BMI Scores Research Articles

The Effect of Parental Weight and Genetics on the Body Mass Index of Very Low Birth Weight Infants as They Reach School Age.

Prematurely born individuals are usually of low or normal weight in childhood; in adulthood, however, their probability of being overweight is twice that of persons born at full term. There is not yet any way to predict the weight development of premature babies. A polygenic BMI score (BMI = body-mass index), calculated from the often very small individual effects of more than 2 million genetic variants, was recently described for adults. We studied the possible association of this score with the course of BMI in premature babies over time, from infancy up to the age of 10-14 years. 508 individuals were included in the study. At the age of 5-7 years, their mean body weight was 18.8 ± 3.3 kg. The difference between the highest and lowest deciles of the polygenic score was 3.3 kg. At age 10-14, the average body weight was 41.3 ± 11.3 kg, and the difference between the highest and lowest deciles had increased to 9.2 kg. In persons with birth weight under the 10th percentile (n = 68), the difference was 19.2 kg (30.9 kg vs. 50.1 kg). The polygenic BMI score was significantly associated with the BMI z-scores of the overall group and the subgroup of growth-retarded children. Extreme values of a polygenic BMI score are strongly associated with the weight development of preterm infants as they develop into children aged 10-14. The large effect size implies that this score may aid in the counseling of prematurely born children and their parents.

Leisure Physical Activity, Sedentary Behavior, and Cardiovascular Health 2-7 Years after Pregnancy in the nuMoM2b HHS Cohort.

To evaluate whether higher moderate-to-vigorous intensity physical activity (MVPA) and lower sedentary behavior (SB) are related to better cardiovascular health (CVH) following pregnancy. In the nuMoM2b Heart Health Study (HHS) cohort, Life's Essential 8 health factors (BMI, blood pressure, glucose, and lipid) were assessed in the first trimester of pregnancy and 2-7 years later (n = 3,985). The four health factors were scored with Life's Essential 8 criteria (0 = poorest; 100 = ideal) and averaged to calculate a CVH health factor score (CVHhf). Self-reported leisure MVPA and SB were assessed at follow-up. Linear regression evaluated associations of MVPA levels and SB quartiles with follow-up CVHhf after adjustment for first trimester CVHhf and covariates. Analyses were repeated after stratification by history of hypertensive disorders of pregnancy (HDP) or gestational diabetes (GDM). Over follow-up (mean 3.2 years after delivery), CVHhf declined from 85.6 to 81.6 points (-4.0 points, p < 0.001). The decline was greatest in lipid (-8.4 points, p < 0.001) and BMI scores (-5.6 points, p < 0.001). Healthier activity profiles (higher MVPA level and lower SB quartile) were each associated with higher CVHhf at follow-up: 0.7 points higher per level of MVPA, p < 0.001; 0.5 points lower per quartile of SB, p = 0.0042. Higher MVPA level associated with healthier BMI, glucose, and lipid scores; lower SB quartile associated with healthier BMI and blood pressure scores (p < 0.05). Although HDP/GDM history was associated with lower CVHhf, patterns of CVHhf across healthier leisure MVPA levels and SB quartiles were similar in those with and without HDP or GDM. Higher MVPA and lower SB during leisure could help to maintain CVH health factors in the years following pregnancy, including among those who experienced HDP or GDM.

Impact of the treatment with TNF inhibitors and JAK Inhibitors on arterial stiffness and lipid parameters in rheumatoid arthritis patients: a cross-sectional study

Abstract Introduction Rheumatoid arthritis (RA) is a chronic inflammatory joint disease associated with an increased cardiovascular risk. Treating disease activity with biologic and synthetic disease-modifying antirheumatic drugs (DMARDs) diminishes cardiovascular risk, but the vascular effects of different biologic and targeted synthetic drugs are poorly understood. Echo-tracking parameters of carotid artery can reveal arterial stiffness as a marker of subclinical atherosclerosis. Methods Patients with RA of at least 6 months of duration, treated with TNF inhibitors or JAK inhibitor - upadacitinib(UPA) and healthy subjects underwent ultrasound examination of carotid artery using the Aloka ProSound Alpha 7. The measurements included pulse-wave velocity (PWVβ), beta-stiffness, augmentation index (AI), arterial compliance (AC), and Ep (Elastic Modulus) and laboratory examination of lipid parameters. Disease activity of RA was measured using Disease activity scores - DAS28-CRP, DAS28-ESR, and Clinical Disease Activity Index (CDAI). Data were analyzed with SPSS v29 and the Kruskal-Wallis test was used to determine statistical differences among the three groups. Results 97 subjects, mean age 55.36±11.84, 83% females. Of them 38 on TNF inhibitors, 36 on UPA, and 23 controls. The three groups were similar in age, BMI, smoking status, and Framingham risk score. Disease activity and disease duration did not differ between the two patients groups. PWV was significantly higher in the UPA group compared to controls but not significantly different from the TNF group. (6.825 vs. 5.8022 vs. 6.468, p=0.034 UPA vs. Control, p=0.59 UPA vs. TNF) (fig.1). AC was lower and Ep was higher in the UPA group compared to controls (0.6511 vs. 0.8678, p=0.032 and132 kPa vs. 92.3, p=0.04 respectively). Total cholesterol levels were higher in the UPA group compared to TNF treated patients and to the control group (fig.2). Conclusion Echo-traching examination of the carotid artery is an easily perfomed, non-invasive and highly informative method of detecting early signs of vascular impairment in patients with RA treated with TNF inhibititors and JAK inhibitor. Treatment with UPA increases the levels of total cholesterol.

