Non-risk Group Research Articles

The Correlation Between Effort–Reward Imbalance at Work and the Risk of Burnout Among Nursing Staff Working in an Emergency Department—A Pilot Study

Background: Nurses in emergency rooms face high levels of psychological stress during their work, which is why they have an increased risk of burnout. The aim of this pilot study was to determine the extent to which effort–reward imbalance (ERI) at work is connected to the risk of burnout among emergency nurses. Methodology: Thirty-five nurses from the central emergency department of a maximum care provider, aged 35.1 ± 0.6 years, voluntarily participated in this pilot study. ERI was recorded using the Effort–Reward Imbalance questionnaire. The nurses were then divided into two groups: the nonrisk group (ERI ratio < 1, n = 19) and the risk group (ERI ratio ≥ 1, n = 16). The burnout dimensions were determined via the Maslach Burnout Inventory (MBI) and the burnout risk was then determined. Results: Nurses in the nonrisk group were significantly less emotionally exhausted (1.6 ± 1.1 points) and had a lower overall risk of burnout (MBI total score 1.2 ± 0.67 points) than the nurses of the risk group. (3.3 ± 1.5 and 2.2 ± 1.2 points, respectively). Eighteen nurses from the total sample had a medium or high risk of burnout. There is a correlation between the risk of burnout and the ERI ratio (r = 0.392, p < 0.05) and the ERI scale “job promotion” (r = −0.462, p < 0.05). Conclusions: The pilot study provides indications of a relationship between effort–reward imbalance at work and burnout risk in emergency nurses. These findings may improve rewards for nurses in the form of increased salary and/or recognition to reduce the risk of burnout among employees and avoid turnover. Further research is needed to investigate the influence of preventive measures on the risk of burnout and gratification crises, particularly with regard to the influence of status and recognition on the risk of burnout.

Isoniazid Prophylaxis Based on Tuberculosis Risk Factors in Living Kidney Transplantation Recipients: A Retrospective Cohort Study

BackgroundTuberculosis (TB) is a major and severe opportunistic infection among solid organ transplant recipients. Chemoprophylaxis is advised for those with latent tuberculosis infection (LTBI). However, the effectiveness of an isoniazid (INH) prophylactic approach based on TB risk factors remains uncertain. MethodsThis study included all living-donor kidney transplant recipients (KTRs) between January 2016 and December 2022. The recipients were categorized into three groups: the risk group with isoniazid (R-INH), the risk group without isoniazid (R-NINH), and the non-risk group (NR), based on the presence of TB risk factors and INH usage. The R-INH group received a 6-month INH prophylactic regimen to prevent post-transplant TB infection. The incidence of active TB among the groups was assessed. ResultsA total of 1348 patients were divided into R-INH (n=108), R-NINH (n=371), and NR (n=869). Forty-seven patients (3.49%) developed TB with an incidence rate of 16.0 per 1000 person-years. Compared to NR, the TB incidence in R-INH was not statistically different (HR, 0.55, 95% CI, 0.07-4.21, P = 0.564), whereas it was significantly higher in R-NINH (HR, 5.04, 95% CI, 2.64-9.62, P < 0.001). The median time from transplantation to TB was 19 months (IQR: 6-39), and 18 patients (38.3%) were diagnosed within one year of transplantation. Ninety-four patients (87.0%) completed INH prophylaxis, with adverse events including two cases of hepatotoxicity (1.85%) and one case of peripheral neuritis (0.93%). ConclusionsA 6-month INH regimen based on TB risk factors is effective and well tolerated for preventing post-transplant TB in KTRs

Clinical characteristics and outcomes of patients with acute coronary syndrome without standard metabolic cardiovascular risk factors

