Objective To explore and quantify the association of hot night exposure during the sperm development period(0–90 lag days) with semen quality.Methods A total of 6,640 male sperm donors from 6 human sperm banks in Chi...Objective To explore and quantify the association of hot night exposure during the sperm development period(0–90 lag days) with semen quality.Methods A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014–2020were recruited in this multicenter study.Two indices(i.e.,hot night excess [HNE] and hot night duration[HND]) were used to estimate the heat intensity and duration during nighttime.Linear mixed models were used to examine the association between hot nights and semen quality parameters.Results The exposure-response relationship revealed that HNE and HND during 0–90 days before semen collection had a significantly inverse association with sperm motility.Specifically,a 1 ℃ increase in HNE was associated with decreased sperm progressive motility of 0.0090(95% confidence interval[CI]:–0.0147,–0.0033) and decreased total motility of 0.0094(95% CI:–0.0160,–0.0029).HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021(95% CI:–0.0040,–0.0003) and 0.0023(95% CI:–0.0043,–0.0002),respectively.Consistent results were observed at different temperature thresholds on hot nights.Conclusion Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.展开更多
Background:A milestone goal of the Healthy China Program(2019-2030)is to achieve 5-year cancer survival at 43.3%for all cancers combined by 2022.To assess the progress towards this target,we analyzed the updated survi...Background:A milestone goal of the Healthy China Program(2019-2030)is to achieve 5-year cancer survival at 43.3%for all cancers combined by 2022.To assess the progress towards this target,we analyzed the updated survival for all cancers combined and 25 specific cancer types in China from 2019 to 2021.Methods:We conducted standardized data collection and quality control for cancer registries across 32 provincial-level regions in China,and included 6,410,940 newly diagnosed cancer patients from 281 cancer registries during 2008-2019,with follow-up data on vital status available until December 2021.We estimated the age-standardized 5-year relative survival overall and by site,age group,and period of diagnosis using the International Cancer Survival Standard Weights,and quantified the survival changes to assess the progress in cancer control.Results:In 2019-2021,the age-standardized 5-year relative survival for all cancers combined was 43.7%(95%confidence interval[CI],43.6-43.7).The 5-year relative survival varied by cancer type,ranging from 8.5%(95%CI,8.2-8.7)for pancreatic cancer to 92.9%(95%CI,92.4-93.3)for thyroid cancer.Eight cancers had 5-year survival of over 60%,including cancers of the thyroid,breast,testis,bladder,prostate,kidney,uterus,and cervix.The 5-year relative survival was generally lower in males than in females.From 2008 to 2021,we observed significant survival improvements for cancers of the lung,prostate,bone,uterus,breast,cervix,nasopharynx,larynx,and bladder.The most significant improvement was in lung cancer.Conclusions:Progress in cancer control was evident in China.This highlights the importance of a comprehensive approach to control and prevent cancer.展开更多
Objective： Gastric cancer （GC） is one of the leading causes of death in China and other Asian countries. Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-ris...Objective： Gastric cancer （GC） is one of the leading causes of death in China and other Asian countries. Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-risk individuals remains a challenge in GC screening programs. Methods： There were 7,302 patients with chronic gastritis involved in this study. Endoscopic examinations were performed, and their demographic characteristics and lifestyle data were collected. Each possible associated factor of GC/premalignant and precursor lesions was evaluated by univariate and multivariate logistic regressions. Nomograms were used for visualization of those models, and receiver operating characteristic （ROC） curve analysis was used to present the predictive accuracy. Resu Its： We detected 8 （0.11% ） gastric adenocarcinomas, 17 （0.23 %） dysplasia cases, 14 （0.19%） hyperplasia cases, 52 （0.71%） intestinal metaplasia cases, 217 （2.97%） inflammatory lesions, 141 （1.93%） gastric ulcers, 10 （0.14%） atrophic gastritis cases, 1,365 （18.69%） erosive gastritis cases, and 5,957 （81.58%） superficial gastritis cases in 7,302 patients. The age （P〈0.001）, gender （P=0.086）, labor intensity （P=0.018） and leek food intake （P=0.143） were identified as independent predictive factors of GC/premalignant lesions possibility. The corresponding nomogram exhibited an area under the curve （AUC） [95% confidence interval （95% CI）] of 0.82 （0.74-0.89） for the modeling group and 0.80 （0.75-0.85） for the validation group. The age （P=0.002）, gender （P=0.024）, smoldng （P=0.002） and leek food intake （P=0.039） were independent predictive factors of precursor lesions possibility. The corresponding nomogram exhibited an AUC （95% CI） of 0.62 （0.60-0.65） for the modeling group and 0.61 （0.59-0.63） for the validation group. Conclusions： We identified several potential associated factors and provided a preclinical nomogram with the potential to predict the possibility of GC/premalignant and precursor lesions.展开更多
AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-base...AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-based cohort of patients with histological evidence of esophagitis without Barrett's esophagus was constructed using electronic pathology reports relating to all esophageal biopsies in Northern Ireland between 1993 and 1996. Person-years of followup and incident cases of esophageal cancer were calculated by linking the cohort to death files and the Northern Ireland Cancer Registry records. Standardized incidence ratios (SIR) were calculated for esophageal cancers (adenocarcinoma, squamous cell carcinoma (SCC), and histologically unspecified cancers).RESULTS: A total of 2 013 patients in the cohort provided 13 559 patient-years of follow-up (mean follow-up 6.7 years). None of the patients developed adenocarcinoma. Three patients developed SCC, and six developed histologically unspecified cancers. The SIR for all esophageal cancers and for SCC were 2.73 (95%CI 1.25-5.19) and 2.93 (95%CI 0.61-8.59), respectively. In a sensitivity analysis in which all unspecified esophageal cancers were treated as adenocarcinomas, the SIR for adenocarcinoma was 2.64 (0.97-5.75).CONCLUSION: The risk of adenocarcinoma is not elevated in patients with histological evidence of esophagitis without Barrett's esophagus; however, these patients may have a moderately increased risk of SCC.Further studies are required to confirm these findings,which suggest that Barrett's esophagus, not esophagitis,is the key precursor lesion in the development of adenocarcinoma.展开更多
Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different inte...Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different intensities of PA practiced in different periods of the day on the subsequent sleep night in a population-based cohort of young adults.Methods::Prospective analyses were conducted for PA performed during the day and its effect on the following sleep night using data from the22-year follow-up of the 1993 Pelotas Birth Cohort in Brazil(mean age of participants-22.6 years).Wrist-worn accelerometry was usedto measure both PA and sleep parameters.Regarding intensity,we analyzed the sleep effect of light PA(LPA),moderate PA,and vigorous PA,stratified by sex.Sleep variables were sleep time window(STW;the difference between sleep onset and sleep end),total sleep time(TST;the sum of minutes classified as sleep in STW),and sleep percent(SP;SP=(TST/STW);expressed in percentage).We performed generalized estimating equations using Stata software.Results::The means of STW,TST,and SP were 443.6 min/day,371.1 min/day,and 84%,respectively.Time spent in moderate PA and vigorous PA in the morning and afternoon was not associated with sleep variables.Among men,10 min/day of morning LPA increased TST by2.56 min/day.Among women,10 min/day of morning LPA increased SP by 0.15 percentage points.Afternoon LPA also increased SP by 0.09 percentage points for women.Night PA seems to have an inverse effect on sleep variables for any intensity and both sexes.Conclusion::The effect of PA on sleep health is intrinsically related to the period of the day in which it is performed.The effect magnitude is different between sexes.For better sleep health,it is preferable that PA be performed during the day.展开更多
The use of the traditional American Joint Committee on Cancer(AJCC)staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma(GSCC)patients.We aimed to establish a comprehensive...The use of the traditional American Joint Committee on Cancer(AJCC)staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma(GSCC)patients.We aimed to establish a comprehensive prognostic nomogram with a prognostic value similar to the AJCC system.Methods:Patients were identified from SEER database.Variables were selected by a backward stepwise selection method in a Cox regression model.A nomogram was used to predict cancer-specific survival rates for 3,5 and 10 years in patients with GSCC.Several basic features of model validation were used to evaluate the performance of the survival model:consistency index(C-index),receiver operating characteristic(ROC)curve,calibration chart,net weight classification improvement(NRI),comprehensive discriminant improvement(IDI)and decision curve analysis(DCA).Results:Multivariate analyses revealed that age,race,marital status,insurance,AJCC stage,pathology grade and surgery were risk factors for survival.In particular,the C-index,the area under the ROC curve(AUC)and the calibration plots showed good performance of the nomogram.Compared to the AJCC system,NRI and IDI showed that the nomogram has improved performance.Finally,the nomogram's 3-year and 5-year and 10-year DCA curves yield net benefits higher than traditional AJCC,whether training set or a validation set.Conclusion:We developed and validated the first GSCC prognosis nomogram,which has a better prognostic value than the separate AJCC staging system.Overall,the nomogram of this study is a valuable tool for clinical practice to consult patients and understand their risk for the next 3,5 and 10 years.展开更多
AIM:To investigate the relationship between near point of convergence(NPC)and mild cognitive impairment(MCI)in the general elderly population.METHODS:The present report is a part of the Tehran Geriatric Eye Study(TGES...AIM:To investigate the relationship between near point of convergence(NPC)and mild cognitive impairment(MCI)in the general elderly population.METHODS:The present report is a part of the Tehran Geriatric Eye Study(TGES):a population-based crosssectional study conducted on individuals 60 years of age and above living in Tehran,Iran using the multi-stage stratified random cluster sampling method.Cognitive status was assessed using the Persian version of the Mini-Mental State Examination(MMSE).All study participants underwent complete ocular examination including measurement of uncorrected and best-corrected visual acuity,objective and subjective refraction,cover testing,NPC measurement,and slit-lamp biomicroscopy.RESULTS:The data of 1190 individuals were analyzed for this report.The mean age of the participants analyzed was 66.82±5.42(60-92y)and 728(61.2%)of them were female.Patients with MCI had a significantly more receded NPC compared to subjects with normal cognitive status(10.89±3.58 vs 7.76±2.71 cm,P<0.001).In the multivariable logistic regression model and in the presence of confounding variables,a receded NPC was statistically significantly associated with an increased risk of MCI(odds ratio:1.334,95%confidence interval:1.263 to 1.410,P<0.001).According to receiver operating characteristic(ROC)analysis,a cut point NPC>8.5 cm(area under the curve:0.764,P<0.001)could predict the presence of MCI with a sensitivity and specificity of 70.9%and 69.5%,respectively.CONCLUSION:A receded NPC can be clinically proposed as a predictor of MCI in older adults.It is recommended that elderly with a receded NPC>8.50 cm undergo detailed cognitive screening for a definite diagnosis of MCI.In this case,the necessary interventions can be carried out to slow down MCI progression to dementia.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a global health concern with a prevalence of about 25%amongst United States adults.Its increased prevalence is attributed to increase in patients with obesity and ...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a global health concern with a prevalence of about 25%amongst United States adults.Its increased prevalence is attributed to increase in patients with obesity and metabolic syndrome,partly due to similar mechanisms of injury.Nephrotic syndrome(NS)is a clinical entity resulting from extensive proteinuria leading to hypoalbuminemia,hyperlipidemia,edema,and other complications.Given its association with hyperlipidemia,there is concern that patients with NS may be at increased risk of NAFLD.AIM To perform a cross-sectional population-based study to investigate the prevalence and risk factors of NAFLD in patients with NS.METHODS A large multicenter database(Explorys Inc.,Cleveland,OH,United States)was utilized for this retrospective cohort study.A cohort of 49700 patients with a diagnosis of“Non-Alcoholic fatty liver disease”using the Systematized Nomenclature of Medicine-Clinical Terms(SNOMED-CT)between 1999-2022 was identified.Inclusion criteria were age≥18 years,presence of NAFLD,presence of NS.There were no specific exclusion criteria.Univariate and multivariate analysis were performed to adjust for multiple risk factors including age,gender,Caucasian race,NS,typeⅡdiabetes mellitus,hypothyroidism,dyslipidemia,obesity,metabolic syndrome and chronic kidney disease.Statistical analysis was conducted using R,and for all analyses,a 2-sided P value of<0.05 was considered statistically significant.RESULTS Among the 78734750 individuals screened in this database,there were a total of 49700 subjects with NAFLD.In univariate analysis,the odds of having NAFLD in patients with NS,type 2 diabetes mellitus,hypothyroidism,dyslipidemia,obesity,metabolic syndrome and chronic kidney disease were 14.84[95%confidence interval(95%CI)13.67-16.10],17.05(95%CI 16.78-17.32),6.99(95%CI 6.87-7.11),13.61(95%CI 13.38-13.84),19.19(95%CI 18.89-19.50),29.09(95%CI 28.26--29.95),and 9.05(95%CI 8.88-9.22),respectively.In multivariate analysis,the odds of having NAFLD amongst patients with NS were increased to 1.85(95%Cl 1.70-2.02),while the odds were also remained high in patients that have type 2 diabetes mellitus[odds ratio(OR)3.84],hypothyroidism(OR 1.57),obesity(OR 5.10),hyperlipidemia(OR 3.09),metabolic syndrome(OR 3.42)and chronic kidney disease(OR 1.33).CONCLUSION Patients with NS are frequently found to have NAFLD,even when adjusting for common risk factors.Hence,clinicians should maintain a high index of suspicion regarding presence of NAFLD in patients with NS.展开更多