Mother’s food neophobia and eating disorder: Are they associated with child’s eating behavior? A study of mother-child pairs

ABSTRACT There may be links between maternal food neophobia (MFN), eating disorders, and children’s food preference. To define whether MFN and eating disorders affect their children’s eating behaviors. The survey included of socio-demographic characteristics, Food Neophobia Scale (FNS), Eating Attitude Test 26 (EAT26) and Children Eating Behaviour Scale. Children’s energy and nutrient intakes were assessed through interviews with their mothers (24-hour dietary recall method). Anthropometric measurements of children were measured and of mothers were recorded. Linear regression analyses were employed to examine the relationships between maternal characteristics and children’s food approach and avoidant behaviors. Mothers (n = 360) and children (n = 360; aged 3–5 years) were enrolled. Of the mothers, 166 were neophobic, 194 neophilic. MFN score inversely correlated with children’s energy and several vitamins and mineral (Na, K, Ca, Mg, Fe, and Zn) intake (all p < .05). The results of the regression analysis indicated that the Children’s Food Approach score was influenced by the mother’s age, BMI, FNS, and EAT-26 score. Conversely, the Children’s Food Avoidant score was found to be affected by the mother’s FNS and EAT-26 score. MFN and maternal eating attitudes have a significant impact on children’s food access and avoidance.

Comparative analysis of efficacy and quality of life between totally extraperitoneal sublay and intraperitoneal onlay mesh repair for ventral hernia

Ventral hernias pose a prevalent challenge in abdominal wall surgery, with ongoing advancements in repair techniques designed to enhance patient outcomes. This study evaluates the efficacy, safety, and socio-economic impact of Totally Extraperitoneal Sublay Repair (TES) versus Laparoscopic Intraperitoneal Onlay Mesh Repair (IPOM) for small to medium-sized ventral hernias, with a particular focus on postoperative quality of life and patient satisfaction. A retrospective cohort study was conducted, encompassing 125 patients who underwent ventral hernia repair between May 2018 and November 2023. The cohort included 55 patients treated with TES and 70 with Laparoscopic IPOM. Baseline characteristics, including age, gender, BMI, operative time, postoperative pain, hospitalization costs, and patient satisfaction score, were compared. Postoperative quality of life was evaluated through outpatient visits or telephone follow-ups. The propensity score matching (PSM) technique was applied in a 1:1 ratio to balance the significant differences in general characteristics between the two groups. Out of 125 patients, 70 cases were successfully matched using the PSM method, resulting in 35 cases in each group. The baseline characteristics of patients in groups were well-matched (P > 0.05). The TES group exhibited a significantly longer operative duration (P < 0.001); however, this group also experienced markedly reduced postoperative pain, decreased hospitalization costs, and diminished postoperative drainage (all P < 0.001). The length of hospital stay and the incidence of long-term complications were similar between the two groups. Follow-up evaluations at 3 and 6 months showed a significantly improved quality of life and higher patient satisfaction in the TES group. Both TES and IPOM demonstrate comparable safety and efficacy in the repair of ventral hernias. Although TES is associated with a longer operative duration, it provides significant advantages in postoperative quality of life, patient satisfaction, and cost-effectiveness, thereby supporting its broader clinical adoption.

Are associations of adulthood overweight and obesity with all-cause mortality, cardiovascular disease, and obesity-related cancer modified by comparative body weight at age 10 years in the UK Biobank study?