Abstract Background/Introduction Patients with acute coronary syndrome (ACS) commonly present with hypertension, diabetes mellitus (DM), and dyslipidaemia as standard modifiable metabolic risk factors. However, little is known about patients with ACS who do not have these risk factors. Purpose This study investigated the clinical characteristics and outcomes of patients with ACS without these risk factors who underwent primary percutaneous coronary intervention (PCI). Methods This retrospective, single-centre observational study included 1131 consecutive patients with ACS who were admitted to a hospital between January 2013 and May 2021. After excluding patients who did not undergo revascularization or who underwent emergency coronary artery bypass surgery, 947 patients who underwent primary PCI were included in the analysis. Patients were classified into two groups: those with one or more of the following: hypertension, DM, or dyslipidaemia (risk group) and those without any of these factors (non-risk group). Major adverse cardiovascular events (MACE), including all-cause mortality, myocardial infarction (MI), stroke, and heart failure requiring rehospitalisation, were assessed at the 1-year follow-up. Results This study classified 78 patients (8.2%) in the non-risk group, who exhibited a significantly lower body mass index (BMI) [23.0 (interquartile range: 21.8–24.7) vs. 23.8 (interquartile range: 21.8–26.2) kg/m2, p = 0.016], compared to the risk group. There were no significant differences in smoking history between the two groups (51.2% vs. 48.9%, p = 0.39). Within 1 year after PCI, MACE occurred in 146 (15.4%) patients (88 [9.2%] with all-cause death, 13 [1.3%] with MI, 23 [2.4%] with stroke, and 27 [2.8%] with heart failure requiring rehospitalisation), with a significantly higher incidence in the non-risk group compared to the risk group (24.4% vs. 14.6%, p = 0.027). Multivariate analysis revealed that both being in the non-risk group and having a low BMI (&amp;lt; 21.5) were independent determinants for the incidence of MACE (hazard ratio [HR]: 1.52; 95% confidence interval [CI]: 1.01–2.29; p = 0.042 and HR: 3.08; 95% CI: 1.30–7.27; p = 0.010, respectively). Kaplan–Meier survival analysis showed a higher MACE rate in the non-risk group than in the risk group (p = 0.009). Conclusions Patients with ACS without hypertension, DM, or dyslipidaemia have a poorer prognosis than those with these risk factors, independent of the presence of a lower BMI, and the underlying pathophysiology in this subset of patients needs to be clarified.figure

Preoperative prognostic stratification and prediction of long-term outcomes after pancreatoduodenectomy for distal cholangiocarcinoma

BackgroundPatients with distal cholangiocarcinoma (DCC) frequently receive adjuvant chemotherapy in preoperative and postoperative settings, but prediction of prognostic risk at the time of treatment selection remains challenging. MethodsThis single-center retrospective study enrolled DCC patients who underwent initial pancreatoduodenectomy (PD) between 2009 and 2022. Preoperative clinical parameters were collected, and Cox regression analysis was used to identify risk factors for overall survival (OS). ResultsAmong 170 patients examined, the median tumor depth was 10 mm, and 37 % of the patients were diagnosed with pT3. Overall, 46 % of patients had lymph node metastasis. The median and 5-year OS was 58.2 months and 50 %, respectively. Multivariate analysis revealed tumor size on computed tomography (CT) ≥15 mm and main pancreatic duct (MPD) dilatation (≥3 mm) as independent risk factors for OS among various preoperative parameters; the prognosis was stratified based on these two parameters. Patients with one risk factor had similar outcomes (5-year OS: 39 %) to pStage IIB DCC (pT2N1 or pT3), while those with two risk factors had a prognosis akin to pStage IIIA (pN2), with a high early recurrence rate of 64 % (5-year OS: 8 %). Among non-risk group patients with low carbohydrate antigen (CA)19-9 levels (<37 U/mL), the prognosis was comparable (5-year OS: 72 %) to those with pStage I DCC. ConclusionA simple stratification approach was developed to predict long-term postoperative outcomes. To improve poor prognosis, intensive therapy, including neoadjuvant chemotherapy, should be considered for patients with two risk factors.

Rates and risk factors for failure of reduction in closed reduction in developmental dysplasia of the hip: a systematic review and meta-analysis.

