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Context: Wheelchair Power Soccer (WPS) is the only team sport that allows the participation of people with severe physical disabilities who require the daily use of motorized wheelchairs. These individuals may live with chronic pain due to the characteristics of the disabilities and treatments, interfering with their health and limiting their participation in sports. Objectives: To investigate the prevalence of musculoskeletal pain and its relationship with mood in WPS players and to analyze the incidence of traumatic injuries during a championship. Methods: A prospective, longitudinal study was carried out on 30 WPS athletes (93.33% male) with a mean (SD) (range) age of 22.37 (9.79) (47) years. Data collection was performed during a South American WPS Championship lasting 3 days, with: investigation of the presence of musculoskeletal pain and mood through a questionnaire; investigation of the occurrence of traumatic injuries through match observation; and confirmation of the occurrence of traumatic injuries through access to medical department records. Results: About 30% (n = 9/30) of the sample presented some pain on the day of evaluation, with an intensity of 5.67 (3.35) (10) points on the visual analog scale. The most common regions of pain were the lower back (13.3%, n = 4/30), thoracic (10%; n = 3/30), and cervical (10%; n = 3/30) areas of the spine. A total of 46.7% (n = 14/30) reported pain in the month before data collection but of less intensity (2.56 [4] [10] points), the most common regions being the lower limbs (20%; n = 6/30) and cervical spine (20%; n = 6/30). Among the between-group comparisons (ie, participants with pain vs without pain), no relationship was observed between mood state and pain. No traumatic injuries were identified during the competition. Conclusion: The presence of musculoskeletal pain was common in WPS players, but it was not related to mood. As no traumatic injuries were observed during the championship, this modality seems to be safe for people with physical disabilities in general. [ABSTRACT FROM AUTHOR]

Chatbots are "computer agents that can interact with the user" in a way that feels like human-to-human conversation.1 While the use of chatbots for reference service in academic libraries is a topic of interest for both library professionals and researchers, little is known about how they are used in library reference service, especially in academic libraries in Canada. This article aims to fill this gap by conducting a web-based survey of 106 academic library websites in Canada and analyzing the prevalence and characteristics of chatbot and live chat services offered by these libraries. The authors found that only two libraries were using chatbots for reference service. For live chat services, the authors found that 78 libraries provided this service. The article discusses possible reasons for the low adoption of chatbots in academic libraries, such as accessibility, privacy, cost, and professional identity issues. The article also provides a case study of the authors' institution, the University of Calgary, which integrated a chatbot service in 2021. The article concludes with suggestions for future research on chatbot use in libraries. [ABSTRACT FROM AUTHOR]

This study examined the prevalence and sociodemographic correlates of meeting individual behavior and 24-hr movement behavior guidelines among Brazilian older adults with chronic diseases. The sample comprised 273 older adults aged ≥60 years (80.2% women) with chronic diseases from Recife, Pernambuco, Brazil. Sociodemographic variables were self-reported, while 24-hr movement behaviors were assessed by accelerometry. Participants were classified as meeting (or not meeting) individual and integrated recommendations for moderate-to-vigorous physical activity (MVPA), sedentary behavior, and sleep duration. No participant met the 24-hr movement behavior guidelines, while only 8.4% met integrated MVPA/sleep recommendations. The prevalence of meeting recommendations of MVPA, sedentary behavior, and sleep was 28.9%, 0.4%, and 32.6%, respectively. Discrepancies according to sociodemographic variables on meeting MVPA recommendations existed. The findings show the need for dissemination and implementation strategies to foster adoption of the 24-hr movement behavior guidelines among Brazilian older adults with chronic diseases. [ABSTRACT FROM AUTHOR]

Background There are 2.8 million youth competitive swimmers in the United States (US), and shoulder pain is the most common complaint among swimmers. Purpose To determine prevalence of shoulder pain, disability, and dissatisfaction in youth competitive swimmers. A secondary purpose was to determine influence of age, competitive swimming experience, and previous history of shoulder pain or injury on shoulder pain, disability, and dissatisfaction, and finally to determine if sex, geographic area, and participation in a second sport relate to shoulder pain, disability, and dissatisfaction. Study Design Multi-site cross-sectional design Methods Six-hundred and seventy-one swimmers aged 9--17 years from six states in the US completed surveys which included demographics, the Penn Shoulder Score (PSS), and the Disability of Arm Shoulder Hand (DASH) Sports. Independent t-tests were used to compare pain, disability, dissatisfaction, the influence of age, sex, participation in second sport, geographic region, and history of shoulder pain. Linear regression analyses were performed to determine the interaction of these variables with reported pain and disability. Results Forty-nine percent of swimmers had shoulder symptoms. Greater shoulder pain and disability were reported in 15 to 17-year-olds compared to 9 to 10-year-olds (pain and disability: p<0.001), in swimmers with greater versus less years of experience (pain and disability: p<0.001), and in swimmers from eastern versus western states (pain: p=0.001, disability: p=0.0014). Swimmers not participating in a second sport had higher shoulder dissatisfaction (p=0.002). History of prior shoulder pain/traumatic injury was the best indicator of increased pain, disability, and dissatisfaction (p<0.001). Conclusion Almost half of swimmers surveyed had shoulder pain, with a higher prevalence found in older age groups, those with greater experience, and in those with prior shoulder pain or traumatic injury. Further research should investigate shoulder pain prevention programs, and surveillance methods are recommended to identify symptomatic swimmers who may benefit from referral to prevent further pain and disability. Level of Evidence III [ABSTRACT FROM AUTHOR]

Effective control of tuberculosis (TB) depends on early diagnosis of disease, yet available tests are unable to perfectly detect infected individuals. In novel hosts diagnostic testing methods for TB are extrapolated from other species, with unknown accuracy. The primary challenge to evaluating the accuracy of TB tests is the lack of a perfect reference test. Here we use a Bayesian latent class analysis approach to evaluate five tests available for ante-mortem detection of pulmonary TB in captive sun bears and Asiatic black bears in Southeast Asia. Using retrospective results from screening of 344 bears at three rescue centres, we estimate accuracy parameters for thoracic radiography, a serological assay (DPP VetTB), and three microbiological tests (microscopy, PCR (Xpert MTB/RIF, Xpert MTB/RIF Ultra), mycobacterial culture) performed on bronchoalveolar lavage samples. While confirming the high specificities (≥ 0.99) of the three microbiological tests, our model demonstrated their sub-optimal sensitivities (<0.7). Thoracic radiography was the only diagnostic method with sensitivity (0.95, 95% BCI: 0.76, 0.998) and specificity (0.95, 95% BCI: 0.91, 0.98) estimated above 0.9. We recommend caution when interpreting DPP VetTB results, with the increased sensitivity resulting from treatment of weakly visible reactions as positive accompanied by a drop in specificity, and we illustrate how the diagnostic value of weak DPP VetTB reactions is particularly reduced if disease prevalence and/or clinical suspicion is low. Conversely, the reduced utility of negative microbiological tests on bronchoalveolar lavage fluid samples when prevalence and/or clinical suspicion is high is demonstrated. Taken together our results suggest multiple tests should be applied and accompanied by consideration of the testing context, to minimise the consequences of misclassification of disease status of bears at risk of TB in sanctuary settings. [ABSTRACT FROM AUTHOR]

Objective: The rising prevalence of cardiovascular diseases (CVD) remains a global concern. In Nigeria, the current prevalence of CVD was 76.11% with its attendance burden. The CVD risk perception of individuals is a precursor to the desired lifestyle modification necessary for CVD prevention and management. This study assessed the CVD risk perception and sociodemographic determinants among rural and urban dwellers in southwest Nigeria. Methods: The study employed a convergent parallel mixed-methods design involving concurrent data collection. The participants' CVD risk perception was obtained using the Perception of Risk of Heart Disease Scale (quantitative data) and a validated focus group discussion (FGD) guide (qualitative data). Quantitative analysis was completed using descriptive statistics, Phi, Cramer's V, and multivariate linear regression, while the FGD was thematically analysed. Results: The quantitative study involved 1,493 participants (62.4% women) with a mean age of 46.90±15.65 years, while the FGD involved 53 participants (52.8% women) with a mean age of 50.10±13.5 years. Over a quarter (28%) of the participants had a poor CVD risk perception; the mean score was 44.40±8.07. Rural residents had a significantly poorer CVD risk perception than their urban counterparts (Mean difference = -3.16, p<0.001). Having tertiary education (β = 0.100, p < 0.001), living in urban areas (β = 0.174, p<0.001), and living in Lagos (β = 0.074, p = 0.013) and in Oyo, other than Ogun state (β = -0.156, p<0.001) significantly predicted having a good perception of CVD risk. FGD produced three themes: knowledge about CVD, CVD risk factors, and CVD prevention. Conclusion: Participants had a fair understanding of the causes and prevention of CVD. Yet, a substantial portion underestimated their own risk of developing CVD, particularly rural dwellers and people with lower education. More public health education is required to improve the CVD risk perception in southwestern Nigeria. [ABSTRACT FROM AUTHOR]

Few national studies have examined the community prevalence of ICD-11 posttraumatic stress disorder (PTSD) and Complex PTSD (cPTSD) symptoms, and their relationship with functioning. A nationally representative Danish sample (n = 689) provided data on trauma exposure. Participants who had experienced at least one traumatic event (n = 470) further provided self-reported data on ICD-11 PTSD and cPTSD, personality, and psychosocial functioning. Mediation analyses and linear regression models investigated the impact of impaired personality functioning, and the severity of PTSD/cPTSD on psychosocial functioning. Despite two-thirds reporting trauma exposure, PTSD and cPTSD prevalence was low (4.7% and 1.9%). Higher severity correlated with lower psychosocial functioning. The influence of impaired personality functioning post-trauma was limited. Replication of findings in clinical samples is warranted. [ABSTRACT FROM AUTHOR]

