Cross-sectional Analysis Research Articles

Exploring heterogeneity in mild cognitive impairment.

Mild cognitive impairment (MCI) is a heterogeneous diagnostic entity, without a clear prognosis, often accompanied by psychiatric symptomatology and physical frailty. Understanding the heterogeneity within MCI is a critical step in improving the early detection of cognitive decline and developing effective interventions. Cross-sectional multivariate latent mixture analyses of data from patients evaluated between 2015 and 2019, who were routinely entered into a multidisciplinary database for research purposes. A sample of 538 community-dwelling older adults drawn from a large academic medical center, referred from within the Department of Neurology (63.7% Female, Mage = 67.8, SDage = 10.6). Participants completed comprehensive neuropsychological assessments, psychiatric symptom measures, and frailty evaluations. Latent profile analyses supported five profiles of cognitive impairment: At-Risk, Pre-MCI, Amnestic MCI, Multiple Domain MCI, and Major Cognitive Impairment. The inclusion of concomitant psychiatric symptoms and frailty criteria revealed two additional profiles: Psychiatric/Frail, without cognitive impairments, and Multiple Cognitive Domains/Psychiatric/Frail. Critically, 55% of those classified as Healthy based on cognitive data alone were reclassified. Significant profile-wise differences emerged across auxiliary variables of brief cognitive screening, sociodemographics, and medical and psychosocial risk. Results highlight heterogeneity represented by neurologic patients referred for neuropsychological evaluation that include key physical and emotional symptoms known to increase the risk of cognitive decline. Findings are in alignment with more recent research suggesting that the traditional paradigm cognitive impairment may need to be expanded to improve diagnostic accuracy and to develop more tailored, precision-driven interventions.

Impact of sleep problems on the cardiometabolic risks: an integrated epidemiological and metabolomics study

BackgroundWe investigated the association between sleep problems and cardiometabolic risks and the potential linking effect of metabolites and metabolic pathways based on multi-layered research, including observational, mendelian randomization (MR), and metabolomics analysis.MethodsA cross-sectional analysis of the 2015–2018 National Health and Nutrition Examination Survey (NHANES) dataset was conducted to identify the association between sleep problems and cardiometabolic risks. A subsequent MR study based on genetic data was performed to explore the causal correlation of significant associations in the NHANES study. The underlying alteration of metabolism was explored by constructing zebrafish models and wide-targeted metabolomics analysis.ResultsThe cross-sectional analysis of the NHANES database revealed a significant association of snoring with obesity [OR = 2.65, 95% confidence intervals (CI): 1.87, 3.74]; sleep apnea with hypertension (OR = 1.68, 95% CI: 1.14, 2.48) and obesity (OR = 1.44, 95% CI: 1.05, 1.96); trouble sleeping with hypertension (OR = 1.84, 95% CI: 1.18, 2.86), obesity (OR = 1.56, 95% CI: 1.07, 2.26), and type 2 diabetes (T2DM) (OR = 1.52, 95% CI: 1.02, 2.25). MR analysis verified the causal relationship between genetically proxied sleep apnea or snoring and obesity. The decreased activity levels and altered expression levels of six circadian genes (bmal1b, cry1aa, cry1ab, clock1a, per1b, per2) were identified in the zebrafish of the sleep disorder group. Multiple metabolites related to disturbed glucose metabolism (e.g., 20-HETE), lipid metabolism (e.g., inosine), and vascular-related metabolites (e.g., riboflavin) were finally identified, indicating the latent effect of metabolism.ConclusionsThis study identified the chain of sleep-circadian rhythm-metabolism-cardiometabolic risks. These findings can promote improved prevention implementation and therapeutic strategies.

Associations of comorbid headache disorders and depression with leisure-time physical activity among 14,088 adults in The Brazilian Longitudinal Study of Adult Health.

