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Background: The association between Estradiol (E2) levels and abdominal aortic calcification (AAC) in postmenopausal women remains unclear. Methods: 614 postmenopausal women from the 2013-2014 NHANES survey cycle were included in this study. The study population was divided into 3 groups according to E2 tertiles: Tertile1 (2.12-3.57pg/mL), Tertile2 (3.60-7.04pg/mL), and Tertile3 (7.06-38.4pg/mL). Estrogen concentration data were natural logarithmically transformed. A Kauppila score > 5 was regarded as prominent arterial calcification and was used to define (EAAC). Logistic regression models were used to assess the association between E2 levels and EAAC prevalence. Subgroup analyses were performed to test whether the association between E2 levels and EAAC prevalence was consistent in different groups. Sensitivity analyses tested the stability of the model in women older than 45 years. Results: EAAC prevalence was significantly higher in Tertile1 (16.6%) than in Tertile2 (9.8%) and Tertile3 (8.3%). On a continuous scale, the adjusted model showed a 58% [OR (95%CI), 1.58 (1.02, 2.54)] increase in the risk of EAAC prevalence for per unit decrease in ln(E2). On a categorical scale, the adjusted model showed that Tertile1 and Tertile2 were 2.55 [OR (95%CI), 2.55 (1.10, 5.92)] and 1.31[OR (95%CI), 1.31(1.03, 2.57)] times higher risk of suffering from EAAC than Tertile3, respectively. Conclusion: This study found that a higher prevalence of AAC in postmenopausal women is closely associated with lower serum E2 levels. Our research further underscores the importance of E2 in maintaining cardiovascular health in postmenopausal women and suggests that monitoring E2 levels may aid in the early prevention and management of AAC and related cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Introduction: Studies examining the relationships among suicidal ideation, emotional vulnerability, and depressive symptoms are scarce. This study examined the effects of emotional vulnerability and depressive symptoms on suicidal ideation among Japanese university students Methods: A questionnaire survey was conducted with 370 Japanese university students. Data were analyzed using descriptive statistics and multiple regression analysis Results: In the multiple regression analysis, depressive symptoms were significant (β = .46, p <.001) but emotional vulnerability was not (β = .05, p = .318). A significant interaction emerged between emotional vulnerability and depressive symptoms (β = .22, p <.001). The model's R² value was.31 (p <.001). Simple slopes tests revealed the impact of depressive symptoms on suicidal ideation, even with low emotional vulnerability (β = .06, β = .27, p <.001), and a higher impact with high emotional vulnerability (β = .15, β = .65, p <.001) Discussion: The negative interaction between emotional vulnerability and depressive symptoms may heighten suicidal ideation among Japanese university students. Interventions targeting emotional vulnerability may help reduce suicidal ideation and achieve lower suicide rates. [ABSTRACT FROM AUTHOR]

Background: Higher thyroid-stimulating hormone (TSH) amidst normal thyroid hormone (TH) levels may contribute to a negative impact on cardiovascular health (CVH). We sought to probe the associations between Life's Essential 8 (LE8), a newly revised CVH evaluation, and low thyroid function among US adults. Methods: The datasets from the 2007-2012 National Health and Nutrition Examination Survey (NHANES) were applied to the study. Low-normal thyroid function and subclinical hypothyroidism (SCH) were both regarded to be low thyroid function. Multivariable logistic regressions were utilized to inquire about the relationship between LE8 and low thyroid function. Results: Among the 6,315 participants (age =20 years), 1,375 (21.77%) were ascertained to be low thyroid function. After adjusting possible confounders, a higher LE8 score was linked to a lower probability of experiencing low thyroid function (Odds ratio [OR] for each 10-point increase: 0.923 [95% CI, 0.884-0.964]). A similar correlation was found between the health factors score and low thyroid function (OR for each 10-point increase: 0.905 [95% CI, 0.876-0.935]). Also, scoring better on physical activity (PA), body mass index (BMI), blood lipid, blood glucose (BG), and blood pressure (BP) may be conducive to reducing the rates of low thyroid function. Furthermore, subgroup and sensitivity analyses indicated that the negative correlations were generally robust. Conclusions: The LE8 score and health factors score were nonlinearly and negatively related to the prevalence concerning low thyroid function. Promoting the regulation of optimum CVH levels could work on mitigating the load of low thyroid function and cardiovascular diseases (CVDs). [ABSTRACT FROM AUTHOR]

Background: Testosterone deficiency (TD) is an urgent health issue that requires attention, associated with various adverse health outcomes including cardiovascular diseases (CVD) and metabolic syndrome. Remnant cholesterol (RC) has emerged as a potential biomarker for cardiovascular risk, but its relationship with testosterone levels and TD has not been thoroughly investigated. This study aims to explore the association between RC and TD in adult American males using data from the National Health and Nutrition Examination Survey (NHANES). Methods: This cross-sectional study utilized data from three NHANES cycles (2011-2016), including 2,848 adult male participants. RC was calculated as total cholesterol minus high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL). TD was defined as total testosterone levels below 300 ng/dL. Multivariable linear and logistic regression analyses, as well as smooth curve fitting and generalized additive models, were performed to assess the associations between RC and total testosterone levels and TD, adjusting for potential confounders. Subgroup analyses were conducted based on age, BMI, smoking status, diabetes, hypertension, CVD, and chronic kidney disease (CKD). Results: Higher RC levels were significantly associated with lower total testosterone levels (b = -53.87, 95% CI: -77.69 to -30.06, p<0.001) and an increased risk of TD (OR = 1.85, 95% CI: 1.29 to 2.66, p=0.002) in fully adjusted models. When RC was analyzed as quartiles, participants in the highest quartile (Q4) had significantly lower total testosterone levels (b = -62.19, 95% CI: -93.62 to -30.76, p<0.001) and higher odds of TD (OR = 2.15, 95% CI: 1.21 to 3.84, p=0.01) compared to those in the lowest quartile (Q1). Subgroup analyses revealed consistent associations across different age groups, particularly strong in participants over 60 years, and in never smokers. The associations remained significant in both hypertensive and non-hypertensive groups, as well as in those with and without CKD. No significant interactions were found across subgroups. Conclusion: This study demonstrates a significant inverse association between RC levels and total testosterone levels, along with a positive association with the risk of TD. These findings suggest that RC could serve as a valuable biomarker for early identification of individuals at risk for TD. Future longitudinal studies are needed to confirm these findings and explore the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background: Hypothyroidism and Type 2 Diabetes Mellitus (T2DM) are prevalent endocrine disorders, and their interplay has garnered significant attention due to potential bidirectional relationships. This study investigates the association of hypothyroidism in T2DM patients, focusing on prevalence, clinical correlations, and implications for management. Materials & Methods: A cross-sectional study was conducted at Hind Institute of Medical Sciences, Uttar Pradesh, involving 50 T2DM patients. Clinical assessments, thyroid function tests, and diabetes parameters were collected. Statistical analyses, including descriptive statistics, odds ratios, and correlation coefficients, were employed to explore associations. Results: Among T2DM patients, 20% exhibited hypothyroidism, emphasizing a noteworthy prevalence. Alterations in thyroid function parameters, including elevated TSH and decreased FT4 and FT3, indicated subclinical hypothyroidism. Glycemic control analyses revealed significant differences in FBG and HbA1c levels between euthyroid and hypothyroid individuals. Odds ratios demonstrated associations between hypothyroidism and age, BMI, and T2DM duration. Medication usage patterns highlighted the necessity of thyroid-specific interventions. Conclusion: This study uncovers a substantial prevalence of hypothyroidism in T2DM patients, emphasizing the intricate relationship between these endocrine disorders. Clinical correlations with age, BMI, and T2DM duration suggest the need for tailored therapeutic approaches. Recognizing the impact on glycemic control, screening strategies, and public health measures may enhance patient outcomes in this complex interplay. [ABSTRACT FROM AUTHOR]