Introduction Dr.Ching-Yu Cheng(Figure 1)is currently an Associate Professor of the Academic Medicine Research Institute and the Academic Clinical Program for Ophthalmology and Visual Sciences(Eye ACP)at Duke-NUS Gradu...Introduction Dr.Ching-Yu Cheng(Figure 1)is currently an Associate Professor of the Academic Medicine Research Institute and the Academic Clinical Program for Ophthalmology and Visual Sciences(Eye ACP)at Duke-NUS Graduate School of Medicine;and Department of Ophthalmology,Yong Loo Lin School of Medicine,National University of Singapore.展开更多
AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40...AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40 years old without a diagnosis of CAD from 2006 until 2011 from a longitudinal health insurance database. The mean follow-up period for the study cohort was 1152 ± 633 d. The control cohort was matched by sex, age, residence, and index date. Hazard ratios(HRs) were calculated using the Cox proportional hazard model and the Kaplan-Meier method. RESULTS After exclusion, a total of 3409 newly diagnosed nonalcoholic cirrhotic patients were identified from one million samples from the health insurance database. We found that CAD(5.1% vs 17.4%) and hyperlipidemia(20.6% vs 24.1%) were less prevalent in nonalcoholic LC patients than in normal subjects(all P < 0.001), whereas other comorbidities exhibited an increased prevalence. Among the comorbidities, chronic kidney disease exhibited the highest risk for mortality(adjusted HR(AHR) = 1.76; 95%CI: 1.55-2.00, P < 0.001). Ascites or peritonitis exhibited the highest risk of mortality among nonalcoholic cirrhotic patients(AHR = 2.34; 95%CI: 2.06-2.65, P < 0.001). Finally, a total of 170 patients developed CAD after a diagnosis of nonalcoholic LC. The AHR of CAD in nonalcoholic LC patients was 0.56(95%CI: 0.43-0.74, P < 0.001). The six-year survival rates for nonalcoholic LC patients with and without CAD were 52% and 50%, respectively(P = 0.012). CONCLUSION We conclude that CAD was less prevalent and associated with a reduced risk of mortality in nonalcoholic cirrhotic patients.展开更多
The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the ...The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the popula-tion-based study in Kinmen, Taiwan. A total of 971 community dwelling adults previously di-agnosed with type 2 diabetes in 1991-1993 un-derwent DR screening in 1999-2002 by a panel of ophthalmologists using on-site indirect oph-thalmoscopy and 45-degree color fundus retinal photographs. The cost-benefit analysis is used to evaluate the DR screening. In terms of bene-fit-cost ratio, the different screening programs for DR could save New Taiwan Dollars (NTD) from 14.38 to 36.83 in discounted costs for each dollar incurred in different screening years from the societal viewpoint for Taiwan and save NTD from 0.81 to 1.80 in different screening years from health care payer’s perspective. The av-erage estimate of willingness-to-pay to translate into benefit yields NTD from 937.8 to 4,689 be- nefits per case due to DR screening in different screening years during 10-year follow-up. The net present value of the DR screening were NTD from -167,318 to -307,251.2 in different screening years. In conclusion, it is worthwhile to initial a routine DR screening of Chinese type 2 diabetes for blindness prevention from the societal per-spective but not from consumer decision based on the willingness-to-pay perspective.展开更多
AIM： To study the natural history and prevalence of heartburn at a 10-year interval, and to study the effect of heartburn on various symptoms and activities. METHODS： A population-based postal study was carried out....AIM： To study the natural history and prevalence of heartburn at a 10-year interval, and to study the effect of heartburn on various symptoms and activities. METHODS： A population-based postal study was carried out. Questionnaires were mailed to the same age- and gender-stratified random sample of the Icelandic population （aged 18-75 years） in 1996 and again in 2006. Subjects were classified with heartburn if they reported heartburn in the preceding year and/or week, based on the definition of heartburn. RESULTS： Heartburn in the preceding year was reported in 42.8% （1996） and 44.2% （2006） of subjects, with a strong relationship between those who experienced heartburn in both years. Heartburn in the precedingweek was diagnosed in 20.8%. There was a significant relationship between heartburn, dyspepsia and irritable bowel syndrome. IndMduals with a body mass index （BMI） below or higher than normal weight were more likely to have heartburn. Heartburn caused by food or beverages was reported very often by 20.0% of subjects. CONCLUSION： Heartburn is a common and chronic condition. Subjects with a BMI below or higher than normal weight are more likely to experience heartburn. Heartburn has a great impact on daily activities, sleep and quality of life.展开更多
BACKGROUND Although the link between cardiovascular disease(CVD)and various cancers is well-established,the relationship between CVD risk and colorectal cancer(CRC)remains underexplored.AIM To elucidate the relationsh...BACKGROUND Although the link between cardiovascular disease(CVD)and various cancers is well-established,the relationship between CVD risk and colorectal cancer(CRC)remains underexplored.AIM To elucidate the relationship between CVD risk scores and CRC incidence.METHODS In this population-based cohort study,participants from the 2009 National Health Checkup were followed-up until 2020.The cardiovascular(CV)risk score was calculated as the sum of risk factors(age,family history of coronary artery disease,hypertension,smoking status,and high-density lipoprotein levels)with high-density lipoprotein(≥60 mg/dL)reducing the risk score by one.The primary outcome was incidence of newly diagnosed CRC.RESULTS Among 2526628 individuals,30329 developed CRC during a mean follow-up of 10.1 years.Categorized by CV risk scores(0,1,2,and≥3).CRC risk increased with higher CV risk scores after adjusting for covariates[(hazard ratio=1.155,95%confidence interval:1.107-1.205)in risk score≥3,P<0.001].This association individuals not using statins.Moreover,even in participants without diabetes,a higher CV risk was associated with an increased CRC risk.CONCLUSION Increased CV risk scores were significantly associated with higher CRC risk,especially among males,younger populations,and non-statin users.Thus,males with a higher CV risk score,even at a younger age,are recommended to control their risk factors and undergo individualized CRC screening.展开更多
OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which...OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which included 249 participants with damp-heat constitution or balanced constitution.Baseline information of participants was collected,and stool samples were collected for gut microbiota analysis.Principal coordinate analysis,linear discriminant analysis effect size analysis,receiver operating characteristic,random forest model,and phylogenetic investigation of communities by reconstruction of unobserved states methods were used to reveal the relationship between gut microbiota and the damp-heat constitution.RESULTS:Compared to those in the BC group,the richness and diversity of the microbiota,specifically those of several short-chain fatty acid producing genera such as Barnesiella,Coprobacter,and Butyricimonas,were significantly decreased in the DHC group.Regarding biological functions,flavonoid biosynthesis,propanoate metabolism,and nucleotide sugar metabolism were suppressed,while arachidonic acid metabolism and glutathione metabolism were enriched in the DHC group.Finally,a classifier based on the microbiota was constructed to discriminate between the DHC and BC populations.CONCLUSION:The gut microbiota of the DHC population exhibits significantly reduced diversity and is closely related to inflammation,metabolic disorders,and liver steatosis,which is consistent with clinical observations,thus serving as a potential diagnostic tool for traditional Chinese medicine constitution discrimination.展开更多
