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Background: With increasing focus on patient-reported outcome measures (PROMs) in chronic rheumatic diseases, we aimed to evaluate the self-reported physical and psychosocial health in children with juvenile idiopathic arthritis (JIA) compared to matched population-based controls. Furthermore, we aimed to study the association of patient- and physician-reported outcome measures in JIA with patient-reported physical disability. Methods: We used data from a Norwegian JIA cohort study (NorJIA), including clinical characteristics and outcome measures in participants with JIA and sex- and age-matched population-based controls. Self-reported physical and psychosocial health were assessed using the generic Child Health Questionnaire (CHQ). Comparisons between children with JIA and controls were performed by test of proportions for categorical variables and t-test for continuous variables. To evaluate the association of patient- and physician-reported outcome measures with patient-reported physical disability, assessed with the Child Health Assessment Questionnaire (CHAQ) in children with JIA, we used logistic regression to estimate adjusted odds ratio (OR) with 95% confidence interval (CI). Results: In total, 221 participants with JIA (59.3% females, median age 12.7 years) and 207 controls with available data were included. In the JIA group, 24.3% scored below the norm for physical health (CHQ PhS < 40) and 8.7% scored below the norm for psychosocial health (CHQ PsS < 40). The corresponding numbers for the control group were 0.5% and 1.9%, respectively. In the JIA group, 57.9% reported physical disability (CHAQ > 0). Several patient-reported outcome measures, such as poor physical health (CHQ PhS < 40), disease-related pain, and the patient's global assessment of disease impact on wellbeing, were strongly associated with self-reported physical disability (CHAQ > 0), adjusted OR 19.0 (95% CI 5.6, 64.1), 14.1 (95% CI 6.8, 29.2), and 14.0 (95% CI 6.2, 31.6), respectively. Associations were also found for active disease according to Wallace (adjusted OR 36.3, 95% CI 10.3, 128.1), and physician-reported global assessment of disease activity (adjusted OR 6.2, 95% CI 3.1, 12.6). Conclusions: The strong association between patient- and physician-reported outcome measures and patient-reported physical disability strengthens the importance of including the patient's voice in a comprehensive evaluation of patient outcome in JIA. Trial registration: ClinicalTrials.gov (No: NCT03904459). [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion This study aimed to describe self‐assessed clinical gerontological nursing competence and its associated factors among licensed practical nurses.A descriptive cross‐sectional design was adopted for the study.Data were collected in Autumn 2023 from 394 licensed practical nurses working in healthcare services for older people in one well‐being services county in Finland. The nurses, recruited through convenience sampling, were surveyed using a 40‐item self‐assessment clinical gerontological nursing competence instrument (on a Likert scale from 1 = poor to 5 = excellent). Descriptive statistical methods were used to analyse the results.Participants mainly assessed their clinical gerontological competence as good. Competence in using assistive devices to support functional ability was assessed as very good, while competence in postoperative wound care was assessed as the weakest. Participants working in 24‐h services assessed their competence as the weakest among the three clinical gerontological nursing areas. Participants under 40 years of age with 5–10 years of work experience self‐assessed statistically significantly stronger competence in disease‐specific nursing than those over 40 with less work experience.The self‐assessed competence of licensed practical nurses varies across different service and care units. Competence in wound care requires more focus and education in the future. Attention should also be paid to competence development in different educational areas, for example, through continuous education and competence development models. The results could facilitate licensed practical nurses' competence development and management in clinical gerontological nursing. The study's insights can also guide allocating resources and education to ensure high‐quality care in different service areas. [ABSTRACT FROM AUTHOR]

Background: Despite the paucity of scientific evidence, complementary and alternative medicine (CAM) is widely used for the prevention and treatment of chronic illness, holistic care, and counteracting the adverse effects of conventional therapies. This study aims to determine the prevalence of CAM use and its associated factors among patients undergoing hemodialysis (HD) in Taiwan. Methods: This quantitative study was conducted from August 2022 to July 2024 in the HD unit at Kaohsiung Chang Gung Memorial Hospital in Taiwan. Face-to-face questionnaire-based interviews were held with 154 of 163 eligible patients (response rate, 94.5%) at the bedside during HD. The completed questionnaires were entered into a secure computer database. Data was performed by descriptive analysis, Chi-square, and Fisher tests. Results: More than half of the patients were CAM users (n = 86; 56%), and women was associated with significantly more usage of CAM. Fifty-six CAM users took Chinese herbal medicine (CHM), 52.3% (n = 45) used dietary supplements, and 19.8% (n = 17) used acupuncture. The benefit in the effectiveness of CAM was the main reason for use, the need of CAM to improve the well-being and HD-related complication was high. 32.7% of patients had used CAM based on recommendation from their family and friends. More than one-third (33.7%) of patients did not disclose their use of CAM to their doctors, most of them think it is unnecessary. Conclusions: The use of CAM by patients with maintenance HD was relatively frequent. Of these, most used CHM, of which are shown to the trend into routine HD care is inevitable by high coverage and utilization in Taiwanese national health insurance system. These findings indicate that it is important for health care providers working in dialysis to assess CAM use. [ABSTRACT FROM AUTHOR]

Numerous studies have suggested that the hemoglobin-to-red blood cell distribution width ratio (HRR) is associated with the onset, progression, and prognosis of various diseases. However, to the best of our knowledge, no research has conducted statistical analyses to determine the association between HRR and stroke. This cross-sectional study was conducted among adults with complete data on hemoglobin-red cell distribution width ratio (HRR) and stroke from the 2005–2018 National Health and Nutrition Examination Survey (NHANES). HRR was calculated by dividing hemoglobin (HGB) in grams per deciliter (g/dL) by the red blood cell distribution width (RDW). Weighted multivariable logistic regression and generalized additive models were employed to investigate the independent and nonlinear relationships between HRR and stroke. Threshold effects were assessed using two-piece linear regression models. Additionally, subgroup analyses and interaction tests were performed. A total of 36,215 participants were included, with 2.92% classified as stroke patients. The prevalence of stroke decreased across increasing tertiles of HRR (Q1: 5.07%; Q2: 2.63%; Q3: 1.69%; P < 0.0001). A negative association between HRR and stroke was observed in both unadjusted and adjusted models. In Model III, each one-unit increase in HRR was associated with a 58% reduction in the likelihood of stroke (Model III: OR = 0.42, 95% CI: 0.29–0.63). Subgroup analyses and interaction tests revealed that the association between HRR and stroke was BMI-dependent (P < 0.05), with the negative association only observed in participants with BMI < = 25 and BMI 25–30, but not in those with BMI > 30. Using a two-piece linear regression model, a threshold effect was identified at a BMI of 30 (K = 1.16). To the left of this breakpoint, there was a negative association between HRR and stroke (OR = 0.55, 95% CI: 0.27–0.97), whereas no such association was detected to the right of the breakpoint (OR = 6.49, 95% CI: 0.75–56.11). HRR is negatively associated with the likelihood of stroke, with a lower risk of stroke in individuals with higher HRR levels. [ABSTRACT FROM AUTHOR]

Background: The aging global population is increasing the attention to cognitive decline in older individuals. Objective: This study sought to examine the potential link between the neutrophil percentage-to-albumin ratio (NPAR) and cognitive function. Methods: We analyzed data from the National Health and Nutrition Examination Survey 2011–2014 using multivariate logistic regression and smooth curve fitting, to investigate the correlation between NPAR and cognitive performance. Restricted cubic spline analysis assessed the linear relationship with high-risk cognitive dysfunction, while piecewise linear regression identified thresholds. Subgroup analyses confirmed the consistency and reliability of our findings. Results: Our study included data from 2759 individuals aged >60 years. NPAR showed a significant correlation with Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word learning score, CERAD delayed recall score, total z-score and a high risk of cognitive dysfunction. Furthermore, there were statistically significant trends in the changes in CERAD word learning, digit symbol substitution test, and CERAD delayed recall scores as the NPAR quartile increased, these trends were inverted U-shaped. When the NPAR exceeded 14.57, there was a positive association with the likelihood of a high risk of cognitive impairment. The link between NPAR and cognitive performance was notably stronger in individuals with moderate body mass index and those aged 73–80 years. Conclusions: A strong link was observed between the NPAR and cognitive function. NPAR may serve as a tool to identify individuals at increased risk of cognitive decline. [ABSTRACT FROM AUTHOR]

Background: In clinical practice, psoriasis is a prevalent chronic inflammatory cutaneous disease featured with the development of red plaque with silvery scales, which considerably affects cutaneous health and quality of life of those afflicted. Objective: This research aimed to examine the association between the body roundness index (BRI) and psoriasis, using data sourced from the National Health and Nutrition Examination Survey (NHANES). Methods: Our study used a cross-sectional design, including 8,479 adults, of whom 234 were diagnosed with psoriasis. Multivariable logistic regression was used to analyze the relationship between BRI and psoriasis, with stepwise adjustments for covariables. Results: Results from multivariable logistic regression analyses indicated a significant positive relationship between BRI and the risk of developing psoriasis; specifically, after comprehensive adjustment for covariables, per 1 unit increase in BRI was linked to an 11% rise in psoriasis risk (OR = 1.11, 95% CI = 1.05–1.17). Furthermore, psoriasis patients exhibited higher average BRI compared to non-psoriasis patients and a greater prevalence of comorbidities such as hypertension and smoking. Conclusion: These findings suggest that higher BRI is positively correlated with the risk of psoriasis in the adult population in the US. BRI could potentially act as a practical anthropometric index for more accurately predicting the risk of developing psoriasis. [ABSTRACT FROM AUTHOR]