Background Pelvic floor dysfunction (PFD) occurs when muscles of the pelvic floor become weakened, impaired, or experience tension leading to a variety of complications. Due to the reactive nature and high demands of many sports, athletes are at increased susceptibility and of particular interest concerning PFD. Hypothesis/Purpose The purpose of this study was to explore the prevalence of PFD among college-aged athletes, assess how PFD impacted athletic performance, and identify contributing factors for increased likelihood of PFD in athletes. Study Design Cross-Sectional Study Methods All fully active LVC NCAA Division 3 athletes were recruited for screening for PFD using the Cozean Pelvic Dysfunction Screening Protocol and were surveyed on their self-knowledge of PFD. Athletes who scored > 3 on this tool completed an additional survey, created by the investigators, to identify the impact PFD had on their athletic performance and personal life and were then randomly assigned to one of three investigators to undergo a noninvasive coccygeal assessment to determine underactive, overactive, or normal pelvic floor muscle (PFM) activity. Results Fifty-three Division III male and female athletes between the ages of 18-25 years old participated in the study. Statistically significant differences were found between Cozean scores and demographic factors of age (p <0.001), gender (p <0.05), self-knowledge of PFD (p <0.001), and sport (p <0.001) among all participants that contributed to the increased likelihood of PFD. Thirteen athletes scored > 3 on the Cozean with the 92.3% experiencing under/over active PFM activity and the majority indicating that PFD significantly impacted their athletic performance and quality of life. Conclusion The results indicate that older female NCAA Division III college athletes who participate in swimming and who possess self-knowledge of PFD are more likely to experience PFD. Additionally, these athletes are likely to encounter a significant impact on their athletic performance and quality of life. These results provide preliminary evidence on the need of PFD awareness and assessment among college athletes. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the association of Time In Range (TIR) obtained from Blood Glucose Monitoring (BGM) with Cognitive Impairment (CI) inpatients with middle-aged Type 2 Diabetes Mellitus (T2DM) and further explored whether a TIR goal for T2DM in adults with > 70% possess a protective effect on cognitive function. Research design and methods: A total of 274 inpatients with T2DM aged 40–64 years, who underwent seven-point BGM (pre meals and 120 min post meals and at bedtime) were recruited in this cross-sectional study. TIR was defined as the percentage of blood glucose within the target range of 3.9-10.0mmol/L. Subjects were divided into Normal Cognitive Function (NCF) (n = 160) and CI (n = 114) groups according to the results of the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). The association of TIR and other glycemic metrics, calculated from seven-point BGM data, with cognitive dysfunction was analyzed. Results: The prevalence of CI was 41.6% in patients with middle-aged T2DM (median age 58 years). TIR was lower in CI group than in NCF group (28.6% vs. 42.9%, P = 0.004). The prevalence of CI decreased with ascending tertiles of TIR (p for trend < 0.05). Binary logistic regression analysis showed a significant association between TIR and CI (odds ratio [OR] = 0.84, p < 0.001) after adjusting for confounders (age, education, marital status, age at Diabetes Mellitus (DM) onset, cerebrovascular disease). Further adjustment of Standard Deviation (SD)(OR = 0.84, p = 0.001) or Coefficient of Variation (CV)(OR = 0.83, p < 0.001), TIR was still associated with CI. While a TIR goal of > 70% probably possessed independent protective effect on cognitive function (OR = 0.25, p = 0.001) after controlling for confounders above. Conclusions: TIR obtained from BGM was related to CI in middle-aged T2DM individuals and a TIR goal of > 70% probably possessed a protective effect on cognitive function for middle-aged T2DM. [ABSTRACT FROM AUTHOR]

Purpose: Nursing is a representative profession with a high prevalence of presenteeism, which is usually associated with negative outcomes. Therefore, it is important to explore the antecedent factors of nurse presenteeism behavior. This study aims to explore the impact and mechanism of head nurses' cognitive preference toward presenteeism on subordinate nurses' presenteeism (SNP), and the mediation effects of subordinate nurses' perception of head nurses' cognitive preference. Patient and Methods: A cross‐sectional study was conducted from July to August 2022. A total of 256 head nurses and 1424 subordinate nurses were recruited from six hospitals located in Zhengzhou, Henan Province, China. The Nurse Presenteeism Questionnaire (NPQ) and Cognitive Preference Questionnaire were used to assess head nurses' cognitive preference toward presenteeism, SNP, and subordinate nurses' perception of head nurse's cognition of presenteeism. We conducted description, multilevel correlation, and multilevel structural equation models for the data analysis. Results: In the past 6 months, 93.4% of nurses experienced presenteeism. Within and between the team, head nurses' cognitive preference toward presenteeism is positively associated with SNP. The mediation effect of nurses' perception of head nurses' cognitive preference was also significant. Conclusion: Head nurses' cognitive preferences are essential predictors of subordinates' presenteeism. In this process, subordinates' subjective initiative plays a crucial role. Implications for Nursing Management: Hospital managers should focus on head nurses' values to formulate multiple interventions of presenteeism and strengthen communication between leaders and subordinates to promote transforming negative outcomes into positive outcomes. [ABSTRACT FROM AUTHOR]

Aim: The faecal immunochemical test (FIT) is now widely used in English primary care to triage people who exhibit signs or symptoms of colorectal cancer (CRC). National guidelines for FIT implementation were based on data that acknowledged limitations. This study examines FIT accuracy in primary care patients with low‐ and high‐risk symptoms of CRC. Methods: This study describes a retrospective cohort study in South Yorkshire, UK (n = 2029). Consecutive symptomatic adult patients in primary care undergoing a FIT between 01/04/2021 and 30/04/2021 were assessed. A threshold > 10 μg Hb/g was defined as a positive FIT result. Lower gastrointestinal tract (LGI) investigations were the reference standard. Follow‐up over 24 months was used to identify serious colorectal diseases (CRC, high‐risk polyps and inflammatory bowel disease [IBD]). Results: Five hundred and fifteen (25.4%) patients had a positive FIT. The CRC prevalence was 1.2% (24/2029). Nineteen (79.1%) of the 24 CRC cases had NG12 symptoms, with two (8.3%) having a negative FIT. For CRC detection, FIT showed 91.7% sensitivity (95% CI: 71.5%–98.5%), 75.4% specificity (95% CI: 73.4%–77.2%), 4.3% positive predictive value (PPV) (95% CI: 2.8%–6.5%) and 99.9% negative predictive value (NPV) (95% CI: 99.5%–99.97%). Combining CRC, high‐risk polyps and IBD increased PPV and specificity but decreased sensitivity and NPV. Conclusions: In primary care, FIT safely triages patients having at‐risk CRC risk symptoms. Negative FIT results indicate a low likelihood of CRC and supports safety‐netting interventions. [ABSTRACT FROM AUTHOR]

Great disparity is observed among studies investigating the prevalence of PTSD after burns. This systematic review and meta-analysis aimed to explore the pooled prevalence of PTSD in adult burn survivors over the first two years post-burn. Five electronic databases were searched for observational studies assessing the prevalence of PTSD symptoms after burns. Meta-analysis was performed using an auto-correlation and hierarchical effects model to estimate the course of PTSD prevalence rates over time and to establish point-prevalences. The effect of different moderators over time was tested with meta-regression. Thirty-two studies were included in the meta-analysis. The overall pooled prevalence of PTSD was 20.5% (95% CI 16.4–24.6) and the prevalence significantly decreased by about 0.37% per month post-burn over time. Questionnaire-based studies, and studies published from 2000 onwards, were more likely to show a decrease in PTSD prevalence over time compared to diagnostic studies and studies before 2000. A qualitative comparison revealed that inter-continental differences are likely to be complex and multi-factorial. PTSD affects about one in five burn survivors, with moderately decreasing rates from six months post-burn onwards. Early screening and identification of burn survivors who require specialist psychological care are vital for burns services. [ABSTRACT FROM AUTHOR]

Background: Diabetes management poses significant challenges worldwide, with individuals often facing increased risks of mental health issues, including suicidal behaviors. While traditional statistical methods have been used to assess risk factors, this study introduces machine learning techniques to predict suicidal behaviors among diabetic patients. Therefore, this study aims to investigate the prevalence and risk factors of suicidal behaviors among individuals with diabetes in Bangladesh using both traditional statistical methods and machine learning models. Methods: A cross‐sectional study was carried out with 390 diabetic patients, assessing demographic characteristics, diabetes‐related variables, mental health indicators, and suicidal behaviors. Statistical analyses including chi‐square tests and logistic regression, and various machine learning models, were employed to examine associations and predict risk factors. Results: This study found that 13.8% of the individuals with diabetes reported lifetime suicidal behavior and 9.0% reported past‐year suicidal behavior. Significant risk factors associated with higher rates of suicidal behaviors included younger age, marital status, lower monthly income, higher educational attainment, being insulin users, not having a family history of diabetes, and suffering from anxiety. Among the machine learning models tested, the CatBoost model outperformed others, obtaining low log loss values of 0.45 and 0.32 for lifetime and past‐year suicidal behaviors, respectively. CatBoost demonstrated excellent accuracy rates of 83.97% and 88.46%, significantly higher than those of traditional logistic regression models. The most significant predictors identified by machine learning were treatment type, followed by occupation, anxiety, age group, and having chronic diseases. Conclusion: The findings suggest the urgent need for comprehensive interventions and support systems for individuals managing diabetes, particularly those at higher risk of suicidal behaviors. Machine learning offers improved predictive power and the ability to identify complex patterns in risk factors. Collaborative efforts between healthcare providers, mental health professionals, and public health initiatives are essential for prioritizing mental well‐being in diabetes management. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) are at higher risk of contracting hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Currently, there is no estimate of pooled data on the prevalence of HBV and HCV infections among HCWs in the country. Thus, this review aimed to determine the pooled prevalence of hepatitis B and C infections among HCWs in Ethiopia. Materials and methods: A comprehensive literature search was conducted using electronic databases, including PubMed, Cochrane Library, Science Direct, Hinari, and African Journals Online to identify pertinent articles from the inception to April 2024. The protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42024527940) and conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted independently by two authors and analyzed using STATA version 11 software. A random-effect model and Egger's test were computed to estimate the pooled prevalence and assess publication bias, respectively. Results: A total of 18 studies involving4,948 healthcare workers were included in this review to estimate the pooled prevalence of HBV and HCV infections among HCWs in Ethiopia. The overall prevalence of HBV was 5.93% (95% CI; 3.22–8.63). The sub-group analysis showed that the prevalence of HBV among medical waste handlers and health professionals was8.6% (95% CI; 3.01–14.13) and 4.98% (95% CI; 1.85–8.11), respectively. The combined prevalence of HCV was 1.12% (95% CI; -4.19–6.43). In the sub-group analysis, the prevalence of HCV among medical waste handlers and health professionals was1.44% (95% CI; -5.28–8.18) and 0.59% (95% CI; -8.09–9.27), respectively. Conclusion: In this review, we found a higher (5.93%) and moderate (1.12%) prevalence of HBV and HCV infections, respectively among Ethiopian HCWs. Therefore, to reduce the infectious burden of HBV and HCV among HCWs; there is a need to strict adherence to infection prevention and control measures. In addition, adequate HBV vaccination coverage for HCWs is mandatory to reduce the burden of HBV infection in the country. [ABSTRACT FROM AUTHOR]

