Reduce Risk Factors Research Articles

Evaluation of the Transmission Rate, the Mortality Rate, and the Level of Endemicity Due to Visceral Leishmaniasis at Marsabit County Referral Hospital

The disease Visceral leishmaniasis is a tropical infection spread by female sandflies. This leishmaniasis affects the spleen, the liver, and bone marrow. Globally, between 0.7 million and 1 million cases of visceral leishmaniasis arise yearly. In Kenya, 4000 cases are reported yearly, while 5 million individuals are at risk of infection. If untreated, the visceral leishmaniasis death rate is more than 95%. The study aims to evaluate the mortality and the transmission rate among visceral leishmaniasis patients referred to the Marsabit County referral hospital. The study adopted a retrospective cohort design. The study used secondary data obtained from the Marsabit County referral hospital. The Susceptible, Infected, and Recovered (S.I.R) Model, was incorporated to evaluate the mortality rate, the transmission rate, and the level of endemicity. The findings revealed that the mortality rate, the transmission rate, and the level of endemicity were estimated at 13.19%, 13.67%, and 0.0141, respectively. In conclusion, the mortality rate increases as the transmission rate increase and there is a need for urgent responses from health personnel to reduce the transmission rate to reduce subsequent morbidity and mortality. The study recommended adopting the following measures; the mortality rate was 13.19%, and the prevalence of the disease was higher in males than among females which subsequently increases mortality among males therefore, there is a need to put more attention to males when creating awareness. The transmission rate was 13.67%, this rate can be reduced by reducing risk factors that are responsible for the transmission of visceral leishmaniasis. Creating awareness at the community level and seeking medication on time to reduce mortality from visceral leishmaniasis in Marsabit County.

Impact of educational attainment on preventive efforts after myocardial infarction: results of the IPP and NET-IPP trials.

Educational attainment might impact secondary prevention after myocardial infarction (MI). The purpose of the present study was to compare the rate of risk factors and the efficacy of an intensive prevention program (IPP), performed by prevention assistants and supervised by physicians, in patients with MI and different levels of education. In this post hoc analysis of the multicenter IPP and NET-IPP trials, patients with MI were stratified into two groups according to educational attainment: no "Abitur" (no A) vs. "Abitur" or university degree (AUD). The groups were compared at the time of index MI and after 12-month IPP vs. usual care. Out of n = 462 patients with MI, 76.0% had no A and 24.0% had AUD. At the time of index, MI rates of obesity (OR 2.4; 95%CI 1.4-4.0), smoking (OR 2.2, 95%CI 1.4-3.6), and physical inactivity (OR 1.6; 95%CI 1.0-2.5) were significantly elevated in patients with no A. At 12months after index MI, larger improvements of the risk factors smoking and physical inactivity were observed in patients with IPP and no A than in patients with IPP and AUD or with usual care. LDL cholesterol levels were reduced by IPP compared to usual care, with no difference between no A vs. AUD. A matched-pair analysis revealed that high baseline risk was an important reason for the large risk factor reductions in patients with IPP and no A. The study demonstrates that patients with MI and lower educational level have an increased rate of lifestyle-related risk factors and a 12-month IPP, which is primarily performed by non-physician prevention assistants, is effective to improve prevention in this high-risk cohort.

Burden of illness, risk factor and physical activity in cardiovascular disease- A review

Cardiovascular illness encompasses a group of diseases affecting the blood vessels and the structure of the heart, and it remains one of the most prevalent non-communicable diseases worldwide. Over the years, the rate of death from cardiovascular diseases has shown a significant decline in several high-income countries, primarily due to reductions in risk factors and advancements in cardiovascular disease management. Nonetheless, the global burden of cardiovascular diseases remains substantial, with an estimated 55 million deaths occurring in 2017, out of which 17.7 million were attributed to cardiovascular disease. The focus of this review is to explore the burden of illness, risk factors, and physical activity levels in populations affected by cardiovascular diseases. Studies have identified 14 potentially modifiable risk factors that were strongly associated with cardiovascular disease and mortality, surpassing the significance of body mass index (BMI), as evidenced by the PURE (Prospective Urban and Rural Epidemiology) study and prior research. While cardiovascular deaths have decreased in several developed countries, there has been a significant increase in low- and middle-income countries. Physical activity has emerged as a critical factor in reducing the risk of mortality and major cardiovascular events, regardless of the type of physical activity and other risk factors. The Physical Activity Guidelines (PAG) for Americans in 2008 recommended a range of moderate and vigorous physical activity and highlighted its inverse association with all-cause mortality, cardiovascular disease mortality, and incident CVD. Emphasizing the importance of physical activity, this low-cost approach holds tremendous potential in reducing deaths and cardiovascular diseases on a global scale. Overall, this review highlights the ongoing global challenge of cardiovascular diseases and underscores the importance of preventive measures, including promoting physical activity, to improve cardiovascular health and reduce the burden of illness worldwide.

