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Purpose: Cap-assisted endoscopic mucosal resection (EMRC), ligation-assisted endoscopic mucosal resection (EMRL), endoscopic submucosal dissection (ESD), and multiband mucosectomy (MBM) are used for treating early esophageal cancer patients. Our aim was to compare the efficacy and safety of four different endoscopic treatments. Methods: Electronic databases (PubMed, Cochrane, Embase, and Web of Science) were systematically searched to include relevant studies published from database inception until February 15, 2021. There were no date or language restrictions. Data related to study such as characteristics, methods, outcomes, and risks of bias were extracted by two reviewers. Results: A total of 11 articles with 1880 patients were included. The results of the network meta-analysis showed that ESD was a better choice considering the efficacy of en bloc resection rate (surface under the cumulative ranking curves (SUCRA) = ESD: 99.5%, EMRC: 26.5%, MBM: 24.1%) and local recurrence rate (SUCRA = EMRC: 95.6%, MBM: 42.9%, ESD: 11.6%). MBM had a lower rate of side effects compared to the other treatments: perforation rate (SUCRA = ESD: 100%, EMRC: 48.1%, MBM: 1.9%), stricture rate (SUCRA = ESD: 99.8%, MBM: 40.8%, EMRC: 9.4%), and bleeding rate (SUCRA = EMRC: 69.4%, ESD: 62.2%, EMRL: 61.6%, MBM: 6.8%). MBM also had the shortest operation time and smallest diameter of the specimens. Conclusion: The MBM endoscopic treatment was recommended for early esophageal cancer patients, but considering the increase in lesion size, ESD would be better. [ABSTRACT FROM AUTHOR]

[Display omitted] • Both low scores on CDAI and physical inactivity are associated with higher prevalence of cognitive impairment. • There is an interaction between CDAI and physical activity. • The elderly population with low scores on CDAI especially combined with physical inactivity should be focused, so as to reduce the odds of cognitive impairment. • It is suggested that elderly individuals with low physical activity can reduce the odds of cognitive impairment by consuming more antioxidant foods. We aim to explore the association between the Composite Dietary Antioxidant Index (CDAI), physical activity, and cognitive impairment. 2395 participants from the 2011–2014 National Health and Nutrition Examination Survey (NHANES) were included in this study. The association of CDAI and physical activity with cognitive impairment was analyzed using binary logistic regression. A stratified analysis was employed for a sensitivity analysis of the logistic regression, examining the interaction between CDAI and each stratified variable. Both low scores on CDAI and physical inactivity are associated with higher prevalence of cognitive impairment. Compared to the fourth quartile of CDAI and active group, the prevalence of cognitive impairment is statistically increased in other sub-groups. There is an interaction between CDAI and physical activity. The elderly population with low scores on CDAI especially combined with physical inactivity should be focused, so as to reduce the adverse effects of cognitive impairment. [ABSTRACT FROM AUTHOR]

Objective: Depression is one of the leading causes of disability burden and frequently co-occurs with multiple chronic diseases, but limited research has yet evaluated the correlation between multimorbidity and depression status by sex and age.Methods: 29303 adults from 2005-2016 National Health and Nutrition Examination Survey were involved in the study. The validated Patient Health Questionnaire (PHQ-9) was used to assess depression status. The linear trend of the prevalence of multimorbidity was tested by logistic regressions, which was visualized by the weighted network. Gamma coefficient (γ) was used to evaluate the correlation between multimorbidity and depression status.Results: The prevalence of multimorbidity in participants with no depression, mild depression, moderate depression and severe depression was 52.1%, 63.0%, 68.4% and 76.1%, respectively (p for trend < 0.001). In network analysis, the absolute network density increased with the levels of depression status (from 4.54 to 15.04). Positive correlation was identified between multimorbidity and depression status (γ=0.21, p<0.001), and the correlation was different by sex and age, where it was stronger in women than men (females: γ=0.23, males: γ=0.16), and stronger in the young and the middle-age (young: γ=0.30, middle-age: γ=0.29, old: γ=0.22).Limitations: This is a cross-sectional study and thus we cannot draw firm conclusions on causal correlations.Conclusions: Positive correlation between multimorbidity and depression status was identified, where the number of multimorbidity increased with the levels of depression status, especially in females, the young and the middle-age. [ABSTRACT FROM AUTHOR]