While headache disorders are linked to low physical activity levels, the impact of depression on this relationship is unclear. To assess how single and comorbid diagnoses of migraine and tension-type headache (TTH) interact with depression and leisure-time physical activity (LTPA) levels in The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). In this cross-sectional analysis based on the ELSA-Brasil baseline data, the relationship of migraine, TTH (both assessed with the International Classification of Headache Disorders, Second Edition), and depression (assessed with the Clinical Interview Schedule-Revised) with LTPA levels (International Physical Activity Questionnaire) was investigated by employing linear regression models. Models were adjusted for sociodemographic, lifestyle, and clinical covariates, and interaction terms were created to examine additive effects of comorbid conditions. Among 14,088 participants, 54.4% (7668/14,088) were female, prevalence rates were: TTH = 39.6% (5573/14,088), migraine = 27.0% (3806/14,088), depression = 0.7% (94/14,088), depression + TTH = 1.1% (148/14,088), and depression + migraine = 2.5% (356/14,088). The mean (standard deviation) LTPA levels across the groups were: no headache + no depression = 148.7 (183.0) min/week, TTH = 133.5 (170.1) min/week, migraine = 110.3 (154.8) min/week, depression = 76.5 (146.3) min/week, depression + TTH = 84.5 (127.7) min/week, and depression + migraine = 64.3 (123.2) min/week. Negative associations were found for depression (β = -55.1, 95% confidence interval [CI] -93.6 to -17.0; p = 0.005), migraine (β = -24.7, 95% CI -33.2 to -15.4; p < 0.001), and TTH (β = -15.5, 95% CI -23.1 to -7.6; p < 0.001) with LTPA. No interaction effect was observed for depression + TTH (β = 36.0, 95% CI -12.6 to 84.6; p = 0.147) and depression + migraine (β = 31.7, 95% CI -11.3 to 74.7; p = 0.149), indicating no additive effect of comorbid conditions on LTPA levels. After adjusting for headache attack frequency, only depression + migraine remained negatively associated with LTPA (β = -38.7, 95% CI -71.6 to -5.8; p = 0.021). Headache disorders and depression were independently and inversely associated with LTPA, with the strongest effects seen in depression alone or comorbid with migraine.

Serum vitamin C levels and risk of osteoporosis: results from a cross-sectional study and Mendelian randomization analysis

BackgroundThe role of vitamin C as an antioxidant in guarding against osteoporosis in adults is still debated. This research employs both a cross-sectional study and a two-sample bidirectional Mendelian randomization (MR) analysis to explore how serum vitamin C levels correlate with the incidence of osteoporosis among adults.MethodsIn this study, we utilized data from the National Health and Nutrition Examination Survey (NHANES) database for the years 2003–2006, and 2017–2018 to conduct both a cross-sectional analysis and MR to investigate the relationship between serum vitamin C levels and the risk of osteoporosis in adults. We adjusted our analyses for essential demographic and lifestyle variables, and applied logistic regression techniques. Genetic determinants of vitamin C levels were analyzed through MR, using methods like inverse-variance weighted (IVW) and MR-Egger to assess causality. Statistical computations were carried out in R, incorporating visual tools such as restricted cubic spline curves (RCS) and forest plots to clarify the dose–response dynamics and variations across different subgroups. This study was approved by the NCHS Ethics Review Board, and informed consent was obtained from all participants.ResultsIn our investigation, we analyzed data from 3,940 participants, among whom 291 were diagnosed with osteoporosis. The logistic regression analysis of serum vitamin C quartiles did not indicate a significant trend. The most adjusted model showed a slight, albeit inconsistent, protective effect in the highest quartile (OR = 0.68, 95% CI: 0.47–0.99, P = 0.22). Mendelian randomization, employing methods such as IVW, reinforced the absence of a significant causal relationship between serum vitamin C levels and osteoporosis risk (IVW OR = 1.000, 95% CI: 0.999–1.001, P = 0.601).Subgroup analyses, visualized through forest plots and restricted cubic spline (RCS) curves, supported the primary findings, showing no significant effects or interactions between vitamin C levels and osteoporosis risk across different demographic and lifestyle subgroups. The RCS analysis particularly highlighted a lack of significant non-linear relationships between serum vitamin C concentration and the odds of osteoporosis (P for nonlinear = 0.840).ConclusionsThe cross-sectional study revealed that higher serum vitamin C levels do not consistently correlate with a reduced risk of osteoporosis. Meanwhile, the Mendelian randomization analysis confirmed that there is no genetic evidence to suggest a causal relationship between vitamin C levels and osteoporosis risk. Recent research highlights the polygenic nature of osteoporosis, with genetic predispositions playing a significant role in disease risk. The relationship between serum vitamin C and osteoporosis requires further research. This suggests the need for further investigation into the connection between vitamin C and bone health.

