Low Group Research Articles

Relationship between early-onset stroke and triglyceride-glucose index among young Chinese adults

BackgroundThe triglyceride–glucose index (TyG index), an alternative indicator of peripheral insulin resistance (IR), is associated with cardiovascular disease (CVD) in the general population. The aim of this research was to determine the correlation between early-onset stroke and the TyG index among young Chinese adults.MethodsParticipants (age ≤ 40 years) who attended their first physical examination in Kailuan General Hospital or its 11 subsidiary hospitals between 2006 and 2012 were enrolled. The subjects were divided into four equal points according to the quartile of the TyG index, with the lowest quartile (Q1) as the reference group. A Cox proportional hazard model was employed to assess the correlation between early-onset stroke incidence and the TyG index. Restricted cubic spline analysis was further conducted to examine nonlinear associations. The TyG index was calculated as Ln [Triglyceride (TG, mg/dL) × Fasting Blood Glucose (FBG, mg/dL)/2].ResultsOverall, 35,999 subjects met the inclusion criteria. Their mean age was 30.8 ± 5.7 years, and 77.1% of subjects were males. During a median observation period of 11 years, 281 stroke events occurred (62 hemorrhagic strokes and 219 ischemic strokes). Compared to the Q1 group (as the lowest group), subjects in groups Q2-Q4 had significantly higher risks of early-onset stroke (P < 0.05) after adjustment for relevant confounders in the Cox proportional hazards model. Similar results were consistent with ischemic stroke. However, no significant associations were observed between the risk of hemorrhage and the baseline TyG index. The restricted cubic splines revealed that the risk of stroke progressively increased with a high TyG index ≥ 8.41.ConclusionsThe TyG index may be a major risk factor for early-onset stroke among young Chinese adults. A TyG index ≥ 8.41 can be used as an indicator for screening high-risk stroke groups.

PS-BPP02-7: DEFINING THE OPTIMAL CUT-OFF POINTS OF BLOOD PRESSURE COMPONENTS TO PREDICT THE PROGRESSION OF CHRONIC KIDNEY DISEASE IN TOYOOKA CITY

Objective: Early control of blood pressure is critical to delaying the progression of chronic kidney disease (CKD) and preventing future cardiovascular events and mortality. The primary objective of the study is to assess the optimal cut-off points of blood pressure components for predicting the worsening of proteinuria or renal function. Design and method: Retrospective longitudinal data from 2013–2017 specific health surveys among participants of National Health Insurance in Toyooka City were analyzed (n = 5,169 at baseline). Association of blood pressure at baseline and worsening of dip-stick proteinuria or estimated glomerular filtration rate (eGFR) during follow-up were determined with Cox proportional hazard analysis. The optimal cut-off points were determined with time-dependent receiver operating characteristic curves (ROC). Results: Survival analysis revealed that worsening of proteinuria during follow-up was significantly associated with baseline systolic and diastolic blood pressure levels independently of age, gender, or HbA1c levels. Time-dependent ROC curves for detecting worsening of proteinuria during follow-up revealed that the optimal cut-off points of systolic and diastolic blood pressure were 126 mmHg (sensitivity 0.62, specificity 0.45) and 81 mmHg (sensitivity 0.38, specificity 0.70), respectively. When the whole population was categorized with the systolic blood pressure levels of &lt; 126, 126–139, or &gt; = 140 mmHg, the age, gender, and HbA1c-adjusted risks for worsening proteinuria in the highest and intermediate systolic blood pressure groups were 1.5-fold (p = 0.002) and 1.3-fold (p = 0.014) higher than that in the lowest group, respectively. In addition, the risks for more than a 15%-decrease in eGFR during follow-up in the highest and intermediate groups were 2.0-fold (p &lt; 0.001) and 1.6-fold (p = 0.009) higher than that in the lowest group, respectively. When the whole population was categorized with the diastolic blood pressure levels of &lt; 81, 81–89, or &gt; = 90 mmHg, the risks for worsening proteinuria in the highest and intermediate diastolic blood pressure groups were 1.5-fold (p = 0.004) and 1.2-fold (p = 0.056) higher than that in the lowest group, respectively. Furthermore, the time-dependent ROC curve for detecting more than a 15%-decrease in eGFR during follow-up revealed that the optimal cut-off point of pulse pressure was 52 mmHg (sensitivity 0.48, specificity 0.58). In subjects with a baseline pulse pressure of &gt; = 52 mmHg, the adjusted odds ratio for detecting more than a 15%-decrease in eGFR during follow-up was 1.5-fold higher than in those with a baseline pulse pressure of &lt; 52 mmHg (p = 0.005). Conclusions: Data from specific health surveys revealed regional blood pressure-related risks associated with worsening of CKD among participants of National Health Insurance.

