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Aim: To explore the correlations between examination tolerance and anxiety, knowledge needs and examination cooperation in sedation‐free gastroscopy examinees. Design: Cross‐sectional survey using convenience sampling. Methods: A total of 170 healthy adults who underwent sedation‐free gastroenteroscopy were asked to complete a visual analogue scale (VAS) to rate their examination tolerance, the state anxiety questionnaire (S‐AI), a newly designed knowledge needs questionnaire and a cooperation questionnaire. Results: The VAS score was 4.47 ± 1.96, the state anxiety score was 39.46 ± 9.81, the total score for knowledge needs was 44.89 ± 11.02, and the average cooperation score was 2.47 ± 0.38. The VAS score during the examination positively correlated with the pretest state anxiety score and pretest knowledge needs score and negatively correlated with the examination cooperation score. The results of multiple linear regression analysis showed that after undergoing the examination for the first time, anxiety, body position and swallowing control were the main factors influencing the examination tolerance of sedation‐free gastroscopy examinees. Patient or Public Contribution: We would like to thank the staff and patients of the participating hospital for their assistance and cooperation in performing the current study. [ABSTRACT FROM AUTHOR]

Objective To investigate the test situation of pulmonary nodules among health examination population in a certain area and analyze its relationship with lifestyle and dietary habits. Methods A study was conducted on 10 580 individuals who underwent health examinations at the health management center of The Affiliated Hospital of Southwest Medical University from June 2022 to June 2023, regardless of occupation. All health examines underwent low-dose spiral computed tomography (LDCT) lung examination to screen for pulmonary nodule patients, the detection rate and imaging characteristics of pulmonary nodules were analyzed, and a questionnaire survey on their lifestyle and dietary habits was conducted, the relationship between the detection rate of pulmonary nodules and lifestyle and dietary habits were analyzed. Results A total of 2 054 positive cases of pulmonary nodules were detected among 10 580 healthy individuals, with a detection rate of 19.41%. Among them, 320 cases were of type 1 nodules (3.02%), 1 425 cases were of type 2 nodules (13.47%), 218 cases were of type 3 nodules (2.06%), and 91 cases were of type 4 nodules (0.86%). There was a statistically significant difference in the classification of Lung RANDS for positive pulmonary nodules of different densities and sizes (P < 0.05). There were statistically significant differences in the detection rate of pulmonary nodules among healthy individuals of different ages, genders, occupational environments, smoking habits, participation in physical exercise, and dietary habits (whether you have the habit of eating breakfast, whether you eat a high-oil diet, whether you eat fried products and the combination of meat and vegetables) . Multivariate logistic regression results showed that males (OR = 2.143, 95% CI: 1.151-3. 9880), smokers (OR = 2.234, 95% CI: 1.435-3.480), aged over 40 years old (OR = 1.451, 95% CI: 1.031-2.040), not participating in physical exercise (OR = 1.582, 95% CI: 1.157-2.165), and no habit of eating breakfast (OR = 1.404, 95% CI: 1.036-1.902), high oil diet (OR = 1.409, 95% CI: 1.073-1.850) and eat fried products (OR = 1.795, 95% CI: 1.269-2.539) were independent risk factors for pulmonary nodules in healthy individuals in this region (P < 0.05) . Conclusion The detection rate of pulmonary nodules in the health examination population in Luzhou region is relatively high, and related lifestyle and dietary habits may affect the occurrence of pulmonary nodules. It is recommended to actively carry out LDCT for people over 40 years old in this area, focusing on high-risk groups who smoke, do not participate in physical exercise, have habits of not eating breakfast, high oil diet and eating fried products. Early detection and management of high-risk pulmonary nodules can reduce the risk of lung cancer. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to clarify the longitudinal association between teleworking and physical health changes of Japanese workers before and during the COVID-19 pandemic. Methods: Participants were in a certain company who received mandatory health examinations in 2019 and 2020. In June 2020, the participants were asked about frequency of teleworking, which was introduced owing to the COVID-19. Whether physical health differed by the frequency of teleworking was analyzed. Results: The participants were 3689 workers. Frequency of teleworking were associated with more deleterious changes in diastolic blood pressure, antilipidemic drag use, low-density lipoprotein (LDL) cholesterol, Glutamic Oxaloacetic Transaminase(GOr), Glutamic Pyruvic Transaminase(GPT), metabolic syndrome, and insufficient walking time among men. In contrast, no significant changes were observed in women. Conclusions: Male workers who teleworked more frequently were more likely to experience a deterioration in their physical health within 1-year compared with those who worked at the office. [ABSTRACT FROM AUTHOR]

Background: Recently, metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed. It is uncertain how indices that predict fatty liver are associated with MAFLD in Japanese. Methods: Among subjects who underwent a health examination at our hospital, 1257 (men: 787, women: 474) subjects participated in fatty liver evaluation of the fatty liver index (FLI) and fatty liver predicting index (FLPI) were included in this cross-sectional study. The discriminatory ability of each index for MAFLD was tested using receiver operating characteristic curve analysis. The association between FLI, FLPI, and MAFLD was investigated using multiple logistic regression analysis. Results: FLI and FLPI had good discriminatory ability for identifying MAFLD in both men and women, with specific cutoff values. Both FLI and FLPI were significantly higher in subjects with MAFLD, and the odds of MAFLD were higher among those in the highest tertile relative to the lowest tertile in both men and women. FLI and FLPI were higher in subjects who met the criteria for both MAFLD and metabolic syndrome (MetS) compared to those who had MAFLD or MetS alone, and most of the examined parameters in subjects with both conditions indicated a high metabolic risk profile. Conclusions: The study suggests that FLI and FLPI are valuable tools for predicting MAFLD and are similarly correlated with the disease. Furthermore, the highest values of these indices were observed in subjects who met the criteria for both MAFLD and MetS, emphasizing the importance of considering both conditions when assessing metabolic risk. [ABSTRACT FROM AUTHOR]

Abstract Aim To explore the correlations between examination tolerance and anxiety, knowledge needs and examination cooperation in sedation‐free gastroscopy examinees. Design Cross‐sectional survey using convenience sampling. Methods A total of 170 healthy adults who underwent sedation‐free gastroenteroscopy were asked to complete a visual analogue scale (VAS) to rate their examination tolerance, the state anxiety questionnaire (S‐AI), a newly designed knowledge needs questionnaire and a cooperation questionnaire. Results The VAS score was 4.47 ± 1.96, the state anxiety score was 39.46 ± 9.81, the total score for knowledge needs was 44.89 ± 11.02, and the average cooperation score was 2.47 ± 0.38. The VAS score during the examination positively correlated with the pretest state anxiety score and pretest knowledge needs score and negatively correlated with the examination cooperation score. The results of multiple linear regression analysis showed that after undergoing the examination for the first time, anxiety, body position and swallowing control were the main factors influencing the examination tolerance of sedation‐free gastroscopy examinees. Patient or Public Contribution We would like to thank the staff and patients of the participating hospital for their assistance and cooperation in performing the current study.