Adults living with overweight or obesity do not represent a single homogenous group in terms of mortality and disease risks. The aim of our study was to evaluate how the associations of adulthood overweight and obesity with mortality and incident disease are modified by (i.e., differ according to) self-reported childhood body weight categories. The sample comprised 191,181 men and 242,806 women aged 40-69 years (in 2006-2010) in the UK Biobank. The outcomes were all-cause mortality, incident cardiovascular disease (CVD), and incident obesity-related cancer. Cox proportional hazards regression models were used to estimate how the associations with the outcomes of adulthood weight status (normal weight, overweight, obesity) differed according to perceived body weight at age 10 years (about average, thinner, plumper). To triangulate results using an approach that better accounts for confounding, analyses were repeated using previously developed and validated polygenic risk scores (PRSs) for childhood body weight and adulthood BMI, categorised into three-tier variables using the same proportions as in the observational variables. In both sexes, adulthood obesity was associated with higher hazards of all outcomes. However, the associations of obesity with all-cause mortality and incident CVD were stronger in adults who reported being thinner at 10 years. For example, obesity was associated with a 1.28 (1.21, 1.35) times higher hazard of all-cause mortality in men who reported being an average weight child, but among men who reported being a thinner child this estimate was 1.63 (1.53, 1.75). The ratio between these two estimates was 1.28 (1.17, 1.40). There was also some evidence that the associations of obesity with all-cause mortality and incident CVD were stronger in adults who reported being plumper at 10 years. In genetic analyses, however, there was no evidence that the association of obesity (according to the adult PRS) with mortality or incident CVD differed according to childhood body size (according to the child PRS). For incident obesity-related cancer, the evidence for effect modification was limited and inconsistent between the observational and genetic analyses. Greater risks for all-cause mortality and incident CVD in adults with obesity who perceive themselves to have been a thinner or plumper than average child may be due to confounding and/or recall bias.

Sex-related functional outcome after periacetabular osteotomy in mild to severe hip dysplasia.

Periacetabular osteotomy (PAO) is well established for acetabular reorientation and has shown successful improvement in patient-reported outcome measures (PROMs). Nevertheless, studies focusing on postoperative outcomes related to patient individual factors are still underrepresented. Therefore, this study aimed to analyze the functional outcome and activity level in relation to patient sex with a minimum follow-up of two years after PAO for mild to severe hip dysplasia. A single-centre study was conducted, enrolling patients undergoing PAO and completing a preoperative and postoperative radiological and clinical outcome assessment. The PROMs were assessed using the modified Harris Hip Score (mHHS), the Hip disability and Osteoarthritis Outcome Score (HOOS) with the subscales for pain, sport, activities of daily living (ADL), and quality of life (QoL), and the University of California, Los Angeles (UCLA) activity score. Kendall's tau were calculated for correlation analyses. In total, 145 patients (28 male, 117 female) were included. The PROMs improved significantly across males and females at the latest follow-up. Female patients had significantly lower preoperative PROMs: mHHS (47 vs 57.4; p = 0.002); HOOS pain (44.9 vs 60; p = 0.003), sport (47 vs 57.4; p = 0.002), ADL (58.9 vs 69.3; p = 0.032), and QoL (26.8 vs 39.3; p = 0.009); and UCLA (5.6 vs 6.7, p = 0.042) scores. Males showed higher postoperative UCLA scores (7.5 vs 6.7; p = 0.03). Kendall's tau showed significant negative correlation between BMI and UCLA scores in females and males (-0.21 to -0.29; p = 0.002/0.048), while BMI and HOOS sport (-0.16; p = 0.015) and ADL (-0.2; p = 0.003), as well as QoL (-0.14; p = 0.031) and preoperative acetabular inclination (-0.13; p = 0.049) were only significantly negatively correlated in females. Patient sex affects PROMs before and after PAO. Female patients experience higher improvement in hip function and activity level, due to poorer preoperative PROMs than males. Thus, these data are particularly interesting in providing preoperative guidance regarding postoperative outcome expectations.

Longitudinal analysis of anthropometric measures over 5 years in patients with Friedreich ataxia in the EFACTS natural history study.