Implementation of Minister of Education and Culture Policy Number 84 of 2013 Article 11

Government through the Minister of Education and Culture of the Republic of Indonesia issued Regulation Number 84 of 2013 concerning the appointment of permanent lecturers at private universities. This study aims to analyze the implementation of the Minister of Education and Culture Regulation Number 84 article 11 at private universities in East Java in improving the quality of its human resources. The subjects in this study were the 7 best private universities in the ranking and clustering version by the Ministry of research, technology, and higher education 2020. The result was that the compensation received by permanent lecturers with the lowest group, namely Expert Assistants in the form of gross monthly salaries ranging from Rp. 3,000,000, 00 – Rp 12,000,000.00. With this compensation, lecturers are also motivated to be more productive in their work (Tridharma of Higher Education) because it is proportional to the compensation they get. This also spurs increasing capabilities such as continuing the postdoctoral education level carried out by lecturers, so universities also provide special rewards. This proves that the performance of a lecturer will increase in line with the high level of satisfaction that comes from the fulfillment of his needs, desires, and expectations. The satisfaction that lecturers get from what they receive from campus creates a commitment to the organizations they join.

Use of the Vascular Overload Index to Predict Cardiovascular Disease in a Rural Population of China.

To explore the relationship between vascular overload index (VOI) and cardiovascular disease (CVD) in rural population and find effective ways to prevent cardiovascular disease in rural low-income populations. The data for this study was obtained from a large cohort study called the Northeast China Rural Cardiovascular Health Study (NCRCHS) conducted in 2013 and followed up during 2015-2018. 10,174 subjects completed at least one follow-up visit. Cox regression equation was used to explore whether VOI and cardiovascular disease were independently related. The Kaplan-Meier curves were used to calculate the cumulative incidence of any adverse outcome, and the log-rank test and restrict mean survival analysis were used to compare group differences. Reclassification and discrimination statistics were used to determine whether VOI could strengthen the ability of the model to predict CVD events. The prevalence of CVD in the VOI quartiles was 1.92%, 3.96%, 5.42%, and 11.34% for Q1-Q4, respectively (P for trend <0.001). After adjusting for multiple confounders, there was a 2.466-fold increased risk of CVD when comparing the highest and lowest groups. Besides, this study found that for every standard deviation increase, the results still exist. The risk of cardiovascular disease increased by 1.358-fold in this model. The restrict mean survival analysis results show that with the increase of VOI, the restrict mean survival time (RMST) within 5 years gradually became shorter. Reclassification and discrimination statistics indicated that VOI significantly enhanced the ability to estimate CVD events within 4 years. Analyses showed that VOI was significantly associated with CVD. VOI is a simple and accurate prognostic marker of CVD risk, which has the potential ability to improve the risk stratification of CVD.

EFFECTS OF NANO CHITOSAN MOUTH SPRAY ON THE EPITHELIAL THICKNESS IN THE TRAUMATIC ULCUS HEALING PROCESS (In vivo)

Background: Traumatic ulcer is one of the most common oral mucosal lesions, which are caused by physical trauma. The prevalence of traumatic ulcers in this world is 83.6%. Ulcers cause pain, difficulty in articulation, mastication and swallowing causing discomfort to the patient. The aim of this study is to analyze the effect of nano chitosan mouth spray on epithelial thickness in the healing process of traumatic ulcers. Methods: This research was true experimental type using post test only control group design with the number of samples are 27 rats divided into three groups. The treatment group was given nano chitosan mouth spray, the positive control group was given aloclair plus spray and the negative control group was given aquadest. After 7 days of treatment, the ulcer tissue was observed using a light microscope, then the average thickness of the epithelium was calculated. They were then analyzed using one-way ANOVA and LSD tests. Results: The results showed difference in the average value of each group. The treatment group is higher than the positive control group and the negative control group with an average epithelial thickness (19.42 ± 2.11). Meanwhile, the negative control group is the lowest group among the three groups with an average epithelial thickness (5.72 ± 0.77). The results based on the One Way Anova parametric test, the value of p = 0.000 (p &lt;0.05) Conclusion: The conclusion obtained is that there is an effect of chitosan nano mouth spray on epithelial thickness on the healing process of traumatic ulcers in male Wistar rats after 7 days of treatment

Association of urinary bisphenol A with chronic obstructive pulmonary disease-related diseases: evidence from the National Health and Nutrition Examination Survey database (2005-2016).