Background: The long-term impact of COVID-19 on the mental health and well-being of college students, specifically trends over time after full removal of COVID-19 restrictions, has not been well-studied. Methods: Four consecutive cross-sectional surveys were conducted in December 2022 (N = 689), March 2023 (N = 456), June 2023 (N = 300), and November 2023 (N = 601) at a university in Sichuan Province, China. Results: The proportion of students with COVID-19 panic decreased from 95.1 to 77.3% (p < 0.001). The prevalence of moderate anxiety and above decreased from 18 to 13.6% (p < 0.001), and the prevalence of moderate and above depression decreased from 33.1 to 28.1% (p < 0.001), while the prevalence of post-traumatic stress disorder (PTSD) increased from 21.5 to 29.6% (p < 0.005). Further, the proportion of suicidal thoughts increased from 7.7 to 14.8% (p < 0.001). Suicidal thoughts and self-injuries were significantly associated with COVID-19 panic, depression, anxiety, and PTSD. Students who reported being in close contact with COVID-19 patients in the past were more likely to develop PTSD. Further, COVID-19-induced panic was a risk factor for self-injury. Conclusion: One year after the COVID-19 pandemic, the overall mental health of college students was not optimal. Hence, we can conclude that the longterm impacts of COVID-19 on the mental health of college students may have already occurred. To mitigate this impact and prepare for the next major public health event, strengthening college students' mental health curricula and promoting healthy behaviors among college students should be a priority for universities and education authorities. [ABSTRACT FROM AUTHOR]

Background: Testosterone deficiency (TD) is closely associated with cardiovascular diseases (CVD). We intended to explore the association of Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health, with the prevalence of TD among US male adults. Methods: The population-based cross-sectional study selected male adults aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. According to the American Heart Association definitions, the LE8 score was measured on a scale of 0-100, and divided into health behavior and health factor scores, simultaneously. Furthermore, these scores were categorized into low (0-49), moderate (50-79), and high (80-100) classifications. TD is defined as a total testosterone level below 300ng/dL. Correlations were investigated by weighted multivariable logistic regression, and the robustness of the results were verified by subgroup analysis. Results: A total of 4971 male adults with an average age of 47.46 ± 0.41 years were eligible for the final analyses, of whom 1372 were determined to have TD. The weighted mean LE8 score of the study population was 68.11 ± 0.41. After fully adjusting potential confounders, higher LE8 scores were significantly associated with low risk of TD (odd ratio [OR] for each 10-point increase, 0.79; 95% CI, 0.71-0.88) in a linear dose-response relationship. Similar patterns were also identified in the association of health factor scores with TD (OR for each 10-point increase, 0.74; 95% CI, 0.66-0.83). These results persisted when LE8 and health factor scores was categorized into low, moderate, and high groups. The inversed association of LE8 classifications and TD remained statistically significant among older, obese, and men without CVD. Conclusions: LE8 and its health factor subscales scores were negatively associated with the presence of TD in linear fashions. Promoting adherence to optimal cardiovascular health levels may be advantageous to alleviate the burden of TD. [ABSTRACT FROM AUTHOR]

Introduction: Insulin resistance (IR) is a feature of metabolic syndrome and plays an important role in cognitive impairment (CI). The triglyceride-glucose (TyG) index is a convenient and cost-effective surrogate for assessing IR. This study aimed to assess the association between the TyG index and CI. Methods: This community population-based cross-sectional study used a cluster-sampling methodology. All participants underwent the education-based Mini-Mental State Examination (MMSE), and those with CI were identified using standard thresholds. The fasting blood triglyceride and glucose levels were measured in the morning, and the TyG index was calculated as ln (½ fasting triglyceride level [mg/dL] × fasting blood glucose level [mg/dL]). Multivariable logistic regression and subgroup analysis were used to assess the relationship between the TyG index and CI. Results: This study included 1484 subjects, of which 93 (6.27%) met the CI criteria. Multivariable logistic regression showed that CI incidence increased by 64% per unit increase in the TyG index (odds ratio [OR] = 1.64, 95% confidence interval [CI]: 1.02-2.63, p = 0.042). CI risk was 2.64-fold higher in the highest TyG index quartile compared to the lowest TyG index quartile (OR = 2.64, 95% CI: 1.19-5.85, p = 0.016). Finally, interaction analysis showed that sex, age, hypertension, and diabetes did not significantly affect the association between the TyG index and CI. Conclusion: The present study suggested that an elevated TyG index was associated with a higher CI risk. Subjects with a higher TyG index should manage and treat at an early stage to alleviate the cognitive decline. [ABSTRACT FROM AUTHOR]

Aims: The primary objective of this study was to investigate the relationship between the platelet/high-density lipoprotein cholesterol ratio (PHR) and the prevalence of nephrolithiasis within the adult population of the United States. Methods: The data used in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2018. The analysis included a non-pregnant population aged 20 years or older, providing proper PHR index and nephrolithiasis data. The research utilized subgroup analyses and weighted univariate and multivariable logistic regression to evaluate the independent association between the PHR and the susceptibility to nephrolithiasis. Results: The study comprised 30,899 participants with an average PHR value of 19.30 ± 0.11. The overall prevalence rate of nephrolithiasis was estimated at 9.98% with an increase in the higher PHR tertiles (T1, 8.49%; T2, 10.11%; T3, 11.38%, P < 0.0001). An elevated PHR level was closely linked with a higher susceptibility to nephrolithiasis. Compared with patients in T1, and after adjusting for potential confounders in model 2, the corresponding odds ratio for nephrolithiasis in T3 was 1.48 (95% CI: 1.06 to 2.08), with a P-value = 0.02. The results of the interaction tests revealed a significant impact of chronic kidney disease on the relationship between PHR and nephrolithiasis. Furthermore, the restricted cubic spline analyses exhibited a positive, non-linear correlation between PHR and the risk of nephrolithiasis. Conclusion: A convenient biomarker, the PHR, was independently associated with nephrolithiasis and could be a novel biomarker in predicting occurrence in clinical decision. [ABSTRACT FROM AUTHOR]