Friedreich ataxia is a rare neurodegenerative disorder caused by frataxin deficiency. Both underweight and overweight occur in mitochondrial disorders, each with adverse health outcomes. We investigated the longitudinal evolution of anthropometric abnormalities in Friedreich ataxia and the hypothesis that both weight loss and weight gain are associated with faster disease progression. Participants were drawn from the European Friedreich's Ataxia Consortium for Translational Studies (EFACTS). Age- and sex-specific BMI and height scores were calculated using the KIGGS-BMI percentiles for children. Height correction was applied for scoliosis. Longitudinal data were analysed using linear mixed effects models and incremental standard deviation scores and growth mixture models identified subclasses with varying BMI trajectories. Five hundred and forty-three adults and fifty-nine children were assessed for up to 5 years. In children, severe underweight (26%), underweight (7%), severe short stature (16%) and short stature (23%) were common. The corrected BMI percentile was stable in children, although 48% had negative incremental BMI scores over 1 year and 63% over 3 years versus 10%/year in a normal reference cohort. Overweight was common in adults (19%), with a slight increase in BMI over time. Longer GAA repeat size was linked to lower BMI in adults. Weight trajectory was not associated with ataxia progression in adults. Significant anthropometric abnormalities were identified, with underweight and short stature prevalent in children and overweight in adults. These findings highlight the need for regular nutritional monitoring and interventions to manage underweight in children and promote healthy weight in adults.

Drivers of stunting and wasting across serial cross-sectional household surveys of children under 2 years of age in Pakistan: potential contribution of ecological factors.

The impact of direct and indirect drivers on linear growth and wasting in young children is of public health interest. While the contributions of poverty, maternal education, empowerment and birth weight to early childhood growth are well recognized, the contribution of environmental factors like heat, precipitation, agriculture outputs and food security in comparable datasets is less well established. To investigate the association of length-for-age z-score (LAZ) and weight-for-length z-score (WLZ) with various indicators among children under 2 years of age in Pakistan using representative household level nutrition surveys and ecological datasets. Using geo-tagged metadata from Pakistan's 2011 and 2018 National Nutrition Surveys (NNS), anthropometric data from 29,887 children (9,231 from 2011 and 20,656 from 2018) were analyzed. Dietary intake and food security data for 140 districts were linked to gridded data on temperature, precipitation and soil moisture, and district measures of agriculture production of edible crops. Multiple linear regressions assessed factors associated with length for age Z score (LAZ) and weight for length z scores (WLZ) in index children. LAZ was positively associated with improved socio-economic conditions (β=0.06), food security (β=0.10), birth size (β=0.26), maternal age (β=0.02), BMI (β=0.02), height (β=0.02) and dietary score (β=0.03). Negative associations with LAZ were found for increased temperature, precipitation, diarrhea, household crowding and parity. Similar patterns were observed with WLZ for higher surface temperatures and precipitation were associated with declines in linear growth, alongside increased diarrhea prevalence and higher maternal parity. Apart from recognized multifactorial drivers of stunting and wasting among children such as poverty, food insecurity and maternal undernutrition, our analysis suggest the potential independent association with climatic factors such as heat and excess precipitation over time. These findings underscore the need for further research and potential integration of climatic mitigation and adaptation with nutrition response strategies.

Neural structural alterations correlates of quadriceps muscle strength deficits in patients after anterior cruciate ligament reconstruction.

Persistent maladaptive changes of corticospinal tract (CST) and quadriceps strength deficits exist in patients with anterior cruciate ligament reconstruction (ACLR). This study aimed to investigate the relationships between the structural alterations of CST and quadriceps muscle strength deficits in patients with ACLR. Twenty-nine participants who had undergone unilateral ACLR (29 males; age=32.61±6.72 years) were enrolled in a cross-sectional investigation. We chose CST as a region of interest and performed diffusion tensor imaging (DTI) that measured the microstructure of white matter tracts. Maximal voluntary isometric quadriceps muscle strength was assessed using a hand-held dynamometer. Simple and partial correlation analyses were performed between the DTI outcomes and quadriceps muscle strength deficits in patients with ACLR before and after controlling for age, sex, BMI, Tegner activity score, and graft type. Sub-group analyses were also performed to investigate the relationships between the DTI outcomes of CST structure and quadriceps muscle strength deficits according to the graft type before and after controlling for age, sex, BMI, and Tegner activity score. Lower limb symmetry index (LSI) of quadriceps muscle strength was associated with a higher ratio of radial diffusivity (RD, r=-0.379, p=0.042) in corticospinal tracts of the injured hemisphere to those of the non-injured hemisphere in ACLR patients after controlling for age, BMI, Tegner activity score and graft type. In subgroup analyses of ACLR patients with hamstring autografts, we found that higher injured quadriceps muscle strength was associated with higher axial diffusivity (AD, r=0.616, p=0.033) of CST structure and lower LSI of quadriceps muscle strength was associated with higher ratio of mean diffusivity (MD, r=-0.682, p=0.014) and RD (r=-0.759, p=0.004) in corticospinal tracts of the injured hemisphere to those of the non-injured hemisphere in ACLR patients after controlling for age, BMI, Tegner activity score. Decreased integrity (higher ratio of RD) of CST microstructure in ACLR patients was significantly associated with lower quadriceps limb symmetry index, which hinted that quadriceps muscle strength deficits of injured side may be a demyelinating process of CST microstructure in ACLR.