Chronic body pain and depression,two major global health concerns,frequently co-occur and collectively impair individuals'well-being,compromising their ability to maintain an independent lifestyle and social relat...Chronic body pain and depression,two major global health concerns,frequently co-occur and collectively impair individuals'well-being,compromising their ability to maintain an independent lifestyle and social relationships[1].A global study of pain prevalence among 52 countries indicated the overall prevalence of pain was estimated to be 27.5%[2],with significant variation across countries(9.9%-50.3%).展开更多
Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospe...Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023.Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality.Stratified analyses were performed based on the individual characteristics of the participants.Results Overall,19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died.The underweight(<18.5 kg/m^(2))presented an increase in all-cause mortality(adjusted hazards ratio[aHR]=2.00,95%confidence interval[CI]:1.66–2.41),while overweight(≥24.0 to<28.0 kg/m^(2))and obesity(≥28.0 kg/m^(2))presented a decrease with an aHR of 0.61(95%CI:0.52–0.73)and 0.51(95%CI:0.37–0.70),respectively.Overweight(aHR=0.76,95%CI:0.67–0.86)and mild obesity(aHR=0.72,95%CI:0.59–0.87)had a positive impact on mortality in people older than 60 years.All-2 cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m(aHR=0.95,95%CI:0.92–0.98)and increased slightly above that value,indicating a U-shaped association.The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years.Therefore,it is essential to consider age differences when formulating health and weight management strategies.展开更多
Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and prematu...Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and premature mortality,which increased by 3%between 2000 and 2019.2 Evidence is strong that maintaining a healthy diet,engaging in regular physical activity(PA),and preventing obesity can prevent or delay the incidence of T2D.展开更多
Background Early childhood developmental adversities have long-term effects on educational and overall health outcomes.However,the developmental outcomes of children from culturally and linguistically diverse(CALD)bac...Background Early childhood developmental adversities have long-term effects on educational and overall health outcomes.However,the developmental outcomes of children from culturally and linguistically diverse(CALD)backgrounds remain unclear.This study aimed to investigate the association between having a CALD backgrounds and developmental vulnerability in Western Australia.Methods We conducted a retrospective population-based cohort study using data from the Australian Early Development Censuses,Midwives Notification System,and Hospital Morbidity Data Collections.Developmental vulnerability was defined as domain scores<10th percentile in five Australian Early Development Censuses domains.Covariate-adjusted logistic regression,incorporating propensity score weighting,was applied,and the population attributable risk calculations results were informed.Results Among 10,048 CALD children and 49,877 non-CALD children,23.7%[95%confidence interval(CI)22.9,24.5%]of CALD children experienced developmental vulnerability in one or more Australian Early Development Censuses domain(s)(DV1)compared with 19.6%(95% CI 19.3,20.0%)of non-CALD children.Adjusted analyses revealed that CALD children had 23%greater odds of DV1[odds ratio(OR)1.23;95% CI 1.16,1.31]and developmental vulnerability in two or more Australian Early Development Censuses domains(DV2)(OR 1.23;95%CI 1.13,1.33).CALD children had more than twice the odds of vulnerability in terms of communication skills and general knowledge(OR 2.16;95%CI 1.99,2.34)and 37%greater odds in language and cognitive skills(school-based)(OR 1.37;95%CI 1.25,1.51).The population attributable risk was 3.77%for DV1,3.67%for DV2,5.90%for language and cognitive skills(school-based),and 16.24%for communication skills and general knowledge.Conclusions This study revealed a greater developmental vulnerability burden among CALD children than among their non-CALD peers,particularly in the domains of communication skills and general knowledge.Strengthening culturally responsive policies,enhancing early childhood support programs,and ensuring equitable access to educational resources for children from CALD backgrounds may help reduce developmental disparities and promote long-term educational outcomes.展开更多
BACKGROUND The number of population-based studies on unclassified inflammatory bowel disease(IBD-U)is very limited.AIM To evaluate the long-term incidence,disease course and surgery rates of IBD-U in a prospective pop...BACKGROUND The number of population-based studies on unclassified inflammatory bowel disease(IBD-U)is very limited.AIM To evaluate the long-term incidence,disease course and surgery rates of IBD-U in a prospective population-based cohort.METHODSThe present study is a continuation of the well-established Veszprem IBD cohort with patient inclusion between1977 and 2018. Both in-hospital and outpatient records were collected. The source of age- and gender-specificdemographic data was derived from the Hungarian Central Statistical Office. Medical therapy, surgery and changein disease phenotype were analyzed.RESULTSData of 119 incident IBD-U patients were analyzed [male/female: 55/64;median age at diagnosis: 34 years(interquartile range: 24-47.5)]. Adjusted mean incidence rate was 0.76 (95%CI: 0.63-0.9)/105 person-years in the totalstudy period. Disease extent at diagnosis was extensive (pancolitis) in 56.3%. Twenty-two of 119 (18.5%) patientswere reclassified to Crohn’s disease during follow up, the probability of developing terminal ileum involvementwas 6.8%, while perianal disease developed in 5% (n = 6). The probability of receiving biological therapy in patientsdiagnosed after the year 2000 (n = 62), was 15.5% (SD: 4.8) at 5 years. The overall resective surgery rate was 16.8%.Segment resection was performed in 5.0% of the patients, and 11.8% underwent subtotal or total colectomy. Thecumulative probability of resective surgery was 7.6% (SD: 2.4) at 1 year, 9.3% (SD: 2.7) at 5 years, 13.5% (SD: 3.3) at10 years, and 18.5% (SD: 3.9) at 20 years.CONCLUSIONThese data extend our knowledge on the overall burden of IBD-U. Colonic involvement was extensive in a highproportion of IBD-U. Disease reclassification to Crohn’s disease was relatively high. High rates of biologicaltherapy and surgery rates support a relatively severe disease course of IBD-U.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
基金funded by the Guangdong Provincial Natural Science Foundation of China(No.2022A1515011517).
