Longitudinal Study Research Articles

Evaluation of the immune system status and hematological dyscrasias, among amphetamine and cannabis abusers at Eradah Hospital in Qassim, Saudi Arabia

This cross-sectional study aims to evaluate the immune system status and hematological disturbances among individuals who abuse amphetamines and cannabis. Substance abuse, particularly of amphetamines and cannabis, has been associated with various adverse effects on the body, including potential impacts on the immune system and hematological parameters. However, limited research has been conducted to comprehensively assess these effects in a cross-sectional design. Additionally, fungal infections are on the rise internationally, and immune-compromised people are particularly susceptible. The study will recruit a sample of amphetamine and cannabis abusers (n = 50) at the Eradah Hospital in the Qassim Region of Buraydah and assess their sociodemographic and biochemical variables, including blood indices and differential WBC indices, liver, and kidney profiles. Additionally, 50 sputum samples in total were cultured for testing for fungus infections. To obtain the descriptive statistics, the data was imported into Microsoft Excel and subjected to statistical analysis using SPSS 22.0. Amphetamine and cannabis abuser's sociodemographic variables analysis observed that the majority (52%) were aged 18–30, with 56% in secondary school. Unemployment was a significant issue, and most had no other health issues. The majority (50%) had 5–10 years of abuse, while 32% had less than 5 years, and only 18% had been drug abusers for more than 10 years. There were significant changes (p < 0.001) in all different leukocyte blood cells, including neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Furthermore, a microscopic examination of blood films from individuals who misuse the combination of the medications "amphetamine and cannabis" reveals hazardous alterations in Neutrophils. Out of 50, 35 sputum samples showed positive growth on Sabouraud dextrose agar (SDA) with chloramphenicol antibiotic, indicating a unicellular fungal growth. The present study explores the immune system and hematological disturbances linked to amphetamine and cannabis abuse, providing insights into health risks and targeted interventions. The findings complement previous research on drug users' hematological abnormalities, particularly in white blood cells. Routine hematological tests help identify alterations in homeostatic conditions, improving patient knowledge and preventing major issues. Further research is needed on multi-drug abuse prevention, early detection, and intervention. The cross-sectional design allows for a snapshot of the immune system and hematological status among abusers, laying the groundwork for future longitudinal studies. Key Words: Drug Effect, Immunity, Epidemiology, Oxidative Stress, Inflammation.

Prevalence of the Gingival Phenotype in Adults and Associated Risk Factors: A Systematic Review of the Literature

The relevance of assessing the gingival phenotype prior to the initiation of periodontal, orthodontic, or prosthetic therapy has been clearly demonstrated. However, publications on this subject are either old or concerned with the means of assessing the gingival phenotype or the main factors likely to modify it. The main objective of this systematic review of the literature was therefore to investigate the prevalence of different gingival phenotypes in adults in good general health and with a healthy periodontium. A systematic review of the literature was performed following the guidelines of PRISMA recommendations using an electronic search strategy on four databases (PubMed, Scopus, Cochrane Library, and Embase) complemented by a manual search. Three independent authors were involved in study selection, data extraction, and bias assessment. Results: Of 807 articles, 17 of them, published between 2012 and 2023, involving 3277 subjects from 11 countries and 9766 dental sites, fulfilled the inclusion criteria. The prevalence of the gingival phenotype could not be determined at the level of an individual or a dental arch because all the publications assessed this phenotype only at the level of certain dental sectors, and were not chosen at random. The maxillary central incisors and maxillary or mandibular first molar sectors were associated with a high and thick gingival phenotype, independently of the dental morphology, gender, and age of adult subjects. Furthermore, in these regions, this gingival phenotype tended to be associated with a thick vestibular bone table. In contrast, maxillary and mandibular incisors and premolars more often had a thin gingival phenotype. For other teeth, the results were less conclusive. It is important not to rely solely on the overall appearance of the dentition but to independently assess the thickness and height of the gingiva at each dental site requiring intervention. Finally, this study highlights a key point, namely the need for further longitudinal studies to determine the prevalence in healthy adults. For practicality and feasibility reasons, these studies should be designed according to therapeutic needs, dental sector by dental sector, and within homogeneous source populations. PROSPERO registration: CRD 42023392602.