In developmental dysplasia of the hip (DDH), concentric reduction of dislocated hips cannot be achieved by closed reduction in many cases, and open reduction is required ('failure of reduction'). The incidence of cases requiring open reduction and the significance of risk factors for unsuccessful reduction remain unclear. We investigated the overall rate and the risk factors for failed closed reduction in DDH. We followed the Cochrane recommendations in our systematic review and meta-analysis. We performed a systematic search in three medical databases to identify all studies reporting on pediatric patients with hip dislocation in DDH on 2 July 2022. Eligible studies reported on the rate of failure in children younger than 36 months. We calculated odds ratios (ORs) with 95% CIs from two-by-two tables (event rate in risk group, event rate in non-risk group). We identified 13 316 studies and included 62 studies (5281 hips) for failure rate and 34 studies (3810 hips) for risk factor analysis. The overall rate of failure in closed reduction was 20%. The risk of failure of reduction increased with the grade of dislocation and was significantly higher for high dislocations (group 0-24: IHDI 4 vs IHDI 2 OR: 17.45, CI: 9.26-32.92; Tönnis 4 vs Tönnis 2 OR: 14.67, CI: 1.21-177.37; Graf IV vs Graf III OR: 3.4, CI: 2.27-5.09). Male gender was also a significant risk factor (OR: 2.27, CI: 1.13-4.56) in group 0-36. Higher grade dislocations and male gender are significant risk factors for failure of reduction in closed reduction in hip dislocation in DDH.

Gut Microbiota as Predictive Biomarker for Chronic Heart Failure in Patients with Different Nutritional Risk.

To examine the relationship between gut microbiota and disease development in chronic heart failure patients with different nutritional risk. The study analyzed stool samples from 62 CHF patients and 21 healthy peoples using 16S rRNA gene sequencing. CHF patients were separated into risk (n = 30) and non-risk group (n = 32) based on NRS2002 scores. Analysis methods used were LEfSe, random forest regression model, ROC curves, BugBase, PICRUSt2, metagenomeSeq. Risk group includes 11 cases of HFrEF, 6 cases of HFpEF, and 13 cases of HFmrEF. LefSe analysis confirmed that the risk group had higher levels of Enterobacter and Escherichia-Shigella. Correlation analysis revealed a negative correlation between prealbumin and Escherichia-Shigella. The presence of Enterobacter and Escherichia-Shigella worsens intestinal inflammation in CHF patients, impacting lysine metabolism by influencing its degradation metabolic function. This interference further disrupts albumin and prealbumin synthesis, leading to malnutrition in CHF patients and ultimately worsening the disease.

Nontraditional Lipid Parameters as a Predictor of Cardiovascular Disease Risk in Nepalese Women.

The use of nontraditional lipid parameters for assessing clinical conditions is emerging; however, no study has identified thresholds for those parameters for the identification of cardiovascular disease (CVD) risk. The present study aimed to establish the thresholds of nontraditional lipid parameters and test its ability to identify CVD risk factors. A cross-sectional study in women (n = 369, age: 46 ± 13 years, body mass index (BMI): 26.31 ± 2.54 kg/m2) was conducted. Blood samples were collected and high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, total cholesterol (TC), and triglycerides (TGs) were estimated. Subsequently, nontraditional lipid parameters were calculated, namely non-HDL-C, Castelli's Risk Index II (CRI-II), CRI-I, lipoprotein combined index (LCI), atherogenic index (AI), and AI of plasma (AIP). Based on TC (≥200 mg/dL), the derived thresholds for non-HDL-C, CRI-II, CRI-I, LCI, AI, and AIP were 139 mg/dL, 2.29, 3.689, 58,066, 2.687, and 0.487, respectively. Similarly, based on the threshold of TG (≥150 mg/dL), the derived thresholds for non-HDL-C, CRI-II, CRI-I, LCI, AI, and AIP were 127 mg/dL, 2.3, 3.959, 58,251, 2.959, and 0.467, respectively. Out of considered five risk factors, non-HDL-C, CRI-II, CRI-I, LCI, and AI thresholds were capable in identifying four risk factors (physical activity, blood pressure, BMI, and age) and AIP was able to associate with two risk factors at most (blood pressure and BMI). The derived thresholds of nontraditional lipid parameters were capable of differentiating between CVD risk and nonrisk groups suggesting the possible use of these thresholds for studying CVD risk.