文摘Objective To explore and quantify the association of hot night exposure during the sperm development period(0–90 lag days) with semen quality.Methods A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014–2020were recruited in this multicenter study.Two indices(i.e.,hot night excess [HNE] and hot night duration[HND]) were used to estimate the heat intensity and duration during nighttime.Linear mixed models were used to examine the association between hot nights and semen quality parameters.Results The exposure-response relationship revealed that HNE and HND during 0–90 days before semen collection had a significantly inverse association with sperm motility.Specifically,a 1 ℃ increase in HNE was associated with decreased sperm progressive motility of 0.0090(95% confidence interval[CI]:–0.0147,–0.0033) and decreased total motility of 0.0094(95% CI:–0.0160,–0.0029).HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021(95% CI:–0.0040,–0.0003) and 0.0023(95% CI:–0.0043,–0.0002),respectively.Consistent results were observed at different temperature thresholds on hot nights.Conclusion Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
基金supported by“National Key R&D Program of China”(grant numbers:2022YFC3600805,2020AAA0109500)the National Natural Science Foundation of China(grant number:82188102)+2 种基金the R&D Program of Beijing Municipal Education Commission(grant num-ber:KJZD20191002302)CAMS Initiative for Innovative Medicine(grant number:2021-1-I2M-012)Shenzhen High-level Hospital Con-struction Fund,Sanming Project of Medicine in Shenzhen(grant num-ber:SZSM202211011).
文摘Background:A milestone goal of the Healthy China Program(2019-2030)is to achieve 5-year cancer survival at 43.3%for all cancers combined by 2022.To assess the progress towards this target,we analyzed the updated survival for all cancers combined and 25 specific cancer types in China from 2019 to 2021.Methods:We conducted standardized data collection and quality control for cancer registries across 32 provincial-level regions in China,and included 6,410,940 newly diagnosed cancer patients from 281 cancer registries during 2008-2019,with follow-up data on vital status available until December 2021.We estimated the age-standardized 5-year relative survival overall and by site,age group,and period of diagnosis using the International Cancer Survival Standard Weights,and quantified the survival changes to assess the progress in cancer control.Results:In 2019-2021,the age-standardized 5-year relative survival for all cancers combined was 43.7%(95%confidence interval[CI],43.6-43.7).The 5-year relative survival varied by cancer type,ranging from 8.5%(95%CI,8.2-8.7)for pancreatic cancer to 92.9%(95%CI,92.4-93.3)for thyroid cancer.Eight cancers had 5-year survival of over 60%,including cancers of the thyroid,breast,testis,bladder,prostate,kidney,uterus,and cervix.The 5-year relative survival was generally lower in males than in females.From 2008 to 2021,we observed significant survival improvements for cancers of the lung,prostate,bone,uterus,breast,cervix,nasopharynx,larynx,and bladder.The most significant improvement was in lung cancer.Conclusions:Progress in cancer control was evident in China.This highlights the importance of a comprehensive approach to control and prevent cancer.
基金supported by the National Natural Science Foundation of China(Grant No.81302160 and 81272447)Beijing Natural Science Foundation ProgramScientific Research Key Program of Beijing Municipal Commission of Education(Grant No.KZ201410025024)
文摘Objective： Gastric cancer （GC） is one of the leading causes of death in China and other Asian countries. Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-risk individuals remains a challenge in GC screening programs. Methods： There were 7,302 patients with chronic gastritis involved in this study. Endoscopic examinations were performed, and their demographic characteristics and lifestyle data were collected. Each possible associated factor of GC/premalignant and precursor lesions was evaluated by univariate and multivariate logistic regressions. Nomograms were used for visualization of those models, and receiver operating characteristic （ROC） curve analysis was used to present the predictive accuracy. Resu Its： We detected 8 （0.11% ） gastric adenocarcinomas, 17 （0.23 %） dysplasia cases, 14 （0.19%） hyperplasia cases, 52 （0.71%） intestinal metaplasia cases, 217 （2.97%） inflammatory lesions, 141 （1.93%） gastric ulcers, 10 （0.14%） atrophic gastritis cases, 1,365 （18.69%） erosive gastritis cases, and 5,957 （81.58%） superficial gastritis cases in 7,302 patients. The age （P〈0.001）, gender （P=0.086）, labor intensity （P=0.018） and leek food intake （P=0.143） were identified as independent predictive factors of GC/premalignant lesions possibility. The corresponding nomogram exhibited an area under the curve （AUC） [95% confidence interval （95% CI）] of 0.82 （0.74-0.89） for the modeling group and 0.80 （0.75-0.85） for the validation group. The age （P=0.002）, gender （P=0.024）, smoldng （P=0.002） and leek food intake （P=0.039） were independent predictive factors of precursor lesions possibility. The corresponding nomogram exhibited an AUC （95% CI） of 0.62 （0.60-0.65） for the modeling group and 0.61 （0.59-0.63） for the validation group. Conclusions： We identified several potential associated factors and provided a preclinical nomogram with the potential to predict the possibility of GC/premalignant and precursor lesions.
基金Supported by The establishment of the NI Barrett's Register was assisted by a grant from the Ulster Cancer Foundation
文摘AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-based cohort of patients with histological evidence of esophagitis without Barrett's esophagus was constructed using electronic pathology reports relating to all esophageal biopsies in Northern Ireland between 1993 and 1996. Person-years of followup and incident cases of esophageal cancer were calculated by linking the cohort to death files and the Northern Ireland Cancer Registry records. Standardized incidence ratios (SIR) were calculated for esophageal cancers (adenocarcinoma, squamous cell carcinoma (SCC), and histologically unspecified cancers).RESULTS: A total of 2 013 patients in the cohort provided 13 559 patient-years of follow-up (mean follow-up 6.7 years). None of the patients developed adenocarcinoma. Three patients developed SCC, and six developed histologically unspecified cancers. The SIR for all esophageal cancers and for SCC were 2.73 (95%CI 1.25-5.19) and 2.93 (95%CI 0.61-8.59), respectively. In a sensitivity analysis in which all unspecified esophageal cancers were treated as adenocarcinomas, the SIR for adenocarcinoma was 2.64 (0.97-5.75).CONCLUSION: The risk of adenocarcinoma is not elevated in patients with histological evidence of esophagitis without Barrett's esophagus; however, these patients may have a moderately increased risk of SCC.Further studies are required to confirm these findings,which suggest that Barrett's esophagus, not esophagitis,is the key precursor lesion in the development of adenocarcinoma.