Assessing the Effectiveness of mHealth Interventions for Diabetes and Hypertension Management in Africa: Systematic Review and Meta-Analysis.

Mobile health (mHealth) interventions are effective in improving chronic disease management, mainly in high-income countries. However, less is known about the efficacy of mHealth interventions for the reduction of cardiovascular risk factors, including for hypertension and diabetes, which are rapidly increasing in low- and middle-income countries. This study aimed to assess the efficacy of mHealth interventions for diabetes and hypertension management in Africa. We searched PubMed, Cochrane Library, Google Scholar, African Journals Online, and Web of Science for relevant studies published from inception to July 2022. The main outcomes of interest were changes in hemoglobin A1c (HbA1c), systolic blood pressure, and diastolic blood pressure. The random or fixed effect model was used for the meta-analysis, and the I2 statistic was used to gauge study heterogeneity. Z tests and P values were used to evaluate the effect of mHealth interventions on HbA1c and blood pressure levels. This review included 7 studies (randomized controlled trials) with a total of 2249 participants. Two studies assessed the effect of mHealth on glycemic control, and 5 studies assessed the effect of mHealth on blood pressure control. The use of mHealth interventions was not associated with significant reductions in HbA1c levels (weighted mean difference [WMD] 0.20, 95% CI -0.40 to 0.80; P=.51) among patients with diabetes and systolic blood pressure (WMD -1.39, 95% CI -4.46 to 1.68; P=.37) and diastolic blood pressure (WMD 0.36, 95% CI -1.37 to 2.05; P=.69) among patients with hypertension. After conducting sensitivity analyses using the leave-one-out method, the Kingue et al study had an impact on the intervention, resulting in a 2 mm Hg reduction in systolic blood pressure (WMD -2.22, 95% CI -3.94 to -0.60; P=.01) but was nonsignificant for diastolic blood pressure and HbA1c levels after omitting the study. Our review provided no conclusive evidence for the effectiveness of mHealth interventions in reducing blood pressure and glycemic control in Africa among persons with diabetes and hypertension. To confirm these findings, larger randomized controlled trials are required.

Model of Strengthening Health Literacy and Prevention of Hypertension Based on Family Independence

Abstract
 Hypertension is often referred to as the silent killer because it is a deadly disease accompanied by early symptoms for people with hypertension. The prevalence of hypertension continues to increase sharply and it is predicted by 2025 as many as 29% of adults, but the tendency to do prevention independently is still low. Prevention of hypertension can’t be separated from the risk factors that exist in the family, including an unhealthy lifestyle. Family involvement in early detection needs to develop and modified so that every family member can reduce risk factors. The brief background of the topic and significance of the study. This study aims to collect information on the family of ability in health literacy as a solution to increase family independence in preventing hypertension. This study is used for research and development (R&D), which is the first of 3 research stages planned to be completed in 3 years. The research design was cross-sectional. The study was conducted on families in Bangkalan Regency with a sample of 150 people from 4 sub-districts representing mountainous, urban, rural, and coastal areas, namely Bangkalan, Kedundung, Sukolilo, and Kokop sub-districts taken by random cluster sampling. Data was collected using questionnaires and analyzed using Partial Least Square Path Modeling. This study has obtained ethically appropriate information through the Research Ethics Committee of the Health Polytechnic of the Ministry of Health Surabaya with the number EA/940/KEPK-Poltekkes Sby/V/2022. The results show that the demographic characteristics of the family have an effect on health literacy in preventing hypertension. Families with good health literacy can increase independence in preventing hypertension. Families who achieve a high level of independence will be able to prevent hypertension. The use of digital literacy can be a solution to improve people's health literacy skills. Materials from health literacy are made simpler but right on target. Supported by more complex forms of communication such as interactive video. Application usage to advance the knowledge of patients' hypertension can increase the independence of hypertension.