Foreign Language Learning Boredom: Refining its Measurement and Determining its Role in Language Learning

Abstract This cross-sectional and longitudinal study sought to refine the measurement of foreign language learning boredom (FLLB) and examine its links with overall/skill-specific second and foreign language (L2) achievement (curriculum-based course exam scores) and proficiency (Cambridge English test scores). In Substudy 1, we developed and validated an 11-item Foreign Language Learning Boredom Scale–Short Form among secondary and tertiary English as a foreign language (EFL) learners in China (n1 = 2,223, n2 = 504, n3 = 934, n4 = 1,109). The scale showed sound psychometric properties (i.e., construct/criterion/convergent/discriminant/predictive validity, reliability, and measurement invariance across time and groups). In Substudy 2, structural equation modeling results show that FLLB had a consistent modest negative effect on overall and skill-specific (vocabulary and grammar, listening, reading, and writing) L2 achievement and proficiency (n4 = 1,109). Substudy 3 was a 12-month three-semester longitudinal investigation (n4 = 1,109). Cross-lagged panel modeling results show that L2 achievement predicted subsequent FLLB negatively, while FLLB did not predict subsequent L2 achievement.

Overparenting and psychological wellbeing among Chinese adolescents: Findings based on latent growth modeling.

Although overparenting is a growing phenomenon across the globe, there is a severe lack of longitudinal studies examining the trajectory of overparenting and its effects on early adolescent development, particularly in non-Western contexts. The study collected three waves of longitudinal data from 1328 early Chinese adolescents in Hong Kong with an interval of 1 year to examine the stability and change of perceived paternal and maternal overparenting and their effects on adolescent psychological wellbeing. The results indicated that perceived paternal and maternal overparenting declined over time. Besides, adolescents reported lower anxiety and depressive symptoms when they perceived a steep decline in maternal overparenting. Adolescent anxiety at earlier time points also predicted a steeper decline in paternal and maternal overparenting trajectories respectively. Furthermore, we identified gender differences in the initial level of paternal overparenting and the trajectory of maternal overparenting, as well as the effects of rates of change of maternal overparenting on adolescent anxiety and depressive symptoms. The findings give support for self-determination theory and the separation-individuation model, suggesting that changes of overparenting may hinder adolescents' desires for autonomy and self-direction, which may increase their psychological morbidity. The study contributes to theoretical development of contemporary Chinese socialization models and provides useful pointers for future studies of overparenting.

Determinants of Decision Regret Regarding Fertility Preservation in Adolescent and Young Adult Cancer Survivors: A Systematic Review.

Given recent advances in cancer therapeutics, there is a growing population of adolescent and young adult (AYA) cancer survivors navigating the physical and psychological consequences of cancer treatment. Fertility preservation (FP) conversations are of increasing importance for these survivors. Decision regret (DR) is a measure of distress or remorse following a health care decision, and it is a useful tool to evaluate the impact of a treatment on quality of life. The aim of this systematic review is to culminate existing literature focused on determinants of FP DR among AYA cancer survivors and to propose future interventions to reduce DR among AYA cancer survivors. An electronic database search was performed using PubMed, Web of Science, and APA PsycINFO for articles published before December 2023 using the following search criteria: PubMed: "Fertility Preservation"[Mesh] AND decision regret, APA PsycINFO and Web of Science: Fertility Preservation AND decision regret. Articles were organized into five categories that emerged after initial review. Nineteen articles that focused on DR and FP in AYA cancer survivors aged ≤40 and ≥12 years were included. Article results were categorized into five categories pertaining to determinants of FP DR: Unmet Informational and Emotional Needs, Need for Developmentally Appropriate Conversations, Insufficiency of Provider Training, Quality and Timeliness of Fertility Preservation Discussions, and Societal Barriers. These results highlight the need for improved patient and provider education on FP, such as future longitudinal studies focused on standardization of FP-related protocols and the impact of their implementation on DR, especially for AYA cancer survivors.