In vivo and in vitro studies have found that exposure to bisphenol A (BPA) can lead to pulmonary diseases, but there exists little evidence regarding the association between urinary BPA level and chronic obstructive pulmonary disease (COPD)-related diseases in the population. National Health and Nutrition Examination Survey data, from 2005 to 2016, were utilized in this study. Participants who self-reported having emphysema, chronic bronchitis, or COPD were defined as having COPD-related diseases. A multivariate logistic regression analysis was used to analyze the association of urinary BPA with COPD-related diseases in the overall population and according to sex. Three separate models including different covariates were used in our analyses. The association of urinary BPA with COPD-related diseases in different subgroups (age, smoking status, participants belonging to "ever had asthma" and "ever had cardiovascular disease") other than sex was also analyzed. Based on the different models, 9189, 7006, and 6946 participants were used in our study. BPA was found to be significantly associated with COPD-related diseases in all models. The concentration of BPA in urine was significantly associated with COPD-related diseases regardless of whether BPA concentration was treated as a continuous variable (odds ratio (OR): 1.24, 95% confidence interval (CI): 1.11-1.38, in model 3) or as tertiles (OR: 2.01, 95% CI: 1.49-2.72, between the lowest group and highest group, in model 3). This association was significant among male but not female participants. BPA also demonstrated a significant association with emphysema and chronic bronchitis in adults, particularly in males. No significant interaction was found for all the other subgroup analyses. Urinary BPA was associated with COPD-related diseases in adult participants, especially males.

Factors associated with health care utilization and catastrophic health expenditure among cancer patients in China: Evidence from the China health and retirement longitudinal study.

Cancer, the leading cause of mortality in China, is a significant burden on patients, their families, the medical system, and society at large. However, there is minimal data on health service utilization and catastrophic health expenditure (CHE) among cancer patients in China. The objective of this study was to identify factors associated with health care utilization and CHE in Chinese cancer patients. The 2018 wave of a nationally representative dataset, the China Health and Retirement Longitudinal Study, was used in our study. Of 18,968 respondents recruited for the analysis, 388 were clinically diagnosed with cancer. CHE was defined as household health expenditure that exceeded 40% of non-food household expenses. A binary logistic regression model was used to identify the risks of cancer exposure among all participants, along with the likelihood of CHE in households with cancer patients at the 40% threshold. A negative binomial regression model was used to identify determinants of health service utilization among cancer patients. Contracting a family physician (incidence rate ratio IRR: 2.38, 1.18-4.77), Urban Employee Basic Medical Insurance (IRR: 4.02, 1.91-8.46, compared to the uninsured), Urban and Rural Resident Basic Medical Insurance (IRR: 3.08, 1.46-6.49, compared to the uninsured), and higher per-capita household consumption were positively associated with inpatient service utilization. Patients with a college education and above reported a greater number of outpatient visits (IRR: 5.78, 2.56-13.02) but fewer inpatient hospital days (IRR: 0.37, 0.20-0.67). Being diagnosed with a non-cancer chronic non-communicable disease was associated with an increased number of outpatient visits (IRR: 1.20, 1.10-1.31). Of the 388 participants, 50.1% of households had CHE, which was negatively correlated with a larger household size (odds ratio OR: 0.52, 0.32-0.86) and lower socioeconomic status [for quintile 5 (lowest group) OR: 0.32, 0.14-0.72]. The socioeconomic characteristics of cancer patients had a considerable impact on their healthcare utilization. Individualized and targeted strategies for cancer management should be implemented to identify high-risk populations and trace the utilization of care among Chinese cancer patients. Strategic purchasing models in cancer care and social health insurance with expanded benefits packages for cancer patients are crucial to tackling the cancer burden in China.

