History Of Alcohol Research Articles

The immediate pain relief of low-level laser therapy for burning mouth syndrome: a retrospective study of 94 cases

SignificanceBurning mouth syndrome (BMS) is a chronic orofacial pain disorder that seriously affects quality of life of patients. In recent years, Low-level laser therapy (LLLT) has been regarded as an important innovation in pain management, but there is insufficient evidence of its effectiveness in patients with painful BMS. This study aimed to evaluate the efficacy of LLLT for immediate pain relief due to BMS.MethodsThis retrospective study included 94 BMS patients that were treated with an intraoral semiconductor laser (635 nm, 100 mW/cm2). Pain was self-assessed before and immediately after LLLT sessions using a 0-to-10 visual analogue scale (VAS). Paired-samples t-test and multivariable binary logistic regression were used to analyze overall efficacy and its influencing factors.ResultsAfter standardized LLLT session, 71.3% of patients reported an immediate pain decrease. Compared to pre-LLLT treatment, the VAS immediately post-LLLT was significantly reduced (P < 0.001). Mean post-LLLT VAS reduction was 2.2 ± 2.0, equivalent to 39.9% of the initial pain level. Meanwhile, low VAS before treatment, history of smoking or alcohol, xerostomia, and gingival lesions correlated with worse LLLT efficacy. There were no side effects or adverse reactions were noticed by the practitioner or reported by the patients.ConclusionsLLLT may provide non-pharmacological, non-invasive, side-effect-free, and rapid pain relief for painful BMS patients. No baseline characteristics affecting overall efficiency were found except for VAS before treatment, history of smoking or alcohol, xerostomia, and gingival lesions.

The moderation effect of mental health services use on the relationship between exposures to adverse childhood experiences and mental health outcomes among US adolescents.

The prevailing exposure to Adverse Childhood Experiences (ACEs) among youth is associated with adolescents' mental health. However, few studies have examined whether receiving help from mental health services affects mental health outcomes among adolescents with ACEs. Therefore, this study examines the moderated effects of mental health services use on the relationship between exposures to ACEs and mental health outcomes among US adolescents. The sample was restricted to adolescents aged 11-17 using data from the National Health Interview Survey (NHIS) from 2019, 2021, and 2022. Multivariate logistic regressions and descriptive analyses were performed to estimate the moderation effect of mental health services use. Using mental health services buffered the associations between ACEs and severe anxiety and depressive symptoms. Receiving counseling/therapy moderated the impact of ever living with an individual who had severe anxiety (Adjusted Odds Ratio, AOR: 0.58, p < .05) and depressive symptoms (AOR: 0.38, p < .01) among adolescents. Furthermore, counseling/therapy moderated the effect of ever living with an individual with a history of alcohol or drug abuse on severe depressive symptoms (AOR: 0.49, p < .05) and the effect of being a victim or witness of violence on severe anxiety symptoms (AOR: 0.45, p < .01). In addition, taking prescription medication moderated the effect of the experience of incarcerated family members on severe anxiety symptoms (AOR: 0.41, p < .05). Our findings suggest that policy and practice need to encourage access to mental health care for vulnerable adolescents with ACEs to reduce the detrimental effect of their experiences on their mental health problems.

Randomized controlled trial of a pilot PrEP linkage intervention for individuals leaving incarceration in a southern state: Design and baseline characteristics.