The combined effect of handgrip strength and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly: A cohort study

ObjectiveThe aim of this study was to investigate the combined effect of handgrip strength (HGS) and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly people. MethodsThe data was used from the China Health and Retirement Longitudinal Study (CHARLS). Middle-aged and older adults who participated in surveys between 2011 and 2018 were included in the study. They were divided into 4 different types of obesity phenotypes based on obesity and metabolic status: metabolically healthy non-overweight/obesity (MHNO), metabolically healthy overweight/obesity (MHO), metabolically abnormal non-overweight/obesity (MANO), and metabolically abnormal overweight/obesity (MAO). The HGS level was divided into low and high groups according to the median values. Cox proportional risk regression model was used to analyze the joint effect of HGS and obesity phenotype on the risk of stroke among participants. ResultsA total of 7904 participants aged 58.89±9.08 years were included in this study. After adjusting for potential confounders, high HGS&MHO (HR=1.86, 95 % CI=1.12–3.09), high HGS&MANO (HR=2.01, 95 %CI=1.42–2.86), high HGS&MAO (HR=2.01, 95 % CI=1.37–2.93), low HGS&MHNO (HR=1.57, 95 % CI=1.00–2.46), low HGS&MHO (HR=2.09, 95 % CI=1.29–3.38), low HGS&MANO (HR=2.02, 95 % CI=1.35–3.03), and low HGS&MAO (HR=2.48, 95 % CI=1.72–3.58) group had significantly higher risks of stroke than the high HGS&MHNO group. ConclusionThe coexistence of metabolically unhealthy and low HGS can synergistically increase the risk of stroke in Chinese middle-aged and elderly people.

The Bergen–Social Media Addiction Scale (BSMAS): longitudinal measurement invariance across a two-year interval

ABSTRACT Objective This study aims to examine the longitudinal measurement invariance of the Bergen Social Media Addiction Scale (BSMAS) over a two-year interval, addressing a gap in research on its consistency over time. Method Confirmatory Factor Analysis with a robust maximum likelihood chi-square estimator was utilised to assess the BSMAS among 276 adults (mean age = 31.86 years; SD = 9.94 years; 71% male) at three time points across two years. This method evaluates the scale’s structural consistency and reliability longitudinally. Results The analysis supported full measurement invariance (configural, metric, scalar, and error variance) of the BSMAS, indicating stable measurement properties over time. Furthermore, temporal stability and equivalency of the BSMAS total mean scores were confirmed across the three-time points, suggesting consistent measurement of social media addiction. Conclusions The findings validate the BSMAS as a reliable instrument for measuring social media addiction over extended periods. Demonstrating its psychometric stability enhances its utility for longitudinal studies, making it a valuable tool for tracking changes in social media addiction behaviours. These results have significant implications for future research and clinical practice, highlighting the BSMAS’s applicability in long-term studies.

Menstrual pain in Australian adolescent girls and its impact on regular activities: a population-based cohort analysis based on Longitudinal Study of Australian Children survey data.

To determine the proportion of Australian adolescent girls who experience menstrual pain (dysmenorrhea); to assess associations of dysmenorrhea and period pain severity with adolescents missing regular activities because of their periods. Prospective, population-based cohort study; analysis of Longitudinal Study of Australian Children (LSAC) survey data. Female adolescents in the nationally representative cross-sequential sample of Australian children recruited in 2004 for the Kinder cohort (aged 4-5 years at enrolment). Survey data from waves 6 (mean age 14 years), wave 7 (16 years) and wave 8 (18 years) were analysed. Severity of period pain during the preceding three months (very, quite, a little, or not at all painful); number of activity types missed because of periods; relationship between missing activities and period pain severity. Of the 1835 participating female members of the LSAC Kinder cohort at waves 6 to 8, 1600 (87%) responded to questions about menstruation during at least one of waves 6 to 8 of data collection. At wave 6 (14 years), 227 of 644 respondents (35%) reported dysmenorrhea, 675 of 1341 (50%) at wave 6 (16 years), and 518 of 1115 (46%) at wave 8 (18 years). Of the 366 participants who reported period pain severity at all three waves, 137 reported no dysmenorrhea at all three waves (37%), 66 reported dysmenorrhea at all three waves (18%), 89 reported increasing period pain over time (24%), and 38 reported declining pain (10%). At wave 6, 223 of 647 participants reported missing at least one activity because of their periods (34%), 454 of 1341 at wave 7 (34%), and 344 of 1111 at wave 8 (31%). Of the participants who experienced very painful periods, 72% (wave 6), 63% (wave 7), and 65% (wave 8) missed at least one activity type because of their periods, as did 45% (wave 6), 36% (wave 7), and 40% (wave 8) of those who experienced quite painful periods. A large proportion of adolescent girls in Australia experience period pain that affects their engagement in regular activities, including school attendance. Recognising adolescent period pain is important not only for enhancing their immediate quality of life with appropriate support and interventions, but also as part of early screening for chronic health conditions such as endometriosis.