BackgroundPatients with schizophrenia are at high risk of suffering from metabolic syndrome. Most previous studies on the influencing factors of metabolic syndrome focused on the inpatients and limited ones on patients dwelling in community.ObjectiveTo explore the influencing factors at different risk levels of metabolic syndrome in community-dwelling patients with schizophrenia in Guangzhou， so as to provide references for future interventions on metabolic syndrome in this patient population.MethodsIn November 2021， 3 339 patients with schizophrenia who were registered in and administered by Guangzhou Mental Health Information System were included. All these patients had finished the physical examination in 2020， and whether they had metabolic syndrome was assessed basing on Guideline for the prevention and treatment of type 2 diabetes mellitus in China （2020 edition）. Patients were divided into high-risk group （n=423）， critical group （n=1 524） and metabolic syndrome group （n=1 392） according to the Chinese expert consensus on the management of metabolic syndrome in patients with schizophrenia. Multiple logistic regression analysis were performed on the risk factors of metabolic syndrome in community-dwelling patients with schizophrenia.ResultsThe prevalence rate of metabolic syndrome in community-dwelling patients with schizophrenia was 41.69%. Univariate analysis showed that the results in gender （χ2=44.610）， age （χ2=55.992）， marriage status （χ2=30.755）， illness course （χ2=25.913） and body mass index （χ2=829.265） were significantly different among the three groups （P

Background Patients with schizophrenia are at high risk of suffering from metabolic syndrome. Most previous studies on the influencing factors of metabolic syndrome focused on the inpatients and limited ones on patients dwelling in community. Objective To explore the influencing factors at different risk levels of metabolic syndrome in community-dwelling patients with schizophrenia in Guangzhou， so as to provide references for future interventions on metabolic syndrome in this patient population. Methods In November 2021， 3 339 patients with schizophrenia who were registered in and administered by Guangzhou Mental Health Information System were included. All these patients had finished the physical examination in 2020， and whether they had metabolic syndrome was assessed basing on Guideline for the prevention and treatment of type 2 diabetes mellitus in China （2020 edition）. Patients were divided into high-risk group （n=423）， critical group （n=1 524） and metabolic syndrome group （n=1 392） according to the Chinese expert consensus on the management of metabolic syndrome in patients with schizophrenia. Multiple logistic regression analysis were performed on the risk factors of metabolic syndrome in community-dwelling patients with schizophrenia. Results The prevalence rate of metabolic syndrome in community-dwelling patients with schizophrenia was 41.69%. Univariate analysis showed that the results in gender （χ²=44.610）， age （χ²=55.992）， marriage status （χ2=30.755）， illness course （χ²=25.913） and body mass index （χ²=829.265） were significantly different among the three groups （P<0.01）. Kruskal-Wallis H test showed that the levels of waist circumference （H=920.331）， systolic blood pressure （H=436.673）， diastolic blood pressure （H=393.337）， fasting blood glucose （H=807.304）， triglyceride （H=1 134.125） and high-density lipoprotein cholesterol （H=593.615） among the three groups were significantly different （P<0.01）. Logistic regression analysis showed that age ≥50 （OR=1.761， 95% CI： 1.087~2.853）， overweight （OR=2.418， 95% CI： 1.862~3.140） and obesity （OR=57.903， 95% CI： 14.340~233.802） were risk factors contributing to high-risk patients becoming critical population （P<0.05 or 0.01）. Female gender （OR=1.295， 95% CI： 1.034~1.622）， aged 40~49 （OR=2.597， 95% CI： 1.582~4.263）， age ≥50 （OR=4.392， 95% CI： 2.609~7.395）， overweight （OR=7.844， 95% CI： 6.018~10.223） and obesity （OR=426.785， 95% CI： 105.724~1 722.839） were risk factors for high-risk patients developing into metabolic syndrome population （P<0.05 or 0.01）.Conclusion The prevalence rate of metabolic syndrome is higher in community-dwelling patients with schizophrenia. Female gender， older age， overweight and obesity would increase the risk of metabolic syndrome in schizophrenic patients [ABSTRACT FROM AUTHOR]

Chronic pain is defined as pain that persists or recurs for more than 3 months. This study focuses on neuropathic pain (NP) and fibromyalgia (FM) which are chronic pain states, and aims to identify lifestyle habits associated with their prevalence. Other neurological disorders are also analyzed as references. Association between the variable referring to disease prevalence (number of claims for reimbursement of marker drugs) and the variable for lifestyle habits/health examination results (collected from insured individuals aged 40–74 years) was determined by analyzing Japanese nationwide datasets, which were collected in 2018 and aggregated by prefecture. Pregabalin, donepezil, and levodopa were used as marker drugs for the chronic pain states, dementia-related diseases (Alzheimer's disease and Lewy body dementia) and Parkinson's disease (PD), respectively. Pearson's correlation analysis and multiple linear regression analysis were conducted. Variables showing correlation coefficient (|r|)>0.5 were put into the multiple linear regression. Exercise habits (ꞵ=−0.3182), smoking habits (0.3218), daily drinking (0.2683), and alanine aminotransferase>51 U/L (0.2309) were finally incorporated in the equation for pregabalin (R2=0.7268). Walking speed (−0.4543) and daily drinking (0.5077) were incorporated in the equation for donepezil (R2=0.5718). The prevalence of chronic pain states is associated with lifestyle habits, just like the dementia-related diseases. Exercise in daily life is negatively associated with the prevalence of the chronic pain states, although excessive alcohol drinking, smoking, and high serum ALT are positively associated with it. The prevalence of PD seems less associated with lifestyle habits. [ABSTRACT FROM AUTHOR]

Abstract Background Many people were found with pulmonary nodules during physical examinations. It is of great practical significance to discriminate benign and malignant nodules by using data mining technology. Methods The subjects' demographic data, baseline examination results, and annual follow‐up low‐dose spiral computerized tomography (LDCT) results were recorded. The findings from annual physical examinations of positive nodules, including highly suspicious nodules and clinically tentative benign nodules, was analyzed. The extreme gradient boosting (XGBoost) model was constructed and the Grid Search CV method was used to select the super parameters. External unit data were used as an external validation set to evaluate the generalization performance of the model. Results A total of 135,503 physical examinees were enrolled. Baseline testing found that 27,636 (20.40%) participants had clinically tentative benign nodules and 611 (0.45%) participants had highly suspicious nodules. The proportion of highly suspicious nodules in participants with negative baseline was about 0.12%–0.46%, which was lower than the baseline level except the follow‐up of >5 years. In the 27,636 participants with clinically tentative benign nodules, only in the first year of LDCT re‐examination was the proportion of highly suspicious nodules (1.40%) significantly greater than that of baseline screening (0.45%) (p 0.05). Furthermore, 322 cases with benign nodules and 196 patients with malignant nodules confirmed by surgery and pathology were compared. A model and the top 15 most important clinical variables were determined by XGBoost algorithm. The area under the curve (AUC) of the model was 0.76 [95% CI: 0.67–0.84], and the accuracy was 0.75. The sensitivity and specificity of the model under this threshold were 0.78 and 0.73, respectively. In the validation of model using external data, the AUC was 0.87 and the accuracy was 0.80. The sensitivity and specificity were 0.83 and 0.77, respectively. Conclusions It is important that pulmonary nodules could be more accurately identified at the first LDCT examination. A model with 15 variables which are routinely measured in the clinic could be helpful to distinguish benign and malignant nodules. It could help the radiological team issue a more accurate report; and it may guide the clinical team regarding LDCT follow‐up.

The present study aimed to establish expert advice on screening indicators of mental health problems in the setting of health examination. According to the advice, it is necessary to include mental health assessment in health examination. The expert advice provided preliminary suggestions on selection of screening indicators of mental health problems in health examination and the procedure of the mental health assessment. The expert advice provided standards and guidance for mental health assessment in the setting of health examination. [ABSTRACT FROM AUTHOR]

Abstract Background Liver cancer is ranked fifth in incidence and second in mortality among cancers in Taiwan. Nevertheless, the Taiwan government does not screen for liver cancer in its free cancer screening and preventive health examination service. This study compared the differences in cancer stage and survival between patients who received an initial liver cancer diagnosis in outpatient departments (OPDs) and those who received such a diagnosis in emergency departments (EDs). Methods This retrospective cohort study used the 2000–2016 National Health Insurance Database to obtain a sample from 2 million Taiwanese residents. To evaluate the effect of the utilization of the adult health examination offered to people aged ≥ 40 years, patients aged ≥ 40 years who received an initial liver cancer diagnosis between 2003 and 2015 were followed up until December 31, 2016. Results In total, 2,881 patients were included in this study. A greater proportion of cancer cases in the OPD group were non-advanced than those in the ED group (75.26% vs. 54.23%). Having stage C or D cancer, having a low monthly salary, and a Charlson comorbidity index score ≥ 8, not having hepatitis B, being divorced, and attending a non-public hospital as the primary care institution were risk factors for initial ED diagnosis. The risk of liver cancer-specific death among the ED group patients was 1.38 times that among the OPD group patients (adjusted hazard ratio = 1.38, 95% confidence interval [CI] = 1.14–1.68, P

