Global Chronic Disease Research Articles

Analysis of influencing factors of diabetes based on logistic regression

Abstract. As a global chronic disease, diabetes has a serious impact on human health and imposes a significant economic burden. Facing this challenge, researchers are actively developing and optimizing predictive models to improve early diagnosis and management of diabetes. This paper analyzed the influence of independent variables on the risk of diabetes by logistic regression from 8 aspects including body mass index (BMI), glycosylated hemoglobin (HbA1c) and heart disease. The logistic regression model, an effective binary classification method, optimizes parameters using maximum likelihood estimation to predict diabetes probability. The model will be evaluated by ROC curve, cross-validation, standardized residual analysis and confusion matrix to comprehensively test its predictive power, stability and classification performance. The results showed that hemoglobin A1c level (HbA1c.level) had the most significant effect on diabetes risk. Other relevant variables, including blood glucose level and body mass index (BMI), demonstrated significant positive correlations, particularly with hypertension and heart disease. The findings will enhance early diabetes identification and provide data to support the development of targeted prevention and intervention measures to reduce the burden of diabetes on individuals and society.

Mapping patient pathways for NCDs from a policy perspective: a novel multinational initiative

Abstract Background Chronic diseases like CVD and DM pose global health challenges. Understanding patient pathways is vital for effective disease management and reducing morbidity and mortality. However, until now, comprehensive multinational mapping of patient pathways from a policy or regulatory perspective in the context of chronic disease has not been undertaken. Previous investigations into patient pathways mainly focused on the perspective of individual patients, assembling trajectories of those patients, but did not delve into how these pathways were designed. Methods Patient pathways for CVD and DM will be mapped across 11 countries: Belgium, Finland, France, Hungary, Iceland, Italy, Latvia, Poland, Romania, Slovenia, and Spain. Using a survey tool, detailed descriptions and diagrams of healthcare pathways will be collected, stratified by Kaiser Permanente health pyramid strata. Stakeholder interviews on policy and practice level will refine mappings and identify gaps in the policies. Results Preliminary findings reveal diverse healthcare trajectories and identified multiple gaps in disease management across countries. For many countries, a complete well-developed patient pathway was not found; instead, the pathways were rather fragmented and lacking for some strata of the health pyramid. These insights underscore the need for tailored interventions and enhanced care coordination to optimize continuity of care and patient outcomes. Conclusions Comprehensive patient pathway mapping offers a strategic framework to address gaps in chronic disease management. Our study emphasizes the importance of collaborative efforts in developing context-specific interventions and strengthening healthcare systems to improve public health outcomes. Key messages • Comprehensive patient pathway mapping reveals numerous gaps in global chronic disease management, prompting the need for enhanced strategies. • Collaborative efforts are key to addressing gaps in chronic disease care.

Smart photonic crystal hydrogels for visual glucose monitoring in diabetic wound healing

Diabetes is a global chronic disease that seriously endangers human health and characterized by abnormally high blood glucose levels in the body. Diabetic wounds are common complications which associate with impaired healing process. Biomarkers monitoring of diabetic wounds is of great importance in the diabetes management. However, actual monitoring of biomarkers still largely relies on the complex process and additional sophisticated analytical instruments. In this work, we prepared hydrogels composed of different modules, which were designed to monitor different physiological indicators in diabetic wounds, including glucose levels, pH, and temperature. Glucose monitoring was achieved based on the combination of photonic crystal (PC) structure and glucose-responsive hydrogels. The obtained photonic crystal hydrogels (PCHs) allowed visual monitoring of glucose levels in physiological ranges by readout of intuitive structural color changes of PCHs during glucose-induced swelling and shrinkage. Interestingly, the glucose response of double network PCHs was completed in 15 min, which was twice as fast as single network PCHs, due to the higher volume fraction of glucose-responsive motifs. Moreover, pH sensing was achieved by incorporation of acid-base indicator dyes into hydrogels; and temperature monitoring was obtained by integration of thermochromic powders in hydrogels. These hydrogel modules effectively monitored the physiological levels and dynamic changes of three physiological biomarkers, both in vitro and in vivo during diabetic wound healing process. The multifunctional hydrogels with visual monitoring of biomarkers have great potential in wound-related monitoring and treatment.Graphical abstract

"I won't ever feel normal": experience reported through photovoice by children with chronic kidney disease.