Abstract Background Cardiometabolic index (CMI), a novel indicator that combines abdominal obesity and lipid levels, has been confirmed to correlate with non-alcoholic fatty liver disease (NAFLD). However, limited research has been conducted on the relationship between CMI and controlled attenuation parameter (CAP), a parameter measured by transient elastography and reflecting the extent of fat accumulation in the liver. The objective of our study was to investigate the relationship between the two variables. Methods This was a cross-sectional study with a sample size of 1,759 U.S. adults with NAFLD sourced from the NHANES 2017–2020. Participants with a median CAP ≥ 248 dB/m were considered to have hepatic steatosis. CMI was calculated as [waist circumference (cm)/height(cm)]×[TG (mmol/L)/HDL-C (mmol/L)]. Multivariate linear regression, generalized additive model and subgroup analysis were employed to examine the association of CMI and CAP. Results The average age of the 1,759 participants was 50.2 years, with males accounting for 50.76% and females 49.24%. The average BMI was 32.23 kg/m². The multivariate linear regression model indicated that with every 1-unit increase in CMI, there was an associated rise of 10.40 dB/m in CAP (95% CI, 7.14–13.67) after adjusting for covariates and a p for trend

Background: Cardiometabolic index (CMI), a novel indicator that combines abdominal obesity and lipid levels, has been confirmed to correlate with non-alcoholic fatty liver disease (NAFLD). However, limited research has been conducted on the relationship between CMI and controlled attenuation parameter (CAP), a parameter measured by transient elastography and reflecting the extent of fat accumulation in the liver. The objective of our study was to investigate the relationship between the two variables. Methods: This was a cross-sectional study with a sample size of 1,759 U.S. adults with NAFLD sourced from the NHANES 2017–2020. Participants with a median CAP ≥ 248 dB/m were considered to have hepatic steatosis. CMI was calculated as [waist circumference (cm)/height(cm)]×[TG (mmol/L)/HDL-C (mmol/L)]. Multivariate linear regression, generalized additive model and subgroup analysis were employed to examine the association of CMI and CAP. Results: The average age of the 1,759 participants was 50.2 years, with males accounting for 50.76% and females 49.24%. The average BMI was 32.23 kg/m². The multivariate linear regression model indicated that with every 1-unit increase in CMI, there was an associated rise of 10.40 dB/m in CAP (95% CI, 7.14–13.67) after adjusting for covariates and a p for trend < 0.05 suggested the existence of a linear association between the two variables. Similarly, generalized additive model also found it a roughly linear relationship between the two. Subgroup analysis revealed a positive correlation in the majority of subgroups. Conclusions: CMI was positively associated with CAP in U.S. adults with NAFLD. Our findings indicated that CMI may serve as an ideal indicator for monitoring the degree of hepatic steatosis among patients with NAFLD. [ABSTRACT FROM AUTHOR]

Background: Chronic alcohol abuse remains a pressing global health concern, with far-reaching implications for both biochemical markers and cardiac function. This cross-sectional study aims to comprehensively assess the impact of chronic alcohol abuse on these parameters. Methods: We conducted a study involving 200 participants to investigate the interplay between demographics, alcohol consumption patterns, biochemical markers, and cardiac function. Data were collected through questionnaires, biochemical assays, and echocardiographic assessments. Results: Demographics and Alcohol Consumption Patterns: Our finding revealed a predominantly middle-aged cohort, with a higher prevalence of males (60%) and an average age of 45 years. Participants demonstrated chronic alcohol abuse, with an average duration of 18 years and daily alcohol intake significantly exceeding recommended limits.In a cohort of 200 chronic alcohol users, our study identified significant elevations in biochemical markers: GGT (70 ± 20 U/L), BNP (300 ± 100 pg/mL), and NT-proBNP (900 ± 300 pg/mL), all surpassing normal ranges, indicative of liver and cardiac stress. Echocardiographic data revealed increased ventricular dilation (35 ± 10%) and reduced ejection fraction (50 ± 8%), highlighting cardiac dysfunction. Conclusion: Comparative analysis showed more pronounced abnormalities in heavy drinkers versus moderate drinkers, emphasizing the dose-dependent impact of alcohol on health. [ABSTRACT FROM AUTHOR]

INTRODUCTION This study comprehensively assessed the association between eight metabolites of urinary nicotine and cognitive impairment. METHODS This cross-sectional study was based on the data of Shenzhen Aging Related Disorder Cohort (SADC), including 51 elderly community data variables such as demographic characteristics, neuropsychological assessment and environmental factors, from July 2017 to November 2018. Participant's cognitive function was assessed by Mini-Mental State Examination (MMSE) scale and urinary nicotine metabolite [including cotinine N-β-D-glucuronide (CotGluc), rac 4-hydroxy-4-(3-pyridyl) butanoic acid dicyclohexylamine salt (HyPyBut), trans-3'-hydroxy cotinine O-β-D-glucuronide (OHCotGluc), and cotinine (Cot), etc.] concentrations were measured by high-performance liquid chromatographytandem mass spectrometry (LC-MS/MS). Generalized linear models and restricted cubic spline models were used to explore the relationships between the urinary levels of nicotine metabolite and cognitive function. RESULTS A total of 296 individuals aged >60 years were included. Individuals in the third quartile of CotGluc had a 0.786 point (95% CI: -1.244 -- -0.329) decrease or in the highest quartile of OHCotGluc had a 0.804 point (95% CI: -1.330 -- -0.278) decreased in attention and calculation compared to those in the lowest quartile (all p for trend <0.05). Compared with those in the lowest quartile, individuals in the highest quartile of CotGluc, HyPyBut, OHCotGluc and Cot, respectively, corresponded to a 1.043 point (95% CI: -2.269-0.182), 1.101 points (95% CI: -2.391-0.188), 2.318 points (95% CI: -3.615 -- -1.020), and 1.460 points (95% CI: -2.726 -- -0.194) decreased in MMSE total score (all p for trend <0.05). A nonlinear dose-response relationship between urinary levels of CotGluc, HyPyBut, OHCotGluc or Cot and cognitive function (all overall p<0.05, non-linear p<0.05). Subgroup analysis showed that urinary levels of CotGluc, OHCotGluc or Cot were significantly negatively associated with cognitive function (all p for trend <0.05) among females and non-smokers. CONCLUSIONS The findings highlight the public health implications of environmental tobacco smoke exposure, and effective interventions need to be performed for vulnerable populations. [ABSTRACT FROM AUTHOR]

Background: Remnant cholesterol (RC) and chronic kidney disease (CKD) have not been definitively linked in individuals with different characteristics. This study aims to investigate the relationship between serum RC level and CKD and examine possible effect modifiers in Chinese patients with hypertension. Methods: Our study is based on the Chinese H-type Hypertension Project, which is an observational registry study conducted in real-world settings. The outcome was CKD, defined as an estimated glomerular filtration rate of less than 60 ml/min·1.73 m2. Multivariate logistic regression and smooth curve fitting were used to analyze the association between RC and CKD. Subgroup analyses were subsequently conducted to examine the effects of other variables. Results: The mean age of the 13,024 patients with hypertension at baseline was 63.8 ± 9.4 years, and 46.8% were male. A conspicuous linear positive association was observed between RC level and CKD (per SD increment; odds ratio [OR], 1.15; 95% confidence interval [CI], 1.08-1.23). Compared with the lowest quartile group of RC, the risk of CKD was 53% higher (OR, 1.53; 95% CI, 1.26-1.86) in the highest quartile group. Furthermore, a stronger positive association between RC level and CKD was found among participants with a higher body mass index (BMI <24 vs. =24 kg/m2; P-interaction = 0.034) or current non-smokers (smoker vs. non-smoker; P-interaction = 0.024). Conclusions: Among Chinese adults with hypertension, RC level was positively associated with CKD, particularly in those with a BMI of =24 kg/m2 and current non-smokers. These findings may help improve lipid management regimens in patients with hypertension. [ABSTRACT FROM AUTHOR]

