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Introduction: Limited data on 24-hour movement behaviors of children aged 5–8 years exist globally. We describe the prevalence and sociodemographic associations of meeting physical activity (PA), sedentary recreational screen time (ST), and sleep guidelines among children from 11 jurisdictions in the US-Affiliated Pacific region. Methods: Cross-sectional representative data from 1192 children aged 5–8 years living in the US-Affiliated Pacific region were drawn from the baseline 2012–2014 Children's Healthy Living Program. Sleep and moderate- to vigorous-intensity PA were calculated from accelerometry. ST and sociodemographic data were collected from caregiver surveys. The percentage of children meeting the Asia-Pacific 24-hour movement guidelines for PA (≥60 min/d of moderate- to vigorous-intensity PA), sleep (≥9 and ≤ 11 h/d) and ST (≤2 h/d) were calculated. Generalized linear mixed models were used to examine associations with adiposity and sociodemographic variables. Results: Twenty-seven percent (95% confidence interval, 24.6–30.0) of children met integrated guidelines; 98% (96.2–98.0) met PA, 78% (75.4–80.0) met sleep, and 35% (32.6–38.0) met ST guidelines. Females (adjusted odds ratio = 1.40 [95% confidence interval, 1.03–1.91]) and those living in lower-middle-income jurisdictions (2.29 [1.49–3.54]) were more likely to meet ST guidelines. Overweight children (0.62 [0.40–0.96]), those aged 8 years (0.39 [0.22–0.69]), and children with caregivers of an education level of high school or beyond (0.44 [0.29–0.68]) were less likely to achieve ST guidelines. Children from midrange annual household incomes were less likely to meet combined guidelines (0.60 [0.39–0.92]). Conclusions: Three-quarters of children are not meeting integrated Asia-Pacific 24-hour movement guidelines. Future strategies for reducing ST and increasing integrated guidelines compliance are needed. [ABSTRACT FROM AUTHOR]

Hazardous alcohol consumption is highly prevalent for men who have sex with men (MSM). The 4 treatments currently approved by the Food and Drug Administration for alcohol use are reaching an alarmingly low percentage of people who would benefit from a reduction in their alcohol use. There is increasing interest in alternative methods of treatment, such as herbal supplements, to address hazardous drinking. However, research on the acceptability of alternative pharmacotherapies among MSM remains limited. We examined the prevalence and correlates of expressing interest in using herbal supplements for alcohol treatment among MSM with hazardous alcohol consumption. We conducted a secondary data analysis from a cross-sectional study of MSM who use alcohol, conducted from March 2015 to July 2017 in San Francisco, California, to assess the overall prevalence of interest in using herbal supplements to help reduce alcohol consumption. Associations between expressing interest in herbal supplements and demographic, social, and clinical characteristics were examined using bivariate and multivariable logistic regression models. One-third (66/200, 33%) of the participants expressed interest in an herbal supplement for reducing alcohol consumption. In the multivariable analyses, weekly binge drinking (adjusted odds ratio [aOR] 2.85, 95% CI 1.17-6.93), interest in abstaining from alcohol use (aOR 5.04, 95% CI 1.46-17.40), higher severity of alcohol dependence score (aOR 1.22, 95% CI 1.04-1.41), and interest in naltrexone (aOR 3.22, 95% CI 2.12-4.91) were independently associated with higher odds of being interested in using an herbal supplement to reduce alcohol consumption, adjusting for age, race or ethnicity, and education. We found that MSM who have hazardous drinking habits, more severe alcohol dependence, and interest in pharmacotherapy were more likely to express interest in using an herbal supplement for reducing alcohol consumption. To our knowledge, this is the first study that has evaluated correlates of interest in herbal supplements for alcohol use among MSM. As researchers implement novel alcohol treatment studies, they should focus on recruitment efforts among MSM with a motivation to reduce their alcohol use patterns.