Background: In low‐income countries, such as Ethiopia, home birth is the main cause of maternal and neonatal mortality. Several separate studies have been conducted on the prevalence of home birth preference. However, there is no pooled prevalence of home birth preferences. So, this systematic review and meta‐analysis is aimed at assessing the overall preference for home birth and related factors among Ethiopian women. Methods and Materials: The review included only published articles. Medline/PubMed, Web Science, Google Scholar, Scopus, and the Cochrane Library are the main databases. The review includes cross‐sectional studies in English that meet eligibility requirements. The combined prevalence of women's preference for home birth is calculated by random effect models. In addition, Egger's tests and funnel diagrams were used to investigate publication biases. STATA Version 14 is used to perform all statistical analyses. Results: The review included 14 studies with 6631 participants. In Ethiopia, the prevalence of women's preference for home birth was 41.48% (confidence interval (CI): 49.99; 63, 56; I2:98.7%; p ≤ 0.001). In the analysis of the subgroups, the Oromia region had the highest home birth preference rate at 61.40% (55.54%, 67.16), while southern Ethiopia had the lowest value at 20.52% (5.18, 29.75). The probability of preferring home birth was higher for women without education (OR = 0.22, p ≤ 0.001, I2 = 69.7%) and for younger women (ODR = 0.47, p ≤ 0.001, I2 = 84.2%). Conclusion: According to the study, 41% of Ethiopian women prefer home births over institutional births. Age and education of women are statistically important factors in the choice of birthplace. To solve this problem, health professionals and other stakeholders are strongly encouraged to provide women's health education at the community and institutional levels. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is a genetically inherited disorder characterized by a wide range of clinical manifestations and genetic variations. This study focuses on the genetic and molecular epidemiology of CF in the Russian population, utilizing data from the national CF registry. The birth prevalence of CF in Russia has been analyzed over a span of years, revealing variations in frequency. The study delves into the genetic landscape of CFTR gene variants in Russian patients, showcasing a diverse spectrum with a predominance of severe variants, some of which are rare and distinct from global populations. A total of 233 variants have been documented, exhibiting frequencies ranging from 0.01% to 51.5%, with 47 of these variants remaining uncharted within international genetic databases. As of 2021, CFTR modulator therapy has been introduced for patients under 19 years, heightening the importance of genetic diagnosis. In 2023, more than 1,850 patients under 19 received CFTR modulator therapy. Notably, the impact of complex alleles on disease progression and response to targeted therapies is gaining recognition. Comparisons with European registries highlight distinctive features of the Russian population, such as differences in age distribution among patients. Additionally, the study emphasizes the need to ascertain clinical significance and pathogenicity of newly identified genetic variants, along with exploring their suitability for targeted therapies. The integration of genetic insights into the management of CF offers potential for enhanced personalized therapeutic interventions. In conclusion, this thorough analysis provides a comprehensive understanding of the genetic nuances within the Russian CF population. By illuminating the intricate relationship between genetic variations and disease manifestation, the study underscores the essential role of genetics in shaping therapeutic strategies and improving patient outcomes. Further research and ongoing genetic exploration are crucial for optimizing the care of individuals with CF in the era of evolving therapeutic options. [ABSTRACT FROM AUTHOR]

Background: This study aims to analyze the historical trends of inflammatory bowel disease (IBD) burden in the elderly from 1990 to 2021 and forecast future trends up to 2051. Methods: Data from the Global Burden of Disease Study 2021 were utilized. Age-standardized rates (ASR) for incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were calculated. Estimated annual percentage changes (EAPCs) were computed to quantify temporal trends. A Bayesian Age-Period-Cohort model was employed to project future trends. Results: From 1990 to 2021, the global number of elderly IBD increased from 573,500 to 1,278,190. The age-standardized incidence rate (ASIR) rose from 8.01 to 8.77 per 100,000, while the age-standardized prevalence rate (ASPR) slightly decreased from 118.14 to 117.29 per 100,000. Death number increased from 14,400 to 33,490, but the age-standardized mortality rate decreased from 3.21 to 2.84 per 100,000. DALYs increased from 324,100 to 683,750, with the age-standardized DALYs rate declining from 68.78 to 60.88 per 100,000. Significant geographical variations were observed, with high Socio-demographic Index regions showing the highest burden. Projections suggest that by 2051, elderly IBD prevalence number may reach 2,316,000, with ASIR and ASPR potentially rising after 2035 and 2042, respectively. Deaths and DALYs are projected to increase to 75,000 and 1,401,000 respectively, despite continued declines in ASRs. Conclusion: The absolute burden of IBD in the elderly population is projected to increase substantially by 2051, despite decreasing ASRs. These findings underscore the need for tailored healthcare strategies and resource allocation to address the growing challenge of elderly IBD globally. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of mental health disorders in the United Kingdom necessitates the exploration of novel treatment modalities. This study aimed to assess the feasibility and acceptability of conducting a randomised controlled trial (RCT) evaluating the efficacy of four osteopathic interventions on psychophysiological and mental health outcomes. Methods: A mixed-methods feasibility study with an explanatory sequential design was implemented. The quantitative phase involved randomising 42 participants into four intervention groups: (1) high-velocity and articulation techniques (HVAT), (2) soft-tissue massage (STM), (3) craniosacral therapy (CST), and (4) a combination approach. Primary outcome measures encompassed recruitment rate, assessment duration, questionnaire completion, intervention attrition, and adverse events. Secondary outcomes included validated assessments of depression, anxiety, stress, psychological flexibility, heart rate variability (HRV), and interoception, administered pre- and post-intervention. Analysis of variance (ANOVA) was employed to evaluate pre-post intervention changes. The qualitative phase comprised semi-structured interviews analysed using thematic analysis. Results: The study achieved a recruitment rate of 21 eligible participants per month, with 54.8% of respondents meeting eligibility criteria. All 33 participants who completed the study underwent interventions and assessments within the allocated one-hour timeframe, with full questionnaire completion. The attrition rate was 21%. No adverse events were reported. Qualitative analysis revealed positive participant experiences, with themes highlighting good practitioner communication, intervention accessibility, and increased bodily awareness. Some participants found the questionnaire battery burdensome. Exploratory quantitative analyses showed variations in effects across interventions for heart rate variability, interoceptive accuracy, and mental health measures, but these results should be interpreted cautiously due to the small sample size. Conclusions: This study provides evidence supporting the feasibility and acceptability of a larger-scale RCT investigating osteopathic interventions for individuals presenting with mild psychological symptoms. The preliminary findings suggest potential efficacy in improving mental health outcomes, warranting further investigation. Trial registration NCT05674071, registered 06/01/2023. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that overall sleep quality among Chinese nurses is relatively low, with a sleep disorder prevalence rate of approximately 66.4%. Against the backdrop of healthcare reforms, China has been striving to improve the mental health and sleep quality of nurses. Stress mindset can influence how individuals respond to stress, but there is limited research on how stress mindset affects nurses' sleep quality. This study aims to explore the impact of stress mindset on sleep quality among nurses, as well as the mediating roles of stress overload and anxiety in this relationship. Methods: The study was conducted online using a questionnaire from February 18 to February 22, 2024. It utilized the Stress Mindset Measure (SMM), the Stress Overload Scale-Short (SOS-S), the Generalized Anxiety Disorder 7-item scale (GAD-7), and the Pittsburgh Sleep Quality Index (PSQI) to survey 441 nurses in three regions of China: Chongqing, Hunan, and Shandong (M = 34.39, SD = 7.82, 95.7% female). A chain mediation model was employed to examine the mediating roles of stress overload and anxiety in the relationship between stress mindset and sleep quality. Results: The participants' average sleep quality score was 7.18 ± 3.47. Nurses' stress mindset was significantly negatively correlated with both stress overload and anxiety, and significantly positively correlated with sleep quality. Stress overload was significantly positively correlated with anxiety and significantly negatively correlated with sleep quality. Anxiety was also significantly negatively correlated with sleep quality. The direct effect of nurses' stress mindset on sleep quality was significant (effect size = -0.10, 95% CI: -0.19 to -0.01), as were the indirect effects through stress overload (effect size = -0.05, 95% CI: -0.11 to -0.01) and anxiety (effect size = -0.09, 95% CI: -0.13 to -0.05), along with their chain mediation effect (effect size = -0.10, 95% CI: -0.14 to -0.06). Conclusion: Our study demonstrates that a higher level of nurses' stress mindset is associated with better sleep quality, with stress overload and anxiety mediating this relationship. A positive stress mindset helps nurses cope more effectively with professional challenges and reduces anxiety, leading to improved sleep quality. Healthcare institutions should therefore prioritize fostering positive stress mindsets in nurses, encouraging regular psychological training and workshops to support the development of effective coping strategies. [ABSTRACT FROM AUTHOR]