Therapeutic Carbohydrate Restriction as a Metabolic Modality for the Prevention and Treatment of Abnormal Uterine Bleeding.

Therapeutic carbohydrate restriction diets have been becoming increasingly popular over the years, resulting in dramatic weight loss and an improvement in metabolic disorders. Obesity, insulin resistance, and diabetes are the risk factors for many gynecologic morbidities such as uterine leiomyoma, endometrial polyps, and polycystic ovarian syndrome. There is evidence suggesting that the pathogenesis of cardiovascular disease is similar to that seen in many causes of abnormal uterine bleeding. We aim to explain how cardiovascular disease risk factor reduction with the use of therapeutic carbohydrate restriction may prevent and potentially treat these gynecologic disorders.

(-)-Epicatechin Inhibits Metastatic-Associated Proliferation, Migration, and Invasion of Murine Breast Cancer Cells In Vitro.

Breast cancer, due to its high incidence and mortality, is a public health problem worldwide. Current chemotherapy uses non-specific cytotoxic drugs, which inhibit tumor growth but cause significant adverse effects. (-)-Epicatechin (EC) is part of a large family of biomolecules called flavonoids. It is widely distributed in the plant kingdom; it can be found in green tea, grapes, and cocoa. Several studies in animals and humans have shown that EC induces beneficial effects in the skeletal muscle and the cardiovascular system, reducing risk factors such as arterial hypertension, endothelial dysfunction, damage to skeletal muscle structure, and mitochondrial malfunction by promoting mitochondrial biogenesis, with no adverse effects reported. Recently, we reported that EC had an antitumor effect in a murine triple-negative mammary gland tumor model, decreasing tumoral size and volume and increasing survival by 44%. This work aimed to characterize the effects of flavanol EC on proliferation, migration, and metastasis markers of triple-negative murine breast (4T1) cancer cells in culture. We found proliferation diminished and Bax/Bcl2 ratio increased. When the migration of culture cells was evaluated, we observed a significant reduction in migration. Also, the relative expression of the genes associated with metastasis, Cdh1, Mtss1, Pten, Bmrs, Fat1, and Smad4, was increased. In conclusion, these results contribute to understanding molecular mechanisms activated by EC that can inhibit metastatic-associated proliferation, migration, and invasion of murine breast cancer cells.

Pre-stroke exercise does not reduce atrophy in healthy young adult mice

Stroke is the main cause of acquired disability in adults. Exercise reduces the risk for stroke and protects against functional loss after stroke. An exercise-induced reduction in key risk factors probably contributes to the protective effect, but direct effects on the brain may also contribute to stroke protection. We previously reported that exercise increases angiogenesis and neurogenesis through activation of the lactate receptor HCA1. Here we exposed young adult wild-type mice and HCA1 knockout mice to interval exercise at high or medium intensity, or to intraperitoneal injections of L-lactate or saline for seven weeks before we induced experimental stroke by permanent occlusion of the distal medial cerebral artery (dMCA). The resulting cortical atrophy measured three weeks after stroke was unaffected by exercise or L-lactate pre-treatments, and independent of HCA1 activation. Our results suggest that the beneficial effect of exercise prior to stroke where no reperfusion occurs is limited in individuals who do not carry risk factors.

Diabetes risk prediction model based on community follow-up data using machine learning

Diabetes is a chronic metabolic disease characterized by hyperglycemia, the follow-up management of diabetes patients is mostly in the community, but the relationship between key lifestyle indicators in community follow-up and the risk of diabetes is unclear. In order to explore the association between key life characteristic indicators of community follow-up and the risk of diabetes, 252,176 follow-up records of people with diabetes patients from 2016 to 2023 were obtained from Haizhu District, Guangzhou. According to the follow-up data, the key life characteristic indicators that affect diabetes are determined, and the optimal feature subset is obtained through feature selection technology to accurately assess the risk of diabetes. A diabetes risk assessment model based on a random forest classifier was designed, which used optimal feature parameter selection and algorithm model comparison, with an accuracy of 91.24% and an AUC corresponding to the ROC curve of 97%. In order to improve the applicability of the model in clinical and real life, a diabetes risk score card was designed and tested using the original data, the accuracy was 95.15%, and the model reliability was high. The diabetes risk prediction model based on community follow-up big data mining can be used for large-scale risk screening and early warning by community doctors based on patient follow-up data, further promoting diabetes prevention and control strategies, and can also be used for wearable devices or intelligent biosensors for individual patient self examination, in order to improve lifestyle and reduce risk factor levels.