Influence of Lateral Hard-Tissue Grafting on Peri-Implant Health or Disease: A Cross-Sectional Study.

To investigate the influence of lateral hard-tissue grafting performed simultaneously to implant placement on peri-implant health or disease. A total of 299 patients exhibiting 897 implants placed either simultaneously with lateral bone grafting using a bovine bone mineral with or without adjunctive native collagen membrane (n = 131/269 patients/implants; LatGr group) or at pristine bone sites without lateral bone grafting (n = 168/628 patients/implants; NoGr group) were enrolled in this cross-sectional analysis. Clinical outcomes (i.e., modified plaque index (mPI), bleeding on probing (BOP), probing depth (PD), mucosal recession (MR)), keratinized mucosa (KM), and the frequency of peri-implant disease were evaluated. Univariate and multiple ordinal regression analyses with mixed effects were conducted to identify factors associated with peri-implant disease. After a mean follow-up period of 59.47 ± 24.66 months, mPI, BOP, and KM values were significantly higher in the control group, whereas no difference between the groups was found for PD and MR. Peri-implantitis was diagnosed in 31.30% of patients and 13.4% of implants in the LatGr group, and in 32.74% of patients and 24.8% of implants in the NoGr group. The corresponding values for peri-implant mucositis at the patient and implant level in the LatGr and NoGr groups were 29.77% and 29.0%, and 26.19% and 28.5%, respectively. Implants of the LatGr group were associated with a significantly lower chance to be affected by peri-implant disease (OR = 0.69, 95%-CI: (-0.72, -0.03), p = 0.032). The presence of plaque at implant sites and smoking significantly correlated with peri-implant disease (OR = 2.92, 95%-CI: (2.11, 4.03), p < 0.001 and OR = 0.22; 95%-CI: (0.06, 0.84), p = 0.027, respectively). Lateral hard-tissue grafting performed simultaneously with implant placement demonstrated comparable peri-implant tissue health to pristine bone sites without lateral bone grafting.

Do dual holders enhance or hinder managerial efficiency?

ABSTRACT This study examines the influence of dual ownership on managerial efficiency using panel data from a dataset of U.S. firms spanning 1996 to 2017. Our findings indicate that dual ownership negatively affects managerial efficiency, demonstrating diminishing productivity in resource utilization when dual ownership is present or increases. Cross-sectional analyses suggest that the adverse effect of dual holders on managerial efficiency is more pronounced in dual-held firms with weaker corporate governance and greater financial constraints. Additional analyses, including propensity score matching, change specifications, Lewbel’s instrumental variable approach, and alternative measures of managerial efficiency, corroborate our findings.

Parental expectations of residential immersive life skills programs for youth with disabilities and their perception of youth changes

Purpose This study explored parents’ expectations before their youth with a disability attended a Residential Immersive Life Skills (RILS) program, and perceptions of youth change over the following 12 months. Understanding expectations is important because parents play a key role in shaping their youth’s ongoing development and future hopes when they return home. Methods A secondary analysis of qualitative interviews with 13 parents was conducted using a recurrent cross-sectional analysis approach at three time-points: before youth attended a RILS program, and three and 12 months post-program. Results Before the RILS program, most parents focused on “concrete” life skills (e.g., self-care, budgeting), with some hoping for more youth self-awareness. After three months, many expectations were exceeded, leading some parents to re-evaluate their youth’s future. By 12 months, expectations had evolved further, although some parents expressed disappointment in perceived lack of change. Many parental expectations had been initially implicit and unstated. Conclusions Exploring parental expectations of RILS programs is critical, as parents can both enhance and diminish their youth’s personal growth and future aspirations. Parents should understand how RILS programs may (or may not) change both the youth and the family dynamic upon return home.