Much of the global chronic kidney disease burden is experienced in low- and middle-income countries. Children living with chronic kidney disease (CKD) face medical and social challenges, and they need support at the individual and family levels. This study aimed to explore children's experiences living with kidney replacement therapy (KRT) who attend the largest pediatric nephrology department in Guatemala. This qualitative study used photovoice and asked children to take pictures that represented what is like to live with CKD. Each child and their caregiver underwent an interview where the photos were used to elicit and facilitate discussion. The interviews were recorded, transcribed, and then analyzed using thematic analysis. Eight children and their mothers participated in the study. Three themes were identified: interactions with the health system, changing and difficult family dynamics, and strains on social interactions. Children face social challenges including self-isolation and alienation. The family dynamics and familial structures often are forced to change, inducing stress. This is all exacerbated by the difficulties that arise in navigating the Guatemalan health system. Photovoice techniques are a feasible way to understand the experiences of children and their families who face CKD. The disease affects all aspects of life and recognizing this while advising and administering care can help provide a comprehensive level of care. Health systems need to make efforts aimed at improving the quality of care as well as the multidisciplinary support available to children and their families.

TikTok and Bilibili as health information sources on gastroesophageal reflux disease: an assessment of content and its quality.

Gastroesophageal reflux disease (GERD) is a global chronic disease. Short video platforms make it easy for patients with GERD to obtain medical information. However, the quality of information from these videos remains uncertain. This study aimed to systematically assess videos related to GERD on TikTok and Bilibili. We conducted a search and gathered 241 Chinese videos related to GERD and recorded the essential information. Two independent evaluators assessed each video based on the completeness of six components of the GERD guidelines, and assessed the quality and reliability of the information in the videos using recognition tools. Finally, videos from different sources were compared. The uploaders of most videos were medical professionals (86.7%, n = 209). The content was mainly about symptoms and treatment. The quality of the videos information varied depending on the sources. Among videos posted on Bilibili, those posted by medical professionals had a lower content score for definition (P < 0.001). Videos produced by non-gastroenterologists had the highest mean modified DISCERN. (The DISCERN scoring tool was initially created for assessing written publications, but nowadays, it is frequently leveraged for appraising various health-related videos. Details can be found in the text) quality of the videos information was acceptable; however, the content varied significantly depending on the type of source used. Videos with broad content should be carefully screened to meet more needs.

Contribution of extracellular vesicles to steatosis-related liver disease and their therapeutic potential.

Extracellular vesicles (EVs) are small particles released by many cell types in different tissues, including the liver, and transfer specific cargo molecules from originating cells to receptor cells. This process generally culminates in activation of distant cells and inflammation and progression of certain diseases. The global chronic liver disease (CLD) epidemic is estimated at 1.5 billion patients worldwide. Cirrhosis and liver cancer are the most common risk factors for CLD. However, hepatitis C and B virus infection and obesity are also highly associated with CLD. Nonetheless, the etiology of many CLD pathophysiological, cellular, and molecular events are unclear. Changes in hepatic lipid metabolism can lead to lipotoxicity events that induce EV release. Here, we aimed to present an overview of EV features, from definition to types and biogenesis, with particular focus on the molecules related to steatosis-related liver disease, diagnosis, and therapy.

Global Chronic Disease Burden Can Be Reduced by Taking Care of Our Mitochondria

Global Chronic Disease Burden Can Be Reduced by Taking Care of Our Mitochondria

Exploring the therapeutic potential of garlic in alcoholic liver disease: a network pharmacology and experimental validation study