Description of Age and Parity with the Occurrence of Sectio Caesarea in Maternity Women in Cilegon City Regional Hospital for the Period July - December 2023

Caesarean section delivery has a 25 times greater risk of death, compared to vaginal delivery. From the research results, it was found that the incidence of Caesarean section delivery in the Cilegon City Regional Hospital for the period July-December 2022 was 153 out of 344 people or (44%). The aim of this research is to determine the description of the age and parity of mothers giving birth and the incidence of caesarean section deliveries in the period July - December 2022. The research method used is descriptive research using simple random sampling techniques. The results of this study show that 42 respondents (54.5%) still found mothers who experienced caesarean section. In the age category, a higher proportion was found in the non-risk age group, 54 people (70.1%). For parity in the at-risk group there were 59 people (76.6%). A higher proportion of mothers who experienced caesarean section occurred in the non-risk group, namely 28 people (52%). The proportion of mothers who experienced caesarean section was higher in the primipara group, 12 people (67%) and in the multipara group, 30 people (51%). Suggestions for educational institutions are that the results of this research can be well documented to be used as a reference source for further research, for health services it is hoped that they will be able to maintain services in accordance with standards, for future researchers they can add variables and broader and more accurate insight.

Patterns of neural activity in response to threatening faces are predictive of autistic traits: modulatory effects of oxytocin receptor genotype

Autistic individuals generally demonstrate impaired emotion recognition but it is unclear whether effects are emotion-specific or influenced by oxytocin receptor (OXTR) genotype. Here we implemented a dimensional approach using an implicit emotion recognition task together with functional MRI in a large cohort of neurotypical adult participants (N = 255, male = 131, aged 17–29 years) to establish associations between autistic traits and neural and behavioral responses to specific face emotions, together with modulatory effects of OXTR genotype. A searchlight-based multivariate pattern analysis (MVPA) revealed an extensive network of frontal, basal ganglia, cingulate and limbic regions exhibiting significant predictability for autistic traits from patterns of responses to angry relative to neutral expression faces. Functional connectivity analyses revealed a genotype interaction (OXTR SNPs rs2254298, rs2268491) for coupling between the orbitofrontal cortex and mid-cingulate during angry expression processing, with a negative association between coupling and autistic traits in the risk-allele group and a positive one in the non-risk allele group. Overall, results indicate extensive emotion-specific associations primarily between patterns of neural responses to angry faces and autistic traits in regions processing motivation, reward and salience but not in early visual processing. Functional connections between these identified regions were not only associated with autistic traits but also influenced by OXTR genotype. Thus, altered patterns of neural responses to threatening faces may be a potential biomarker for autistic symptoms although modulatory influences of OXTR genotype need to be taken into account.

Driving and mobile phone use: Work addiction predicts hazardous but not excessive mobile phone use in a longitudinal study of young adults.