Methylation Patterns of Diabetes and Obesity Susceptibility Genes in Gestational Diabetes Mellitus: A Cross-Sectional Analysis from Karachi, Pakistan.

Background: Women with gestational diabetes mellitus (GDM) and their offspring have an increased risk of adverse perinatal and long-term health outcomes, which may be attributable to epigenetic modification of diabetes and obesity susceptibility genes. We aimed to investigate the methylation patterns of eight genes in GDM and normoglycemic (NG) mothers, and their respective offspring. Methods: This cross-sectional study, conducted at Aga Khan University from August 2019 to December 2022, recruited pregnant women in the first trimester of gestation from the outpatient obstetrics clinic. Participants were classified as NG or GDM based on the Society of Obstetricians and Gynecologists Pakistan. Venous blood samples were collected from mothers and cord blood from neonates. Peripheral blood mononuclear cells were used for DNA extraction and methylation analysis using methylation-specific PCR. Maternal and neonatal clinical data were recorded. Statistical analysis was performed using R, including binary logistic regression to assess the association between various gene methylation levels and GDM. Results: The study found that GDM mothers had significantly higher fasting blood glucose, 2-hr OGTT, and serum carboxymethyl lysine (CML) levels compared to NG mothers, but no significant differences in neonatal birth weight or serum CML levels. Chemerin methylation was significantly lower in GDM mothers and their babies, while NAMPT, MTNR1B, FNDC5, FAT4, and FTO methylation levels were higher in GDM offspring compared to NG offspring. GDM mothers also had higher methylation levels of brain-derived neurotrophic factor gene (BDNF). Multivariable binary logistic regression identified methylation levels of maternal BDNF and neonatal MTNR1B to be independently associated with GDM. Conclusions: Our study shows a trend of epigenetic modifications in both GDM mothers and their offspring in various genes related to metabolism and inflammation, suggesting an intergenerational transmission of increased risk of developing metabolic disorders. These findings emphasize the need for high throughput studies, early screening, tight glucose control during pregnancy, and postnatal follow-up to mitigate long-term health risks.

Prevalence and Center Variability of Catheter-Based Hemodialysis in Vienna: Insights from the Vienna ACTS NOW Study

Objectives: The choice of vascular access continues to be a critical component in the management of hemodialysis patients. Despite the international consensus favoring arteriovenous (AV) fistulas, the use of central venous catheters (CVCs) remains prevalent, with substantial variations across countries and even among dialysis centers within the same region. This study examines the prevalence of CVC use among chronic hemodialysis (CHD) patients in Vienna, Austria, and explores inter-center differences. Methods: A cross-sectional analysis was conducted on patients receiving CVC-based CHD in Vienna as of March 2023. Patient demographics, comorbidities and their hemodialysis history were collected. Additionally, a subset of the population underwent vascular access (VA) mapping to assess eligibility for AV fistula (AVF) or AV graft (AVG) creation. Results: A total of 335 patients received CVC-based hemodialysis, equaling a CVC proportion of 42.5%. 191 (57.0%) patients on CVC-based CHD gave their consent to record their clinical data and vascular access history. Of the 191 included patients, 61 gave their consent to receive VA mapping. Of the 61 patients who received VA mapping, 60 (98.4%) were eligible for an upper extremity AVF or AVG. There was no significant difference regarding patient demographics, dialysis vintage, history of previous AVF or AVG or Charlson Comorbidity Index between the mapping and non-mapping group. The odds ratio of having a CVC in the absence of in-house vascular surgery was 3.41 (95% CI: 2.31–5.02, p-value &lt; 0.001) compared to patients with in-house vascular surgery. Conclusions: The majority of patients that consented to ultrasound VA mapping fulfilled vascular requirements for AVF or AVG creation. Our study highlights the potential to decrease the prevalence of CVC-based CHD in Vienna that could translate to a reduction in CVC-associated complications.

Adherence to the Mediterranean diet and risk of anxiety and depression in people with obesity: a cross-sectional analysis.