Undergraduates' lifestyle and Suboptimal Health Status (SHS): A cross-sectional study in the Ha'il region of Saudi Arabia.

University students in Saudi Arabia are embracing some of the negative traits of the fast-paced modern lifestyle, typified by unhealthy eating, low physical activity, and poor sleep habits that may increase their risk for poor health. Health and holistic well-being at the population level are among the priorities of the 2030 vision of a vibrant society in the Kingdom of Saudi Arabia. The current study thus aims at determining the prevalence and predictive factors of Suboptimal Health Status (SHS) among university students. A cross-sectional study was conducted among 9,026 undergraduate students between 31st May and 15th June 2023. The data was collected through an online questionnaire using the Arabic translation of the SHS (ASHSQ-25) and the Simple Lifestyle Indicator Questionnaire (SLIQ). The chi-square test, Canonical Correlation Analysis (CCA), hierarchical multiple regression, and Receiver Operating Characteristic (ROC) were performed to analyze the data using IBM SPSS software (version 25.0) at a significance level of p<0.05. The findings showed that 33.7% (3038) of the students were classified as having SHS. The prevalence of SHS was statistically higher among younger and those studying social science discipline, overweight, had poor diets, engaged in low physical activity, and slept <6 hours (p<0.001). Canonical loadings of these factors were significant in predicting the five SHS dimensions range (0.52-0.97). Furthermore, the extracted significant variables from the multiple regression analysis indicated the final model (Model 3) was statistically significant, R2 = 0.646, F (6,9019), p <0.0001, suggesting that 64.6% of the variance in the SHS can be explained by the predictor variables in the model. These variables included age, college, academic level, diet, BMI, and sleeping duration. Findings show that modifiable predictors such as poor sleep quality, higher BMI scores, and poor dietary habits increase SHS risk among university students in Saudi Arabia. Therefore, the findings of this study emphasize the necessity of early interventions that promote healthy lifestyles.

Evaluation of the Effects of Night Eating Syndrome and Mindful Eating on Sleep Quality Among Female Students in the Faculty of Health Sciences

Poor sleep quality is prevalent among university students and has been linked to unhealthy eating behaviors, including night eating and low mindful eating, which may negatively impact overall health and well-being. The purpose of this study is to evaluate the effects of mindful eating and night eating syndrome on sleep quality among female students in the Faculty of Health Sciences. This cross-sectional study was conducted with a total of 360 female university students aged 18 to 24 years. Data were collected through face-to-face surveys, and the Mindful Eating Questionnaire (MEQ), Night Eating Questionnaire (NEQ), and Pittsburgh Sleep Quality Index (PSQI) were administered. Among the participants, 40.8% were classified as good sleepers, while 59.2% were poor sleepers. Additionally, MEQscores were not statistically different between the two groups (p &gt; 0.05), while NEQ total scores were significantly higher in participants with poor sleep quality (p = 0.003). Higher total PSQI scores were significantly associated with skipping meals (Beta = 0.101), alcohol consumption (Beta = 0.163), high BMI (Beta = 0.610), and NEQ score (Beta = 0.084). In conclusion, poor sleep quality among female university students is significantly associated with night eating behaviors, higher BMI, meal skipping, and alcohol consumption, highlighting the need for interventions targeting these behaviors to improve sleep quality and overall well-being.

Clinical Impact of Sarcopenia in the Decision-Making Process for Patients with Acute Diverticulitis.

Background: Acute diverticulitis (AD), an inflammatory complication of diverticulosis, affects around 4% of individuals with diverticulosis, with increased incidence in older populations. This study aims to assess the impact of sarcopenia, the age-related loss of muscle mass, on the clinical decision-making and outcomes of patients with AD. Materials and Methods: A retrospective study was conducted on 237 patients admitted to the Emergency Department (ED) between January 2014 and February 2022. Patients diagnosed with AD Hinchey ≥ 2 via contrasted tomography (CT) were included. Sarcopenia was assessed using CT scans at the third lumbar vertebra (L3), with skeletal muscle area (SMA) normalized by height to calculate the skeletal muscle index (SMI). Patients were divided into two groups based on sarcopenia status and analysed for surgical outcomes, non-operative management (NOM) success, and complications. Results: The prevalence of sarcopenia was 46%. Sarcopenic patients were significantly older and had lower BMI and higher frailty scores. A higher proportion of sarcopenic patients underwent Hartmann, while non-sarcopenic patients more often had anastomosis. Sarcopenia did not significantly affect overall morbidity, mortality, or the failure rate of NOM. However, sarcopenic patients with a BMI > 25 had a higher likelihood of requiring redo surgeries. Conclusions: Sarcopenia plays a critical role in the surgical management of AD but does not predict worse clinical outcomes. The decision to perform surgery, particularly Hartmann's procedure, is influenced by sarcopenia, yet morbidity and mortality rates are comparable between sarcopenic and non-sarcopenic patients. These findings highlight the need for sarcopenia to be considered in preoperative assessments.