We report baseline characteristics of a pilot intervention, PrEP-Link, which uses a community health worker (CHW) model to provide navigation to PrEP, the daily HIV preventative medication, and other medical and social services upon release from incarceration. This pilot study uses a randomized controlled trial design. The control group receives enhanced standard of care, and the intervention receives enhanced standard of care plus personalized navigation services from the CHW for up to one year. PrEP-Link is modeled after the Transitions Clinic Program, where a CHW who has lived experience of incarceration builds close relationships with individuals and community partners. After COVID-19 restrictions prevented recruitment within local jails, recruitment for this study took place in local reentry centers which house individuals as they near completion of their jail or prison sentence. Data are collected at baseline, 6 months, and 12 months. Planning and reporting was guided by the CONSORT 2010 checklist. We enrolled 80 participants between September 2021 and April 2023. Thirty-nine participants were assigned to the control group and forty-one to the intervention group. Data collected at baseline included measures of PrEP usage, HIV risk, drug and alcohol use, healthcare usage, and history of incarceration. Analysis of baseline characteristics show comparability of both demographic and HIV-related risk factors between the two arms. At baseline, participants had high clinical indication for potential PrEP benefit, particularly with respect to self-reported intravenous drug use and condomless sex. Participants responded with high PrEP acceptability within both study arms. Participants reported low preventative healthcare utilization at baseline. Barriers to accessing PrEP among the study population are significant. Results of this pilot RTC will help inform CHW lead PrEP-linkage interventions for people leaving incarceration.

A Comparative Study of Anterior and Posterior Tuberculosis Lesions for the Treatment of Thoracolumbar Tuberculosis disease: A Single Institution Experience in a Major Academic Hospital.

To compare the efficacy of anterior and posterior surgery for thoracolumbar tuberculosis disease. Clinical data of 30 patients with thoracolumbar tuberculosis disease undergoing anterior and posterior surgery from January 2021 to December 2023 were collected for a retrospective study. According to the two surgical procedures, patients were divided into two groups: 1) anterior group (n=15) and 2) posterior group (n=15). We compared the two groups regarding age, gender, body mass index, affected segments, past history (cardiovascular and cerebrovascular diseases, respiratory diseases, endocrine system diseases, metabolic diseases, and tuberculosis history), smoking history, drinking history, operation time, postoperative bleeding, postoperative drainage, postoperative time, postoperative complications (dural tear, lower limb intermuscular vein thrombosis, lower limb deep vein thrombosis, sinus infection, postoperative recurrence rate), and waist VAS score before and after surgery, waist ODI score, and JOA score. The intraoperative blood loss was significantly less in the posterior group than in the anterior group, and the difference was significant (P <0.05); the lumbar VAS score was lower in the posterior group than in the anterior group, and the difference between the two groups was significant (P <0.05). The analysis of the remaining data showed no significant difference between the two groups (P> 0.05), indicating that the efficacy of the two procedures was the same. In the treatment of thoracolumbar tuberculosis disease, there is no significant difference in the clinical efficacy of anterior surgery and posterior surgery. Intraoperative bleeding in posterior surgery was less than in anterior surgery, but the latter showed a significant improvement in postoperative pain relief. Therefore, spinal surgeons should choose the corresponding surgical treatment according to the actual situation of the patient in order to maximize the efficacy.

High-Risk Influential Factors for Cardiovascular Diseases among Young Adults.

The aim of this study was to compare high-risk influential factors for cardiovascular diseases among different young adults. It was a retrospective study carried out from January 2020 to 2022. A total of 700 young adults who underwent a physical examination or were hospitalised at the Baoding No.1 Central Hospital, Baoding, Hebei, P. R. China. The participants were divided into three groups: Young social health examinees (n = 300), who underwent physical examinations in January 2020; young medical workers (n = 300), young hospital employees who underwent physical examinations in January 2020; and young myocardial infarction patients (n = 100), who were hospitalised with myocardial infarction from January 2019 to 2021. Analysis was performed on the cardiovascular high-risk influential factors of different young adults. The proportions of males, smoking history, drinking history, hypertension history, lack of exercise, high stress, obesity, fatty liver levels of serum uric acid (UA), body mass index (BMI), diastolic blood pressure (DBP), systolic blood pressure (SBP), and weight in the young myocardial infarction patient group were higher than the other two groups while the HDL levels were lower than those of the latter two groups (p <0.05). The proportions of drinking history, hypertension history, lack of exercise, and high stress levels of UA, DBP, and SBP in the young medical worker group were higher than those in the young social health examinee group (p <0.05). Multivariate analysis revealed that males, high stress, obesity, high DBP and SBP levels were independent risk factors for cardiovascular diseases in young adults (p <0.05). High-risk influential factors of cardiovascular diseases in young adults include males, high stress, obesity, high blood pressure, etc. Key Words: Young people, Cardiovascular system, Medical workers, High-risk influential factors.