Physical fitness decline and career paths: a longitudinal study of medical undergraduates

IntroductionExercise enhances one's health and competitiveness. A strong physical fitness status can pave the way for a promising future. This study presents the time-based trends in physical fitness indicators—including height, weight, BMI, lung capacity, dash, long-distance running, and standing long jump—among medical undergraduates during their university years. Additionally, we analyzed the impact of students' physical fitness on their career paths.MethodWe conducted a retrospective database study by collecting physical fitness test data and career paths information for 634 medical students from a university in southwestern China. These students graduated in 2022. The career paths included pursuits in further studies, employment, and unemployment. To detect differences in these aspects, we used the t-test and Chi-square test.ResultsOur study indicates a significant declining trend in the physical fitness of medical students during their university years. The changes observed between the first and fourth tests are as follows:Weight (kg): 58.52 ± 10.48 to 60.73 ± 12.07, P < 0.00BMI (kg/m^2): 20.79 ± 2.74 to 21.24 ± 3.06, P < 0.0050-m dash (s): 8.91 ± 0.99 to 9.25 ± 1.11, P < 0.00Standing long jump (cm): 187.74 ± 30.98 to 182.59 ± 32.25, P < 0.00800-m run for females (min): 3.84 ± 0.47 to 4.48 ± 0.85, P < 0.001000-m run for males (min): 3.98 ± 0.63 to 4.62 ± 0.87, P < 0.00Sit-ups for females (count): 30.39 ± 7.5 to 29.03 ± 8.82, P < 0.00Upon analyzing the correlation between changes in physical fitness and career paths, students with stable or decreased BMI had better post-graduation outcomes compared to students with increased BMI.ConclusionsMedical students show a declining trend in physical fitness during their undergraduate years. A good physical health status is beneficial for achieving better career paths. Medical students should place greater emphasis on physical exercise during their time in school.

Different trajectories of post-concussive symptom subscales after pediatric mild traumatic brain injury: Data from a prospective longitudinal study

PurposeThe aim of this study was to investigate the trajectory of parent-rated post-concussive symptoms (PCS), attentional performance and participation within 6 months in children after mild traumatic brain injury (mTBI). MethodsFor this prospective longitudinal study, we included data on 64 children after mTBI and 57 healthy control children (age 8–16 years). Parents rated PCS using the Post-Concussion Symptom Inventory (PCSI) immediately (T0), 1 week (T1), and 3–6 months after injury (T2). Attentional performance (alertness, selective and divided attention) was measured using the Test of Attentional Performance (TAP) at T1 and T2 and participation was measured using the Child and Adolescent Scale of Participation (CASP) at T2. ResultsFriedman tests showed different trajectories of PCS subscales over time: Compared to pre-injury level, the amount of somatic and cognitive PCS was still elevated at T1, while emotional PCS at T1 were already comparable to pre-injury level. The rating of sleep-related PCS at T2 was significantly elevated compared to the pre-injury rating. Quade ANCOVAs indicated group differences in PCS subscales between patients and controls at T1, but not at T2. Patients and controls showed a similar performance in tests of attention at T1 and T2, but parental rating of participation at school was significantly reduced. Although cognitive PCS and attention were not correlated, there were significantly negative Spearman correlations between participation at home and pre-injury and concurrent PCS at T2. ConclusionsOur data imply that sleep-related PCS are still elevated weeks after injury and are thus a target for interventions after mTBI.