Awareness About Risk Factors, Signs and Symptoms of Cardiovascular Diseases and the Perceived Level of Physical Activity along with Sedentary Behaviour in Young Adults of Pune Region: A Questionnaire Based Study

Background: Cardiovascular diseases (CVDs) are the leading cause of death globally. Young adults are more inclined towards unhealthy lifestyle habits, in turn leading to increased risk of developing CVDs. Identifying the level of awareness about CVDs risk factors and signs and symptoms along with their physical activity and sedentary behaviour will help in creating awareness which in turn might help in reduction of the modifiable CVD risk factors. Objective: To assess awareness and knowledge about risk factors, signs and symptoms of CVDs in young adults of Pune region along with evaluating their perceived level of physical activity and sedentary behaviour. Method: A questionnaire was designed to address all the components. Face validation of the questionnaire was done. Participants were explained in detail about the study purpose and the procedure; post their informed consent questionnaire was administered on an interview basis. Responses analysed using SPSS software and represented as descriptive statistics. Result: Total 115 participants were included in the study, with the mean age 21.94±2.26 years. 68 % of the study participants denied gender predisposition and 12% of participants were not sure about it as a risk factor.69% of the participants had 3-5; whereas 31% had 1-2 modifiable risk factors. Sedentary behaviour was the most prevalent risk factor present in 96.5% of the study participants, followed by physical inactivity in 65.2% of participants. None of the participants met WHO guidelines of healthy diet for adults.55% of the participants perceived to have fair level of awareness. Only 11.30% of the participants perceived to have good level of physical activity. However, 65% of the participants were physically inactive. Sedentary behaviour was found to be 10.8±2.86 hour on a typical day. Conclusion: In our study, participants had good knowledge and awareness about the risk factors and signs and symptoms of cardiovascular diseases except for few factors. Majority of participants perceived that they have fair levels of physical activity but more than half of the study participants failed to meet recommended criteria. Majority of our study participants already possessed three to five modifiable risk factors with unhealthy diet, sedentary behaviour and physical inactivity being at top of the list. They are also engaged in high sedentary behaviour. KEY WORDS: Non communicable diseases, Cardiovascular diseases, Physical activity, Risk factors, Signs and symptoms, Sedentary behaviour, Awareness, Knowledge, Perceived levels.

Shimpai Muyou: Confronting Child Suicides in Japan through a Serious Game & School-based Intervention

School bullying is responsible for a large number of child suicides in Japan. Serious games have proved to be effective and highly motivational educational tools capable of increasing awareness, changing behaviour, reduce risk factors and even improving protective skills. This paper presents a novel approach of using both participatory design and gameplay to sensitize children (aged 7–12​ years old) on bullying victimization. Action research strategy is used with intentions to improve the quality of school life in Japan through the use of a serious game called Shimpai Muyou. What makes it stand out from the rest of the crowd is that the entire intervention was design, developed and evaluated through partnering with children in a school setting. The research is largely qualitative and exploratory in nature, stemmed from interdisciplinary core ideas related to technology, education, psychology and interactive theatre. Findings from both formative and summative evaluations indicated that child-users empathically engaged with the synthetic characters, attributing a range of emotions to their actions e.g., empathy, compassion, sadness, anger etc., tackling ethical dilemmas and bullying situations with confidence. From these results, we can conclude that Shimpai Muyou is a useful and engaging school-based anti-bullying intervention.

Extrauterine Growth Retardation—Incidence, Risk Factors, and Prediction Model in Tertiary Care Neonatal Intensive Care Unit in North India

Background With the increasing survival of preterm infants, their nutrition becomes an enormous challenge. Adequate nutrition plays an important role in good neurodevelopmental outcomes. Extrauterine growth retardation (EUGR) is defined as discharge weight below 10th percentile of the weight expected for that gestation after plotting on postnatal growth charts. Aims and Objective This study was conducted to assess the incidence of EUGR in preterm babies and its associated risk factors. Material and Methods This was a retrospective medical chart review of neonates admitted from January 2017 to November 2021 to a level III Neonatal Intensive Care Unit in Delhi, India. Eligible neonates were all preterm babies born at <35 completed weeks’ gestation admitted in NICU within 24 hours of birth and survived for at least 7 days. Neonates who died during hospitalization or were born with a major congenital anomaly requiring surgery in immediate neonatal period or with any genetic syndrome were excluded. Results A total of 250 babies were enrolled in the study, out of which 45.2% neonates were EUGR. Factors significantly associated with EUGR status were long duration of hospital stay, lower birth weight, small for gestational age (SGA) at birth, male sex, persistent ductus arteriosus, sepsis, broncho-pulmonary dysplasia, use of total parenteral nutrition, long duration of mechanical ventilation, longer time to reach full feeds, and interruption of feeds. SGA was associated with highest odds of developing EUGR [OR-80.45 (16.96-1441.09), P<0.001 followed by use of TPN [OR-2.86 (1.61-5.08), p<0.001]. Risk of EUGR increased manifold as the number of risk factors increased. Future plans Strategies for prevention of EUGR should focus on prevention of various neonatal morbidities and risk factor reduction during the hospital stay.