Background: Elevated homocysteine (Hcy) levels have been linked to cardiovascular disease (CVD), but their association with cardiometabolic multimorbidity (CMM) remains uncertain. Methods: Data from the baseline survey of the China Northwest Cohort-Ningxia Project (CNC-NX) were used to recruit 22,566 participants. Demographic characteristics, lifestyle factors, and laboratory exam results were collected. Logistic regression was used to evaluate the association between Hcy levels and CMM risk. Restricted cubic splines (RCS) explored potential non-linear relationships, and subgroup analyses assessed the consistency of the association across distinct groups. Sensitivity analysis accounted for cluster variability. Results: The final analysis included 18,126 participants. Higher Hcy levels were significantly associated with an increased risk of CMM (adjusted OR = 1.005, P = 0.003), with a linear relationship confirmed by RCS analysis (P for non-linearity = 0.142). There was a stronger association between Hcy-CMM in high-risk people, including elderly, males, and those with high BMI (P < 0.05). No significant association was observed between Hcy levels and more severe types of CMM. Conclusions: Elevated Hcy levels are correlated with an increased risk of CMM, warranting further investigation into the underlying mechanisms and potential interventions. Given the individual differences in the Hcy-CMM relationship, targeted comprehensive interventions for high-risk groups are necessary to reduce the risk of CMM. [ABSTRACT FROM AUTHOR]

Highlights: This systematic review and meta-analysis uncovered that in China, there's a shortage of medical records coding staff, coupled with heavy coding workloads. The insights gleaned from analyzing the allocation of medical records to full-time coders in China offer valuable guidance and benchmarks for hospitals in allocating these tasks. Ensuring accurate coding is pivotal for reliable data collection and the effective implementation of Diagnosis-Related Groups (DRGs) and Diagnosis Intervention Package (DIP) systems nationwide. Importance: The homepage of medical records holds significant importance for national performance assessments, DIP settlement lists, and DRG payments. Coders, as auditors of the codes, wield a crucial influence on the quality of the medical records' homepage. Objective: To analyze the general situation of the allocation of medical record full-time coders in China. Data source: CNKI, Wanfang, VIP, PubMed and other databases were searched from database inception to November 31, 2023. Main outcomes and measures: The primary outcome was the allocation of medical records to full-time coders, with the workload of the coders being the primary focus. Secondary outcomes encompassed the professional background of the coders, including their academic qualifications, professional titles, possession of medical coding certificates, and years of experience in coding. Results: Eleven studies, comprising data from 1783 hospitals and 4448 coders, were analyzed. Among the coders, 61% had a medical-related professional background, 62% held a bachelor's degree or higher, 54% possessed an intermediate title or higher, 61% had coding certificates, and 51% had less than 5 years of work experience. The summary findings regarding the number of coders and coded medical records in secondary and tertiary hospitals indicated an average discharge rate of 22,704.0 per hospital in China. The number of coded cases averaged around 11,300. Specifically, coders in tertiary hospitals coded approximately 12,049 medical records on average, while those in secondary hospitals coded around 7,399 medical records. Conclusion and relevance: Our study highlights the shortage of medical record coding personnel in the majority of hospitals, coupled with a significant coding workload, low educational qualifications among staff, short working hours, and an imbalanced title structure. Given these findings, hospitals and relevant management authorities should prioritize the recruitment of highly educated professionals, streamline the assessment process for professional titles, alleviate the coding workload, and enhance coding quality. [ABSTRACT FROM AUTHOR]

Background: Severe acute respiratory infection (SARI) is a major cause for hospital admission and associated with high mortality among children worldwide. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza viruses and respiratory syncytial virus (RSV) are the most frequently identified pathogens in children with SARI. The duration of care can be affected by the type of infection and patient characteristics. Therefore, the objective of this study was to identify factors affecting the length of hospitalization in children infected with SARS-CoV-2, influenza A and RSV. Methods: We collected data on 713 children with SARI from the medical databases of a university hospital in Hungary. To examine whether there is a difference in the length of hospitalization in children with the SARI Kruskal-Wallis test was performed. To determine the factors that may have an impact on the duration of care a multiple logistic regression analysis was executed. Results: Our results showed that among RSV infected patients the proportions of children requiring intensive care (8.94%), mechanical ventilation (8.94%) and oxygen therapy (13.01%) and suffering from pneumonia (29.27%) were larger than among cases with SARS-CoV-2 and influenza A infection. Considering the age distribution and the duration of care in children with SARI, cases with RSV were significantly younger (p < 0.001) and stayed longer in the hospital (median: 5 days, IQR: 4–7 days, p < 0.001) than those with SARS-CoV-2 and influenza A virus. Multiple logistic regression analysis showed that RSV infection (adjusted odds ratio (aOR): 3.25, 95% confidence interval (CI): 1.43–7.38; p = 0.005), pneumonia (aOR: 3.65, 95% CI: 2.14–6.24; p < 0.001), mechanical ventilation or oxygen therapy (aOR: 3.23, 95% CI: 1.29–8.11; p = 0.012) and underlying illnesses (aOR: 2.39, 95% CI: 1.35–4.23; p = 0.003) significantly increased the odds of hospitalization for more than 4 days. Conclusions: Our research showed that of the viruses causing SARI, RSV had the greatest clinical relevance, contributing to hospital stays of more than 4 days in a large share of paediatric patients below 1 year of age. Our results supply new information on children with SARI, and provide evidence for health policy makers to allocate additional resources to hospitals during SARI epidemics. [ABSTRACT FROM AUTHOR]

\nIntroduction: The aim of this cross-sectional study was to explore the degree whereby dentists differentiate between repair versus replacement for failed restorations. A random selection of adult patients from North Norway was chosen from the larger Tromsø 7 study. Methods: A randomized sample of 3,653 persons (11.5% of the total number of individuals invited to the Tromsø 7 study, 51.5% women, aged 40–93 years) were included. Based on FDI’s clinical criteria for the evaluation of restorations – 2010, 17 calibrated dentists evaluated patients by clinical and radiographical pictures in a specially designed software developed for this purpose. The dental practitioners’ opinions gave rise to the reported treatment decisions. Descriptive statistics and multivariable multilevel mixed-effect logistic regression models (STATA 17/SE) were performed. Results: The participants’ DMFT values ranged from 0 (0.9%) to 24 (8.8%) (median DMFT 21.3, mean 20.0). A total of 90.062 teeth (24.7 teeth per patient) were assessed. Re-treatment suggestions were made for 3,006 restorations, i.e., an average of 3.3% re-treatments. Of these, 25.3% (n = 814) were suggested for repair and 74.7% (n = 2,192) for replacement. Dental treatment was suggested for 1,597 patients and varying from 1 to 14 suggestions per patient. Secondary caries (37.6%) and restoration fracture (15.2%) were found to be most frequently used indications for re-treatment, surface properties the least. No significant difference was found between assessing dentists based on sex or age. Clustering by dentist level was checked using intra-class correlation coefficients, demonstrating that 16% of the variance in suggestions for restoration re-treatment was explained at the dentist level. Thus, a wide range of treatment suggestions was noted among the dentists. Conclusion: Need for restoration revision seems low in North Norway. There is a tendency towards larger and more indirect restorations, and the diagnosis of secondary caries is still a matter of uncertainty. A randomized population of adults over 40 years, selected among the citizens of Tromsø County in North Norway, were examined by dentists, resulting in a study group of 3,653. Clinical examinations were executed, clinical photos and X-rays taken of each patient in a dental clinic. This is part of the Tromsø 7 study. A specially designed data programme was developed, and 17 trained dentists were able to assess the clinical state of restorations. All the dentists were working as clinical teachers in dental schools. The purpose was to decide what kind of treatment they thought best for unacceptable restorations. Should they be replaced or repaired if revision was needed. Only 3.3% of all examined teeth were proposed for restoration revision, which seemed to be rather low. Among the suggested revisions, approx. 25% were recommended for repair, while 75% was assigned for replacement. Tooth-coloured material, i.e., composite, was recommended in almost 75% of the cases. Different kinds of crowns counted for 25%. A considerable difference in the number of treatment suggestions was noted among the dentists. Statistical analyses demonstrated that 16% of the difference in suggestions for restoration re-treatment depended on different dentist opinions. Secondary caries and restoration fracture were found to be the most used indications for re-treatment. Need for restoration revision seems low in North Norway. However, there is a tendency towards larger and more indirect restorations. The diagnosis of secondary caries is still a matter of uncertainty. [ABSTRACT FROM AUTHOR]

Our study aimed to investigate the association between RFM and kidney stones, focusing specifically on the mediating role of high-density lipoprotein cholesterol (HDL-C). We performed a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007 to 2018. Our analytical approach included multivariate logistic regression modeling, subgroup analysis, generalized additive modeling (GAM), smoothed curve fitting, and receiver operating characteristic (ROC) curve, as well as mediation analysis to assess the association between RFM and kidney stones. Finally, we categorized RFM into normal and elevated groups to conduct a sensitivity analysis. This study involved 29,712 participants, with a kidney stone prevalence of 9.88%. We discovered a positive association between RFM and kidney stones (OR = 1.41 per SD increment, 95% CI: 1.24, 1.60). Subgroup analysis revealed a consistent positive association across all subgroups, with a notably higher likelihood of developing kidney stones in young adulthood (P for interaction < 0.05). The smooth curve fitting shows that RFM is nonlinearly and positively correlated with the prevalence of kidney stones. Additionally, HDL-C was found to be negatively associated with kidney stones. Importantly, HDL-C demonstrated a significant mediating effect, with a mediation ratio of 13.52%. ROC analysis indicated that RFM (AUC = 0.616) provided better diagnostic accuracy than traditional measures such as BMI (AUC = 0.565) and WC (AUC = 0.599). Furthermore, the sensitivity analysis further supports the robustness of our findings. RFM is nonlinearly and positively correlated with the prevalence of kidney stones, with HDL cholesterol playing a significant mediating role in this relationship. However, further studies are needed to confirm these associations and explore potential mechanisms. [ABSTRACT FROM AUTHOR]