ObjectiveEmploying network pharmacology and molecular docking, the study predicts the active compounds in garlic and elucidates their mechanism in inhibiting the development of alcoholic liver disease (ALD). ALD is a global chronic liver disease with potential for hepatocellular carcinoma progression.MethodsThe main active ingredients and targets of garlic were identified through screening the TCMSP, TCM-ID, and ETCM databases. ALD disease targets were sourced from DisGeNET, GeneCards, and DiGSeE databases, and intervention targets for garlic were determined through intersections. Protein interaction networks were constructed using the STRING platform, and GO and KEGG pathway enrichment analyses were performed with R software. The garlic component-disease-target network was established using Cytoscape software. Validation of active ingredients against core targets was conducted through molecular docking simulations using AutoDock Vina software. Expression validation of core targets was carried out using human sequencing data of ALD obtained from the GEO database.ResultsIntegration of garlic drug targets with ALD disease targets identified 83 target genes. Validation through an alcohol-induced ALD mouse model supported certain network pharmacology findings, suggesting that garlic may impede disease progression by mitigating the inflammatory response and promoting ethanol metabolism.ConclusionThis study provides insights into the potential therapeutic mechanisms of garlic in inhibiting ALD development. The identified active ingredients offer promising avenues for further investigation and development of treatments for ALD, emphasizing the importance of botanical remedies in liver disease management.

Additive interaction of disability with chronic conditions on mortality risk in middle-aged and older adults in Spain

BackgroundDisability and chronic diseases are prevalent conditions associated with mortality, but little information is available on their potential synergistic effects. ObjectiveThis study aimed to describe additive interactions between disability and chronic diseases on mortality risk in middle-aged and older adults. MethodsA representative cohort of 22,800 community-dwelling Spanish people aged 50 years or older were interviewed for disability with the Global Activity Limitation Indicator and specific chronic diseases in the 2011–12 and 2014 National Health Surveys and subsequently followed up for mortality. Five-year all-cause mortality risks were standardized in each disability-by-comorbidity category through inverse probability weighting. We computed interaction contrasts as the departure of the standardized risk difference for people with both conditions from the sum of the standardized risk differences for those with any single condition. ResultsThe baseline prevalence of disability was 35.1 % (95 % confidence interval [CI] 34.4 %, 35.9 %). There was compelling evidence of synergistic effects of disability with chronic liver disease, heart diseases other than myocardial infarction, cancer, and cerebrovascular disease, with large positive interaction contrasts (95 % CIs) of 106.7 (−16.4, 229.9), 45.7 (6.9, 84.5), 45.1 (−15.0, 105.2), and 42.9 (−41.0, 126.9) excess deaths per 1000 persons. Less clear synergistic responses were observed for other comorbidities. We found some evidence of antagonism for osteoporosis, with a negative interaction contrast of −18.0 (95 % CI −82.2, 46.2) deaths per 1000 persons. ConclusionGiven the high mortality risk in people with disability, the study of its synergistic effects with target comorbidities can provide relevant information regarding preventive measures.

Nutrition's Role in Quality Healthcare in the United States: Opportunities and Education for Pharmacists to Take a Bite of the Apple and Strengthen Their Skills.

With global chronic disease rates on the rise, diet and nutrition remain pivotal yet under-appreciated aspects of healthcare, including in pharmacy practice. This perspective paper delves into how current United States health policies support nutrition's role in healthcare and its integration into pharmacy practice. The paper also reviews the landscape of nutrition education and training for pharmacists, pharmacy roles in multidisciplinary teams and interprofessional nutrition care, and the opportunities for post-graduate nutrition-focused certification, training, and continuing education. It advocates for a paradigm shift towards greater emphasis on nutrition within pharmacy practice, to improve skills and benefit quality patient nutrition care.

Associations among global long interspersed nuclear element-1 DNA methylation, metal exposure, and chronic kidney disease.

Long interspersed nuclear element-1 (LINE-1) methylation serves as an indicator of global DNA methylation. This study explored the correlation between LINE-1 methylation and chronic kidney disease (CKD). We also evaluated whether LINE-1 methylation could modify the association between CKD and metal exposure. A total of 213 patients with clinically defined CKD, without hemodialysis and 416 age and sex matched controls were recruited. Levels of LINE-1 methylation, total urinary arsenic, blood lead, blood cadmium, and plasma selenium were assessed. The results reveal a positive association between LINE-1 methylation and CKD, with an odds ratio (OR) of 5.30 (95% confidence interval: 2.81 to 9.99). Total urinary arsenic and blood cadmium concentrations were positively related with LINE-1 methylation. This study was the first to observe that low plasma selenium, high blood cadmium, and high blood lead levels significantly and additively interact with increased LINE-1 methylation to increase the OR of CKD. Additionally, high LINE-1 methylation interacted multiplicatively with low plasma selenium to increase the OR of CKD (p < 0.001). This study highlighted the significant association between LINE-1 hypermethylation and CKD. Furthermore, the results demonstrate that LINE-1 methylation can interact with high blood cadmium or low plasma selenium to affect CKD risk.