Background: Neck pain and primary headache disorders are highly prevalent in populations and clinical cohorts. Medication-overuse headache (MOH) is a treatable secondary headache, mainly developing in migraine sufferers, that accounts for the majority of patients presenting to headache clinics. Nevertheless, the association between neck pain and MOH has not been reported. This study evaluated the prevalence and clinical course of neck pain in patients with MOH before and after MOH treatment. Methods: We analyzed 635 MOH patients enrolled in a nationwide, prospective, multicenter MOH registry. Demographics and clinical data were collected at baseline and 3 months to evaluate changes in the status and severity of neck pain and headache. Severity of neck pain was graded into 4 groups, and severe neck pain was defined as grade 3 or 4. Results: Among 635 patients with MOH, 366 (57.6%) reported neck pain at baseline. MOH patients with neck pain had an earlier onset of their primary headache disorder (23.4 ± 12.7 vs. 26.2 ± 13.3 years, p = 0.007). Although monthly headache days were comparable between the patients with neck pain and those without neck pain, the neck pain group had higher levels of anxiety (7.4 ± 5.8 vs. 6.4 ± 5.4, p = 0.017), more severe cutaneous allodynia (2.4 ± 3.3 vs. 1.8 ± 3.0, p = 0.038), and poorer quality of life (171.7 ± 70.4 vs. 184.0 ± 68.9, p = 0.029). At 3 months, 456 (71.8%) were followed-up, and 257 (56.4%) were recovered from MOH. Compared to the baseline, the proportion of severe neck pain (40.4% vs. 19.4%, p < 0.001) was decreased. The proportion of severe neck pain was much lower in patients with recovery from MOH compared to those without (4.7% vs. 15.1%, p < 0.001). Conclusions: Neck pain in MOH patients was associated with earlier onset of headache, higher levels of anxiety and allodynia, and poorer quality of life. Improvement in neck pain improvement was linked to recovery from MOH. These findings suggest the potential importance of integrating and management of neck pain into clinical practice for MOH. [ABSTRACT FROM AUTHOR]

Background: The prevalence of steatotic liver disease (SLD) in patients with type 2 diabetes (T2DM) exceeds 50%. This study aimed to investigate the clinical characteristics of SLD and liver fibrosis in Chinese patients with T2DM. Methods: Inpatients from 2021 to 2023 were included in the study. Fatty liver index (FLI) and fibrosis-4 (FIB-4) were calculated to assess hepatic steatosis and fibrosis respectively. Statistical analysis was completed by SPSS v25 and GraphPad Prism v8.0.1. Results: Of the 1466 participants, about one-third of the patients in T2DM-SLD group were diagnosed with liver fibrosis (LF), and the percentage of patients over 50 years old was 85.9%. Patients with SLD had higher levels of BMI, blood pressure, liver enzymes, fasting blood glucose (FBG), HbA1c, C-peptide, total cholesterol (TC) and triglyceride (TG) (P<0.05 for all). Patients with liver fibrosis had lower TC, TG, hemoglobin (Hb), erythrocyte count (RBC), leukocyte count (WBC) and platelet (PLT) levels (P<0.05 for all). Compared with simple T2DM and SLD-NLF (non-liver fibrosis) groups, for patients over 50 years old, the prevalence of coronary heart disease, stroke, tumor, and diabetic nephropathy was higher in patients with liver fibrosis. Liver fibrosis might be the risk factor of arterial stiffness, stroke, coronary heart disease and numbness based on multivariable logistic regression analysis. Conclusion: Hepatic steatosis and fibrosis were common in patients with T2DM. Liver fibrosis was relevant to many macrovascular and microvascular diabetic complications. [ABSTRACT FROM AUTHOR]

Background: Turnover intention (TI) indicates an employee's intention to depart from their current role within a defined timeframe. In China, the Targeted Admission Medical Education (TAME) program, initiated in 2010, offers tuition-free education to cultivate rural doctors. Despite continuous professional development (CPD) being considered a viable retention strategy, TI of alumni doctors from the TAME program remains high in recent years. This study aims to describe the prevalence of "turnover intention" among alumni doctors of the TAME program doctors in rural placements, and associated factors that predict high turnover intention. Methods: A snowball sampling method was adopted to collect survey responses from 1,369 alumni doctors of the TAME program in Jiangxi Province, China. Based on the survey data, a binary variable was constructed to measure the turnover intention, and multivariate binary logistic regression models were used to investigate the relationship between doctors' turnover intention and demographic characteristics, work environment characteristics, and CPD activities. Results were presented using adjusted odds ratios with 95% confidence intervals. Results: Among the 1,369 alumni doctors of the TAME program surveyed in this study, 392 (28.6%) expressed intentions to leave their current positions. Of the respondents, 620 (45.3%) were female, and 930 (67.9%) were married. Additionally, 1,232 respondents (90%) indicated that their fathers were engaged in farm work. Strong associations with turnover intention were notably found among individuals who had undergone training at a higher-level healthcare institution for more than three months (aOR = 6.810, 95% CI: 3.333 to 13.909, p-value < 0.001), particularly those who had participated in CPD through a graduate degree program (aOR = 1.818, 95% CI: 1.272 to 2.597, p-value < 0.001). Conclusion: Rural doctors in China from the tuition-free medical education program exhibit high turnover intention, especially those in graduate degree programs as CPD. To retain these highly qualified rural doctors, it is vital to offer competitive efficiency wages aligned with their skills and provide ample long-term career growth opportunities within the rural healthcare system. Highlights: Retaining rural doctors in China who graduated from the tuition-free medical education program continues to pose a significant challenge. High turnover intention is particularly prevalent among those enrolled in CPD graduate degree programs. Offering competitive efficiency wages and creating abundant long-term career growth opportunities within the rural healthcare system are essential measures. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Methods Results Conclusions Drug‐induced liver injury (DILI) is a major global health concern resulting from adverse reactions to medications, supplements or herbal medicines. The relevance of DILI has grown with an aging population, the rising prevalence of chronic diseases and the increased use of biologics, including checkpoint inhibitors. This article aims to summarise current knowledge on DILI epidemiology and risk factors.This review critically appraises available evidence on DILI frequency, outcomes and risk determinants, focusing on drug properties and non‐genetic host factors that may influence susceptibility.DILI incidence varies across populations, with hospitalised patients experiencing notably higher rates than outpatients or the general population. Increased medication use, particularly among older adults and women, may partly explain age‐ and sex‐based disparities in DILI incidence and reporting. Physiological changes associated with aging likely increase susceptibility to DILI in older adults, though further exposure‐based studies are needed for definitive conclusions. Current evidence does not strongly support that women are inherently more susceptible to DILI than men; rather, susceptibility appears to depend on specific drugs. However, once DILI occurs, older age and female sex are associated with greater severity and poorer outcomes. Other less‐studied host‐related risk factors are also discussed based on available evidence.This article summarises existing data on DILI frequency, outcomes, drug properties affecting hepatotoxicity and non‐genetic host risk factors while identifying critical knowledge gaps. Addressing these gaps through future research could enhance understanding and support preventive measures. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aim Methods Results Conclusion Coeliac disease (CD) is common in patients with type 1 diabetes (T1D), but prevalence varies globally due to differing screening protocols. There have been substantial changes in screening guidelines over the past two decades.To evaluate CD prevalence in patients with T1D, focusing on screening studies using antitissue transglutaminase (anti‐tTG) antibody.We searched PubMed, Web of Science, Embase and Scopus for studies published up to 11 December 2023 using keywords related to CD and diabetes. We used random‐effects models for overall prevalence and all subgroups, with heterogeneity assessed using Cochran's Q test and the I2 statistic performed in STATA 18.We included 106 articles involving 65,102 T1D patients across 40 countries. The pooled CD seroprevalence and confirmed CD prevalence were 9% (95% confidence interval, CI, 8%–10%) and 6% (95% CI 5%–7%), respectively. The prevalence was higher in females and children. Denmark, Saudi Arabia and Libya exhibited the highest prevalence (11%), followed by India and Egypt (10%). Belgium, France, Germany, South Africa and the United States had the lowest prevalence (2%). High‐income countries showed significantly a lower CD prevalence than middle‐income countries (p = 0.03). Meta‐regression based on the Human Development Index (HDI) indicated that countries with higher HDI have lower seroprevalence and confirmed CD prevalence.Approximately 1 in 16 patients globally and 1 in 12 patients in Asia and the Middle East with T1D has CD. We suggest that all patients with T1D should be screened for CD. [ABSTRACT FROM AUTHOR]

Genome-wide association studies (GWAS) provide valuable insights into the genetic architecture of complex traits, yet interpreting their results remains challenging due to the polygenic nature of most traits. Gene set analysis offers a solution by aggregating genetic variants into biologically relevant pathways, enhancing the detection of coordinated effects across multiple genes. In this study, we present and evaluate a gene set prioritization approach utilizing Bayesian Linear Regression (BLR) models to uncover shared genetic components among different phenotypes and facilitate biological interpretation. Through extensive simulations and analyses of real traits, we demonstrate the efficacy of the BLR model in prioritizing pathways for complex traits. Simulation studies reveal insights into the model's performance under various scenarios, highlighting the impact of factors such as the number of causal genes, proportions of causal variants, heritability, and disease prevalence. Comparative analyses with MAGMA (Multi-marker Analysis of GenoMic Annotation) demonstrate BLR's superior performance, especially in highly overlapped gene sets. Application of both single-trait and multi-trait BLR models to real data, specifically GWAS summary data for type 2 diabetes (T2D) and related phenotypes, identifies significant associations with T2D-related pathways. Furthermore, comparison between single- and multi-trait BLR analyses highlights the superior performance of the multi-trait approach in identifying associated pathways, showcasing increased statistical power when analyzing multiple traits jointly. Additionally, enrichment analysis with integrated data from various public resources supports our results, confirming significant enrichment of diabetes-related genes within the top T2D pathways resulting from the multi-trait analysis. The BLR model's ability to handle diverse genomic features, perform regularization, conduct variable selection, and integrate information from multiple traits, genders, and ancestries demonstrates its utility in understanding the genetic architecture of complex traits. Our study provides insights into the potential of the BLR model to prioritize gene sets, offering a flexible framework applicable to various datasets. This model presents opportunities for advancing personalized medicine by exploring the genetic underpinnings of multifactorial traits. Author summary: Our study introduces a new method for prioritizing biological pathways in complex diseases using Bayesian Linear Regression (BLR) models. Genome-wide association studies (GWAS) have significantly advanced our understanding of complex traits, but interpreting their results remains challenging due to their complexity. Our method addresses this challenge by integrating genetic variants into biologically relevant pathways, aiding in identifying coordinated effects across multiple genes. Through simulations and analyses of real traits, including type 2 diabetes (T2D) and related phenotypes, we demonstrate the effectiveness of the BLR model in prioritizing pathways associated with complex traits. Our study provides insights into the model's performance under various scenarios and highlights its ability to identify significant associations with T2D-related pathways. Furthermore, our findings suggest that our approach could inspire future research in genetics by offering a robust framework for gene set prioritization. This could potentially lead to advancements in personalized medicine by enhancing our understanding of the genetic basis of complex diseases. [ABSTRACT FROM AUTHOR]