Anxiety and depression are common mental disorders worldwide, in particular in people with obesity. Adherence to the Mediterranean diet has been found beneficial for the prevention of anxiety and depression in the general population. We aimed to evaluate this association in a large cohort of people with obesity. A cross-sectional study of 4957 patients with obesity (63.1% women, median age 49 years, IQR 40-58 years and BMI 33.6 kg/m2, IQR 31.6-36.9 kg/m2) was carried out. Clinical history, anthropometric measurements and lifestyle-related information were investigated. A 14-item MEDAS questionnaire was used to assess adherence to the Mediterranean diet. The 20-item STAI2 questionnaire and the 24-item QD questionnaire were used to assess the presence of anxious and depressive symptoms, respectively. Clinical cases of anxiety and depression were identified among patients with a physician-made diagnosis of anxiety and depression or with STAI2 and QD score ≥95th percentiles of reference population. Overall, 11.9% of participants were positive for anxiety and 11% for depression. Multivariate linear regression models showed a decrease in STAI2 and QD scores of 0.18 points (95%CI: -0.33, -0.03) and 0.10 points (95%CI: -0.16, -0.03), respectively, for each 1-point increase in MEDAS score. The multivariate logistic regression model showed a 7% reduction in the odds of anxiety and depression for each 1-point MEDAS increase (OR = 0.93, 95%CI: 0.89, 0.99; OR = 0.93, 95%CI: 0.88, 0.98). Mediterranean diet is associated with a lower risk of anxiety and depression in people with obesity. Longitudinal studies are needed to determine causality.

Chronotype and leisure-time physical activity among civil servants in Japan: a cross-sectional analysis of the Aichi workers’ cohort study

BackgroundThe association between chronotype and leisure-time physical activity (LTPA) remains unclear. We investigated the difference in regular LTPA and for a sufficient duration between those with evening-type (ET) and morning-type chronotypes (MT).MethodsWe conducted a cross-sectional analysis using the data of the Aichi Workers’ Cohort Study. It included 3,221 men (mean [standard deviation] age: 45.0 [11.6] years) and 1,294 women (39.8 [11.2] years). Chronotypes were determined with the reduced version of the Morningness-Eveningness Questionnaire. We calculated the metabolic equivalents (METs) consumed per week based on the four types of LTPA: strolling, brisk walking, light- and moderate-intensity PA, and vigorous-intensity PA. Regular LTPA and for a sufficient duration was defined as doing once or more per week and for 30 min or longer per session, respectively. Logistic regression analysis was conducted separately by sex to calculate odds ratios of ET for regular LTPA and for a sufficient duration, adjusted for age and other factors, for each type of LTPA.ResultsET men consumed fewer total METs per week than MT men (p < .001), although this pattern is not found in women. Compared to MT men, ET men were less likely to be engaged in regular LTPA in all types of LTPA (prevalence and adjusted odds ratio [95% confidence interval]: strolling: 39.1% vs. 28.7%, 0.685 [0.524–0.895]; brisk walking: 23.9% vs. 14.4%, 0.639 [0.454–0.899]; light- and moderate-intensity PA: 15.4% vs. 8.4%, 0.613 [0.404–0.929]; vigorous-intensity PA: 21.4% vs. 16.8%, 0.715 [0.518–0.989]). They were less likely to spend a sufficient duration in brisk walking (25.9% vs. 16.5%, 0.635 [0.461–0.875]), light- and moderate-intensity PA (37.1% vs. 26.8%, 0.684 [0.521–0.899]), and vigorous-intensity PA (35.3% vs. 35.8%, 0.741 [0.568–0.968]). Compared with MT women, ET women were less likely to be engaged in strolling (30.5% vs. 22.2%, 0.629 [0.398–0.995]), and less likely to spend a sufficient duration in light- and moderate-intensity PA (27.3% vs. 15.3%, 0.561 [0.335–0.937]).ConclusionsET was inversely associated with LTPA in men and partly in women.

