Quality and methodological heterogeneity of COVID-19 vaccine safety studies focusing on the myocarditis safety signal: A systematic review, meta-analysis and meta-regression.

The German National Cohort (NAKO Gesundheitsstudie) is a prospective cohort study with 205 053 participants. Its goal is to identify risk factors for chronic diseases, including cancer. We describe the methods of ascertaining cancer cases in NAKO (i.e., linkage with cancer registries and self-reporting), the incidence and prevalence figures obtained so far, and the ratios of observed to expected (O/E) case numbers. Case ascertainment identified 2774 existing cancer cases diagnosed within the five years prior to study enrollment and 4295 new cancer cases diagnosed up to five years after enrollment. Cancers of the breast, prostate, lung, and colorectum made up 55% of the incident cases. Fewer incident cases were found than would have been expected on the basis of incidences in the general population (O/E ratio 0.80, 95% confidence interval [0.76;0.83] for the first two-years of prospective follow-up); the O/E ratio varied across tumor sites (breast 1.02, prostate 1.12, lung 0.38, colorectum 0.62). Possible explanations include healthy volunteer bias, delayed reporting, as well as incomplete data collection from registries and self-reporting. Rising case numbers for the most common types of cancer are expected in the next few years and will enable comprehensive epidemiological analysis of the risk factors of cancer.

LDL and non-HDL cholesterol with the lowest mortality in the general population in 1991-2018.

Metabolic dysregulation plays a pivotal role in the pathogenesis of type 2 diabetes mellitus (T2DM). While the metabolic vulnerability index (MVX) captures multidimensional metabolic characteristics, its utility as a composite score and its specific association with incident T2DM risk and diabetes-related mortality outcomes require further validation in large-scale populations. This study harnessed data from the UK Biobank (UKB), comprising a cohort of over 500 000 native UK residents recruited between 2006 and 2010. We conducted two independent analyses: incident T2DM in the general population and all-cause mortality in the baseline diabetes cohort. After excluding individuals with baseline diabetes and those missing MVX information, the analysis of incident T2DM included 453 209 participants; while the all-cause mortality analysis among diabetes cohort included 34 735 diabetic patients after excluding those with missing MVX information. Cox proportional hazards models were employed to evaluate the associations between MVX and outcomes. Subgroup analyses were performed by gender, age and BMI, and sensitivity analyses were conducted to assess the robustness of the findings. Each 1-standard deviation (SD) increase in MVX was associated with a 14% increased risk of incident T2DM (HR = 1.14, 95% CI: 1.11-1.16, p < 0.001). Participants in the highest quartile (Q4) showed a 32% higher risk compared to the lowest quartile (Q1) (HR = 1.32, 95% CI: 1.24-1.39, p = 0.004). Subgroup analyses indicated that the association was more pronounced in individuals with normal BMI, females, and those aged < 60 years. Specifically, each 1-SD increase in MVX was associated with a 24% increased risk of incident T2DM in the normal BMI group (HR = 1.24, 95% CI: 1.16-1.32, p < 0.001), a 17% increased risk in females (HR = 1.17, 95% CI: 1.14-1.20, p < 0.001) and an 18% increased risk in participants aged < 60 years (HR = 1.18, 95% CI: 1.14-1.22, p < 0.001). Regarding mortality, each 1-SD increase in MVX was associated with a 10% higher risk of all-cause mortality among participants with diabetes (HR = 1.10, 95% CI: 1.07-1.13, p < 0.001) and a 16% higher risk of cardiovascular disease (CVD) mortality (HR = 1.16, 95% CI: 1.06-1.26, p < 0.001). Moreover, subgroup analysis revealed an 18% increased risk of all-cause mortality in individuals with T1DM (HR = 1.18, 95% CI: 1.07-1.30, p < 0.001) and a 7% increased risk in those with T2DM (HR = 1.07, 95% CI: 1.04-1.10, p < 0.001). Sensitivity analyses corroborated the robustness of the associations between MVX and incident T2DM, as well as all-cause mortality in patients with diabetes. This study highlights the independent association between MVX and T2DM outcomes as well as diabetes-related mortality. The strength of MVX lies in capturing the risk of incident T2DM in individuals with normal BMI, younger populations and females, thereby serving as a valuable supplementary tool for clinical early screening and the identification of high-risk individuals missed by traditional indicators.