Background: Gout stands as a prevailing manifestation of inflammatory arthritis. While it is linked to several well-established risk factors, the associations between lipid profiles and the risk of gout remain unclear. Methods: This research involved National Health and Nutrition Examination Survey data (2007–2018). The cardiometabolic index, which incorporates the Triglycerides (TG)/High-density lipoprotein cholesterol (HDL) ratio and waist to height ratio (WHtR), was used to assess lipid profiles and metabolic health. Multivariate logistic regression analysis, propensity score matching, and mediation analyses were utilized to evaluate the associations of lipid profiles and the cardiometabolic index with the risk of developing gout. Results: Among 11,032 participants, each 1-unit increase in TG levels was associated with a 65% increase in the odds of developing gout before matching [1.65 (1.15–2.38), P = 0.007] and a 155% increase in the odds of developing gout after matching [2.55 (1.59–4.09), P = 0.007]. Each 1-unit increase in the cardiometabolic index was linked to an 81% increase in the odds of developing gout before matching [1.81 (1.22–2.70), P = 0.004] and a 215% increase in the odds of developing gout after matching [3.15 (1.84–5.40), P < 0.001]. The participants with HDL levels in the third quartile presented a 35% reduction in gout risk relative to those with HDL levels in the first quartile before matching [0.65 (0.46–0.92), P = 0.014] and a 51% reduction in gout risk after matching [0.49 (0.32–0.75), P < 0.001]. Mediation analyses revealed that BMI, WHtR, and homeostatic model assessment for insulin resistance (HOMA-IR) mediated the relationships between TG levels and the risk of developing gout at 18.75%, 24.28%, and 5.35%, respectively. For the association between HDL levels and the risk of developing gout, the mediating effects of BMI, WHtR, leukocytes, γ-glutamyltransferase (in those with HDL < 56 mmol/L), and HOMA-IR were 57.98%, 69.03%, 8.77%, 5.18%, and 11.14%, respectively. Conclusion: This study reveals the relationship between lipid profiles and the risk of developing gout. Regularly checking TG and HDL levels and actively managing obesity, insulin resistance, oxidative stress and inflammation are important for lowering the risk of developing gout. [ABSTRACT FROM AUTHOR]

Introduction: Gestational diabetes mellitus (GDM) is associated with an increased risk of developing type 2 diabetes mellitus (T2DM). The inflammatory potential of diet is crucial in GDM development. This study compares dietary inflammatory indices (DII) in females with and without a history of GDM and constructs a predictive model for prediabetes risk. Methods: Cross-sectional data from NHANES cycles (2011–2014) were analyzed using the DII. Independent t tests, chi-square test, and Mann-Whitney U test examined DII scores in relation to GDM history. Multivariate logistic regression assessed DII's association with prediabetes in females with GDM history. Restricted cubic spline (RCS) and LASSO regression modeled non-linear relationships and predicted prediabetes risk. Results: 971 female participants were included. Those with GDM history had lower DII scores (1.62 (0.58, 2.93) vs. 2.05 (0.91, 2.93)). Higher DII scores in females with GDM were linked to prediabetes, remaining significant after adjusting for confounders. RCS analysis found no non-linear correlation (non-linear p = 0.617). The prediabetes model for GDM history had strong predictive performance (AUC = 88.6%, 95% CI: 79.9-97.4%). Conclusion: Females with GDM history show lower DII levels, potentially reflecting improved diet and health awareness. Higher DII scores correlate with increased prediabetes risk in this group, emphasizing diet's role in diabetes risk. Further studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the sleep status of middle-aged and elderly adults in Bengbu City, Anhui Province, China, to identify the major dietary patterns, and to analyze the association of different sleep duration and dietary patterns with metabolic syndrome (MetS) and its related influencing factors, as well as to explore the predictive value of sleep duration and dietary patterns. A cross-sectional analysis was performed utilizing data collected from the Community-based Cardiovascular and Health Promotion Study 2019 (COCHPS 2019) conducted in Bengbu. The definition of MetS adhered to the criteria of Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults (2016 Revision). Dietary information was obtained using the Food Frequency Questionnaire (FFQ) to assess dietary intake over the past year. Principal component analysis (PCA) was performed to identify dominant dietary patterns. A logistic regression model was developed to analyze the associations among sleep duration, dietary patterns, and MetS, and a decision tree (DT) model was developed to compare factors affecting MetS and screen people at high risk for MetS. The prevalence of MetS was 13.4% among the 9132 middle-aged and elderly residents over 45 years of age included in COCHPS 2019. Participants were divided into short (< 6 h/d), normal (6–8 h/d), and long (> 8 h/d) groups based on their daily sleep duration. Three dietary patterns were identified by PCA, the fruit-milk pattern, the tubers-meat pattern, and the vegetable-cereal pattern. After adjusting for covariables, logistic regression analysis showed that long sleep duration was significantly negatively associated with MetS. The fruit-milk and vegetable-cereal patterns were negatively associated with MetS, whereas the tubers-meat pattern was positively correlated with MetS. The results of the DT model analysis showed that the vegetable-cereal pattern is the most important factor impacting MetS, followed by marital status, the tubers-meat pattern, the fruit-milk pattern, exercise, sleep duration, and gender. The DT model also screened out five types of MetS high-risk groups. The results of our study indicate that normal sleep duration and consumption of either a fruit-milk or vegetable-cereal diet may lower the likelihood of developing MetS in middle-aged and elderly adults. [ABSTRACT FROM AUTHOR]

Background: Psychiatric nurses often encounter patients with mental health disorders and consequently experience prolonged periods of high stress, increased workload, and frequent incidents of workplace violence. These aspects can lead to a higher incidence of poor sleep quality. This study examined the interplay between workplace violence and emotional labour (surface and deep acting) to suggest measures for enhancing sleep quality among psychiatric nurses. Methods: A total of 300 completed and valid online questionnaires were collected. The Pittsburgh Sleep Quality Index was used to measure sleep quality, Workplace Violence Scale (WVS) to measure the occurrence of workplace violence, and Emotional Labour Scale to measure surface and deep acting. The data were analysed using Hayes' PROCESS macro with SPSS. Independent samples t-tests and one-way ANOVA were used to compare differences in sleep quality and emotional labour (surface and deep acting) between psychiatric nurses with different demographics. Results: The prevalence of poor sleep quality (PSQI > 5) was 55% among the nurses. Surface acting in emotional labour partially mediated the relationship between workplace violence and sleep quality(a1*b1=0.035,95%CI: 0.002, 0.079), whereas deep acting had a suppressive effect(a2*b2=-0.033,95%CI: -0.071, -0.003). Occupational identity had a positive moderating effect on the relationship between workplace violence and surface acting(Effect=0.091,95%CI: 0.004, 0.179). Conclusions: The relationship between workplace violence and poor sleep quality was partially mediated by surface acting and suppressed by deep acting. Moreover, nurses with higher occupational identity engaged in more surface acting after workplace violence. Workplace violence, surface acting, and deep acting emerged as significant factors influencing sleep quality among psychiatric nurses. Deep acting can reduce the impact of workplace violence on sleep quality. The results provide a new and expanded view of the interplay between workplace violence and emotional labour concerning sleep quality. Interprofessional collaboration with clinicians, administrators, educators, and spiritual leaders can contribute to the development of related education and training. Trial registration: Chinese Clinical Trial Registry ChiCTR2200062347. https://www.chictr.org.cn/showproj.html?proj=173264 [ABSTRACT FROM AUTHOR]

Background:Methods:Results:Conclusions:The field of dietary therapies for migraine has grown in popularity. Less research has been conducted to establish the relationship between migraine and the composite dietary antioxidant index (CDAI), a crucial indicator for evaluating the overall combined effects of multiple dietary antioxidants. Therefore, this study addressed this gap based on the National Health and Nutrition Examination Survey (NHANES) database.Multivariate logistic regression equations were used to investigate the relationship between CDAI and migraine, and smoothed-fitted curves were plotted. After a nonlinear relationship was discovered, the recursive algorithm and a two-stage linear regression model were employed to calculate the turning point. Additional stratified analyses were performed to explore differences between populations.This study included a total of 9,190 participants aged 20 years old or older. A U-shaped association was observed between the CDAI and migraine, with an inflection point of 0.2. They were negatively correlated before the inflection point with OR of 0.93 (95% CI = 0.88–0.97) and positively correlated after the inflection point with OR of 1.04 (95% CI = 1.01–1.07). This U-shaped relationship persisted among people aged <60 and ≥60 years, women, and people with BMI <30 and ≥30.We identified a U-shaped association between CDAI and migraine in the U.S. adult population. Further case–control studies and experimental research are needed to explore the underlying mechanisms of action. [ABSTRACT FROM AUTHOR]

• The first study revealing niacin status in Chinese subpopulation with hyperglycemia risk. • Higher plasma niacin concentration was associated with a lower hyperlipidemia risk in diabetic participants. • There was no association between plasma niacin and hyperlipidemia risk in nondiabetic participants. Evidence is limited regarding the association of plasma niacin with the risk of hyperlipidemia in participants with diabetes. We aimed to determine the relationship between plasma niacinamide/nicotinic acid and hyperlipidemia in participants with/without diabetes. Plasma niacinamide/nicotinic acid concentrations were measured using high-performance liquid chromatography-tandem mass spectroscopy. Multivariable logistic regression analyses were performed to evaluate the association between plasma niacin and hyperlipidemia in participants with diabetes and nondiabetes in a cross-sectional study. Compared to the first quartile, plasma nicotinamide, nicotinic acid, and niacin (nicotinamide plus nicotinic acid) were associated with a 54%, 50%, and 52% lower risk of hyperlipidemia in diabetic participants, respectively, but no significant association was observed in nondiabetic participants. These inverse associations persisted across subgroups stratified by sex, age, body mass index, smoking status, alcohol consumption, and physical activity. In addition, the fully adjusted odds ratios (95% confidence intervals) for hypercholesterolemia and hypertriglyceridemia among diabetic participants were 0.54 (0.38, 0.77) and 0.61 (0.44, 0.85), respectively, when comparing to the first quartile of plasma niacin concentrations (all P trend <.001). This study of 2647 participants observed that plasma niacin was inversely associated with hyperlipidemia in those with diabetes. Plasma niacin reduced hyperlipidemia risk in participants with diabetes among Chinese adults [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Osteoporosis (OP) is a complex skeletal disorder characterized by reduced bone mass, microarchitectural deterioration of bone tissue, and increased susceptibility to fractures. Bone mineral density (BMD), as the best indicator of bone mineral content per unit area of bone, is one of the key diagnostic factors for OP. Platelets (PLT), serving as important immune cells and components of the coagulation system, have been demonstrated to be associated with bone formation, resorption, and remodeling processes. However, no research has established the relationship between BMD and platelet count (PC) in the American population thus far. This study aims to investigate the correlation between BMD and PC among the American population, and to appraise the effects of additional risk factors on this association. Methods: This investigation examined the relationship between BMD and PC by analyzing data from the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018. A weighted multivariate logistic regression analysis was employed to assess this correlation. Additionally, subgroup and smooth curve analyses were conducted to delve deeper into the BMD-PC relationship and to identify other potential determinants of PC. Results: This study reveals a significant negative correlation between BMD and PC in the American adult population (β=-15.05, 95% CI: -22.07 to -8.03, p < 0.0001). Subgroup analysis highlights notable differences in this correlation between genders and various racial groups. Smooth curve fitting and generalized additive models were applied to further explore the relationship between BMD and PC, considering the influence of multiple factors. Conclusion: The present study investigated the correlation between BMD and PC in adults, with a particular focus on the potential risk factors for thrombocytopenia. This negative correlation was found to be markedly pronounced in males, an association not observed in females. Additionally, a potential inverse relationship between BMD and hemoglobin (HGB) levels was identified. Consequently, for individuals with elevated bone mass or osteoporosis (OP), we advocate for routine complete blood count monitoring to identify hematological irregularities. Considering the significant variations by sex, age, and race, special vigilance is advised for changes in PC among non-Hispanic white males under the age of 55. [ABSTRACT FROM AUTHOR]