Background: Allergic conjunctivitis is a prevalent ocular condition characterized by inflammation of the conjunctiva due to hypersensitivity reactions to various allergens. Understanding its epidemiology and clinical characteristics is crucial for effective management and public health interventions. Methods: This cross-sectional study investigated the prevalence, triggers, and associated factors of allergic conjunctivitis among residents of the Southern region of Saudi Arabia. Data were collected using a structured questionnaire administered through Google Forms. Statistical analysis was performed using IBM SPSS, including descriptive statistics and bivariable/multivariable analyses. Results: A total of 693 participants were recruited through convenience sampling via online platforms. Among the participants, 73.9% reported ocular symptoms, while 26.1% did not. Dust emerged as the most common trigger for ocular symptoms (32.9%), followed by eye drops/contact lenses (8.7%), animal dander (6.9%), and chemicals (5.8%). Notably, 39.7% reported experiencing ocular symptoms throughout the year. Despite the prevalence of ocular symptoms, only 26.7% consulted an ophthalmologist. Multivariable analysis revealed that gender and seasonal variation in symptoms were associated with allergic conjunctivitis diagnosis. Females showed a lower odds ratio (OR) of being diagnosed with allergic conjunctivitis compared to males (OR: 0.62, 95% CI: 0.29–1.31), and participants experiencing symptoms with no specific season had significantly lower odds of being diagnosed with allergic conjunctivitis (OR: 0.28, 95% CI: 0.11–0.72). A history of allergic rhinitis demonstrated a strong positive association with allergic conjunctivitis diagnosis (OR: 3.77, 95% CI: 1.83–7.75). Conclusion: The study highlights the considerable burden of allergic conjunctivitis and the underutilization of healthcare services among affected individuals in the Southern region of Saudi Arabia. Tailored interventions and increased awareness are essential for effective management and mitigation of allergic conjunctivitis's impact on affected individuals and healthcare systems. [ABSTRACT FROM AUTHOR]

Background and aim: The burden of orofacial clefts (OFCs) has declined globally except in sub-Saharan Africa, with a great disease burden in North Africa. Children with OFCs have a high risk of malnutrition, and African countries have some of the highest malnutrition rates. This scoping review assessed the status of research on OFCs and nutrition and feeding among children living in African countries. Methods: We followed the Joanna Briggs Institute guidelines for conducting scoping reviews. We searched eleven databases for articles on malnutrition and feeding among children with OFCs living in African countries. No restriction was done by type of study or publication date. Books, book chapters, and reviews were excluded. Only publications in English language were included. We extracted information about the publication year, study design, setting, location, participants' age, data collection methods, international collaboration, and funding. We classified articles into studies assessing (1) the impact of nutritional deficiencies during pregnancy on OFCs, (2) the impact of OFCs on malnutrition, (3) feeding problems in children with OFCs, and (4) the impact of nutritional status on OFCs repair outcomes. We calculated frequencies and used bar charts and a map. Results: Out of 208 search results, 36 were duplicates, and 25 eventually fit the inclusion criteria, with 52% retrieved from Google Scholar. About 80% of the studies were from four countries: Nigeria, South Africa, Ghana, and Uganda; 72% were hospital-based and 52% were cross-sectional. The most frequent data collection method was clinical examination and questionnaires. Most studies focused on feeding problems in children with OFCs (44%) and the impact of OFCs on malnutrition (32%). International collaboration was observed in six studies, with one study showing South-South collaboration. Only two studies were funded. Conclusions: There is a predominance of under-funded descriptive research not indexed by international databases. Minimal research has been directed to population-level OFC preventive programs in primary healthcare settings and assessing interventions supporting children with OFCs. A research agenda is needed to prioritize research needs and secure funds to support South-South collaboration to address the nutrition and feeding-related problems associated with OFCs. [ABSTRACT FROM AUTHOR]

Porcine deltacoronavirus (PDCoV) is an infectious disease that causes diarrhoea in pigs of different ages; however, piglets are more susceptible. PDCoV was first reported in 2012 in China and Hong Kong. Later, it was first reported in the USA in 2014 and in Mexico in 2019. Several studies have shown that M protein is highly conserved and, therefore, suitable for diagnostic systems. In this study, for the first time, an indirect enzyme‐linked immunosorbent assay (iELISA) based on a recombinant M protein (rM‐PDCoV) was developed to evaluate the seroprevalence of PDCoV in four states in Mexico. High sensitivity (83%) and specificity (100%) were observed for the iELISA. The kappa index calculated a nearly perfect agreement (0.8831) compared to the Western blot (gold standard test), suggesting acceptable statistical value support. In this study, 50.38% of the serum samples from backyard pigs were PDCoV‐positive. The serological comparison showed that PDCoV/PEDV coinfections occurred in 31.98% of the analysed sera. These results can enrich our understanding of how this virus spreads and enable the evaluation of PDCoV infections. Moreover, it highlights the importance of continually investigating the seroprevalence of PDCoV in Mexico because there is also no information about the current prevalence of the disease. [ABSTRACT FROM AUTHOR]

Background and Objectives: South Africa has a high prevalence of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) and to a lesser extent human T‐lymphotropic virus (HTLV). Each of these agents is transfusion‐transmissible (TT) but deciding whether to implement preventive screening depends upon knowledge of background prevalence in transfused patients. We determined the prevalence of HIV, HBV and HTLV I/II among blood transfusion recipients in South African hospitals. Materials and Methods: We obtained identity‐unlinked samples used for blood cross‐matching at 634 South African hospitals served by the South African National Blood Service (SANBS). The ABBOTT Alinity S® Immunochemiluminescent system measured HIV, HBV and HTLV I/II antibodies. Repeatedly reactive samples were confirmed using the Roche Cobas® 8000. Logistic regression was performed to investigate the determinants of associations for HIV, HBV and HTLV infections. Results: The overall prevalences of HIV, HBV and HTLV were 37.8%, 7.4% and 0.6%, respectively. The HIV prevalence in blood recipients was twice as high as general population estimates. Public hospital patients had a significantly higher prevalence compared with private hospital patients for HIV and HBV. HIV prevalence was significantly higher in females, and HBV prevalence was significantly higher in males, excluding the unknown gender results. Conclusion: Patients receiving blood transfusions in South Africa have high rates of HIV and HBV infection that should be taken into consideration when determining donor screening strategies for other viral infections. Measurable prevalence of HTLV indicates endemicity of this infection in South Africa. [ABSTRACT FROM AUTHOR]

Objective: Limited evidence exists regarding the impact of the COVID‐19 pandemic on the onset and trajectory of eating disorders (EDs) among young in Spain. This study aims to analyze the characteristics and recent trends in hospital admissions for EDs within the pediatric population. Methods: A retrospective analysis was conducted on hospital admissions for EDs among patients aged 10–19 years between 2016 and 2022. The main outcomes examined included hospital rates (overall, stratified by ED type and age group), psychiatric comorbidities, and length of stay. Results: A total of 8275 hospitalizations due to EDs were identified, constituting 1 in 6 hospital admissions for mental illness and behavioral disorders. Predominant characteristics of this population included female sex (93%), aged 15–19 years (58.3%), admission primarily for anorexia nervosa (71.6%), and psychiatric comorbidity (35.6%). Hospital admissions for EDs in the pediatric population showed an increasing trend, with an annual average increase of 11.1% (95% CI: 2.6, 22.6). This rise was led by children aged 10–14 years, with a yearly increase in EDs hospitalization rates of 28.4% (95% CI: 13.5, 56.3) since 2019. Each discharge related to EDs was associated with a median stay of 24 days (IQR: 10, 40). Discussion: Efforts in community healthcare should prioritize early detection and intervention for symptoms indicative of EDs in the pediatric population, aiming to mitigate the severity of cases requiring hospitalization. These findings underscore the necessity for targeted health planning policies to address the growing burden of EDs among Spanish youth. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is a paradigmatic case for childhood medicalisation. Critical studies of medicalisation have pointed to the increasing clinical role of schools, with teachers tending to rely on medical treatment of students with ADHD and are perceived as a primary source of diagnostic information. Based on 27 semi‐structured interviews with teachers working in two Israeli elementary and middle schools, this research explored how teachers mediate the medicalisation process and understand their responsibilities in the classroom amidst the emphasis on inclusion in contemporary Israel. We found that teachers offer a wide range of explanations of the disorder and its prevalence, and their attitudes to medication are ambivalent. We argue that teachers develop pedagogical (lay) expertise in the field of ADHD in parallel with and in opposition to medical solutions. Such expertise is based on practical experience and close interaction with students. A top‐down ideological imperative of inclusion, combined with uncertainty about ADHD, has generated a bottom‐up set of preformative practices of 'containment' of troubled students. Teachers' emerging knowledge and practices raise questions about the relationship between medicalisation, policy, expertise and the pragmatic value of medical categories when applied outside the medical establishment. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Intranodal hemangiomas are rare benign vascular tumors of the lymph nodes, often misdiagnosed as malignant lymphadenopathies due to their clinical and radiological features. This case report and systematic review aim to elucidate the epidemiology, clinical profile, and therapeutic interventions for intranodal hemangioma, enhancing diagnostic accuracy and management. Methods: A systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were conducted in PubMed, Scopus, Web of Science, and Google Scholar up to March 15, 2024, using keywords like "intranodal hemangioma," "primary intranodal hemangioma," "nodal hemangioma," "vascular tumor," and "lymph node hemangioma." Inclusion criteria included studies on clinical presentation, diagnostic strategies, and therapeutic interventions for intranodal hemangioma in patients of all ages. Excluded were reviews, opinion pieces, non-English studies, cases of hemangioendothelioma, sclerosing hemangioma, and animal studies. Key aspects analyzed included demographics, clinical presentation, management strategies, and histopathological findings. Results: Our case involves a 3-year-old female with a submandibular mass, initially diagnosed with hemangioma. After no response to beta-blocker therapy and conflicting imaging results, surgical excision was performed. Histopathology confirmed intranodal hemangioma. From 233 records, 19 publications (36 patients, including our case) met the inclusion criteria. The review shows common clinical presentations as painless, slowly enlarging lymph nodes, primarily in the cervical and axillary regions. Diagnostic challenges often require imaging and biopsy to differentiate from malignancies. Conclusion: Recognizing intranodal hemangiomas, particularly in childhood, is crucial to prevent misdiagnosis and inappropriate treatment. The rarity of these tumors in childhood and their clinical presentation similar to malignancies in older patients make diagnosis challenging without widespread awareness. Surgical excision remains the mainstay of both diagnosis and treatment, often leading to favorable outcomes. [ABSTRACT FROM AUTHOR]