Work addiction (WA), characterized by dimensions such as overcommitment, difficulties in detachment from work, and work-life imbalance, is presumed to be associated with increased smartphone usage, even during risky activities like driving. The study investigated the connection between WA and future problematic and hazardous smartphone use, considering personality factors: anxiety, rumination, and worry. A three-wave longitudinal study (N=1,866) was conducted from March to July 2019, June to September 2020, and June to November 2021, involving a representative sample of 18-34-year-old residents in Hungary's capital. The study employed Hungarian versions of the Bergen Work Addiction Scale, Problematic Mobile Phone Use Questionnaire, Ruminative Response Scale, Anxiety subscale of the Brief Symptom Inventory 18, and Penn-State Worry Questionnaire. Additionally, author-developed questions on mobile phone use while driving were included. At baseline, those at risk for WA showed more frequent mobile phone use while driving at both time points 2 and 3 compared to the non-risk group. Path analyses revealed rumination, anxiety at time 1, and worry at time 2 as significant mediators between baseline WA and mobile phone use while driving at time 3. However, when analyzing all three mediators together, only anxiety at time 1 and worry at time 2 remained significant. This study demonstrates that WA predicts future mobile phone use while driving through mediation by anxiety and worry. Our findings add to the growing evidence highlighting the detrimental aspects of WA, emphasizing the need for improved prevention and treatment strategies.

Identifying disparities in Mental Illness and Well-Being across Non-Risk, Risk, and Intersectional Groups during COVID-19 and the Sociodemographic's Role in Mental Health Outcomes.

Few pandemic studies explored positive aspects of mental health and employed an intersectional perspective, which considers the concomitant action of different risk conditions. Our intersectional investigation aimed to identify possible mental illness and well-being differences between groups identified as psychologically vulnerable in the pandemic by the WHO (immigrants, minorities, and people with psychiatric diagnoses) and people without pre-existing risk factors while controlling for sociodemographic variables. A cross-sectional survey involved 1,134 participants (76.1% women) aged 18 to 76. We utilized the Depression, Anxiety, and Stress Scales (DASS-21) for mental disorder assessment and the Life Satisfaction and Positive and Negative Affects Scales for well-being evaluation. Since a variable-centered approach, multivariate analysis revealed significant differences between the groups in the variables of mental health, depression [F(2.1131)=72.7, p<.001], anxiety [F(2.1131)=78.0, p<.001], stress [F(2.11 1)=85.9, p<.001], and subjective well-being [F(2.1131)=53.6, p<.001]. The groups also differed when we employed a person-centered approach to analyze the variables jointly using Latent Profile Analysis. We identified six mental profiles composed of different levels of depression, anxiety, stress, and well-being. Risk and intersectional groups were more likely to be characterized by Generalized Suffering [ORrisk=0.85, ORintersec=0.93] and Profound Anguish [ORrisk&intersec=0.97] profiles. Control of demographic variables indicated that mental health disparities were partially attributed to participant risk conditions.

Public Heterogeneous Preferences for Low-Dose Computed Tomography Lung Cancer Screening Service Delivery in Western China: A Discrete Choice Experiment.

Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is an efficient method that can reduce lung cancer mortality in high-risk individuals. However, few studies have attempted to measure the preferences for LDCT LCS service delivery. This study aimed to generate quantitative information on the Chinese population's preferences for LDCT LCS service delivery. The general population aged 40 to 74 in the Sichuan province of China was invited to complete an online discrete choice experiment (DCE). The DCE required participants to answer 14 discrete choice questions comprising five attributes: facility levels, facility ownership, travel mode, travel time, and out-of-pocket cost. Choice data were analyzed using mixed logit and latent class logit (LCL) models. The study included 2529 respondents, with 746 (29.5%) identified as being at risk for lung cancer. Mixed logit model (MLM) analysis revealed that all five attributes significantly influenced respondents' choices. Facility levels had the highest relative importance (44.4%), followed by facility ownership (28.1%), while out-of-pocket cost had the lowest importance (6.4%). The at-risk group placed relatively more importance on price and facility ownership compared to the non-risk group. LCL model identified five distinct classes with varying preferences. This study revealed significant heterogeneity in preferences for LCS service attributes among the Chinese population, with facility level and facility ownership being the most important factors. The findings underscore the need for tailored strategies targeting different subgroup preferences to increase screening participation rates and improve early detection outcomes.