基金financed in part by the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior-Brasil (CAPES) (Finance Code 001)by the Science and Technology Department of the Brazilian Ministry of Health,with resources transferred through the Brazilian National Council for Scientific and Technological Development (CNPq) (400943/2013-1)+1 种基金Helen Gon?alves (305759/2017-5),Ana Menezes (302029/ 2017-6),Fernando Barros,and Fernando C.Wehrmeister (309236/2018-5) received funding through a CNPq research productivity grantAndrea Wendt was funded by a CAPES PhD scholarship (Finance Code 001)。
文摘Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different intensities of PA practiced in different periods of the day on the subsequent sleep night in a population-based cohort of young adults.Methods::Prospective analyses were conducted for PA performed during the day and its effect on the following sleep night using data from the22-year follow-up of the 1993 Pelotas Birth Cohort in Brazil(mean age of participants-22.6 years).Wrist-worn accelerometry was usedto measure both PA and sleep parameters.Regarding intensity,we analyzed the sleep effect of light PA(LPA),moderate PA,and vigorous PA,stratified by sex.Sleep variables were sleep time window(STW;the difference between sleep onset and sleep end),total sleep time(TST;the sum of minutes classified as sleep in STW),and sleep percent(SP;SP=(TST/STW);expressed in percentage).We performed generalized estimating equations using Stata software.Results::The means of STW,TST,and SP were 443.6 min/day,371.1 min/day,and 84%,respectively.Time spent in moderate PA and vigorous PA in the morning and afternoon was not associated with sleep variables.Among men,10 min/day of morning LPA increased TST by2.56 min/day.Among women,10 min/day of morning LPA increased SP by 0.15 percentage points.Afternoon LPA also increased SP by 0.09 percentage points for women.Night PA seems to have an inverse effect on sleep variables for any intensity and both sexes.Conclusion::The effect of PA on sleep health is intrinsically related to the period of the day in which it is performed.The effect magnitude is different between sexes.For better sleep health,it is preferable that PA be performed during the day.
基金supported by grants from National Natural Science Foundation of China(No.81702708)Natural Science Foundation of Hunan Province(No.2018JJ3862,No.2017JJ2392,and No.2019JJ50979)+1 种基金Scientific Research Project of Hunan Provincial Health Commission(No.B20180054)Changsha Science and Technology Project(No.kq1706072).
文摘The use of the traditional American Joint Committee on Cancer(AJCC)staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma(GSCC)patients.We aimed to establish a comprehensive prognostic nomogram with a prognostic value similar to the AJCC system.Methods:Patients were identified from SEER database.Variables were selected by a backward stepwise selection method in a Cox regression model.A nomogram was used to predict cancer-specific survival rates for 3,5 and 10 years in patients with GSCC.Several basic features of model validation were used to evaluate the performance of the survival model:consistency index(C-index),receiver operating characteristic(ROC)curve,calibration chart,net weight classification improvement(NRI),comprehensive discriminant improvement(IDI)and decision curve analysis(DCA).Results:Multivariate analyses revealed that age,race,marital status,insurance,AJCC stage,pathology grade and surgery were risk factors for survival.In particular,the C-index,the area under the ROC curve(AUC)and the calibration plots showed good performance of the nomogram.Compared to the AJCC system,NRI and IDI showed that the nomogram has improved performance.Finally,the nomogram's 3-year and 5-year and 10-year DCA curves yield net benefits higher than traditional AJCC,whether training set or a validation set.Conclusion:We developed and validated the first GSCC prognosis nomogram,which has a better prognostic value than the separate AJCC staging system.Overall,the nomogram of this study is a valuable tool for clinical practice to consult patients and understand their risk for the next 3,5 and 10 years.
基金Supported by Iran University of Medical Sciences (IUMS)。
文摘AIM:To investigate the relationship between near point of convergence(NPC)and mild cognitive impairment(MCI)in the general elderly population.METHODS:The present report is a part of the Tehran Geriatric Eye Study(TGES):a population-based crosssectional study conducted on individuals 60 years of age and above living in Tehran,Iran using the multi-stage stratified random cluster sampling method.Cognitive status was assessed using the Persian version of the Mini-Mental State Examination(MMSE).All study participants underwent complete ocular examination including measurement of uncorrected and best-corrected visual acuity,objective and subjective refraction,cover testing,NPC measurement,and slit-lamp biomicroscopy.RESULTS:The data of 1190 individuals were analyzed for this report.The mean age of the participants analyzed was 66.82±5.42(60-92y)and 728(61.2%)of them were female.Patients with MCI had a significantly more receded NPC compared to subjects with normal cognitive status(10.89±3.58 vs 7.76±2.71 cm,P<0.001).In the multivariable logistic regression model and in the presence of confounding variables,a receded NPC was statistically significantly associated with an increased risk of MCI(odds ratio:1.334,95%confidence interval:1.263 to 1.410,P<0.001).According to receiver operating characteristic(ROC)analysis,a cut point NPC>8.5 cm(area under the curve:0.764,P<0.001)could predict the presence of MCI with a sensitivity and specificity of 70.9%and 69.5%,respectively.CONCLUSION:A receded NPC can be clinically proposed as a predictor of MCI in older adults.It is recommended that elderly with a receded NPC>8.50 cm undergo detailed cognitive screening for a definite diagnosis of MCI.In this case,the necessary interventions can be carried out to slow down MCI progression to dementia.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a global health concern with a prevalence of about 25%amongst United States adults.Its increased prevalence is attributed to increase in patients with obesity and metabolic syndrome,partly due to similar mechanisms of injury.Nephrotic syndrome(NS)is a clinical entity resulting from extensive proteinuria leading to hypoalbuminemia,hyperlipidemia,edema,and other complications.Given its association with hyperlipidemia,there is concern that patients with NS may be at increased risk of NAFLD.AIM To perform a cross-sectional population-based study to investigate the prevalence and risk factors of NAFLD in patients with NS.METHODS A large multicenter database(Explorys Inc.,Cleveland,OH,United States)was utilized for this retrospective cohort study.A cohort of 49700 patients with a diagnosis of“Non-Alcoholic fatty liver disease”using the Systematized Nomenclature of Medicine-Clinical Terms(SNOMED-CT)between 1999-2022 was identified.Inclusion criteria were age≥18 years,presence of NAFLD,presence of NS.There were no specific exclusion criteria.Univariate and multivariate analysis were performed to adjust for multiple risk factors including age,gender,Caucasian race,NS,typeⅡdiabetes mellitus,hypothyroidism,dyslipidemia,obesity,metabolic syndrome and chronic kidney disease.Statistical analysis was conducted using R,and for all analyses,a 2-sided P value of<0.05 was considered statistically significant.RESULTS Among the 78734750 individuals screened in this database,there were a total of 49700 subjects with NAFLD.In univariate analysis,the odds of having NAFLD in patients with NS,type 2 diabetes mellitus,hypothyroidism,dyslipidemia,obesity,metabolic syndrome and chronic kidney disease were 14.84[95%confidence interval(95%CI)13.67-16.10],17.05(95%CI 16.78-17.32),6.99(95%CI 6.87-7.11),13.61(95%CI 13.38-13.84),19.19(95%CI 18.89-19.50),29.09(95%CI 28.26--29.95),and 9.05(95%CI 8.88-9.22),respectively.In multivariate analysis,the odds of having NAFLD amongst patients with NS were increased to 1.85(95%Cl 1.70-2.02),while the odds were also remained high in patients that have type 2 diabetes mellitus[odds ratio(OR)3.84],hypothyroidism(OR 1.57),obesity(OR 5.10),hyperlipidemia(OR 3.09),metabolic syndrome(OR 3.42)and chronic kidney disease(OR 1.33).CONCLUSION Patients with NS are frequently found to have NAFLD,even when adjusting for common risk factors.Hence,clinicians should maintain a high index of suspicion regarding presence of NAFLD in patients with NS.