Background: Demographic information has been shown to help predict high antibody titers of COVID-19 convalescent plasma (CCP) in CCP donors. However, there is no research on the Chinese population and little evidence on whole-blood donors. Therefore, we aimed to investigate these associations among Chinese blood donors after SARS-CoV-2 infection. Methods: In this cross-sectional study, 5,064 qualified blood donors with confirmed or suspected SARS-CoV-2 infection completed a self-reported questionnaire and underwent tests of SARS-CoV-2 Immunoglobulin G (IgG) antibody and ABO blood type. Logistic regression models were used to calculate odds ratios (ORs) for high SARS-CoV-2 IgG titers according to each factor. Results: Totally, 1,799 participants (with SARS-CoV-2 IgG titers=1:160) had hightiter CCPs. Multivariable analysis showed that a 10-year increment in age and earlier donation were associated with higher odds of high-titer CCP, while medical personnel was associated with lower odds. The ORs (95% CIs) of high-titer CCP were 1.17 (1.10-1.23, p< 0.001) and 1.41 (1.25-1.58, p< 0.001) for each 10-year increment in age and earlier donation, respectively. The OR of high-titer CCP was 0.75 (0.60-0.95, p = 0.02) for medical personnel. Female early donors were associated with increased odds of high-titer CCP, but this association was insignificant for later donors. Donating after 8 weeks from the onset was associated with decreased odds of having high-titer CCP compared to donating within 8 weeks from the onset, and the HR was 0.38 (95% CI: 0.22-0.64, p <0.001). There was no significant association between ABO blood type or race and the odds of high-titer CCP. Discussion: Older age, earlier donation, female early donors, and non-medicalrelated occupations are promising predictors of high-titer CCP in Chinese blood donors. Our findings highlight the importance of CCP screening at the early stage of the pandemic. [ABSTRACT FROM AUTHOR]

Objective: In patients with bipolar disorder (BD), rapid cycling (RC) presents a risk for a more severe illness, while euthymia (EUT) has a better prognosis. This study focused on the progression of RC and EUT, which are contrasting phenomenology, and aimed to clarify the influence of patient backgrounds and prescription patterns on these different progressions, using a large sample from the first and second iterations of a multicenter treatment survey for BD in psychiatric clinics (MUSUBI). Methods: In the cross-sectional study (MUSUBI), a questionnaire based on a retrospective medical record survey of consecutive BD cases (N = 2,650) was distributed. The first survey was conducted in 2016, and the second one in 2017. The questionnaire collected information on patient backgrounds, current episodes, and clinical and prescribing characteristics. Results: In the first survey, 10.6% of the participants had RC and 3.6% had RC for two consecutive years, which correlated with BP I (Bipolar disorder type I), suicidal ideation, duration of illness, and the use of lithium carbonate and antipsychotic medications. Possible risk factors for switching to RC were comorbid developmental disorders and the prescription of anxiolytics and sleep medication. Moreover, 16.4% of the participants presented EUT in the first survey, and 11.0% presented EUT for two consecutive years. Possible factors for achieving EUT included older age; employment; fewer psychotic symptoms and comorbid personality disorders; fewer antidepressants, antipsychotics, and anxiolytics, and more lithium prescriptions. Conclusion: RC and EUT generally exhibit conflicting characteristics, and the conflicting social backgrounds and factors contributing to their outcomes were distinctive. Understanding these clinical characteristics may be helpful in clinical practice for management of patients with BD. [ABSTRACT FROM AUTHOR]

Purpose: Oral health plays an important role in overall health. But there is scarce information available on oral health behavior and oral health service utilization among cancer patients. This study aimed to evaluate oral health behavior and oral health service utilization among different population groups of cancer patients in China. Methods: A multicenter cross-sectional study in three tertiary hospitals was conducted to explore the oral health behaviors and oral health service utilization of 162 cancer patients in China. Results: We investigated a total of 162 cancer patients, 81 from urban and rural areas, respectively. The participant's ages ranged from 18 and 82 years, mean age was 44.62 years (SD = 15.72). Overall, cancer patients have poor oral health behaviors and limited oral health service utilization. There were statistically significant differences (p < 0.05) between urban and rural cancer patients in terms of oral health behaviors, including brushing methods, the use of fluoride toothpaste, the use of dental floss, dental caries, and bleeding gums while brushing teeth. As for oral health service utilization, there were significant differences (p < 0.05) between urban and rural cancer patients on regular dental cleaning, the reasons for visiting a dental clinic, and whether they took the initiative to learn about oral health. Conclusion: The study findings suggest that cancer patients had poor oral health behaviors and limited oral health service utilization, and rural patients perform poorer than their urban counterparts. Oral health education should be provided to cancer patients to improve their oral health behaviors and oral health service utilization. [ABSTRACT FROM AUTHOR]

Introduction: Although carpal tunnel syndrome (CTS) is an incident entrapment neuropathy disorder, there has been inadequate evidence about the effect evaluation of adding low-level laser therapy to ultrasound (US) plus median nerve glide exercises in these patients. Hence, this research investigated the trace of US plus median nerve glide exercises with and without low-level laser therapy (LLLT). Materials and Methods: Thirty-six patients with moderate CTS in two groups of intervention were assessed. One group received 10 sessions of adding LLLT to median nerve glide exercises plus US and the other group received median nerve glide exercises plus US without LLLT. Outcome measures were hand grip strength (HGS), visual analogue scale (VAS), Boston questionnaire (BQ), and cross-sectional area (CSA) of the median nerve. Results: Baseline analysis revealed similarities between the two groups in all parameters. Statistical analysis indicated significant improvement of HGS, VAS, BQ, and CSA of the median nerve in two groups of intervention. Conclusion: In patients with CTS, US and median nerve glide exercises with and without LLLT significantly improved without the superiority of adding LLLT to mentioned treatment. [ABSTRACT FROM AUTHOR]