Objective: This study aimed to assess the changes in the frequency of physical activity (PA) counseling and in the predictors of primary care PA promotion in Québec primary care physicians (PCPs) between 2010 and 2020. Methods: In 2010, we conducted a survey among Québec PCPs. Questions included: frequency of promoting PA to patients, perceived barriers, needs to improve PA promotion practice, frequency of PCPs' PA practice, and sociodemographic information. In 2020, we took over the 2010 questionnaire to document the evolution of the PA promotion practice. Results: The proportion of PCPs discussing PA with their patients significantly increased (P <.05) in 2020 for the following health conditions: depression, low back pain, chronic obstructive pulmonary disease, and cancer; it declined (P <.05) for overweight patients, those with metabolic syndrome, and in primary prevention. Collaboration with PA professionals was the major need identified, and it increased in 2020. PCPs' own practice of PA was a predictor of PA promotion in 2010 (odds ratio = 6.679; P <.001) and in 2020 (odds ratio = 6.679; P <.001). In both 2010 and in 2020, older or more experienced PCPs were more likely to discuss PA with their patients without diagnosed diseases than younger ones or those with less experience. Conclusions: Over the last 10 years, there has been a significant increase in PCPs promoting PA in Québec; however, it has been mainly oriented toward secondary prevention. It is concerning that PA counseling in primary prevention has declined, notably among younger PCPs. The stronger claim for closer collaboration with kinesiologists suggests that PCPs are in favor of an interprofessional strategy, namely collaboration with PA specialists. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate peri-implant tissue health and bone resorption in patients with implant-supported fixed partial rehabilitations. In particular, possible correlations between plaque accumulation and bone loss, as well as other periimplant health parameters, were investigated. Materials and Methods: A total of 44 patients rehabilitated with fixed implant-supported partial rehabilitations were included. The following parameters were recorded: spontaneous bleeding (SB), suppuration, bleeding on probing (BOP), plaque index (PI), and probing depth (PD). Periapical radiographs were taken to measure crestal bone loss (BL). A nonparametric test (Spearman rank coefficient; rs) was used to identify possible correlations between the clinical parameters recorded. Results: A total of 121 implants were analyzed. Global PI and BOP were 49.58% and 20.25%, respectively. There were no cases of suppuration, and only 2 implants showed spontaneous bleeding. Mean BL was 1.53 mm (SD: 0.98). No implants showed peri-implantitis. There was a weak, statistically significant correlation between PI and BL (rs = 0.27, P [2-tailed] = .99) and between PI and the other peri-implant parameters (BOP: rs = 0.14, P = .14; PD: rs = 0.04, P = .65; SB: rs = --0.08, P = .34). A very weak correlation was also found between BL and BOP (rs = 0.1, P = .2) and between BL and PD (rs = 0.02, P = .7). Correlation was found between BL and age (rs = 0.13, P = .81) and between the other peri-implant parameters and age using dichotomization (> or < 65 years; PI: rs = --0.14, P = .11; PD: rs = --0.21, P = .01; BOP: rs = --0.21, P = .01; SB: rs = 0.05, P = .53). No statistically significant correlations were found between the clinical parameters evaluated and the sex or the dental arch treated (maxilla vs mandible). In contrast, the correlation between periodontal parameters and years elapsed since surgery (follow-up) was significant. Conclusions: The present research suggests that in implant-supported fixed partial rehabilitations, dental implants with greater plaque accumulation are more likely to present augmented probing depth, peri-implant inflammation, and bone loss, although the correlation is statistically very weak. Patient age and time of follow-up also significantly affected peri-implant health parameters. [ABSTRACT FROM AUTHOR]

PurposeIn 2013, afatinib was approved for non-small-cell lung cancer with subsequent indication expansion. We investigated published afatinib clinical trials to assess risk and benefit profiles for the drug in its approved indication of non-small-cell lung cancer as well as in off-label uses. Previous literature demonstrates excessive patient burden and limited benefit as afatinib has spread into more indications. A trial analysis is needed to establish efficacy and risk.MethodsIn this investigation, we screened literature databases and clinical trial registries for trials of afatinib as monotherapy or in combination interventions for cancer treatment. We extracted participant demographics, adverse event characteristics, as well as clinical and surrogate endpoints for each trial. Studies were deemed positive, negative, or indeterminate based on their achieving of primary endpoints as well as their safety.ResultsOur search yielded 2444 articles; we excluded 2352 articles for a final inclusion of 92 trials of 8859 patients. Our sample had 49 (53%) positive trials, 27 (29%) negative trials, and 16 (17%) indeterminate trials. The most common off-label indications for afatinib were breast cancer and squamous cell carcinoma of head and neck. The median OS for all trials was 8.4 months, median PFS 3.4 months, and the total ORR was 29.6%. Our study found that trials performed in disease states beyond the initial indications were largely negative with little patient benefit. The adverse events within our trial sample appear to be in line with expectations for toxicity.ImplicationsThese results are consistent with other studies that present similar findings, such as in Carlisle et al which indicate limited efficacy in nonapproved indications. Future trials should keep this potential evidence and patient burden in mind before initiation of those trials. This study contributes to the understanding of afatinib's risk-benefit profile across many clinical applications.