Resting-State Functional Connectivity Predicts Attention Problems in Children: Evidence from the ABCD Study.

Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, and numerous functional and structural differences have been identified in the brains of individuals with ADHD compared to controls. This study uses data from the baseline sample of the large, epidemiologically informed Adolescent Brain Cognitive Development Study of children aged 9-10 years old (N = 7979). Cross-validated Poisson elastic net regression models were used to predict a dimensional measure of ADHD symptomatology from within- and between-network resting-state correlations and several known risk factors, such as biological sex, socioeconomic status, and parental history of problematic alcohol and drug use. We found parental history of drug use and biological sex to be the most important predictors of attention problems. The connection between the default mode network and the dorsal attention network was the only brain network identified as important for predicting attention problems. Specifically, we found that reduced magnitudes of the anticorrelation between the default mode and dorsal attention networks relate to increased attention problems in children. Our findings complement and extend recent studies that have connected individual differences in structural and task-based fMRI to ADHD symptomatology and individual differences in resting-state fMRI to ADHD diagnoses.

Impact of Radiation Dose on the Survival of Patients With Non-small Cell Lung Cancer Treated With Palliative Intent: Results of a Multicenter Prospective Study.

Many patients with non-small cell lung cancer (NSCLC) receive palliative radiotherapy (RT). Several factors were analyzed to aid in prescribing an optimal treatment for these patients. This prospective observational multicenter study investigated several potential factors for associations with overall survival (OS) in 61 patients with NSCLC receiving palliative RT with or without chemotherapy (CT). Investigated factors included age, sex, performance status, history of smoking or alcohol, hemoglobin, co-morbidities, different clinical symptoms, and quality-of-life aspects. Median OS was 10.8 months, and OS rates at 6, 12, and 24 months were 58.5%, 42.5%, and 28.4%, respectively. On multivariate analysis, RT alone (without CT), RT doses ≤30 Gy, advanced tumor stage (stage IV), and poor emotional functioning at diagnosis were associated with significantly worse OS. Patients with NSCLC assigned to palliative RT may benefit from RT doses >30 Gy and additional CT. Sequential CT appears preferable, since concurrent CT increases esophageal toxicity.

Prevalence of pulmonary hypertension and its associated factors among chronic obstructive pulmonary diseases patients at public hospitals of Addis Ababa, Ethiopia, 2024: a facility-based cross-sectional study.

Pulmonary hypertension (PH) is a serious medical condition characterized by elevated pressure in the lung blood vessels, with chronic heart and lung diseases being the most common causes worldwide. However, there is a dearth of studies on the prevalence of pulmonary hypertension and its associated factors among chronic obstructive pulmonary disease (COPD) patients in Ethiopia and the study area. This study aimed to assess the prevalence of pulmonary hypertension and its associated factors among patients with chronic obstructive pulmonary disease at public hospitals in Addis Ababa, Ethiopia, 2024. A facility-based cross-sectional study involving 422 COPD patients charted in Addis Ababa town, Ethiopia from May - June 2024 was conducted. Respondents' records were chosen using simple random numbers. Structured, and pretested questionnaires, were used to collect data. The data were coded and entered into EpiData 3.1 before being exported to SPSS version 25 for analysis. Logistic regression was employed to identify factors influencing the prevalence of pulmonary hypertension. Statistical significance was set at p < 0.05 with a 95% confidence interval. The study found the prevalence of pulmonary hypertension was 52% (95% CI: 49, 54.4%). Aged above 55 years [Adjusted Odds Ratio (AOR): 2.45 (1.55-3.9), Being male (AOR): 2.5 (1.5-4.1)]. Furthermore, having a history of alcohol [(AOR): 5.5 (2.4-13)], a history of smoking [(AOR): 4.6 (2.7-7.8), and congestive heart failure (AOR): 2.65 (1.5-4.6)], all increase the likelihood of pulmonary hypertension. The study revealed a higher prevalence of pulmonary hypertension among COPD patients. Significant associations were found with being male, belonging to an older age group, and having a history of alcohol use, smoking, and congestive heart disease. Implementing screening programs, smoking cessation programs, educational initiatives, and counseling patients on lifestyle modifications were recommended.