Management of Obesity-Related Inflammatory and Cardiovascular Diseases by Medicinal Plants: From Traditional Uses to Therapeutic Targets.

Inflammation is a crucial factor in the development and progression of cardiovascular diseases (CVD). Cardiac remodeling in the presence of persistent inflammation leads to myocardial fibrosis and extracellular matrix changes, which reduce cardiac function, induce arrhythmias, and finally, cause heart failure. The majority of current CVD treatment plans concentrate on reducing risk factors such as hyperlipidemia, type 2 diabetes, and hypertension. One such strategy could be inflammation reduction. Numerous in vitro, animal, and clinical studies indicate that obesity is associated with low-grade inflammation. Recent studies have demonstrated the potential of medicinal plants and phytochemicals to cure and prevent obesity and inflammation. In comparison to conventional therapies, the synergistic effects of several phytochemicals boost their bioavailability and impact numerous cellular and molecular targets. Focusing on appetite, pancreatic lipase activity, thermogenesis, lipid metabolism, lipolysis and adipogenesis, apoptosis in adipocytes, and adipocyte life cycle by medicinal plants and phytochemicals represent an important goal in the development of new anti-obesity drugs. We conducted an extensive review of the literature and electronic databases, including Google Scholar, PubMed, Science Direct, and MedlinePlus, for collecting data on the therapeutic effects of medicinal plants/phytochemicals in curing obesity and its related inflammation and CVD diseases, including cellular and molecular mechanisms, cytokines, signal transduction cascades, and clinical trials.

Effectiveness of a Health Education Program in Hypertensive Patients with Dyslipidemia and/or Microalbuminuria: A Quasi-Experimental Study in Vinh Long Province, Vietnam.

Hypertension, a major health concern, is associated with significant mortality and disease burden worldwide, including Vietnam. Comprehensive interventions targeting medication, lifestyle modifications, dyslipidemia (DLP), and microalbuminuria (MAU) are vital for effective hypertension management and reducing the risk of cardiovascular disease complications (CDV). While medication interventions have proven efficacy, the evidence regarding the effectiveness of community-based health education interventions in managing DLP and MAU is limited. Therefore, this study aims to evaluate the effectiveness of community health education interventions in reducing hypertension risk factors and achieving hypertension management objectives, as well as managing DLP and MAU among hypertension patients. A quasi-experimental study was conducted on 330 hypertensive patients with dyslipidemia (DLP) and/or microalbuminuria (MAU) who were divided into a control group (n = 164) and an intervention group (n = 166). The control group received standard national hypertension management, while the intervention group received additional intensive health education provided by trained volunteers. The effectiveness of the intervention was assessed by comparing outcomes such as lifestyle factors, BMI control, treatment adherence, hypertension control, and DLP and MAU status between the two groups before and after a two-year intervention period. The health education intervention resulted in significant reductions in dietary risk factors, specifically in fruit and vegetable consumption (p < 0.001). There was a lower prevalence of high salt intake in the intervention group compared to the control group (p = 0.002), while no significant differences were observed in other dietary factors. Smoking habits and low physical activity significantly decreased in the intervention group, with a notable disparity in physical activity proportions (p < 0.001). Both groups showed significant improvements in achieving hypertension management targets, with the intervention group demonstrating superior outcomes. The intervention was effective in reducing the prevalence of risk factors, particularly treatment non-adherence, blood pressure control, and low physical activity. Additionally, the intervention group had a higher likelihood of achieving DLP and MAU control compared to the control group. This study underscored the additional positive impact of incorporating health education by non-professional educators in achieving favorable outcomes, including better control of BMI, blood pressure, medication adherence, and management of dyslipidemia (DLP) and microalbuminuria (MAU). Further research is warranted to fully explore the potential of health education in primary healthcare settings and maximize its effectiveness.