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Background: There is a debate regarding the sensitivity of the QuantiFERON-TB Gold In-Tube (QFT) among people with diabetes, and prior studies have shown heterogeneous results. We evaluated whether the QFT TB antigen was modified among persons with differing diabetes status and other related risk factors. Methods: A cross-sectional study of 5,302 people was conducted to screen latent tuberculosis infection (LTBI) in eastern China. The QFT assay was performed as an indicator of LTBI. Fasting plasma glucose (FPG) was collected from each participant; the definition of diabetes followed the guidelines from the American Diabetes Association. Participants were classified into normoglycemia, prediabetes, undiagnosed diabetes, and previously diagnosed diabetes to evaluate the relationship between the QFT TB antigen and distinct diabetes status. Results: TB antigen values from the QFT were statistically different among participants with differing diabetes status (P = 0.008). Persons with undiagnosed diabetes had a higher TB antigen value (0.96 ± 0.20) than persons with normoglycemia (0.50 ± 0.02, P < 0.05). However, the TB antigen values demonstrated no significant difference among the four different diabetic groups when stratified by the standard cutoff for the QFT (P = 0.492 for the positive group and P = 0.368 for the negative group). In a linear regression model, we found that FPG, age, and smoking were positively associated with the QFT TB antigen value (P = 0.017, P < 0.001, and P < 0.001). Conclusions: Diabetes status had little influence on the level of QFT TB antigen response among IGRA-positive persons. However, FPG, old age, and smoking were important risk factors for increasing levels of QFT TB antigen [ABSTRACT FROM AUTHOR]

Background & objectives: Body mass index (BMI) and waist circumference (WC) are widely used to assess obesity, but they are limited in their ability to distinguish complicated body metabolic situations (fat mass, lean body mass, visceral and subcutaneous fat deposits in the abdomen). The purpose of this study was to evaluate the diagnostic efficacy of different anthropometric indices in metabolic dysfunction-associated fatty liver disease (MAFLD) and to identify the best cut-off point for the diagnosis of MAFLD in United States adults. Methods: A cross-sectional study among 4,195 participants over 18 years old in the National Health and Nutrition Examination Survey (NHANES) 2017-2018 was performed. All patients underwent vibration controlled transient elastography (VCTE). Assess the anthropometric measurements, including BMI, WC, waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), cardiometabolic index (CMI), triglyceride-glucose (TyG) index, hepatic steatosis index (HSI), lipid accumulation product (LAP), body roundness index (BRI), visceral fat index (VAI), abdominal volume index (AVI), cone index (CI), and body fat index (BAI). Logistic regression analyses were conducted to estimate the impact of these indices, on the odds ratio (OR) values of MAFLD. Receiver operator characteristic (ROC) analyses were performed to assess the diagnosing capacity of these anthropometric indices for MAFLD and identify the optimal cut-offs points. Results: A total of 4,195 (2,069 men and 2,126 women) participants were performed, with 45.4 ± 0.64 (mean ± SD) years old. All anthropometric metrics were positively associated with MAFLD, irrespective of whether it was treated as continuous or categorical variable (P<0.05). Multivariate logistic regression showed a positive correlation between AVI, HSI, WHtR, BRI, and MAFLD, with significant interaction with gender. ROC curves results showed that LAP had the highest AUC [0.813 (95% CI, 0.800-0.826)], especially in participants aged between 18 and 50 years old. Furthermore, LAP showed the highest ROC in both the training set [0.812 (95% CI, 0.800-0.835)] and the validation set [0.809 (95% CI, 0.791-0.827)]. Conclusions: In the present study, we showed that those anthropometric indices were significantly associated with MAFLD in United States adults. Besides, the association of HSI, BRI, AVI, and WHtR with MAFLD was more obvious in men than in women. LAP may be a sensitive marker for diagnosing MAFLD in U.S. adults. [ABSTRACT FROM AUTHOR]

Purpose of the study. To study the view of the Irkutsk physicians of different specialities on the vaccination.Materials and methods. We assessed the degree of awareness of 324 physicians of different specialities on the preventive vaccination based on the data of cross-sectional descriptive multicenter research. All the respondents were divided into three groups: group 1 (n = 218) – physicians prescribing vaccination for children (pediatricians, neonatologists); group 2 (n = 54) – physicians prescribing vaccination for adults (general practitioners, obstetricians-gynecologists); group 3 (n = 52) – physicians who can consult on the problems of vaccinations (neurologists and other physicians). Statistical analysis of the research results was carried out using Statistica 6.0. Critical level of statistical significancep assumed equal 0,05.Results. Physicians aged 21 to 50 years old prevailed (251/324 – 77,5%). Pediatricians (89/159 – 56%; χ2 = 5,94; df = 1; p < 0,05) and neurologists (19/27– 70,4%; χ2 = 4,46; p < 0,05) state their «sufficient» level of awareness on the vaccination. Obstetricians-gynecologists (28/42 – 66,6%; χ2 = 4,78; p < 0,05) state their «insufficient» level of awareness on the vaccination. Physicians of group 1 more often inform patients about the importance of vaccination (χ2 = 7,9, p < 0.01 and χ2 = 6,3, p < 0,05, respectively) and consider it necessary to vaccinate children additionally from current infections, unlike physicians of group 2 (χ2 = 27,6; df = 1; p < 0,0001). Most of the respondents (211/324 – 65,1%) agree with the necessity of introduction of a law on parental responsibility in case of vaccine-controlled disease for his child.Conclusion. Monitoring the adherence of physicians to immunologic prophylaxis for themselves and their patients will allow timely identification and elimination of emerging contradictions and problems, as well as to maintain a high level of confidence in vaccination among the population.

Background: Although oral anticancer medications (OAM) provide opportunity for treatment at home, challenges include prescription filling, monitoring side effects, safe handling, and adherence. We assessed understanding of and adherence to OAM in vulnerable patients. Methods: This 2018 pilot study defined vulnerable patients based on Chinese language, older age (≥65 years), and subsidized insurance. All participants had a cancer diagnosis and were taking an OAM filled through the hospital's specialty pharmacy. Participants reported on OAM taking (days per week, times per day, special instructions) and handling (handling, storage, disposal). The specialty pharmacist classified patient-reported responses about OAM taking and handling as adequate or inadequate. OAM regimens were classified by complexity. Results: Of 61 eligible patients, 55 participated. Mean age was 68 years (standard deviation [SD] = 12) and 53% were female. Patient subgroups were: 27% Chinese, 64% ≥65 years, and 9% subsidized insurance. Forty-nine percent were on frontline therapy and median time on OAM was 1 year (Quartile 1 = 0.4, Quartile 3 = 1.7). Adequacy of OAM taking (30%) and handling (15%) were low; 15% had adequacy in both. Adequacy of OAM taking and handling did not vary by patient subgroup or regimen complexity. Mean patient-reported adherence was high (5.4, SD = 1, possible range 1–6) and did not vary by adequacy of OAM taking or handling. Conclusions: Understanding of OAM taking and handling in this group of vulnerable patients was low and did not align with patient-reported adherence. Future interventions should ensure that patients understand how to safely take and handle OAM, thereby optimizing their therapeutic potential. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety can be defined as feeling nervous and having anxious thoughts. Although this is a normal process in daily life, it can be categorized as a disorder or disease if anxiety starts to impair one's quality of life and functionality. The aim of this study is to determine anxiety sypmptoms and related risk factors in 15 years and older people in Ağaçören district of Aksaray. Methods: The research type is cross-sectional. People aged 15 and over in the district were stratified according to age and gender groups, and the number of people to be reached in each group was determined. 341 (93.6%) people were reached. In the research, a questionnaire form for the descriptive features of the participants and Beck Anxiety Scale were used as the data source. Results: 341 people were examined in the study. The average score of Beck Anxiety Inventory of the participants is 8.52 ± 8.63, and the median is 6 (min: 0, max: 42). Anxiety was found in 14.7% of the participants. Anxiety symptoms were found in 27.8% of women and 8.1% of men . Conclusion: In our study, it was found that one out of every seven people had anxiety symptoms. Most of the studies conducted in our country are specific to various groups. Community studies are needed. The risk of anxiety disorder was found to be three times higher in women than in men. Increasing awareness about risk factors can be one of the important steps to prevent the development of anxiety in women. [ABSTRACT FROM AUTHOR]