Background: The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) index is a relatively new composite lipid index, the relationship between NHHR and depression is unclear from the current study. The primary aim of our study was to examine the association between the prevalence of depression and NHHR in a US population. Methods: The National Health and Nutrition Examination Survey (NHANES) provided the data for our investigation from 2005 to 2018. and primarily included participants who contained complete data on NHHR and depression in U.S. adults (age ≥20 years). Associations between NHHR and depression were assessed using multifactorial logistic regression analysis, subgroup analysis, and smoothed curve fitting. Results: In our study, 29,561 subjects in total showed a mean NHHR index of 3.12± 1.58,A noteworthy positive correlation was observed between NHHR and depression in multifactorial logistic regression analysis. Subgroup analyses and tests of interaction showed that gender, age, ethnicity, PIR, smoking, alcohol consumption, coronary heart disease, diabetes mellitus, hypertension, and stroke did not influence the NHHR and the association between depression (P for interaction > 0.05), whereas two stratification factors, BMI and sleep disturbance, may be potential factors in the association between NHHR and depression (P for interaction < 0.05). Conclusion: According to our present study, if the level of NHHR rises in American adults, their likelihood of developing depression also increases. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between Erectile dysfunction (ED) and peripheral arterial disease (PAD) in adult American males using a large database. Methods: The relationship between ED and PAD prevalence among participants in the 2001-2004 National Health and Nutrition Examination Survey (NHANES) database was assessed using a series of statistical analyses. ED was evaluated based on a single-item measure of self-reported erection problems from the Massachusetts Male Aging Study. PAD was defined as ankle-brachial index (ABI) < 0.9 in at least one leg. Multifactorial logistic regression models were used to investigate the association between ED and PAD. Results: A total of 2394 participants were enrolled, of whom 905 individuals (37.8%) were diagnosed with ED. After adjusting for confounding variables, the association between ED and PAD remained positive, with an odds ratio of 2.05 (95% confidence interval 1.24-3.39). Subgroup analysis revealed that the relationship between ED and PAD was significant in patients aged >50 years old, without hypertension, without diabetes, without cardiovascular disease, without high cholesterol, former smokers, low physical activity levels, and a body mass index of 25-30 (P < 0.05). In addition, all subgroups analyzed were evaluated for any potential interaction, and no statistically significant association was discovered. Conclusions: In a sample of US adults aged ≥40, this cross-sectional study found that ED is related to a higher occurrence of PAD. ED may be an independent predictor of PAD, and thus it should be considered in the treatment of patients with ED. [ABSTRACT FROM AUTHOR]

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]

Aim: To explore the knowledge and attitude among oncology patients toward proton radiotherapy. Materials & methods: This cross-sectional study was performed using self-designed questionnaire. Results: Based on 546 valid questionnaires, mean knowledge and attitude scores of 3.4 ± 3.6 (range: 0–12) and 31.1 ± 3.5 (range: 10–50) were observed. Multivariate analysis demonstrated that higher education (p = 0.021), higher monthly income (p = 0.005), and proton radiotherapy history (p < 0.001) were independently associated with higher knowledge scores. Higher knowledge (p = 0.020), older age (p = 0.030), not smoking (p = 0.032) and medication use (p = 0.035) were independently associated with higher attitude scores. Conclusion: Oncology patients have insufficient knowledge and negative attitude toward proton radiotherapy, which might be affected by their age, education, income, proton radiotherapy history, employment, smoking and medication use. Article highlights Understanding oncology patients' knowledge and attitude toward proton radiotherapy is benefit for the improvement of their clinical outcomes and quality of care. This study aimed to explore the knowledge and attitude among oncology patients toward proton radiotherapy. A multi-center, cross-sectional study was conducted on 546 oncology patients, using a self-designed questionnaire. Patients' knowledge and attitude scores toward proton radiotherapy were assessed by the questionnaire. Multivariate logistic regressions were used to explore the associations among sociodemographic characteristics, knowledge and attitude. Oncology patients might have insufficient knowledge and negative attitude toward proton radiotherapy. Age, education, income, proton radiotherapy history, employment, smoking, and medication treatment for other conditions might have an impact on their knowledge and attitude. The findings would help clinicians to identify cancer patients who require further education and interventions to improve their knowledge and attitude. [ABSTRACT FROM AUTHOR]