Hearing loss(HL) represents a significant public health concern. This study aimed to determine the association between hearing loss and gout and to elucidate the underlying causative mechanisms. Data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) and Mendelian randomization (MR) basic databases. Initially, baseline characteristics of individuals with and without gout were compared. A nonlinear relationship between pure tone audiometry (PTA) values and gout prevalence was confirmed through restricted cubic spline (RCS) curve analysis. Subsequently, hearing loss was categorized into different levels based on PTA values, and multiple logistic regression analysis was employed to calculate the impact of varying degrees of hearing loss on the risk of gout. Finally, MR analysis was conducted to further elucidate the causal relationship between hearing loss and gout. A total of 3,258 individuals were included in this study, with a gout prevalence of 3.7%. Significant differences were observed between the gout group and the non-gout group in variables such as age, gender, blood uric acid level, BMI, hypertension, and diabetes. RCS curve analysis revealed a significant nonlinear relationship between PTA values and gout risk, particularly when PTA values exceed a specific threshold, where the curve flattens. Based on different levels of hearing loss derived from PTA values, multiple logistic regression analysis demonstrated that mild and moderate hearing loss significantly increased the risk of gout, remaining statistically significant after adjusting for covariates (odds ratio (OR) = 2.10–3.48, P < 0.05). MR analysis further confirmed the causal relationship between hearing loss and gout. Inverse variance weighting (IVW) was employed as the primary method, revealing that both individuals with hearing difficulties (OR = 0.98, 95% confidence interval (CI) 0.96–0.999, P = 0.012) and those without hearing impairment (OR = 1.02, 95% CI 1.01–1.04, P = 0.012) exhibited a significant causal relationship with gout. Goodness-of-fit tests and sensitivity analyses were used to verify the reliability of the results. Hearing loss has a significant causal relationship with an increased risk of gout, providing a new perspective for the prevention and management of gout. Focused attention and prompt treatment of hearing loss, particularly mild and moderate hearing loss, may significantly reduce the risk of developing gout. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Objectives Methods Results Conclusions Weight loss is a critical health issue among the older population. This study aimed to explore the association between weight loss and oral health in older adults.We used cross‐sectional data from the Uonuma Chronic Kidney Disease Cohort Study. The binary logistic regression models were fitted to estimate the relationship between weight loss and independent variables including the number of teeth present.The participants included 1656 females and 1625 males. There were 1217 females (73.4%) and 1236 males (76.0%) with normal BMI (18.5 ≤ BMI < 25) in the previous year. Weight loss was determined over a 12‐month period. Individuals with normal BMI in previous year, and those with weight loss (≥ 5%) or those whom maintained a stable weight were further analysed. The regression analysis (model 3, fully adjusted) showed that females with 0 and 1–10 teeth present had a higher likelihood of losing weight (OR = 4.07; 95% CI = 1.85–8.93, OR = 2.33; 95% CI = 1.24–4.39) compared with those with 20 or more teeth. Current smokers had a higher likelihood of losing weight (OR = 3.15; 95% CI = 1.01–9.76) than lifelong abstainers. Among males, both current and previous smokers showed a higher likelihood of losing weight (OR = 4.94; 95%CI = 1.76–13.8, OR = 3.35; 95% CI = 1.29–8.68) than those who never smoked.This study indicates that the number of teeth and smoking are both linked to weight loss in females. However, in males, the association between the number of teeth and weight loss may be compromised due to the high prevalence of smoking in this group. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the level of burden in pediatric and adolescent atopic dermatitis (AD) patients in Japan, the associated burden on caregivers/families, and whether this burden varied with age. Methods: Data were drawn from the Adelphi Pediatric AD Disease Specific Programme (DSP)™, a cross‐sectional survey of physicians and their patients conducted in Japan between July and December 2022. Physicians reported patient demographics, clinical characteristics, disease burden, and current/previous therapies. Patients and/or caregivers reported perceived disease severity and impact of AD, including the Children's Dermatology Life Quality Index (CDLQI) and Dermatitis Family Impact questionnaire (DFI). Results: Overall, 55 physicians provided data for 537 AD patients aged ≤17. Mean (SD) overall scores for CDLQI, POEM, and DFI were 9.3 (6.3), 8.3 (6.8), and 11.7 (7.2), respectively. Age was associated with higher patient and/or caregiver‐reported CDLQI scores, which increased by 0.543 points per year of age (P = 0.01). Patients with severe disease reported a more significant impact on quality of life factors compared with mild patients (P < 0.001). Age was associated with higher caregiver‐reported burden, with DFI scores increasing by 0.325 per year (P = 0.01). Physician‐reported impact on caregivers showed that age was significantly associated with increased burden on sleep, daily activities, work, and mood (P < 0.05), with disease severity associated with impact across all factors (P < 0.01). Conclusions: Both increasing age and disease severity were associated with the increased impact of AD on patients and their caregivers. Disease control/modification through appropriate therapeutic intervention at a younger age may relieve the burden of pediatric AD on patients and their families. [ABSTRACT FROM AUTHOR]

Background: Differences in the effects of cream‐type denture adhesives and home liners remain unclear. Objective: This cross‐sectional study aimed to clarify the differences in the oral‐hygiene status and masticatory performance between participants using cream‐type denture adhesives and those using home liners. Methods: Masticatory performance with and without cream‐type denture adhesives and home liners was evaluated using colour‐changeable chewing gum. Oral hygiene was assessed using the tongue coating index (TCI). Propensity‐score matching was performed using oral moisture, presence of palatal or mandibular protuberances, type of residual ridge, denture type (complete or partial denture), and denture retention as background factors. Wilcoxon signed‐rank test was used to examine the differences in masticatory performance with and without cream‐type denture adhesives and home liners and differences in masticatory performance and TCI between the cream‐type denture adhesive and home‐liner groups. Results: This study included 38 and 40 cream‐type adhesive and home‐liner users, respectively, and 17 pairs were obtained after propensity‐score matching. The Wilcoxon signed‐rank tests showed that masticatory performance was significantly different with and without the use of home liners, and higher values were obtained with the use of home‐liners. However, the cream‐type denture adhesive and home‐liner groups showed no significant differences in terms of the change in masticatory performance with the use of them. Furthermore, Wilcoxon signed‐rank tests showed that TCI values were significantly high in the cream‐type adhesive group. Conclusion: The findings in this study suggest that home liners improve masticatory performance and that participants regularly using cream‐type denture adhesives have poorer oral hygiene. [ABSTRACT FROM AUTHOR]

Aims: To test the Triangle of Human Ecology by examining associations between unipolar depression and different measures of human biological factors, health behaviour, and the physical environment. Methods: Data originate from the third wave of the Nord-Trøndelag Health Study (2006–2008). The survey was based on a random sample of 50,000 Norwegians (response rate: 54%). Logistic regression was performed, using unipolar depression, measured with the Hospital Anxiety and Depression Scale score, as outcome variable and 38 explanatory variables. Results: Biological factors including older age and male gender were associated with higher odds of depression, as were behavioural factors including drinking behaviour and having a neurotic personality. Reduced odds were associated with units of alcohol consumed, extrovert personality and physical activity. Social networks were an environmental factor with reduced odds at both personal and neighbourhood levels, as was warmer outdoor temperatures. Conclusions: Using the Triangle of Human Ecology provides a holistic insight into how behaviour, biology and the environment influence mental health. [ABSTRACT FROM AUTHOR]

Purpose: To examine the relative importance of social cognitive predictors (ie, performance accomplishment, vicarious learning, verbal persuasion, affective state) on health promotion self-efficacy among older adults during COVID-19. Design: Cross-sectional. Setting: Data collected online from participants in British Columbia (BC), Canada. Subjects: Seventy-five adults (n = 75) aged ≥65 years. Measures: Health promotion self-efficacy was measured using the Self-Rated Abilities for Health Practices Scale. Performance accomplishment was assessed using the health directed behavior subscale of the Health Education Impact Questionnaire; vicarious learning was measured using the positive social interaction subscale of the Medical Outcomes Survey - Social Support Scale (MOS-SSS); verbal persuasion was assessed using the informational support subscale from the MOS-SSS; and affective state was assessed using the depression subscale from the Depression Anxiety Stress Scale (DASS-21). Analysis: Multiple linear regression was used to investigate the relative importance of each social cognitive predictor on self-efficacy, after controlling for age. Results: Our analyses revealed statistically significant associations between self-efficacy and performance accomplishment (health-directed behavior; β =.20), verbal persuasion (informational support; β =.41), and affective state (depressive symptoms; β = −.44) at P <.05. Vicarious learning (β = −.15) did not significantly predict self-efficacy. The model was statistically significant (P <.001) explaining 43% of the self-efficacy variance. Conclusion: Performance accomplishment experiences, verbal persuasion strategies, and affective states may be the target of interventions to modify health promotion self-efficacy among older adults, in environments that require physical and social distancing. [ABSTRACT FROM AUTHOR]