BACKGROUND: In Ethiopia, maternal health service utilization is very low, especially postnatal care (PNC). The percentage of mothers who receive care within two days of childbirth has shown little progress, from 2.4% in 2000 to 13% in 2014. However, it is very far below the expected level as compared to other sub-Saharan regions. Therefore, the aim of this study was to assess PNC services utilization and its associated factors among married women in Benchi-Maji Zone, Southwest Ethiopia. METHOD: A cross-sectional studywas conducted from June 15 to August 15, 2015. A total of 801 married women wassampled from randomly selected districts in the zone. Semi-structured questionnaire was used to collect, data and informed consent was obtained from participants. The collected data were entered into the computer using Epi-data version 3.0, and then exported to SPSS Windows version 20.0 for analysis. Logistic regression was used to identify important predictors of PNC utilization. RESULT: Out of 765 participants, 392(51.24%) of married women who attended PNC in this study. Out of them, more than two-third 305(77.8%) attended mainly to immunize their baby. The vast majority, 251(86.3%), of respondents mentioned lack of information as a main reason for not following PNC, and of them, the majority mentioned that they were appointed to come after 45 days for Family Planning(FP). In comparison with house wives, farmer women were less likely (AOR 0.3, 95% CI 0.2-0.7) to attend for PNC. Awareness of problems during postnatal period showedthe strongest association in which those who knew the problems were about nine times (AOR 8.7 95% CI 5.6-13.4) more likely to attend PNC. Similarly, married women who followedantenatal care (ANC) were more likely (AOR 2.2 95% CI 1.1-4.6) to attend PNC in comparison with those who did not attend ANC at all. CONCLUSION: Residence, ANC follow-up, maternal occupation, awareness about problems of postnatal period had effects on use of PNC. In light of this study, providing deep counselling about PNC at the timeof ANC visit and discharge after delivery is strongly recommended. Furthermore, targeting more of rural married women may increase PNC utilization. [ABSTRACT FROM AUTHOR]

The article reveals a cross-sectional analysis on frozen conflicts in post-Soviet space. The case studies on frozen conflicts identify the causes and consequences, the risk of activization in the context of dynamic developments at international level. Based on the synthesis of relevant sources, the author concludes on the risks determined by frozen conflicts. Frozen conflicts in post-Soviet space continue to be a source of insecurity (human, economic, political, social, military, ecological, etc.) in the eastern neighborhood of the European Union. [ABSTRACT FROM AUTHOR]

Purpose: Older adults are the fastest growing population group worldwide. Regular physical activity (PA) is reported to reduce the risk of health conditions and improve personal well-being. Few validated instruments can be used to measure the PA levels among older adults in Saudi Arabia. The Physical Activity Scale for the Elderly (PASE) is used worldwide for evaluating the PA levels of the elderly in epidemiological studies. However, this scale has not been translated into Arabic. This study aimed to cross-culturally adapt the PASE into Arabic language and evaluate its reliability and validity among community-dwelling older adults in Saudi Arabia. Patients and methods: This study was a cross-sectional one following Beaton guidelines to translate and perform cultural adaptation, as well as test the reliability and validity of the PASE Arabic version (PASE-A). Elderly (N=74) people from both genders, who lived in a community dwelling in Riyadh city, were selected from several primary health care centers. The study used Cronbach's alpha coefficient to assess the internal consistency reliability, while intraclass correlation coefficient (ICC2,1) was used for test-retest reliability and the Spearman's rank correlation coefficient (r) was used to evaluate the correlation among PASE-A and grip strength, Timed Up and Go test, body mass index, and fat percentage. Results: Out of 74 older adults, 59 (79.7%) completed the PASE-A questionnaire twice. The internal consistency of the PASE-A components was good (Cronbach's alpha 0.70-0.75), and the reliability of the components was excellent (ICC2,1 0.90-0.98). A higher PASE-A score was associated with higher grip strength (r=0.28, p=0.05) and with shorter Timed Up and Go test times (r=-0.45, p=0.01). Conclusion: The PASE-A version was easy, understandable, and relevant for Saudi older adults' culture. This scale was a reliable and valid tool for evaluating and assessing the PA level among community-dwelling older adults in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Alzheimer's disease is a major public health issue that will increasingly affect the health and well-being of the population. Memory disorders will become conventional, and there is an increased need for excellent health care services for the aged population. Developing positive attitudes towards people with Alzheimer's disease is necessary yet challenging. Nursing care plays a crucial role in providing care for geriatric patients at hospital, community and home because of the effects of aging and multiple co-morbid medical conditions. In general, nursing students spend significant periods of time on clinical placements. Also, evidence suggests that the health services in developing countries were not adequately prepared to provide better services for people with Alzheimer's disease-related dementia. Objective. The study evaluated the nursing students' knowledge toward individuals with Alzheimer's disease. Methodology. The research design used for the study are experimental one group pre-test post-test carried out with a randomly a selected group of nursing students (N = 120) from Chennai, India. The study used the Alzheimer's disease Knowledge scale (30 questions). Results. The analysis of the study findings revealed that there is a significant difference in the level of knowledge scores between the Master degree, Post basic degree, and bachelor degree students. The knowledge score was 75.5 ± 8.4 slightly higher compared to the students from post basic and bachelor degree students. Conclusion. The study concluded that the students had inadequate Knowledge of Alzheimer's disease during the pre-test. However, they have some knowledge towards the same patients, giving way to improve their knowledge related to the disease after providing Essential knowledge on the same. Thus, there is vital necessity to augment the nursing students study plan concerning the content of the study and strengthen their knowledge of comprehensive care to individuals with Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Namen. Namen raziskave je bil ugotoviti, kateri bolezenski simptomi se najpogosteje pojavljajo pri odraslem prebivalstvu Slovenije in določiti njihovo prevalenco in dejavnike, ki nanjo vplivajo. Metode. Raziskava je bila presečna opazovalna in je potekala s pomočjo računalniško podprtega telefonskega anketiranja - CATI. Vključena sta bila 1002 prebivalca, stara med 15 in 90 let. Telefonski intervju je zajemal vprašanja o pojavnosti 23 bolezenskih simptomov, njihovem trajanju in o demografskih podatkih. Izsledki. Slovensko prebivalstvo ima najpogosteje težave z bolečinami v hrbtenici (409 oseb - 40,8 %), bolečinami v sklepih (334 oseb - 33,4 %), s prekomerno utrujenostjo (308 oseb - 30,7 %), z živčnostjo (285 oseb - 28,4 %), glavobolom (280 oseb - 27,9 %), razdražljivostjo (261 oseb - 26,1 %) in z nespečnostjo (259 oseb - 25,8 %). Statistično pogosteje so se bolezenski simptomi pojavljali pri ženskah, starejših, nižje izobraženih, ljudeh z nižjim osebnim dohodkom, nezaposlenih, upokojenih in tistih z znano kronično boleznijo. Neodvisna napovedna dejavnika za prisotnost vsaj enega bolezenskega simptoma sta ženski spol in prisotnost kronične bolezni. Sklepi. Slovensko prebivalstvo je znatno obremenjeno z bolezenskimi simptomi, saj 77,3 % vprašanih bremeni vsaj en bolezenski simptom. Raziskava je odkrila skupine prebivalstva, ki so bolezenskim simptomom še posebej podvržene (ženske, starejši, kronični bolniki, ljudje z nižjim socioekonomskim statusom) in katerim bi morala biti namenjena še posebna pozornost na ravni primarnega zdravstvenega varstva in preventivne dejavnosti