Background: Many people were found with pulmonary nodules during physical examinations. It is of great practical significance to discriminate benign and malignant nodules by using data mining technology. Methods: The subjects' demographic data, baseline examination results, and annual follow‐up low‐dose spiral computerized tomography (LDCT) results were recorded. The findings from annual physical examinations of positive nodules, including highly suspicious nodules and clinically tentative benign nodules, was analyzed. The extreme gradient boosting (XGBoost) model was constructed and the Grid Search CV method was used to select the super parameters. External unit data were used as an external validation set to evaluate the generalization performance of the model. Results: A total of 135,503 physical examinees were enrolled. Baseline testing found that 27,636 (20.40%) participants had clinically tentative benign nodules and 611 (0.45%) participants had highly suspicious nodules. The proportion of highly suspicious nodules in participants with negative baseline was about 0.12%–0.46%, which was lower than the baseline level except the follow‐up of >5 years. In the 27,636 participants with clinically tentative benign nodules, only in the first year of LDCT re‐examination was the proportion of highly suspicious nodules (1.40%) significantly greater than that of baseline screening (0.45%) (p < 0.001), and the proportion of highly suspicious nodules was not different between the baseline screening and other follow‐up years (p > 0.05). Furthermore, 322 cases with benign nodules and 196 patients with malignant nodules confirmed by surgery and pathology were compared. A model and the top 15 most important clinical variables were determined by XGBoost algorithm. The area under the curve (AUC) of the model was 0.76 [95% CI: 0.67–0.84], and the accuracy was 0.75. The sensitivity and specificity of the model under this threshold were 0.78 and 0.73, respectively. In the validation of model using external data, the AUC was 0.87 and the accuracy was 0.80. The sensitivity and specificity were 0.83 and 0.77, respectively. Conclusions: It is important that pulmonary nodules could be more accurately identified at the first LDCT examination. A model with 15 variables which are routinely measured in the clinic could be helpful to distinguish benign and malignant nodules. It could help the radiological team issue a more accurate report; and it may guide the clinical team regarding LDCT follow‐up. [ABSTRACT FROM AUTHOR]

Abstract Purpose To estimate the frequency of age-related macular degeneration (AMD) among people who underwent health examination in Hunan, China and to determine the relationship between dietary pattern and the risk of AMD. Methods The Questionnaire was used to collect dietary data from 56,775 study participants of ≥ 50 years old who underwent health examination at the Department of Health Management, the Third Xiangya Hospital of Central South University between January 2017 and December 2019. The diagnosis of AMD was based on the results of color fundus photography (CFP), spectral-domain optical coherence tomography (OCT) and multispectral imaging (MSI). After excluding participants with incomplete records or other ocular disease that may affect the results of fundus examination, a total of 43,672 study participants were included. The univariate and multivariate logistic regression analyses were used to determine the relationship between dietary pattern and the frequency of AMD. Results Among the 43,672 study participants, 1080 (2.5%) had early AMD: the frequencies were 2.6% (n = 674) in men and 2.3% (n = 406) in women; the frequencies were 1.0% (n = 289), 3.6% (n = 401), 9.1% (n = 390) in 50–59, 60–69, ≥ 70 years old, respectively. And the age-standard frequency was 6.6% over the 60 years old in Hunan China. The high-salt intake increased the risk of early AMD [odds ratio (OR) = 1.61, 95% confidence interval (CI) = 1.54–1.68], whereas the intake of meat decreased the risk (OR = 0.90, 95% CI = 0.81–0.99). Conclusion In Hunan China, there was a high frequency of early AMD detected through health examination over the 60 years old. And high-salt intake increases the risk of early AMD, whereas intake of meat decreases the risk. Modulating the dietary pattern and reducing the salt intake as an AMD prevention strategy warrant further study.

Background: Fatty liver index (FLI) is a predictor of non-alcohol fatty liver disease (NAFLD). This study aimed to assess the association between FLI and carotid intima media thickness (CIMT). Methods: In this cross-sectional study, we enrolled 277 individuals for health examination from the China-Japan Friendship Hospital. Blood sampling and ultrasound examinations were conducted. Multivariate logistic regression and restricted cubic spline analyses were performed to evaluate the association between FLI and CIMT. Results: Overall, 175 (63.2%) and 105 (37.9%) individuals had NAFLD and CIMT, respectively. The multivariate logistic regression analyses results showed that high FLI was independently associated with a high risk of increased CIMT, T2 vs. T1 (odds ratio [OR], 95% confidence interval [CI]): 2.41, 1.10-5.25, p = 0.027; T3 vs. T1 (OR, 95% CI): 1.58, 0.68-3.64, p = 0.285. The association between FLI and increased CIMT exhibited a J-shaped curve (nonlinear, p = 0.019). In the threshold analysis, the OR for developing increased CIMT was 1.031 (95% CI: 1.011-1.051, p = 0.0023) in participants with FLI < 64.247. Conclusion: The relationship between FLI and increased CIMT in the health examination population is J-shaped, with an inflection point of 64.247. [ABSTRACT FROM AUTHOR]

Background: Liver cancer is ranked fifth in incidence and second in mortality among cancers in Taiwan. Nevertheless, the Taiwan government does not screen for liver cancer in its free cancer screening and preventive health examination service. This study compared the differences in cancer stage and survival between patients who received an initial liver cancer diagnosis in outpatient departments (OPDs) and those who received such a diagnosis in emergency departments (EDs). Methods: This retrospective cohort study used the 2000–2016 National Health Insurance Database to obtain a sample from 2 million Taiwanese residents. To evaluate the effect of the utilization of the adult health examination offered to people aged ≥ 40 years, patients aged ≥ 40 years who received an initial liver cancer diagnosis between 2003 and 2015 were followed up until December 31, 2016. Results: In total, 2,881 patients were included in this study. A greater proportion of cancer cases in the OPD group were non-advanced than those in the ED group (75.26% vs. 54.23%). Having stage C or D cancer, having a low monthly salary, and a Charlson comorbidity index score ≥ 8, not having hepatitis B, being divorced, and attending a non-public hospital as the primary care institution were risk factors for initial ED diagnosis. The risk of liver cancer-specific death among the ED group patients was 1.38 times that among the OPD group patients (adjusted hazard ratio = 1.38, 95% confidence interval [CI] = 1.14–1.68, P < 0.001). However, the use of health examination did not exert a significant effect on the likelihood of liver cancer diagnosis in an ED (adjusted odds ratio = 0.86, 95% CI = 0.61–1.21, P = 0.381). Conclusion: Government-subsidized health examinations are insufficient to prevent first-ever diagnosed liver cancers in EDs. Patients with liver cancers diagnosed in EDs had a higher risk of advanced stage and mortality. For early detection and treatment, the government may consider implementing liver cancer screening for high-risk and low-socioeconomic people. [ABSTRACT FROM AUTHOR]

Abstract Objective Hearing loss is an important public health problem. Its causes vary, including infections, noise, and aging. The first wave of the COVID-19 pandemic occurred in April 2020 in Japan. During the pandemic, people were urged to stay at home and drastically changed their lifestyles. This study aimed to examine hearing loss before and during the pandemic. The prevalence during the pandemic after April 2020 was compared for the period in 2019. Study subjects were those who received health checkups in both periods. Hearing loss was defined as a hearing threshold of > 30 dB at 1 kHz and > 40 dB at 4 kHz in either ear using pure-tone audiometry. Results A total of 2367 persons presented in both 2019 and 2020. The overall rates of hearing loss were 9.5% and 13.2% before and after the pandemic, respectively. After controlling for age, sex, current smoking, regular exercise and alcohol consumption, the rate of hearing loss showed a significant increase in 2020 (p =