A case-matched series comparing functional outcomes for robotic-assisted unicompartmental knee arthroplasty versus functionally aligned robotic-assisted total knee arthroplasty.

Unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) have both been shown to be effective treatments for osteoarthritis (OA) of the knee. Many studies have compared the outcomes of the two treatments, but less so with the use of robotics, or individualized TKA alignment techniques. Functional alignment (FA) is a novel technique for performing a TKA and shares many principles with UKA. Our aim was to compare outcomes from a case-matched series of robotic-assisted UKAs and robotic-assisted TKAs performed using FA. From a prospectively collected database between April 2015 and December 2019, patients who underwent a robotic-assisted medial UKA (RA-UKA) were case-matched with patients who had undergone a FA robotic-assisted TKA (RA-TKA) during the same time period. Patients were matched for preoperative BMI, sex, age, and Forgotten Joint Score (FJS). A total of 101 matched pairs were eligible for final review. Postoperatively the groups were then compared for differences in patient-reported outcome measures (PROMs), range of motion (ROM), ability to ascend and descend stairs, and ability to kneel. Both groups had significant improvements in mean FJS (65.1 points in the TKA group and 65.3 points in the UKA group) and mean Oxford Knee Score (OKS) (20 points in the TKA group and 18.2 in the UKA group) two years following surgery. The UKA group had superior outcomes at three months in the OKS and at one year in ROM (5°), ability to kneel (0.5 points on OKS question), and ascend (1.3 points on OKS question) and descend stairs (0.8 points on OKS question), but these were not greater than the minimal clinically important difference. There were no differences seen in FJS or OKS at one year postoperatively. There were no statistically significant differences between the groups at 24 months in all the variables assessed. FA-RATKA and RA-UKA are both successful treatments for medial compartmental knee arthritis in this study. The UKA group showed a quicker recovery, but this study demonstrated equivalent two-year outcomes in all outcomes measured including stair ascent and descent, and kneeling.

The impact of ureteral access sheaths on radiation exposure in the ureterorenoscopic treatment of urolithiasis.

Ureteral access sheaths (UAS) are widely used in the endoscopic treatment of urolithiasis. In modern medicine, radiation exposure from diagnostics and therapy is increasing; however, the impact of UAS on procedure duration, fluoroscopy time, and radiation exposure is still uncertain. This retrospective study included 1,026 patients who received ureterorenoscopic treatment for urolithiasis between 2016 and 2018 at a large academic center. Patients were dichotomized according to the use of UAS, and propensity score matching was performed based on age, BMI and stone size. Patient demographics, stone size, radiographic density, perioperative complications, and postoperative outcome were assessed. Procedure time and radiation exposure, recorded as the fluoroscopy time and area dose product, were analyzed. In total, 300 patients were successfully matched to the cohort with UAS (n=150) and the cohort without UAS (n=150). Patients' demographics were similar for age, gender, BMI and ASA score (each p>0.05). Median stone size was 8mm and 7.5mm in the cohort with and without UAS (p=0.335). Procedure time showed no differences between the two cohorts (p=0.749). Fluoroscopy time and area dose product were significantly lower in patients treated with the use of UAS (p=0.004; p<0.001). The use of a UAS does not prolong operation time in patients with equivalent stone burden. In addition, the use of a UAS reduces fluoroscopy time and radiation exposure. In the future, to reduce radiation exposure to the patient and medical staff, the use of a UAS should also be considered for limited stone disease.