Serum IL-6 and TGF-β1 concentrations as diagnostic biomarkers in elderly male patients with osteoporosis.

This research is intended to evaluate the correlations of serum IL-6 and TGF-β1 concentrations with bone density and turnover markers as well as their diagnostic value in elderly male patients with osteoporosis (OP). A retrospective analysis was conducted on 335 elderly men (≥ 60years; 90 with normal bone mass, 120 osteopenia cases, and 125 OP cases). Lumbar spine/femoral neck BMD values were measured using dual-energy X-ray absorptiometry. Correlations of serum IL-6 and TGF-β1 concentrations with bone density and bone turnover markers in OP patients were analyzed utilizing Pearson or Spearman correlation coefficients. Independent influencing factors for OP were identified by logistic multivariate regression analysis. The diagnostic value of serum IL-6 and TGF-β1 was assessed with ROC curves and MedCalc software. Smoking history, drinking history, lumbar spine BMD, femoral neck BMD, PINP, and β-CTX markedly differed among the normal bone mass, osteopenia, and OP groups. Elevated IL-6 and reduced TGF-β1 concentrations were observed in serum samples of OP. Serum IL-6 concentrations was inversely associated with bone density markers but positively lined to bone turnover markers. Conversely, serum TGF-β1 was positively related to bone density markers but negatively associated with bone turnover markers. Smoking history, PINP, and IL-6, were identified as independent risk factors while lumbar spine BMD, femoral neck BMD, and TGF-β1 were independent protective markers for OP. The combined assessment of serum IL-6 and TGF-β1 showed superior diagnostic performance for OP. Serum IL-6 in combination with TGF-β1 exhibits good diagnostic performance for OP. Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

Analysis of clinical characteristics and risk factors on serrated polyps with synchronous advanced adenoma in elderly and non-elderly people: a retrospective cohort study

ObjectivesSerrated polyps (SPs) with synchronous advanced adenoma (AA) may increase the incidence of colorectal cancer. However, current studies do not address this combination of SPs and AAs in detail with...

Nutritional status of patients with gastrointestinal cancers and analysis of factors for postoperative infections

BackgroundPatients with gastrointestinal cancer have a higher risk of malnutrition and postoperative infection.ObjectiveTo investigate the nutritional status of patients with gastrointestinal cancers and factors for postoperative infections.MethodBased on the nutritional risk status, 294 patients with gastrointestinal tumours were divided into a nutritional risk group and a non-nutritional risk group, and the differences between the two groups were compared.ResultsAmong the included patients, 128 were at preoperative nutritional risk (43.54%); there were significant differences between the two groups in terms of age (66.25 ± 11.73 vs. 58.36 ± 10.41 years, P < 0.001), percentage of gastric cancers (39.84% vs. 28.92%, P = 0.049), percentage of stage IV tumours (60.16% vs. 45.18%, P = 0.011), total protein (64.90 ± 6.82 vs. 67.21 ± 7.41 g/L, P = 0.007), albumin (38.32 ± 4.74 vs. 41.61 ± 5.10 g/L, P < 0.001) and haemoglobin (112.72 ± 22.63 vs. 125.11 ± 22.79 g/L, P < 0.001). Multivariate logistic regression analysis showed that risk factors for postoperative infections in patients included age ≥ 60 years (odds ratio [OR] = 2.266 95%CI = 1.357–4.134), Nutrition Risk Screening (NRS)-2002 score ≥ 3 (OR = 2.183, 95%CI = 1.218–4.102), alcohol history (OR = 2.505, 95%CI = 1.370–4.683), comorbid diabetes mellitus (OR = 2.110, 95%CI = 1.381–4.023) and surgical time ≥ 6 h (OR = 2.446, 95%CI = 1.359–4.758).ConclusionPatients with gastrointestinal cancers are at high incidence of preoperative nutritional risk, and those with an NRS-2002 score of > 3, history of alcohol consumption and surgical time of > 6 h have a higher risk of postoperative infections.