Role of Inflammation in Short Sleep Duration Across Childhood and Psychosis in Young Adulthood

Short sleep duration over a prolonged period in childhood could have a detrimental impact on long-term mental health, including the development of psychosis. Further, potential underlying mechanisms of these associations remain unknown. To examine the association between persistent shorter nighttime sleep duration throughout childhood with psychotic experiences (PEs) and/or psychotic disorder (PD) at age 24 years and whether inflammatory markers (C-reactive protein [CRP] and interleukin 6 [IL-6]) potentially mediate any association. This cohort study used data from the Avon Longitudinal Study of Parents and Children. Data analysis was conducted from January 30 to August 1, 2023. Nighttime sleep duration was collected at 6, 18, and 30 months and at 3.5, 4 to 5, 5 to 6, and 6 to 7 years. PEs and PD were assessed at age 24 years from the Psychosislike Symptoms Interview. CRP level at ages 9 and 15 years and IL-6 level at 9 years were used as mediators. Latent class growth analyses (LCGAs) were applied to detect trajectories of nighttime sleep duration, and logistic regressions were applied for the longitudinal associations between trajectories of nighttime sleep duration and psychotic outcomes at 24 years. Path analyses were applied to test CRP and IL-6 as potential mediators. Data were available on 12 394 children (6254 female [50.5%]) for the LCGA and on 3962 young adults (2429 female [61.3%]) for the logistic regression and path analyses. The LCGA identified a group of individuals with persistent shorter nighttime sleep duration across childhood. These individuals were more likely to develop PD (odds ratio [OR], 2.50; 95% CI, 1.51-4.15; P < .001) and PEs (OR, 3.64; 95% CI, 2.23-5.95; P < .001) at age 24 years. Increased levels of IL-6 at 9 years, but not CRP at 9 or 15 years, partially mediated the associations between persistent shorter sleep duration and PD (bias-corrected estimate = 0.003; 95% CI, 0.002-0.005; P = .007) and PEs (bias-corrected estimate = 0.002; 95% CI, 0-0.003; P = .03) in young adulthood. Findings of this cohort study highlight the necessity of addressing short sleep duration in children, as persistence of this sleep problem was associated with subsequent psychosis. This study also provides preliminary evidence for future targeted interventions in children addressing both sleep and inflammatory responses.

Health-related quality of life predictors for patients with stroke: A prospective longitudinal study of matched pairs of patients with stroke and family caregivers.

Patients with stroke require long-term rehabilitation for functional recovery and daily activities. The health-related quality of life (HRQOL) of patients with stroke may deteriorate because of family caregivers' nonpreparedness and increased role burden. To investigate how caregivers' preparedness and sense of competence predict the HRQOL of patients with stroke. A prospective longitudinal study. The study population comprised patients with stroke who were hospitalized for rehabilitation and their family caregivers. A total of 158 patient-family caregiver dyads were recruited from June to September 2021. Data were collected at the initiation of rehabilitation therapy and upon discharge. Information about the characteristics of the family caregivers and patients with stroke and about the former's preparedness and sense of competence were collected at baseline. Furthermore, the HRQOL of patients with stroke was measured at baseline and upon discharge to evaluate the change. This study of matched pairs of patients and family caregivers demonstrated that the latter's caregiving preparedness and sense of competence predicted positive changes in patients' HRQOL. Family caregivers who were satisfied with their care recipients (patients) and had better recognition of the consequences of care involvement better predicted changes in patients' HRQOL. The findings of this study indicate the importance of family caregivers' caregiving preparedness and sense of competence in predicting changes in patients' HRQOL. Clinically, the findings of this study highlight the importance of assessing and supporting family caregivers in developing a strong caregiving preparedness and sense of competence and in understanding the implications of their role as caregivers as it may help improve patients' HRQOL. The integration of interventions that enhance caregiver satisfaction and awareness into clinical practice may result in a more comprehensive and effective patient care. WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Previous studies have demonstrated that the health-related quality of life (HRQOL) of patients with stroke is influenced by sociodemographic factors, such as sex, age, marital status, pain, cognitive ability and activities of daily living. A substantial association was observed between caregivers' preparedness and the HRQOL of patients with stroke. However, few studies have examined the association between caregivers' sense of competence and the HRQOL of patients with stroke. The present study indicated that clinical nursing activity must include assessment and intervention of family caregivers to improve the HRQOL of patients with stroke. The family caregivers of patients with stroke hospitalized in the post-stroke period may experience a sense of sacrifice and limitation in their personal lives. Clinical nursing practice should assess family caregivers' caregiving preparedness and sense of competence to improve the HRQOL of patients with stroke. This study adhered to the relevant EQUATOR guidelines and named the reporting method.