Non-invasive Assessment of Liver Damage Degree in Patients with Viral Hepatitis: Is It Feasible and Acceptable?

Background: Hepatitis C and B virus infections significantly contribute to global chronic liver disease mortality. Objectives: This study explores the role of serum markers (AST/ALT ratio, APRI Score, FIB-4 Score, and Forns index) in non-invasively assessing liver damage in patients with chronic hepatitis C and B. Methods: In this single-center, retrospective, observational study, we analyzed data from 327 patients to establish correlations between serological markers and fibrosis grade using Spearman's correlation. Receiver operator characteristic (ROC) analysis evaluated the ability of these markers to predict advanced fibrosis. Results: In hepatitis B and C cohorts, all markers show significant positive correlations with liver fibrosis (P &lt; 0.001). FIB-4 and the Forns index exhibit moderate correlation (Spearman’s rho 0.48), while AST/ALT and APRI score show mild correlation (Spearman’s rho 0.21 and 0.31). In hepatitis C, the Forns index (0.814) and FIB-4 (0.80) outperform other markers. In hepatitis B, Forns (AUC = 0.73), APRI (AUC = 0.68), and FIB-4 (AUC = 0.68) demonstrate significant predictive ability. Conclusions: FIB-4 and the Forns index hold clinical significance as fibrosis biomarkers in the management of chronic viral hepatitis. FIB-4 is a universal marker, while the interpretation of the Forns index requires consideration of the etiology of chronic viral hepatitis.

Chronic obstructive pulmonary disease burden, grades and erythrocytosis at a tertiary hospital in western Uganda

BackgroundChronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide among people over 40 years of age, and erythrocytosis is one of the major complications associated with increased mortality among COPD patients. The study aimed to determine the proportion of COPD, associated factors, and the burden of erythrocytosis among COPD participants.Methods and materialsA descriptive cross-sectional study design was used. A consecutive sampling technique was used to obtain study participants at the Fort Portal Regional Referral Hospital outpatient clinic. Focused history and physical examination were carried out to select eligible participants. Participants were screened using the COPD population screener for spirometry after consenting to participate. The study enrolled all adults at risk of having COPD based on the COPD population screener and able to undergo spirometry. Spirometry was carried out according to the Global Chronic Obstructive Lung Disease and European Respiratory Society guidelines, and haemoglobin concentration was measured.ResultsOne hundred eighty participants were enrolled in the study, most of whom were females.The modal and mean age of participants was 60 years with 139 (77.2%) females and primary as the highest education level 149(82.8%). The proportion of COPD was 25% (45) [95% CI 18.9 – 32] and highest among females (68.9%) and those aged 60 years and above (70%). The combined COPD assessment tool groups had a proportion of 55.6%, 37.8%, 4.4%, and 2.2% for groups A, B, C, and D, respectively. Age < 50 years was protective against COPD, while for every additional year of smoking, there was an associated 6.5% increased risk compared to the general population. Additionally, the proportion of erythrocytosis among COPD participants was 6.7%.Conclusions and recommendationsThere was a high proportion of COPD among study participants (25%), with a 6.7% proportion of erythrocytosis. We recommend a complete blood count for every patient in groups C and D of the ABCD COPD GOLD groups.

Efficacy and safety of moxibustion for ulcerative colitis: protocol for a systematic review and meta-analysis

IntroductionUlcerative colitis (UC) is a global chronic inflammatory bowel disease, and the poor efficacy of currently available pharmacological regimens makes the management of UC a great challenge. Moxibustion has shown...

Efficient and generalizable cross-patient epileptic seizure detection through a spiking neural network.

