Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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International journal of yoga therapy
Randomized Controlled Trial on the Effect of Yoga on Anxiety Severity, Quality of Life, and Biomarkers in Individuals with Anxiety Disorder
Anxiety disorders are highly prevalent mental health conditions characterized by physiological dysregulation that includes heightened stress responses, low-grade systemic inflammation, and metabolic imbalance, which together contribute to impaired quality of life. Although yoga-based interventions are increasingly used as complementary therapies, evidence isolating the effects of slow pranayama (yoga breathing) and savasana (corpse pose) on psychological outcomes and biochemical markers in anxiety disorders remains limited. This randomized controlled study evaluated the effects of slow pranayama and savasana, implemented as adjuncts to routine psychiatric care, on anxiety severity, quality of life, and selected biochemical markers in individuals with anxiety disorders. A total of 150 people diagnosed with anxiety disorders were allocated to either routine psychiatric care alone (control group) or routine care plus slow pranayama and savasana (intervention group) for 8 weeks. We assessed anxiety severity using the Hamilton Anxiety Rating Scale, quality of life using the World Health Organization Quality of Life-Brief questionnaire, and biochemical markers such as serum cortisol, brain-derived neurotrophic factor (BDNF), inflammatory markers, and metabolic parameters. Outcomes were analyzed using mixed-design analysis of covariance with Bonferroni correction, and correlational analyses were performed between psychometric, quality-of-life, and biochemical variables. Of the enrolled participants, 112 completed the study. Significant Group × Time interactions were observed for anxiety severity scores and the physical, psychological, and environmental domains of quality of life, with improvements noted only in the pranayama group. Serum cortisol levels decreased and BDNF levels increased significantly in the intervention group compared with controls. Inflammatory and metabolic parameters did not show statistically significant changes after correction, although favorable directional trends were observed. Anxiety severity and quality-of-life scores demonstrated significant correlations with cortisol, BDNF, and inflammatory and metabolic markers. Slow pranayama and savasana appear to be safe, feasible, and effective adjuncts to standard psychiatric care, improving anxiety severity and quality of life while favorably modulating stress-related physiological markers in people with anxiety disorders.
31 July 2026
Read appraisal →Journal of medical Internet research
User Acceptability and Adoption of AI-Generated Lifestyle Intervention Recommendations: Scoping Review and Theoretical Integration
BACKGROUND: Artificial intelligence (AI)-generated lifestyle recommendations are increasingly used to support health behavior change. However, AI advice does not necessarily mean that users will accept or adopt those recommendations. Although prior reviews have examined AI-enabled lifestyle interventions and health behavior technologies, fewer have focused on whether users accept and adopt AI-generated recommendations. OBJECTIVE: This scoping review aimed to map user acceptability and adoption of AI-generated lifestyle recommendations in user-facing systems used by end users or caregivers. Objectives were to characterize systems and evaluation contexts, clarify how recommendation-level outcomes were conceptualized and measured, synthesize shaping factors, and develop an evidence-informed framework to guide future research, evaluation, and design. METHODS: Following JBI (Joanna Briggs Institute) guidance and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), we searched Ovid MEDLINE, Ovid Embase, APA PsycInfo via ProQuest, Web of Science Core Collection, Scopus, ACM Digital Library, and IEEE Xplore from database inception to May 5, 2026. The initial search was conducted on November 21, 2025, and an updated search was conducted on May 5, 2026. Eligible studies reported empirical end-user or caregiver data, evaluated AI-generated lifestyle recommendation content delivered without manual review or editing, and reported an acceptability or adoption outcome linked to recommendations. English empirical papers and conference papers were included. Data were charted on study, system, outcome, measurement, factor, and theoretical characteristics. Quality was assessed with the Mixed Methods Appraisal Tool. Findings were synthesized descriptively and through evidence mapping. RESULTS: Searches yielded 12,997 records; 8570 unique records were screened, and 21 studies were included. Most were published in 2025 or 2026 (17/21, 81%). Large language model-centered systems were the most common format (12/21, 57.1%). Outcomes were concentrated in acceptability-related perceptions, such as satisfaction or enjoyment, perceived quality or fit, and persuasiveness, whereas adoption-related outcomes were assessed less often and mainly reflected intention, in-study uptake, or short-term enactment. Factors clustered across system capabilities, content properties, individual states and capacities, and contextual constraints. Findings informed an integrative perception-intention-enactment framework positioning acceptability and adoption as a system-content-user-context process. CONCLUSIONS: This review extends prior AI and digital health reviews by shifting attention toward how users perceive, intend to follow, and enact AI-generated lifestyle recommendations. Acceptability and adoption appear to depend on systems eliciting and adapting to context, content being actionable and credible, users having the capacity to interpret, trust, and engage with recommendations while retaining control, and resources, routines, and social contexts allowing enactment. The framework can guide theory-driven evaluation, outcome selection, and system design by identifying where recommendation processes may succeed or fail, but should be interpreted as preliminary and evidence-informed rather than causal. By integrating implementation, behavioral, and human-AI perspectives, this review provides a foundation for moving AI-generated lifestyle recommendations from technically plausible outputs toward user-centered, context-sensitive, and behaviorally actionable support.
16 July 2026
Read appraisal →BMC oral health
The association between oral hygiene and metabolic dysfunction-associated steatotic liver disease - a systematic review
BACKGROUND: Given the increasingly evident links between oral health and systemic health, the aim of this review was to investigate whether oral hygiene practices influence the risk or progression of metabolic dysfunction-associated steatotic liver disease (MASLD). The findings support the potential importance of good oral hygiene and regular dental visits, especially for patients with MASLD. METHODS: This systematic review was registered with PROSPERO (CRD420251041530), and PubMed, Scopus, Embase and Web of Science were used for literature research up to June 2026. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, screening, study selection and quality check were performed using Rayyan and the Joanna Briggs Institute (JBI) critical appraisal checklists. Studies assessing the potential link between the frequency of oral hygiene procedures and the incidence, prevalence or progression of MASLD were selected for a systematic synthesis. The old terms non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) were considered as well. RESULTS: A total of 570 results were identified of which six studies met the inclusion criteria. Five of them reported a correlation between higher tooth brushing frequency and a lower incidence, prevalence or progression of NAFLD/NASH compared to individuals with lower tooth brushing frequency. Notably, one study revealed significantly worse liver parameters among NASH patients without regular dental visits than among those who visited a dentist more than once a year. CONCLUSIONS: An association between oral hygiene habits and NAFLD/NASH was found in all included studies. A greater frequency of daily tooth brushing as well as regular dental visits might have beneficial effects on both the development and progression of fatty liver disease. However, there is not enough evidence to establish causality yet and the impact of confounding factors must be further investigated. CLINICAL TRIAL REGISTRATION: Not applicable.
11 July 2026
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