Impact of Breakfast Skipping and Choices on The Nutrient Intake and BMI of University Hostel Students of Lahore

This longitudinal study aimed to investigate the food choices of university hostel students and explore the relationship between breakfast skipping, food choices, nutrient intake, and BMI. Data were collected from students residing in university hostels over a three-month period, with monthly assessments. The study included 306 students divided into breakfastskippers and breakfast-eaters (control group), each comprising 153 students. Further categorization was performed among the breakfast eaters. A valid assessment questionnaire was used, encompassing social demographic characteristics, anthropometric measures, lifestyle assessment, dietary assessment through 24-hour dietary recall, and food composition table analysis. Among breakfast skippers, 15% were classified as obese and 13.7% as overweight, which was higher compared to other groups. Among the non-cereal-based breakfast eaters, 14.4% were obese, and 21% were overweight. The cereal-based breakfast eaters had the lowest rates of obesity and overweight, with 6.4% falling into each category. Significant differences were observed in calorie consumption and the intake of micronutrients across different breakfast categories. This study provided strong evidence linking breakfast skipping to a higher BMI (26.2 vs 24.1) and age-related patterns, with more breakfast skippers among younger individuals. Non-cereal-based breakfasts had a superior nutrient intake, while breakfast skippers had more screen time and insufficient sleep. Emotional states as triggers for binge eating were reported

Fluctuations in emotion regulation as a mechanism linking stress and internalizing psychopathology among adolescents: An intensive longitudinal study

Stressful life events (SLEs) are tightly coupled with the emergence of anxiety and depression symptoms among adolescents, but the mechanisms underlying this relationship remain poorly understood. We investigated within-person fluctuations in emotion regulation as a mechanism linking SLEs and internalizing psychopathology in an intensive longitudinal study. We examined how monthly fluctuations in SLEs were related to engagement in three emotion regulation strategies—acceptance, reappraisal, and rumination—and whether these strategies were associated with changes in internalizing symptoms in adolescents followed for one year (N = 30; n = 355 monthly observations). Bayesian hierarchical models revealed that on months when adolescents experienced more SLEs than was typical for them, they also engaged in more rumination, which, in turn, was associated with higher anxiety and depression symptoms and mediated the prospective relationship between SLEs and internalizing symptoms. In contrast, greater use of acceptance and reappraisal selectively moderated the association between stressors and internalizing symptoms, resulting in stronger links between SLEs and symptoms. These results suggest that emotion regulation strategies play different roles in the stress-psychopathology relationship. Understanding how changes in emotion regulation contribute to increases in internalizing symptoms following experiences of stress may provide novel targets for interventions aimed at reducing stress-related psychopathology.

Behavioural, psychiatric, and cognitive phenotypes associated with numbers of repeats of the FRAXE allele on the FMR2 gene

Background The FRAXE site on the X-chromosome has a variable number of trinucleotide repeats. The rare condition Fragile XE has &gt;200 repeats, but most X chromosomes have &lt;60 such repeats, with evidence of a bimodal distribution. It is known that when the number of repeats is &lt;60, the repeat number can increase from mother to son, which raises the question as to whether there is an evolutionary advantage in the size of these repeats. This paper investigates whether the higher of the &lt;60 repeats are associated with neurocognitive differences among boys in a general population. We hypothesised that although there was previous evidence of a link between higher numbers of repeats in the boys in this population with maternal grandmothers with schizophrenia, there may be cognitive or behavioural advantages to their grandsons of increased levels of repeats. Methods We compared 1951 behavioural, psychiatric, and cognitive outcomes of 5060 boys from the Avon Longitudinal Study of Parents and Children (ALSPAC) using a phenome scan. Results We found that boys with relatively high levels of repeats (&gt;24) had a higher risk of certain neurocognitive outcomes (P&lt;0.01). Boys with &gt;24 repeats were more likely to report: (a) psychosis-like experiences; (b) increased ability to recognise facial signs of anger; (c) increased risk of eating disorders; (d) increased likelihood of smoking cigarettes and using illicit drugs during adolescence than would be expected by chance. There was no sign of associations with cognitive abilities. Conclusions We concluded that there was little evidence that higher levels of the normal range of FRAXE repeats were associated with a difference in cognitive abilities, but there was evidence of increased reports of psychotic-like experiences and other behaviour problems in this group. There was no evidence of evolutionary neurocognitive advantage.