Bodily Distress Disorder (BDD) is a newly introduced diagnosis in the International Classification of Diseases, 11th Revision (ICD-11) that aims to capture the interplay between somatic symptoms and psychological distress. Existing diagnostic tools based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the ICD-10 do not fully encompass BDD as defined in ICD-11, highlighting the need for a psychometrically robust assessment tool. To address this issue, the present study examines the psychometric properties of the newly constructed Bodily Distress Disorder Scale (BoDI) in continuously trauma exposed individuals. Data were collected from 3000 Israeli general population participants under conditions of collective trauma. The validation of the 10-item BoDI included factor analysis to test the BoDI's factor structure. In addition, tests of internal consistency, convergent, and discriminant validity were conducted to assess the psychometric properties of the scale. A two-factor structure was identified and showed excellent fit. The two factors - Persistent Preoccupation (cognitive-affective component) and Medical Reassurance-Seeking (behavioral component) showed adequate internal consistency. The BoDI exhibited high convergent validity with established measures of somatic symptoms and good discriminant validity, showing moderate correlations with measures of depression, anxiety, and adjustment disorder, and weaker associations with post-traumatic stress disorder (PTSD) and Complex PTSD. These findings provide initial support for the BoDI as a psychometric tool for assessing BDD. While the findings highlight the potential of the BoDI in trauma-exposed general populations, its practical application in general populations with no collective trauma in the background remains to be explored. The present results provide a valuable foundation for future studies to evaluate its real-world utility in guiding assessment and intervention.

This study describes the human leukocyte antigen (HLA) Class II allele frequencies in patients with anti-CNTN1+ and anti-Caspr1+ autoimmune nodopathy (AN). Forty-four AN patients and 50 seronegative CIDP patients from 19 different European hospitals were included in the study. Thirty AN patients had anti-contactin 1 (CNTN1) antibodies, 11 anti-contactin-associated protein 1 (Caspr1) antibodies, and 3 had antibodies against both proteins. HLA-DRB1 was genotyped at the 4-digit allele levels, and the percentage of individuals carrying each allele was compared with that of the general population, obtained from the Allele frequencies database. HLA-DRB1*11 alleles appeared in higher proportions in anti-CNTN1+ patients than in seronegative CIDP patients and in the general population (46.7% vs 18% vs 28.4%), with an odds ratio of 3.99 (CI = 1.44 to 11.03, p = 0.01) and 2.2 (CI = 1.07 to 4.53, p = 0.04), respectively. HLA-DRB1*03:01 alleles appeared in significantly higher proportions in anti-Caspr1+ patients than in CIDP patients and in the general population (64.3% vs 22% vs 24.2%), with an odds ratio of 6.38 (CI = 1.77 to 22.99, p = 0.007) and 5.64 (CI = 1.876 to 16.96, p = 0.002), respectively. In the anti-Caspr1+ group, we included 3 patients presenting with antibodies against both CNTN1 and Caspr1 proteins in the acute phase, in which the anti-CNTN1 antibodies disappeared in the chronic phase. HLA-DRB1*11 alleles are associated with the detection of anti-CNTN1 antibodies in AN patients, and HLA-DRB1*03:01 alleles associate with anti-Caspr1 antibodies. In addition, our study suggests that antiparanodal antibodies targeting both Caspr1 and CNTN1 are present in a small number of patients with AN. These data reinforce the idea that these patients represent specific subsets with clinical features and risk factors that differ from seronegative CIDP patients and from other AN patients. However, further studies should address the functional relevance of these associations and their pathophysiologic implications.

Insulin resistance (IR) is a major determinant of cardiovascular disease and mortality, yet its direct measurement is limited by the need for insulin assays. The triglyceride-glucose (TyG) index has emerged as a simple and inexpensive surrogate marker of IR, but its prognostic relevance for mortality remains uncertain due to the heterogeneity of available studies. This study aimed to: (i) evaluate the predictive value of the TyG index for all-cause and cardiovascular mortality risk in the general population; (ii) assess the shape and magnitude of the dose-response relationship; and (iii) identify the most appropriate threshold for mortality risk prediction. A systematic review and dose-response meta-analysis was conducted, including prospective cohort studies that assessed baseline TyG and subsequent mortality. Random-effects models were used to pool hazard ratios, and restricted cubic splines were applied to examine potential non-linearity in the dose-response relationship. Twelve studies comprising 14 independent cohorts (≈10.8 million participants) were included. Each one-unit increase in TyG was associated with a 14% higher risk of all-cause mortality and a 16% higher risk of cardiovascular mortality starting from 6.9 units (or 3.79 units in the alternative scale). Associations were linear and consistent across sensitivity analyses. There was a significant heterogeneity among studies, but no evidence of publication bias. The TyG index independently and linearly predicts all-cause and cardiovascular mortality, supporting its potential role as a clinically useful, low-cost marker for early cardio-metabolic risk stratification in population-based settings.