Association of Maternal Caffeine Consumption During Pregnancy With Child Growth

Greater caffeine consumption in pregnancy is associated with reduced birth size, but potential associations with childhood growth are unclear. To evaluate the associations of pregnancy caffeine and paraxanthine measures with child growth in a contemporary cohort with low caffeine consumption and a historical cohort with high caffeine consumption. The Environmental Influences on Child Health Outcomes cohort of the National Institute of Child Health and Human Development Fetal Growth Studies (ECHO-FGS; 10 sites, 2009-2013) was a pregnancy cohort with 1 child measurement between ages 4 and 8 years (follow-up in 2017-2019). The Collaborative Perinatal Project (CPP) was a pregnancy cohort (12 sites, 1959-1965) with child follow-up through 8 years (1960-1974). The current secondary analysis was conducted in 2021 and 2022. Concentrations of caffeine and its primary metabolite, paraxanthine, were quantified from plasma (ECHO-FGS) and serum (CPP) collected in the first trimester. Cut points for analyses were defined by quartiles in ECHO-FGS and quintiles in CPP. Child z scores for body mass index, weight, and height were evaluated, as well as fat mass index and percentage and obesity risk measured at 1 time between age 4 and 8 years in ECHO-FGS. In a secondary analysis of the CPP cohort, child z scores and obesity risk longitudinally through age 8 years were evaluated. In ECHO-FGS (median caffeine intake <50 mg/d), 788 children (mean [SD] age, 6.8 [1.0] years; 411 boys [52.2%]) of women in the fourth vs first quartile of plasma caffeine concentrations had lower height z scores (β = -0.21; 95% CI, -0.41 to -0.02), but differences in weight z scores were only observed in the third quartile (β = -0.27; 95% CI, -0.47 to -0.07). In CPP, beginning at age 4 years, 1622 children (805 boys [49.7%]) of women in the highest caffeine quintile group had lower height z scores than their peers from the lowest group, with the gap widening with each successive year of age (β = -0.16 [95% CI, -0.31 to -0.01] at 4 years; β = -0.37 [95% CI, -0.57 to -0.16] at 8 years). There were slight reductions in weight at ages 5 to 8 years for children in the third vs first caffeine quintile (β = -0.16 to -0.22). Results were consistent for paraxanthine concentrations in both cohorts. Intrauterine exposure to increasing levels of caffeine and paraxanthine, even in low amounts, was associated with shorter stature in early childhood. The clinical implication of reductions in height and weight is unclear; however, the reductions were apparent even with levels of caffeine consumption below clinically recommended guidelines of less than 200 mg per day.

Association Between Nadir Hematocrit and Severe Acute Kidney Injury After Off-Pump Coronary Artery Bypass Graft Surgery: A Retrospective Cohort Study Based on the MIMIC-IV Database

BACKGROUND We aimed to evaluate the association between postoperative nadir hematocrit (Hct) and severe acute kidney injury (AKI) in patients undergoing off-pump coronary artery bypass graft (OPCABG) surgery. MATERIAL AND METHODS Data of patients who received OPCABG were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. A generalized additive model was applied to explore the relationship between nadir Hct and severe AKI. Patients were divided into 4 groups by quartiles of postoperative nadir Hct, with the lowest group (Hct <25%) as reference. We conducted multivariate logistic regression models to calculate adjusted odds ratios (OR) and 95% CI and evaluate trend among the 4 groups. RESULTS In total, 1783 OPCABG patients were included. A nonlinear association between nadir Hct and severe AKI was identified. After adjusting for potential confounders, nadir Hct was negatively associated with risk of severe AKI when Hct was less than 31%; there was no statistical significance between highest Hct group (Hct ≥31%) and control group (Hct <25%; P>0.05). Tests for trend were significant (P<0.05). Subgroup analyses showed each 1% increase in postoperative nadir Hct was associated with a 23% decrease in risk of severe AKI (OR, 0.77; P=0.002) in lower BMI group (<30 kg/m²). CONCLUSIONS The association between postoperative nadir Hct and severe AKI in patients after OPCABG was nonlinear. Lower nadir Hct may be associated with increased risk of severe AKI when Hct values are less than 31%. However, no statistical significance was found between the highest Hct group and control group.

Greater habitual resveratrol intakes were associated with lower risk of hip fracture- a 1:1 matched case-control study in Chinese elderly.

The aim of the study was to testify the association of dietary resveratrol (RSV) intakes with hip fracture risk in Chinese elderly. This was a 1:1 age- and gender- matched case-control study. Eligible cases were newly diagnosed patients of hip fracture. Dietary assessment was made by a 79-item validated food frequency questionnaire. Habitual RSV intakes were estimated as the sum of trans- and cis- isomers of resveratrol and piceid according to the available database. Multivariable conditional logistic regression was applied to examine the relationship of dietary RSV and RSV-rich foods with hip fracture risk. A total of 1,070 pairs of hip fracture incident cases and controls were recruited and 1,065 were included for analysis. Compared with the lowest group, total RSV in the highest quartile group had significantly reduced hip fracture risk by 66.3% (OR: 0.337, 0.222 ~ 0.571, ptrend < 0.001). Similar findings were observed for cis- and trans-RSV, cis- and trans-Piceid, as well as RSV-rich foods (grapes, apples and nuts) respectively. Subgroup analysis suggested more evident findings among female and less obese participants. Our findings demonstrated that higher habitual RSV intakes and RSV-rich foods, even in a relatively low amount, were associated with reduced risk of hip fracture in Chinese elderly.