Background: As global aging accelerates, depression among the elderly becomes more common. Research had revealed that patients with late-life depression (LLD) face a higher risk of suicide compared to their counterparts in other age groups, with the pathways to suicide being multifaceted. Thus, investigating the various factors linked to the elevated risk of suicide in patients with LLD is critical. Objective: To investigate the factors associated with a high level of suicide risk among patients with LLD. Methods: A total of 108 patients with LLD were recruited for this study. From October 2022 to November 2023, a cross-sectional study was conducted on patients with LLD from the Affiliated Brain Hospital of Guangzhou Medical University. Suicide risk was evaluated using the Chinese version of the Nurses' Global Assessment of Suicide Risk Scale (NGASR). Potential influencing factors were included and analyzed through multivariate linear regression to identify the factors associated with a high level of suicide risk among patients with LLD. Results: The mean NGASR score among patients with LLD was 7.30 ± 4.34 (range: 0 ~ 19). Multiple linear regression analyses revealed that depression-anxiety of the Brief Psychiatric Rating Scale (BPRS) (β = 0.31, 95% CI = 0.13, 0.45, p<0.001), activation of the BPRS (β=-0.29, 95% CI=-1.22, -0.35, p<0.001), normal cognitive function of the Mini-Mental State Examination (MMSE) (β = 0.21, 95% CI = 0.50, 3.48, p<0.05), involuntary admission (β = 0.20, 95% CI = 0.44, 3.43, p<0.05), and objective support of the Social Support Rating Scale (SSRS) (β = 0.21, 95% CI = 0.08, 0.66, p<0.05) were statistically associated with a high level of suicide risk in patients with LLD. Conclusion: This study found that LLD patients with severe depression-anxiety, low activation, normal cognitive function, involuntary admission, and strong objective support exhibited a high level of suicide risk. These patients should receive intensified monitoring and comprehensive measures should be implemented to prevent the occurrence of suicidal behaviors during hospitalization. [ABSTRACT FROM AUTHOR]

Background: As intrinsic capacity (IC) declines, older adults are at a significantly increased risk of frailty, care dependency, and death. Currently, the research on IC among older adults in China was still insufficient. We aimed to identify the status quo and influencing factors among community-dwelling older adults in China and explore the relationship between IC, external environment, and social network. Methods: A convenience sampling method was used to collect 312 older people from May 2023 to February 2024 in five communities in Chengdu, Sichuan Province. Data were collected using the general information questionnaire, Integrated Care of the Elderly (ICOPE) screening tool, World Health Organization Quality of live scale (WHOQOL-100), and Social Network Scale (LSNS-6). Results: The IC score among Chinese community-dwelling older adults was 3.39 ± 1.60, and the prevalence of IC decline was 86.9%. Marital status, age, number of chronic diseases, social network, and external environment were influencing factors of IC, which explained 35.7% of the total variance. External environment and social network were positively correlated with IC. Conclusions: Chinese community-dwelling older adults had low IC scores and a high prevalence of IC decline. The government should focus on IC for older adults, especially those who are older, not married or widowed, and suffering from multiple chronic diseases. In addition, the richer the external resources available to older adults, the more social support they received, and the better the IC. These findings could provide a theoretical basis for managing and improving IC in older adults. Highlights: • Older adults have low intrinsic capacity scores and a high prevalence of intrinsic capacity decline. • External environment and social networks were positively correlated with intrinsic capacity. • Marital status, age, number of chronic diseases, social network, and external environment influenced intrinsic capacity of older adults. [ABSTRACT FROM AUTHOR]

Objective: The weight-adjusted-waist index (WWI) is a novel obesity measurement indicator, and this study aims to determine the relationship between WWI and Familial hypercholesterolemia (FH). Methods: Using data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to March 2020, cross-sectional data from 3698 participants were analyzed. The study examined the correlation between WWI and FH using multivariate logistic regression and smooth curve fitting, and conducted subgroup analysis and interaction tests. Results: The study sample consisted of 3698 subjects for whom the overall probable prevalence of FH was 5.43% and increased with WWI tertile (quantile 1: 4.00%; quantile 2: 4.94%; quantile 3: 7.34%); individuals with the highest WWI tertile were significantly more likely to have FH than those with the lowest tertile (OR = 4.60,95% CI: 2.00-10.60). Subgroup analysis and interaction tests showed significant significance between WWI and personal history of early Atherosclerotic cardiovascular disease (ASCVD), family history of early ASCVD and probable prevalence of FH (p < 0.05). Conclusion: This study demonstrates a nonlinear positive correlation between WWI and FH. This may provide new ideas for the prevention and treatment of FH in the future. [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]