Elucidating a proper framework for the determination of threading dislocation densities in semiconductor films: a comprehensive study based on Ge/Si(001)

Abstract Methods of deducing threading dislocation densities (TDDs) from x-ray diffraction (XRD) peak widths have been reevaluated based on crystallography theories. Moreover, Ge/Si heteroepitaxial structures were taken as model materials for investigation. The procedure is tailored in accordance with the specific designs of modern XRD systems to minimize instrumental interference, whereas practical characteristics of heteroepitaxial films are also considered to avoid intrinsic errors. TDDs of samples grown with different epitaxy methods were investigated using the newly implemented XRD method and etch pit density (EPD) method, and satisfactory agreement has been achieved among three independently calculated sets of TDD results: two from XRD and one from EPD. These values were further corroborated by cross-sectional transmission electron microscopy analysis. Key considerations that are of scientific and technical importance in TDD studies are also discussed in detail. The present work provides not only the most up-to-date elucidation on obtaining TDD values in semiconductor epitaxial films, but also insights into the long-existing ambiguity in TDD calculation methods, which will be helpful for the future studies of defect density characterizations in various material systems.

Assessment of inflammatory bowel disease risk prior to commencing IL‐17 inhibitors: A cross sectional analysis of Irish practice

Assessment of inflammatory bowel disease risk prior to commencing IL‐17 inhibitors: A cross sectional analysis of Irish practice

Sex-related differences in the presentation, management and response to treatment of eosinophilic esophagitis: Cross sectional analysis of EoE CONNECT registry.

Eosinophilic esophagitis (EoE) predominantly affects males across all ages; however, little is known about sex differences for other aspects of EoE. To investigate associations between sex and clinical presentation, endoscopic features, treatment choice and response in EoE patients in real-world practice. Cross-sectional analysis of the multicenter EoE CONNECT registry. The independent contribution of patients' sex and other relevant variables were statistically assessed by multivariate models. A total of 2976 patients (76% male) were evaluated. Males were diagnosed at a younger age compared to females (32.7±14.8 vs. 34.8±15.6years, respectively; p=0.002) with similar diagnostic delay. EoE symptoms varied significantly between sexes, with food impaction predominating in males and dysphagia, heartburn, regurgitation and abdominal and epigastric pain in females. However, female sex contributed to higher symptom severity at diagnosis as measured with Dysphagia Symptom Score (R2=0.57; p=0.013) and presented higher peak eosinophil count in esophageal biopsies (p=0.005). Males showed increased risk of stricturing or mixed phenotypes (adjusted OR 1.43, 95%CI:1.05-1.96; p=0.024). No association was found between patients' sex and first-line treatment modality: proton pump inhibitors (PPI) were preferred over topical corticosteroids in patients with inflammatory phenotypes instead of stricturing or mixed phenotypes, and in patients who did not present food impaction. Both topical corticosteroids and dietary interventions were preferred over PPI in pediatric patients regardless of sex. Sex is associated with clinical and phenotypical presentation of EoE at diagnosis, with more fibrotic findings in males but higher symptom score in females.

Association of METS-IR index with Type 2 Diabetes: A cross-sectional analysis of national health and nutrition examination survey data from 2009 to 2018.

With rising global diabetes prevalence, precise early identification and management of diabetes risk are critical research areas. The metabolic score for insulin resistance (METS-IR), a novel non-insulin-based tool, is gaining attention for quantifying insulin resistance using multiple metabolic parameters. Despite its potential in predicting diabetes and its precursors, evidence on its specific relationship with diabetes is limited, especially in large-scale population validation and mechanistic exploration. This study aims to analyze the association between METS-IR and type 2 diabetes (T2DM) in American adults. We conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data from 2009 to 2018. Participants aged 20 years and above were included, excluding individuals with missing data on BMI, fasting blood glucose, high-density lipoprotein cholesterol glycated hemoglobin and diabetes status. Logistic regression analysis, subgroup analysis, and restricted cubic spline analysis were used to assess the association between METS-IR and T2DM, controlling for potential confounding factors. After adjusting for age, gender, race, education level, smoking status, drinking habits, depression, physical activity, hypertension, and hyperlipidemia, we found a positive association between METS-IR and the risk of T2DM. Specifically, each unit increase in METS-IR was associated with a 7% increase in the risk of T2DM (OR = 1.07, 95% CI: 1.06, 1.08). Subgroup analysis showed that the association between METS-IR and T2DM incidence was significantly positive in the highest quartile group, particularly among Mexican Americans over 40 years old and those diagnosed with depression, hypertension, or hyperlipidemia. Our study revealed a significant positive association between METS-IR and the prevalence of T2DM, indicating that this relationship persists even after controlling for various confounding factors. Therefore, monitoring METS-IR may provide a valuable tool for the early identification of individuals at risk of glucose metabolism disorders. Further research should focus on the applicability of METS-IR in different populations and its potential impact on clinical practice.