Excessive visceral adipose tissue (VAT) is a significant risk factor for various diseases. Diet plays a crucial role in controlling obesity. This study examined the association between the Dietary Approaches to Stop Hypertension (DASH) diet and VAT in 9027 adults using data from the National Health and Nutrition Examination Survey. Linear regression models were used to explore this association, with subgroup analyses included. Results showed a significant inverse association between DASH scores and VAT area, even after adjusting for covariates (β = −2.18, 95% CI: −3.10, −1.27). Participants in the highest DASH score tertile had significantly lower VAT areas compared to those in the lowest tertile (β = −7.2, 95% CI: −10.40, −4.01). This inverse association was most pronounced in middle-aged participants. Further prospective cohort studies are necessary to confirm these findings. [ABSTRACT FROM AUTHOR]

Alcohol consumption is not uncommon among people with HIV (PWH) and may exacerbate HIV-induced intestinal damage, and further lead to dysbiosis and increased intestinal permeability. This study aimed to determine the changes in the fecal microbiota and its association with alcohol consumption in HIV-infected patients. A cross-sectional survey was conducted between November 2021 and May 2022, and 93 participants were recruited. To investigate the alterations of alcohol misuse on fecal microbiology in HIV-infected individuals, we performed 16s rDNA gene sequencing on fecal samples from the low-to-moderate drinking (n = 21) and non-drinking (n = 72) groups. Comparison between groups using alpha and beta diversity showed that the diversity of stool microbiota in the low-to-moderate drinking group did not differ from that of the non-drinking group (all p > 0.05). The Linear discriminant Analysis effect size (LEfSe) algorithm was used to determine the bacterial taxa associated with alcohol consumption, and the results showed altered fecal bacterial composition in HIV-infected patients who consumed alcohol; Coprobacillus , Pseudobutyrivibrio , and Peptostreptococcaceae were enriched, and Pasteurellaceae and Xanthomonadaceae were depleted. In addition, by using the Kyoto Encyclopedia of Genes and Genomes (KEGG), functional microbiome features were also found to be altered in the low-to-moderate drinking group compared to the control group, showing a reduction in metabolic pathways (p = 0.036) and cardiovascular disease pathways (p = 0.006). Low-to-moderate drinking will change the composition, metabolism, and cardiovascular disease pathways of the gut microbiota of HIV-infected patients. • Alcohol use and gut microbial composition in PWH is an important area of research. • Alcohol consumption alters the composition of the gut microflora in PWH. • Alcohol consumption reduces metabolic pathways and cardiovascular disease pathways. [ABSTRACT FROM AUTHOR]

Multiple epidemiological studies have observed the connection between aging and brain volumes. The concept of accelerated biological aging (BA) is more powerful for observing the degree of aging of an individual than chronologic age (CA). The objective of this study is to explore the relationship between BA and brain volumes. BA was measured from clinical traits using two blood-chemistry algorithms, the Klemera-Doubal method (KDM) and the PhenoAge. The two age acceleration biomarkers were calculated by the residuals from regressing CA, termed "KDM-acceleration" and "PhenoAge-acceleration". Brain volumes were from brain magnetic resonance imaging (MRI) data. After adjustment for confounding factors, general linear regression models were used to examine associations between KDM-acceleration and PhenoAge-acceleration and brain volumes, respectively. Additionally, we stratified participants by sex, age, and the four quartiles of the Townsend Deprivation Index (TDI) for extra subgroup analysis. 14,725 participants with available information were enrolled. After full adjustment, we observed negative associations between KDM-acceleration and brain volumes, such as gray matter (β = −0.029), white matter (β = −0.021), gray and white matter (β = −0.026), and hippocampus (β = −0.011 for left and β = −0.014 for right). There were also negative associations between PhenoAge-acceleration and brain volumes, such as white matter (β = −0.008), gray and white matter (β = −0.010), thalamus (β = −0.012 for left and β = −0.012 for right). In the subgroup analysis stratified by sex, age, and the four quartiles of TDI, the association between KDM-acceleration and PhenoAge-acceleration and brain volumes still existed. In subgroup analyses, the variation in associations suggests that socioeconomic and biological factors may differentially influence brain aging. Our research indicated that more advanced BA was associated with less brain tissue. • The concept of accelerated biological aging (BA) is more powerful for observing the degree of aging than chronologic age. • We measured BA from clinical traits using two blood-chemistry algorithms, the Klemera-Doubal method (KDM) and the PhenoAge. • Then, we applied linear regression analysis to test the associations between brain volume loss and the two accelerated BA. • Our research indicated that more advanced BA were associated with less brain tissue. [ABSTRACT FROM AUTHOR]

Background: Inflammatory responses and lipid metabolism make vital impacts on the development of gallstones. This study investigated the relationship between gallstone disease (GSD) and the neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) in American patients with gallstones. Methods: The data analyzed were sourced from the 2017–2020 National Health and Nutrition Examination Survey (NHANES) and comprised of participants with complete data on GSD and NHR. The relationship between NHR and GSD was evaluated with weighted multivariable logistic regression analysis. Additionally, subset analyses, interaction tests, smoothed curve fitting, and threshold effect analyses were conducted. Results: Among the 7894 participants analyzed in this study, the prevalence of GSD was 10.98%, and the average NHR value was 3.41 ± 0.06. The fully adjusted multivariable logistic regression results demonstrated an obvious positive association between NHR and the likelihood of GSD (OR = 1.09, 95% CI: 1.01, 1.16; P = 0.0197). Consistency of this association was confirmed through subset analyses and interaction tests across various subgroups, including those categorized by smoking status and asthma. Furthermore, smoothed curve fitting and threshold effect analyses revealed a nonlinear relationship with a threshold of 2.86. Conclusions: NHR shows a positive relationship to an increased likelihood of GSD among Americans. It can act as an easy and cost-effective tool for the early detection and management of individuals at risk for GSD. [ABSTRACT FROM AUTHOR]

Background: Dental filling is a prevalent method for treating dental defects. This study aimed to investigate the knowledge, attitude, and practice (KAP) toward dental defects and dental fillings among dental patients in Jinan, Shandong Province, China. Methods: This cross-sectional study was conducted at the main campus and several branch campuses of Jinan Stomatological Hospital, and community locations within Jinan city between October 2023, and January 2024. Spearman correlation analysis and mediation analysis were used to assess the associations and interrelationships between KAP scores. Results: In this study, 2529 dental patients participated, with 69.1% being females. Of these, 1711 had no dental defects, 551 had defects and fillings, and 267 had defects without fillings. Their median knowledge, attitude, and practice (Questions 1–6) scores were 8.00 [5.00, 12.00] (possible range: 0–18), 27.00 [26.00, 29.00] (possible range: 10–50), and 19.00 [15.00, 24.00] (possible range: 9–45), respectively. Mediation analysis revealed that in patients without dental defects, knowledge had a direct effect on attitude (β = -0.983, 95% CI: -0.999, -0.966, P < 0.001). Additionally, attitude had a direct effect on practice (β = -0.797, 95% CI: -1.490, -0.103, P = 0.024), while knowledge had an indirect effect on practice through attitude (β = 0.783, 95% CI: 0.096, 1.470, P = 0.026). In patients with dental defects who had undergone dental fillings, significant direct effects were observed between knowledge and attitude (β = -0.736, 95% CI: -0.821, -0.650, P < 0.001), knowledge and practice (β = 0.396, 95% CI: 0.214, 0.577, P < 0.001), and attitude and practice (β = -0.499, 95% CI: -0.683, -0.315, P < 0.001). Moreover, knowledge had an indirect effect on practice (β = 0.367, 95 CI: 0.221, 0.513, P < 0.001). In patients with dental defects but without any fillings, direct effects were found between knowledge and attitude (β = -0.929, 95% CI: -1.028, -0.829, P < 0.001). Conclusions: Dental patients had inadequate knowledge, attitude, and practices concerning dental defects and fillings. It is recommended that clinical interventions should focus on enhancing patient education and promoting positive engagement in dental care practices. [ABSTRACT FROM AUTHOR]

Background: Abnormalities in lipid metabolism are common among adult asthmatics. However, the precise directionality linking asthma to blood lipid levels remains controversial. Our study aimed to evaluate the association between the Non-HDL to HDL Ratio (NHHR), a lipid composite index, and asthma prevalence among the adult population in the United States. Methods: Utilizing adult participants' data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2009 to 2018, the study employed a multivariable logistic regression model, adjusting for covariables, to establish the relationship between NHHR levels and the prevalence of asthma. Furthermore, smoothing curve fitting and subgroup analyses were conducted to investigate the robustness of this association. Results: This study included 26,023 adult individuals (mean age = 49.63 ± 17.66). In the fully adjusted model, a significant inverse association was observed between log-transformed NHHR values and asthma prevalence (OR = 0.85, 95% CI: 0.79–0.93). Subgroup analysis revealed that gender served as a modulator, altering the association between NHHR levels and asthma prevalence. A more pronounced negative association between lnNHHR and asthma prevalence was noted among male participants [(Male: OR = 0.78, 95% CI: 0.69–0.88) vs. (Female: OR = 0.92, 95% CI: 0.83–1.03), P for interaction = 0.0313]. Conclusions: Our study revealed an inverse association between NHHR levels and the prevalence of asthma in the US adult population, which is influenced by gender. NHHR measurement may be a potential tool for early identification and prediction of adult asthmatics in specific populations. [ABSTRACT FROM AUTHOR]