Rationale: Seasonal nadirs in 25-hydroxyvitamin D (25[OH]D) concentrations overlap with increased incidence and severity of obstructive sleep apnea (OSA) in winter. We hypothesized that, because lower 25(OH)D concentrations might lead to upper airway muscle dysfunction, low 25(OH)D would be associated with higher apnea-hypopnea index (AHI), a measure of OSA severity.Objectives: To determine if lower 25(OH)D concentration is associated with greater prevalence and increased severity of OSA, independent of established OSA risk factors.Methods: Using unconditional logistic regression, we performed a cross-sectional analysis in the Outcomes of Sleep Disorders in Older Men study, which included in-home overnight polysomnography, serum 25(OH)D measurement, and collection of demographic and comorbidity data. The primary outcome was severe sleep apnea, as defined by AHI of 30/h or more.Measurements and Main Results: Among 2,827 community-dwelling, largely white (92.2%), elderly (aged 76.4 ± 5.5 yr [mean±SD]) males, mean 25(OH)D concentration was 28.8 (±8.8) ng/ml. Subjects within the lowest quartile of 25(OH)D (6-23 ng/ml) had greater odds of severe sleep apnea in unadjusted analyses (odds ratio = 1.45; 95% confidence interval = 1.02-2.07) when compared with the highest 25(OH)D quartile (35-84 ng/ml). However, further adjustment for established OSA risk factors strongly attenuated this association (multivariable adjusted odds ratio = 1.05; 95% confidence interval = 0.72-1.52), with body mass index and neck circumference as the main confounders. There was also no evidence of an independent association between lower 25(OH)D levels and increased odds of mild (AHI = 5.0-14.9/h) or moderate (AHI = 15.0-29.9/h) sleep apnea.Conclusions: Among community-dwelling older men, the association between lower 25(OH)D and sleep apnea was largely explained by confounding by larger body mass index and neck circumference. [ABSTRACT FROM AUTHOR]

This study focuses on pre-service science teachers' interpretations of graphs. First, the paper presents data about the freshman and senior pre-service teachers' interpretations of graphs. Then it discusses the effects of pre-service science teacher training program on student teachers' interpretations of graphs. The participants in the study were 117 preservice science teachers. Fifty-six of the participants were freshman. The data of the study were gathered with a questionnaire adapted from Aoyama (2007). The questionnaire includes two graphs each based on a different context, and having four questions about the interpretation of the graphs. The participants' interpretations of graphs were analysed in five levels. The levels were listed from low to high level: Idiosyncratic, Basic Graph Reading, Rational/Literal, Critical, and Hypothesising and Modelling. The results of this study reveal that preservice science teacher can read values and trends in graphs, but they are not successful at the higher levels within the interpretations of graphs hierarchy. Moreover, the Turkish pre-service science teacher training program does not promote student teachers' interpretations of graphs. These findings suggest that teaching modules should be designed to promote pre-service science teachers' interpretations of graphs and challenge them to go beyond basic graph reading. Furthermore, the factors that affect the pre-service science teachers' interpretations of graphs, such as the type of graphs and the context of the graphs, can be useful as the findings of the study can be used to aid in designing graphs teaching modules. [ABSTRACT FROM AUTHOR]

Abstract: Purpose of the research: The aims of the present study were to examine patients' perceptions of received information and satisfaction with information after completion of adjuvant radiotherapy (RT) for breast cancer. Associations between satisfaction with information and health related quality of life (HRQoL), and clinical variables were also studied. Methods and sample: A total of 93 consecutive women planned for adjuvant RT were asked to complete two questionnaires (EORTC QLQ-C30 and QLQ-INFO25) in connection with their last treatment. Key results: A total of 88 patients (95%) responded. The mean values for the information subscale scores, on a 0 to 100 point scale (QLQ-INFO25) regarding “the treatments” and “the disease” were 46 and 53 respectively. A total of 48% of the patients expressed a wish for more information. Patients treated with chemotherapy previous to RT reported statistically significant lower levels of information about “the disease”. Age was statistically significant related to satisfaction with received information. Younger women were less satisfied with the information received, and a higher proportion wanted more information (55%), as well among women treated with chemotherapy previous to RT (63%). Patients satisfied with information scored significantly higher on global health status and emotional functioning and reported less fatigue. Positive associations were found between “satisfaction with information” and HRQoL. Conclusions: Improvements of information to breast cancer patients during their treatments are needed. The results also underline the need for patient-centred information in general and that extra attention should be paid to younger women and patients undergoing combined treatment. [Copyright &y& Elsevier]

Background: Community-acquired pneumonia in children is common in China. To understand current clinical characteristics and practice, we conducted a cross-sectional study to analyze quality of care on childhood pneumonia in eight eastern cities in China. Methods: Consecutive hospital records between January 1, 2010 and December 31, 2010 were collected from 13 traditional Chinese medicine (TCM) and western medicine (WM) hospitals in February, May, August, and November (25 cases per season, 100 cases over the year), respectively. A predesigned case report form was used to extract data from the hospital medical records. Results: A total of 1298 cases were collected and analyzed. Symptoms and signs upon admission at TCM and WM hospitals were cough (99.3% vs. 98.6%), rales (84.8% vs. 75.0%), phlegm (83.3% vs. 49.1%), and fever (74.9% vs. 84.0%) in frequency. Patients admitted to WM hospitals had symptoms and signs for a longer period prior to admission than patients admitted to TCM hospitals. Testing to identify etiologic agents was performed in 1140 cases (88.4%). Intravenous antibiotics were administered in 99.3% (595/598) of cases in TCM hospitals and in 98.6% (699/700) of cases in WM hospitals. Besides, Chinese herbal extract injection was used more frequently in TCM hospitals (491 cases, 82.1%) than in WM hospitals (212 cases, 30.3%) (p < 0.01). At discharge, 818 cases (63.0%) were clinically cured, with a significant difference between the cure rates in TCM (87.6%) and WM hospitals (42.0%) (OR = 9.8, 95% confidence interval (CI): 7.3 ~ 12.9, p < 0.01). Pathogen and previous medical history were more likely associated with the disappearance of rales (OR = 7.2, 95%CI: 4.8 ~ 10.9). Adverse effects were not reported from the medical records. Conclusions: Intravenous use of antibiotics is highly prevalent in children with community-acquired pneumonia regardless of aetiology. There was difference between TCM and WM hospitals with regard to symptom profile and the use of antibiotics. Intravenous use of herbal injection was higher in TCM hospitals than in WM hospitals. Most of the cases were diagnosed based on clinical signs and symptoms without sufficient confirmation of aetiology. Audit of current practice is urgently needed to improve care. [ABSTRACT FROM AUTHOR]