A cross-sectional study on post-stroke depression and the quality of life

BackgroundPost-stroke depression (PSD) is a common mood disorder associated with stroke. By investigating the differences in life quality factors among stroke survivors, the results of this study offer insights into how to better prevent and manage the onset and progression of depression.MethodsThis study is a cross-sectional study that selected patients receiving treatment in the Department of Rehabilitation Medicine at Hebei University Affiliated Hospital from September 1 to November 30, 2023. The inclusion criteria for this study were as follows: 1. Age ≥ 18 years; 2. Diagnosis of hemorrhagic or ischemic stroke confirmed by imaging examination. The exclusion criteria included: 1. A history of psychiatric disorders such as depression or anxiety prior to the onset of the illness; 2. History of psychiatric medication use before the onset; 3. Functional impairments, such as speech, cognitive, or consciousness disorders, that hinder cooperation with the survey questionnaire. Ultimately, a total of 131 patients were included in the study. Based on the results of the Patient Health Questionnaire-9 (PHQ-9), patients were divided into the PSD group and the non-PSD group. The primary evaluation metrics included the General Self-Efficacy Scale (GSES), Visual Analogue Scale (VAS), modified Rankin Scale (mRS), and Fatigue Assessment Scale (FAS), allowing for a comparison of demographic, clinical data, and evaluation metrics between the two groups. Statistical analysis was performed using SPSS version 25.0, and GraphPad Prism version 9.0 was used for graphical representations.ResultsThe morbidity rate of PSD in this study was 48%, which was slightly higher than the global statistical data. The demographic data did not show any statistical differences in terms of age, sex, history of smoking and drinking, or occupation, but they did show a significant difference in terms of education level (p < 0.05), which was primarily related to low education level in the PSD group. In contrast, the clinical data did not show any differences in terms of stroke type, pathogenic site, or medical history (p > 0.05).ConclusionIn this study, statistical results indicated no significant difference in the mRS between the two groups. However, the GSES, VAS, and FAS showed significant differences. This suggests a strong correlation between GSES, VAS, and FAS with the occurrence of PSD, indicating that these factors may serve as predictors for PSD. In medical practice, focusing on patients’ self-efficacy, pain, and fatigue levels could facilitate recovery. When developing rehabilitation plans, it is crucial to minimize patients’ feelings of self-defeat, enhance their self-efficacy, and manage fatigue effectively. Furthermore, reinforcing pain management throughout the rehabilitation process may promote more effective patient recovery.

Silent Devastation: Acute Marchiafava-Bignami Disease Unmasked by Chronic Alcoholism in a 24-Year-Old Male: A Case Report

Marchiafava-Bignami disease (MBD) is an uncommon condition that is mainly linked to prolonged alcoholism and nutritional deficits. It is characterised by necrosis and demyelination of the corpus callosum. Due to its rarity and vague clinical signs, this disorder can frequently be misdiagnosed. It manifests as a range of neurological symptoms, from altered awareness to motor impairments. We present a 24-year-old man in this case report who has a history of intravenous drug use, chronic alcohol intake, and recent binge drinking.He presented with a 10-day history of constipation, vomiting, and a high-grade continuous fever. Over two days, the patient’s condition deteriorated into a drowsy state with abdominal pain.On examination, the patient was drowsy but arousable, with stable vital signs except for hypertension. Neurological findings indicated reduced deep tendon reflexes, hypotonia, and neck stiffness. A systemic workup revealed normal brain CT findings, however, diffusion limitation was seen in the corpus callosum's splenium on MRI, along with mild oedema and T2/FLAIR hyperintensity. The lumbar puncture showed lymphocytic predominance, low CSF glucose, and elevated protein levels suggestive of a possible CNS infection. The differential diagnosis included Marchiafava-Bignami disease (MBD) and cytotoxic lesions of the corpus callosum (CLOCCs).The patient was managed with intravenous steroids, empirical antitubercular therapy (ATT), broad-spectrum antibiotics, and supportive care, including airway protection via intubation. Despite the late diagnosis, the clinical history of chronic alcoholism, recent binge, and imaging findings confirmed MBD. Early recognition and treatment of this disorder can improve neurological outcomes. The present study emphasises how crucial it is to take MBD into account when making a differential diagnosis for alcohol-related encephalopathies, especially in individuals who have neurological decline and prolonged alcohol consumption.

