood was assessed using the Beck Depression Inventory-II (BDI-II) and the Profile of Mood States (POMS) questionnaires, while quality of life was assessed using the Rand 36-Item Short Form (SF-36). Results: Body weight significantly decreased in the TRE group (−3.38%; 95% CI, −6.04 to −0.71%, p = 0.008), but not in the CR group (−1.80%, 95% CI, −4.50 to 0.91%, p = 0.32) versus controls by month 6. Fat mass, lean mass, and visceral fat mass remained unchanged in TRE and CR groups, versus controls, from baseline to month 6. No changes were observed in depression scores (BDI-II), total mood disturbance, or any POMS subscales (tension, depression, anger, fatigue, confusion, or vigor) in either the TRE or CR groups compared to controls. Similarly, there were no significant changes in the quality-of-life SF-36 constructs of vitality, bodily pain, mental health, and general physical health in the TRE or CR group versus controls. By month 6, there were no associations between changes in body weight, quality of life, and mood outcomes in any group. Conclusions: In conclusion, our findings suggest that TRE and CR do not have any effect on mood or quality of life in adults with T2D, relative to controls. However, the participants’ baseline mood and quality of life were generally within healthy ranges, and only minimal weight loss was achieved (3.5%, TRE only), which may explain the lack of observed effects.

Learning how to effectively respond to ethical dilemma can affect nurses’ physical and mental health, which is not conducive to developing a nursing career. Nursing students’ ethical behavior warrants attention as professionals about to begin clinical work. We aim to understand the current situation and influencing factors of Chinese nursing students’ ethical behavior. A cross-sectional descriptive study was conducted. Descriptive statistics and multiple linear regression were used to analyze the data. Full-time nursing students were recruited from an undergraduate medical university in Jinan through convenient sampling from November to December 2021. Research ethics approval (No. 2022-0018) was obtained from the Ethics Committee of Affiliated Hospital of Shandong University of Traditional Chinese Medicine. Informed consent was also received from participants. The EBT scores of the nursing students were 95.14 ± 11.37, which was not high compared with the total score. Gender, year level, and professional values had a significant impact on participants’ ethical behavior. A positive correlation was found between nursing professional values and ethical behavior. A gap still exists between the moral development and maturity of undergraduate nursing students. To further cultivate their ethical behavior and improve their confidence and ability to respond to ethical dilemmas, more innovative methods must be employed in teaching ethics courses, and continuity in the ethics education system must be maintained. For male and third- and fourth-year nursing students who showed lower ethical behavior scores, nursing educators can develop their ethical behaviors by helping them establish positive professional values. Plain Language Summary Ethical behavior refers to the actions taken by individuals when they encounter ethical dilemmas, which can either benefit or harm others and society. The occurrence of clinical ethical dilemmas is unavoidable, which often causes pressure to nurses and threatens the physical and mental health of nurses. Nursing students are valuable assets to the nursing profession, and their demonstration of positive ethical behavior can significantly boost their confidence and competence in resolving ethical dilemmas, which is conducive to the development of nursing work and career. This study aimed to investigate the current situation and influencing factors of nursing students’ ethical behavior in China. A total of 921 nursing students from a medical college in Shandong Province were surveyed using the Chinese version of the Ethical Behavior Test (EBT) and Revised Nursing Professional Values Scale (NPVS-R). The results of this study showed that ethical behavior of Chinese nursing students was relatively immature. Female nursing students, first- and second-year nursing students and nursing students who agree with the nursing professional view have more mature ethical behavior and they can deal with ethical dilemmas more effectively. We should focus on those students who have difficulties in adopting positive ethical behavior to solve ethical dilemmas and find powerful measures to improve the current situation of ethical behavior. This study is limited by a single sample source and limited exploration variables. Future research should expand the sample sources at more universities, explore other influencing factors, and take intervention measures to improve the moral behavior of nursing students.