Gender disparities in lung cancer incidence in the United States during 2001–2019

Lung cancer ranks as one of the top malignancies and the leading cause of cancer death in both males and females in the US. Using a cancer database covering the entire population, this study was to determine the gender disparities in lung cancer incidence during 2001–2019. Cancer patients were obtained from the National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology and End Results (SEER) database. The SEER*Stat software was applied to calculate the age-adjusted incidence rates (AAIR). Temporal changes in lung cancer incidence were analyzed by the Joinpoint software. A total of 4,086,432 patients (53.3% of males) were diagnosed with lung cancer. Among them, 52.1% were 70 years or older, 82.7% non-Hispanic white, 39.7% from the South, and 72.6% non-small cell lung cancer (NSCLC). The AAIR of lung cancer continuously reduced from 91.0 per 100000 to 59.2 in males during the study period, while it increased from 55.0 in 2001 to 56.8 in 2006 in females, then decreased to 48.1 in 2019. The female to male incidence rate ratio of lung cancer continuously increased from 2001 to 2019. Gender disparities were observed among age groups, races, and histological types. In those aged 0–54 years, females had higher overall incidence rates of lung cancer than males in recent years, which was observed in all races (except non-Hispanic black), all regions, and adenocarcinoma and small cell (but not squamous cell). Non-Hispanic black females aged 0–54 years had a faster decline rate than males since 2013. API females demonstrated an increased trend during the study period. Lung cancer incidence continues to decrease with gender disparities among age groups, races, regions, and histological types. Continuous anti-smoking programs plus reduction of related risk factors are necessary to lower lung cancer incidence further.

A latent profile analysis of at-risk students in a multilevel prevention program: Who chooses to participate and the impact on outcomes

The goal of the current study was to adopt a novel comprehensive approach to examine the efficacy of the targeted intervention component of a multilevel prevention program. We addressed four fundamental issues with this approach: (1) Distinct subpopulations within the sample; (2) Characteristics of those who chose to complete the intervention and those who did not by profile; (3) Changes in the experimental group by profile; and (4) Changes in the comparison group by profile? Latent Profile Analyses revealed that our initial sample of students identified as at-risk due to current symptoms of distress, clustered into three distinct profiles of risk (High Risk (HR), Average Risk (AR) and Low Risk (LR)). Regarding characteristics related to opting for active participation, we found that the higher the level of initial risk, the more likely students were to opt to participate in the program, and within the AR profile, we found that those participants with lower study skills opted more often for the intervention. Latent Growth Modeling, in the experimental group, showed that the HR profile benefited substantially from participation in the intervention with significant reductions in symptoms and risk factors, as well as significant increases in protective factors. Changes in the AR profile were in the expected direction, but this group remained notably anxious although not depressed anymore. The LR profile showed significant reductions in symptoms following the intervention. In the comparison group, the HR profile improved some, the AR and the LR did not change significantly, except for significant decreases in personal goal and values consolidation in the LR profile. The current study highlights the importance of adopting a more comprehensive evaluation of efficacy and how this must inform selection criteria for future studies.

Temporal relationships between BMI and obesity-related predictors of cardiometabolic and breast cancer risk in a longitudinal cohort

Prospective inter-relationships among biomarkers were unexplored, which may provide mechanistic insights into diseases. We investigated the longitudinal associations of BMI change with trajectories of biomarkers related to cardiometabolic or breast cancer risk. A longitudinal study was conducted among 444 healthy women between 2019 to 2021. Cross‑lagged path analysis was used to examine the temporal relationships among BMI, cardiometabolic risk score (CRS), and obesity‑related proteins score (OPS) of breast cancer. Linear mixed-effect models were applied to investigate associations of time-varying BMI with biomarker-based risk score trajectories. Baseline BMI was associated with subsequent change of breast cancer predictors (P = 0.03), and baseline CRS were positively associated with OPS change (P < 0.001) but not vice versa. After fully adjustment of confounders, we found a 0.058 (95%CI = 0.009–0.107, P = 0.020) units increase of CRS and a 1.021 (95%CI = 0.041–1.995, P = 0.040) units increase of OPS as BMI increased 1 kg/m2 per year in postmenopausal women. OPS increased 0.784 (95%CI = 0.053–1.512, P = 0.035) units as CRS increased 1 unit per year. However, among premenopausal women, BMI only significantly affected CRS (β = 0.057, 95%CI = 0.007 to 0.107, P = 0.025). No significant change of OPS with time-varying CRS was found. Higher increase rates of BMI were associated with worse trajectories of biomarker-based risk of cardiometabolic and breast cancer. The longitudinal impact of CRS on OPS is unidirectional. Recommendations such as weight control for the reduction of cardiometabolic risk factors may benefit breast cancer prevention, especially in postmenopausal women.