• This study includes 596 children with 26.5% having confirmed vitamin A deficiency. • Xerophthalmia is highly prevalent (48.8%) in this study population. • The most common ocular sign in this study population is conjunctival xerosis (38.9%). • Boys and indigenous schoolchildren have higher risk of xerophthalmia. • Overweight/obesity status is associated with a reduced risk of xerophthalmia. • Identified risk factors linked to xerophthalmia aid in targeted intervention efforts. Vitamin A deficiency (VAD) remains a major health issue in developing nations, contributing to preventable childhood blindness. However, there is lack of recent data on xerophthalmia, especially among school-aged children in Malaysia. We hypothesized that xerophthalmia persists among rural schoolchildren in Malaysia and potentially associated with socio-demographic status and malnutrition. We conducted a cross-sectional study on 596 schoolchildren (8-12 years) from ten rural primary schools located in five states across Malaysia. Children meeting the criteria for xerophthalmia assessment included those diagnosed with vitamin A deficiency (VAD) (plasma retinol < 0.70 µmol/L) and marginal VAD (plasma retinol 0.70 to < 1.05 µmol/L). The overall prevalence of xerophthalmia was 48.8%, with the most common ocular sign being conjunctival xerosis (38.9%). The occurrence of xerophthalmia was negatively associated with retinol-binding protein 4 (RPB4) (P =0.003), alpha-carotene (P =0.04), hemoglobin (P =0.004), weight (P =0.02), body mass index (BMI) (P =0.04) and WAZ (weight-for-age z-score) (P =0.04) status. Based on multivariate logistic regression analysis, a higher risk of xerophthalmia was observed in boys (Adjusted odd ratio [AOR]: 1.7, 95% confidence interval [CI]: 1.2-2.5) and Orang Asli (OA, indigenous) schoolchildren (AOR: 2.0, 95% CI: 1.3-3.0), while schoolchildren with overweight/obesity status (AOR: 0.5, 95% CI: 0.3-0.8) were associated with a reduced risk of xerophthalmia. The present study unveils a high prevalence of xerophthalmia among vitamin A-deficient primary schoolchildren in rural areas of Malaysia, especially among the indigenous community. The identified socio-demographic and nutritional factors associated to xerophthalmia would facilitate the implementation of more targeted interventions in addressing these issues. This cross-sectional study included 596 rural primary schoolchildren (8-12 years old) in Malaysia, diagnosed with vitamin A deficiency (VAD) and marginal VAD. Xerophthalmia prevalence was 48.8%, with conjunctival xerosis (38.9%) as the most common sign. Higher risk of xerophthalmia was seen in boys and Orang Asli (indigenous) students, while children with overweight/obesity showed reduced risk. The identified risk factors linked to xerophthalmia could aid in targeted intervention efforts. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives: People with HIV are at increased risk for metabolic dysfunction‐associated steatohepatitis (MASH). Although sex differences are documented in the general population, their role in the context of HIV is less understood. Methods: This was a multicentre cohort study including people with HIV without viral hepatitis coinfection. A FibroScan‐AST (FAST) score >0.35 was used to diagnose MASH with significant liver fibrosis (stage F2–F4). We investigated sex‐based differences in MASH trends as a function of age using a segmented linear mixed‐effects model. Random effects accounted for clustering by the four sites. Adjusted models included ethnicity, diabetes, hypertension, and detectable HIV viral load. Results: We included 1472 people with HIV (25% women). At baseline, the prevalence of MASH with fibrosis by FAST score was lower in women than in men (4.8% vs. 9.2%, p = 0.008). Based on the adjusted model, male sex (+0.034; p = 0.04), age per year (+0.003; p = 0.05), detectable HIV viral load (+0.034; p = 0.02), and hypertension (+0.03; p = 0.01) were positively associated with MASH with fibrosis. Although men exhibited generally higher FAST scores, FAST scores increased in women during the critical biological age of presumed perimenopause to menopause (between 40 and 50 years), reaching levels similar to those in men by the age of 55 years. Conclusion: Despite women with HIV having a lower prevalence of MASH with fibrosis than men, they exhibit an acceleration in FAST score increase around the perimenopausal age. Future studies should target adequate consideration of sex differences in clinical investigation of metabolic dysfunction‐associated steatotic liver disease to fill current gaps and implement precision medicine for people with HIV. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence and cumulative incidence of neuro‐retinal‐disorders (NRD) in HIV‐controllers. Design: Prospective, single‐centre, cohort study of people living with HIV (PLWH): elite‐controllers, long‐term‐non‐progressors and early diagnosed. Methods: The study compared "HIV‐controllers" (including elite‐controllers and long‐term‐non‐progressors), who were not on antiretroviral therapy (ART), and "HIV‐treatment" (HIV‐infected subjects with a recent diagnosis and on ART). A matched cohort of "non‐HIV subjects" was created. NRD was defined as at least one altered (not normal) ophthalmological parameter (functional or structural). Functional (visual acuity, contrast sensitivity, chromatic vision, visual field) and structural parameters (ganglion cells, macular nerve fibre layer, peripapillary nerve fibre layers, vascular calibre) as well as quality of life (Medical Outcomes Study‐HIV Short Form‐30) were assessed. Results: Between March 2012 and November 2015, the study included all HIV‐controllers (16 elite‐controllers, 1 long‐term‐non‐progressor), 11 HIV‐treatment and 16 non‐HIV. Prevalence of NRD at baseline was 88.2% (15/17, 95% CI: 65.7%–96.7%), 90.9% (10/11, 95% CI: 62.3%–98.4%) and 56.3% (9/16, 95% CI: 33.2%–76.9%), respectively. Cumulative incidence at 3 years was 50% (1/2), 100% (1/1) and 33.3% (2/6), respectively. None of the participants manifested ocular clinical symptoms. Three years later, prevalence of NRD was 92.3% (12/13, 95% CI: 66.7%–98.6%), 75% (6/8, 95% CI: 40.9%–92.9%) and 50.0% (7/14, 95% CI: 26.8%–73.2%), respectively. Contrast sensitivity and structural parameters were globally the most affected among PLWH. Quality of life (total score) [median (interquartile range)] at baseline and 3 years was 82 (71–89) and 74 (63.5–79.25) in HIV‐controllers and 80 (73–88) and 88 (83–92) in HIV‐treatment. Conclusions: HIV‐controllers and those individuals on ART presented a higher percentage of NRD than non‐HIV. Our results suggest that NRD could be a biomarker of ocular aging among PLWH. [ABSTRACT FROM AUTHOR]

Background: Alcohol use is increasing among adults in midlife (i.e., ages 35–60), but few studies examine specific alcohol use behaviors in this age group. We examined measures of typical drinks, maximum drinks, binge drinking, and high‐intensity drinking by age, sex, and race/ethnicity among midlife adults, as well as the prospective association between age 18 binge drinking and midlife behaviors. Methods: Data from 5180 respondents participating in the national Monitoring the Future Panel study who were aged 35–60 in 2022 (followed since they were in 12th grade in 1980–2005) were used to estimate past 30‐day midlife drinking behaviors (i.e., typical drinks, maximum drinks, binge, and high‐intensity drinking) by age group, sex, and race/ethnicity. Associations between age 18 binge drinking status and midlife drinking outcomes were examined, as well as moderation by sociodemographic characteristics. Results: Across ages 35–60, the mean typical number of drinks on drinking days within the past month ranged from 1.4 to 1.8; the mean maximum drinks ranged from 2.3 to 3.2. Past‐month binge and high‐intensity drinking prevalence ranged from 19.1% to 31.2% and 3.6% to 8.1%, respectively. Estimates of drinking behaviors were generally higher among respondents aged 35–40 (vs. older age groups), males (vs. females), those identifying as White (vs. other racial/ethnic groups), and those who reported age 18 binge drinking (vs. not). Adolescent binge drinking was a stronger predictor of high‐intensity drinking among females than males and of typical and maximum drinks among older (age 60) than younger (age 35) respondents. Conclusion: Binge and high‐intensity drinking were reported by a meaningful percentage of the US midlife adults. Binge drinking in adolescence was a predictor of subsequent alcohol‐related risks. These long‐term connections were especially strong among females. Age 18 binge drinking was a stronger predictor of high‐intensity drinking at age 60 than earlier in midlife, underscoring that adolescent binge drinking is a key indicator of risk across the lifespan. [ABSTRACT FROM AUTHOR]