Analysis of risk factors for autoimmune thyroid disease based on blood indicators and urinary iodine concentrations.

The aim of this study was to elucidate the relationships between thyroid hormones, lifestyle factors, biochemical markers, and autoimmune thyroid disease (AITD), thereby identifying the factors influencing the development of these diseases. The study encompassed 517 patients with AITD and 549 patients with non-autoimmune thyroid disease. Demographic and clinical data were collected, and various laboratory indicators, including urinary iodine and thyroid hormones, were measured and compared between the groups. Lasso regression was employed to select the independent variables, while logistic regression analysis determined the factors associated with the development of AITD. The prevalence of drinking alcohol history, median urinary iodine, and TSH concentrations proved significantly greater in the AITD group compared to the control group, while FT3 levels demonstrated lower values within the AITD group (p<0.05). Furthermore, there was a significant difference in the distribution of iodine nutrition status between the two groups (p<0.05). Both univariate and multivariate logistic regression analyses revealed significant associations among excessive iodine intake, drinking alcohol history, TSH, FT3, and the development of AITD. Excessive iodine intake and drinking alcohol history are implicated in an augmented risk of developing AITD. The prevention of AITD may necessitate the regular monitoring of TSH and FT3 concentrations.

Social support for cancer patients and alcohol and tobacco use: an integrative review

Objective: to assess the knowledge about social support and mental health of people diagnosed with cancer, smokers, and alcohol users, and the implications of these behaviors for cancer treatment. Methods: integrative review using the following databases: CINAHL, Embase, LILACS, PsycINFO, MEDLINE, SCOPUS, and Web of Science, without restriction of period and language. The data was analyzed descriptively. Results: 3,010 documents were identified, 14 studies were eligible. The different types of social support received by people with cancer and a history of alcohol and tobacco use stand out: emotional (n=5), informational (n=4), family and material (n=2 each), religious, sexual-affective partner, tangible, affective, positive social interaction, instrumental and social companionship (n=1 each). Conclusion: targeted social support that is sensitive to the particularities of the history of substance use can significantly improve the way people cope with the disease and treatment. Contributions to practice: providing integrated social support for this population is essential for thinking about quality of life throughout treatment and recovery.

Correlation between the ease of cage plates implantation and endplate Hounsfield unit value during ACDF: a retrospective study

ObjectiveTo investigate the correlation between the implantation status of the ROI-C cervical cage plates and the Hounsfield unit(HU) value of the target vertebral endplate during anterior cervical decompression and fusion (ACDF)surgery.MethodsReview of patient data undergoing ACDF from January 2018 to December 2021. Data on gender, age, body mass index, history of hypertension, diabetes, hyperlipidemia, smoking, alcohol consumption, cervical cage plates status, and HU values of the cervical vertebral endplate. Logistic regression analysis was used to evaluate the relationship between the HU values and the plates status.ResultsA total of 17 cases (12.1%) had misplaced implants during surgery. There were statistical differences in gender, long-term smoking history, drinking history, and cervical vertebral endplate HU values between the abnormal implantation group and the normal implantation group (P < 0.05). The cervical vertebral endplate HU values in the abnormal implantation group were significantly higher than those in the normal implantation group (729.3 ± 36.2 HU vs. 484.4 ± 59.2 HU, P < 0.001). In the logistic regression analysis, cervical endplate HU value (OR 1.081; 95% CI 1.016–1.375) was an independent factor influencing improper plate implantation. The area under the ROC curve (AUC) for the cervical endplate HU value in predicting implantation difficulty was 0.836 (P < 0.05), with an optimal threshold of 724 HU (sensitivity 83.2%; specificity 90.4%).ConclusionsThe cervical vertebral segment endplate HU value can independently predict whether the implantation of the plates is misplaced during ACDF surgery.