Epilepsy is a global chronic disease that brings pain and inconvenience to patients, and an electroencephalogram (EEG) is the main analytical tool. For clinical aid that can be applied to any patient, an automatic cross-patient epilepsy seizure detection algorithm is of great significance. Spiking neural networks (SNNs) are modeled on biological neurons and are energy-efficient on neuromorphic hardware, which can be expected to better handle brain signals and benefit real-world, low-power applications. However, automatic epilepsy seizure detection rarely considers SNNs. In this article, we have explored SNNs for cross-patient seizure detection and discovered that SNNs can achieve comparable state-of-the-art performance or a performance that is even better than artificial neural networks (ANNs). We propose an EEG-based spiking neural network (EESNN) with a recurrent spiking convolution structure, which may better take advantage of temporal and biological characteristics in EEG signals. We extensively evaluate the performance of different SNN structures, training methods, and time settings, which builds a solid basis for understanding and evaluation of SNNs in seizure detection. Moreover, we show that our EESNN model can achieve energy reduction by several orders of magnitude compared with ANNs according to the theoretical estimation. These results show the potential for building high-performance, low-power neuromorphic systems for seizure detection and also broaden real-world application scenarios of SNNs.

МЕТОДИ ДОСЛІДЖЕННЯ ФУНКЦІЇ ЗОВНІШНЬОГО ДИХАННЯ В ДІАГНОСТИЦІ ТА МОНІТОРИНГУ ХРОНІЧНОГО ОБСТРУКТИВНОГО ЗАХВОРЮВАННЯ ЛЕГЕНЬ (СПІРОМЕТРІЯ, БОДИПЛЕТИЗМОГРАФІЯ, DLCO) З УРАХУВАННЯМ ЗМІН ДО GOLD-2024

Pulmonary function testing (PFT) is an integral component in the diagnosis of broncho-obstructive diseases. Spirometry is a mandatory method of pulmonary research, and chronic obstructive pulmonary disease (COPD) is the only respiratory nosology, the diagnosis of which is based on a change in functional indicators, which are measured precisely with the help of spirometry. With the help of spirometry, only the obstructive type of PFT violations can be clearly determined. But one can also suspect restrictive and mixed (presence of both restrictions and obstruction) types. To diagnose these disorders, an indicator of Total Lung Capacity (TLC) is required, which cannot be determined by spirometry, as it consists of TLC and Residual Lung Volume (RES), which is also not determined by spirometry. More complex and less widespread methods of investigation can determine these missing indicators: bodyplethysmography — it is a method of a wider study of lung volumes and capacities and makes it possible to measure general and specific bronchial resistance (Rtot, sRaw). It is not an indispensable condition for confirming obstructive disorders, but it can be useful for identifying underlying diseases and their functional consequences — an increase in TLC, RV or RV/TLC above the upper limit of normal variability allows to suspect the presence of emphysema, severe bronchial asthma, and also to assess the severity hyperinflation. Another important study for a more complete assessment of PFT — diffusion capacity of the lungs for carbon monoxide (DLCO); performed after forced spirometry (determination of FVC, VC) or bodyplethysmography (VC) and determination of the structure of static volumes. It is used in patients with restrictive and obstructive diseases, for the diagnosis of emphysema or pulmonary fibrosis. With the help of this study, the diffusion capacity of the lungs (DLCO) and the alveolar volume (Va) are determined. The article presents the results of research in which these methods were used and provides justification for their application. Conclusion. Different methods of PFT are important and complement each other in clinical practice Key words: chronic obstructive pulmonary disease, diagnosis, spirometry, bodyplethysmography, diffusion capacity of the lungs, Global initiative chronic obstructive pulmonary disease (GOLD).

Monitoring of Lipid Fluxes Between Host and Plastid-Bearing Apicomplexan Parasites.

Apicomplexan parasites are unicellular eukaryotes responsible for major human diseases such as malaria and toxoplasmosis, which cause massive social and economic burden. Toxoplasmosis, caused by Toxoplasma gondii, is a global chronic infectious disease affecting ~1/3 of the world population and is a major threat for any immunocompromised patient. To date, there is no efficient vaccine against these parasites and existing treatments are threatened by rapid emergence of parasite resistance. Throughout their life cycle, Apicomplexa require large amount of nutrients, especially lipids for propagation and survival. Understanding lipid acquisition is key to decipher host-parasite metabolic interactions. Parasite membrane biogenesis relies on a combination of (a) host lipid scavenging, (b) de novo lipid synthesis in the parasite, and (c) fluxes of lipids between host and parasite and within. We recently uncovered that parasite need to store the host-scavenged lipids to avoid their toxic accumulation and to mobilize them for division. How can parasites orchestrate the many lipids fluxes essential for survival? Here, we developed metabolomics approaches coupled to stable isotope labelling to track, monitor, and quantify fatty acid and lipids fluxes between the parasite, its human host cell, and its extracellular environment to unravel the complex lipid fluxes in any physiological environment the parasite could meet.