Background: Both age‐associated hearing loss (AAHL) and peripheral neuropathy (PN) are common in older patients, and both are associated with impaired balance, falls, and premature mortality. The objectives of this study were to document the prevalence and severity of AAHL in older primary care patients, and to explore associations between AAHL, PN, balance, falls, and mortality. Methods: We analyzed information obtained in 1999 from 793 primary care patients recruited from practices participating in the Oklahoma Longitudinal Assessment of the Health Outcomes of Mature Adults (OKLAHOMA) Studies. Available data included demographic and health information, history of falls and hospitalizations, audiometry, balance testing, examination of the peripheral nerves, 50 foot timed gait, and dates of death up to 22 calendar years and 8106 person‐years of follow‐up. Proportionate hazards (PH) and structural equation modeling (SEM) were used to examine associations between AAHL, PN, balance, gait time, and mortality. Results: 501 of the 793 participants (63%) had AAHL. Another 156 (20%) had low frequency and 32 (4%) had unilateral deficits. Those with moderate or severe AAHL and the 255 (32%) with PN had impaired balance (p < 0.0001), increased gait time (p = 0.0001), and reduced survival time (p < 0.0001). In the PH model, both AAHL and PN were associated with earlier mortality (H.Rs. [95% C.I.]: 1.36 [1.13–1.64] and 1.32 [1.10–1.59] respectively). The combination of moderate or severe AAHL and PN, present in 24% of participants, predicted earlier mortality than predicted by either deficit alone (O.R. [95% C.I.I] 1.55 [1.25–1.92]). In the SEM models, the impacts of both moderate or severe AAHL and PN on survival were mediated, in part, through loss of balance. Conclusions: Hearing loss and PN, both common in older patients, appear to be independently and additively associated with premature mortality. Those associations may be mediated in part by impaired balance. The Mechanisms are likely multiple and complex. [ABSTRACT FROM AUTHOR]

Background: Older women experience more adverse drug reactions (ADRs) than older men. However, the underlying basis for this sex difference is unclear. Sex (biological status) and/or gender (sociocultural constructs) influences on patterns of inappropriate prescribing in multimorbid older adults may be one reason for this ADR sex difference. In this secondary analysis, we examined whether incident ADR sex differences could be related to concurrent sex differences in potentially inappropriate prescribing. Design and Setting: A retrospective secondary analysis of sex differences in the prevalence of potentially inappropriate medications (PIMs), potential prescribing omissions (PPOs), and ADRs among the 1537 participants (47.2% female, median [IQR] age 78 [72–84] years) was undertaken in the SENATOR clinical trial database, conducted in six large European medical centers. Participants and Methods: We looked specifically for male/female differences relating to PIMs and PPOs (defined by STOPP/START version 2 criteria) identified within 48 h of acute hospitalization. We also assessed sex differences for ADRs identified at 14 days from admission or discharge, whichever came first. ADRs were assessed by blinded endpoint adjudication panel consensus. Results: During hospitalization, significantly more females experienced ≥1 ADR compared to males (28% and 21%, respectively; odds ratio 1.40, 95% CI 1.10–1.78, p < 0.005). Nine of the 11 STOPP‐criteria PIMs showing a significant sex difference occurred more often in females. Of the four START‐criteria PPOs showing a significant sex difference, all occurred more often in females. Some sex‐associated PIMs reflect higher prevalence of related conditions in older women. Conclusion: We conclude that specific STOPP‐criteria PIMs and START‐criteria PPOs were identified more frequently in older women than older men during acute hospitalization, possibly contributing to higher ADR incidence in older women. Prescribers should appreciate sex differences in exposure to potentially inappropriate prescribing and ADR risk, given the preponderance of older women over older men in most clinical settings. [ABSTRACT FROM AUTHOR]

Hydration status monitoring through weight charts can help active individuals maintain optimal fluid balance and prevent health/performance impairments. This study aimed to determine the prevalence of athletes above an acute hypohydration threshold (within practices), a chronic hypohydration threshold (across practices), and the prevalence of athletes below the acute hypohydration threshold and above the chronic hypohydration threshold simultaneously (e.g., undetected chronic hypohydration). Second, involvement of baseline hydration verification (BV; with/without), sex, and competition level (high school, college/university) with acute hypohydration, chronic hypohydration, and undetected chronic hypohydration were also examined. Undetected chronic hypohydration was prevalent across sexes (6.4 ± 16.7% males; 1.4 ± 5.8% females) and competition levels (6.5 ± 16.4% high school; 5.4 ± 15.6% college/university). No significant differences existed across BV status for average acute hypohydration (with BV = 0.8; without BV = 0.8) or chronic hypohydation (with BV = 0.7; without BV = 0.8). All three calculations, absolute body mass loss, acute hypohydration, and chronic hypohydration, should be utilized to determine the prevalence of hypohydration, and they should also be used to assist athletic trainers while making clinical decisions regarding appropriate rehydration interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: U.S. Special Operations Forces (SOF) are at increased risk of multiple mild traumatic brain injury (mmTBI). Testosterone was prescribed for several participants in a VA program designed to address sequelae of mmTBI for SOF. OBJECTIVE: To determine testosterone prevalence in the Palo Alto VA Intensive Evaluation and Treatment Program (IETP) and observe for association between testosterone and neurobehavioral outcomes. METHODS: A retrospective cohort study included patients in the Palo Alto VA IETP. Sociodemographic data, testosterone blood levels, and neurobehavioral outcomes were collected from medical records. RESULTS: 55 IETP participants were included: six were testosterone users; the rest were classified as non-users. Testosterone use in this population is 11%, higher than reported national averages in the U.S. Of the 6 testosterone users, 2 (33%) had a formal diagnosis of hypogonadism prior to initiation of testosterone. Neurobehavioral outcome scores between testosterone users and non-users failed to show statistically significant differences, except for the PROMIS pain score, which was higher in the testosterone user population. CONCLUSION: The current study did not find an association between mmTBI, testosterone use, or testosterone level and neurobehavioral outcomes. This study highlights a need to further examine the relationship between hypogonadism, mmTBI, SOF culture around testosterone, and the effects of testosterone use in this population. [ABSTRACT FROM AUTHOR]

Aim: Previous studies have shown that chronic diseases are strongly linked to the development of sarcopenia. Few studies have assessed the relationship between multimorbidity patterns and sarcopenia. This study aimed to investigate the impact of multimorbidity patterns on sarcopenia transitions in Chinese older adults. Methods: A total of 3842 older adults (aged 66.7 ± 6.2 years) with complete data at baseline and at least one follow‐up record (2 years) were included from the China Health and Retirement Longitudinal Study. Multimorbidity patterns were identified using latent class analysis. Sarcopenia was determined by the Asian Working Group for Sarcopenia 2019 criteria. Multistage Markov modeling was used to explore the association of multimorbidity patterns with sarcopenia transitions after controlling for covariates in demographic features, health status and health‐related behaviours. Results: Four multimorbidity patterns were identified at baseline: respiratory (17.73%), osteoarthritis‐hypertension (22.23%), digestive‐osteoarthritis (26.78) and cardiometabolic (33.27%). Participants with non‐sarcopenia had 1‐year transition probability of developing possible sarcopenia (10.1%) or sarcopenia (5.4%). Compared with the group without chronic diseases, the presence of cardiometabolic pattern increased the risk of progression from non‐sarcopenia to possible sarcopenia (HR 1.43, 95% CI 1.05–2.95). The presence of the osteoarthritis‐hypertension pattern (HR 1.55, 95% CI 1.00–2.41) and the digestive‐osteoarthritis pattern (HR 1.78, 95% CI 1.20–2.66) were associated with the transition toward sarcopenia from non‐sarcopenia. Conclusions: Sarcopenia is a dynamic condition in older adults. To address sarcopenia in older adults, tailored interventions should be targeted at populations with different multimorbidity patterns. Geriatr Gerontol Int 2024; 24: 1137–1143. [ABSTRACT FROM AUTHOR]

The prevalence of depressive symptoms has rapidly accelerated among recent US adolescent birth cohorts, yet there remains little understanding of trends among racialized and minoritized groups. These groups may experience depressive symptoms due to the deleterious effects of structural racism. Using 2005-2020 Monitoring the Future survey data, we examine all racialized groups using within-group analyses to observe trends in high levels of depressive symptoms across cohorts. Generally, across racialized groups and ages, the odds of high depressive symptoms increased in recent birth cohorts. For example, among 15- to 16-year-old students racialized as American Indian or Alaska Native and Black Hispanic/Latine, the 2003-2006 birth cohort had 3.08 (95% CI, 2.00-4.76) and 6.95 (95% CI, 2.70-17.88) times' higher odds, respectively, of high depressive symptoms as compared with the 1987-1990 birth cohorts. Moreover, in a given year, 15- to 16-year-olds generally experienced the highest depressive symptoms compared with 13- to 14-year-olds and 17- to 18-year-olds, suggesting that age effects peaked during midadolescence. Depressive symptoms increased among US adolescents by birth cohort, within all racialized and minoritized groups assessed. Public health efforts to reduce disparities may consider barriers such as structural racism that may impact the mental health of racialized/minoritized adolescents while increasing access to culturally competent mental health providers and school-based services. This article is part of a Special Collection on Mental Health. [ABSTRACT FROM AUTHOR]