Xia Cao,1– 3 Yanhui Lin,1– 3 Binfang Yang,1– 3 Ying Li,1– 3 Jiansong Zhou4 1Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2Health Management Research Center, Central South University, Changsha, Hunan, People’s Republic of China; 3Hunan Chronic Disease Health Management Medical Research Center, Central South University, Changsha, Hunan, People’s Republic of China; 4National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of ChinaCorrespondence: Jiansong Zhou, National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, 410011, People’s Republic of China, Tel/Fax +86 073188618573, Email jasonzhou75@163.comPurpose: Using machine learning method to predict and judge unknown data offers opportunity to improve accuracy by exploring complex interactions between risk factors. Therefore, we evaluate the performance of machine learning (ML) algorithms and to compare them with logistic regression for predicting the risk of renal function decline (RFD) using routine clinical data.Patients and Methods: This retrospective cohort study includes datasets from 2166 subjects, aged 35– 74 years old, provided by an adult health screening follow-up program between 2010 and 2020. Seven different ML models were considered – random forest, gradient boosting, multilayer perceptron, support vector machine, K-nearest neighbors, adaptive boosting, and decision tree - and were compared with standard logistic regression. There were 24 independent variables, and the baseline estimate glomerular filtration rate (eGFR) was used as the predictive variable.Results: A total of 2166 participants (mean age 49.2± 11.2 years old, 63.3% males) were enrolled and randomly divided into a training set (n=1732) and a test set (n=434). The area under receiver operating characteristic curve (AUROC) for detecting RFD corresponding to the different models were above 0.85 during the training phase. The gradient boosting algorithms exhibited the best average prediction accuracy (AUROC: 0.914) among all algorithms validated in this study. Based on AUROC, the ML algorithms improved the RFD prediction performance, compared to logistic regression model (AUROC:0.882), except the K-nearest neighbors and decision tree algorithms (AUROC:0.854 and 0.824, respectively). However, the improvement differences with logistic regression were small (less than 4%) and nonsignificant.Conclusion: Our results indicate that the proposed health screening dataset-based RFD prediction model using ML algorithms is readily applicable, produces validated results. But logistic regression yields as good performance as ML models to predict the risk of RFD with simple clinical predictors.Keywords: deep learning, chronic kidney disease, algorithm, health examination

Objective:China has established a goal of reducing adult smoking prevalence from 27.7% to 20% by 2030. Understanding the possible ongoing impairment in lung function in smokers, is critically important to encourage the populations to change their smoking behavior.MethodsA total of 14,273 males joined the health examination at Huadong Sanatorium from Jan 2012 to Dec 2019 were included. In cross-sectional analysis, we used multiple linear regression to evaluate the association between baseline lung function and smoking status. Then, 3,558 males who received ≥2 spirometry exams were analyzed in longitudinal study. Annual lung function decline was compared using mixed linear models adjusted for confounders.ResultsIn cross-sectional analysis, compared with never-smokers, decreases of −133.56 mL (95% CI: −167.27, −99.85) and −51.44 mL (−69.62, −33.26) in FEV1, −1.48% (−1.94, −1.02) and −1.29% (−1.53, −1.04) in FEV1/FVC were observed in former and current smokers. In longitudinal analysis, significant declines were observed in FEV1 [5.04 (2.30, 7.78) mL] and FEV1/FVC [0.09 (0.05, 0.13) %] in current smokers but not observed in former smokers after adjustment. Participants with long duration of smoking cessation had decelerate lung function than short duration. The annual decline rate of current smokers with high smoking intensity (≥30 cigarettes per day) was 13.80 and 14.17 times greater than that of never-smokers in FEV1 and FVC. Thus, early smoking cessation can slow down lung function decline trend for current smokers.ConclusionsThe harms of current smoking on lung function emphasize the necessity of smoking cessation, especially for those with comorbidities.

Introduction: Maintaining a better physical and mental health status is an important issue for older adults in their later life. Thus, the study's purpose was to evaluate the association between body mass index (BMI) and mental health status in older adults aged 65 years old or above residing in communities of Taipei City, Taiwan. Methods: We carried out secondary data analysis with data from a volunteer-based health examination project for older adults >65 years old residing in Taipei City from 2006 to 2010 with a retrospective study design. BMI, calculated by standardized measuring procedures for height and weight, and mental health status, evaluated by 5-item Brief Symptom Rating Scale (BSRS-5), were collected at their first visits of health examination. A BSRS-5 score ≥6 was considered an inferior mental health status for the outcome. In statistical analysis, univariable and multivariable logistic regressions were adopted to estimate the relative risk of inferior mental health status, treating BMI as the major exposure of interest. Results: A total of 90,576 subjects were involved, with a mean age of 73.38 years old (SD = 6.64 years) and 49.21% females. With confounders controlled, compared to normal or overweight (23 ≤ BMI <30), an adjusted OR of 1.23 (95% CI: 1.18, 1.29) on inferior mental health status was detected for the underweight group (BMI <23) significantly. Adjusted OR for those obese (BMI ≧30) was 0.87 (95% CI: 0.79, 0.96). Significantly elevated ORs of underweight were found for both genders, but the significantly protective effect of obese was only detected for females. Conclusion: Keeping an appropriate weight or even being overweighted might be beneficial for older adults dwelling in the community, especially for males. [ABSTRACT FROM AUTHOR]

This retrospective cross-sectional study aimed to evaluate associations between peptic ulcer disease (PUD), bone mineral density, and metabolic syndrome (MetS) and its components in healthy populations. Data were collected from the health examination database of a tertiary medical center in southern Taiwan from January 2015 to December 2016. Subjects who had undergone metabolic factors assessment, upper gastrointestinal endoscopy, and dual energy X-ray absorptiometry scans were enrolled. In total, 5102 subjects were included, with mean age 52.4 ± 12.0 years. Among them, 1332 (26.1%) had PUD. Multivariate logistic regression analysis showed that age (OR 1.03, p < 0.001), male (OR 1.89, p < 0.001), diabetes (OR 1.23, p = 0.004), BMI (OR 1.03, p = 0.001), and GOT (OR 1, p = 0.003) are risk factors for PUD. Regarding MetS parameters, larger waist circumference (OR 1.26, p = 0.001) is associated with PUD, and high triglycerides (OR 1.20, 95% CI 1.01–1.43) is associated with gastric ulcer, while low HDL (OR 1.31, 95% CI 1.07–1.59) and osteoporosis (OR 1.44, 95% CI 1.08–1.91) are associated with duodenal ulcer. In conclusion, central obesity is associated with PUD in a middle-aged healthy population. Subjects with high triglycerides are prone to gastric ulcers, and those with osteoporosis and low HDL are prone to duodenal ulcers. [ABSTRACT FROM AUTHOR]

This study confirmed the validity of the health score(HS) calculation methodology and results. HS is an index that scores the degree of personal health by applying clinical standards and statistical function to health check-up items. It’s calculated by the total size of the biomarker on the health change, the influence on the health change, the weight change rate according to the degree of outlier, and the standardized value. In order to confirm the validity of the results, several diseases were selected and HS was compared between the disease occurrence group and the disease absence group. And by segmenting the ranked HS, the disease incidence rate was compared. As a result, in all selected diseases, the difference in the mean of HS was significant according to the presence or absence of disease, and the incidence of selected diseases showed a tendency to increase as HS decreased. [ABSTRACT FROM AUTHOR]