Sleep habits have emerged as robust correlates of hallucinatory phenomena. Hallucinations, while commonly studied in clinical populations, also occur in the general population as Hallucinatory-Like Experiences (HLEs), which vary in frequency and expression. Although poor sleep quality has been linked to increased occurrence of HLEs, the specific role of habitual sleep patterns in shaping both the occurrence and subjective qualities of HLEs remains unclear. In a large non-clinical French sample (N=1650), participants reported typical weekday and weekend sleep habits and completed measures of auditory and visual HLEs frequency and characteristics (i.e., vividness, emotional valence, control, source location, agency, distress, confidence). Using multivariable regression models in which multiple sleep parameters were entered simultaneously, analyses showed that sleep fragmentation and later bedtimes were associated with HLEs frequency. Moreover, bedtime, sleep efficiency, the feeling of being woken up at night and weekend-to-weekday sleep duration variation were associated with specific features, such as negative emotional valence, increased distress, and external spatial location of the experience, even when controlling for HLEs frequency. These findings underscore the relationship between sleep quality, delayed bedtimes, and HLEs. From a sleep medicine perspective, they highlight sleep continuity and timing as key dimensions associated with both the frequency and subjective impact of HLEs. Moreover, they suggest that habitual sleep habits may serve as clinically informative indicators of vulnerability to HLEs in the general population.

Many studies have reported an association between Helicobacter pylori infection and an increased risk of colorectal cancer (CRC); however, the impact of eradication therapy on CRC remains unclear. We compared CRC incidence and mortality in individuals who received H. pylori treatment with those in the general population. We conducted a population-based study of 931 585 participants aged ≥ 20 years who received H. pylori eradication (HPE) therapy between 2009 and 2011. We used the one-sample log-rank test to compare standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) for CRC. The mean follow-up period was 12.4 ± 1.1 years. CRC incidence and mortality rates were significantly lower in H. pylori-treated individuals than in the general population (total SIR: 0.66, 95% confidence intervals [CI] 0.64-0.67 and SMR: 0.51, 95% CI 0.49-0.54). Significant results were also observed in the 30-39, 40-49, 50-59, 60-69, and ≥ 70 age groups: The SIRs (95% CIs) were 0.80 (0.71-0.89), 0.73 (0.70-0.77), 0.62 (0.60-0.65), 0.66 (0.63-0.68), and 0.62 (0.59-0.66), respectively, and the SMRs (95% CIs) were 0.53 (0.36-0.76), 0.46 (0.39-0.54), 0.41 (0.37-0.46), 0.48 (0.44-0.53), and 0.65 (0.60-0.71), respectively. Similar results were observed when colon and rectal cancer were analyzed separately. HPE may help reduce the risk and improve the survival from CRC. Its benefits may extend beyond preventing gastric cancer to CRC prevention. Our findings support the need for aggressive H. pylori screening and eradication treatment.

Environmental influences on anxiety, perceived stress and walking levels in people with epilepsy: A qualitative study using walk-along interviews.

Adopting a Trauma-Informed Framework in Clinical Practice.

Observational studies often rely on nonprobability samples that may not represent the target population, limiting the generalizability of findings. Health examination data from the Korean National Health Insurance Service (NHIS) faces this challenge, as voluntary participation introduces sampling bias. Poststratification offers a potential solution by reweighting samples to match population distributions. Using the NHIS-National Sample Cohort, we demonstrated three poststratification approaches-simple poststratification, raking, and multilevel regression with poststratification-to estimate obesity prevalence among adults 20-39 years of age in 2019. The Korea National Health and Nutrition Examination Survey served as the reference standard for population-level estimates. We compared these methods with inverse probability sampling weights. Additionally, we applied poststratification to evaluate the accuracy of self-reported disease history for hypertension, diabetes, dyslipidemia, and stroke. Crude obesity prevalence from NHIS-National Sample Cohort was 36.3% (95% confidence interval: 36.0, 36.6), substantially higher than the Korea National Health and Nutrition Examination Survey reference of 31.4% (28.8, 33.9). Simple poststratification using age and sex reduced this estimate to 33.9% (33.6, 34.2), ranking with additional smoking and alcohol variables yielded 34.7% (33.9, 35.5), and multilevel regression with poststratification incorporating region produced 34.2% (33.3, 35.0). Inverse probability sampling weights yielded comparable results (33.9%-34.1%). For self-reported disease history, poststratification consistently produced modest decreases in sensitivity estimates, suggesting that health examination participants may report disease history more accurately than the general population. Poststratification provides a principled framework for improving population-level inferences from nonprobability samples. These methods warrant broader application in epidemiological research using administrative and electronic health record data.