Effects of a Multi-professional Intervention on Quality of Life of Women with Overweight or Obesity Post-Covid-19. A Pragmatic Trial

Obesity is a global Non-Communicable Chronic Disease (NCD) associated with various comorbidities and a high mortality rate. This scenario has increasingly affected the female population, leading to a rise in prevalence and related health issues. Therefore, the present study aimed to assess the health-related quality of life of women with overweight or obesity and symptoms of COVID-19 using a multi-professional intervention model. This research was conducted as a parallel group and repeated measures pragmatic trial, in which 28 participants aged between 25 and 65 were allocated into two groups: experimental (intervention group) and control (non-intervention participants). The Body Mass Index (BMI) was (30.5 ± 5.45 kg/m²) in the Experimental Group, and the Control Group was (31 ± 8.2 kg/m2). The 12-Item Health Survey (SF-12) questionnaire was applied to assess the quality of life in the physical and mental domains of COVID-19 survivors with different symptom severities (mild, moderate, severe) compared to the control group. At the end of the program, 28 participants finished the study (15 from the experimental group and 13 from the control group). The results indicated a significant improvement in the mental health domain only in the experimental group after the intervention period (p &lt; 0.05). However, no significant differences in physical health were observed between the experimental and control groups (p &gt; 0.05). Considering these findings, multi-professional actions emerge as a crucial component for enhancing the quality of life, particularly within mental health, during the 16-week intervention period.

Mixture of Peanut Skin Extract, Geniposide, and Isoquercitrin Improves the Hepatic Lipid Accumulation of Mice via Modification of Gut Microbiota Homeostasis and the TLR4 and AMPK Signaling Pathways.

Metabolic-dysfunction-associated steatotic liver disease (MASLD, formerly known as NAFLD) is a global chronic liver disease, and no licensed drugs are currently available for its treatment. The incidence of MASLD is increasing, which could lead to a huge clinical and economic burden. As a multifactorial disease, MASLD involves a complex set of metabolic changes, and many monotherapies for it are not clinically effective. Therefore, combination therapies using multiple drugs are emerging, with the advantages of improving drug efficacy and reducing side effects. Peanut skin extract (PSE), geniposide (GEN), and isoquercitrin (IQ) are three natural antiaging components or compounds. In this study, the preventive effects of individual PSE, GEN, and IQ in comparison with the effects of their mixture (MPGI) were examined in a mouse model of high-fat-feed-induced MASLD. The results showed that MPGI could significantly reduce the body and liver weights of mice and improve hepatic steatosis and liver function indicators. Further mechanistic studies showed that PSE, GEN, and IQ worked together by reducing inflammation, modulating the intestinal flora, and regulating the TLR4/NF-κB, AMPK/ACC/CPT1, and AMPK/UKL1/LC3B signaling pathways. It is a promising therapeutic method for preventing MASLD.

Prevention of Type 2 Diabetes: The Role of Intermittent Fasting

Despite the progress in treatment options and improved understanding of pathophysiology, type 2 diabetes remains one of the costliest and most harmful global chronic diseases. The current guidelines encourage physicians to fight an uphill battle and react to an incubated disease state that has been propelled forward by clinical inertia. The authors completed a literature search of PubMed, ScienceDirect, and NIH, searching with the terms intermittent fasting, type 2 diabetes, and prediabetes, and excluded studies related to religion-based fasting. There is emerging evidence that intermittent fasting could be an option to aid in weight loss, reduce hepatic steatosis, and lower the level of biomarkers such as fasting glucose while improving insulin resistance. If incorporated into the lives of patients with risk factors for type 2 diabetes, intermittent fasting could prove to be a cost-effective and efficient tool for preventing this insidious disease. This clinical review examines current evidence supporting the implementation of this lifestyle to prevent the onset or exacerbation of type 2 diabetes and the hurdles that must still be overcome for physicians to confidently prescribe this to their patients.