The correlation between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with non-alcoholic fatty liver disease: an analysis of the population-based NHANES (2017–2018)

Background/objectiveNon-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of liver disorders, from benign steatosis to more severe conditions like non-alcoholic steatohepatitis, with risks of progressing to fibrosis, cirrhosis, and hepatocellular carcinoma. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) indicates lipid metabolic dysregulation and is associated with increased risks of various diseases. This study examines the relationship between NHHR and NAFLD to evaluate NHHR as a potential predictive biomarker for NAFLD.MethodsData from the 2017–2018 National Health and Nutrition Examination Survey (NHANES) were used for cross-sectional analysis. After excluding individuals with incomplete data, hepatitis infections, heavy alcohol use, and those under 18, the study included 2,757 adults. The relationship between NHHR and NAFLD was analyzed using multivariable logistic regression, including subgroup analysis and interaction testing.ResultsAmong the 2,757 participants (mean age 49.91 years), 44.9% had NAFLD. NHHR showed a significant positive association with NAFLD, with an unadjusted odds ratio (OR) of 1.71 and a fully adjusted OR of 1.45. Quartile analysis revealed a 228% higher prevalence of NAFLD in the highest NHHR quartile, with an OR of 3.28. This positive association was consistent across various subgroups.ConclusionOur findings suggest that elevated NHHR is positively correlated with the prevalence of NAFLD and possesses predictive value. We recommend that future research validate the clinical utility of NHHR, particularly for early detection of high-risk individuals and guiding personalized interventions.

Impact of protein consumption on sleep problems: Insights from NHANES data

Sleep problems are common and significantly impact health and well-being. Diet, particularly protein intake, may affect sleep, yet the precise relationship remains unclear. This study investigates the association between protein consumption and sleep problems while considering potential confounders and gender differences, using data from the National Health and Nutrition Examination Survey. Our cross-sectional analysis included 18,077 women (51.3%) and 17,175 men (48.7%), averaging 45.9 years (standard deviation = 17.7). Protein consumption was assessed through 24-h dietary recall interviews and sleep problems were assessed through the question: &amp;ldquo;Have you ever told a doctor or other health professional that you have trouble sleeping?&amp;rdquo; Using binary logistic regression models, we found that 24.6% of individuals reported sleep problems. A statistically significant association emerged between protein consumption and the likelihood of experiencing sleep problems across quartiles of protein intake. Specifically, individuals in the highest quartile of protein consumption had the lowest odds of sleep problems compared to those in the lowest quartile, even after adjusting for various demographic and lifestyle factors (P &lt; 0.001). Gender-stratified analysis revealed a persistent association between protein intake and sleep problems, with a stronger effect observed in females (P &lt; 0.002) compared to males (P = 0.337). Overall, our findings suggest that higher protein consumption is independently associated with reduced odds of sleep problems. This underscores the importance of adequate protein intake for promoting better sleep outcomes and highlights potential implications for public health interventions and clinical practice.

Sleep duration and pain during the COVID-19 pandemic with depression and chronic diseases as mediators

The bidirectional relationship between sleep duration and pain during the COVID-19 pandemic remains poorly understood. This study explores these interactions and the mediating roles of depression and chronic diseases using data from the China Health and Retirement Longitudinal Study (CHARLS) cohort. A cross-sectional analysis was conducted on 15,979 participants aged 45 and older. Sleep duration was self-reported, and pain was assessed using validated anatomical charts. Depression symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), and chronic diseases were self-reported. Personal activity during the pandemic was measured using the Personal Activity Score during COVID-19 (PAS-COVID-19). The results showed a significant association between deviations from optimal sleep duration and increased pain frequency. Participants with both shorter and longer sleep durations reported higher pain levels, with depression and chronic diseases acting as significant mediators. However, personal activity did not significantly mediate the association between sleep duration and pain. These findings underscore the complex interplay among sleep duration, pain, depression, and chronic diseases during the COVID-19 pandemic, emphasizing the importance of integrated interventions to manage these interconnected health issues.