Objective: Information on dependency level of elderly in rapidly aging developing countries is limited, but this is needed to ascertain the extent of need for help with activities of daily living (ADLs). Method: In-person information was obtained in 1995 from a statewide survey of representative community residents ≥60 years of age in the state of Rio Grande do Sul, Brazil (N = 7,040), on demographic characteristics, health conditions, social ties, health behaviors, and ADL performance. Results: Nearly 40% needed help with one or more ADLs. In controlled analyses, need for help approximately doubled with each succeeding decade. Increased education and income and regular physical activity reduced risk. Selected health conditions (stroke, depression, poor self-rated health) were consistently associated with need for help. Discussion: A large proportion of noninstitutionalized elderly have ADL problems. In addition to health care, interventions promoting equity of access to education and economic opportunity could reduce ADL dependency in coming generations. [ABSTRACT FROM AUTHOR]

We investigated the effect of dental anxiety and dental visiting habits, as well as various sociodemographic variables, on oral health-related quality of life (OHQoL) among subjects aged 15-54 years living in Udaipur district, India. The total sample size was 1235 individuals and a stratified cluster sampling procedure was employed to collect the representative sample. Dental anxiety and oral health-related quality of life were assessed using the Corah Dental anxiety scale and the OHQoL-UK(W)© questionnaire, respectively. The majority of the female and older individuals showed higher dental anxiety than their male and younger counterparts. Stepwise linear regression analysis revealed that the best predictors of dental anxiety were, in descending order, occupation, gender and education, which provided a variance of 10.3%. Females were more likely to have poor OHQoL than males. Dental anxiety had a significant influence on OHQoL, people with high dental anxiety being 2.34 times more likely to present poor OHQoL than those having low anxiety. Furthermore, it was found that those who never visited a dentist had an odds ratio of 1.62 for poor OHQoL relative to those who had visited a dentist within the last 12 months. Dental anxiety differed significantly with age and dental visiting practices, and had a significant impact on oral health-related quality of life after controlling for other variables. [ABSTRACT FROM AUTHOR]

Objectives:To determine the prevalence of ‘hypertriglyceridemic waist’ (HTGW) in Oji-Cree, to examine its interaction with hepatic nuclear factor-1α (HNF1A) in association with type 2 diabetes, and to characterize its putative genetic determinants.Method:The presence or absence of HTGW was determined in 522 Oji-Cree subjects (223 males, 299 females), 18 years of age, in whom physical measurements and fasting plasma analyte concentrations were gathered, and a 75-g oral glucose tolerance test was administered, as part of a cross-sectional study. Subjects were genotyped for HNF1A codon 319, angiotensinogen (AGT) codons 174 and 235, G-protein β3-subunit (GNB3) nucleotide 825, fatty acid-binding protein (FABP2) codon 54, nucleotides −455 and −482 of the apolipoprotein (apo) C-III (APOC3) promoter, and a 5-bp insertion/deletion polymorphism within the 3′-untranslated region of protein phosphatase 1 regulatory subunit 3 (PPP1R3).Results:The unadjusted prevalence of HTGW in Oji-Cree adults was 20.5%, with more males affected than females (27.8 vs 15.1%, P=0.0004). Logistic regression analysis, adjusted for age and gender, showed type 2 diabetes was associated with both HNF1A G319S (odds ratio (OR) 4.85, 95% CI 2.45, 9.58) and HTGW (OR 4.96, 95% CI 2.49, 9.88). When the HNF1A mutation and HTGW were present in combination, the OR for type 2 diabetes was markedly increased (OR 43.2, 95% CI 12.4, 150). In women only, both GNB3 825C>T and FABP2 A54T genotypes were significantly associated with HTGW (OR 2.02, 95% CI 1.01, 4.05 and OR 1.95, 95% CI 1.01, 3.74, respectively).Conclusions:HTGW is prevalent in Oji-Cree, especially in men. The ORs for type 2 diabetes were similar (∼5-fold) for subjects with either the presence of HTGW or the private HNF1A G319S mutation. These two independent risk factors acted synergistically to confer an even greater increased risk of type 2 diabetes.International Journal of Obesity (2006) 30, 484–491. doi:10.1038/sj.ijo.0803152; published online 8 November 2005 [ABSTRACT FROM AUTHOR]

Background: As the literature now stands, a bewildering number and variety of biological, psychological and social factors are, apparently, implicated in back problems. However, if and how these have a direct influence on back problems is not clear. Obesity, for example, has in many studies been shown to be associated with back problems but there is no evidence for a causal link. This could be explained by a dearth of suitably designed studies but also because obesity may be but a proxy for some other, truly explanatory variable. Coping has been linked with, particularly, persistent back problems as well as with health in general. The question is, whether coping could be the explanatory link between, for example, these two variables. A cross-sectional study was undertaken using data from the Swedish Army, consisting of the entire cohort of males (N = 48,502) summoned in 1998 to serve in the military. The purpose of the study was to investigate the relation between five independent variables and two dependent variables (‘outcome variables’). The independent variables were two anthropomorphic variables (height and body mass index), two psychological variables (intellectual capacity and coping in relation to stress), and one social variable (type of education). The two outcome variables were back problems and ill health. In particular, we wanted to determine whether controlling for coping would affect the associations between the other four independent variables and the two outcome variables. Methods: Data for the analysis come from a battery of standardized examinations, including medical examinations, a test of intellectual capacity, and a test of coping in relation to stress. Each of these examinations was conducted independently of the others. Unadjusted and adjusted odds ratios were calculated for the outcome variables of back problems and ill health. Results: The associations between height, body mass index, intellectual capacity, type of education and the two outcome variables (back problems and ill health) were weak to moderate. Additionally, there were strong associations between coping and the two outcome variables and when controlling for coping the previously noted associations diminished or disappeared, whereas none of the other variables had a large effect on the association between coping and the two outcome variables. Conclusion: Coping emerged as strongly associated with both back problem and ill health and coping had a leveling effect on the associations between the other independent variables and the two outcome variables. This study is noteworthy particularly because the association with coping is so robust. It is a retrospective, cross-sectional study, however, and, as such it raises questions of causality; which - if any - came first, inability to cope or back pain? The results of this study call attention to the need for a prospective study, in which coping is clearly defined. Such a study has been undertaken and will be presented separately. [ABSTRACT FROM AUTHOR]