文摘Introduction Dr.Ching-Yu Cheng(Figure 1)is currently an Associate Professor of the Academic Medicine Research Institute and the Academic Clinical Program for Ophthalmology and Visual Sciences(Eye ACP)at Duke-NUS Graduate School of Medicine;and Department of Ophthalmology,Yong Loo Lin School of Medicine,National University of Singapore.
基金Supported by Chung Shan Medical University Hospital,Taichung,Taiwan,No.CSH-2013-C-032
文摘AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40 years old without a diagnosis of CAD from 2006 until 2011 from a longitudinal health insurance database. The mean follow-up period for the study cohort was 1152 ± 633 d. The control cohort was matched by sex, age, residence, and index date. Hazard ratios(HRs) were calculated using the Cox proportional hazard model and the Kaplan-Meier method. RESULTS After exclusion, a total of 3409 newly diagnosed nonalcoholic cirrhotic patients were identified from one million samples from the health insurance database. We found that CAD(5.1% vs 17.4%) and hyperlipidemia(20.6% vs 24.1%) were less prevalent in nonalcoholic LC patients than in normal subjects(all P < 0.001), whereas other comorbidities exhibited an increased prevalence. Among the comorbidities, chronic kidney disease exhibited the highest risk for mortality(adjusted HR(AHR) = 1.76; 95%CI: 1.55-2.00, P < 0.001). Ascites or peritonitis exhibited the highest risk of mortality among nonalcoholic cirrhotic patients(AHR = 2.34; 95%CI: 2.06-2.65, P < 0.001). Finally, a total of 170 patients developed CAD after a diagnosis of nonalcoholic LC. The AHR of CAD in nonalcoholic LC patients was 0.56(95%CI: 0.43-0.74, P < 0.001). The six-year survival rates for nonalcoholic LC patients with and without CAD were 52% and 50%, respectively(P = 0.012). CONCLUSION We conclude that CAD was less prevalent and associated with a reduced risk of mortality in nonalcoholic cirrhotic patients.
文摘The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the popula-tion-based study in Kinmen, Taiwan. A total of 971 community dwelling adults previously di-agnosed with type 2 diabetes in 1991-1993 un-derwent DR screening in 1999-2002 by a panel of ophthalmologists using on-site indirect oph-thalmoscopy and 45-degree color fundus retinal photographs. The cost-benefit analysis is used to evaluate the DR screening. In terms of bene-fit-cost ratio, the different screening programs for DR could save New Taiwan Dollars (NTD) from 14.38 to 36.83 in discounted costs for each dollar incurred in different screening years from the societal viewpoint for Taiwan and save NTD from 0.81 to 1.80 in different screening years from health care payer’s perspective. The av-erage estimate of willingness-to-pay to translate into benefit yields NTD from 937.8 to 4,689 be- nefits per case due to DR screening in different screening years during 10-year follow-up. The net present value of the DR screening were NTD from -167,318 to -307,251.2 in different screening years. In conclusion, it is worthwhile to initial a routine DR screening of Chinese type 2 diabetes for blindness prevention from the societal per-spective but not from consumer decision based on the willingness-to-pay perspective.
基金Supported by (in part) The Medical Research Fund of the National Hospital of Icelandthe Medical Research Fund of Wyeth,Iceland+2 种基金AstraZeneca,IcelandGlaxoSmithKline,Icelandand the Icelandic College of Family Physicians
文摘AIM： To study the natural history and prevalence of heartburn at a 10-year interval, and to study the effect of heartburn on various symptoms and activities. METHODS： A population-based postal study was carried out. Questionnaires were mailed to the same age- and gender-stratified random sample of the Icelandic population （aged 18-75 years） in 1996 and again in 2006. Subjects were classified with heartburn if they reported heartburn in the preceding year and/or week, based on the definition of heartburn. RESULTS： Heartburn in the preceding year was reported in 42.8% （1996） and 44.2% （2006） of subjects, with a strong relationship between those who experienced heartburn in both years. Heartburn in the precedingweek was diagnosed in 20.8%. There was a significant relationship between heartburn, dyspepsia and irritable bowel syndrome. IndMduals with a body mass index （BMI） below or higher than normal weight were more likely to have heartburn. Heartburn caused by food or beverages was reported very often by 20.0% of subjects. CONCLUSION： Heartburn is a common and chronic condition. Subjects with a BMI below or higher than normal weight are more likely to experience heartburn. Heartburn has a great impact on daily activities, sleep and quality of life.
文摘BACKGROUND Although the link between cardiovascular disease(CVD)and various cancers is well-established,the relationship between CVD risk and colorectal cancer(CRC)remains underexplored.AIM To elucidate the relationship between CVD risk scores and CRC incidence.METHODS In this population-based cohort study,participants from the 2009 National Health Checkup were followed-up until 2020.The cardiovascular(CV)risk score was calculated as the sum of risk factors(age,family history of coronary artery disease,hypertension,smoking status,and high-density lipoprotein levels)with high-density lipoprotein(≥60 mg/dL)reducing the risk score by one.The primary outcome was incidence of newly diagnosed CRC.RESULTS Among 2526628 individuals,30329 developed CRC during a mean follow-up of 10.1 years.Categorized by CV risk scores(0,1,2,and≥3).CRC risk increased with higher CV risk scores after adjusting for covariates[(hazard ratio=1.155,95%confidence interval:1.107-1.205)in risk score≥3,P<0.001].This association individuals not using statins.Moreover,even in participants without diabetes,a higher CV risk was associated with an increased CRC risk.CONCLUSION Increased CV risk scores were significantly associated with higher CRC risk,especially among males,younger populations,and non-statin users.Thus,males with a higher CV risk score,even at a younger age,are recommended to control their risk factors and undergo individualized CRC screening.