Healthful and unhealthful provegetarian food patterns and micronutrient intake adequacy in the SUN cohort.

To investigate the association between different versions of a provegetarian food pattern (FP) and micronutrient inadequacy. Cross-sectional analysis. Dietary intake was assessed at baseline through a validated 136-item FFQ. Participants were classified according to groups of different versions of a provegetarian FP: overall, healthful and unhealthful. The prevalence of inadequate intake of vitamins B1, B2, B3, B6, B12, C, A, D, E, folic acid, Zn, I, Se, Fe, Ca, K, P, Mg and Cr was evaluated using the estimated average requirement (EAR) cut-point method and the probabilistic approach. Logistic regression analyses were conducted to estimate the probability of failing to meet EAR for either ≥ 3 or ≥ 6 micronutrients. Seguimiento Universidad de Navarra (SUN) cohort. 17 825 Spanish adults. Overall, subjects in the highest group of the unhealthful provegetarian FP had the highest prevalence of inadequate dietary intake for every vitamin and mineral, compared to those in the lowest group. The adjusted OR of failing to meet ≥ 3 EAR (highest v. lowest group) was 0·65 (0·54, 0·69) for the overall, 0·27 (0·24, 0·31) for the healthful and 9·04 (7·57, 10·4) for the unhealthful provegetarian FP. A higher adherence to an overall and healthful provegetarian FP was inversely associated with the risk of failing to meet EAR values, whereas the unhealthful version was directly associated with micronutrient inadequacy. Provegetarian FP should be well planned, prioritising nutrient-dense plant foods and minimising ultra-processed and unhealthy ones.

Associations of dietary folate, vitamin B6 and B12 intake with cardiovascular outcomes in 115664 participants: a large UK population-based cohort.

The evidence of relationship between dietary intake of folate, vitamin B6 and vitamin B12 and cardiovascular diseases (CVD) in UK populations is limited. We aimed to analyze the association of dietary intake of folate, vitamin B6, and vitamin B12 with CVD events [stroke, myocardial infarction (MI)] and CVD mortality. We included 115,664 participants, aged 40-70 years, with no CVD events or cancer at baseline, enrolled between 2006 and 2010 and followed up to the end of 2018. Dietary intake was measured with an online 24-h dietary assessment. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the associations. After multivariate adjustment, higher dietary folate intake was inversely associated with CVDs with hazard ratios of 0.99, 0.92, and 0.88 in groups 2-4 compared with group 1 (the lowest group); inversely associated with stroke with hazard ratios of 0.94, 0.90, and 0.86 groups 2-4 compared to group 1 (lowest group); inversely associated with MI with hazard ratios of 1.01, 0.90 and 0.86 groups 2-4 compared to group 1 (lowest group); inversely associated with CVD mortality with hazard ratios of 0.95, 0.80 and 0.74 Groups 2-4 compared to group 1 (lowest group). Each tablespoon/day higher intake of raw vegetable intake, pieces/day higher intake of fresh fruit intake bowls/week higher intake of cereal intake, and g/day higher intake of dietary fiber were associated with higher intakes of folate every 0.02,0.06,0.05, and 0.08 SD, respectively. E-value analysis suggested robustness to unmeasured confounding. Each increase in folate intakes was related to 5% lower risks of total CVD events and 10% lower risks of CVD mortality. Our findings support that strengthening dietary folate intake as a primary prevention strategy for CVD events and CVD mortality.