This paper probes how temporality is integral to the health examination regime that aims to protect citizens from infectious diseases in Taiwan. The paper finds that migrant workers in less-skilled occupations are examined more frequently than foreign professionals. Analyzing such differentiation, this paper argues that a hierarchy of sanitization is built on and increases the inequality between them and perpetuates instability in migrant workers' circumstances. Applying a temporal approach to the study of health examination opens new inroads into our understanding of how a "migration state" achieves the exclusion of migrant workers by making them outsiders subject to permanent intrusion into their bodies. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the frequency of age-related macular degeneration (AMD) among people who underwent health examination in Hunan, China and to determine the relationship between dietary pattern and the risk of AMD.Methods: The Questionnaire was used to collect dietary data from 56,775 study participants of ≥ 50 years old who underwent health examination at the Department of Health Management, the Third Xiangya Hospital of Central South University between January 2017 and December 2019. The diagnosis of AMD was based on the results of color fundus photography (CFP), spectral-domain optical coherence tomography (OCT) and multispectral imaging (MSI). After excluding participants with incomplete records or other ocular disease that may affect the results of fundus examination, a total of 43,672 study participants were included. The univariate and multivariate logistic regression analyses were used to determine the relationship between dietary pattern and the frequency of AMD.Results: Among the 43,672 study participants, 1080 (2.5%) had early AMD: the frequencies were 2.6% (n = 674) in men and 2.3% (n = 406) in women; the frequencies were 1.0% (n = 289), 3.6% (n = 401), 9.1% (n = 390) in 50-59, 60-69, ≥ 70 years old, respectively. And the age-standard frequency was 6.6% over the 60 years old in Hunan China. The high-salt intake increased the risk of early AMD [odds ratio (OR) = 1.61, 95% confidence interval (CI) = 1.54-1.68], whereas the intake of meat decreased the risk (OR = 0.90, 95% CI = 0.81-0.99).Conclusion: In Hunan China, there was a high frequency of early AMD detected through health examination over the 60 years old. And high-salt intake increases the risk of early AMD, whereas intake of meat decreases the risk. Modulating the dietary pattern and reducing the salt intake as an AMD prevention strategy warrant further study. [ABSTRACT FROM AUTHOR]

Objective: Hearing loss is an important public health problem. Its causes vary, including infections, noise, and aging. The first wave of the COVID-19 pandemic occurred in April 2020 in Japan. During the pandemic, people were urged to stay at home and drastically changed their lifestyles. This study aimed to examine hearing loss before and during the pandemic. The prevalence during the pandemic after April 2020 was compared for the period in 2019. Study subjects were those who received health checkups in both periods. Hearing loss was defined as a hearing threshold of > 30 dB at 1 kHz and > 40 dB at 4 kHz in either ear using pure-tone audiometry. Results: A total of 2367 persons presented in both 2019 and 2020. The overall rates of hearing loss were 9.5% and 13.2% before and after the pandemic, respectively. After controlling for age, sex, current smoking, regular exercise and alcohol consumption, the rate of hearing loss showed a significant increase in 2020 (p = < 0.0001). With age stratification, an increase was observed in the participants aged < 40 years (1.3% vs. 3.1%, p < 0.001) and 40–59 years (7.2% vs. 12.6%, p < 0.001). Further studies are needed to confirm the impact of the COVID-19 pandemic on hearing loss. [ABSTRACT FROM AUTHOR]

Isolde Sommer,1 Viktoria Titscher,1 Monika Szelag,1 Gerald Gartlehner1,2 1Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Krems, Austria; 2RTI International, Research Triangle Park, Raleigh, NC, USACorrespondence: Isolde SommerDepartment for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, Krems 3500, AustriaTel +43 (0)2732 893-2927Fax +43 (0)2732 893-4910Email isolde.sommer@donau-uni.ac.atPurpose: Despite evidence from clinical guideline development that physicians and patients show discordance in what they consider important in outcome selection and prioritization, it is unclear to what extent outcome preferences are concordant between experts and citizens when it comes to the context of primary prevention. Therefore, the objective of this study was to assess whether expert judgments about the importance of beneficial and harmful outcomes differ from citizen preferences when considering intervention options for a periodic health examination (PHE) program.Participants and Methods: We conducted an online survey using a modified Delphi approach. The target population for the survey consisted of citizens who had attended the PHE (n=18) and experts who made evidence-based recommendations (n=11). Citizens and experts assigned a score on a 9-point Likert scale for each outcome of 14 interventions. We analyzed the intragroup agreement based on Krippendorff’s alpha and the intergroup agreement using the cube root product measure (CRPm). We further tested for significant differences between the groups using the Mann U-test.Results: Agreements within the groups of citizens and experts varied across the interventions and tended to be poor (α ≤ 0 to 0.20) or fair (α = 0.21 to 0.40), with three exceptions showing moderate agreement (α = 0.44 to 0.55). The agreements between the citizens and experts across the interventions was fair (CRPm = 0.28) during the first Delphi rating round. The mean differences between the citizens and experts on the Likert scale ranged from 0.0 to 3.8 during the first rating round and from 0.0 to 3.3 during the second. Across interventions, the citizens rated the outcomes as more important than the experts did (p< 0.01). Individual participants’ ratings varied substantially.Conclusion: Because experts generally underestimated the outcomes’ importance to citizens, the involvement of citizens in guideline panels for preventive services is important.Keywords: outcome ratings, guideline methodology, patient involvement, GRADE, health examination

Objective To analyze the prevalence and epidemiological characteristics of TORCH [Toxoplasma gondii (TOX), coxsackie virus (0), rubella virus (RV), cytomegalovirus (CMV), herpes simplex virus (H) J infection among women undergoing preconception examination in Chongqing, and provide evidence for preconception health care. Methods total of 4 009 serum samples were collected from women of childbearing the w ho were participated in the examination of preconception in Department of Women's Health of the hospital from January 2017 to December 2019. IgM and IgG antibodies of CMV, RV and Tox in serum were determined. The overall infection status and infection status of different age groups and years we re analyzed. The pregnancy out comes of IgM-positive patients we r e followed up after one year. Results The positive rate of CMV IgM was 3. 04 % ( 122/ 4 009), RV IgM was o. 85% (:34 / 4 009), TOX IgM was 0. 80 % 02/4 009). The positive rate of CMV IgG was 90. 70 % (:3 636/4 009), RV IgG was 91. 89 % (:3 68 4/ 4 009), TOX IgG was 2.:39%(96/4 009). There was significant difference in the positive rate of CMV IgM between different age groups (P<0.05), and significant differences in CMV IgM and RV IgM between different years (P<0.05). The adverse pregnancy rate in the TORCH IgM positive group was significantly higher than that in the negative group (P<0.05 ). Conclusion T ORCH infection is common among women of childbearing age in Chongqing, and there are obvious differences in infection rates among different ages and years, an d the incidence of adverse pregnancy in the TORCH positive group was significantly higher than that in the negative group. Therefore, screening for TORCH infection before pregnancy is very important. [ABSTRACT FROM AUTHOR]

This retrospective cross-sectional study aimed to evaluate associations between peptic ulcer disease (PUD), bone mineral density, and metabolic syndrome (MetS) and its components in healthy populations. Data were collected from the health examination database of a tertiary medical center in southern Taiwan from January 2015 to December 2016. Subjects who had undergone metabolic factors assessment, upper gastrointestinal endoscopy, and dual energy X-ray absorptiometry scans were enrolled. In total, 5102 subjects were included, with mean age 52.4 ± 12.0 years. Among them, 1332 (26.1%) had PUD. Multivariate logistic regression analysis showed that age (OR 1.03, p < 0.001), male (OR 1.89, p < 0.001), diabetes (OR 1.23, p = 0.004), BMI (OR 1.03, p = 0.001), and GOT (OR 1, p = 0.003) are risk factors for PUD. Regarding MetS parameters, larger waist circumference (OR 1.26, p = 0.001) is associated with PUD, and high triglycerides (OR 1.20, 95% CI 1.01–1.43) is associated with gastric ulcer, while low HDL (OR 1.31, 95% CI 1.07–1.59) and osteoporosis (OR 1.44, 95% CI 1.08–1.91) are associated with duodenal ulcer. In conclusion, central obesity is associated with PUD in a middle-aged healthy population. Subjects with high triglycerides are prone to gastric ulcers, and those with osteoporosis and low HDL are prone to duodenal ulcers.