Divergence in smoking and drinking trends: Results from age-period-cohort analytical approach

BackgroundSmoking has dropped substantially over time while alcohol consumption has increased. Understanding how smoking and drinking relate to age, time-period or birth cohorts may improve public health measures. MethodThe cross-sectional Continuous Household Survey in Northern Ireland provided bi-annual, household-level data on smoking and drinking from 1985 to 2015. An age-period-cohort approach was employed using 10-year age groups and 9 birth cohorts. A descriptive analysis of smoking and drinking by birth cohort was performed and supplemented by a joinpoint analysis. An Intrinsic Estimator model was used to examine behaviour patterns defined separately by age, time-period, and cohort. ResultsAge effects showed that smoking and drinking peaked during adolescence and young adulthood (relative risk (RR) of age 25–34 vs. all ages: RR smoking = 1.59, RR drinking = 1.61, p < 0.001), followed by a progressive subsequent decline with age. Distinct secular trends were observed whereby smoking decreased over time but non-abstinence rates in relation to alcohol consumption increased substantially from 1985 to 2015. Cohort effects in smoking and drinking suggested that Generation X (born around 1961–1980) appeared to have a slightly higher likelihood of smoking and drinking but this converged with other cohorts over time. ConclusionThe absence of similar policy efforts for alcohol as given to smoking may explain the divergence in secular trends of smoking and drinking. Targeting interventions towards adolescents and young adults may offer the best chance of reducing smoking and drinking prevalence. Cohort effects suggest the need for further research about the relationship between drinking and Northern Ireland's political history.

Incidence and Risk Factors of Postoperative Delirium in Lumbar Spinal Fusion Patients: A National Database Analysis

Postoperative delirium (POD) is a frequent complication observed in patients following spinal surgeries. The incidence of POD is particularly concerning for major procedures like lumbar spinal fusion, leading to a range of detrimental outcomes. However, existing research on the prevalence and risk factors associated with POD after lumbar spinal fusion is limited, especially when relying on data from large-scale national databases. This study employed a comprehensive analysis of the National Inpatient Sample database, encompassing data from 2010 to 2019. The study population included patients who underwent primary lumbar spinal fusion surgery. We compared patients who did not experience POD with those who developed POD postoperatively, analyzing demographic characteristics, pre-existing comorbidities, and perioperative complications. Analysis of the National Inpatient Sample database identified a total of 493,481 patients who underwent lumbar spinal fusion. The overall incidence of POD following the procedure was 1.07%. Patients who experienced delirium postoperatively exhibited significantly longer hospital stays, incurred higher healthcare costs, and faced a heightened risk of in-hospital mortality (P < 0.001). Additionally, POD following lumbar spinal fusion was associated with various medical complications, including acute renal failure, myocardial infarction, pneumonia, pulmonary embolism, stroke, and urinary tract infections. Several independent predictors were identified as being significantly associated with POD, including advanced age (≥ 65years), pre-existing neurological disorders, a history of alcohol or drug abuse, depression, psychotic disorders, fluid and electrolyte imbalances, diabetes, weight loss, deficiency anemia, coagulopathy, congestive heart failure, pulmonary circulation disorders, peripheral vascular disease, chronic renal insufficiency, and receiving treatment at a teaching hospital. Notably, neurological disorders demonstrated the strongest correlation with the development of POD. Overall, our analysis revealed a relatively low prevalence of POD following lumbar spinal fusion surgery. Nevertheless, it is critical to investigate and understand the independent predictors of POD to effectively prevent and mitigate its negative impact on patient outcomes.