Analyses Of Physical Performance Determinants In Male Professional Soccer Players

Aerobic, anaerobic and anthropometric characteristics have been reported as important components of physical performance (PP) in soccer. It is theorized that better PP can enhance the degree of success and reduce risk of musculoskeletal injuries. However, evidence of how PP of each player impacts soccer team’s success is lacking, especially at the professional level. PURPOSE: To determine the effect of individual players PP on team performance success in male professional soccer league. METHODS: Cross-sectional study design with 114 male professional soccer players of the highest Czech league were classified according to team´s final league ranking into four groups: (G1) 1st-4th ranking (n = 31), (G2) 5th-8th ranking (n = 32), (G3) 9th-12th (n = 26) and (G4) 13th-16th (n = 25). PP determinants were assessed using the following indicators: Body height (BH), body weight (BW), fat mass (FM), height of vertical jump (CMJ), maximal vertical ground force (VGF), isokinetic strength (60°.s-1) of knee extensors (KE), flexors (KF) for dominant (DL) and non-dominant (NL) leg and maximal oxygen uptake (VO2max). Multivariate analyses of variances, Bonferroni post hoc test, and partial eta square (ηp2) were used for statistical assessment. RESULTS: A significant overall effect of PP on team’s performance success (p < 0.01, ηp2 = 0.16) was found. Post-hoc analyses revealed players in the G1 had significantly (p < 0.05) higher CMJ (43.70 ± 5.09 cm) compared to G3 (38.60 ± 3.98 cm) and G4 (40.40 ± 3.51 cm) players. Moreover, players in the G1 generated greater VGF (26.93 ± 2.80 N.kg-1) compare to G4 (25.14 ± 1.79 N.kg-1) and higher values of KE compare to G3 players in both DL and NL (G1: KEDL = 3.19 ± 0.47 N.m.kg-1, KENL = 3.17 ± 0.46 N.m.kg-1, G3: KEDL = 2.89 ± 0.31 N.m.kg-1, KENL = 2.87 ± 0.28 N.m.kg-1). Players in the most successful teams (G1) also showed significantly higher VO2max (60.32 ± 2.62 ml.min.kg-1) compare to players in the lowest group (G4: 57.87 ± 2.74 ml.min.kg-1). CONCLUSIONS: The current findings indicate PP including CMJ, VGF, muscle strength of KEs and VO2max of individual player is associated with final team ranks in the Czech professional soccer league. This evidence may be valuable to discuss team’s success in male professional soccer league.

Research on optimization of cutting force in AISI D2 hardened steel ultrasonic vibration-assisted turning

This study utilized the self-developed ultrasonic vibration-assisted turning system to conduct turning experiments on AISI D2 hardened steel. The investigation is carried out by the Robust Design method via controlling different ultrasonic vibration-assisted turning factors and levels, including feed rate, spindle speed, depth of cut, and the magnitude of amplitude of the ultrasonic vibration tool tip. This study is carried out with optimal cutting force by the Robust Design goals. The optimal combination is A1 (0.5 mm depth of cut) B1 (0.08 mm/rev feed rate) C3 (20 μm amplitude) D2 (885 rpm spindle speed). The cutting force is 119.85 N which hugely decreased 28.6% by comparing with the lowest group. Through analysis of variance, the depth of cut and feed rate play a dominant role in cutting force. These two factors are used for obtaining the difference of cutting force and tool wear by comparing the two factors at different levels. The experimental results show that the optimal depth of cut and feed rate can be reduced by 15.8% and 28.4% in cutting force, and 72% and 81% in tool wear compared with other levels. When turning AISI D2 hardened steel, ultrasonic vibration-assisted turning systems can greatly improve the turning efficiency.

Impact of The Social Media on COVID-19: Is YouTube In or Out?

Background and aim The COVID-19 is an important urgent public health problem in the last century. Youtube has become one of the information points for COVID-19. Many COVID-19 patients have talked about their experiences on Youtube. It has been aimed to evaluate the proficiency of videos about COVID-19 symptoms on Youtube. Methods The terms “COVID 19 symptoms”, “coronavirus 19 symptoms”, “symptoms of coronavirus” and “symptoms of COVID 19” have been searched on Youtube on 01 April 2020, the videos that were uploaded in 2020 and viewed more than 10,000 times until then were scanned and 719 videos were examined. Videos with an inappropriate language, videos with a duration of shorter than 1 minute, videos that have been deleted by the uploader and videos that contain information incompatible with the title excluded. The videos were examined by two physicians in terms of discussing the symptoms and wrong information and graded. Results Totally 202 videos were included in the study. Among the uploaders Healthcare Personnel (HP) (3.5%) and Institutions (9.4%) are the two lowest groups. No difference has been found between Institutions, HP, Individuals Other Than Healthcare Personnel (IOHP) and Unknown Uploaders. Among the uploader groups with 12 and higher points, IOHP stood out among other uploaders significantly with a ratio of 46.7%. Only 4.1% of the videos included wrong/imperfect information and a statistically significant relation between uploader groups was not determined (p&amp;gt;0.05). Conclusions It is important that COVID-19 symptoms are reflected correctly on Youtube, which is one of the most frequently used sites all over the world, in terms of people recognizing the disease in the time of pandemic and isolating themselves and making the decision to apply for a healthcare provider. Creation of more content by healthcare personnel, in a period with such heavy social media usage, will be useful in terms of informing the public.