This article aims to provide a historical overview of how workplace safety and health legislations in Singapore and Japan have evolved, and perform a comparative analysis of the occupational health systems where work-related medical examinations and health screening are concerned. The discourse is centered on three key themes - coverage, comprehensiveness, and continuity of care. The comparative analysis was performed based on secondary data obtained from open-source platforms. Singapore and Japan have robust workplace safety and health legislative frameworks and laws. However, their approaches diverge because of differing socioeconomic and political contexts. Japan's regulations are generally more comprehensive, require more frequent monitoring of workers' health status, and encompass both physical and mental health components. Singaporean companies focus primarily on the physical component of health, and statutory examinations are required only for exposure to specific occupational hazards. With increasing prominence of mental health issues and shift towards preventive care in Singapore, there will be greater emphasis on a holistic approach to each employee's overall health in future. For Japan, the challenge would be to strike a balance between long-term sustainability of current policies against the need for state and corporations to still retain an adequate stake in ensuring workers' overall health.

Abstract Background and Aims The early and reliable detection of chronic kidney disease is important. In the present study, we aimed to compare the diagnostic results for proteinuria and hematuria between the dipstick test used in primary occupational health examinations and the quantitative tests used in more thorough examinations in clinics. Methods We conducted a single‐center observational study of male staff (N = 573) at Kagoshima University who underwent a health examination in 2017. Both dipsticks and biochemical methods were used to assess proteinuria and hematuria. Results For the dipstick test, the sensitivity, specificity, and positive predictive value were 55.6%, 92.4% and 10.4% for proteinuria, and 64.3%, 98.3% and 66.7% for hematuria, respectively. Four participants for whom false‐negative results were obtained using dipsticks for proteinuria, and two of these had 3+ urinary glucose. Conclusion Qualitative tests for proteinuria and hematuria had low sensitivities and positive predictive values. Therefore, for the early and reliable detection of chronic kidney disease, the use of quantitative urine tests should be considered during occupational health examinations.

IntroductionAnnual LDCT has been offered as a regular examination among many unit staff in China. Along with the wide application of LDCT, more and more ground-glass nodules were found. We focused on characteristics and relationship of ground-glass nodules detected by LDCT as a regular health examination among Chinese hospital employees and their parents.MethodsWe recorded LDCT-detected ground-glass nodules (GGNs) in the hospital employees and parents between 2019 and 2020. Clinical information, including age, gender, smoking status was collected and analyzed.ResultsA total of 5,574 employees and 2,686 employs’ parents ≥60 years in Xiangya hospital performed annual physical examination. In total, LDCT incidentally detected ground-glass nodules 392 (24.78%, 392/1,582) in hospital employees and 254 in parents (10.80%, 254/2,352). The GGN-detection rate was significantly greater in employee group than parent group and more non-smokers in former (P

Introduction: Annual LDCT has been offered as a regular examination among many unit staff in China. Along with the wide application of LDCT, more and more ground-glass nodules were found. We focused on characteristics and relationship of ground-glass nodules detected by LDCT as a regular health examination among Chinese hospital employees and their parents. Methods: We recorded LDCT-detected ground-glass nodules (GGNs) in the hospital employees and parents between 2019 and 2020. Clinical information, including age, gender, smoking status was collected and analyzed. Results: A total of 5,574 employees and 2,686 employs' parents ≥60 years in Xiangya hospital performed annual physical examination. In total, LDCT incidentally detected ground-glass nodules 392 (24.78%, 392/1,582) in hospital employees and 254 in parents (10.80%, 254/2,352). The GGN-detection rate was significantly greater in employee group than parent group and more non-smokers in former (P <0.001). The detection rate was significantly greater in female than male both in employees group and parents group, and the proportion of female was bigger in employees group (P <0.001). There were more pure-GGNs both in employees group and parents group. There were less participants with solitary GGN in employee group than parent group (P = 0.033). Besides, there were more large GGNs (≥10 mm) (P <0.001), LU-RADS 4 GGNs (P <0.001) and LU-RADS 4B GGNs (P = 0.003), LU-RADS 4C-5 GGNs (P = 0.001) in parent group than employee group. There were 36 employee–parent pairs (27.07%) both had GGNs among 133 pairs who both performed LDCT. GGNs in employees were smaller and lower-grade than their parents (P < 0.001, P = 0.001). Conclusions: Among the employees and parents who had ground glass nodules, 1/4 of them both detected GGNs. Although the detection rate of GGNs in the parent group was lower than that in the employee group, the grade of nodules was significantly higher. All these suggest that the occurrence and development of ground glass nodules may be related to genetic factors. [ABSTRACT FROM AUTHOR]

Abstract Background Low back pain (LBP) is a common complaint in the elderly Japanese population. Although previous studies showed that height loss was associated with LBP, it remains unclear whether LBP is associated with body composition. The objective of the present study was to investigate whether body composition and physical characteristics, including height loss, were associated with LBP. Methods The present study is retrospectively registered, and the participants were 2212 community-dwelling Japanese people aged over 60 years who participated in the Shimane CoHRE study in 2016. We investigated the presence of LBP, body composition parameters (muscle, fat, body weight, and bone mass), physical characteristics (body height and height loss), chronic diseases, history of fall, smoking, and drinking habits. We examined the relationships of body composition parameters and physical characteristics with point prevalence of LBP using multivariate logistic regression. Results The point prevalence of LBP was 43.2% in women and 39.5% in men. Logistic regression models showed that body height and body composition were not significantly associated with LBP; however, height loss was associated significantly with LBP in women and men (OR: 1.14, 95% CI: 1.08–1.20 and OR: 1.13, 95% CI: 1.06–1.21, respectively). Hypertension (OR: 1.32, 9 5% CI: 1.04–1.69) and chronic heart disease (OR: 1.57, 95% CI: 1.01–2.43) in women and history of fall (OR: 1.70, 95% CI: 1.13–2.56) and cerebrovascular disease (OR: 1.88, 95% CI: 1.05–3.34) in men were significantly associated with LBP. However, body composition was not associated with LBP in either gender. Conclusions The present study demonstrated that height loss, but not body composition, was related to LBP in community-dwelling elderly people. To elucidate the cause of LBP, it is important to consider the relationship with height loss.

Abstract Background Asylum seekers in Sweden are offered tuberculosis (TB) screening at a voluntary post-arrival health examination. The role of this screening in improving the TB diagnostic pathway has not been previously evaluated. The aim of this study was to determine diagnostic pathways for active TB cases and compare diagnostic delays between different pathways. Methods Retrospective review of medical records of patients reported with active TB in Stockholm in 2015, using a structured and pre-coded form. Results Seventy-one percent of patients actively sought health care due to symptoms. As for source of referral to TB specialist clinic, 15% came from screening of eligible migrants, of whom the majority were asymptomatic. Among asylum seekers, 69% were identified through screening at a health examination (HE). The main sources of referral to TB clinics were emergency departments (27%) and primary health care centers (20%). Median health care provider delay was significantly longer in patients identified through migrant screening in health examination. Conclusions Screening at a health examination was the main pathway of active TB detection among mainly asymptomatic and non-contagious asylum seekers but contributed modestly to total overall TB case detection. In these patients TB was diagnosed early in a non-contagious phase of the disease. Further research is required to assess the effectiveness and cost-effectiveness of HE TB screening as well as inclusion of other groups of migrants from high incidence countries in the screening program in terms of impact on delay, transmission and treatment outcomes.