Construction and external validation of a non-invasive pre-hospital screening model for stroke patients: a study based on artificial intelligence DeepFM algorithm

To construct a non-invasive pre-hospital screening model and early based on artificial intelligence algorithms to provide the severity of stroke in patients, provide screening, guidance and early warning for stroke patients and their families, and provide data support for clinical decision-making. A retrospective study was conducted. The clinical information of stroke patients (n = 53 793) were extracted from the Yidu cloud big data server system of the Second Affiliated Hospital of Dalian Medical University from January 1, 2001 to July 31, 2023. Combined with the results of single factor screening and the opinions of experts with senior professional titles in neurology, the input variable was determined, and the output variable was the National Institutes of Health Stroke Scale (NIHSS) representing the severity of the disease at admission. Python 3.7 was used to build DeepFM algorithm model, and five data mining models including Logistic regression, CART decision tree, C5.0 decision tree, Bayesian network and deep neural network (DNN) were built at the same time. The original data were randomly divided into 80% training set and 20% test set, which were used to train and test the models, adjust the parameters of each model, respectively calculate the accuracy, sensitivity and F-index of the six models, carry out the comprehensive comparison and evaluation of the model. The receiver operator characteristic curve (ROC curve) and calibration curve were drawn, compared the prediction performance of DeepFM model and the other five algorithms. In addition, the data of stroke patients (n = 1 028) were extracted from Dalian Central Hospital for external verification of the model. A total of 14 015 stroke patients with complete information were selected, including 11 212 in the training set and 2 803 in the testing set. After univariate screening, 14 indicators were included to construct the model, including gender, age, recurrence, physical impairment, facial problems, speech disorders, head reactions, disturbance of consciousness, visual disorders, abnormal cough and swallowing, high risk factor, family history, smoking history and drinking history. DeepFM model adopted the two-order crossover feature. The number of hidden layers in DNN layer was 3. Dropout was used to discard the neurons in the neural network. Rule was used as the activation function. Each layer used Dense full connection. The objective function was random gradient descent. The number of iterations was 15. There were 133 922 training parameters in total. Comparing the predictive value of the six models showed that the accuracy of DeepFM model was 0.951, the sensitivity was 0.992, the specificity was 0.814, the F-index was 0.950, and the area under the curve (AUC) was 0.916. The accuracy of the other five data mining models was between 0.771-0.780, the sensitivity was between 0.978-0.987, the F-index was between 0.690-0.707, and the AUC was between 0.568-0.639. The calibration curve of the DeepFM model was more aligned with the ideal curve than the other five data mining models. Suggesting that the prediction performance of DeepFM model was the best. External validation was conducted on the DeepFM model, and its accuracy was 0.891, indicating good generalization performance of the model. The pre-hospital non-invasive screening prediction model based on DeepFM can accurately predict the severity grading of stroke patients, and has potential application value in rapid screening and early clinical decision-making of stroke.

Randomized trial of early exercise rehabilitation and its effects on patients with acute coronary syndrome

To assess the psychological and physiological benefits of early exercise rehabilitation in patients with acute coronary syndrome (ACS). Among 559 ACS-diagnosed patients at Fuzhou University Affiliated Provincial Hospital from January to December 2021, 200 eligible participants were assigned to two groups. The control group received standard care, while the experimental group received early exercise rehabilitation in addition to standard care. The outcomes measured included changes in depression levels (PHQ-9), fasting blood glucose, and troponin I (TnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Data were analyzed using SPSS, with t tests and chi-square tests for group comparisons. In comparison to the control group, the experimental group demonstrated significant improvements in PHQ-9 scores (P < 0.001) and lower fasting blood glucose levels before discharge (P = 0.046). Additionally, the experimental group had notably reduced TnI levels at 72 h after admission (P = 0.001), especially among non-diabetic NSTEMI patients over 60 years old, who showed decreased TnI levels at the 48-hour mark (P = 0.016). However, there were no significant differences in NT-ProBNP change values between the two groups (P > 0.05). Subgroup analysis revealed enhanced outcomes in the intervention group for ACS patients without smoking or drinking history and no heart failure (P = 0.025,P = 0.014,P = 0.018). Early exercise rehabilitation has notable benefits for ACS patients, including reduced depression, improved blood glucose control, and enhanced myocardial protection, especially in nondiabetic NSTEMI patients aged 60 and above.