Social Pain Minimization Mediates Discrimination’s Effect on Sleep Health

ABSTRACT Objective Discrimination disrupts sleep and contributes to race-based health inequities for Black Americans, but less is known about the psychological mechanisms underlying this relation. The current work tests whether emotion invalidation, termed Social Pain Minimization (SPM), mediates discrimination’s negative effects on sleep quality. We focus on the experiences of Black Americans because of racism’s disproportionate effect on the health outcomes of Black individuals in the U.S. Methods Four studies with cross-sectional (Studies 1a-1b) and cross-lagged panel designs (Studies 2–3; N total = 1,176) were used. Discrimination and SPM were assessed with established measures and self-reported sleep quality was assessed with three different operationalizations including the short form Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep-Related Impairment (SRI) subscale and composites of the Insomnia Severity Index (ISI). Results Cross-sectional (Studies 1a-1b) and longitudinal mediation analyses (Studies 2–3) indicated discrimination’s negative effect on sleep quality partially operated through SPM (Study 1a, 95% CI = [−.24, −.016]); Study 1b, 95% CI = [−.22, −.03]; Study 2, 95% CI = [−.268, −.007]]; Study 3, 95% CI = [−0.043, −.002]). Conclusion Beyond its direct negative effect on sleep, discrimination also operates through SPM to reduce sleep quality. Emotion invalidation stemming from discrimination damages sleep.

Clinical, genomic, and proteomic perspectives in the analysis of comorbid conditions in type 2 diabetes mellitus: a retrospective study.

Type-2 Diabetes Mellitus (T2DM) affects millions globally, with escalating rates. It often leads to undiagnosed complications and commonly coexists with other health conditions. This study investigates two types of prevalent comorbidities related to T2DM-the circulatory system (DCM1) and digestive system diseases (DCM2)-using clinical, genomic and proteomic datasets. The aim is to identify new biomarkers by applying existing machine learning (ML) based techniques for early detection, prognosis and diagnosis of these comorbidities. Here, we report a cross-sectional retrospective analysis from a T2DM dataset of T2DM associated concordant comorbidities (diseases with shared pathophysiology and management) from the Diastrat cohort (a T2DM cohort) recruited at the Northern Ireland Centre for Stratified Medicine (NICSM), in Northern Ireland. In the clinical data analysis, we identified that lipidemia was shown to negatively correlate with depression in the DCM1 group while positively correlate with depression in the DCM2 group. In genomic analysis, we identified statistically significant variants rs9844730 in procollagen-lysine (PLOD2), rs73590361 in beta-1,4-N-acetyl- galactosaminyl-transferase (B4GALNT3) and rs964680 in A kinase (PRKA) anchor protein 14 (AKAP14) which appear to differentiate DCM1 and DCM2 groups. In proteomic analysis, we identified 4 statistically significant proteins: natriuretic peptides B (BNP), pro-adrenomedullin (ADM), natriuretic peptides B (NT-proBNP) and discoidin (DCBLD2) that can differentiate DCM1 and DCM2 groups and have built robust ML model using clinical, genomic, and proteomic markers (0.83 receiver operative characteristics curve area, 84% positive predictive value and 83% negative predictive value and a classification accuracy of 83%) for prediction of DCM1 and DCM2 groups. Our study successfully identifies novel clinical, genomic, and proteomic biomarkers that differentiate between circulatory and digestive system comorbidities in Type-2 Diabetes Mellitus patients. The machine learning model we developed demonstrates strong predictive capabilities, providing a promising tool for the early detection, prognosis, and diagnosis of these T2DM-associated comorbidities. These findings have the potential to enhance personalized management strategies for patients with T2DM, ultimately improving clinical outcomes. Further research is needed to validate these biomarkers and integrate them into clinical practice.