Background: To date, there are no official diagnostic criteria for the frequently reported phenomenon of exercise addiction. Therefore, the aim of the present study was to investigate how mental disorders, specifically depression and attention-deficit hyperactivity disorder (ADHD), are related to exercise addiction (EA). Methods: A total of 173 participants aged between 18 and 70 years, who reported exercising more than 10 h a week and continued to exercise despite injury or illness, answered questionnaires including the Exercise Dependence Scale, the Beck Depression Inventory, and the Homburger ADHD scale for adults. Multiple linear regression analyses were performed adjusting for relevant confounders (age, gender) and stepwise regression was used to identify which of the two mental disorders is the more influential predictor of EA. Results: Pearson correlation analysis showed that depressive symptoms [r (171) = 0.422, p < 0.00] and ADHD symptoms [r (171) = 0.308, p < 0.001] were positively correlated with EA symptoms. The relation between depressive symptoms and EA remained after adjusting for confounders in the regression model (B = 20.531; t(170) = 5.950; 95% CI [13.719, 27.343]; p < 0.001). Similarly, the positive link between ADHD symptoms and EA persisted after controlling for confounders (B = 15.507; t(170) = 3.771; 95% CI [7.389, 23.625]; p < 0.001). Additionally, a stepwise regression model identified that depressive symptoms are a stronger predictor for EA than ADHD symptoms. Conclusion: Depressive symptoms seem to be a stronger predictor for EA compared to ADHD symptoms in frequent exercisers. Although individuals with ADHD May exercise extensively, they might be less at risk for EA than individuals with depression. These results contribute to the complex characterization of the psychiatric profile of individuals with exercise addiction, and underline the need for further research elucidating the interplay between mental disorders and EA. [ABSTRACT FROM AUTHOR]

Introduction: Studies examining the relationships among suicidal ideation, emotional vulnerability, and depressive symptoms are scarce. This study examined the effects of emotional vulnerability and depressive symptoms on suicidal ideation among Japanese university students Methods: A questionnaire survey was conducted with 370 Japanese university students. Data were analyzed using descriptive statistics and multiple regression analysis Results: In the multiple regression analysis, depressive symptoms were significant (β =.46, p <.001) but emotional vulnerability was not (β =.05, p =.318). A significant interaction emerged between emotional vulnerability and depressive symptoms (β =.22, p <.001). The model's R 2 value was.31 (p <.001). Simple slopes tests revealed the impact of depressive symptoms on suicidal ideation, even with low emotional vulnerability (b =.06, β =.27, p <.001), and a higher impact with high emotional vulnerability (b =.15, β =.65, p <.001) Discussion: The negative interaction between emotional vulnerability and depressive symptoms may heighten suicidal ideation among Japanese university students. Interventions targeting emotional vulnerability may help reduce suicidal ideation and achieve lower suicide rates. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) has a close association with cardiovascular diseases. Few studies have investigated the association of Life's Essential 8 (LE8), the updated measurement of cardiovascular health (CVH), with MetS. Methods: The National Health and Nutrition Examination Survey (2005–2018) data was extracted. The LE8 comprised 4 health behaviors (diet, physical activity, nicotine exposure, and sleep health) and 4 health factors [body mass index (BMI), blood lipids, blood glucose, and blood pressure (BP)]. The total LE8 score is the average of 8 metric scores (0-100), categorized into low (0–49), moderate (50–79), and high CVH (80–100) levels. Multivariable logistic regression models, restricted cubic spline models and stratified analyses were performed to examine the relationship between LE8 and MetS. Results: In this study, a total of 21,543 participants represented 146.6 million non-institutionalized U.S. adults. Following adjustment for various potential covariates, participants who attained a moderate [adjusted odds ratio (AOR) = 0.234, 95% CI: 0.209, 0.262] or a high CVH level (AOR = 0.026, 95% CI: 0.021, 0.032) exhibited an inverse correlation with MetS risks when comparing those with a low CVH level. An inverse linear dose-response relationship between LE8 scores and MetS risks was also identified (P for nonlinearity > 0.05). Conclusions: LE8 was inversely associated with the risk of MetS. Adhering to LE8 guidelines to sustain a higher CVH level may be beneficial for preventing MetS. [ABSTRACT FROM AUTHOR]