Integrative network toxicology and multi-omics analyses reveal divergent molecular programs underlying pyrethroid-induced ovarian dysfunction.

Prevalence of Carpal Tunnel Syndrome During Pregnancy in Iran.

Paraphilias and paraphilic disorders in Attention-Deficit/Hyperactivity Disorder: an observational study.

High joint forces can contribute to the pathogenesis of patellofemoral pain in adolescents. Minimalist shoes may reduce patellofemoral joint forces during running compared with commonly worn motion-control shoes. Patellofemoral joint, lateral patella, and quadriceps forces will be lower, while gastrocnemius forces will be higher when adolescents run in minimalist shoes compared with motion control shoes. Cross-sectional study; Level of evidence, 2. This within-session 2-period randomized crossover study was conducted from March 2023 to September 2024. A total of 51 physically active adolescents aged between 12 and 19 years (mean age, 16.9 ± 2 years) (23 female adolescents [45%]) with patellofemoral pain were recruited from the general population. Kinematic, kinetic, and electromyography (EMG) data were collected during overground running in minimalist and motion-control shoes, with testing randomized within the same session. Patellofemoral joint force was measured during the stance phase of running using an EMG-informed neuromusculoskeletal model. The primary outcome was the resultant patellofemoral joint force (N). Secondary outcomes included lateral patellar force (defined as the peak force acting on the patella in the frontal plane) and quadriceps and gastrocnemius muscle forces (N). All outcomes were analyzed at peak using paired t tests. Compared with the motion control shoes, running in the minimalist shoes reduced peak resultant patellofemoral joint force by 7.5% (mean difference [MD], 363.2 N [95% CI, 666.8-59.5]; P = .02), reduced peak lateral patellar force by 7.8% (MD, 202.7 N [95% CI, 379-26.4]), and increased peak gastrocnemius muscle forces by 26.6% (MD, 449.3 N [95% CI, 298.6-560]). The minimalist shoe did not meaningfully alter quadriceps muscle forces compared with the motion-control shoe. As hypothesized, running in minimalist shoes reduced peak resultant patellofemoral joint and lateral patellar forces compared with running in motion-control shoes, while gastrocnemius forces were increased. Running in minimalist shoes did not meaningfully alter quadriceps muscle forces compared with motion-control shoes.

Although death certificates are widely used to study mortality in the general population, their use to study mortality among individuals with military service has been limited in part by a lack of information on the validity of military service reported on death certificates. Our objective was to estimate bias parameters for the misclassification of military service to facilitate quantitative bias analysis in studies of mortality in military populations. We included 2014-2021 death certificates from decedents aged 18-64 years who resided and died in Alabama, Michigan, Minnesota, Montana, or Oregon. Death certificates were linked to military service records by the U.S. Defense Manpower Data Center using Social Security numbers. Military service was defined as any service in the Regular, Reserve, or National Guard components of the U.S. military in Defense Manpower Data Center records. We estimated sensitivity, specificity, and predictive values for military service reported on death certificates stratified by demographics, military characteristics, and manner of death. Among the 467,075 death certificates included, 9.3% indicated military service; however, military records showed that 10.9% had served (sensitivity 81.5%, 95% confidence interval [CI] = 81.2%, 81.8%; specificity 99.5%, 95% CI = 99.5%, 99.5%). Sensitivity was lower among female (72.3%) compared with male (82.2%) servicemembers and was particularly low for those who had never served on active duty (63.5%). Military service was underreported on death certificates, especially for female servicemembers and those without active-duty service. The bias parameters we estimated can be used to account for this misclassification when analyzing death certificates.

Insomnia symptoms in children with sleep-disordered breathing: A scoping review.

Seroprevalence of dengue virus infection in people residing in Vietnam: A systematic review and meta-analysis.

Prevalence and associated factors of ICD/DSM-diagnosed depressive disorders among people living with HIV: A systematic review and meta-analysis.