Socioeconomic disadvantage and polygenic risk of overweight in early and mid-life: a longitudinal population cohort study spanning 12 years

We describe BMI by socioeconomic disadvantage and by polygenic risk in parallel cohorts of children and adults (their parents). We examine whether hypothetically intervening to reduce childhood disadvantage could reduce adolescent obesity. From a population-based cohort (N=5107) with a mixed design (survey and direct assessment), 24-31% had genotype data: 1607 children (50% male) followed biennially from age 2-3 to 14-15; 2406 adults (36% male) followed from mean age 35-47 years. Exposures were polygenic risk score for BMI, and neighbourhood- and family-level socioeconomic disadvantage categorised as 'most' (top two cohort-specific quintiles), 'average', or 'least' disadvantage (bottom two quintiles). We explored trends in estimated BMI and risk of overweight/obesity by disadvantage, stratified by polygenic risk. We used generalised linear regression to estimate the reduction in overweight/obesity at 14-15 years in children living in 'least/average disadvantage' in early childhood relative to those in 'most disadvantage', adjusted for confounders. Causal effect estimates were obtained separately for children with higher and lower polygenic risk. A positive trend between disadvantage and overweight/obesity was most apparent among participants with high polygenic risk. Among children with higher polygenic risk (n=805), hypothetical target trial results imply that intervening to lessen population-wide neighbourhood disadvantage from most to least disadvantage could reduce adolescent overweight/obesity by 32% (risk ratio (RR) 0.68, 95% CI 0.50-0.92), or by 42% if intervening to lessen family disadvantage (RR 0.58, 95% CI 0.42-0.79). Positive effects were smaller when isolating the population to those with lower polygenic risk (7-17%), and for the whole population, regardless of polygenic risk (25-39%). Children at higher polygenic risk of obesity suffer disproportionate BMI impacts of disadvantage. At the population-level, and especially for those with higher polygenic risk, tackling disadvantage could potentially reduce obesity and associated morbidity, mortality, and costs. Australian National Health and Medical Research Council. Funding information is detailed in the funding statement.

Analysis of Cognitive Levels and Influencing Factors in Children with Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) in children is prevalent worldwide and affects their physiological, psychological, and cognitive functions. However, the research on OSA's impact on children's cognitive function remains inconclusive. This study aims to analyze the cognitive levels and influencing factors in children with OSA in a single-center study in China. We selected 110 children with OSA who visited the Department of Otorhinolaryngology, Head and Neck Surgery at the Children's Hospital of Zhejiang University School of Medicine from March 2023 to April 2024. Cognitive function was assessed using the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), and data on the OAHI, BMI, lowest blood oxygen saturation, and tonsillar hypertrophy were collected. A correlation analysis was performed using SPSS Statistics 26.0. The mean WISC-IV score of the children with OSA was 102.32, within the normal range. Gender and tonsillar grade had no significant effect on the cognitive levels. The BMI scores were significantly negatively correlated with verbal comprehension. The OAHI was weakly negatively correlated with perceptual reasoning but not with other cognitive dimensions. OSA may negatively affect specific cognitive domains in children, particularly perceptual reasoning and working memory. The BMI is a crucial factor influencing cognitive function in children with OSA. Future research should increase the sample size, include more variables, and conduct long-term follow-ups to comprehensively evaluate the influencing factors of OSA on children's cognitive function.

A Comparison of Causative Pathogens in Bone and Prosthetic Joint Infections: Implications for Antimicrobial Therapy.

Background: The microbiological profile of bone and joint infections is important for determining the empiric choice of both systemic and local antimicrobial therapy. This study assessed whether there was a difference in the bacterial species that were isolated on culture in osteomyelitis (OM), fracture-related infection (FRI) or prosthetic joint infection (PJI). This was a retrospective, observational cohort study of patients who had surgical intervention for PJI or OM or FRI with a positive microbial culture between 2019 and 2022. Methods: Data including patient demographics, the site of injury, JS-BACH score, organism classification and antibiotic resistance to vancomycin and gentamicin were extracted from the medical records. Results: A total of 440 patients were included in this study: 163 patients with osteomyelitis, 109 with fracture-related infection with fixation implants and 168 with prosthetic joint infection. The patients with PJI were older, more likely to be female and had a higher BMI and ASA score compared to those with OM. Patients with PJI were more likely to have a higher JS-BACH score and more complex infections. Staphylococcus aureus was the most commonly isolated organism in all three groups. It was more frequently isolated in osteomyelitis than in PJI (p = 0.016). In both osteomyelitis and FRI, after Staphylococcus aureus, the next most common organisms were Gram-negatives, whilst for PJIs, the most commonly isolated organisms were Staphylococcus aureus, followed by coagulase-negative Staphylococci and then Streptococcus species. The rates of other organisms were broadly similar between the three groups. When adjusted for confounders, including symptom duration, JS-BACH score, the location of injury, age and BMI, there was no statistically significant difference in the presence of Staphylococcus aureus (OR = 0.765; 95% CI 0.633-1.232; p = 0.465) or polymicrobial infection (OR = 1.175; 95% CI 0.803-1.721; p = 0.407). Conclusions: Causative pathogens are similar across bone and joint infections and are independent of the presence of prosthetic material.