Background: The cardiometabolic index (CMI) is a new predictor of obesity-related diseases, but its link to periodontitis is under-researched. This study aims to examine the potential association between the CMI and periodontitis. Methods: We conducted a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) database (2009–2014) to examine the potential association between CMI and periodontitis. The study utilized a weighted multivariate logistic model to assess the association between TG, HDL-C, TG/HDL-C, obesity indices (BMI, WC, WHtR, CMI), and periodontitis, employing the area under the receiver operating characteristic curves (ROC) to estimate areas under the curve (AUC). Furthermore, generalized smooth curve fitting was conducted to examine the relationship between CMI and periodontitis. Finally, the study incorporated subgroup analysis and interaction tests to examine consistency across different populations. Results: TG/HDL-C, WHtR, and CMI were positively associated with periodontitis in the fully adjusted classification model. It was observed that for each unit increase in CMI, there was a corresponding 17.8% increase in the prevalence of periodontitis [1.178 (1.049, 1.322) 0.00562] and 18.7% increase in the prevalence of moderate/severe [1.187 (1.057, 1.334) 0.00376] in the fully adjusted model. When CMI was used as a categorical variable, the adjusted OR for periodontitis prevalence increased significantly with increasing CMI after adjusting for all potential covariates (T3 vs. T1: OR, 1.28 [1.06, 1.55], p < 0.05). The ROC analysis indicated that a larger area under the curve was found in the CMI [0.554 (0.538–0.570)] than in the WC [0.544 (0.528–0.560)] and WHtR [0.544 (0.528–0.561)]. Nonetheless, the discrepancy observed did not reach statistical significance (all p > 0.05). Further generalized smooth curve fitting and threshold effect models indicated a positive linear correlation between CMI and periodontitis. Moreover, there is no interactive association between TG/HDL-C, WHtR, CMI, and periodontitis. Conclusions: This cross-sectional study revealed a positive relationship between CMI and periodontitis. Further prospective studies are warranted to validate our findings. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the level of oral health knowledge among teachers in a city of the Brazilian Amazon region (Belem, Pará) and explore the association between teachers' knowledge and their proposed actions in the event of dental trauma accidents within the school environment. The descriptive cross‐sectional study involved 170 elementary teachers from public schools in the Metropolitan Region of Belem, Para State, Brazil. A self‐administered questionnaire with multiple‐choice questions was utilized to assess teachers' oral health knowledge across various domains. The questionnaire comprised seven targeted sections: the first section focused on demographic and professional aspects of the educators, while the remaining six sections addressed the oral health knowledge related to oral health education, dental caries, dental trauma (specifically dental avulsion), periodontal disease, visits to the dentist, and the educator's role in promoting oral health. Data analysis involved descriptive statistics and χ2 tests using Statistical Package for Social Science (SPSS; 20.0 version). Most of the sample were female (92.2%) and around 41–60 years (36.0%). Most teachers had over 5 years of teaching experience (87.0%) and held an undergraduate degree (63.0%). A significant association was found between teaching experience and the choice of storage method for avulsed teeth following dental trauma (p = 0.005). However, the teachers examined in this study exhibited inadequate knowledge concerning the appropriate treatment for cavities and the recommended age for a child's first dental appointment. These findings underscore the crucial role teachers play in promoting oral health among students, particularly in regions characterized by social inequality and limited access to basic sanitation and healthcare services. [ABSTRACT FROM AUTHOR]

Background: The relationship between serum uric acid (SUA) levels and prostate cancer (PCa) remains controversial. This cross-sectional study investigated the association between SUA levels and PCa incidence. Methods: A total of 9,776 participants aged ≥40 from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2020 were included, 503 of whom had PCa. Weighted univariate logistic regression, multivariate logistic regression, and smooth-fitting curve analyses were used to analyze the association between SUA and PCa incidence. Concurrently, the fitted smoothing curves were used to explore the potential non-linear relationships. If non-linearity was observed, a recursive algorithm further calculated the inflection point. Results: Three models were used to analyze the correlation between SUA levels and PCa incidence. All regression models demonstrated a negative correlation between SUA levels and PCa incidence (model 1: OR = 0.88, 95% CI=0.80–0.97; model 2: OR = 0.87, 95% CI=0.80–0.96; model 3: OR = 0.87, 95% CI=0.78–0.96). According to the trend test, with increasing SUA, the risk of PCa showed a downward trend (three models P for trend = 0.037, 0.015, 0.016). According to the subgroup analysis, a significant negative correlation between SUA and PCa was detected in individuals aged >60 years, non-Hispanic whites, those of other races, and those with hypertension. Moreover, the association between SUA and PCa followed a U-shaped curve among participants without hypertension, and the inflection point of SUA was 5.1 mg/dl. Conclusions: This cross-sectional study revealed a negative relationship between SUA levels and the risk of PCa, particularly in specific demographic groups. These findings offer a fresh perspective on the role of SUA in PCa patients, potentially paving the way for new approaches for the prevention and treatment of PCa. However, further studies are necessary to validate these findings. [ABSTRACT FROM AUTHOR]