Association of Thyroid Hormone Medication Adherence With Risk of Dementia.

Recent studies suggest that hypothyroidism is a risk factor for dementia. Based on existing literature, it is unclear if treatment or compliance to treatment is associated with decreased dementia risk in hypothyroidism patients. To determine the association between thyroid hormone medication adherence and risk of dementia. A population-based cohort study following patients with newly diagnosed hypothyroidism until incidence of dementia, death, or December 31, 2020, whichever came earliest. The study comprised 41 554 older adults age 50 and above with newly diagnosed hypothyroidism between 2004 and 2008 who underwent health screening. Risk of dementia was evaluated using multivariable-adjusted Cox proportional hazards regression. Among 5188 men (12.5%) and 36 366 (87.5%) women, 2120 cases of incident dementia were identified. After stratification of the participants according to the interquartile range of the medication possession ratio (MPR), the fourth quartile (highest adherence) showed a 14% lower risk of overall dementia compared with the first quartile (lowest adherence) (adjusted hazard ratio 0.86; 95% CI 0.76-0.97). No consistent association was observed between thyroid hormone medication adherence and vascular dementia. After a dichotomous stratification of the MPR, higher MPR (≥0.8) showed a lower risk of Alzheimer disease (adjusted hazard ratio 0.91; 95% CI 0.84-0.99) than lower MPR (<0.8). Better adherence to thyroid hormone medication may be beneficial in preventing incident dementia, especially Alzheimer disease, in older adults with newly diagnosed hypothyroidism. Along with the resolution of hypothyroid symptoms and the reduction of cardiovascular risk factors, the reduction of dementia risk may be another potential benefit of thyroid hormone medication.

HYPERTENSION AND RISK FACTORS: A CASE CONTROL STUDY

Hypertension is a global health issue. It is the leading cause of morbidity and mortality. Therefore, the management and reduction of risk factors are essential to prevent and control the incidence of hypertension. The research aims to find out the risk factors associated with the incidence of hypertension in Puskesmas Matiti, Humbang Hasundutan District. This study is a correlation analytic study with a case control approach.. The population case is all the people with hypertension and the population control is the people without hypertension at Puskesmas Matiti. The research samples are composed of 32 people with hypertension and 64 people without hypertension. The samples are obtained using simple random sampling technique. Data are collected using questionnaires and analyzed using logistic regression test. The result indicates that sodium consumption (0.007&lt;0.05) and obesity (0.025&lt;0.05), both have a significant correlation with the incidence of hypertension. While smoking (0.054&gt;0.05) and alcohol consumption (0.558&gt;0.05), both have no significant correlation with hypertension incidence. The research concludes that the risk factors associated with the incidence of hypertension in Puskesmas Matiti are sodium consumption and obesity, with sodium consumption being the dominant factor. It is recommended to practice a healthy lifestyle by limiting the consumption of high sodium foods and maintaining the ideal weight by exercising and maintaining a healthy diet.

Plant Proteins: Methods of Quality Assessment and the Human Health Benefits of Pulses.

As countries increase their standard of living and individual income levels rise, there is a concomitant increase in the demand for animal-based protein. However, there are alternative sources. One of the alternatives available is that of increased direct human consumption of plant proteins. The quality of a dietary protein is an important consideration when discussing the merits of one protein source over another. The three most commonly used methods to express protein quality are the protein efficiency ratio (PER), a weight gain measurement; protein digestibility-corrected amino acid score (PDCAAS); and the digestible indispensable amino acid score (DIAAS). The possibility that alterations in the quality and quantity of protein in the diet could generate specific health outcomes is one being actively researched. Plant-based proteins may have additional beneficial properties for human health when compared to animal protein sources, including reductions in risk factors for cardiovascular disease and contributions to increased satiety. In this paper, the methods for the determination of protein quality and the potential beneficial qualities of plant proteins to human health will be described.