Dietary intake of beans and risk of disabling dementia: The Circulatory Risk in Communities Study (CIRCS).

To examine whether bean intake (including soybeans) among Japanese adults is associated with risk of disabling dementia severe enough to require care under the national insurance system. This cohort study involved 3739 individuals aged 40 to 64 years. The participants were categorized into five groups based on their dietary bean intake estimated by a 24h dietary recall. Hazard ratios and 95% confidence intervals of disabling dementia were estimated using Cox proportional hazard models adjusted for potential confounding factors (smoking, drinking, and intakes of energy and fish). During the 59,681 person-year follow-up, 670 cases of disabling dementia were observed. A weak inverse association between bean intake and risk of disabling dementia was found; the multivariable hazard ratios (95% CIs) were 0.79 (0.62-1.00), 0.80 (0.63-1.01), 0.84 (0.67-1.06), and 0.78 (0.62-0.99) for the four groups with higher bean intake, respectively, compared with the lowest group (P for trend = 0.21). A significant inverse association was observed for dementia without a history of stroke; for the four groups with higher bean intake the multivariable hazard ratios were 0.81 (0.61-1.08), 0.70 (0.52-0.95), 0.71 (0.52-0.95), and 0.69 (0.51-0.92), respectively, (P for trend = 0.03). No such association was observed for dementia with history of stroke. The group with increased natto intake were inversely associated with risk of disabling dementia (P for trend = 0.003), but tofu intake was not (P for trend = 0.19). Bean intake was inversely associated with risk of disabling dementia in those without a history of stroke.

Validation of the obesity paradox by body mass index and waist circumference in patients undergoing percutaneous coronary intervention.

The paradoxical association of obesity with mortality, named the "obesity paradox", has been inconsistent, possibly due to a difference between body mass index (BMI) and central obesity, estimated by waist circumference (WC) as patterns of adiposity. We enrolled 8513 participants from the Kumamoto Intervention Conference Study, a multicenter registry that included consecutive patients undergoing percutaneous coronary intervention (PCI) at 18 centers between 2008 and 2017 in Japan. Patients were divided into quartiles in ascending order of the BMI or WC. The primary endpoints were all-cause mortality and cardiovascular death within a year. There were 186 deaths (case fatality rate, 22.1/1000 person-years) during the follow-up period. The lowest group (1st quartile) of BMI or WC had the worst prognosis among the quartiles (1st quartile, 4.2%; 2nd quartile, 1.9%; 3rd quartile, 1.5%; 4th quartile, 1.1%; P < 0.001 (χ2) and 1st quartile, 4.1%; 2nd quartile, 2.3%; 3rd quartile, 1.2%; 4th quartile, 1.5%; P < 0.001 (χ2), respectively). Similar results were obtained for cardiovascular death. In a multivariable analysis adjusted by nine conventional factors, the lowest group (1st quartile) of BMI (hazards ratio, 2.748; 95% confidence interval [CI], 1.712-4.411) and WC (hazards ratio, 2.340; 95% CI, 1.525-3.589) were independent prognostic factors for all-cause mortality. By dividing the participants into two groups according to either the BMI or WC based on the National Cholesterol Education Program Adult Treatment Panel III and World Health Organization classification, the highest mortality was observed in the lower group. However, the C-statistic after adding BMI (quartile) to conventional factors was found to be slightly higher than BMI (two categories) and WC (two categories) (0.735 vs. 0.734). The obesity paradox was observed in patients after PCI, and single-use of BMI (or WC) was sufficient to predict the prognosis of patients after PCI.

Blood Pressure Trajectories for 16 Years and the Development of Left Ventricular Hypertrophy and Increased Left Atrial Size: The Korean Genome and Epidemiology Study.