Background: Environmental contaminants may play a significant role in the development of migraine. Perchlorate, nitrate, and thiocyanate were selected for this study due to their known impact on thyroid function, which is closely linked to neurological processes. Disruptions in thyroid function have been associated with various neurological disorders, including migraines. However, there is currently no evidence linking exposure to these specific chemicals to migraine. The study aims to evaluate the association between urinary concentrations of perchlorate, nitrate, and thiocyanate with the prevalence of severe headache or migraine in U.S. adults. Methods: A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2001–2004. Utilizing electrospray tandem mass spectrometry in conjunction with ion chromatography, urinary concentrations of perchlorate, nitrate, and thiocyanate urine were measured. Multiple logistic regression models were employed to evaluate the linear correlation between perchlorate, nitrate, and thiocyanate exposure and severe headache or migraine. The non-linear relationship is described analytically using a fitted smoothing curve and a two-piecewise regression model. Subgroup analyses were used to further clarify the stability of this relationship across different populations. Results: There were 1,446 participants in this population-based study, ranging in age from 20 to 85. After adjusting for potential confounding variables, the multiple logistic regression findings demonstrated that thiocyanate was significantly positively associated with the prevalence of migraine (odds ratio [OR] = 1.18; [1.06, 1.30]; p < 0.001). There was consistency in this connection across different subgroups (p for interaction >0.05). Furthermore, there was a non-linear correlation between urinary thiocyanate and migraine. Using a fitted smoothing curve and a two-piecewise regression model, it was found that the correlation between urinary thiocyanate and migraine was U-shaped (p for Log-likelihood ratio = 0.002). According to the findings of the multiple regression analysis, there was no significant correlation between urinary perchlorate and nitrate and migraine (both p > 0.05). Conclusion: We should limit our exposure to thiocyanate by keeping it within a reasonable range, as indicated by the U-shaped correlation between urinary thiocyanate and migraine. [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]

INTRODUCTION: Early detection of both objective and subjective cognitive impairment is important. Subjective complaints in healthy individuals can precede objective deficits. However, the differential associations of objective and subjective cognition with modifiable dementia risk factors are unclear. METHODS: We gathered a large cross‐sectional sample (N = 3327, age 18 to 84) via a smartphone app and quantified the associations of 13 risk factors with subjective memory problems and three objective measures of executive function (visual working memory, cognitive flexibility, model‐based planning). RESULTS: Depression, socioeconomic status, hearing handicap, loneliness, education, smoking, tinnitus, little exercise, small social network, stroke, diabetes, and hypertension were all associated with impairments in at least one cognitive measure. Subjective memory had the strongest link to most factors; these associations persisted after controlling for depression. Age mostly did not moderate these associations. DISCUSSION: Subjective cognition was more sensitive to self‐report risk factors than objective cognition. Smartphones could facilitate detecting the earliest cognitive impairments. Highlights: Smartphone assessments of cognition were sensitive to dementia risk factors.Subjective cognition had stronger links to most factors than did objective cognition.These associations were not fully explained by depression.These associations were largely consistent across the lifespan. [ABSTRACT FROM AUTHOR]

• The prevalence of ESEs was inversely related to fiber intake. • A nonlinear dose-response relationship was observed between dietary fiber intake levels and decreased ESEs. Epilepsy, a neurological disorder, is identified by the presence of recurrent seizures. We aimed to detect dietary fiber intake and its association with epilepsy prevalence in U.S. adults. This cross-sectional study obtained data from the 2013–2018 National Health and Nutrition Examination Survey database. Univariate and multivariate logistic regression models were employed to estimate the association between dietary fiber intake and epilepsy prevalence. The restricted cubic spline (RCS) model was also applied to investigate the dose-response relationships between dietary fiber intake and epileptic seizure events(ESEs). Our final sample included 13,277 NHANES participants, with the average prevalence of ESEs being 1.09 % (145/13277). After adjusting for all confounding factors, the third quartile of dietary fiber intake levels remained significantly associated with a decreased risk of ESEs[odds ratios (OR) 0.54,95 % confidence interval (CI) 0.33–0.88, P = 0.014)] compared to the first quartile. Higher fiber intake indicated a stable negative association with ESEs in the multivariate logistic regression analysis, weighted generalized additive model. A nonlinear dose-response relationship was observed between dietary fiber intake levels and decreased ESEs risk (P for overall=0.017, P for nonlinear=0.155). Interaction tests showed no significant effect of demographic and disease status on the association between dietary fiber intake and ESEs. In this cross-sectional study, people with a high dietary fiber intake were at a reduced risk of ESEs. However, further prospective studies are needed to investigate the effect of dietary fiber intake in epilepsy events and to determine causality. [ABSTRACT FROM AUTHOR]