Epidermal growth factor receptor (EGFR) plays a pivotal role in collective cell migration by mediating cell-to-cell propagation of extracellular signal-regulated kinase (ERK) activation. Here, we aimed to determine which EGFR ligands mediate the ERK activation waves. We found that epidermal growth factor ( EGF )–deficient cells exhibited lower basal ERK activity than the cells deficient in heparin-binding EGF ( HBEGF ), transforming growth factor alpha ( TGFα ) or epiregulin ( EREG ), but all cell lines deficient in a single EGFR ligand retained the ERK activation waves. Surprisingly, ERK activation waves were markedly suppressed, albeit incompletely, only when all four EGFR ligands were knocked out. Re-expression of the EGFR ligands revealed that all but HBEGF could restore the ERK activation waves. Aiming at complete elimination of the ERK activation waves, we further attempted to knockout NRG1 , a ligand for ErbB3 and ErbB4, and found that NRG1 -deficiency induced growth arrest in the absence of all four EGFR ligand genes. Collectively, these results showed that EGFR ligands exhibit remarkable redundancy in the propagation of ERK activation waves during collective cell migration.

Smartphone diet-tracking apps may help individuals lose weight, manage chronic conditions, and understand dietary patterns; however, the usabilities and functionalities of these apps have not been well studied. The aim of this study was to review the usability of current iPhone operating system (iOS) and Android diet-tracking apps, the degree to which app features align with behavior change constructs, and to assess variations between apps in nutrient coding. The top 7 diet-tracking apps were identified from the iOS iTunes and Android Play online stores, downloaded and used over a 2-week period. Each app was independently scored by researchers using the System Usability Scale (SUS), and features were compared with the domains in an integrated behavior change theory framework: the Theoretical Domains Framework. An estimated 3-day food diary was completed using each app, and food items were entered into the United States Department of Agriculture (USDA) Food Composition Databases to evaluate their differences in nutrient data against the USDA reference. Of the apps that were reviewed, LifeSum had the highest average SUS score of 89.2, whereas MyDietCoach had the lowest SUS score of 46.7. Some variations in features were noted between Android and iOS versions of the same apps, mainly for MyDietCoach, which affected the SUS score. App features varied considerably, yet all of the apps had features consistent with Beliefs about Capabilities and thus have the potential to promote self-efficacy by helping individuals track their diet and progress toward goals. None of the apps allowed for tracking of emotional factors that may be associated with diet patterns. The presence of behavior change domain features tended to be weakly correlated with greater usability, with R ranging from 0 to .396. The exception to this was features related to the Reinforcement domain, which were correlated with less usability. Comparing the apps with the USDA reference for a 3-day diet, the average differences were 1.4% for calories, 1.0% for carbohydrates, 10.4% for protein, and -6.5% for fat. Almost all reviewed diet-tracking apps scored well with respect to usability, used a variety of behavior change constructs, and accurately coded calories and carbohydrates, allowing them to play a potential role in dietary intervention studies.

As one of the megadiverse countries, the effectiveness of wildlife protection in China is of great significance to global biodiversity conservation. With continued evolution and revisions, China’s Wildlife Protection Law has listed over 140 marine species; however, it is still inclined toward terrestrial animals. To narrow the gap between compliance and enforcement, we collected 1,309 effective responses from various coastal cities of China through an anonymous online questionnaire survey, to investigate their exposure, understanding and attitudes toward Wildlife Protection Law for marine species (mWPL). Most respondents demonstrated an overall good understanding about the context, necessity and effectiveness of mWPL. The fisher communities were found to be more aware of the dissemination and implementation of mWPL. However, they understood less of the penal system, and exhibited negative attitudes toward the necessity and punishment of the legislation, probably due to the conflicts between resource utilizations and legislative interventions. The participants also indicated that seahorses, horseshoe crabs and corals were commonly subjected to illegal exploitations. While most respondents suggested greater fines, tighter laws and better public enforcement, we advocate the exploration of bottom-up options such as community engagement and environmental education to improve compliance and implementation of mWPL for the benefit of marine wildlife conservation in China.