Abstract Background Increasing evidence suggest that statin therapy has a diabetogenic effect. Individual types of statin may have a different effect on glucose metabolism. Using the repeated nationwide population-based health screening data in Korea, we investigated the longitudinal changes in fasting glucose level of non-diabetic individuals by use of statins. Methods From the National Health Screening Cohort, we included 379,865 non-diabetic individuals who had ≥ 2 health screening examinations with fasting blood glucose level measured in 2002–2013. Using the prescription records of statins in the database, we calculated the proportion of days covered (PDC) and average number of defined daily doses per day (anDDD) by statins. We constructed multivariate linear mixed models to evaluate the effects of statins on the changes in fasting glucose (Δglu). Results High PDC by statins had a significant positive effect on Δglu (coefficient for PDC 0.093 mmol/L, standard error 0.007, p

Introduction: Medical practitioners provide pre-employment examinations and periodic health examinations to seafarers, fishermen, offshore employees, and maritime students to ensure that they are fit for work. So far, very little is known about doctors’ perceptions of their professional training needs and expectations. The objective of this study was to gain insight on (a) the breadth of services offered, (b) follow-up practices, and (c) perceived training needs on aspects of maritime medicine. Methods: All maritime doctors (110) recognized by the Danish Maritime Authority (DMA) and 100 general practitioners (GPs) were invited to participate. A questionnaire was sent out electronically to gather information on the demographics, breadth of services, follow-up practices, and perceived training needs of the participants. Descriptive statistics described the characteristics of the 2 groups. Results: The training priorities of maritime doctors were rules and regulations (68.7%) followed by working conditions and health risks aboard ship (62.8%). The self-rated training priorities of the GPs were working conditions and health risks aboard ship (44.1%), occupational disease diagnostics, prevention, and follow-up (41.1%), and health and safety at work (38.2%). Conclusion: Members of both medical disciplines were in favor of flexible and accredited training. More specifically, GPs considered a course in occupational risks, diseases, and follow up targeting high-risk professions very important. Maritime doctors suggested the establishment of a website as a one-stop shop for relevant guidelines and information. The small size of the GPs sample prevented a more in-depth gap analysis; however, the results could be used to help the respective authorities establish relevant training programs.

Objective: Oxidative stress is considered to cause lifestyle-related diseases, including cancer. Urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) is widely analyzed as an oxidative stress marker. We extensively scrutinized the relationships between 8-OHdG levels and lifestyle choices as carcinogenic factors. Methods: In this study, we investigated health examination results and working conditions affecting urinary 8-OHdG levels in 503 male workers. Results: The urinary 8-OHdG level was positively associated with high blood sugar and leanness in smokers. In addition, urinary 8-OHdG tended to increase with organic solvent or hydrochloric acid exposure, as well as long working hours. On the other hand, the urinary 8-OHdG level was negatively associated with high plasma LDL-cholesterol levels in non-smokers and anemia. Conclusion: According to the results, anemia decreased the oxidative stress, regardless of smoking status, while leanness or high blood sugar increased the oxidative stress in smokers, and the presence of plasma cholesterol contributed to the lower oxidative stress in non-smokers. Certain types of occupational exposure may cause oxidative stress. The measurement of urinary 8-OHdG at annual health checks may be a useful biomarker for preventing lifestyle-and work-related diseases. [ABSTRACT FROM AUTHOR]

For newly arrived asylum seekers, a health examination is common practice in many countries. For asylum seekers, this part of the asylum-seeking process can be experienced as a burden due to communication barriers, feelings of mistrust and insecurity and the experience of being an object rather than an individual. The aim of this study was to explore asylum seekers' lived experiences of dignity while undergoing a health examination. Eight asylum seekers participated in individual in-depth interviews. A phenomenological hermeneutical approach was used to analyse the collected data. The study is reported in accordance with COREQ guidelines. The lived experience of dignity was linked to dignity violation as well as to dignity safeguarded. The participants experienced anxiety about how they would be received. Some were met with kindness and care, but there were also many incidents of demeaning behaviour. With an interpreter present, the participants experienced that they could not speak freely. Numerous healthcare personnel and frequent transfers caused confusion and insecurity. Well-organised health centres made participants experience a sense of safety and respect. The results can be understood as a pattern consisting of four categories: rights-related, care-related, communication-related and system-related. This small study, which limits the conclusions that can be drawn, conveys that ethical awareness and professional expertise may contribute to safeguarding asylum seekers' dignity in the above categories during a health examination. [ABSTRACT FROM AUTHOR]

Objective: To examine the biofactors associated with bone mineral density (BMD) in southern Taiwanese adults. Materials and Methods: The medical records of 3242 adults who underwent health examinations between June 2014 and February 2018 at a regional hospital in southern Taiwan were reviewed. The data collected included health history, anthropomorphic characteristics, clinical laboratory results, biochemical parameters, and BMD. The data were used to identify the biofactors associated with BMD/T-scores at the lumbar spine and femoral neck by multivariate linear regression analysis with the stepwise method. Results: The mean age of the patients was 58.1 years, and 71.4% were male. Factors positively correlated with BMD and the T-score included body mass index (BMI), male gender, calcium, and creatinine. Age, alkaline phosphatase (ALP), triiodothyronine, serum thyroxine, low-density lipoprotein cholesterol, and a history of hyperlipidemia were negatively correlated with BMD and the T-score. Conclusion: The associated biofactors reported here were similar to and had similar relationships as the biofactors identified in previous literature reports. Not all of the sites examined for BMD were influenced by the same association factors, except for BMI, male gender, age, and ALP, implying that the bone remodeling processes that shape BMD involve a complex regulatory network and demonstrating that our extracted factors are the most useful for clinical practice. [ABSTRACT FROM AUTHOR]

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Objectives: The objective of this study was to estimate the prevalence of dyslipidemia and associated influencing factors in young adults in the southeastern coastal area of China.Methods: This study adopted a cross-sectional survey and included 7,859 young people who underwent examinations at three hospitals in Wenzhou, Zhejiang Province, China. All subjects completed a questionnaire in the form of face-to-face interviews and underwent anthropometric measurements and biochemical tests. The continuous data are presented as the means ± standard deviations and were compared using Student's t-tests. The categorical variables are presented as proportions. The influencing factors associated with dyslipidemia were evaluated through a multivariate logistic regression.Results: The prevalence of dyslipidemia among young adults aged 18–45 years in the southeastern coast of China was high with 7.1, 15.0, 22.9, and 4.0% for high-total cholesterol (TC), high-triglyceride (TG), low-high-density lipoprotein cholesterol (HDL-C), and high-low-density lipoprotein cholesterol (LDL-C). Among those with dyslipidemia, a statistically significant difference in sex was observed, and all types of dyslipidemia were associated with smoking and alcohol consumption. However, those with high-TG, high-LDL, and low-HDL levels did not significantly differ in education level or occupation. The presence of dyslipidemia was significantly associated with increased age, the male sex (OR: 1.85, 95% CI: 1.39–2.21), smoking (OR: 2.02, 95% CI: 1.98–2.13), alcohol consumption (OR: 1.33, 95% CI: 1.16–1.63), overweight or obesity (OR: 2.01, 95% CI: 1.79–2.41), and intellectual work (OR: 1.36, 95% CI: 1.11–1.72).Conclusion: The prevalence of dyslipidemia among young adults aged 18–45 years in the southeastern coast of China was high. To prevent dyslipidemia at an early age, it is essential to conduct effective intervention programs targeting risk factors and to implement routine screening programs.