Pruritic dermatoses and sleep disorders have significant impacts on the health and quality of life of patients. Inflammatory conditions may lead to the sensation of itching. This study was to evaluate the association between pruritic dermatoses and inflammatory factors on sleep disorders. Data in the cross-sectional study were extracted from the National Health and Nutrition Examination Survey. The study population was divided into participants with and without sleep disorders. Pruritic dermatoses were assessed by the participant's self-report. Inflammatory factors included white blood cell count (WBC), lymphocyte count (LYM) and prognostic nutritional index (PNI). Logistic regression models were used with odds ratios and confidence intervals. The attributable proportion of interaction (AP) was utilized to assess the interaction between pruritic dermatoses and inflammatory factors on sleep disorders. Totally, 3,520 participants were included and 214 (6.08%) had sleep disorders. Pruritic dermatoses were associated with sleep disorders after adjusting for gender, age, race, marital status, body mass index, drinking, smoking, asthma, hay fever, allergy, depression and caffeine. LYM was associated with sleep disorders when inflammatory factors were divided by median. The interaction between participants without pruritic dermatoses and PNI < median on sleep disorders was observed compared to participants without pruritic dermatoses and PNI > median. Pruritic dermatoses were significantly associated with sleep disorders. We also found that a high level of PNI had an enhanced effect on the relationship between pruritic dermatoses and sleep disorders. Clinicians should focus on the potential sleep-related risks and changes in inflammatory factors in patients with pruritic dermatoses and intervene in time. [ABSTRACT FROM AUTHOR]

• BMI is a key factor moderating the link between depression and COPD. • Depression significantly increases the odds of COPD, highlighting mental health impacts. • Underweight individuals showed less depression impact on COPD risk than normal BMI. • Tailored COPD treatment should consider mental health and BMI. • The study emphasizes the complexity of the depression-COPD nexus, urging further research. Prior research has established a connection between depression and chronic obstructive pulmonary disease (COPD). However, the influence of age and BMI on this association remains unclear. We used the National Health and Nutrition Examination Survey (NHANES) database to explore the relationship between depression and COPD, and to investigate whether age and Body mass index (BMI) act as moderators in this relationship. We analyzed data from 10,940 participants in the NHANES database. Depression served as the independent variable. COPD status served as the outcome variable. We employed multivariable logistic regression to examine the relationship between depression and COPD. Of the 10,940 respondents surveyed, about 3.9 % had COPD and 8.5 % had depression. The prevalence of depression in COPD patients was significantly greater than the prevalence of overall respondents (21.1 % VS.8.5 %). We found that the association between depression and COPD was mediated by BMI status. Controlling for other covariates, the association between depression and COPD increased significantly. For the underweight group, the impact of depression on the risk of COPD was lower compared to the normal BMI group. This study confirms a significant association between depression and COPD, with BMI serving as a moderator. These findings enhance our understanding of the complex interplay between depression and COPD and underscore the importance of considering individual physical health characteristics in clinical assessments. The results have significant implications for clinical practice and public health policymaking. [ABSTRACT FROM AUTHOR]

Objectives: The psychological effects of the COVID-19 pandemic have been shown to include anxiety. However, the association between demographic and physiological factors in COVID-19-associated anxiety symptoms is poorly understood. Therefore, the present cross-sectional study was conducted to examine anxiety symptoms and associated factors among patients with the SARS-CoV-2 Omicron variant during the quarantine period in Shanghai. Methods: The study was conducted between April 16, 2022, and May 21, 2022, at Fangcang Shelter Hospital in Shanghai, China. Data were collected using an anonymous online questionnaire. Demographic characteristics, respiratory symptoms, vaccine dose, comorbidities (such as hypertension and diabetes), type of work, and mental health symptoms were evaluated. Logistic regression was used to examine the relationship between anxiety symptoms and risk factors. Stratified analyses were performed to investigate potential interactions. Results: A total of 2132 patients with confirmed Omicron variant SARS-CoV-2 infection were enrolled. The results demonstrated that female gender (OR = 1.47, 95% CI = 1.11-1.94), nonmanual labor (OR = 1.62, 95% CI = 1.25-2.09), respiratory symptoms (OR = 3.19, 95% CI = 2.30-4.43), and having other comorbidities (OR = 1.65, 95% = 1.09-2.50) were positively associated with anxiety symptoms. A significant interaction was found between gender and (a) nonmanual labor (OR = 1.54, 95% = 1.29-1.85), (b) respiratory symptoms (OR = 2.06, 95% = 1.72- 2.48), and (c) comorbidities (OR = 1.57, 95% = 1.16-2.12), such that the relationship with anxiety symptoms was stronger in women compared to men. There were also significant interactions between age group and (a) nonmanual labor (stronger in those ages >46) and (b) respiratory symptoms (stronger in those ages 36-45) regarding the association with anxiety symptoms. Conclusions: Alleviation of respiratory symptoms, addressing comorbidities, and implementation of both psychological and psychopharmacological treatments may help reduce anxiety symptoms following infection with the SARS-CoV-2 Omicron variant in mainland China. [ABSTRACT FROM AUTHOR]