Psoriasis is linked to insulin resistance (IR). Nevertheless, the applicability of the METS-IR index, a new IR evaluation tool, for evaluating changes in insulin sensitivity in psoriasis populations is currently unknown. This study aimed to investigate the relationship between the METS-IR index and psoriasis in a US adult population. This cross-sectional study utilized data from adults aged 20 to 80 years from the U.S. National Health and Nutrition Examination Survey (NHANES) spanning 2003–2006 and 2009–2014. The associations between the METS-IR index and psoriasis were examined using multivariate logistic regression and smoothed curve fitting. Subgroup analyses and interaction tests were conducted to verify the stability of the association within the population. This study included 5,966 participants, of whom 182 had psoriasis. In the fully adjusted model, the METS-IR index was positively associated with psoriasis, showing a 1.7% increase in psoriasis prevalence for each one-unit increase in the METS-IR index (Model 2: OR 1.017, 95% CI 1.006–1.028). Participants in the highest quartile group were 91.9% more likely to develop psoriasis compared to those in the lowest quartile group (OR = 1.919, 95% CI 1.180–3.118). Smooth curve fitting revealed a nonlinear association between the METS-IR index and psoriasis, with an inflection point of 41.675. This positive association was more pronounced in females, non-obese individuals, those with light alcohol consumption, comorbid coronary heart disease and hyperlipidemia, non-hypertensive and non-diabetic individuals. The results of the study suggest that higher METS-IR scores are associated with an increased likelihood of psoriasis among U.S. adults. The METS-IR index is specifically recommended as a clinical indicator for the management and treatment of psoriasis in women, non-obese individuals, light alcohol consumers, individuals with comorbid coronary artery disease andhyperlipidemia, non-hypertensive and non-diabetic individuals. However, Considering the many known and unknown covariates that may be associated with psoriasis and influence theresults of the study, we remain cautious about the results obtained and look forward to the addition of subsequent studies. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on individuals' mental health and well-being worldwide. This study investigated the prevalences of and association between mental health and quality of life (QOL) in Thailand after the COVID-19 outbreak. A cross-sectional study was conducted among Thai individuals aged ≥ 20 years across all regions. Descriptive statistics, chi-square tests, and multiple logistic regression analyses were performed to examine the association between mental health and QOL. A total of 1,133 participants (mean age: 35.1 ± 17.2 years) completed the survey. The prevalence of depression with PHQ-9 instrument was 19.4%. Depression was significantly associated with those who have had family members die from COVID-19 infection (adjusted odds ratio [AOR] 2.27, 95% confidence interval [CI] [1.13–4.52]). The percentages of depression, anxiety, and stress with DASS-21 instrument were 32.4%, 45.4%, and 24.1%, respectively. Smokers and alcohol consumption had approximately 1.5-time higher risk of stress compared with non-smokers and no alcohol consumption (AOR = 1.50, 95% CI [1.01–2.24], AOR = 1.48, 95% CI [1.09–2.02], respectively). An association was observed between socioeconomic factors such as job and income loss and mental health outcomes. Depression, anxiety, and stress were significantly negatively associated with QOL. This study demonstrates a strong association between mental health and QOL among Thai people after the COVID-19 outbreak. The findings underscore the need for interventions targeting lifestyles, including those addressing alcohol consumption and smoking, especially among those who have had family members die from COVID-19 infection and mental health support services that can address depression, anxiety, and stress to improve the overall well-being of the population. [ABSTRACT FROM AUTHOR]

Background: Inflammation is crucial in the development of depression. This study aims to examine the potential association between the Neutrophil-Percentage-to-Albumin Ratio(NPAR) and depression symptoms. Methods: This study adopted a cross-sectional design, involving patients with depression symptoms and those without depression symptoms with comprehensive NPAR data originated from the National Health and Nutrition Examination Survey(NHANES) spanning 2011 to 2018. The research utilized weighted multivariate logistic regression models and multivariate linear regression to investigate the linear relationship between NPAR levels and depression symptoms and its severity scores. The characterization of nonlinear relationships was accomplished by employing fitted smoothing curves. Furthermore, subgroup analyses and interaction assessments were conducted to offer additional insights. Results: This study involved a total of 10,829 participants, and the prevalence of depression among them was found to be 15.08%. The multiple logistic regression analysis revealed a statistically significant positive association between the continuum of NPAR and depression symptoms[OR:1.03, 95% CI: (1.00, 1.05)], as well as depression severity scores[β: 0.08, 95% CI: (0.04,0.11)]. Stratifying NPAR into quartiles, we found that higher NPAR associated with increased odds of depression symptoms. Furthermore, in subgroup analysis, there were no significant differences in the relationship between NPAR levels and depression symptoms or its severity scores within populations with or without diabetes and cardiovascular diseases. Additionally, the use of a two-stage linear regression model uncovered a non-linear relationship between NPAR and depression symptoms. Conclusions: Our research indicates that NPAR levels were associated with depression symptoms. To corroborate our findings, larger prospective studies are warranted to elucidate nonlinear associations in greater detail. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Background Design Methods Results Conclusion This study aims to investigate the prevalence of significant psychological distress and identify risk factors associated with it among early‐stage lung cancer patients in the preoperative period.Lung cancer is a major cause of cancer deaths worldwide, with low survival rates and significant psychological distress. While much research has focused on distress in advanced‐stage patients, less is known about the prevalence and risk factors of psychological distress in early‐stage lung cancer patients before surgery.A cross‐sectional study.The study included 427 early‐stage lung cancer patients preparing for surgery. Researchers used a study‐specific questionnaire to gather general information and employed the Distress Management Screening Measurement, Patient Health Questionnaire‐9 and Generalised Anxiety Disorder‐7 to assess personal situations and psychological distress levels. Statistical analyses investigated distress across various patient characteristics and examined correlations with anxiety and depression. Binary logistic regression identified significant predictors of psychological distress.The study found that 41.9% of early‐stage lung cancer patients experienced significant psychological distress preoperatively, with an average score of 3.31 ± 2.18. Psychological distress was significantly positively correlated with depression (r = 0.474, p < 0.001) and anxiety (r = 0.591, p < 0.001). Significant risk factors for psychological distress included pulmonary nodules (OR = 2.884, 95% CI: 1.496–5.559), smoking history (OR = 2.092, 95% CI: 1.016–4.306) and chronic diseases (OR = 2.013, 95% CI: 1.073–3.776).Early‐stage lung cancer patients often experience a high incidence of clinically significant psychological distress during the preoperative period, strongly associated with depression and anxiety. Adverse factors contributing to psychological distress include multiple indeterminate pulmonary nodules, smoking history and concurrent chronic diseases. Routine screening for psychological distress in these patients is recommended, along with personalised interventions and self‐management strategies to help alleviate their distress during the perioperative period. [ABSTRACT FROM AUTHOR]

Background: The Platelet to High-Density Lipoprotein cholesterol Ratio (PHR) is a novel indicator of inflammatory response and metabolic disorders, linked to various chronic diseases. This study aims to investigate the relationship between PHR and hypertension. Methods: Data from the National Health and Nutrition Examination Survey (NHANES), collected across seven consecutive cycles from 2005 to 2018, were analyzed. The dataset included participants' hypertension status as reported by a doctor, their use of antihypertensive medications, and the average of three blood pressure measurements to identify hypertensive adults, along with complete information for PHR calculation. PHR was calculated based on Platelet (PLT) count and High-Density Lipoprotein cholesterol (HDL-C) using the following formula: PHR = [PLT (1000 cells/µL) / HDL-C (mmol/L)]. A multivariable logistic regression model was employed to assess the association between PHR and hypertension, and subgroup analyses were conducted to explore potential influencing factors. Additionally, Restricted Cubic Spline (RCS) curves were applied for threshold effect analysis to describe nonlinear relationships. Results: Higher PHR was associated with an increased prevalence of hypertension. After adjusting for various covariates, including race, education level, Family Poverty Income Ratio (PIR), smoking, alcohol consumption, sleep disturbances, waist circumference, diabetes, coronary heart disease, angina, heart attack, and stroke, the results remained significant (OR = 1.36; 95% CI, 1.32, 1.41, P < 0.001). Participants with the highest PHR levels had a 104% higher risk of hypertension compared to those with the lowest PHR levels (OR = 2.04; 95% CI, 1.89, 2.21, P < 0.001). Conclusion: Elevated PHR levels are strongly associated with an increased risk of hypertension. Specifically, when PHR is below 280, the risk of hypertension increases in proportion to PHR. This suggests that regular monitoring of PHR may help identify patients at risk of hypertension early, allowing for timely interventions to slow disease progression. Larger cohort studies are necessary to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Obesity is a major contributing factor to the formation of gallstones. As early identification typically results in improved outcomes, we explored the relationship between visceral lipid accumulation indicators and the occurrence of gallstones. Methods: This cross-sectional study involved 3,224 adults. The researchers employed multivariable logistic regression, smoothed curve fitting (SCF), threshold effects analysis, and subgroup analysis to examine the relationship between metabolic scores for visceral fat (METS-VF), waist circumference (WC), lipid accumulation products (LAP), and visceral adiposity index (VAI) and gallstones. A Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was used to identify key factors which were then used in the construction of a nomogram model. The diagnostic efficacy of this model in detecting gallstones was then determined using receiver operating characteristic curves. Results: Visceral lipid accumulation indicators were strongly linked to the likelihood of having gallstones. Specific saturation effects for METS-VF, WC, LAP, and VAI and gallstones were determined using SCF. The inflection points for these effects were found to be 8.565, 108.400, 18.056, and 1.071, respectively. Subgroup analyses showed that associations remained consistent in most subgroups. The nomogram model, which was developed using critical features identified by LASSO regression, demonstrated excellent discriminatory ability, as indicated by an area under the curve value of 0.725. Conclusions: Studies have shown that increases in METS-VF, WC, LAP, and VAI are linked to increased prevalences of gallstones. The nomogram model, designed with critical parameters identified using LASSO regression, exhibits a strong association with the presence of gallstones. [ABSTRACT FROM AUTHOR]