An inertial measurement system for estimating gait parameters indicating cognitive impairment is developed for use during large-scale health checkups. Current health checkups conduct a 10 m fastest gait examination to assess signs of cognitive impairment and physical performance. Earlier methods require examiners to follow a subject and measure the gait time using a stopwatch. The method proposed herein reduces burdens on examiners. Several gait parameters in addition to the gait time of many subjects can be measured simultaneously and quantitatively from three-dimensional foot movements estimated using inertial sensors comprising two accelerometers and two gyroscopes with different measurement range attached to both feet. Gait parameters derived from the inertial sensor are gait time, stride length, gait cycle, gait velocity, toe angle, toe height, and the percentage of swing phase. The gait condition, such as walking or running, is distinguished from the moment of toe off and heel contact of both feet. In all, 1406 subjects with ages of 19-93 years old were given instructions to walk at their highest velocity on a straight 16-m-long walking course. Mini-Mental State Examination (MMSE) is conducted on subjects. The score is used as a reference valuation of the cognitive impairment level. Experimental results show that the proposed measurement system provides equal performance to that obtained using a stopwatch and improves correlation between the MMSE score and the fastest 10 m gait time of subjects who did not run. Furthermore, it is confirmed that the proposed measurement system using inertial sensors can quantitatively provide spatiotemporal gait parameters to evaluate the physical performance in a short time during the large-scale health checkups.

Abstract Background Poor uptake among socio-economically disadvantaged and susceptible populations is a well-known challenge of general health check interventions, and is widely cited as one of the reasons for the lack of population level effects seen in many studies. We report on patient characteristics among attendees and non-attendees of health checks made available to residents in the social housing sector of the municipality of Aarhus. We focus on this general population, as well as a particular sub-group living in an exceptionally deprived social housing area, and discuss the properties of intervention uptake that we need to be aware of to qualify and compare the effects of general versus targeted health checks in socially deprived areas. Methods Cross-sectionally in a sample of 6650 residents of the Aarhus social housing sector who were invited for a health check in the first year of the ‘Your Life – Your Health’ program. The analyses consisted of 1) descriptive analysis of the characteristics of attenders/non-attenders, 2) unadjusted and adjusted Poisson regression to examine associations of patient characteristics and uptake of health checks, and 3) decision tree analyses (CHAID) to examine interaction and homogeneity in patient characteristics among attenders. Results Of the overall population 30% attended. In a nested cohort of people residing in a particularly deprived social housing settlement, 25% attended. Further, in the overall population, we found an association between the likelihood of taking up a health check and age, sex, country of origin, educational attainment, cohabitation, occupational status, and past medical treatment. In the nested cohort the association between uptake and medical treatment was non-significant, while the association between uptake and occupation was limited to people who were employed. These results resonate with past evidence on health check attendance. Conclusions Attendance in the ‘Your Life – Your Health’ program is higher among people of a higher socio-economic status. This should be taken into consideration when analysing and interpreting the overall study effects. Moreover, the results suggest that a targeted approach in the social housing sector could be more effective than a mass screening approach. However, more information is required to make such assertion definitive.

Objective: To investigate the prevalence and related risk factors of osteoporosis in Partial Population of Beijing. Methods: 346 people who came to our hospital for health examination in Haidian district, Beijing from January to June 2018 were slected. Bone mineral density (BMD) of the hip was measured using dual energy X-ray absorptiometry. The height, weight and the body mass index (BMI) was collected. A survey of previous history, including previous disease, drug use and lifestyle habits was conducted. The occurrence of osteoporosis and its related risk factors between different bone masses and genders was analyzed. Results: The prevalence of osteoporosis is 26.8% for all 346 people, and 35.3% for female. BMD abnormal accounts for 69.5% in all population. For all population, advanced age, coffee consumption and carbonated drinks are risk factors of osteoporosis (OR 1.098, 95% CI 1.072-1.125; OR 3.576, 95% CI 1.302-9.826; OR 5.407, 95%CI 1.317-22.202). For male, advanced age, use of hormone and coffee consumption are risk factors of osteoporosis (OR 1.103, 95%CI 1.065-1.142; OR 127.924, 95%CI 10.045->999.999; OR 11.863, 95%CI 2.969-47.400). For female, advanced age is risk factor of osteoporosis (OR 1.088, 95%CI 1.059-1.117). Conclusion: The middle-aged and elderly population in Haidian District of Beijing has a high prevalence of osteoporosis. Advanced age, low body weight and poor living habits are risk factors related to osteoporosis, and higher body weight is protective factor of osteoporosis, thus early screening and intervention are advised for these population. [ABSTRACT FROM AUTHOR]

Objectives: At the Fukushima Daiichi Nuclear Power Plant, run by the Tokyo Electric Power Company, new procedures were introduced as part of the fitness for duty program in July 2016. These were designed to ensure that treatment and further investigations identified as necessary during health examinations were carried out. This study aimed to assess the effectiveness of the initiative by testing whether workers who needed further health examinations obtained them promptly, and whether the number with unmet health needs decreased and the number of workers being treated increased. Methods: The primary contractors reported aggregated quarterly results of health examinations of both their own and their subcontractors' employees, and follow‐up visits to medical institutions were also reported over the next two quarters. The study used data for the period from July 2016 to December 2018. Incident rate ratios were estimated using a multilevel Poisson regression model, including the logarithm of the number of workers who took health examination for each primary contractor company as offset. The linear trend was assessed by treating the number of periods as a continuous variable. Results: The incident rate ratio for workers who needed treatment having a follow‐up examination promptly showed a significant decrease over time. The incident rate ratio for those with unmet needs decreased, and those being treated increased over time. Conclusions: The findings showed that the initiative was effective, with the number of early visits for further health examinations increasing and a decrease in the number of people with unmet health needs. [ABSTRACT FROM AUTHOR]

Abstract Background Shark meat is used as sacrificial food in Gyeongsangbuk-do, and is a major source of dietary mercury. This study aimed to evaluate the effects of shark meat intake or the ritual of Jesa on blood mercury levels within workers living in Gyeongsangbuk-do. Methods This study was conducted from September 2016 to October 2016 in two cities of Gyeongsangbuk-do. To compare the differences between urban and rural areas, two workplaces each in Daegu as the urban area and Yeongcheon as the rural area were selected. General characteristics and characteristics related to shark meat consumption of the workers were acquired by personal interviews during their health examination. Blood mercury concentrations were analyzed by the gold amalgamation method using a direct mercury analyzer (DMA-80; Milestone Inc., Shelton, CT, USA). Results The shark consumption group had a higher blood mercury concentration than the non-consumption group. The levels of blood mercury increased with the frequency, annual intake, as well as most recent date of shark meat consumption. Moreover, the levels of mercury in blood increased according to the annual frequency of participation in Jesa (times per year) and the annual frequency of shark meat consumption during Jesa (times per year). Conclusions Shark meat intake and the ritual of Jesa contributed to an increase in the blood mercury levels of workers in Gyeongsangbuk-do. Therefore, it is necessary to evaluate dietary exposure, occupational as well as other factors that may influence blood mercury concentrations in workers during their health examination, particularly in regions with high mercury exposures.

Background: To investigate the impact of the Great East Japan Earthquake on preschool children's physical growth in the disaster-affected areas, the three medical universities in Iwate, Miyagi, and Fukushima Prefectures conducted a health examination survey on early childhood physical growth. Methods: The survey was conducted over a 3-year period to acquire data on children who were born in different years. Our targets were as follows: 1) children who were born between March 1, 2007 and August 31, 2007 and experienced the disaster at 43–48 months of age, 2) children who were born between March 1, 2009 and August 31, 2009 and experienced the disaster at 19–24 months of age, and 3) children who were born between June 1, 2010 and April 30, 2011 and were under 10 months of age or not born yet when the disaster occurred.We collected their health examination data from local governments in Iwate, Miyagi, and Fukushima Prefectures. We also collected data from Aomori, Akita, and Yamagata Prefectures to use as a control group. The survey items included birth information, anthropometric measurements, and methods of nutrition during infancy. Results: Eighty municipalities from Iwate, Miyagi, and Fukushima Prefectures and 21 from the control prefectures participated in the survey. As a result, we established three retrospective cohorts consisting of 13,886, 15,474, and 32,202 preschool children. Conclusions: The large datasets acquired for the present survey will provide valuable epidemiological evidence that should shed light on preschool children's physical growth in relation to the disaster.