A stronger understanding of the factors influencing implementation of interventions in community-based early childcare settings is needed. The purpose of this systematic review was to synthesize existing research on facilitators and barriers to implementation and sustainability of nutrition and physical activity interventions in early childcare settings targeting 2–5-year-old children, including considerations for equitable implementation. This review adhered to PRISMA 2020 guidelines. Peer-reviewed literature was searched in PubMed, EMBASE, CINAHL, ERIC, and PsycINFO databases up to September 2020. Primary research studies that examined facilitators and barriers (or related synonyms) to the implementation and sustainability of nutrition and physical activity interventions in early childcare settings were eligible for inclusion. The search yielded 8092 records that were screened by four analysts in Covidence software with a final review of 24 studies. Two independent reviewers conducted study selection, data extraction, and quality appraisal (Mixed Methods Appraisal Tool). A “best fit” framework was applied using the Consolidated Framework for Implementation Research (CFIR) constructs to code barriers and facilitators. The most salient constructs were (1) “Available Resources,” which was composed of time, staffing, space, and staff trainings; (2) adaptability; and (3) compatibility, the latter two indicating that easily modifiable interventions facilitated a smoother “fit” and were more likely to be successful, given adequate site-level resources. Only nine (28%) reported the use of a theory, model, or framework to guide evaluation; six studies (24%) included factors related to sustainability; and nine studies (38%) conducted their interventions with low-income or minoritized groups. The findings point to the need for intervention evaluations examining nutrition and physical activity to more consistently consider (a) sustainability factors early on in design and adoption phases; (b) use of theory, model, or framework to guide evaluation; and (c) equity-related frameworks and considerations for how equitable implementation.

Despite the mounting evidence supporting the use of intermittent fasting as a safe and effective weight loss intervention, many myths about fasting persist in popular culture. Here, we review some common beliefs about intermittent fasting that are not supported by scientific evidence.

Time restricted eating (TRE) has become one of the most popular diets in recent years. It involves restricting individuals’ eating window to 4-10 hours per day and fasting with energy-free beverages for the remaining hours. The sudden rise in popularity of TRE may be because it does not require individuals to count calories to lose weight. However, long-term randomized trials evaluating the efficacy of TRE are limited. The goal of this study was to compare the effects of 8-h TRE versus traditional calorie restriction (CR) and controls on body weight, metabolic risk factors, mood, and quality of life, over 12-months. Participants with obesity (n = 90) were randomized to 1 of the 3 groups: (1) 8-h TRE (ad libitum eating 12-8pm); (2) CR (25% energy restriction daily); or (3) control (eating over >10 h per day) over 12 months. 77 participants completed the study (40 ± 11 y; 33% Black; 46% Hispanic). By month 12, TRE and CR decreased body weight by -4.87% (95%CI, -7.61% to -2.31%) and -5.30% (95%CI, -9.06% to -1.54), respectively, relative to controls, with no difference between TRE and CR. Energy intake decreased with TRE (-425 ± 531 kcal/d) and CR (-405 ± 712 kcal/d), with no difference between groups. TRE participants were adherent to their eating window 6.1 days per week, while 61% of CR participants were adherent to their diet over 12 months. Fat mass, waist circumference, and BMI decreased by TRE and CR, versus controls, while lean mass and visceral fat mass remained unchanged. Insulin sensitivity increased by TRE compared to controls, but not compared with CR. Blood pressure, heart rate, plasma lipids, fasting glucose, fasting insulin, insulin resistance, HbA1c, mood, and quality of life remained unchanged in the TRE and CR groups, relative to controls. These findings suggest that TRE is more effective in producing weight loss when compared with controls, but not more effective than CR, in a racially diverse population.

This review examines the effects of two popular intermittent fasting regimens on sleep in adults with overweight and obesity. Specifically, the effects of time restricted eating (TRE; eating all food within a 4–10 h window) and alternate day fasting (ADF; 600 kcal fast day alternated with ad libitum feast day) on sleep quality, sleep duration, sleep latency, sleep efficiency, insomnia severity, and risk of obstructive sleep apnea, will be summarized. The role of weight loss will also be discussed. Results from our review reveal that the majority of these trials produced weight loss in the range of 1–6% from baseline. Sleep quality and sleep duration remained unaltered with TRE and ADF, as assessed by the Pittsburgh Sleep Quality Index (PSQI). The effects of intermittent fasting on sleep latency and sleep efficiency are mixed, with one study showing worsening of these parameters, and others showing no effect. Insomnia severity and the risk of obstructive sleep apnea remained unchanged in the trials assessing these metrics. Taken together, these preliminary findings suggest that TRE and ADF produce mild to moderate weight loss (1–6%) but their effects on sleep remain unclear. Solid conclusions are difficult to establish since participants in the studies had healthy sleep durations and no clinical insomnia at baseline, leaving little room for improvement in these metrics. Moreover, none of the trials were adequately powered to detect statistically significant changes in any measure of sleep. Future well-powered trials, conducted in individuals with diagnosed sleep disturbances, will be necessary to elucidate the effect of these popular diets on sleep.