Recurrence of Diabetic Foot Complications: A Domino Effect Leading to Lethal Consequences - Insights from a National Longitudinal Study

Abstract Background Foot complications are common in people with diabetes mellitus (DM), leading to increased healthcare utilization, heightened mortality risk, and notable recurrence rates even after treatment. This retrospective cohort study aimed to investigate the impact of repeated occurrence of DM-related foot complications on the risk of all-cause mortality and to identify the potential risk factors associated with repeated events. Methods People with DM admitted with foot complications (ulcer, skin and soft tissue infection or osteomyelitis) from 2012 to 2014 were identified from Taiwan’s National Health Insurance Research Database, with a three-year follow-up for repeated events. We categorized the study subjects based on their cumulative number of hospital admission with foot complications. Logistic regression was conducted to explore the potential risk factors associated with repeated diabetic foot events. Kaplan-Meier curves and Cox proportional hazard models were used to examine the associations between repeated diabetic foot events and all-cause mortality. Results In this study, 28,754 eligible individuals were enrolled and classified into three groups: no repeated diabetic foot events (76.1%), one repeated event (16.0%), and two or more repeated events (7.9%). Logistic regression revealed that advanced age, males, and those with congestive heart failure, dyslipidemia, hypertension, nephropathy, retinopathy, neuropathy, peripheral vascular disease, diabetes-related preventable hospitalizations, and outpatient visits due to diabetic foot were significantly associated with repeated events of diabetic foot complications. Compared to those with no repeated events, the adjusted hazard ratio (95% CI) for all-cause mortality were 1.26 (1.19-1.34) for one repeated event and 1.36 (1.26-1.47) for two or more repeated events. Conclusions The significant association between repeated diabetic foot and elevated mortality risk highlights the critical necessity for proactive and targeted patient care within clinical practice. More research to delve into the predictive factors related to the repeated occurrence of diabetic foot is needed to provide additional insights for prevention strategies.

The Acute: Chronic Workload Ratio and Injury Risk in Semiprofessional Football Players.

The purpose of this study was to analyze the association and predictive capacity between the acute:chronic workload ratio (ACWR) and non-contact injuries in a semiprofessional football team. Seventeen football or soccer players from a Spanish Third Division football team participated voluntarily in this study. A prospective longitudinal study was developed during the 2020/2021 season. Twenty-four weeks were analyzed from October to March, including a regenerative microcycle due to the absence of competition during Christmas. Rate of perceived exertion (RPE) and session-rate of perceived exertion (sRPE) were registered for every training and game session. Afterward, acute and chronic workloads were calculated, and ACWR was subsequently derived from them. Furthermore, non-contact injuries were registered during the period mentioned. The main findings were that there is a poor correlation between the ACWR and non-contact injuries (r=0.069 (p<0.05)), and the use of the ACWR by itself is insufficient to predict the occurrence of non-contact injuries in a semiprofessional football team. Consequently, the ACWR is not an useful predictive tool for injuries in semiprofessional football teams.

Testosterone therapy does not affect coagulation in male hypogonadism: a longitudinal study based on thrombin generation.

Testosterone therapy has been variably associated with increased thrombotic risk but investigations of global coagulation in this setting are lacking. To compare global coagulation of hypogonadal men before (T0) and 6 months after (T1) starting testosterone replacement therapy (TRT), and healthy controls. Observational prospective cohort study. Two tertiary endocrinological ambulatory care centers. Thirty-eight men with hypogonadism (mean age 55, SD 13) and 38 age-matched healthy controls. Thrombin generation assay (TGA) was performed at T0 and T1 in hypogonadal men and in controls. TGA is an in vitro procedure based on the continuous registration of thrombin generation and decay under conditions mimicking the process that occurs in vivo. The following TGA parameters were recorded: lag-time; thrombin-peak concentration; time-to-reach the peak, velocity index and endogenous thrombin potential (ETP), the latter representing the total amount of thrombin generated under the driving forces of procoagulants opposed by the anticoagulants. PC, antithrombin, factor (F)VIII, and fibrinogen were assessed. No changes of TGA parameters were observed between T0 and T1. Hypogonadal men displayed significantly higher ETP, fibrinogen, and significantly lower antithrombin levels both at T0 and T1 compared to controls. Thrombin-peak of hypogonadal men was significantly higher than controls at T0 but not at T1. ETP and antithrombin were correlated with testosterone levels. Hypogonadal men display a procoagulant imbalance detected by increased thrombin generation. Short-term TRT does not worsen global coagulation, suggesting that the treatment can be safely prescribed to men diagnosed with hypogonadism.