Background Elevated single blood pressure (BP) measurement can be associated with the development of hypertension-mediated target organ damage including left ventricular hypertrophy (LVH) and left atrial (LA) enlargement (LAE). However, long-term patterns of BP and their effects on LVH and LAE are poorly understood. We evaluated the association between the BP trajectories and the presence of LVH and LAE. Methods We analyzed a total of 2,565 participants (1,267 males, 47.8 ± 6.7 years old) from the first biennial examination (2001-2002) of the Korean Genome and Epidemiology Study. The presence of LVH and LAE was identified by echocardiography performed at the 8th biennial examination (2015-2016). Latent mixture modeling was used to identify trajectories in mid-BP ((systolic BP + diastolic BP)/2) over time. Linear logistic regression was used for assessing BP trajectories with the outcomes. Results We identified 4 distinct mid-BP trajectories: group 1 (lowest, 20.9%, n = 536), group 2 (36.2%, n = 928), group 3 (32.3%, n = 828), and group 4 (highest, 10.6%, n = 273). Compared with the lowest group, trajectories with elevated mid-BP had greater odds ratios having LVH and LAE by multivariable-adjusted regression models. Adjusted odd ratios for LVH were 2.033 (95% CI = 1.462–2.827, P < 0.001) for group 2, 3.446 (95% CI = 2.475–4.797, P < 0.001) for group 3, and 4.940 (95% CI = 3.318–7.356, P < 0.001) for group 4. Adjusted odd ratios for LAE were 1.200 (95% CI = 0.814–1.769, P = 0.358) for group 2, 1.599 (95% CI = 1.084–2.360, P = 0.018) for group 3, and 1.944 (95% CI = 1.212–3.118, P = 0.006) for group 4. Conclusions Higher long-term mid-BP was an independent risk factor of cardiac structural changes such as LVH and LAE among middle-aged population.

Increased neutrophil count Is associated with the development of chronic kidney disease in patients with diabetes.

BackgroundThis study aims to investigate the potential association of peripheral inflammatory blood cell parameters with the incidence and progression of chronic kidney disease (CKD) in patients with diabetes.MethodsThe cross‐sectional study included 1192 subjects with diabetes derived from one center. The cohort study included 2060 subjects with diabetes derived from another two centers followed up for 4 years. Logistic regression and Cox proportional hazards models were used to evaluate the association of peripheral inflammatory blood cell with CKD.ResultsIn the cross‐sectional study, neutrophil count performed best as an independent risk factor for CKD (odds ratio 2.556 [95% confidence interval 1.111, 5.879]) even after 1:1 case–control matching for age, gender, history of high blood pressure and duration of diabetes. Spline regression revealed a significant linear association of CKD incidence with continuous neutrophil count in excess of 3.6 × 109/L. In the cohort study, subjects were grouped based on tertile of neutrophil count and neutrophil‐to‐lymphocyte ratio. Cox regression analysis results showed that only neutrophil count was independently associated with CKD progression (the highest group vs. the lowest group, hazard ratio 2.293 [95% confidence interval 1.260, 4.171]) after fully adjusting for potential confounders. The cumulative incidence of CKD progression in patients with diabetes gradually increased with increasing neutrophil count (53 (7.7%) subjects in the lowest group vs. 60 (8.2%) in the middle group vs. 78 (12.2%) in the highest group).ConclusionsThis study suggested that neutrophil count is an independent risk factor for progression of CKD in patients with diabetes.

High waist circumference is a risk factor for hypertension in normal-weight or overweight individuals with normal metabolic profiles.

This study aims to investigate the relationship between waist circumference and hypertension risk in normal‐weight/overweight individuals with normal cardiometabolic profiles. The authors included 7217 normal‐weight and overweight individuals with normal cardiometabolic profiles from the 2001 to 2014 US National Health and Nutrition Examination Survey. The authors summarized demographic characteristics, cardiometabolic profiles, and behavioral factors across waist circumference quartiles. Then, in the logistic regression analysis, the authors observed a positive and significant association between waist circumference (as a continuous variable) and the prevalence of hypertension in all three models (nonadjusted, minimally adjusted, and fully adjusted), with odds ratios (95% confidence intervals) of 1.76 (1.65–1.86), 1.29 (1.20–1.39), and 1.24 (1.09–1.40), respectively. When analyzed as a categorical variable, individuals in the highest waist circumference group had a 1.48‐fold increased risk of hypertension than the lowest group in the fully adjusted model. Moreover, the Cox regression analysis revealed a positive and significant association between waist circumference and all‐cause mortality in individuals with hypertension in the nonadjusted model (HR, 1.27; 95% CI, 1.10–1.47) and the fully adjusted model (HR, 1.59; 95% CI, 1.22–2.06). In conclusions, our results showed that, even in those with normal metabolic profiles, high waist circumference was significantly associated with the increased prevalence of hypertension. And once hypertension has been established, patients with high waist circumference showed elevated all‐cause mortality. Therefore, waist circumference should be routinely measured and controlled regardless of metabolic profiles.