Relationship Between Ante Natal Care As A Health Education Approach And Incidence Of Hypertension (Gestational Hypertension) Among Pregnant Women

This study aims to determine the relationship between antenatal care (ANC) education approach and the incidence of hypertension in pregnant women. This study used a descriptive method to understand the relationship between the ante natal care as a health education approach and the incidence of hypertension in pregnant women. Samples were randomly taken on pregnant women who visited Antenatal Care in Leuwiliang district with a correlation formula as a minimal calculation. Eighty-seven subjects were included, and blood pressure measurements were carried out following the SOP for blood pressure measurement with description analysis and analysis of the relationship between hypertension events with ANC visits and gestational age. The highest variable of antenatal care visits in incomplete visits was 66 pregnant women (66.0%). Pregnant women who have the most hypertension status were 55 pregnant women (55.0%). The most hypertension in the group was not at risk as much as 46%. The highest percentage were mothers whose antenatal care visits were incomplete and hypertension was 44%. The lowest percentage is mothers with complete antenatal care visits and normal hypertension which was 8%. There was an incidence of hypertension in the non-risk group and ANC visits and showed the presence of hypertension in the incomplete ANC visit group. Thus, educational approaches and efforts to increase awareness of pregnant women in ANC need to be improved

A health risk information strategy to change perceptions of objective health risks for physical inactivity among sedentary women

IntroductionThe present study investigated the effects of a health risk information strategy on changes in perceptions of objective health risks associated with physical inactivity among sedentary women. Materials and methodsThirty-eight women participated in the 12-week health risk information intervention as a strategy for strengthening the effect of health risk information on risk perception. During this period, the study participants’ objective risk factors (BMI, waist circumference, C-reactive protein, glucose, and insulin) and risk perceptions were measured. A repeated measures ANOVA was performed to examine the effects of the intervention on perceptions of objective health risks. ResultsResults indicated that the health risk information strategy was substantially effective to enhance health risk perception toward heart disease and obesity over the 12-week intervention. In addition, among the objective risk factors waist circumference was a significant factor in all physical-inactivity related diseases (heart disease, obesity, and diabetes) between the risk and non-risk groups. ConclusionThe current study suggests that the physical inactivity-related health risk information is an effective intervention strategy to change health risk perception associated with physical inactivity, which in turn, may actually reduce diseases caused by physical inactivity.

Altered Gut Microbiota Composition Is Associated with Difficulty in Explicit Emotion Regulation in Young Children.

Executive function (EF) consists of explicit emotion regulation (EER) and cognitive control (CC). Childhood EER in particular predicts mental and physical health in adulthood. Identifying factors affecting EER development has implications for lifelong physical and mental health. Gut microbiota (GM) has attracted attention as a potential biomarker for risk of physical and mental problems in adulthood. Furthermore, GM is related to brain function/structure, which plays a crucial role in emotional processing. However, little is known about how GM compositions are associated with the development of emotion regulation in early childhood. Therefore, in this study, we examined 257 children aged 3-4 to investigate links between GM and risk to EF. EF was measured using the Mother-Reported Behavior Rating Inventory of Executive Function-Preschool version. GM composition (alpha/beta diversity and genus abundance) was evaluated using 16S rRNA gene sequencing and compared between EF-risk and non-risk groups. Our results show that children with EER-risk (an index of inhibitory self-control) had a higher abundance of the genera Actinomyces and Sutterella. Although we have not established a direct link between GM and CC risk, our findings indicate that GM of preschoolers is closely associated with emotional processing and that EERrisk children have more inflammation-related bacteria.

Sociodemographic disparities affect COVID-19 vaccine uptake in non-elderly adults with increased risk of severe COVID-19.