基金National Nonprofit Institute Research Grant for the Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences:Mechanism of Regulating Phlegm-Dampness Constitution to Prevent Metabolic Diseases based on Gut Microbiota-host DNA Methylation(No.YZ-202151)。
文摘OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which included 249 participants with damp-heat constitution or balanced constitution.Baseline information of participants was collected,and stool samples were collected for gut microbiota analysis.Principal coordinate analysis,linear discriminant analysis effect size analysis,receiver operating characteristic,random forest model,and phylogenetic investigation of communities by reconstruction of unobserved states methods were used to reveal the relationship between gut microbiota and the damp-heat constitution.RESULTS:Compared to those in the BC group,the richness and diversity of the microbiota,specifically those of several short-chain fatty acid producing genera such as Barnesiella,Coprobacter,and Butyricimonas,were significantly decreased in the DHC group.Regarding biological functions,flavonoid biosynthesis,propanoate metabolism,and nucleotide sugar metabolism were suppressed,while arachidonic acid metabolism and glutathione metabolism were enriched in the DHC group.Finally,a classifier based on the microbiota was constructed to discriminate between the DHC and BC populations.CONCLUSION:The gut microbiota of the DHC population exhibits significantly reduced diversity and is closely related to inflammation,metabolic disorders,and liver steatosis,which is consistent with clinical observations,thus serving as a potential diagnostic tool for traditional Chinese medicine constitution discrimination.
基金supported by Shandong Province Traditional Chinese Medicine Science and Technology Program(M-2022254)Shandong First Medical University(Shandong Academy of Medical Sciences)Youth Science Fund Cultivation and Support Program(202201-127)+1 种基金High Level Key Discipline Construction Project of the State Administration of Traditional Chinese Medicine(zyyzdxk-2023123)the Major Science and Technology Innovation Project of Shandong Province(2022CXGC020510,2024CXGC010609).
文摘Chronic body pain and depression,two major global health concerns,frequently co-occur and collectively impair individuals'well-being,compromising their ability to maintain an independent lifestyle and social relationships[1].A global study of pain prevalence among 52 countries indicated the overall prevalence of pain was estimated to be 27.5%[2],with significant variation across countries(9.9%-50.3%).
基金supported by the CAMS Innovation Fund for Medical Sciences(CIFMS)[grant number 2021-I2M-1-037]the National Natural Science Foundation of China[grant numbers 82373647,and 82473697].
文摘Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023.Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality.Stratified analyses were performed based on the individual characteristics of the participants.Results Overall,19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died.The underweight(<18.5 kg/m^(2))presented an increase in all-cause mortality(adjusted hazards ratio[aHR]=2.00,95%confidence interval[CI]:1.66–2.41),while overweight(≥24.0 to<28.0 kg/m^(2))and obesity(≥28.0 kg/m^(2))presented a decrease with an aHR of 0.61(95%CI:0.52–0.73)and 0.51(95%CI:0.37–0.70),respectively.Overweight(aHR=0.76,95%CI:0.67–0.86)and mild obesity(aHR=0.72,95%CI:0.59–0.87)had a positive impact on mortality in people older than 60 years.All-2 cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m(aHR=0.95,95%CI:0.92–0.98)and increased slightly above that value,indicating a U-shaped association.The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years.Therefore,it is essential to consider age differences when formulating health and weight management strategies.
文摘Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and premature mortality,which increased by 3%between 2000 and 2019.2 Evidence is strong that maintaining a healthy diet,engaging in regular physical activity(PA),and preventing obesity can prevent or delay the incidence of T2D.
基金funded by the Australia National Health and Medical Research Council(#1195716)funded by the Australia National Health and Medical Research Council(#1099655 and#1173991).
文摘Background Early childhood developmental adversities have long-term effects on educational and overall health outcomes.However,the developmental outcomes of children from culturally and linguistically diverse(CALD)backgrounds remain unclear.This study aimed to investigate the association between having a CALD backgrounds and developmental vulnerability in Western Australia.Methods We conducted a retrospective population-based cohort study using data from the Australian Early Development Censuses,Midwives Notification System,and Hospital Morbidity Data Collections.Developmental vulnerability was defined as domain scores<10th percentile in five Australian Early Development Censuses domains.Covariate-adjusted logistic regression,incorporating propensity score weighting,was applied,and the population attributable risk calculations results were informed.Results Among 10,048 CALD children and 49,877 non-CALD children,23.7%[95%confidence interval(CI)22.9,24.5%]of CALD children experienced developmental vulnerability in one or more Australian Early Development Censuses domain(s)(DV1)compared with 19.6%(95% CI 19.3,20.0%)of non-CALD children.Adjusted analyses revealed that CALD children had 23%greater odds of DV1[odds ratio(OR)1.23;95% CI 1.16,1.31]and developmental vulnerability in two or more Australian Early Development Censuses domains(DV2)(OR 1.23;95%CI 1.13,1.33).CALD children had more than twice the odds of vulnerability in terms of communication skills and general knowledge(OR 2.16;95%CI 1.99,2.34)and 37%greater odds in language and cognitive skills(school-based)(OR 1.37;95%CI 1.25,1.51).The population attributable risk was 3.77%for DV1,3.67%for DV2,5.90%for language and cognitive skills(school-based),and 16.24%for communication skills and general knowledge.Conclusions This study revealed a greater developmental vulnerability burden among CALD children than among their non-CALD peers,particularly in the domains of communication skills and general knowledge.Strengthening culturally responsive policies,enhancing early childhood support programs,and ensuring equitable access to educational resources for children from CALD backgrounds may help reduce developmental disparities and promote long-term educational outcomes.
文摘BACKGROUND The number of population-based studies on unclassified inflammatory bowel disease(IBD-U)is very limited.AIM To evaluate the long-term incidence,disease course and surgery rates of IBD-U in a prospective population-based cohort.METHODSThe present study is a continuation of the well-established Veszprem IBD cohort with patient inclusion between1977 and 2018. Both in-hospital and outpatient records were collected. The source of age- and gender-specificdemographic data was derived from the Hungarian Central Statistical Office. Medical therapy, surgery and changein disease phenotype were analyzed.RESULTSData of 119 incident IBD-U patients were analyzed [male/female: 55/64;median age at diagnosis: 34 years(interquartile range: 24-47.5)]. Adjusted mean incidence rate was 0.76 (95%CI: 0.63-0.9)/105 person-years in the totalstudy period. Disease extent at diagnosis was extensive (pancolitis) in 56.3%. Twenty-two of 119 (18.5%) patientswere reclassified to Crohn’s disease during follow up, the probability of developing terminal ileum involvementwas 6.8%, while perianal disease developed in 5% (n = 6). The probability of receiving biological therapy in patientsdiagnosed after the year 2000 (n = 62), was 15.5% (SD: 4.8) at 5 years. The overall resective surgery rate was 16.8%.Segment resection was performed in 5.0% of the patients, and 11.8% underwent subtotal or total colectomy. Thecumulative probability of resective surgery was 7.6% (SD: 2.4) at 1 year, 9.3% (SD: 2.7) at 5 years, 13.5% (SD: 3.3) at10 years, and 18.5% (SD: 3.9) at 20 years.CONCLUSIONThese data extend our knowledge on the overall burden of IBD-U. Colonic involvement was extensive in a highproportion of IBD-U. Disease reclassification to Crohn’s disease was relatively high. High rates of biologicaltherapy and surgery rates support a relatively severe disease course of IBD-U.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