Abstract 4146319: Racial Disparities and Driving Factors in the AHA's Life's Essential 8 Among American Adults: Insights from NHANES 2011-2020

Backgrounds: The AHA introduced "Life's Essential 8" (LE8) in 2022 as a comprehensive metric to facilitate detailed tracking and management of cardiovascular health (CVH) at the population level. However, the racial/ethnic differences in LE8, how these differences change over time, and the driving factors of LE8 in each subgroup remain unclear. Methods: We utilized data from the continuous NHANES from 2011 to 2020 to examine racial disparities and driving factors in the AHA's LE8 among American adults. To ensure national representation, appropriate weights were applied. Survey-weighted and age-standardized trends in LE8 scores by racial and ethnic groups were analyzed using generalized linear models (GLMs). To identify the driving factors—specific metrics influencing the LE8 overall score—we calculated z-scores for all components. Then we used the spider chart to visualize the driving factors. Results: A total of 13,915 adult were included, of whom the mean age is 47.9 ± 0.37 years, 6,612 (47.55%) were women, 3,485 (14.63%) were Hispanics, 5,335 (69.74%) were non-Hispanic Whites, 3,464 (10.82%) were non-Hispanic Blacks, and 1,631 (4.81%) were Asians. From 2011-2020, the LE8 scores did not change significantly overall and across all racial groups (all p-trend &gt; 0.10, Figure 1 ). During the study period, racial/ethnic disparity persisted with Asian adults consistently having the highest LE8 scores and Black adults having the lowest scores. Notably, the lower LE8 scores in Black adults were primarily driven by lower scores of diet, blood pressure, and sleep health, whereas the higher LE8 scores in Asian adults primarily driven by higher scores of diet, nicotine exposure, and BMI. The LE8 scores in White adults were primarily driven by blood glucose and physical activity and the LE8 score in Hispanic adults were primarily driven by blood pressure ( Figure 2-A ). In 2017-2020 ( Figure 2-B ), Black adults had the lowest scores for all LE8 components, except for blood lipids. In contrast, Asian adults had the highest scores in diet, physical activity, nicotine exposure, and sleep health. Throughout the study period, the racial/ethnic disparity in LE8 score did not change significantly (all p &gt;0.10). Conclusion: We found persistent racial disparities in cardiovascular health among U.S. adults, with Black adults having the lowest LE8 scores in almost all components. The driving factors for LE8 scores varied by racial subgroups, emphasizing the need for targeted interventions.

Classifying Chronic Kidney Disease Stages Based on Predicted Value of Estimated Glomerular Filtration Rate From Serum Creatinine Levels Using Chronic Kidney Disease Risk Factors and Renal Sinus Anteroposterior Diameter on a Computed Tomography Image.

This study aimed to investigate whether the calculated predicted value of the estimated glomerular filtration rate from serum creatinine levels (eGFRcreat-PV)from multiple regression equations using the anteroposterior diameter of the renal sinus (APDRS) measured on multidetector row computed tomography (MDCT) axial imagesand easily obtainable chronic kidney disease (CKD) risk factors (age and body mass index, BMI) is useful for separating CKD stages. The Review Board approved this study, and the additional approval requirement was waived for this retrospective study. We investigated the association between eGFRcreat and age, BMI, and APDRS using stepwise multivariate regression analysis in 98 patients who underwent MDCT and calculated eGFRcreat-PV from the obtained multiple regression equation. We investigated significant differences in eGFRcreat-PV according to the variation in the CKD stage 3 categories and cutoff value. Additionally, we analyzed the area under the curve (AUC), sensitivity, and specificity of eGFRcreat-PV to differentiate between the patients with greater and less than CKD stage 3. Age, BMI, and APDRS scores were independent factors influencing eGFRcreat. The difference in eGFRcreat-PV between the groups with greater and less than CKD stage 3 was significant. Additionally, the cutoff value, AUC, sensitivity, and specificity of eGFRcreat-PV used to distinguish between the two groups of greater and less than CKD stage 3 were 61.5, 0.801, 63.9%, and 80.6%, respectively. The eGFRcreat-PV from the APDRS, measured on MDCT axial images, along with ageand BMI, helps differentiate the less and more than CKD stage 3.