Background: This study aimed at investigating the relationship between the weekend catch-up outdoor duration (WCOD) and prevalence of myopia among students in China. Methods: This cross-sectional study recruited participants in 107 schools (six cities, 30 districts) from China from May to June 2021. Demographic characteristics (age, grade, sex, ethnicity, BMI, resident, and parents' myopia), optically habits (bad writing habits, working/studying time per day, continuous working/studying time per day, and screen time per day) and outdoor duration (weekday and weekend) were obtained from questionnaire. WCOD was defined as outdoor time 1 h longer on weekends than on weekdays. Spherical equivalent (SE) of refractive error were measured with non-cycloplegic refraction. Adjusted multivariate logistic regression analysis was performed to evaluate the relationship between WCOD and prevalence of myopia. Results: Students with myopia had shorter WCOD compared with those without myopia (P < 0.001). Adjusted multivariate logistic regression analyses showed negative associations between WCOD and prevalence of myopia in Chinese students, especially in students with WCOD of 2–3 h (OR = 0.577, P < 0.001) and 3–4 h (OR = 0.571, P = 0.004) when the weekday outdoor duration was 0.5–1 h, as well as students with WCOD of 2–3 h (OR = 0.614, P = 0.003) when the weekday outdoor duration was 1–2 h. Similar results were observed in students with high myopia. Students with high myopia had shorter WCOD compared with those without high myopia (P = 0.001). Negative associations between WCOD and prevalence of high myopia were significant in students with WCOD of 1–2 h when the weekday outdoor duration was < 0.5 h (OR = 0.585, P = 0.007) and 0.5–1 h (OR = 0.537, P = 0.018). Conclusion: Our study, for the first time, reported that a WCOD have a potential to reduce the prevalence of myopia and high myopia in Chinese students. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions To explore an cost‐effective, convenient method for lipohypertrophy (LH) detection with a high detection rate, and to construct a classification table for LH, so as to provide reference for LH screening and management.From December 2021 to November 2022, 395 hospitalized patients with diabetes from a Tianjin tertiary hospital were enrolled. The LH was detected through ultrasound scanning (USS), structured visual palpation (SVP), and ordinary visual palpation (OVP), and the detection rates were compared. A classification table for LH (LH‐LNT table) was constructed based on SVP characteristics.Under USS, SVP, and OVP, the detection of LH was 89.6%, 78.0%, and 66.6% respectively, with site detection at 92.3%, 71.2%, and 57.8% respectively, showcasing statistically significant differences among the three methods. SVP had a lower misdiagnosis rate than OVP, with upper arm and thighs being common misdiagnosed sites. LH was mostly found in the lower abdomen, flat, and soft on palpation. L1N2T1 (two soft LH on abdomen) was the main type, accounting for 35.4%.SVP is useful for detecting LH and deserves clinical promotion. The LH‐LNT table constructed here effectively summarizes patient LH status, aiding doctor‐nurse–patient communication. [ABSTRACT FROM AUTHOR]

Background: Endometriosis is a complex disorder with genetic, immune, inflammatory, and multifactorial etiologies. Zinc, an essential trace element, plays a crucial role in various physiological processes. Dysregulation or deficiency of zinc can lead to aberrations in human physiology. However, the association between dietary zinc and endometriosis remains ambiguous. This study aimed to investigate the link between dietary zinc intake and endometriosis. Methods: Utilizing cross-sectional data from the National Health and Nutrition Examination Survey, we analyzed information from American women aged 20–54 years between 1999 and 2006. After adjusting for relevant covariates, multivariable logistic regression analysis was employed to assess correlations. Results: A total of 4315 women were included in the study. The multivariable logistic regression model revealed a positive correlation between dietary zinc intake and the risk of endometriosis, even after controlling for confounding variables. Relative to individuals with lower zinc consumption (≤ 8 mg/day), the adjusted odds ratio (OR) values for dietary zinc intake and endometriosis in the 8–14 mg/day and > 14 mg/day groups were 1.19 (95% CI: 0.92–1.54, p = 0.189) and 1.60 (95% CI: 1.12–2.27, p = 0.009), respectively. Conclusions: Our findings suggest a positive correlation between dietary zinc intake and the prevalence of endometriosis. However, further investigations are necessary to better understand this association and explore the potential role of dietary zinc in endometriosis. [ABSTRACT FROM AUTHOR]

ABSTRACT There are no established diagnostic criteria for neonatal vitamin A deficiency (VAD), and applying adult VAD criteria to neonates may overestimate the neonatal VAD rate. This study aimed to evaluate neonatal vitamin A (VA) status and redefine thresholds for neonatal VA adequacy and deficiency based on maternal VA nutrition. A cross‐sectional study involving 1901 mother–neonate pairs was conducted in Chongqing, China. VA nutritional status was assessed by measuring serum VA levels and dietary VA intake from the third trimester to birth. The VAD rates of maternal dietary intake and serum were 27.091% and 23.356%, respectively, while 88.8% of neonates had serum VA levels < 0.70 μmol/L, the threshold for adult VAD. Neonatal VA levels were significantly lower than maternal levels. All neonates were healthy, with no clinical signs of VAD. Neonatal VA levels correlated positively with maternal VA levels. The threshold for neonatal VA adequacy was estimated to be ≥ 0.489 (95%CI: 0.464–0.512) μmol/L when maternal VA nutrition was adequate, and the 2.5th percentile of VA levels among all neonates was 0.192 μmol/L, predicting neonatal VAD. The study concluded that neonatal VAD rates might be overestimated, as most neonates received adequate VA from their mothers. Maternal VA status is a reliable predictor of neonatal VA status due to their close relationship. This study offers a new perspective on prenatal nutrition for determining neonatal VA adequacy and deficiency thresholds and developing neonatal VA supplementation programs. Further research is needed. [ABSTRACT FROM AUTHOR]

Background: Annual breast magnetic resonance imaging (MRI) is highly recommended to assist mammography for women at high risk of breast cancer (BC). This study explored the knowledge, attitude, and willingness toward breast MRI screening among women at high risk of BC. Methods: This cross-sectional study enrolled women at high risk of BC between August 2022 and January 2023 in Beijing, China. A structural equation model (SEM) was used to analyze the relationships among knowledge, attitude, and willingness. Results: A total of 596 questionnaires were collected, and 412 questionnaires (69.13%) were valid. The women's knowledge and attitude scores were 7.75 ± 2.79 (possible range: 0–12) and 48.53 ± 6.31 (possible range: 13–65). Among the women, 297 (72.09%) were willing to undergo regular breast MRI screening. The SEM showed that knowledge had direct effect on attitude [β = 0.77, 95% CI: (0.57, 0.98), P < 0.001], the attitude had direct effect on willingness [β = 0.02, 95% CI: (0.01, 0.02), P < 0.001], knowledge had an indirect effect on willingness through attitude [β = 0.01, 95% CI: (0.01,0.02), P < 0.001], and the direct effect of knowledge on practice was not significant. Conclusions: The women at high risk of BC had insufficient knowledge and a relatively positive attitude toward breast MRI screening. Most of them were willing to undergo regular breast MRI screening. Advertising and public health education programs should be designed to improve their knowledge and attitude, therefore improving their willingness and practice. [ABSTRACT FROM AUTHOR]

Background: The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) is a novel lipid measure for assessing the risk of cardiovascular disease. Lipid metabolism disorders are reportedly associated with hearing impairment. This study aimed to investigate the potential association between NHHR and hearing. Methods: The data used in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) cycles of 2005–2010 and 2017–2018, including 4,296 participants aged 6–19 years. The NHHR was calculated from lipid profiles, and hearing was assessed using pure-tone audiometry. Weighted multivariate logistic regression analyses were used to investigate the association between the NHHR and hearing loss. Subgroup and sensitivity analyses were performed to verify the robustness of the results. Results: Univariate analysis revealed significant associations between the NHHR and hearing threshold at all categorized frequency (low, speech, or high-frequency) (P < 0.001). Three models were used: an unadjusted model, a model adjusted for age, sex, and race, and a model further adjusted for PIR, BMI, and diabetes. Multiple regression analysis confirmed these associations consistently across all models. When considered as a continuous variable, NHHR had a significant association with enhanced hearing thresholds at all categorized frequencies: low-frequency (β:0.56, 95% CI: 0.36–0.75), speech-frequency (β:0.55, 95% CI: 0.36–0.7), and high-frequency (β:0.55, 95% CI: 0.36–0.74). The adjusted models showed persistent positive correlations after controlling for covariates. The NHHR was consistently positively associated with hearing loss. The NHHR and auditory thresholds showed a general dose-response association across all frequencies. Conclusions: NHHR is a promising biomarker for predicting adolescent hearing threshold shifts and hearing loss. The study highlights the importance of early lipid monitoring and management as strategies to prevent or reduce hearing impairment. [ABSTRACT FROM AUTHOR]

This cross-sectional survey aims to determine whether cotinine exposure would enhance the relationship between blood manganese (Mn) and non-alcoholic fatty liver disease (NAFLD) in children using the NHANES database. Restricted cubic spline (RCS) and logistic regression analyses were adopted to determine the potential relationship. Besides, we tested the robustness of the results by performing trend tests and subgroup analyses. The study finally enrolled 866 children aged 18 years and below. Blood Mn was linearly linked to NAFLD and the risk of NAFLD was increased with the blood Mn elevation (P < 0.05). There was a notable relationship between blood Mn and NAFLD in crude model 1, which was still significant upon adjustment of all the identified covariates (all P < 0.05). Under Mn exposure, the cotinine-exposed group had a higher risk of NAFLD than the cotinine-unexposed group. In conclusion, blood Mn level is an independent risk factor for pediatric NAFLD, and cotinine exposure can enhance this relationship to some degree. Therefore, reducing cotinine exposure may alleviate detrimental consequences related to exposure to heavy metals in children. [ABSTRACT FROM AUTHOR]