There is limited information about sociodemographic disparities in COVID-19 vaccine uptake among non-elderly adults with an increased risk of severe COVID-19. We investigated the COVID-19 vaccine uptake in individuals aged 18-64 years with an increased risk of severe COVID-19 (non-elderly risk group) in Stockholm County, Sweden. We used population-based health and sociodemographic registries with high coverage to perform a cohort study of COVID-19 vaccine uptake of one to four doses up until 21 November 2022. The vaccine uptake in the non-elderly risk group was compared with non-risk groups aged 18-64 years (non-elderly non-risk group) and individuals aged ≥65 years (elderly). The uptake of ≥3 vaccine doses was 55%, 64% and 87% in the non-elderly non-risk group (n=1,005,182), non-elderly risk group (n=308,904) and elderly (n=422,604), respectively. Among non-elderly risk group conditions, Down syndrome showed the strongest positive association with receiving three doses (adjusted risk ratio [aRR] 1.62, 95% confidence interval [CI] 1.54-1.71), whereas chronic liver disease showed the strongest negative association (aRR 0.90, 95% CI 0.88-0.92). Higher vaccine uptake among the non-elderly risk group was associated with increasing age, being born in Sweden, higher education, higher income and living in a household where other adults had been vaccinated. Similar trends were observed for the first, second, third and fourth doses. These results call for measures to tackle sociodemographic disparities in vaccination programmes during and beyond the COVID-19 pandemic.

The number of metabolic syndrome risk factors predicts alterations in gut microbiota in Chinese children from the Huantai study

BackgroundEvidence on the effect of gut microbiota on the number of metabolic syndrome (MetS) risk factors among children is scarce. We aimed to examine the alterations of gut microbiota with different numbers of MetS risk factors among children.MethodsData were collected from a nested case–control study at the baseline of the Huantai Childhood Cardiovascular Health Cohort Study in Zibo, China. We compared the differences in gut microbiota based on 16S rRNA gene sequencing among 72 children with different numbers of MetS risk factors matched by age and sex (i.e., none, one, and two-or-more MetS risk factors; 24 children for each group).ResultsThe community richness (i.e., the total number of species in the community) and diversity (i.e., the richness and evenness of species in the community) of gut microbiota decreased with an increased number of MetS risk factors in children (P for trend < 0.05). Among genera with a relative abundance greater than 0.01%, the relative abundance of Lachnoclostridium (PFDR = 0.009) increased in the MetS risk groups, whereas Alistipes (PFDR < 0.001) and Lachnospiraceae_NK4A136_group (PFDR = 0.043) decreased in the MetS risk groups compared to the non-risk group. The genus Christensenellaceae_R-7_group excelled at distinguishing one and two-or-more risk groups from the non-risk group (area under the ROC curve [AUC]: 0.84 − 0.92), while the genera Family_XIII_AD3011_group (AUC: 0.73 − 0.91) and Lachnoclostridium (AUC: 0.77 − 0.80) performed moderate abilities in identifying none, one, and two-or-more MetS risk factors in children.ConclusionsBased on the nested case–control study and the 16S rRNA gene sequencing technology, we found that dysbiosis of gut microbiota, particularly for the genera Christensenellaceae_R-7_group, Family_XIII_AD3011_group, and Lachnoclostridium may contribute to the early detection and the accumulation of MetS risk factors in childhood.

Evaluation of a new digital pediatric malnutrition risk screening tool for hospitalized children with congenital heart disease

BackgroundIn a cohort of hospitalized children with congenital heart disease (CHD), a new digital pediatric malnutrition screening tool as a mobile application was validated, and its effectiveness and clinical value were determined as a prospective study.Methods and resultsChildren with CHD (n = 1125) were screened for malnutrition risk. The incidence of risk and the differences among various age groups and types of CHD were characterized. The optimal threshold for the tool to determine if there is a risk of malnutrition is score 2, while the Youden index was 79.1%, and the sensitivity and specificity were 91.2% and 87.9%, respectively. Based on such criterion, 351 children were at risk of malnutrition accounting for 31.20% of the total. Compared with the non-malnutritional risk group, the median age for the group at risk for malnutrition was younger (8.641 months [4.8, 23.1] vs. 31.589 months [12.4, 54.3], P < 0.01), and the length of stay was longer (12.000 [8.0, 17.0] vs. (8.420 [5.0, 12.0], P < 0.01]. There were significant differences in malnutrition risk among different age groups (χ2 = 144.933, P < 0.01), and children under one year of age exhibited the highest risk for malnutrition and more extended hospital stay (H = 78.085, P < 0.01). The risk of malnutrition among children with cyanotic CHD was higher than in those with non-cyanotic CHD (χ2 = 104.384, P < 0.01).ConclusionsThe new digital pediatric malnutrition screening tool showed high sensitivity and specificity in children with CHD. The tool indicated that the malnutrition risk for young children and children with cyanotic or Bethesda moderate and complex CHD was higher, and the hospitalization time was longer than in the non-risk group. The tool provides a rational approach to targeted nutrition intervention and support and may improve clinical outcomes.