A decade of ongoing armed conflict in Syria has damaged the physical and mental health of millions of adults and children. This study aimed to systematically review the prevalence of post-traumatic stress disorder among youth exposed to the Syrian conflict, and understand its individual and contextual determinants. The screening procedure resulted in 26 studies, with a total of 11,400 Syrian children and adolescents. The prevalence was 36% (95% CI (0.29–0.43), p < 0.001). Loss of family members or acquaintances, witnessing violence, and social withdrawal increased the risk of post-traumatic stress disorder, while social trust and social support were protective factors. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Adverse childhood experiences (ACEs) are preventable, potentially traumatic events with lifelong negative impacts. Population-level data on ACEs among adolescents have historically relied on parent reports and excluded abuse-related ACEs. We present the self-reported prevalence of ACEs among a large population-based sample of US high school students. METHODS: Using cross-sectional, state-representative data from 16 states that included core ACE questions on their 2021 Youth Risk Behavior Survey, we estimate the prevalence of 8 individual (lifetime emotional, physical, or sexual abuse, physical neglect, witnessed intimate partner violence, household substance use, household poor mental health, incarcerated parent or guardian) and cumulative ACEs (0, 1, 2-3, ≥4) among a large population-based sample of adolescents, overall and by demographic characteristics (sex, race and ethnicity, age, sexual orientation). RESULTS: Emotional abuse (65.8%), household poor mental health (36.1%), and physical abuse (32.5%) had the highest prevalence. ACEs were very common, with 80.5% of adolescents experiencing at least 1 ACE and 22.4% experiencing ≥4 ACEs. Experiencing ≥4 ACEs was highest among adolescents who were female (27.7%), non-Hispanic multiracial (33.7%), non- Hispanic American Indian or Alaska Native (27.1%), gay or lesbian (36.5%), bisexual (42.1%), or who described their sexual identity some other way or were not sure of their sexual identity (questioning) (36.5%). CONCLUSIONS: Self-reported ACE estimates among adolescents exceed previously published parent- reported estimates. ACEs are not equally distributed, with important differences in individual and cumulative ACEs by demographic characteristics. Collecting ACE data directly from adolescents at the state level provides actionable data for prevention and mitigation. [ABSTRACT FROM AUTHOR]

Approximately 20% of patients sustaining a fragility femur fracture use an anticoagulant, and over 30% use an antiplatelet medication, both of which can result in surgical delay. Previously confined to fractures of the proximal femur, performance assessment, outcome and surgical delay is now assessed for all fractures of the femur in older patients, including those involving implants. This narrative review draws together all literature pertaining to anticoagulation and antiplatelet management in older patients with a fracture of the femur to address 5 key points: prevalence of anticoagulant and antiplatelet use; analysis of management protocols; collation of national guidelines; comparison of perioperative management; timing of surgery and perioperative outcomes. Our review found that the prevalence of fragility femur fracture patients taking anticoagulant and antiplatelet medication ranges from 20–40% and 25–35% respectively. More anticoagulated patients are taking direct oral anticoagulants compared to vitamin k antagonists with growing implications for variation in practice and delays to surgery. Several national guidelines exist although these are characterised by marked variation, there is little standardisation, and none are generalised across all fragility femur fractures. Expedited surgery within 36 hours of admission in patients taking an anticoagulant or antiplatelet medication is safe and has been demonstrated in fractures of the proximal femur across many small number studies although no such evidence exists in non-proximal femur fractures despite this population sharing similar characteristics. There is a need for all fractures of the femur in older people to be considered when researching and assessing performance in this population to prevent needless variation and delay. [ABSTRACT FROM AUTHOR]

Introduction: Gibbus deformity has been documented as a common musculoskeletal abnormality in mucopolysaccharidosis type I (Hurler syndrome, MPS IH), and its recognition often leads to the diagnosis of MPS IH. While the incidence has been described, the progression of gibbus deformities is not well known. Here we describe the natural history of gibbus deformity in a single center patient population using serial spinal MRI scans. Methods: All spinal MRI scans in MPS IH patients were retrospectively reviewed. The presence, spinal location, and angulation of the gibbus deformities were collected. The angles between the superior endplate of the superior normal vertebral body and the inferior endplate of the inferior normal vertebral body were measured. Results: 24 of 47 patients (51%) were found to have cervico-thoracic deformity on their cervical MRI scans, and 19 of those 24 (79%) patients were found to have progressive cervico-thoracic deformity with average change of angle of 17.1 degrees [range 3.9, 62.8] over 5.3 years. 7 of 8 patients who had thoraco-lumbar MRI were found to have thoraco-lumbar deformity, and 4 of those 7 patients (57%) were found to have progressive thoraco-lumbar deformity with the average increase angle of 16.7 degrees [range 3.3, 47.1] over an average of 4.1 years. Conclusion: We found out that baseline spinal measurement cannot reliably predict the progression as multiple patients with normal alignment eventually developed severe deformity, whereases patients with severe deformity did not progress to require surgical intervention. [ABSTRACT FROM AUTHOR]

Objectives ANA-associated rheumatic and musculoskeletal (MSK) diseases (RMDs) [SLE, primary SS (pSS), scleroderma, inflammatory myositis, MCTD and UCTD] make up a disease spectrum with overlapping clinical and immunological features. MSK inflammation is common and impactful across ANA-associated RMDs. The objectives of this study were to evaluate MSK inflammation (ANA-associated arthritis) prevalence in a multidisease ANA-associated RMD study, assess its clinical impact across ANA-associated RMD diagnoses, propose new basket groupings of patients, and evaluate immunological profiles in legacy and new basket contexts. Methods An observational study enrolled patients with ANA-associated RMDs. Demographic variables, comorbidities, therapies, disease activity instruments [BILAG, SLEDAI, the EULAR SS disease activity index (ESSDAI), physician visual analogue scale (VAS)], patient-reported outcomes [SF36, FACIT-Fatigue, EQ5D, ICECAP-A, Work Productivity and Activity impairment (WPAI), patient VAS] and the biomarker profile (six-gene expression scores, flow cytometry, autoantibody profile) were analysed. Reclustering utilized Gaussian mixture modelling (GMM). The clinical and immune features of new and legacy clusters were compared. Results Inflammatory MSK symptoms were prevalent across ANA-associated RMDs, in 213/294 patients. In ANA-associated arthritis patients, most variables did not differ between diagnoses, with the exception of the EQ5D-5L index and mobility domains (lower in MCTD/pSS, both P  < 0.05). FM and OA prevalence were similar across diagnoses. Therapy use differed significantly, the use of biologics being greatest in SLE (P  < 0.05). GMM yielded two multidisease clusters: High MSK disease activity (n  = 89) and low MSK disease activity (n  = 124). The high MSK disease activity cluster included all patients with active joint swelling, and they had significantly higher prednisolone usage, physician global assessment (PGA), Sm/RNP/SmRNP/chromatin positivity, Tetherin mean fluorescence intensity (MFI), and IFN Score-A activity, along with numerically lower FM and OA prevalence. Conclusion We defined ANA-associated arthritis, a more clinically and immunologically homogeneous population than existing RMD populations for trials, and a more prevalent population for therapies in the clinic. [ABSTRACT FROM AUTHOR]

Objectives The aim of our study was to identify the potential distinct phenotypes within a broad SpA population. Methods We conducted a cross-sectional study using the REGISPONSER registry, which has data from 31 specialist centres in Spain, including patients with SpA who have fulfilled the ESSG criteria. A latent class analysis (LCA) was performed to identify the latent classes underlying SpA according to a set of predefined clinical and radiographic features, independently of expert opinion. Results In a population of 2319 SpA patients, a five-classes LCA model yielded the best fit. Classes named 'Axial with spine involvement' and 'Axial with isolated SI joint involvement' showed a primarily axial SpA phenotype defined by inflammatory back pain and high HLA-B27 prevalence. Patients in class 'Axial + peripheral' showed a similar distribution of manifest variables to previous classes but also had a higher likelihood of peripheral involvement (peripheral arthritis/dactylitis) and enthesitis, therefore representing a mixed (axial and peripheral) subtype. Classes 'Peripheral + psoriasis' and 'Axial + peripheral + psoriasis' were indicative of peripheral SpA (and/or PsA) with high likelihood of psoriasis, peripheral involvement, dactylitis, nail disease, and low HLA-B27 prevalence, while class 'Axial + peripheral + psoriasis' also exhibited increased probability of axial involvement both clinically and radiologically. Conclusion The identification of five latent classes in the REGISPONSER registry with significant overlap between axial and peripheral phenotypes is concordant with a unifying concept of SpA. Psoriasis and related features (nail disease and dactylitis) influenced the phenotype of both axial and peripheral manifestations. [ABSTRACT FROM AUTHOR]

We propose, in this paper, a hybrid Cholera transmission model with phage to simulate the interaction between Vibrio cholerae and phages in the host population and environment, which is coupled with some reaction–diffusion equations and first-order partial differential equations. The precise formulation of basic reproduction number ( ℛ 0 ) is deduced, which characterizes the elimination or prevalence of this disease. Specifically, the disease-free steady state is globally asymptotically stable for ℛ 0 ≤ 1 but unstable for ℛ 0 > 1. Further, the phage invasion reproduction number ℛ 1 is also obtained, which portrays the impact of phages on Vibrio cholerae in the environment. That is, for ℛ 0 > 1 , the phage-free endemic steady state is globally asymptotically stable if ℛ 1 ≤ 1 , and the phage-present endemic steady state is globally asymptotically stable if ℛ 1 > 1. Numerical simulations are introduced for the purpose of verifying the main results. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular disease (CVD) is a leading cause of death worldwide among adults. Traditionally, the disease has been considered as a condition affecting older adults. However, its risk factors (e.g., poor diet, sedentary behavior, inadequate sleep, and obesity) are increasingly being identified in younger populations. There is a need to increase the evidence of CVD risk factors in this population to further support preventive programs in this demographic. Objective(s): This study investigates the prevalence of CVD risk factors in young adult, college students. Design: Data was used from the American College Health Association's National College Health Assessment (ACHA‐NCHA) II‐C. Sample: The sample included data from 426,259 students, ages 18–25. Measurements: Data was reviewed on race, nutrition, physical activity, tobacco use, sleep, weight, and history of chronic disease. Descriptive statistics were utilized to examine the prevalence of CVD risk factors. Results: There was a notable prevalence of CVD risk factors, such as insufficient nutrition, obesity, insufficient physical activity, and inadequate sleep, among college students. Conclusions: CVD‐related risk factors are on the rise within this demographic. There is a pressing need for the expansion of public health initiatives aimed at enhancing CVD awareness and prevention among college students. [ABSTRACT FROM AUTHOR]