In Italy, breast cancer survivors are increasing. Body image is a complex posttreatment concern for breast cancer survivors, particularly younger women. This population reports higher levels of body-image concerns associated with higher psychological distress and lower quality of life. Body image concerns and factors that can impact the body image of older breast cancer survivors remain an important but under-explored research area. The purpose of this study is to examine the association of negative and positive body image with both well-being and psychological inflexibility in a sample of breast cancer survivors. 114 women who have completed breast cancer treatment (±5 years) completed a questionnaire to measure the research variables. Hierarchical regressions and indirect effects were performed. Functionality appreciation and body compassion accounted for a significant percentage of the variance of well-being (34%) and psychological inflexibility (50%) of the participants. The indirect effect of body dissatisfaction on well-being and psychological inflexibility through body compassion was significant. The results emphasise the relevance of the positive aspect of body image on well-being and psychological inflexibility. Functionality appreciation and body compassion contribute to understanding the health-status description of these women and could be considered in future health-promotion interventions aimed at reducing psychological distress associated with body image concerns in older breast cancer survivors. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The Composite Dietary Antioxidant Index (CDAI) measures the antioxidant capacity of the diet, which is believed to provide protection against various diseases, including depression, osteoporosis, and papillomavirus infection, by neutralizing harmful oxidative stress. However, the relationship between CDAI and infertility is not well understood. This research aims to explore the potential correlations between CDAI and the risk of infertility.This research harnessed data from the National Health and Nutrition Examination Survey (NHANES) to execute a cross‐sectional analysis involving 8263 US women aged 20–45. Each participant was subjected to two distinct 24‐h dietary recall interviews. We calculated the CDAI using average daily antioxidant intake. Infertility was assessed using a standardized questionnaire. The association between CDAI and infertility was examined using weighted multiple logistic regression models, while nonlinear correlations were explored through restricted cubic splines. To affirm the robustness of our findings, sensitivity and subgroup analyses were performed using unweighted logistic regression. Additionally, to ascertain the causal influence of circulating antioxidant levels on infertility, a two‐sample univariable Mendelian randomization (MR) analysis was conducted, using the inverse variance weighted (IVW) method as the primary analytic approach.Participants who were infertile exhibited lower CDAI levels compared to their fertile counterparts. When confounding variables were accounted for in the multivariate weighted logistic regression model, an inverse relationship was observed between CDAI and infertility, with the odds ratio for the highest versus lowest quartile being 0.55 (0.33–0.90, P = 0.02). However, the IVW method indicated that genetically predicted elevated levels of CDAI did not significantly correlate with infertility.Cross‐sectional observational studies indicate that antioxidants from diets might diminish infertility risks. However, findings from MR studies do not confirm a causal connection. Additional prospective research is required to elucidate this association further. [ABSTRACT FROM AUTHOR]

Introduction: Appropriate cooking methods can improve food safety, decrease contaminants, and increase nutrient bioavailability. Few studies assessed the sociodemographic characterization of their use in European populations. We aimed to characterize the socio-demographic, lifestyle, and anthropometric predictors of cooking methods in the Swiss population. Methods: Adults aged 18–75 years (n = 2,050) participating in the cross-sectional national nutrition survey in Switzerland (menuCH) (2014–2015), representing the 7 main regions in the country. We used logistic regressions to assess the probability of the presence or absence of boiled, roasted, microwaved, oven-cooked, gratinated, fried, steamed, and grilled foods by sociodemographic variables. Results: Among all participants, the most frequently used cooking methods were boiling (46%), stove-cooking (19%), and steaming (8%). Single participants had a higher probability of consuming grilled or fried foods (68%) than their married counterparts and participants with obesity had a higher probability of consuming grilled or fried foods (67% or 135%) compared to those with normal weight. Divorced or separated participants had a 55% lower probability of consuming roasted foods than married participants. Those following a diet had a 57% lower probability of consuming grilled foods compared to those not on a diet. Conclusion: We found differences in the distribution of cooking methods in the Swiss population by sociodemographic variables. Further studies should examine the link between cooking methods and disease risk. [ABSTRACT FROM AUTHOR]

Objective To analyze whether there is a threshold effect between thyroid hormone sensitivity indexes and breast cancer, and to analyze the subgroup analysis and interaction test of age. Methods 2 892 adults from NHANES were collected between 2007 and 2012, including 83 breast cancer patients. Central thyroid hormone sensitivity indices were calculated, including Thyroid Feedback Quantile Index for T4(TFQIFT4) and T3(TFQIFT3), Thyroid Stimulating Hormone T4 Resistance Index(TT4RI), Thyroid Stimulating Hormone T3 Resistance Index(TT3RI), and TSH Index(TSHI), as well as peripheral thyroid hormone sensitivity index FT3/FT4. The association between breast cancer and the thyroid system was investigated using a multivariable logistic regression model. Smooth curve fitting and stratified analysis were used too, and subgroup analysis and interaction tests were performed based on age. Results Model3 showed that Thyroid Stimulating Hormone (TSH) (OR=1.33, 95%CI:1.08-1.63), TFQIFT4(OR=2.61, 95%CI:1.25-5.45), TFQIFT3(OR=3.15, 95%CI:1.18-8.44), TT4RI(OR=1.03, 95%CI:1.01-1.05), TT3RI(OR=1.10, 95%CI:1.03-1.18), and TSHI(OR=1.68, 95%CI:1.14-2.50) were significantly positively associated with the risk of breast cancer. A linear relationship with breast cancer was observed when TFQIFT3≥0.7, TSHI≥2.4, and TT4RI<50(P<0.05). TFQIFT4 showed a threshold effect(likelihood ratio test=0.040) when TFQIFT4<0.25. The relationship between TFQIFT4 and breast cancer was not significant(OR=1.07, 95%CI:0.36-3.15), but when TFQIFT4≥0.25, it was significantly associated with an increased risk of breast cancer(OR=12.79, 95%CI:2.50-65.40). Subgroup analysis further revealed that in women over 55 years old, increased central thyroid hormone sensitivity indices were associated with breast cancer risk(P<0.05). Conclusion Increased central thyroid hormone sensitivity indices are significantly associated with the risk of breast cancer, which may be a potential indicator for breast cancer detection in the future. [ABSTRACT FROM AUTHOR]

Background: The triglyceride glucose (TyG) index, defined as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2], provides insights into overall metabolic status. However, the association between the TyG index and gout has not been investigated. Therefore, this study explored the correlation between the TyG index and gout. Methods: Using data from the National Health and Nutrition Examination Survey, which was conducted from 2007 to 2018, this study investigated the relationship between the TyG index and gout. Demographic data and potential risk factors were analyzed and compared using t tests for continuous data and chi-square tests for categorical data. Logistic regression and subgroup analysis were performed to examine the association between the TyG index and gout. Results: A total of 14,924 participants were enrolled, among whom 726 (4.86%) were diagnosed with gout. Without controlling for any covariates, a significant positive correlation was observed between an elevated TyG index and increased risk of gout, with an odds ratio (OR) of 2.07 and a 95% confidence interval (CI) ranging from 1.76 to 2.43. After full adjustment, this association remained statistically significant, with an adjusted OR of 1.43 and a 95% CI from 1.14 to 1.80. Subgroup analyses revealed significant interactions, particularly for females (OR = 2.55; 95% CI: 2.00-3.26), individuals with no military service history (OR = 2.15; 95% CI: 1.66–2.43), and those without diabetes (OR = 2.00; 95% CI: 1.64–2.43). Conclusion: A positive correlation was observed between the TyG index and gout. Consequently, further large-scale prospective studies are warranted for a comprehensive analysis of the role of the TyG index in gout. [ABSTRACT FROM AUTHOR]

Background In Denmark, a girls-only human papillomavirus (HPV) vaccination program was initiated in 2008–2009. The study aim was to assess the HPV prevalence and type distribution in younger men prior to HPV vaccination in men. Methods The study population was younger men who attended information days regarding military service. At random days (2019–2020), 280 men were included. We collected questionnaire data regarding risk factors for HPV infection and a penile swab for HPV testing. We compared results in this study with those from a previous study of young men (2006–2007). Results The majority of participants (94%) were 18–20 years old. The median number of lifetime sexual partners was 4. Altogether, 130 men (46.4%) were HPV positive. No infections with HPV types 6, 11, 16, 18, 31, and 45 were detected. The most frequent type was HPV-51 (detected in 11.1%). Comparison showed that the odds of high-risk HPV type infection were higher in 2019–2020 (prevalence odds ratio [POR], 1.7 [95% confidence interval {CI}, 1.1–2.7]) compared with 2006–2007. In contrast, the odds were lower (POR, 0.3 [95% CI,.1–.6]) for HPV types targeted by the 9-valent HPV vaccine. Conclusions The multicohort girls-only vaccination program has to a large degree protected young men against the HPV types included in the licensed vaccines. This does not speak against gender-neutral vaccination as the HPV prevalence is still high, although consisting largely of less carcinogenic HPV types. [ABSTRACT FROM AUTHOR]

Background: Lateral epicondylitis (LE) is characterized by pain, inflammation and local tenderness over the bony prominence of the lateral epicondyle and is exacerbated under stressful and repetitive movements such as prolonged supination and pronation movements, twisting (wringing, turning) and rolling activities (stirring and mixing). Lateral Epicondylitis ranks as the second most commonly diagnosed musculoskeletal condition. Females, especially housewives, are more affected by LE. It can lead to persistent elbow pain, reduced grip strength, limited arm movement, and difficulty performing daily tasks. Results: All of our 150 participants were women aged 25–50 + years. We found that 86% of housewives reported some level of pain (mild, moderate and severe) according to the PRTEE questionnaire but 39.33% (59/150) showed positive lateral epicondylitis cases assessed physically by special test (Cozen, Mills, Maudsley's test). Among the individuals diagnosed with lateral epicondylitis, a significant majority, 71.19% (42 out of 59), reported pain in their right arm while only 16.95% were experiencing pain in their left arm, however, 11.86% (7 out of 59) reported pain in both arms. The odds ratio estimates of age groups suggested that the 25–30 years group had higher odds of getting LE about 0.95 than the reference group. Among the individuals with lateral epicondylitis, 59.32% (35 out of 59) were experiencing chronic pain, while 40.67% (24 out of 59) were dealing with acute pain. 54.24% (32/59) of individuals with lateral epicondylitis experienced functional disability in specific activities, while 28.81% (17/59) reported functional disability in routine activities. Conclusion: We found a high prevalence of 39.33% lateral epicondylitis among housewives. There is a dire need to raise awareness among housewives for changing their lifestyle and activities regimen in order to avoid any such disorders like L.E. Robust studies with larger sample sizes are needed to establish conclusive evidence. [ABSTRACT FROM AUTHOR]