Malnutrition: A risk factor for vascular access problems.

Vascular access problems are leading causes of morbidity, hospitalization, and impaired quality of life in chronic hemodialysis patients. Native arteriovenous fistula is the gold standard of vascular access. Geriatric nutritional risk index (GNRI), has recently been shown to be an easy and objective instrument for assessing nutritional status in these patient groups. Considering the association between arteria-venous fistula patency and inflammation, as well as the fact that inflammation is a component of malnutrition, the objective of this study was to determine the relation of malnutrition identified by GNRI with fistula patency. This is a single-center, retrospective, observational study. Hemodialysis patients with AVF were included in the research. Preoperative and postoperative GNRI values were computed and laboratory data were recorded. The patients were analyzed in two groups as the ones without thrombosis history (Group 1) and with thrombosis history (Group 2). According to GNRI, patients were investigated in four groups: G0 (non-risk group, >98), G1 (low risk, 92-98), G2 (moderate risk, 82-91), and G3 (high risk, 82). Of the 331 patients, 60.1% (199) were male and the average age was 55 ± 15 years. Preoperative GNRI levels were significantly higher in group 1. In correlation analysis, patency time was positively correlated with preoperative GNRI values. Among the preoperative GNRI groups, the G3 group had a patency duration of 6 months (4.9-7.04), whereas the G0 group had a patency length of 37.59 (35.5-39.65) months. By linear regression analysis, preoperative GNRI and postoperative albumin level were determined to be the significant indicators of patency time. GNRI a new tool for detecting malnutrition was strongly associated with fistula patency in hemodialysis patients. Detection of malnutrition before fistula operation may be helpful for the future follow up of the patients in terms of fistula patency.

Emotional and intuitive eating: an emerging approach to eating behaviours related to obesity.

Emotional and intuitive eating are associated with obesity. In the present study, it was aimed to evaluate the relationship between intuitive eating and emotional eating behaviours in adults with anthropometric measurements of obesity-related disease risk and gender. Body weight, body mass index (BMI), waist, hip and neck circumferences were taken. Emotional Eater Questionnaire and Intuitive Eating Scale-2 were used for the assessment of eating behaviour. A total of 3742 adult individuals (56⋅8% (n 2125) female and (n 1617) male) were participated voluntarily. The total score and subscales of EEQ were higher in females than males (P < 0⋅001). The scores of the IES-2 subscales and the total score were higher in males than females (P < 0⋅05). In metabolic risk classification according to waist and neck circumference, EEQ scale scores (except type of food) were higher in the metabolic risk group, while IES-2 (except body-food congruence in neck circumference) scores were higher in the non-risk group (P < 0⋅05). While there was a positive correlation between EEQ and body weight, BMI, waist circumference, waist-height ratio, a negative correlation was found between age and waist-hip ratio. There was a negative correlation between IES-2 and body weight, BMI, waist-height ratio, waist-hip ratio. In addition, a negative correlation was found between IES-2 and EEQ. Intuitive eating and emotional eating differ by gender. Anthropometric measures and metabolic disease risk is associated with emotional eating and intuitive eating. Interventions to increase intuitive and decreasing emotional eating behaviour can be effective in preventing both obesity and obesity-related diseases.