A sweet burden? The effect of bride prices on parents' health

AbstractThe bride price, as an informal institution originated from traditional culture, is pervasive in many areas of the developing world in a form of a payment from the family of the groom to that of the bride at marriage. We study the effects of bride price on parents' health in China. Using information on bride price payment and various health measures from the China Health and Retirement Longitudinal Study, we find that the bride price significantly reduces self‐reported health among the grooms' parents after addressing the endogeneity issue with average sex ratio within a family computed as an instrumental variable. The reductions are heterogenous across urban and rural areas. Mechanism analysis suggests the negative health outcomes are driven by family debt, heavier psychological stress and longer work hours caused by bride price payments.

Determinants of urinary dialkyl phosphate metabolites in midlife women: the Study of Women's Health Across the Nation Multi-Pollutant Study (SWAN-MPS).

Biomonitoring data and determinants of urinary dialkylphosphate (DAP) metabolites, markers of organophosphate pesticides, in racially diverse, non-occupationally exposed populations are scarce. This study evaluated urinary concentrations and potential determinants of DAP metabolites of organophosphate pesticides in a multi-site, multi-racial/ethnic cohort of women aged 45-56 years, the Study of Women's Health Across the Nation Multi-Pollutant Study (SWAN-MPS). We analyzed 963 urine samples collected in 1999-2000, the baseline of SWAN-MPS for longitudinal studies, and quantified DAP metabolites, including dimethyl alkylphosphates (DMAPs): dimethylphosphate (DMP), dimethylthiophosphate (DMTP), dimethyldithiophosphate (DMDTP); and diethyl alkylphosphates (DEAPs): diethylphosphate (DEP), diethylthiophosphate (DETP), diethyldithiophosphate (DEDTP), using gas chromatography and triple quadrupole mass spectroscopy. Adjusted least squared geometric means (LSGMs) and 95% confidence intervals (CIs) were computed to compare DAP concentrations by socio-demographic, behavioral and dietary factors. The geometric means (geometric standard deviations) of total DAPs, DMAPs, and DEAPs were 141 (2.63) nmol/L, 102 (2.99) nmol/L, and 26.8 (2.46) nmol/L, respectively. Body mass index (BMI) was inversely associated with DMAPs and DEAPs: LSGM (95% CI) = 68.8 (55.7-84.9) and 21.0 (17.7-25.0) nmol/L for women with obesity vs. 102 (84.7-123) and 30.1 (25.7-35.1) nmol/L for women with normal/underweight, respectively. Fruit consumption was positively (74.9 (62.1-90.2) for less than 5-6 servings/week vs. 105 (84.8-130) nmol/L for 1 serving/day and more) whereas meat consumption was inversely associated with DMAPs (110 (95.0-128) for seldom vs. 82.3 (59.5-114) nmol/L for often consumption). Fresh apple consumption appears to be attributed to the DMAP differences. Alcohol consumption was positively associated with DEAPs (27.5 (23.1-32.7) for 2 drinks/week and more vs. 23.0 (20.0-26.6) nmol/L for less than 1 drink/month). Black women had higher concentrations of DEAPs compared with White women (27.3 (21.2-35.2) vs. 23.2 (20.2-26.7) nmol/L). Organophosphate pesticides (OPs) are synthetic chemicals and currently the most widely used type of insecticides. We examined multi-site, multi-ethnic cohort of midlife women in the U.S. that offers a unique opportunity to evaluate major determinants of OP exposure. We improved OP metabolite detection rates and obtained accurate concentrations using an improved analytical technique. Our findings suggest that consumptions of fruit, meat and alcohol are important determinants of OP exposure for midlife women. Higher concentrations of diethyl OP metabolites in Black women compared to White women, even after accounting for dietary intake, suggests additional, but unknown racial-ethnic differences that affect exposure.